Progesterone implantation in habitual abortion

Department CONDUCTED

of Reviews and Abstracts BY GEORGE

W.

Selected

KOSMAK,

M.D., NEW YORK

Abstracts

Abortion Swyer, G. I. M., and Daley, Doreen: M. J. 1: 1073,

Progesterone

Implantation

in Habitual

Abortion,

Brit.

1953.

The authors have studied a series of 113 women who have had two or more consecutive spontaneous abortions. This number was divided into two groups as follows: 60 patients who received single implants of six 25 mg. pellets of progesterone as soon as preg nancy was diagnosed with a successful outcome of the pregnancy in 80 per cent; 53 control patients who were given no specific therapy with 75 per cent success. The successful outcome of the control group of patients is higher than the calculations of Malpas and Eastman. Therefore, the authors question the validity of their estimations. There were 47 patients with three or more spontaneous abortions who may be desig nated as “habitual aborters ” and these were also divided into two groups: 27 implanted with 47 per cent success and 20 untreated controls who had a 55 per cent successful outcome of pregnancy. The differences between the two groups are not statistically significant. The authors state that these limited data do not give evidence of beneficial effects from the progesterone implantation. Furthermore, the successful result in the untreated patients (55 per cent) was far better than one would expect from the calculations of Malpas, namely, somewhere between 6 and 27 per cent for patients with three or more abortions. Pregnandiol-excretion studies on both groups of patients provided no evidence of a diminished output in patients with habitual abortion and likewise failed to show any effect after progesterone implantation. The authors raise the question as to whether or not psychotherapeutic measures contributed to the successful outcome of the pregnancy in treated and untreated groups of patients. They conclude that the prognosis for the untreated patient is much better than has heretofore been supposed. CARL T. JAVERT

Russell, Keith

P.:

Changing

Indications

for Therapeutic

Abortion,

J. A.

M.

A. 151:

108,

1953. The author reports a statistical study of therapeutic abortions performed at the Los Angeles County Hospital during a 20 year period. A total of 295 cases are ihcluded in these statistics, an incidence of one therapeutic abortion per 285 deliveries. There were 174 terminations (60 per cent) for pulmonary tuberculosis, 34 (11.5 per cent) for maternal heart disease, and 37 (12.5 per cent) for renal and hypertensive heart disease, accounting for over 85 per cent of all abortions done. Fourteen (4.5 per cent) were done for nervous These figures have changed in and mental diseases and 36 for miscellaneous indications. the past years. Only 2 patients have had abortions in the past two years for pulmonary tuberculosis. 1159