Pharmacologic actions of progestins to inhibit cervical ripening and prevent delivery depend on their properties, the route of administration, and the vehicle.
OBJECTIVE
The purpose of this study was to evaluate cervical changes and delivery at term during pregnancy in rats after various progestin treatments.


METHODS
Pregnant rats were treated by various routes and vehicles with progesterone, 17-alpha-hydroxyprogesterone caproate (17P), R5020, and RU-486. Delivery time was determined and cervical ripening was assessed in vivo by collagen light-induced fluorescence.


RESULTS
The cervix is rigid in the progesterone injection, 17P, and vaginal R5020 groups vs controls. Vaginal progesterone had no effect. RU-486 treatment softened the cervix during preterm delivery. Only subcutaneous injected progesterone, R5020 (subcutaneous and vaginal), and topical progesterone in sesame and fish oil inhibits delivery. Delivery is not changed by subcutaneous injection of 17P, vaginal progesterone, oral progesterone, and topical progesterone in Replens (Crinone; Columbia Labs, Livingston, NJ).


CONCLUSIONS
Inhibition of cervical ripening and delivery by progestins depends on many factors that include their properties, the route of administration, and the vehicle. This study suggests reasons that the present treatments for preterm labor are not efficacious.
Kuon
Ruben J
RJ
Department of Obstetrics and Gynecology, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85004, USA.
Shi
Shao-Qing
SQ
Maul
Holger
H
Sohn
Christof
C
Balducci
James
J
Maner
William L
WL
Garfield
Robert E
RE
D019326:17-alpha-Hydroxyprogesterone / Q000494:pharmacology; D000818:Animals; D020070:Cervical Ripening / Q000187:drug effects*; D005260:Female; D005395:Fish Oils; D008055:Lipids; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D011374:Progesterone / Q000008:administration & dosage / Q000494:pharmacology; D011372:Progestins / Q000494:pharmacology*; D011397:Promegestone / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D012715:Sesame Oil; D014622:Vaginal Creams, Foams, and Jellies
D005395:Fish Oils; D008055:Lipids; D011372:Progestins; C085472:Replens; D014622:Vaginal Creams, Foams, and Jellies; D011374:Progesterone; D019326:17-alpha-Hydroxyprogesterone; D012715:Sesame Oil; D011397:Promegestone
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