Progesterone's Serum Level and a New Ultrasonographic Parameter in the First Trimester Pregnancy – Prognostic Factors for Embryonic Demise

Background. Endocrine disorders such as amenorrhea, lactation, and irregular menstruation caused by antipsychotics are common in female patients. How to reduce or eliminate these adverse reactions is a matter of concern. Objective. To evaluate the therapeutic effect of progesterone in combination with vitamin B6 in the treatment of antipsychotic-induced amenorrhea. Methods. In our hospital, from May 2019 to May 2021, 120 patients with amenorrhea caused by antipsychotics who underwent surgery were selected for this prospective study. The random residue grouping method divided them into a progesterone group (60 cases) and a vitamin B6 group (60 cases). Among them, the progesterone group was treated only with progesterone, while the vitamin B6 group was given progesterone in combination with vitamin B6. The differences in endocrine index, prolactin, uterine size, and endometrial thickness, effectiveness, and safety analysis of the progesterone and vitamin B6 groups of patients were observed and compared. Results. Before treatment, there was no change in the comparison of endocrine indexes between the progesterone and vitamin B6 groups ( P > 0.05 ). After 1 month of treatment, there were significant differences in estradiol, prolactin, and follicle-stimulating hormone between the progesterone and vitamin B6 groups of patients ( P < 0.05 ). After 1 month of treatment, there were significant differences in prolactin, uterine size, and endometrial thickness, and the vitamin B6 group was significantly lower than the progesterone group ( P < 0.05 ). The clinical efficiency of 95.00% in the vitamin B6 group was significantly higher than 83.33% in the progesterone group ( P < 0.05 ). There were no adverse reactions in the progesterone and vitamin B6 groups. Conclusion. The effectiveness of progesterone combined with vitamin B6 in treating amenorrhea caused by antipsychotics is significantly better than simple progesterone, which can effectively improve the endocrine condition of patients and provide a reference for the clinical treatment of amenorrhea caused by antipsychotics.

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“…During bleeding, such patients are given progesterone treatment. There is withdrawal bleeding [16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Clinical Study of Progesterone Combined with Vitamin B6 in the Treatment of Amenorrhea Endocrine Disorders Caused by Antipsychotics

Zhao

Zhai

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Five studies were excluded from the data analyses, data failed verification in 3 studies [60,74,77], and progesterone cut-off threshold was unknown for reported sensitivity and specificity in 2 studies [42,75].…”

Section: Resultsmentioning

confidence: 99%

Performance of single serum progesterone in the evaluation of symptomatic first-trimester pregnant patients: a systematic review and meta-analysis

Ghaedi

Cheng²,

Ameri

et al. 2022

Can J Emerg Med

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Objectives Pain and bleeding complicate 30% of pregnancies, raising concerns for viability. The objective is to evaluate the diagnostic characteristics of a single serum progesterone level in assessing pregnancy viability among symptomatic patients. Methods We conducted a predefined literature search in MEDLINE, Embase (OVID), CINAHL and Cochrane databases for studies that enrolled patients in first trimester with miscarriage symptoms, measured progesterone and reported pregnancy viability, from inception to July 2020. We extracted data for 2 × 2 tables, progesterone threshold levels and viability. We obtained summary estimates of sensitivity, specificity, Diagnostic Odds Ratio (DOR), and predictive values at given prevalence rates. ResultsWe identified 54 publications. There was a total of 15,878 patients enrolled, of whom 7864 patients (49.5%) were confirmed to have a viable pregnancy and 8014 patients (50.5%) were confirmed to have a non-viable pregnancy. The cut-off value of progesterone ranged from 3.2 to 25 ng/mL (20.034-79.5 nmol/L). We evaluated the performance of the following progesterone cut-off categories: < 6.3, 6.3-12.6, 12.7-19.9, and 20-25 ng/mL. To detect non-viable pregnancy, progesterone with cut-off < 6.3 ng/mL had sensitivity 73.1%, specificity 99.2% and DOR 322.0 (PPV 0.91, 0.97 and 0.99 at prevalences 0.1, 0.25, 0.5, respectively, indicating higher likelihood of non-viable pregnancy), and cut-off category 20-25 ng/mL had sensitivity 91.3%, specificity 75% and DOR 31.4 (NPV 0.99, 0.96 and 0.89 at the prevalences above indicating higher likelihood of viable pregnancy). Conclusion A single progesterone level provides a clinically useful prognostic information on pregnancy viability. More than nine out of ten patients with a level < 6.3 ng/mL (< 20.034 nmol/L) will be diagnosed with a non-viable pregnancy, and more than 90% of patients with a level ≥ 20-25 ng/mL (63.6-79.5 nmol/L) will have a viable pregnancy confirmed.

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Progesterone's Serum Level and a New Ultrasonographic Parameter in the First Trimester Pregnancy – Prognostic Factors for Embryonic Demise

Cited by 2 publications

References 19 publications

Clinical Study of Progesterone Combined with Vitamin B6 in the Treatment of Amenorrhea Endocrine Disorders Caused by Antipsychotics

Clinical Study of Progesterone Combined with Vitamin B6 in the Treatment of Amenorrhea Endocrine Disorders Caused by Antipsychotics

Performance of single serum progesterone in the evaluation of symptomatic first-trimester pregnant patients: a systematic review and meta-analysis

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