Abstract

PIP: To determine the long-range gynecological and histological effects of parenteral progesterone administration during pregnancy, 10 pregnant women, 15-25 years old, were given a total of 500 mg medroxyprogesterone acetate (Depo-Provera) in 100 mg weekly intramuscular injections from Weeks 30-36 of gestation, and compared to 10 other pregnant women as controls during pregnancy and up to 8 weeks postpartum. Prolonged dysfunctional uterine bleeding occurred in 6 out of 11 patients treated with Depo-Provera and did not occur in the controls. Endometrial biopsies at the time of delivery were similar for both groups, but 6-8 weeks postpartum the treated patients showed persistent inactivity. 24-hour urinary excretions of FSH, 17-KS, 17 OHCS, estradiol and estrone were similar for both groups throughout the study as were the Metoprione test for pituitary function and PBI determinations. Urinary excretions of pregnanediol, estriol and total estrogen were lower in the treated patients at the end of pregnancy and postpartum. Evaluation of a larger series of 77 pregnant patients treated with Depo-Provera led to the finding that the drug's effect on the menstrual cycle dissipated within 1 year. 32 of these patients subsequently became pregnant with 28 successful deliveries and 4 spontaneous abortions. Depo-Provera is concluded to cause prolonged ovarian suppression and suppressed placental synthesis of progesterone and estriol.