Adolf E. Schindler

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PROGESTERONE AND PROGESTINS
IN PREGNANCY DIAGNOSTIC AND THERAPEUTIC
CONSIDERATIONS

• Adolf E. Schindler

Institute for Medical Research and Education,
Essen, Germany
PRIZEWINNER OF PROFESSOR IOSEB JORDANIA
INTERNATIONAL PRIZE-2007
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• Progesterone is essential for implantation and
  maintenance of pregnancy. Progesterone is the
  dominant hormone throughout pregnancy. Among the
  manifold actions progesterone is essential for
  the protection of the allogenic conceptus from
  immunological rejection by the mother. At first,
  production and secretion of progesterone is
  determined by placental HCG. However, later
  progesterone continuous to rise throughout
  pregnancy independent from the HCG serum levels.
  Indeed, there is at the beginning of pregnancy a
  HCG-doubling time, which is prolonged in
  pregnancy failure (orthotopic as well as
  ectopic).

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• Lack of normal HCG-doubling time indicates
• Ectopic location of the gestation
• Trophoblast abnormalities
• Disturbed placentation
• Genetic aberrations

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It is important to note that there is a
luteal-placental shift around week 8 to 10 of
gestation, which can be associated with a
decrease of circulating amount of progesterone
and this can lead to bleeding, uterine
contractions and finally to abortion. The renewed
increase indicates placental progesterone
production, since the Corpus luteum function
fades away.
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• The major endocrine causes of spontaneous or
  recurrent abortions are
• Corpus luteum insufficiency
• Defective luteo-placental-shift
• Placental insufficiency.

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• Which clinical conditions may be
  effectively treated by progesterone or
  progestins?
• Spontaneous abortions
• Habitual abortion
• Premature labor
• Hypertension in pregnancy

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• At present the following preparations are
  available for clinical use in pregnancy
• Micronized progesterone (vaginal)
• Dydrogesterone (Oral) Duphaston
• 17-a Hydroxyprogesterone caproate (i.m.)
• Treatment schedules for the various clinical
  conditions will be outlined and the results
  discussed.

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90 CME credits Intercontinental Academy of
Medical-Social Sciences (IAMSS) OGASH Number 90
(ninety) IAMSS International CME credits are
recognized by Post Congress IAMSS OGASH Awards
Commission Chairperson, IAMSS Presidium
Chairperson, Hon. Academician of OGASH,
Academician Secretary of OGASH Prof / Dr IRMA de
LUCA BRUNORI MD., PhD. Verified the achievement
award of the proceeding author Adolf E.
Schindler Post Congress IAMSS OGASH Awards
Commission Chairman,IAMSS Presidium
Chairperson,Hon. Academician of
OGASHAcademician Prof./Dr. Malkhaz Mizandari
MD., PhD. CERTIFIES the achievement of n. 90
International credits (IAMSS)