Pregnancies Observed in the Likely-To-Abort Patient with or Without Hormone Therapy Before or After Conception

Bleeding suggesting threatened abortion may be expected in 20 to 25 per cent of pregnancies. When abortion threatens:A.Approximately 28 per cent will abort if treatment consists only of bed rest.B.The routine administration of stilbestrol to all pregnant patients does not reduce the incidence of abortion or fetal loss. A cytologically demonstrable deficiency of progesterone was noted in 38 per cent (approximately one-third) of the patients who later aborted- their pregnancies.A.The 11 per cent of patients with evidence of a progesterone deficiency accounted for 36.6 per cent (approximately one third) of the spontaneous abortions we have observed.B.The routine administration of stilbestrol to all patients who show cytological evidence of a progesterone deficiency in early pregnancy does not seem to decrease significantly the incidence of spontaneous abortion even among such patients (21.4 to 19.3 per cent23).C.Prompt administration of progesterone (intravenously) to all patients who threaten to abort reduces the proportion actually aborting from 28 to 18 per cent15 (the one-third who show progesterone deficiency? In the management of the patient likely to abort because of a bad obstetrical history:A.We have observed no fetal survival when a patient with a bad history also had a cytologically evident deficiency of progesterone early in the pregnancy.B.The postconceptional administration of stilbestrol might be credited for some fetal survivals but such live births were observed only when there had been no cytological evidence of progesterone deficiency early in the pregnancy.C.The placental adequacy characteristic of the pregnancy associated with a good smear and a. relatively lower incidence of fetal loss seems most likely to be assured by preconceptional “priming”11 of the endometrium.