Makena - Expensive and Probably Not Necessary
The FDA has approved Makena (17-Hydroxyprogesterone) to prevent preterm labor. It's very expensive and most probably inferior to cheap natural progesterone itself in doing the same thing. Pregnant women crank out a ton of progesterone when pregnant so it stands to reason if progesterone levels were normalized that would be the most beneficial tweaking of that particular component in preventing premature birth. Blood levels and saliva levels of many hormones are available, unfortunately mainstream physicians don't check saliva levels and seldom check blood levels.
The last medicine that tweaked progesterone, medroxyprogesterone (Provera), had all sorts of nasty stuff started happening. In fact Provera carries a category X rating, meaning, bad things will happen to your baby if you take medroxyprogesterone when pregnant.
Women are likely best off supplementing with progesterone topical cream if boosting the levels is warranted. Reducing exposure to xenoestrogens (mimic estrogen) is also warranted. Xenoestrogens include paint, glue, nail polish, hair spray, plastics, sugar, etc. There are many others. Progesterone balances estrogen. Reducing exposure to xenoestrogens helps keep the body in balance.
Makena is first and foremost a cash cow. Don't expect head-to-head trials with progesterone-that would potentially be a cash cow killer.