Dr Achari

for the use only of a registered medical practitioner or a hospital or a laboratory

for the use only of a registered medical practitioner or a hospital or a laboratory.



(A Clinical Study of 62 cases with `LEPTADEN)

Dr. (Mrs.) K. ACHARI, M.S., M.R.C.O.G. Lecturer in Obstetrics and Gynacology, Patna Medical College, and

Dr. RENU SINHA, M.B.B.S. (Hon.) Rajendra Nagar Hospital, Patna

The Patna Journal of Medicine, Vol. XXX No. 1. P.1-3 Jan. 1966


The treatment of threatened and recurrent abortion occurring during the first 20-22 weeks of pregnancy is very unsatisfactory as often no cause can be discovered. Even when local; and general -causes are excluded, there is still a large number of cases to be accounted for etiological factors. It is in such cases that hor­mone deficiency is postulated as an important cause. And Progesterone is commonly used empirically, with varying degrees of success to preserve pregnancy.

Increasing knowledge of hormone activity and understanding of possible causes of abor­tions give a hope for improvement in treatment. Till then the treatment has to be symptomatic with hormones, vitamins. Restoration of confi­dence in the patients is the most significant part of management of these patients.

The present clinical trials with a herbal drug - LEPTADEN - were undertaken 'against this background of rather unsatisfactory treatment available at present in threatened and recurrent abortions during the first 20-22 weeks of pre­gnancy.




The patients in this series were selected from those who attended eithbr the Hospital for Women, Patna Medical College Hospital, Patna or the private clinics of the authors during the year 1964.

Drug: Leptaden (Alarsin) was selected for these trials.   .

It is a herbal drug and each tablet consists of;

Jeevanti (Leptadenia reticulata)       150 mg.

Kamboji (Breynia patens)    150 mg.


The mode of action of this drug is not known. It may perhaps be acting as a uterine sedative either by direct action or through the hormone mechanism.


Its usefulness in threatened and habitual abortions was first suggested by Patel. Man­ageshikar (1957) has reported encouraging re­sults in a trial of 26 cases of habitual abortions with LEPTADEN.


Dose: 1) Leptaden: 2 tablets t.d.s. were given throughout pregnancy. 2) Progesterone (depot) 125 mg. I.M. was given once a week till 22nd week of pregnancy.

They did not receive any other hormone treatment. They had sedative, bed rest and av­oidance of sexual intercourse or excitement.




There were 40 cases of threatened abortion between 6-22 weeks of pregnancy. Each of them had one bout of bleeding before admis­sion 'to the hospital or clinics. The following criteria was fulfilled before taking the case for this trial.

(1) Normal anatomy of the uterus and cervix according to the period of gestation

(2) Exclusion of general etiological factors

(3) Absence of incompetent OS

(4) Negative serological test.

The results were as shown in Table I.

TABLE -I Results of Leptaden therapy in 40 cases of threatened 'abortion


in weeks

No. of Cases



Pregnancy continued by22nd weeks

Full term delivery



















Table I indicates that if the treatment is started from early pregnancy the results are likely to be better.



12 cases were taken from the private clinics of the authors and 10 cases were taken from the hospital series. In all 22 cases between 20­30 years age group who could give a reliable history of one or more consecutive and spon­taneous abortions before 20th week of pre­gnancy were selected. All cases with abnormal anatomy of cervix, size of uterus which did not correspond with amenorrhoea were excluded. Cases who had some general etiological fac­tors as probable cause of abortion or in whom were found complicating factors such as as­sociated medical diseases of obvious potential significance were also excluded.


Results of
22 cases of recurrent abortions with Leptaden treatment


Previous            No. of              Abortion     Pregnancy       Full term

Abortion        Cases                             Proceeded    delivery

1 Abotion              8                 2(25%)                 6        6(75%)
2 Abortions '          6                 2(33.5%)             
4        3(66.5%)
3 or more              8                 3(37%)                
5        4(50%)



It is difficult to estimate the result of treatment in these cases because it has been found that even after repeated abortions a pregnancy often goes to full term without any general or specific treatment. Because of the uncertainty about prognosis of a case of threatened or re­current abortion several types of treatments have been advocated and gained clinical popu­larity in different hands at different times:

Where faulty germ plasm or improper mater­nal environment is the most predominant cause of habitual abortion no therapy-hormone or other - is likely to be helpful. Also in bleeding of placenta previa abortion after 22 weeks of pre­gnancy, very little can be offered by way of treatment.

The most striking feature of reports in recent literature (Bicharch 1940, Smith 1948, Bavis 1,951, Bishop and Richard 1952) is the unifor­mity of results claimed for various methods of treatments. As they clearly all indicate a suc­cess rate of the order of about 80% it is rather surprising that management of threatened and recurrent abortions should still be considered a burning problem and its treatment as uncertain and unsatisfactory! And real doubt arises whether prognosis for the untreated patients may not be much better than was generally sup­posed!

An alternative explanation would be that psychic factors are of paramount importance and that all the treatments are effective simply by giving the needed psychological boost to create confidence in the drug and other mea­sures adopted.

When there is definite history of threatened or recurrent abortion, the treatment should start from preconception period. Any specific medi­cal or gynaecological cause should be de­tected, and treated before conception, it is worth considering if use of Leptaden in precon­ception period is likely to give better results par­ticularly when its administration is simple and safe.



In our series of 62 cases of threatened and recurrent abortion of idiopathic origin and oc­curing before 20-22 weeks of pregnancy Lepta­den with Progesterone seem to have brought down the incidence of recurrent abortion. Safe and simple dosage of Leptaden is an additional advantage for its use throughout pregnancy.



Our thanks are due to Prof. S. N. Upadhyay, MD., FRCOG., FiCS., FACS., who gave us val­uable suggestion and help.

Our thanks are due to Alarsin Pharmaceuti­cals, Bombay 1, for supplying Leptaden tablets for this trial.


1. Bacharch, A. L., Brite. Med. Jour., 1.890, 1970.

2. Bevis, D. C. A., Lencet, 2.207,1951.
3. Bishop, P. M. F., Guy's Hosp. Rep. 87.367, 1937.

4. Bishop, and Richards, N. A., Brit. Med. Jour., 1.244,1952.

5. Jones, G. E. S. and Delfs, E., J. Amer Med. Ass. 149.1212,1951.

6. Malpas; P., J. Obstet. Gynaec. Brit. Emp., 45.932,1938.

7. Mangeshikar, S. N., Paper read at the All India Med. Conf. (Personal Comm.) 1957. 8. Osmand-Clark, F. & Murray, M., Brit. Med. J.,1.307,1958.

9. Patel, N. V., The Antiseptic, 15.6,1947. 10. Somervillie, IF., Marrian, G. F. and Kellar, R. 10. J. Lancet, 2.89, 1948.

11. Swayer, G. I. M., Lancet, 1.104,1949.
12. Swayer, G. I. M. & Daley, Doreen, Brite. Med. Jour., 1.1073,1953.

I for information on ALARSIN products

please write to : ALARSIN , Alarsin House, A/32, Road No. 3, M.I.D.C., Andheri (E), Bombay-400 093.