Pharmacokinetics of Vaginal Progesterone in Pregnancy

Characterization of pharmacokinetics (PK) is lacking for vaginal progesterone in pregnancy. Dosing of vaginal progesterone for preterm birth prevention has been empirical. Due to pregnancy-related changes in vaginal and uterine blood flow, hepatic metabolism, renal clearance, and endogenously elevated serum progesterone, studies outside of pregnancy may not be applicable. The lack of the PK profile of vaginally administered progesterone in pregnancy limits the ability to define the exposure:response relationship needed to optimize dosing, which has implications for its use in research and clinical care regarding management of short cervix, prevention of recurrent preterm birth, and prevention of recurrent miscarriage.

Source: American Journal of Obstetrics and Gynecology - June 14, 2019 Category: OBGYN Authors: Rupsa C. Boelig, Athena F. Zuppa, Walter K. Kraft, Steve Caritis Tags: SMFM Statement Source Type: research