Encounter with sex steroid hormone therapy (No 4):  first case of sex steroid therapy in severe preeclampsia in Japan

( the first case with estrogen-progesterone therapy; in 1969)

A 32-year old women  (gravida-3, para-1) had a history of severe preeclampsia during
previous conception.  At week 30 she was hospitalized to my father’s hospital
because of prominent edema and possible fetal growth retardation.

Although she was treated with bed rest, and furosemide was administered, her blood
pressure abruptly rose up to 190/130 mmHg and proteinuria developed. Seven days
after admission (observation time), administration of estradiol and progesterone was
started and maintained for 23 days. On the 4th day of steroid treatment serum
levels fell to a very low level of 25 mg/dl/h (unit). 

Thereafter it was increased to nearly the mean value of a normal pregnancy
( week 33), while the blood pressure gradually decreased and the body weight
was lowered.  When the P-LAP level showed its peak at week 33, her blood
pressure fell to 148/110 mmHg. Despite continuation of this treatment,
the P-LAP level thereafter started to show a decreasing tendency again, and

improvement of hypertension could not observe any longer.

 Cesarean section was performed because of the decreasing tend of P-LAP
more than 9 days, a male infant weighing 1,750 g( Apgar score 8) was
delivered uneventfully at week 35.

Please see our NPO home page: natural hormonal therapy for pregnancy
induced (gestational) hypertension and preterm birth, c) severe clinical
cases Case 7.

P-LAP:I will mention about P-LAP in next time.