allylestrenol and Abnormalities--Drug-Induced

198 women who had been trying for years to have a baby were submitted to a trial of prophylactic allyloestrenol therapy in an attempt to lower the incidence of spontaneous abortion. Allyloestrenol (Gestanon) was given at a dosage of 10 mg daily until the 8th week of pregnancy; the dosage was then stepped up to 15 to 20 mg daily until the 12th week of pregnancy and then rapidly tailed off. A decrease in the miscarriage rate was seen only in the group of women in whom treatment had been commenced immediately following ovulation (27 women: 1 miscarriage). If therapy was initiated only after the first missed period then it was without effect (161 women: 23 miscarriages). There were 4 cases of severe congenital abnormality; 3 of these cases arose in the group given allyloestrenol immediately after ovulation (with a drastic reduction in miscarriage rate). The results are discussed. They speak against a cytotoxic effect of the gestagen. It appears likely that the lowering in miscarriage rate occurs at the expense of a failure to prevent the nidation of abnormal fetuses who would normally be aborted.

Topics: Abnormalities, Drug-Induced; Abortion, Threatened; Allylestrenol; Drug Administration Schedule; Estrenes; Female; Humans; Pregnancy; Pregnancy Trimester, First

The 1980-1984 data base of the Hungarian Case Control Surveillance System for Congenital Anomalies was used to evaluate possible teratogenicity of allylestrenol therapy during pregnancy. In an initial global analysis, three of the 24 congenital anomaly groups studied (ie, clubfoot, multiple anomalies, and hypospadias) had a significantly higher incidence of allylestrenol use. A case control analysis, however, excluded a pathogenetic role for allylestrenol in the etiology of clubfoot and multiple congenital anomalies. A greater use of allylestrenol in the first global evaluation was explained by a higher incidence in these groups of impending miscarriage and preterm labor, which are indications for allylestrenol therapy. The case control analysis did indicate a greater use of allylestrenol in the hypospadias group, but this difference was not statistically significant in the critical period for induction of hypospadias (ie, the third and fourth months of gestation). The causal role of subfertility in the etiology of hypospadias was an indirect factor, explaining the greater use of allylestrenol during pregnancy in this group; in Hungary, women with a history of infertility frequently receive hormonal support in the first trimester. The authors conclude that the data analyzed do not indicate any teratogenic effects of the use of allylestrenol during pregnancy.

Topics: Abnormalities, Drug-Induced; Allylestrenol; Estrenes; Female; Fetus; Humans; Pregnancy; Risk Factors

A case of holoprosencephaly is reported in which the mother was prescribed high doses of oestroprogestins during the first 5 months of the pregnancy. Investigation of the family failed to reveal any sign of physical abnormality. A normal karyotype was detected in the proband. The authors suggest that this case may shed some light on the normal and abnormal way in which embryonic fields develop.

Topics: Abnormalities, Drug-Induced; Abortion, Spontaneous; Adult; Allylestrenol; Brain; Dydrogesterone; Estrenes; Female; Humans; Infant, Newborn; Male; Pregnancy

Topics: Abnormalities, Drug-Induced; Allylestrenol; Animals; Diethylstilbestrol; Estrenes; Female; Fetus; Humans; Infant, Newborn; Pregnancy; Rats; Receptors, Estrogen; Receptors, Glucocorticoid; Receptors, Steroid