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Depot medroxy progesterone acetate: a poor preparatory agent for endometrial resection
A Kriplani1, R Manchanda, D Monga
1Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India. kriplani@medinst.ernet.in
Objective:
To evaluate the efficacy of depot medroxy progesterone acetate (DMPA) as a preparatory agent for endometrial resection.
Study Design:
Endometrial resection was performed on 50 women for excessive uterine bleeding. The patients were randomly divided into 2 equal groups, with the first group receiving DMPA and the second group not receiving any hormonal pre-medication. The resected tissue was sent for histopathology and all the patients were followed up regularly for a maximum period of 4 years.
Results:
DMPA was found to increase the thickness of the endometrium, making it more fluffy and oedematous. The procedure in these patients was associated with a significantly greater fluid consumption and deficit. A power analysis showed the overall power of the study to be >90%. Forty-four percent of group 1 and 64% of group 2 patients achieved amenorrhoea or spotting. Three patients in all underwent a repeat procedure, and 1 a hysterectomy, following a dissatisfactory result. However, no statistically significant difference was found in the outcomes of the 2 groups.
Conclusion:
As a preparatory agent, DMPA, seems to have no added benefit. Larger studies are required to bring out differences in outcomes, if any.