Vol 92, No 6 (2021)
Research paper
Published online: 2021-03-12

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The influence of vaginal progesterone on Uterine Artery Pulsatility Index

Ersin Çintesun1, Feyza Nur İncesu Çintesun2, Nigar Mammadova1, Çetin Çelik1
Pubmed: 33757153
Ginekol Pol 2021;92(6):436-439.


Objectives: Uterine artery Doppler is frequently used in the first trimester and it is one of the more effective measurement methods in the prediction of preeclampsia and intrauterine growth restriction (IUGR). Progesterone is a hormone that is used quite frequently in various indications in obstetrics and gynecologic practice. We aimed to investigate the influence of progesterone on the uterine artery Doppler pulsatility index (PI) at 11–14 gestational weeks.
Material and methods: This study is a retrospective case-control study conducted in Selcuk University Faculty of Medicine between January and December 2019. Uterine artery Doppler PI values of patients using progesterone were compared with PI values of patients not using progesterone. Uterine artery PI was measured two times, left and right. Then the mean PI was calculated. All measurements were made by two operators and by the same ultrasonography machine.
Results: A total of 288 patients, 140 patients using progesterone and 148 patients not using progesterone were included in the study. Demographic characteristics were similar between the groups (p > 0.05). There were no significant differences between the groups in the right and left uterine artery PI values. There was no significant difference for average uterine artery PI between the groups (p < 0.05).
Conclusions: Progesterone has no significant influence on uterine artery PI. However, more prospective studies in which all potential confounding factors are considered including serum progesterone levels are needed for this subject.

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  1. Kim YM, Chaiworapongsa T, Gomez R, et al. Failure of physiologic transformation of the spiral arteries in the placental bed in preterm premature rupture of membranes. Am J Obstet Gynecol. 2002; 187(5): 1137–1142.
  2. Zhou Y, Damsky CH, Fisher SJ. Preeclampsia is associated with failure of human cytotrophoblasts to mimic a vascular adhesion phenotype. One cause of defective endovascular invasion in this syndrome? J Clin Invest. 1997; 99(9): 2152–2164.
  3. Neggers YH. Trends in maternal mortality in the United States. Reprod Toxicol. 2016; 64: 72–76.
  4. Zeisler H, Llurba E, Chantraine F, et al. Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. N Engl J Med. 2016; 374(1): 13–22.
  5. Agrawal S, Cerdeira AS, Redman C, et al. Meta-Analysis and Systematic Review to Assess the Role of Soluble FMS-Like Tyrosine Kinase-1 and Placenta Growth Factor Ratio in Prediction of Preeclampsia: The SaPPPhirE Study. Hypertension. 2018; 71(2): 306–316.
  6. Cnossen JS, Morris RK, ter Riet G, et al. Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ. 2008; 178(6): 701–711.
  7. Kleinrouweler CE, Bossuyt PMM, Thilaganathan B, et al. Value of adding second-trimester uterine artery Doppler to patient characteristics in identification of nulliparous women at increased risk for pre-eclampsia: an individual patient data meta-analysis. Ultrasound Obstet Gynecol. 2013; 42(3): 257–267.
  8. Plasencia W, Maiz N, Poon L, et al. Uterine artery Doppler at 11 + 0 to 13 + 6 weeks in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol. 2007; 30(5): 742–749.
  9. Kosiński P, Samaha RB, Bomba-Opoń DA, et al. Reference values for placental growth factor (PlGF) concentration and uterine artery doppler pulsatility index (PI) at 11-13(+6) weeks of gestation in the Polish population. Ginekol Pol. 2014; 85(7): 488–493.
  10. Tayyar A, Guerra L, Wright A, et al. Uterine artery pulsatility index in the three trimesters of pregnancy: effects of maternal characteristics and medical history. Ultrasound Obstet Gynecol. 2015; 45(6): 689–697.
  11. Seravalli V, Masini G, Morelli C, et al. Impact of bladder filling on uterine artery Doppler variables in the first trimester of pregnancy. J Clin Ultrasound. 2019; 47(2): 83–87.
  12. Drouin O, Johnson JA, Chaemsaithong P, et al. Transverse technique: complementary approach to measurement of first-trimester uterine artery Doppler. Ultrasound Obstet Gynecol. 2018; 52(5): 639–647.
  13. Gómez O, Figueras F, Fernández S, et al. Reference ranges for uterine artery mean pulsatility index at 11-41 weeks of gestation. Ultrasound Obstet Gynecol. 2008; 32(2): 128–132.
  14. Mäkikallio K, Tekay A, Jouppila P. Uteroplacental hemodynamics during early human pregnancy: a longitudinal study. Gynecol Obstet Invest. 2004; 58(1): 49–54.
  15. Velauthar L, Plana MN, Kalidindi M, et al. First-trimester uterine artery Doppler and adverse pregnancy outcome: a meta-analysis involving 55,974 women. Ultrasound Obstet Gynecol. 2014; 43(5): 500–507.
  16. Fitzpatrick LA, Good A. Micronized progesterone: clinical indications and comparison with current treatments. Fertil Steril. 1999; 72(3): 389–397.
  17. Nahoul K, Dehennin L, Scholler R. Radioimmunoassay of plasma progesterone after oral administration of micronized progesterone. J Steroid Biochem. 1987; 26(2): 241–249.
  18. Daya S. Luteal support: progestogens for pregnancy protection. Maturitas. 2009; 65 Suppl 1: S29–S34.
  19. Sotiriadis A, Papatheodorou S, Makrydimas G. Threatened miscarriage: evaluation and management. BMJ. 2004; 329(7458): 152–155.
  20. Walch K, Hefler L, Nagele F. Oral dydrogesterone treatment during the first trimester of pregnancy: the prevention of miscarriage study (PROMIS). A double-blind, prospectively randomized, placebo-controlled, parallel group trial. J Matern Fetal Neonatal Med. 2005; 18(4): 265–269.
  21. Keçecioğlu M, Tokmak A, Keçecioğlu TS, et al. Does progesterone therapy increase nuchal translucency in women with threatened miscarriage? Ginekol Pol. 2016; 87(5): 390–394.
  22. Hassan SS, Romero R, Vidyadhari D, et al. PREGNANT Trial. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2011; 38(1): 18–31.
  23. Wang S, Wang XT, Liu RH, et al. Dydrogesterone has no effect on uterine fibroids when used to prevent miscarriage in pregnant women with uterine fibroids. Ginekol Pol. 2017; 88(12): 679–685.
  24. Czajkowski K, Sienko J, Mogilinski M, et al. Uteroplacental circulation in early pregnancy complicated by threatened abortion supplemented with vaginal micronized progesterone or oral dydrogesterone. Fertil Steril. 2007; 87(3): 613–618.
  25. Jamal A, Moshfeghi M, Molaei B, et al. The effect of vaginal progesterone on Doppler findings in increased uterine artery resistance. J Matern Fetal Neonatal Med. 2019 [Epub ahead of print]: 1–4.
  26. Maged AM, Shoab AY, Hussein EA, et al. The Effect of Antenatal Vaginal Progesterone Administration on Uterine, Umbilical, and Fetal Middle Cerebral Artery Doppler Flow: A Cohort Study. Am J Perinatol. 2020; 37(5): 491–496.