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Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests

Year 2023, Volume: 10 Issue: 1, 42 - 46, 10.04.2023
https://doi.org/10.47572/muskutd.1095993

Abstract

In this study, the effect of progesterone use on biomarkers due to abortion complaints in aneuploidy screenings was investigated. Two hundred seventy-six singleton pregnant patients with threatened abortion were enrolled in this retrospective study. The treatment group consisted of patients who received oral, vaginal, or intramuscular progesterone (n=137) while the control group received no progesterone (n=139). The results of the double and triple screening tests of the study groups were compared. Nuchal translucency measurements and pregnancy-associated plasma protein-A (PAPP-A), (MoM) values were significantly lower in the group that received treatment with progesterone compared to the control group (p=0.009 and p<0.001, respectively). Beta-human chorionic gonadotropin (βhCG), (MoM) and alpha-fetoprotein (MoM) were found to be statistically significantly higher in the group receiving oral progesterone treatment compared to the group receiving other types of progesterone treatment (p=0.032 and p=0.001, respectively). The PAPP-A was found to be significantly lower in the oral treatment group (p=0.001). It was also significantly lower in the hydroxyprogesterone caproate treatment group (p=0.013). In the vaginal progesterone treatment group, βhCG was significantly lower (p=0.036) than that in oral treatment group. The study showed that there is a relationship between different progesterone administration routes and fetal aneuploidy screening markers.

References

  • 1. Zegers-Hochschild F, Adamson GD, de Mouzon J, et al. The international committee for monitoring assisted reproductive technology (ICMART) and the world health organization (WHO) revised glossary on ART terminology, 2009. Hum Reprod. 2009;24(11):2683-7.
  • 2. Zeng W, Liu Z, Zhang S, et al. Characterization of T follicular helper cells in allogeneic normal pregnancy and PDL1 blockage-induced abortion. Sci Rep. 2016;6(1):1-14.
  • 3. Robertson SA, Petroff MG, Hunt JS. Immunology of pregnancy. Knobil and Neill’s Physiology of Reproduction 4th ed Oxford, UK: Elsevier. 2015:1835-74.
  • 4. Coomarasamy A, Williams H, Truchanowicz E, et al. A randomized trial of progesterone in women with recurrent miscarriages. N Engl J Med. 2015;373(22):2141-8.
  • 5. Griesinger G, Tournaye H, Macklon N, et al. Dydrogesterone: pharmacological profile and mechanism of action as luteal phase support in assisted reproduction. Reprod Biomed Online. 2019;38(2):249-59.
  • 6. Malone FD, Canick JA, Ball RH, et al. First-trimester or second-trimester screening, or both, for Down's syndrome. N Engl J Med. 2005;353(19):2001-11.
  • 7. Kurtoğlu E, Perçin Z. İlk trimester maternal serum PAPP-A ve serbest Beta-hCG değerlerinin gebelik komplikasyonları ile ilişkisi. Van Tıp Derg. 2012;19(2):60-5.
  • 8. Kagan KO, Sonek J, Wagner P, et al. Principles of first trimester screening in the age of non-invasive prenatal diagnosis: screening for chromosomal abnormalities. Arch Gynecol Obstet. 2017;296(4):645-51.
  • 9. Ong CY, Liao AW, Spencer K, et al. First trimester maternal serum free β human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications. BJOG. 2000;107(10):1265-70.
  • 10. Currier R, Wu N, Van Meter K, et al. Integrated and first trimester prenatal screening in California: program implementation and patient choice for follow‐up services. Prenat Diagn. 2012;32(11):1077-83.
  • 11. Kagan K, Wright D, Spencer K, et al. First‐trimester screening for trisomy 21 by free beta‐human chorionic gonadotropin and pregnancy‐associated plasma protein‐A: impact of maternal and pregnancy characteristics. Ultrasound Obstet Gynecol. 2008;31(5):493-502.
  • 12. Nicolaides K, Azar G, Snijders R, et al. Fetal nuchal oedema: associated malformations and chromosomal defects. Fetal Diagn Ther. 1992;7(2):123-31.
  • 13. Giorlandino C, Cignini P, Padula F, et al. Effects of exogenous progesterone on fetal nuchal translucency: an observational prospective study. Am J Obstet Gynecol. 2015;212(3):335.e1-7.
  • 14. Karaca I, Erdoğan ŞV, Doğan K, et al. The effects of exogenous oral micronized progesterone on first trimester aneuploidy screening markers in women with threatened miscarriage: a matched case control study. J Matern-Fetal Neonatal Med. 2020;1:16-21.
  • 15. Proctor L, Toal M, Keating S, et al. Placental size and the prediction of severe early‐onset intrauterine growth restriction in women with low pregnancy‐associated plasma protein‐A. Ultrasound Obstet Gynecol. 2009;34(3):274-82.
  • 16. Jelliffe-Pawlowski LL, Shaw GM, Currier RJ, et al. Association of early-preterm birth with abnormal levels of routinely collected first-and second-trimester biomarkers. Am J Obstet Gynecol. 2013;208(6):492.e1-11.
  • 17. Gündüz ÖD, Eser A, Çoban U, et al. Evaluation of the impact of triple test results on perinatal outcomes. Perinat J. 2016;24(1):26-31.
  • 18. Palagiano A, Bulletti C, Pace M, et al. Effects of vaginal progesterone on pain and uterine contractility in patients with threatened abortion before twelve weeks of pregnancy. Ann. N Y Acad Sci. 2004;1034(1):200-10.
  • 19. Wahabi HA, Fayed AA, Esmaeil SA, et al. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev. 2018;8:CD005943.
  • 20. Haas DM, Ramsey PS. Progestogen for preventing miscarriage. Cochrane Database Syst Rev. 2013(10): CD003511.
  • 21. Keçecioğlu M, Tokmak A, Keçecioğlu TS, et al. Does progesterone therapy increase nuchal translucency in women with threatened miscarriage? Ginekol Polska. 2016;87(5):390-4.
  • 22. Spencer K, Ong CY, Liao AW, et al. The influence of ethnic origin on first trimester biochemical markers of chromosomal abnormalities. Prenat Diagn. 2000;20(6):491-4.
  • 23. Spencer K, Spencer C, Stamatopoulou A, et al. Early vaginal bleeding has no impact on markers used in first trimester aneuploidy screening. Prenat Diagn. 2010;30(6):547-50.
  • 24. Cuckle H, Van Oudgaarden E, Mason G, et al. Taking account of vaginal bleeding in screening for Down's syndrome. BJOG. 1994;101(11):948-52.
  • 25. Heinig J, Steinhard J, Schmitz R, et al. Does vaginal bleeding influence first‐trimester markers for Down syndrome? Prenat Diagn. 2007;27(4):312-6.
  • 26. De Biasio P, Canini S, Crovo A, et al. Early vaginal bleeding and first‐trimester markers for Down syndrome. Prenat Diagn. 2003;23(6):470-3.
  • 27. Kalem MN, Kalem Z, Bakırarar B, et al. The effect of progesterone use in the first trimester on fetal nuchal translucency. J Turk Ger Gynecol Assoc. 2018;19(1):29-33.
  • 28. Karadağ C, Yoldemir T, Demircan S, et al. The effects of progesterone treatment on nuchal translucency in women with threatened miscarriage. J Obstet Gynaecol. 2020;41(4):601-4.
  • 29. White MM, Zamudio S, Stevens T, et al. Estrogen, progesterone, and vascular reactivity: potential cellular mechanisms. Endocr Rev. 1995;16(6):739-51.
  • 30. Archer DF, Fahy GE, Viniegra-Sibal A, et al. Initial and steady-state pharmacokinetics of a vaginally administered formulation of progesterone. Am J Obstet Gynecol. 1995;173(2):471-8.
  • 31. Golub MS, Kaufman FL, Campbell MA, et al. “Natural” progesterone: information on fetal effects. Birth Defects Research Part B: Developmental and Reproductive Toxicology. 2006;77(5):455-70.

Farklı Progesteron Tedavi Yöntemlerinin Fetal Anöploidi Tarama Testleri Üzerine Etkilerinin Değerlendirilmesi

Year 2023, Volume: 10 Issue: 1, 42 - 46, 10.04.2023
https://doi.org/10.47572/muskutd.1095993

Abstract

Bu çalışmada abortus imminens nedeniyle progesteron kullanımının, anöploidi taramalarındaki biyobelirteçler üzerine etkisi araştırıldı. Bu retrospektif çalışmaya düşük tehdidi olan iki yüz yetmiş altı tekil gebe hasta dahil edildi. Tedavi grubu oral, vajinal veya intramüsküler progesteron (n=137) alan hastalardan, kontrol grubu ise progesteron almayan (n=139) hastalardan oluşturuldu. Çalışma gruplarının ikili ve üçlü tarama testlerinin sonuçları karşılaştırıldı. Nukal saydamlık (NT) ölçümleri ve gebelikle ilişkili plazma protein-A (PAPP-A), (MoM) değerleri progesteron tedavisi alan grupta kontrol grubuna göre anlamlı derecede düşüktü (sırasıyla p=0.009 ve p<0.001). Beta-insan koryonik gonadotropin (βhCG), (MoM) ve alfa-fetoprotein (MoM) oral progesteron tedavisi alan grupta diğer tür progesteron tedavisi alanlara göre istatistiksel olarak anlamlı derecede yüksek bulundu (p=0.032 ve p=0.001, sırasıyla). PAPP-A oral tedavi grubunda anlamlı olarak daha düşük bulundu (p=0.001). Hidroksiprogesteron kaproat tedavi grubunda da anlamlı olarak daha düşüktü (p=0.013). Vajinal progesteron tedavi grubunda βhCG, oral tedavi grubuna göre anlamlı derecede düşüktü (p=0.036). Çalışma, farklı progesteron uygulama yolları ile fetal anöploidi tarama belirteçleri arasında bir ilişki olduğunu göstermiştir.

References

  • 1. Zegers-Hochschild F, Adamson GD, de Mouzon J, et al. The international committee for monitoring assisted reproductive technology (ICMART) and the world health organization (WHO) revised glossary on ART terminology, 2009. Hum Reprod. 2009;24(11):2683-7.
  • 2. Zeng W, Liu Z, Zhang S, et al. Characterization of T follicular helper cells in allogeneic normal pregnancy and PDL1 blockage-induced abortion. Sci Rep. 2016;6(1):1-14.
  • 3. Robertson SA, Petroff MG, Hunt JS. Immunology of pregnancy. Knobil and Neill’s Physiology of Reproduction 4th ed Oxford, UK: Elsevier. 2015:1835-74.
  • 4. Coomarasamy A, Williams H, Truchanowicz E, et al. A randomized trial of progesterone in women with recurrent miscarriages. N Engl J Med. 2015;373(22):2141-8.
  • 5. Griesinger G, Tournaye H, Macklon N, et al. Dydrogesterone: pharmacological profile and mechanism of action as luteal phase support in assisted reproduction. Reprod Biomed Online. 2019;38(2):249-59.
  • 6. Malone FD, Canick JA, Ball RH, et al. First-trimester or second-trimester screening, or both, for Down's syndrome. N Engl J Med. 2005;353(19):2001-11.
  • 7. Kurtoğlu E, Perçin Z. İlk trimester maternal serum PAPP-A ve serbest Beta-hCG değerlerinin gebelik komplikasyonları ile ilişkisi. Van Tıp Derg. 2012;19(2):60-5.
  • 8. Kagan KO, Sonek J, Wagner P, et al. Principles of first trimester screening in the age of non-invasive prenatal diagnosis: screening for chromosomal abnormalities. Arch Gynecol Obstet. 2017;296(4):645-51.
  • 9. Ong CY, Liao AW, Spencer K, et al. First trimester maternal serum free β human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications. BJOG. 2000;107(10):1265-70.
  • 10. Currier R, Wu N, Van Meter K, et al. Integrated and first trimester prenatal screening in California: program implementation and patient choice for follow‐up services. Prenat Diagn. 2012;32(11):1077-83.
  • 11. Kagan K, Wright D, Spencer K, et al. First‐trimester screening for trisomy 21 by free beta‐human chorionic gonadotropin and pregnancy‐associated plasma protein‐A: impact of maternal and pregnancy characteristics. Ultrasound Obstet Gynecol. 2008;31(5):493-502.
  • 12. Nicolaides K, Azar G, Snijders R, et al. Fetal nuchal oedema: associated malformations and chromosomal defects. Fetal Diagn Ther. 1992;7(2):123-31.
  • 13. Giorlandino C, Cignini P, Padula F, et al. Effects of exogenous progesterone on fetal nuchal translucency: an observational prospective study. Am J Obstet Gynecol. 2015;212(3):335.e1-7.
  • 14. Karaca I, Erdoğan ŞV, Doğan K, et al. The effects of exogenous oral micronized progesterone on first trimester aneuploidy screening markers in women with threatened miscarriage: a matched case control study. J Matern-Fetal Neonatal Med. 2020;1:16-21.
  • 15. Proctor L, Toal M, Keating S, et al. Placental size and the prediction of severe early‐onset intrauterine growth restriction in women with low pregnancy‐associated plasma protein‐A. Ultrasound Obstet Gynecol. 2009;34(3):274-82.
  • 16. Jelliffe-Pawlowski LL, Shaw GM, Currier RJ, et al. Association of early-preterm birth with abnormal levels of routinely collected first-and second-trimester biomarkers. Am J Obstet Gynecol. 2013;208(6):492.e1-11.
  • 17. Gündüz ÖD, Eser A, Çoban U, et al. Evaluation of the impact of triple test results on perinatal outcomes. Perinat J. 2016;24(1):26-31.
  • 18. Palagiano A, Bulletti C, Pace M, et al. Effects of vaginal progesterone on pain and uterine contractility in patients with threatened abortion before twelve weeks of pregnancy. Ann. N Y Acad Sci. 2004;1034(1):200-10.
  • 19. Wahabi HA, Fayed AA, Esmaeil SA, et al. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev. 2018;8:CD005943.
  • 20. Haas DM, Ramsey PS. Progestogen for preventing miscarriage. Cochrane Database Syst Rev. 2013(10): CD003511.
  • 21. Keçecioğlu M, Tokmak A, Keçecioğlu TS, et al. Does progesterone therapy increase nuchal translucency in women with threatened miscarriage? Ginekol Polska. 2016;87(5):390-4.
  • 22. Spencer K, Ong CY, Liao AW, et al. The influence of ethnic origin on first trimester biochemical markers of chromosomal abnormalities. Prenat Diagn. 2000;20(6):491-4.
  • 23. Spencer K, Spencer C, Stamatopoulou A, et al. Early vaginal bleeding has no impact on markers used in first trimester aneuploidy screening. Prenat Diagn. 2010;30(6):547-50.
  • 24. Cuckle H, Van Oudgaarden E, Mason G, et al. Taking account of vaginal bleeding in screening for Down's syndrome. BJOG. 1994;101(11):948-52.
  • 25. Heinig J, Steinhard J, Schmitz R, et al. Does vaginal bleeding influence first‐trimester markers for Down syndrome? Prenat Diagn. 2007;27(4):312-6.
  • 26. De Biasio P, Canini S, Crovo A, et al. Early vaginal bleeding and first‐trimester markers for Down syndrome. Prenat Diagn. 2003;23(6):470-3.
  • 27. Kalem MN, Kalem Z, Bakırarar B, et al. The effect of progesterone use in the first trimester on fetal nuchal translucency. J Turk Ger Gynecol Assoc. 2018;19(1):29-33.
  • 28. Karadağ C, Yoldemir T, Demircan S, et al. The effects of progesterone treatment on nuchal translucency in women with threatened miscarriage. J Obstet Gynaecol. 2020;41(4):601-4.
  • 29. White MM, Zamudio S, Stevens T, et al. Estrogen, progesterone, and vascular reactivity: potential cellular mechanisms. Endocr Rev. 1995;16(6):739-51.
  • 30. Archer DF, Fahy GE, Viniegra-Sibal A, et al. Initial and steady-state pharmacokinetics of a vaginally administered formulation of progesterone. Am J Obstet Gynecol. 1995;173(2):471-8.
  • 31. Golub MS, Kaufman FL, Campbell MA, et al. “Natural” progesterone: information on fetal effects. Birth Defects Research Part B: Developmental and Reproductive Toxicology. 2006;77(5):455-70.
There are 31 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Original Article
Authors

Müjde Can İbanoğlu 0000-0002-8413-2064

Caner Kose 0000-0002-3044-4804

Tugce Kacan 0000-0002-6158-5968

Kadriye Erdoğan 0000-0002-8789-1875

Sinan Karadeniz 0000-0003-4994-9658

Salim Erkaya 0000-0002-0215-8552

Yaprak Ustun 0000-0002-1011-3848

Publication Date April 10, 2023
Submission Date March 30, 2022
Published in Issue Year 2023 Volume: 10 Issue: 1

Cite

APA İbanoğlu, M. C., Kose, C., Kacan, T., Erdoğan, K., et al. (2023). Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 10(1), 42-46. https://doi.org/10.47572/muskutd.1095993
AMA İbanoğlu MC, Kose C, Kacan T, Erdoğan K, Karadeniz S, Erkaya S, Ustun Y. Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests. MMJ. April 2023;10(1):42-46. doi:10.47572/muskutd.1095993
Chicago İbanoğlu, Müjde Can, Caner Kose, Tugce Kacan, Kadriye Erdoğan, Sinan Karadeniz, Salim Erkaya, and Yaprak Ustun. “Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10, no. 1 (April 2023): 42-46. https://doi.org/10.47572/muskutd.1095993.
EndNote İbanoğlu MC, Kose C, Kacan T, Erdoğan K, Karadeniz S, Erkaya S, Ustun Y (April 1, 2023) Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10 1 42–46.
IEEE M. C. İbanoğlu, C. Kose, T. Kacan, K. Erdoğan, S. Karadeniz, S. Erkaya, and Y. Ustun, “Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests”, MMJ, vol. 10, no. 1, pp. 42–46, 2023, doi: 10.47572/muskutd.1095993.
ISNAD İbanoğlu, Müjde Can et al. “Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10/1 (April 2023), 42-46. https://doi.org/10.47572/muskutd.1095993.
JAMA İbanoğlu MC, Kose C, Kacan T, Erdoğan K, Karadeniz S, Erkaya S, Ustun Y. Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests. MMJ. 2023;10:42–46.
MLA İbanoğlu, Müjde Can et al. “Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, vol. 10, no. 1, 2023, pp. 42-46, doi:10.47572/muskutd.1095993.
Vancouver İbanoğlu MC, Kose C, Kacan T, Erdoğan K, Karadeniz S, Erkaya S, Ustun Y. Evaluation of The Effects of Different Progesterone Treatment Methods on Fetal Aneuploidy Screening Tests. MMJ. 2023;10(1):42-6.