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The Role of Progesterone in Avoiding Preterm Labor

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Those at risk of giving birth prematurely may be considered good candidates for progesterone hormone therapy, an often used tool for warding off contractions and the unintended consequences of preterm childbirth.

Progesterone, a sex hormone, is responsible for many growth and reproductive functions in a woman’s body, including menstruation, pregnancy, and breastfeeding. Two primary pregnancy roles progesterone plays are preparing the womb to allow a fertilized egg to attach to the uterine walls and kickstarting the chemical reaction that provides nutrients to an embryo. Thus, progesterone plays a critical role in maintaining a pregnancy and avoiding complications from premature birth which may prove catastrophic for the baby if not otherwise alleviated.

Progesterone: The Basics

Progesterone is a hormone that a woman assigned at birth as a female produces to thicken the uterine wall in readiness for pregnancy. The body produces an egg after ovulation during a woman’s menstrual cycle. The release of the egg forms a corpus luteum that triggers progesterone production to thicken the tissue of the uterine walls, known as the endometrium. Without a fertilized egg, the endometrium sheds during menstruation as progesterone levels get progressively lower.

What Happens to Progesterone when a Woman Becomes Pregnant?

Normally, an implanted fertilized egg causes the corpus luteum to continue progesterone production to thicken the endometrium with rich blood that feeds the growing embryo. After the placenta forms, it becomes the primary source of progesterone production during pregnancy. Rising progesterone levels during pregnancy help keep ovulation and contractions from occurring. Thus, sufficient progesterone levels are essential to prevent premature labor.

If Progesterone Levels are Too Low During Pregnancy, Then What?

When progesterone levels are too low, the pregnancy may end in miscarriage, ectopic pregnancy (when an egg implants outside of the uterus), or preterm labor. To prevent preterm labor and delivery, doctors often prescribe progesterone supplements in the form of injections, creams, or vaginal suppositories. Premature labor and delivery, meaning before 37 weeks gestation, often results in babies born with several health problems, and therefore, doctors must act to prevent early childbirth.

Can Progesterone Supplementation Help to Avoid Birth Injuries?

Preterm babies may suffer from underdeveloped organs, especially the lungs, which are the last to develop during pregnancy. When the liver, which processes bilirubin, is not fully developed, the body cannot break down red blood cells. As a result, premature babies are at risk for infection, respiratory disease, severe jaundice, blindness, cognitive deficiencies, brain damage, and death. Oxygen deprivation and bleeding from fragile blood vessels can cause HIE (Hypoxic-ischemic encephalopathy) and cerebral palsy when a baby is born too early.

An OB/GYN may administer or prescribe progesterone to prevent complications resulting from premature labor. To prevent early birth and associated injuries, the treating physician often gives the patient progesterone shots from the second to the third trimester. The treatment starts around the 16th week into the 36th with weekly injections. Also, physicians who are aware of a patient’s history and risk for preterm labor may prescribe a daily application of natural progesterone vaginally by suppository, gel, or tablet.

Risk Factors Prompting Progesterone Treatment During Pregnancy

Several factors and conditions commonly prompt doctors to treat pregnant women with progesterone supplementation. First, a pregnant woman’s history of preterm labor, whether with a singleton or multiple fetuses, may cause a physician to begin progesterone therapy.

Another reason for progesterone treatment is a short cervix. This reproductive organ is critical in keeping the baby in the uterus. When a woman has an abnormally short cervix, the risk of the cervix opening and early pregnancy is higher. As a general precaution, obstetricians should measure all pregnant women’s cervixes in the late second or early third trimester, especially if the woman has a history of preterm pregnancy. A cervix is visible in an ultrasound. Short cervixes may be due to genetics or a history of premature rupturing of the membranes, D&C (dilation and curettage) procedures, cervical biopsy, childbirth trauma, abortions, and diethylstilbestrol (DES) exposure.

Finally, a physician may prescribe progesterone therapy to patients experiencing contractions that can lead to early onset of labor or to one whose membranes ruptured prematurely in a previous pregnancy. PROM, or premature rupture of membranes, occurs when the amniotic sac encasing the baby leaks or breaks before labor starts. PROM increases the risk of infection and early labor and delivery.

When is Progesterone Therapy Involved in Medical Malpractice Lawsuits?

Physicians entrusted to pregnancy care must be aware of an expectant mother’s history. When they are not aware that a pregnant patient has delivered a premature baby, experienced preterm labor, delivered twins early, or had PROM previously, they may miss a treatment window to prevent a premature delivery. Also, failing to check for a short cervix may result in premature childbirth and a child with lifelong disabilities.

When the American College of Obstetricians and Gynecologists provides guidelines for the use of progesterone therapy for preterm birth prevention, a physician should follow practices aligned with a leading professional organization informed by research and experience from OB-GYNs. Failing to use progesterone supplementation for a high-risk patient may be considered negligence, supporting a medical malpractice action.

An obstetrician must be fully aware of all of the devastating effects of prematurity and must take all necessary precautions for preterm childbirth prevention, including progesterone therapy if and when it is indicated. For example, if an an obstetrician typically prescribes progesterone to a pregnant patient with a history of risk factors for prematurity, including a short cervix, but your obstetrician does not, you may have grounds for a medical malpractice claim if your baby is injured at birth.

Low Progesterone Led to Your Baby’s Complications in NJ? Get Legal Help

Babies born with birth injuries from prematurity frequently require long-term, sometimes lifetime, care. The costs for the various therapies a child may need to adapt to daily life circumstances, such as physical, speech, occupational, and psychological aspects of functioning, can be enormous. If a medical professional caused your child injuries due to negligence, they may be found liable to pay those past and future therapeutic costs in addition to medical expenses and other costs associated with the care and accommodations a special needs child may need to eat, sleep, move, read, see, hear, or speak.

For a free review of your potential claim regarding failure to prevent preterm labor through effective progesterone treatment, contact our legal team today. Our medical malpractice and birth injury attorneys are skilled at investigating, analyzing, and building strategically solid claims for compensation on behalf of parents and their injured children throughout New Jersey. Call 866-708-8617 to speak with a seasoned attorney who can assist you further.

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