ABSTRACT
PIP: Epostane is a steroid which inhibits the synthesis of progesterone by inhibiting the enzyme 3-beta-hydroxysteroid dehydrogenase. Progesterone is produced during early pregnancy by the corpus luteum, but after the 7th week, production of progesterone is taken over by the placenta, which also secretes human chorionic gonadotropin. In a clinical trial 50 patients in early (5-8 weeks) pregnancy were given 800 mg of Epostane for 7 days. 84% aborted, including 90% of primigravidas and 76% of multigravidas. Side effects were mild and included nausea, cramps, and vaginal bleeding. In the 16% of patients who did not respond to Epostane there was an increase in cortisol levels. Since cortisol induces human chorionic gonadotropin synthesis and this increases the activity of 3-beta-hydroxysteroid dehydrogenase, it is evident that the nonresponders required a larger dose of Epostane to suppress progesterone synthesis. Epostane is thus a candidate for a "morning after" method to terminate early pregnancy and induce labor.^ieng
