Treatment of Recurrent and Threatened Abortion Report of Two Hundred and Twenty-six Cases

Abstract

In the series of 226 cases there were 42 cases with histories of recurrent abortion or primary sterility who received progesterone prophylactically and 184 cases of threatened abortion of which 139 received progesterone and 45 did not. In the prophylactic group 33 went to term with no bleeding, 4 bled and were delivered prematurely and 5 aborted. In the group of threatened abortion 64 went to term, 10 were premature, and 65 aborted under progesterone therapy. Of those which received no progesterone 22 went to term, 6 were premature and 17 aborted. The dosage of progesterone used varied but on the avg. it was given in 1 mg. doses twice a wk. for the first 3 mos. in the prophylactic group and 1-5 mg. once or twice a day until the symptoms subsided in the cases of threatened abortion. Progesterone is of definite value in the treatment of recurrent abortion. To be effective, it should be started early and continued regularly through the 5th mo. of pregnancy. Progesterone is of value in true cases of threatened abortion when such cases can be differentiated from inevitable abortion due to the death of the fetus. The critical period of pregnancy is the 2d and 3d mos., at which time the production of progesterone is taken over by the placenta. Retained or delayed abortion may result from continued use of large doses of progesterone for bleeding. The incidence of prematurity and developmental defects is higher than the normal expectancy in patients who bleed during pregnancy.