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This commentary reflects on the effectiveness of progesterone in early pregnancy complications. Several studies have investigated the role of progesterone in women with bleeding in early pregnancy and in women with recurrent miscarriages. These publications suggests that first trimester use of progesterone is not effective to prevent miscarriages when there is blood loss in the first trimester, and that it is also not effective to prevent new miscarriages in women with recurrent miscarriages in their history. However, subgroup analysis tells us it might be effective to prevent new miscarriages in women with blood loss in the first trimester and three earlier miscarriages. Expert groups in the Netherlands are currently considering recommendations on the prescription of progesterone for women with early pregnancy complications.

A 45-year-old woman presented at the emergency room with acute dyspnoea and slight fever, without coughing. The chest radiography showed a consolidation in the lower left lobe. The CT scan revealed a consolidation in the posterior-basal segment of the lower left lobe without an air bronchogram but with various densities. Based on these findings, the possibility of pulmonary sequestration was considered. A CT scan showed an arterial branch arising from the aorta that supplied the consolidation, confirming pulmonary sequestration. The patient underwent resection of the intralobar sequestrum, after which she recovered and was asymptomatic. Pulmonary sequestration should be considered in any patient with pneumonia or recurrent pneumonia in the lower lobes of the lung, especially in the absence of an air bronchogram or signs of endobronchial obstruction. The treatment ofchoice is surgical resection.