Progesterone Preterm Birth Prevention?! Controversial data, what I tell patients, & what I chose

#pretermbirth #progesterone #mfmdoctor
Does taking progesterone in pregnancy help prevent preterm birth? OBGYN & MFM fellow explains the data around Makena (IM progesterone) and vaginal progesterone supplementation in pregnancy to prevent recurrent preterm birth.
0:00 Intro
0:41 Background
3:56 Progesterone & preterm birth
10:13 How I counsel patients
12:37 My pregnancy
More resources:
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For more educational information on everything OB-GYN including BIRTH CONTROL, FERTILITY, POST-PARTUM, and PERIODS... follow me on Instagram / dr.martaperez
**Video is for educational purposes only and should not be used as personal medical advice. Please discuss anything related to your own health, diagnosis, and treatment with your own medical provider as information in this video may not pertain to your individual and specific situation. **

[@abigailharley7072]

Really hoping for the short Cervix video and the effects of progesterone

[@lunanomnom9432]

The most informative video I’ve seen so far . Could you please make a video about short cervix .

[@karapond818]

My FMF did not recommend progesterone for my 3rd pregnancy, which directly followed my preterm birth. I was so glad he did not feel it was necessary and I think it gave me peace of mind to not over stress. He was born at 37 weeks 5 days and is now a healthy 3 year old.

[@kelseylambeth2918]

PPROM at 29 weeks with my first and delivered a week later. My son spent 49 days in the NICU during COVID in March 2020. I am pregnant with my second now. When I tell you I am heartbroken thinking we had an answer to make it full term and now we may not. My doctor ordered Makena for us on Wednesday and the next day the FDA voted.

[@hannahortiz1629]

I had two spontaneous PPROM births one at 33 and 6 and one at 36 and 4 and my ob who is a high risk didn't seem concerned about it with my third child I had him full term, currently pregnant with baby #4 and I'm dealing with irritated uterus and worried that it could cause PPROM! Is that true?

[@alimueller2514]

Would love to see a video on short cervix/cerclage. I got a cerclage about 2.5 weeks ago, at 22.5 weeks gestation due to cervical shortening and fingertip dilation. I also take progesterone suppositories, even though my drs were pretty wishy washy about the benefits. So far so good, but I am pretty in the dark about how long I should expect my cerclage to hold up.

[@moniquealvarado-arellano1204]

How did it go for you and your baby? I got the cerclage at 18 weeks and have to take the progesterone every night until delivery. I missed a couple of days taking it and my Cervix weakened . But I also have a lot of stuff I do like being a mom to a toddler , cleaning, cooking , moving , and working. Bed rest is not recommended but me and my husband are considering me getting back hours or quitting. Would love to know how it worked for you!

[@alimueller2514]

Hi! I took it super easy with the cerclage. Limited lifting, limited chores, etc. can someone else assist? I made it to 39.5 weeks!

[@elysiacelestewells4155]

Thank you for the videos. Could you please please do a video on the risks to the baby with IVF?

[@MichouBeauty]

I was on makena and still gave birth to my son at 33 weeks and 1 day, i really hope to find something that works for my 3rd baby

[@annar2754]

I have a consult with an MFM next week. I’m in limbo on what to do about makena yet. I had a spontaneous preterm at 30 weeks. I also have a bicornate(*spelling)uterus anomaly. Just a question and I understand it’s not medical advice, but is there any risks involved with taking makena? I understand it might not help, but if I take it could it cause harm?

[@astrospirit]

Makena was proven to be harmful

[@astrospirit]

Was suppose to be taken off the market

[@melissaandrews197]

Hi Dr. Perez, I am 6 weeks and 5 days along in my pregnancy. My progesterone today was 24. Is that fine?

[@maryhdez145]

I believe you are fine my OB said they want it atleast to 20 and up

[@brittaneycook4712]

This is my very first pregnancy, I’m 35 I found out I had a short cervix and my high risk ob said I had 2 options the progesterone or a cerclage. Me and my husband wanted a low risk option and took the progesterone for 2 nights and I had severe symptoms. I couldn’t feel the baby move hardly at all whilst always feeling drowsy and I started to have cramps so bad I couldn’t walk. We stopped taking it and probably won’t do the cerclage surgery due to even more high risks. Been on bed rest and praying for a healthy delivery. I am thankful for your information because we didn’t have any idea until we looked it up after I was having a bad reaction to the medication.

[@estellangum9265]

How is everything going?Did u go in for the cerclage??

[@PrincessYadii]

Any update?

[@estellangum9265]

@PrincessYadii i did go for cerclage and suppository progesterone and its helping me.I had a cerclage at 15weeks due to preterm with incompetent cervix and by week 21 my cervix shorten to 1.82cm and i advocate for progesterone By week 23 my cervix went down to 1cm once the progesterone kick in 3week later my cervix grew from 1cm to 2.5cm. I am also taking things slow.Currently 27weeks and 4days and doing great.

[@br4insful]

@@estellangum9265 were on bed rest as well?

[@sscc6853]

I had my first pregnancy at 32 yrs old, i am now 39 yrs old, expecting my 4th. I am considered high risk for preterm birth in every pregnancy due to having a short cervix. Every pregnancy starting at 16 weeks my obgyn doctor will start cervical measurement with vaginal ultrasound. I also always see a specialist. I always measure between 2.5-2.8cm in every pregnancy. Based on my history of full-term births & being over 1.5 cm, i have never had a vaginal cerclage. I have always been prescribed vaginal progesterone. 1st pregnancy 39w & 6 days, 2nd pregnancy 39w & 5 days, 3rd pregnancy 38w & 3 days. Currently 20 weeks pregnant with baby#4...and doctor said it was optional to continue fhe vaginal progesterone. Im choosing to continue it until the end of pregnancy, and im really hoping i make it full term again.

[@lindamarimendez]

Is the short cervix video out yet?

[@jhcoleman18]

I had an irritable uterus with my first pregnancy. Everyone told me to ignore it. pPROM at 34 weeks. For my 2nd, I opted to get the Makena injections. With each one, my uterus was quiet for 5-6 days and started contracting again by the end of the week. I gained a ton of weight on them- but had a drug free, 84 minute labor on my due date. I think they were lifesavers in many ways for me.

[@hannahortiz1629]

I'm having irritated uterus as well I had two spontaneous PPROM births that wasn't because of irritated uterus I didn't have them then but this time around this pregnancy is so painful 😭

[@symplysweets]

I’m currently 25 weeks with a rescue cerclage, funneling at the stitch with membrane funneling. My short cervix was found at my 20 week anatomy scan. I have a history or prom, preterm labor and preterm dilation. I’m currently on endometrim I see a mfm & OB, they don’t think I’ll make it passed 32 weeks 🙁

[@nayara414]

😢

[@nayara414]

Scary. What happened?

[@fighttheevilrobots3417]

Thank you for talking about the effects of systemic racism on pregnant people. It's really important.

[@fighttheevilrobots3417]

@@Obi_P Nope. I meant what I said. People who are not women get pregnant all the time.

[@tridharachakrabarti1515]

Only women ( with an XY chromosome) get pregnant..u can mean anything but that does not stop that meaning to be bullshit

[@br4insful]

@@fighttheevilrobots3417 when over 90% of body cells are female by chromosome it doesn't matter what these people are telling about themselves being 'not women'

[@davanza]

I had to take progesterone during my second pregnancy to prevent preterm birth and it worked. I had gestational diabetes with my second, so could that be a reason why?

[@kataychandtler6813gbv]

I’m same situation but I was go deny it ! But I shouldn’t cause of gestational diabetes

[@davanza]

@@kataychandtler6813gbv I wouldn’t because you could go into labor early. I had to stay in the hospital for 4 days for them to try to get my contractions to stop at only 30 weeks. They were sure he would be delivered that same day. Thank God it worked and he came full term.

[@pinkm6422]

Did you take it full pregnancy or you had to stop it at some point?

[@valeriaperez4752]

My first born was born at 34 weeks I also had gestational diabetes the specialist OB strongly recommended me to take it. My biggest worry was for the baby to be born is a disability because I didn’t know what I was putting into my body she explained it’s something we have but this helps prevent me from having another premature baby… or worse a miscarriage or micro baby so I said yes but now I’m looking into everything I can before putting this into my body

[@br4insful]

@@davanza that the problem - you don't know for sure. You may take it and it doesn't work, you may not take it and it works. That's what the studies are about. Read about 'Survivorship bias'

[@spirititi2303]

I was just put on intravaginal progesterone for shortening of the cervix (it was almost 5cm at 20w and shortened to 1.7 now at 29 weeks). I hope it works and I can keep baby in for a bit longer. In my country they don’t do cerclage in the third trimester.

[@taqdeesmustajab630]

Hi is there any update on your pregnancy? Currently i am 27 weeks pregnant and my doctor also told me to use progesterone due to shortening of cervix

[@spirititi2303]

@@taqdeesmustajab630 I’m at 31weeks 2 days. I’m still taking progesterone and I’m on modified bedrest. I get checked up weekly, everything has remained stable so far. I get frequent braxton hicks contractions and I’m bored to hell but baby is still staying inside, which is good! I hope we make it to full term :)

[@spirititi2303]

@@taqdeesmustajab630 I wish you lots of strength and hopefully you can keep your baby in for a while longer too! Every day we can keep the baby in longer is a huge benefit for their health and development. Try to find a relaxing hobby if you are bored on modified bedrest. I’m currently doing embroidery, but there are lots of options! Some useful ones can be knitting, crocheting, making birth cards for baby, … that way we’re still doing something for baby while we keep calm. Because with short cervix we shouldn’t be doing lots of chores and other nesting behaviour, sadly.

[@spirititi2303]

@@taqdeesmustajab630 for my pregnancy, I'm currently 31w+2d, everything has remained stable so far. I have check ups every friday. I'm still on progesterone and modified bedrest. I'm super bored but baby is still doing good, which is all that matters!

[@alyssakepler7218]

I had the shot once a week with my son about 5 years ago but with my current pregnancy they told me they discontinued the shot even for those that have used it in the past cuz with my first child she was 29 weeks my second was a miscarriage at 17 weeks and even with the shot my son was at 2 months early i was 3cm and they gave me 2 steroid shots for his lungs and he ended up coming a week before his actual due date but my current pregnancy because of them discontinuing the shot i wasn't given anything to help with anything but today i did my 20 week ultrasound and my cervix is short so now they have me on the vaginal progesterone so i hope it works like the shot did for me with my son 12:35

[@nickawilliams5175]

I miscarried @ 18 weeks 6 days 3 weeks ago. It was so spontaneous and the worst day ever.

[@clvrarose]

I have an incompetent cervix and have had 2 second trimester losses (one was a late term miscarriage). After the second loss, my consultant said he will be prescribing progesterone pessaries and aspirin in the next pregnancy as well as doing a preventative stitch in at 12/13 weeks gestation. Apparently progesterone works well for incompetent cervix management, even without the stitch. I have tried looking for the research but I actually cannot find a lot out there

[@br4insful]

there are bunch of old studies telling progesterone helps and bunch of new studies telling it makes no difference. The problem is that every baby born progesterone is a typical example of 'survival's mistake' because there is no evidence it really helps. I am shown healthy fetuses on the scan and the next minute I am told my cervix is shortening so I need to start progesterone when it has literally zero benefits on twin pregnancies. So, I am extremely confused about the topic and I am afraid it gets me more stress which may lead to the future shortening of the cervix...

[@ecarschasmith2528]

This video is not encouraging at all for women who've had a preterm birth. It's like just hope and see 😒

[@valeriaperez4752]

That’s how I felt I’ve been trying to find a way to research it. Both my OBs strongly recommend it because I’ve already had a 34 week baby and a miscarriage before him. Idk what to do

[@estellangum9265]

I did follow-up with few of her videos. She seem to be a very controversial Doctor.Please follow your gut and advocate for yourself.i have family members that progesterone and cerclage made them mom with recurrent miscarriages.