Hensleigh P A, Fainstat T
Fertil Steril. 1979 Oct;32(4):396-400. doi: 10.1016/s0015-0282(16)44292-5.
These studies were designed to show that properly timed measurements of serum progesterone (P) can be conveniently used in the diagnosis and treatment of patients with recurrent and threatened abortion. Luteal phase serum P levels between 2 and 10 ng/ml and serum P levels below 15 ng/ml in the first 10 weeks of gestation were considered diagnostic of corpus luteum (CL) dysfunction. Patients were treated with clomiphene, gonadotropins, and/or progesterone suppositories in order to correct serum P levels, thus elevating the serum P into the normal range. When treatment of patients with subnormal P levels resulted in normalization of serum P, successful pregnancies occurred. CL dysfunctions, either before or after conception, were found in eight of the nine patients with histories of recurrent spontaneous abortions. Correction of serum P was associated with successful pregnancy in these eight patients. Twelve patients with threatened abortion were also found to have subnormal serum P levels. Progesterone suppositories corrected the serum P levels in nine of the eleven patients treated, and none of these patients aborted. Serum P measurements provide a means for evaluation of CL function during early gestation. Management of patients with CL dysfunction can also be monitored with serial serum P measurements, provided that progesterone is the therapeutic agent rather than synthetic progestins.
这些研究旨在表明，血清孕酮（P）的适时测量可方便地用于复发性流产和先兆流产患者的诊断和治疗。黄体期血清P水平在2至10 ng/ml之间，以及妊娠前10周血清P水平低于15 ng/ml被认为可诊断为黄体（CL）功能不全。患者接受克罗米芬、促性腺激素和/或孕酮栓剂治疗，以纠正血清P水平，从而将血清P提高到正常范围。当血清P水平低于正常的患者接受治疗后血清P恢复正常时，妊娠成功。在9例有复发性自然流产病史的患者中，有8例在受孕前或受孕后存在CL功能不全。这8例患者血清P的纠正与妊娠成功相关。12例先兆流产患者也被发现血清P水平低于正常。在接受治疗的11例患者中，有9例使用孕酮栓剂后血清P水平得到纠正，且这些患者均未流产。血清P测量为早期妊娠期间CL功能的评估提供了一种手段。只要孕酮是治疗药物而非合成孕激素，CL功能不全患者的治疗也可通过连续血清P测量进行监测。
