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• W2315676350 abstract "Progesterone is essential to sustain pregnancy in the first eight weeks. Its synthesis requires the enzyme 3 beta-hydroxysteroid dehydrogenase (3-HSD). We tested the efficacy of an orally administered 3-HSD inhibitor, epostane, in terminating unwanted early pregnancy. Fifty women in the fifth through eight weeks of pregnancy took epostane (200 mg orally every six hours) for seven days. By day 14, pregnancy had been terminated in 42 of the 50 patients (84 percent). Eight women (16 percent) did not abort and underwent dilation and curettage. Vaginal blood loss occurred on average on the third day of epostane treatment, and abortion on the fifth day. Two patients had incomplete abortions; one required a transfusion because of blood loss. Nausea was frequent (in 86 percent), but 76 percent of the participants concluded that epostane was preferable to dilation and curettage. The mean (+/- SD) pretreatment progesterone level (76 +/- 16 nmol per liter) decreased by day 7 (to 16 +/- 11 nmol per liter) and day 14 (to 10 +/- 9 nmol per liter) in those who aborted; levels of human chorionic gonadotropin also decreased from the mean at base line (73 +/- 72 kIU per liter) to 18 +/- 7 kIU per liter on day 7 and 9 +/- 5 kIU per liter on day 14. In those who did not abort after epostane treatment, progesterone levels decreased only slightly by day 7 (to 52 +/- 21 nmol per liter) and rose again (to 81 +/- 18 nmol per liter) by day 14. Among women who responded to epostane, normal menstrual periods had resumed by day 42 after the beginning of treatment in 72 percent. We conclude that epostane taken orally is an effective and safe method for the noninvasive termination of undesired early pregnancy.The efficacy of the 3 beta-hydroxysteroid dehydrogenase inhibitor epostane in terminating early pregnancy was investigated in 50 women who were in the 5th-8th weeks of pregnancy. In previous studies, epostane has been shown to reduce progesterone levels significantly in pregnant and nonpregnant women without disruption of subsequent menstrual cycles or adverse effects on adrenal steroidogenesis or hepatic function. The study subjects received 200 mg of epostane orally every 6 hours for 7 days. In 42 women (84%), the pregnancy was terminated by the 14th day after epostane treatment was initiated. There were more responders among primigravidas (90%) than among multigravidas (76%), although the difference was not statistically significant. On average, vaginal blood loss occurred on the 3rd day of treatment and abortion on the 5th day. The mean pretreatment progesterone level (76 + or - 16 nmol/liter) decreased by day 7 to 16 + or - 11 nmol/liter and by day 14 to 10 + or - 9 nmol/liter in women who aborted, while levels of human chorionic gonadotropin decreased from a baseline mean of 73 + or - kIU/liter to 18 + or - 7 kIU/liter on day 7 and 9 + or - 5 kIU/liter on day 14. In women who did not abort, progesterone levels decreased only slightly 7 days after epostane treatment (to 52 + or - 21 nmol/liter) and rose again to 81 + or - 18 nmol/liter by day 14. 86% of study subjects reported treatment-related nausea; however, in 64%, the nausea was no worse than pretreatment nausea. 76% indicated epostane was preferable to dilation and curettage. Normal menstrual periods were resumed by day 42 after the initiation of treatment in 72% of the women who responded to epostane. Overall, these findings suggest that epostane is an effective alternative method for the termination of unwanted pregnancy in the 1st 8 weeks of gestation and should be given serious consideration as a noninvasive alternative to dilation and curettage." @default.
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• W2315676350 date "1988-09-29" @default.
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• W2315676350 title "Termination of Early Pregnancy by the 3β-Hydroxysteroid Dehydrogenase Inhibitor Epostane" @default.
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• W2315676350 doi "https://doi.org/10.1056/nejm198809293191301" @default.
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