Summary: \”I\’m three weeks pregnant. The doctor said my progesterone is a little low. What should I do?\” \”I\’m pregnant for the first time. I\’m now 5 weeks pregnant. I had vaginal bleeding yesterday. I went to the hospital for a checkup. The doctor said I need progesterone. Will this affect the baby? \” \”I am three weeks pregnant and the doctor said my progesterone is a little low. What should I do? \” \”My first pregnancy, I am now 5 weeks old. I had vaginal bleeding yesterday. I went to the hospital for a checkup. The doctor said that to maintain pregnancy, you have to take progesterone, will it affect the baby? \”… Pregnancy, threatened abortion, and pregnancy protection are the hottest topics as long as you open any pregnancy-related platform.
\”Whether it is necessary to preserve the fetus for threatened abortion varies from person to person,\” Li Yingtao, director of the Obstetrics Department of the Third Affiliated Hospital of Guangzhou Medical University, said in an interview with reporters. Regarding the \”low progesterone\” that often scares first-time mothers to death, Li Yingtao made it clear that there is no need to worry too much about this indicator, \”because there are many factors that affect progesterone and HCG, and we cannot judge the status of the embryo just by looking at these two indicators. The most accurate way to make an absolute judgment is to do a B-ultrasound at 6 to 8 weeks, so that the condition of the embryo can be seen at a glance.”
Threatened abortion due to certain causes requires fetal insurance
Vaginal bleeding in early pregnancy is a phenomenon that scares most expectant mothers. What to do at this time? In foreign countries, most doctors will let the mother go home to rest and let the fetus accept the natural law of natural selection and survival of the fittest. In China, many doctors will prescribe some \”fetal protection drugs\” to mothers, usually progesterone, and then the expectant mother will spend weeks of constant anxiety with the \”comfort\” and \”support\” of the drugs.
In fact, there has been a lot of controversy in the traditional Chinese medicine community in recent years about whether progesterone should be used to \”protect the fetus\” in early pregnancy threatened abortion.
Some experts point out that it is meaningless to use progesterone without specific reasons for threatened abortion. What is a \”specific cause\”? \”This is luteal phase insufficiency.\” Li Yingtao explained that luteal insufficiency refers to underdevelopment of the corpus luteum after ovulation, insufficient secretion of progesterone or premature degeneration of the corpus luteum, resulting in reduced endometrial secretion responsiveness; insufficient endometrial secretion conversion, resulting in Ovulatory dysfunction is not conducive to the implantation of a fertilized egg, which can lead to infertility or habitual miscarriage. Clinically, it is characterized by asynchronous endometrial development and embryonic development, and its etiology is not yet fully understood. There are no uniform and accurate diagnostic criteria for the clinical diagnosis of luteal insufficiency.
\”For example, these women secrete very little progesterone, which makes it difficult for the uterus to form fertile soil for fertilized eggs to implant. They often suffer from problems such as irregular menstruation or pre-pregnancy infertility. Therefore, this is a pathological disease. ” condition, these women are unable to produce normal hormones in their bodies, so they need external supplements to help them regulate menstruation, pregnancy, or miscarriage. \”
Therefore, if a pregnant woman has irregular menstruation before pregnancy, or if she conceives a baby through assisted reproductive technology, she may have a threatened miscarriage in early pregnancy.The causes are mostly related to insufficient corpus luteum. For this situation, progesterone preservation makes sense.
Blind miscarriage or loss outweighs the gain
In contrast, for women who are pregnant for the first time and have no health problems before pregnancy, more than 50% of threatened abortions are related to embryonic chromosomal abnormalities. In addition, there are many factors that may lead to threatened abortion, such as pregnant women being exposed to toxic substances, mothers suffering from complications such as diabetes, lupus erythematosus, and hypertension.
\”The use of progesterone is ineffective in miscarriage caused by the above reasons.\” Li Yingtao said, because in these cases, miscarriage is a protective response of the body to eliminate foreign bodies. On the contrary, it will have an inhibitory effect on the uterus, weakening the contractile function of the uterus, thereby reducing the uterus\’ ability to expel foreign bodies. This will not only increase the chance of incomplete miscarriage in pregnant women, but may also lead to increased bleeding and even complications such as secondary infection.
However, there are still many expectant mothers who cannot accept the reality and desperately want to save their fetuses. They repeatedly asked doctors to prescribe abortion pills, and even asked around for \”ancient prescriptions\” and \”home remedies\” for preventing miscarriage.
\”In fact, blindly protecting unexplained threatened abortion may ultimately cause trouble for the child.\” Li Yingtao believes that the correct approach to early pregnancy threatened abortion is to check hormone levels (to rule out luteal insufficiency) and conduct detailed examinations through B-ultrasound. \”B-ultrasound examination is the most intuitive. Generally, B-ultrasound examination is done at 6-8 weeks of pregnancy. If the diameter of the gestational sac is 2.5-4 cm and there is no embryo, the diameter of the head and buttocks is greater than 7 mm, and there is no fetal heartbeat, the embryo may have stopped. Accurately Mothers should face the reality bravely, take care of themselves and prepare for the next pregnancy.”
As for the use of \”ancient prescriptions\” and \”folk remedies\” to protect the fetus, most obstetricians are against it. For these unproven methods, the risks to the mother and fetus far outweigh the benefits.
Expert reminder
No need to be overly nervous about changes in progesterone and HCG indicators
In addition to threatened miscarriage, fluctuations in progesterone and HCG indicators often frighten expectant mothers until they turn pale. Nowadays, most women go to the hospital for an early pregnancy test as soon as possible after their menstrual period. The physical examination report they get usually has three indicators: progesterone, HCG and estrogen. Some people\’s progesterone level will be low, or the test will be normal this time, but it will be low next time. At this time, some nervous mothers will worry: \”Does low progesterone mean that the embryo is not developing well?\” \”Is it easy to miscarry?\”.
In this regard, Li Yingtao explained that these three indicators only reflect the status of the embryo at the moment when blood is drawn, but in fact these indicators change 24 hours a day. For example, progesterone is sometimes measured at 100 in the morning and 20-30 in the afternoon. The two data differ by as much as five times.
Do these fluctuations mean patients are at risk for miscarriage? Li Yingtao clearly denied this statement, “These indicators themselves will be affected by many factors.The interference can only be used as a reference. The most accurate judgment is to look at the B-ultrasound. \”Clinically, the level of progesterone is maintained above 30 to 50. As long as the growth of fetal chorionic hormone (HCG) is consistent with the gestational age, pregnant women do not need to be afraid and there is no need to rush to take medicine.
Register your menstrual cycle during pregnancy preparation
Menstruation is a health signal that accompanies women throughout their lives. For pregnancy, the menstrual cycle is a \”light\” that can point the way. However, many women don’t even know how many days their menstrual cycle lasts.
The numbers are all \”mongolia\”.
Li Yingtao suggested that women should register their menstrual cycles while preparing for pregnancy. The main information includes the time and number of days of each menstruation, and the number of days in the menstrual cycle. \”These records are not only useful during pregnancy preparation, but during pregnancy, they can also become a reference for doctors to determine whether there is luteal insufficiency, whether embryo development is consistent with gestational age and other important issues.\”
Medical Guidance/Guangzhou Medical University Li Yingtao, Director of the Obstetrics Department of the Third Affiliated Hospital
Text/Guangzhou Daily Reporter Li Heng Correspondent Huang Xianjun