Progesterone Therapy in Pre‐Eclamptic Toxaemia

Abstract

Progesterone was the principal therapeutic agent used in 40 cases of pre-eclamptic toxaemia. It was also given to 10 normal pregnant women who served as a control group. A significant fall in both the systolic and diastolic blood pressures was observed in 80% of the toxaemic patients. In all cases there was a marked increase in the 24-hour urinary output with an apparent loss of weight. Serum uric acid showed a significant drop and the urea clearance values also improved. The serum sodium showed an apparent decline while the serum potassium did not show any marked variation. The serum uric acid, urea clearance, blood urea, serum sodium and serum potassium remained unchanged in the control group.

Progesterone blunts vascular endothelial cell secretion of endothelin-1 in response to placental ischemia

“…17-OHPC may exert its antihypertensive effects due to its antiinflammatory properties; indeed other investigators have also shown an important role for 17-OHPC in blood pressure regulation. 15 Progesterone is an essential reproductive hormone for the maintenance of pregnancy. A role for progesterone supplementation to prevent or reduce the incidence of preterm birth has received much attention recently.…”

“…In the 1930s, it was first suggested that progesterone deficiency might play a role in the pathogenesis of PE, but the results from several small cases series were not encouraging. 14 Dalton 22 briefly revived the idea in the 1960s and Sammour et al 15 in the 1970s through 1980s but progesterone for the prevention of PE did not achieve widespread clinical acceptance. Although 3 groups of investigators found no deficiency of progesterone in association with PE 23,24 ), a group from Sweden provided evidence that plasma progesterone increased until week 24 in normotensive and hypertensive women with further increase in normotensive women as compared with the hypertensive group.…”

“…A recent Cochrane Collaboration review demonstrated that there is insufficient evidence for reliable conclusions about the effects of progesterone for preventing PE and its complications. 14 Alternatively, a review by Sammour et al 15 concluded that progesterone appears to be effective for the treatment of PE. We hypothesize that decreased endogenous progesterone could serve as a stimulus for elevated inflammatory cytokines as a mechanism to chronically activate endothelial cells to secrete ET-1 in PE women compared to NP women.…”