Role of vaginal progesterone on uterine artery Doppler changes in pregnant women at risk of preterm labor

Abstract

BackgroundProgesterone is increasingly being used in women at high risk for preterm labor and for maintenance tocolysis. Ultrasound evaluation of uterine in pregnant women in the second trimester of pregnancy can be a predictor of birth complications.ObjectiveTo study the effect of vaginal progesterone on uterine by doppler sonography among women in the second and third trimesters of pregnancy who are at risk of preterm labor.Patients and methodsA prospective study was carried out on 60 patients attending Obstetrics and Gynecology Department, Menoufia Teaching Hospital, Menoufia, Egypt, during the period from March 2019 to March 2020. The patients were admitted to the hospital for preterm labor, which was arrested by acute tocolysis within 48 h. All participants were subjected to routine baseline investigations and Doppler flow assessment.ResultsThere was a highly statistically significant difference (P < 0.001) in uterine artery pulsatility index (PI) before and after treatment (P = 0.000). Uterine artery PI decreased significantly after treatment (0.817 ± 0.16) than before treatment (0.969 ± 0.27). Uterine artery PI decreased significantly after treatment than before treatment in different periods of gestation (weeks). Moreover, there was no statistically significant difference (P>0.05) between the studied women as change in umbilical artery PI before and after treatment in different periods of gestation (weeks). Moreover, uterine artery PI was significantly correlated (P < 0.05) with period of gestation (week) before and after progesterone treatment.ConclusionUterine artery pulsatility index (PI) decreased significantly after progesterone treatment than before treatment in different periods of gestation (weeks). Umbilical artery PI and middle cerebral artery Doppler PI were not significant different among the studied patients before and after progesterone treatment in different periods of gestation (weeks). Uterine artery PI and middle cerebral artery Doppler PI were negatively associated with period of gestation (week) before and after progesterone treatment.