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  • Title: Effect of 15(s)15-methyl-PGF2alpha-methyl ester vaginal suppositories on circulating hormone levels in early pregnancy.
    Author: Puri CP, Laumas V, Agarwal N, Zoremthangi, Hingorani V, Laumas KR.
    Journal: Prostaglandins; 1977 Feb; 13(2):363-73. PubMed ID: 847240.
    Abstract:
    Intravaginal administration of 15-methyl-PGF2alpha-methyl ester in the form of suppositories terminated pregnancy in 70 percent of the cases whose last menstrual periods ranged from 35 to 56 days. The use of these suppositories in 49 patients, between 57 to 80 days of gestation, dilated the cervix by 10 mm or more, in one hundred percent of the cases. A decrease in circulating levels of estradiol-17beta and progesterone was observed following 15-methyl-PGF2alpha administration. The mean estradiol-17beta levels declined by about 55.9 percent at 9 hours whereas, the corresponding fall in progesterone was 32.7 percent. This was indicative of a direct action of 15-methyl-PGF2alpha on the corpus luteum. The vaginal use of 15-methyl-PGF2-alpha-methyl ester suppositories thus appears to be a promising method for the termination of early pregnancy and for pre-operative cervical dilatation. The termination of early pregnancy appears to be partly due to the luteolytic effect of 15-methyl-PGF2alpha besides stimulating uterine contractions. 2 uses of prostaglandin analogs (15 methyl PGF2 alpha ester) were studied: effect of vaginal suppositories with the analog on cervical dilation in patients 57-80 days of gestation, and effectiveness of intravaginal use of suppositories containing this analog as a menstrual regulator and early abortifacient. Suppositories containing (each) 1- or 1.5-mg doses of the analog successfully terminated pregnancy of 30-56 days duration in 65-70% of 40 women treated. No significant differences were observed between the 2 dose schedules. In a group of 49 patients studied for the effect of intravaginal administration of PGF2 alpha methyl ester for cervical dilation, cervical dilation of 10 mm or greater was observed after 4 suppositories in all cases. Gastrointestinal side effects were statistically more pronounced in the 1.5-mg vs. 1-mg groups (P.05). Hormonal assays (estradiol-17 beta and progesterone) showed a decline in circulating estradiol-17 beta after vaginal administration of the analog in early pregnancy. Mean levels of 7 cases fell from 2.43 mg/ml-2.1 in 1 hour. These declines were significanly different from pretreatment values (P=.01). Serum progesterone alterations following analog administration were more variable. Whereas the mean level of Estradiol-17 beta fell by 55% after vaginal administration of the abortifacient, mean levels of progesterone fell only 32.7%, mainly because of individual variations. The data indicate a direct action of the analog on the corpus luteum. In addition, the termination of early pregnancy (menstrual regulation) seemed to be caused, partly, by the luteolytic effect of the PGF2 alpha methyl ester as well as by uterine contractions.
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