Current concepts in obstetrics and gynecology. Isoxsuprine in the prevention of abortion. Preliminary report
Leep, J.H.
Western Journal of Surgery Obstetrics and Gynecology 71: Vi-Viii Passim
1963
PMID: 13929191 Document Number: 8640
Eighty abortion-prone patients, chosen for having one or more of 6 predisposing factors from a series of 400 consecutive obstetrical patients, were treated prophylactically with isoxsuprine. DOsage ranged from 20 to 60 mg. daily in divided oral doses. Six of these treated patients and 3 untreated patients aborted. This total of 9 patients is approximately 2% of the 400 patients. (For comparison, Javert cites an abortion incidence for all pregnancies of approximately 10%.) Correction for one isthmico-cervical pregnancy, 1 relatively certain criminal abortion and 4 pregnancies in which there was evidence of death of the embryo before beginning treatment (all of which may be considered nonpreventable) reduces the abortion rate to 0.75%. Corrected incidence of abortion in the treated 80 abortion-prone patients is slightly over 1%, as compared with an abortion rate of 53% in a similarly abortion-prone group of 28 patients. The etiology of most abortions may be due to ischemia of the conceptus as a consequence of inadequate uterine softening, relaxation and stretching at a critical period between 6 and 8 weeks after conception. It is apparently of considerable importance to initiate treatment with isoxsuprine before or at the time of the second missed menstrual period, in view of the fact that all but 1 of the abortions in the treated group occurred in patients who began treatment 8 weeks or more after conception (10 weeks or more after the last normal period.) It thus would seem that the chief value of isoxsuprine would be in the prophylaxis of abortion, rather than in treatment of the already threatening abortion, when irreparable harm already might have been done to the conceptus. Further study is recommended- perhaps administering isoxsuprine to every patient in a larger group, rather than selecting only the abortion-prone patients in the group for treatment.
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