Depot medroxy progesterone acetate: a poor preparatory agent for endometrial resection.
OBJECTIVE
To evaluate the efficacy of depot medroxy progesterone acetate (DMPA) as a preparatory agent for endometrial resection.


METHODS
Endometrial resection was performed on 50 women for excessive uterine bleeding. The patients were randomly divided into 2 equal groups, with the first group receiving DMPA and the second group not receiving any hormonal pre-medication. The resected tissue was sent for histopathology and all the patients were followed up regularly for a maximum period of 4 years.


RESULTS
DMPA was found to increase the thickness of the endometrium, making it more fluffy and oedematous. The procedure in these patients was associated with a significantly greater fluid consumption and deficit. A power analysis showed the overall power of the study to be >90%. Forty-four percent of group 1 and 64% of group 2 patients achieved amenorrhoea or spotting. Three patients in all underwent a repeat procedure, and 1 a hysterectomy, following a dissatisfactory result. However, no statistically significant difference was found in the outcomes of the 2 groups.


CONCLUSIONS
As a preparatory agent, DMPA, seems to have no added benefit. Larger studies are required to bring out differences in outcomes, if any.
Kriplani
A
A
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India. kriplani@medinst.ernet.in
Manchanda
R
R
Monga
D
D
Takkar
D
D
D000328:Adult; D004717:Endometrium / Q000187:drug effects* / Q000601:surgery*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008595:Menorrhagia / Q000188:drug therapy / Q000601:surgery*; D008875:Middle Aged; D045167:Progesterone Congeners / Q000008:administration & dosage*; D016037:Single-Blind Method
D045167:Progesterone Congeners; D017258:Medroxyprogesterone Acetate