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Is it mandatory during pregnancy to have duvadilan during the last trimester?

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Practicing since : 2008
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Hi, i am currently 30 weeks pregnant. my recent USG done 2 days ago showed my baby is in Breech presentation. i am feeling perfectly normal and healthy but my doctor has suggested me to have Maintane and Duvadilan 3 times a day. i dont feel any uterine contractions, no period like cramps. is it necessary to have both Maintane and Duvadilan? will Duvadilan help my baby to turn into the optimum birth position? i just dont want to take unnecessary medications if there is no complications. Is it mandatory during pregnancy to have Duvadilan especially during the last trimester?What does the medicines Maintane and Duvadilan exactly do??

Thanking you in advance,
Posted Sat, 27 Oct 2012 in Women's Health
Answered by Dr. Asra Ishtiaq Ahmed 4 hours later
Hello there,
Thanks for writing to us.
Breech presentation is where buttocks of the baby occupy the lower pole of uterus and are the first to be delivered in the event of labour (contrast to the normal cephalic position where head occupied lower pole of uterus).
Duvadilan is Isoxsuprine (beta-adrenergic agonist) that causes direct relaxation of uterine and vascular smooth muscle via beta-2 receptors, and doctors use it for preterm labour. It is a tocolytic(uterine relaxant) and used to halt uterine contractions till the effect of steroids have come for lung maturation of preterm babies. Steroids are used when there are chances of delivery before 34 weeks to mature the lung of preterm fetus before they are delivered. Duvadilan or any other tocolytic (uterine relaxant) are used only till steroid dose is being administered which is for 48hours after first steroid dose. So i suggest you to use duvadilan only if you are taking steroid injection and having uterine contractions or your doctor found any changes of dilatation or softening of cervix on your XXXXXXX examination. Incase you have no pain with uterine contractions or no XXXXXXX changes of cervix then there is no role of continuing duvadilan as no tocolytic can halt preterm labour. Their use is only for safe transport of patient to hospital in event of preterm labour or in the period for beneficial effect of steroids to come. Tocolytics especially Beta agaonist like duvadilan have side effects of increased heart rate, fall in blood pressure and deranged blood sugar levels . So I suggest you should not use it if you are not in preterm labour using steroids.
It wont turn your baby to a normal position.
Coming to maintane, it is a progesterone containing tablet. Progesterone is a hormone which supports pregnancy and relaxes uterus. It is used in early pregnancy mainly to avoid abortion, and some use it in preterm labour though 100% efficacy is still not proved in both the conditions. There is no harm in using this drug though it’s not definite that it would halt your labour or turn your baby to normal position.
Many breech position turn to normal cephalic position spontaneously. No medications are there to turn it to normal position but this has its own risks. So you can discuss with your gynecologist though in the modern era , a caesarean section is always better than ECV.
Its no rule that all breech pregnancies land into preterm labour unless there are certain special circumstances.
So in case you have no symptoms of preterm labour ( pain , bleeding, discharge ) or signs( uterine contractions, leaking of fluid, cervical changes) then there is no need to use duvadilan or progesterone(maintane).
Just take precautions to avoid preterm labour like avoid intercourse, take adequate bed rest and avoid heavy work and stress.
Hope your pregnancy goes well.
take care.
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