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Last Updated:
Nov 20th, 2007 - 00:03:00
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Question
In the last 7 years I gave birth tin my first pregnancy. This followed with two miscarriages at approximately 9 weeks, a spontaneous and a missed abortion. After the spontaneous, through my obgyn I was placed on thyroid medication. He concluded that I had also had a decrease in progesterone. I lost this baby, and in the next pregnancy, he would not start me on progesterone until reading my blood levels. By this time it was too late. I never quite got a conclusive answer as to why I lost both babies.
Today I am pregnant, and I am beginning to freak out after I read an answer to an individual letting her know that her doctor can start her on progesterone even before she is pregnant. Is this correct? My doctor only told me to call him as soon as I knew I was pregnant to start the progesterone.
In both pregnancies, my doctor did an immediate ultrasound and verified the pregnancies. He also ran the blood tests.
In my first pregnancy I had an incompetent cervix and had a procedure done to stitch it up for six months of bedrest. My current obgyn (I have since changed) states that he does not feel I needed it. Do you think I will need it now? What can I do to stay on top of things and take care of the baby if things go well? I remember having had a brownish/orange discharge, and the reason why I ended up having the procedure.
Should I exercise? I normally was running 10-15 miles a week. I am unsure as to what to do now. I am on my feet at work all day; is this good? Will this cause a threat? What can/should I do?
I will be calling my doctor tomorrow, and I will hopefully be seeing him tomorrow. I want to be ready to deal with him and decisions made.
Adriana
Answer
Dear Adriana-
Progesterone is the predominant hormone in the post-ovulatory phase and is necessary for building up the lining of the uterus and for maintaining a pregnancy. From your history, it sounds as if low progesterone may have contributed to your miscarriages.
Progesterone can be used in the post ovulatory phase of the cycle for women who have low progesterone while they are cycling. Low progesterone can manifest itself with premenstrual spotting and bleeding, PMS, infertility, and miscarriages. The way to accurately check the levels is to first be taught how to chart your cycles by a certified teacher. Then the progesterone levels are taken on specific days after ovulation. Your levels are then compared to a normal curve and analyzed.
I would guess that if you have had low progesterone levels during pregnancy, you probably have some low levels during your post ovulatory phase.
Progesterone can be used throughout your pregnancy and is used by many physicians who are trained in NaProTechnology through the Pope Paul VI Institute in Omaha, NE.
You would need to check with your doctor about the incompetent cervix and the running. I have heard of many women who maintain their exercise schedule during pregnancy; however, I do think this is rare. Doctors usually encourage women to exercise during pregnancy but on a modified schedule. With your history of cervical incompetence, I would be very careful about impact sports and switch to something else such as swimming. Again, check with your doctor about how much work you are doing and how to incorporate exercise. Be sure that you are taking a multivitamin with folic acid each day.
I do hope that this information helps and that this pregnancy will be healthy for both you and your child.
Sincerely,
Gretchen Marsh, D.O.
Dr. Marsh is a family practioner in Yuba City, CA where she lives with her husband and 5 boys.
She is a Creighton model certified Medical Consultant and a certified Fertility Care Practioner.
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