Labor induction abortion utilizing trilostane, a 3beta-hydroxysteroid dehydrogenase inhibitor.
Labor induction abortion in the second trimester is a difficult problem in developing countries because antiprogestins are either not available or unaffordable. When prostaglandins are used alone for labor induction abortion without antiprogestin pretreatment, the induction to delivery interval and the treatment failure rate increase. Trilostane, an inhibitor of 3beta-hydroxysteroid dehydrogenase enzyme system, was given to 93 women between 13 and 19 weeks gestation. The trilostane dosage used was 120 mg twice daily for the first 24 h, and then 240 mg twice daily for the next 24 h. The women returned after 48 h for hospital admission. The women were randomized to three different misoprostol regimens: low-dose vaginal group (200 microg every 4 h), high-dose vaginal group (initial dose of 400 microg followed by 200 microg every 4 h) and vaginal-oral group (400 microg vaginally followed by 200 microg orally every 4 h). The median induction to abortion times were 17, 8.3 and 9.4 h, respectively. The latter two groups had significantly shorter induction to delivery times (p<.05). The most common side effects were a burning feeling in the face (47.7%) and nausea (13.3%). Overall, trilostane side effects were mild and self-limiting and did not interfere with therapy. In conclusion, trilostane can be given as out-patient therapy prior to admission for prostaglandin administration in labor induction abortion.
le Roux
Paul A
PA
Reproductive Medicine Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town/Groote Schuur Hospital, P.O. Box 34584, Groote Schuur, 7937, Cape Town, South Africa. pleroux@absamail.co.za
van der Spuy
Zephne M
ZM
D015096:3-Hydroxysteroid Dehydrogenases / Q000037:antagonists & inhibitors*; D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage*; D000028:Abortion, Induced; D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D013196:Dihydrotestosterone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics; D004334:Drug Administration Schedule; D004791:Enzyme Inhibitors / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013019:South Africa; D013997:Time Factors
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D004791:Enzyme Inhibitors; D013196:Dihydrotestosterone; D016595:Misoprostol; D015096:3-Hydroxysteroid Dehydrogenases; C009954:trilostane