Iranian Society of Gynecology Oncology


1 Department of Perinatology, Medical School, Tehran University of Medical Sciences, Tehran, Iran

2 MD, Pediatrics Department of Perinatology, Medical School, Shahed University of Medical Sciences, Tehran, Iran

3 Assistant Professor of Gynecology and Obstetrics, Department of Perinatology, Medical School, Tehran University of Medical Sciences, Tehran, Iran


Background: Progesterone is a smooth muscle relaxant and also has a vasodilator effect on human placental arteries and veins.
Objectives: The aim of this study was to evaluate the effect of progesterone therapy on fetal Doppler velocimetry in intrauterine growth retardation (IUGR) and preterm fetuses.
Methods: Thirty pregnant females with IUGR and thirty pregnant females with threatened preterm labor at 28 to 37 weeks of gestation were enrolled in the clinical trial study. Fetal Doppler velocimetry was investigated before, 24 hours and two weeks after progesterone therapy. Seven patients with IUGR and 9 patients with preterm labor were excluded from the study before completion of the survey due to the termination of pregnancy.
Results: Following progesterone treatment, middle cerberal arterypulsatility index (MCA_PI) significantly decreased after 24 hours in patients with IUGR and after two weeks in patients with preterm labor (P < 0.001). There was not a statistically significant decrease in the pulsatility index of the fetal umbilical artery (UmA) after 24 hours in the IUGR fetuses (P = 0.18). Umbilical artery pulsatility index (UmA_PI) significantly decreased after two weeks in IUGR fetuses (P < 0.004).
Conclusions: Progesterone led to a reduction in the MCA_PI and UmA_PI in IUGR and preterm fetuses. Vasodilatory effect of pro gesterone on the umbilical artery is mediated by multiple doses in IUGR fetuses. 


  1. Thompson JL, Kuller JA, Rhee EH. Antenatal surveillance of fetal growth restriction. Obstet Gynecol Surv. 2012;67(9):554-65. [DOI:10.1097/OGX.0b013e31826a5c6f]
  2. Nardozza LM, Araujo Junior E, Barbosa MM, Caetano AC, Lee DJ, Moron AF. Fetal growth restriction: current knowledge to the general Obs/Gyn. Arch Gynecol Obstet. 2012;286(1):1-13. [DOI:10.1007/s00404-012-2330-6]
  3. Paonessa DJ, Shields AD, Howard BC, Gotkin JL, Deering SH, Hoeldtke NJ, et al. 17-Hydroxyprogesterone caproate reverses induced vaso constriction of the fetoplacental arteries by the thromboxane mimetic U46619. Am J Obstet Gynecol. 2006;195(4):1011-4. [DOI:10.1016/j.ajog.2006.06.041]
  4. Longo S, Bollani L, Decembrino L, Di Comite A, Angelini M, Stronati M. Short-term and long-term sequelae in intrauterine growth retardation (IUGR). J Matern Fetal Neonatal Med. 2013;26(3):222-5. [DOI:10.3109/14767058.2012.715006]
  5. Liu J, Chen D, Yao Y, Yu B, Mao X, He J, et al. Intrauterine growth retardation increases the susceptibility of pigs to high-fat diet-induced mitochondrial dysfunction in skeletal muscle. PLoS One. 2012;7(4):e34835. [DOI:10.1371/journal.pone.0034835]
  6. Chernausek SD. Update: consequences of abnormal fetal growth. J Clin Endocrinol Metab. 2012;97(3):689-95. [DOI:10.1210/jc.2011-2741]
  7. Coupe B, Grit I, Hulin P, Randuineau G, Parnet P. Postnatal growth after intrauterine growth restriction alters central leptin signal and energy homeostasis. PLoS One. 2012;7(1):e30616. [DOI:10.1371/journal.pone.0030616]
  8. Nugent JL, Wareing M, Palin V, Sibley CP, Baker PN, Ray DW, et al. Chronic glucocorticoid exposure potentiates placental chorionic plate artery constriction: implications for aberrant feto placental vascular resistance in fetal growth restriction. Endocrinology. 2013;154(2):876-87. [DOI:10.1210/en.2012-1927]
  9. Krishna U, Bhalerao S. Placental insufficiency and fetal growth restriction. J Obstet Gynaecol India. 2011;61(5):505-11. [DOI:10.1007/s13224-011-0092-x]
  10. Barda G, Ben-Haroush A, Barkat J, Malinger G, Luria O, Golan A, et al. Effect of vaginal progesterone, administered to prevent preterm birth, on impedance to blood flow in fetal and uterine circulation. Ultrasound Obstet Gynecol. 2010;36(6):743-8. [DOI:10.1002/uog.7606]
  11. Li HF, Zheng TZ, Li W, Qu SY, Zhang CL. Effect of progesterone on the contractile response of isolated pulmonary artery in rabbits. Can J Physiol Pharmacol. 2001;79(6):545-50. [DOI:10.1139/y01-024]
  12. Hermenegildo C, Oviedo PJ, Garcia-Martinez MC, Garcia-Perez MA, Tarin JJ, Cano A. Progestogens stimulate prostacyclin production by human endothelial cells. Hum Reprod. 2005;20(6):1554-61. [DOI:10.1093/humrep/deh803]
  13. Omar HA, Ramirez R, Gibson M. Properties of a progesterone-induced relaxation in human placental arteries and veins. J Clin Endocrinol Metab. 1995;80(2):370-3. [DOI:10.1210/jc.80.2.370]