Effect of hemodialysis on serum progesterone level in pregnant women

The objective of this study is to evaluate the effect of chronic hemodialys is on serum progesterone level in pregnancy, Serum progesterone levels were measured predialysis and postdialysis using the radioimmunoassay technique in seven gravid women with renal failure requiring hemodialysis, Uterine c ontractions were measured before and after hemodialysis using home uterine activity monitoring (HUAM) in two patients, Thirty-three paired serum sampl es were obtained between 14 and 39 weeks' gestation, The mean change in ser um progesterone level postdialysis throughout pregnancy ranged from -52.0% to +8.7% for each individual patient, The change in serum progesterone leve l was unrelated to gestational age. The woman experiencing the most signifi cant decrease in serum progesterone level with dialysis continued her pregn ancy to greater than 39 weeks. No significant increase in uterine contracti on frequency was noted on HUAM postdialysis (P = 0.22), although both monit ored patients experienced a small increase in serum progesterone levels, In conclusion, serum progesterone values showed a variable patient-specific r esponse when measured predialysis and postdialysis in pregnancies complicat ed by renal failure, There was no significant increase in uterine activity noted postdialysis, Progesterone withdrawal does not appear to explain the increased frequency of preterm delivery in women after dialysis, (C) 1999 b y the National Kidney Foundation, Inc.