Effects of Exogenous Progesterone on Fetal Nuchal Translucency Measured By 2d Ultrasonography

Abstract

Background: Progesterone is an essential hormone for the continuation of pregnancy and is prescribed in 13–40% of women with threatened miscarriage, according to the literature. Progesterone shows these effects by releasing certain anti-abortive cytokines, modulation of the maternal immune system (immunological tolerance of the fetus), and with relaxation of uterine muscles. Objective: To evaluate the thickness of fetal nuchal translucency between 11-14 weeks’ gestation among women receiving exogenous progesterone and to compare these findings with controls to determine the effect of progesterone on NT. Patients and Methods: This is a prospective case control study upon pregnant women presented to the obstetric outpatient clinic and fetal medicine unit at Al-Hussien hospital in their first trimester during the period from March 2019 till the end of March 2020. One handred women were included in this study, and they were divided into two equal groups: group A and group B control group. To evaluate the thickness of fetal nuchal translucency between 11-14 weeks’ gestation among women receiving exogenous progesterone and to compare these findings with controls to determine the effect of progesterone on NT. Results: There was a statistical significant correlation between nuchal translucency (NT) among cases and control group as mean thickness in cases was 1.5 cm ranging from 1 cm to 2 cm with ± 0.4 standard deviation, while in control group the mean thickness was 1.2 cm ranging from 0.9 cm to 1.8 cm and ± 0.2 standard deviation and p value 0.001 which correlate statistical significance. Thus exogenous progesterone significantly increases NT thickness when compared with controls. However, none of cases nor control had babies with pathological thickness in the nuchal translucency. Thus none of the studied groups underwent further assessment using biochemical markers in the form of β HCG and PAPP-A nor amniocentesis. The mean NT was s significantly higher in the studied cases taking progesterone. However, this increase was still within the normal range of NT and did not affect the risk of aneuploidy. Conclusion: The mean nuchal translucency significantly increased in cases taking progesterone therapy in the first trimester. However, this increase is still within the normal range of nuchal translucency. Although nuchal translucency was found to be associated to progesterone intake, the dose of which, duration and indication of intake didn’t statistically relate to the thickness of nuchal translucency.