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Pregnant with twins. Done test to check down syndrome. Can I continue taking Duphaston?

May 2013
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Practicing since : 2006
Answered : 4909 Questions
My wife is carrying twins (natural) and she is at 16 weeks at the moment. She is taking Iron and Calcium tablets. Recent NT scan and the blood test came up normal for both babies for down's syndrome. Her cervix length is 3.2cm. Now my wife wants to move to her mom's place, when we consulted a doctor near her mom's place, it was advised that she should take Duphaston (oral) tablet everyday till labor. Is it necessary for taking this medication? I am against taking any medication which is unnecessary, we are infact very happy with the doctor whom we are consulting at the moment. Should I ask my wife to stay back in my place and continue consulting the doctor or should we try some other doctor at her mom's place or continue visiting the doctor who is insisting on Duphaston. Also few of my relatives are suggesting to stitch up the cervix as twin pregnancy may lead to preterm birth, is it a practical suggestion?
Posted Sun, 27 Oct 2013 in Women's Health
Answered by Dr. Sree Gouri SR 32 minutes later
Brief Answer:
natural micronized progesterone, no stitch

Detailed Answer:
Thanks for the query.
As all her ultrasound findings and other reports are normal, no need to worry.
Her cervical length is normal.
No need of any cervical stitch, as she is not having any incompetence.
Cervical stitch won't prevent the premature uterine contractions due to over distension of the uterus.
Coming to progesterone pills, usually they are not needed just because of twin pregnancy.
As she is going for journey, during these two weeks she can take the pills to prevent premature uterine action. After that she can stop them.
Better to prefer natural micronized progesterone as per as possible.
You can take second opinion from other doctor in your wife's mother's place.
Hope I have answered your query. I will be available to answer followup queries. If you are satisfied with the answer, please give your review at the end of the discussion.
Take care.
Above answer was peer-reviewed by
Follow-up: Pregnant with twins. Done test to check down syndrome. Can I continue taking Duphaston? 1 hour later
Thanks Doctor. Have some questions based on your answer.

Can you please suggest any brand for natural micronized progesterone. Is there any ayurveda product available?

If wife prefer to stay back with me then no need to take any medication. Please correct me if I am wrong.

Coming to stitching up cervix, if she develop incompetence in future, how is detected? When is it too late to go for the stitch. As of now she is monitered every month with ultrasound and other basic parameters like weight, bp etc. Is the interval sufficient?
Answered by Dr. Sree Gouri SR 16 hours later
Brief Answer:
natural micronized progesterone, regular followups

Detailed Answer:
-In our hospital we usually recommend natural progesterones like naturogest, susten etc . Better to use with your doctor's advice.
-Better to stick to allopathy, as she might have been talking or may need allopathic medicines in future.
-Yes. Other than routine supplements like folic acid, iron and calcium, she may not need any other medicines at present.
If she develops any complications in future, she may need related tablets.
-If incompetence of cervix is there, that can be diagnosed by physical examination and ultrasound. And usually cervical incompetence can lead to second trimester abortions.
As she is almost 16 weeks now, there is less possibility of incompetence.
In case of incompetent cervix, usually cervical stitch should be applied between 14 to 16 weeks preferably.
Usually after 24 weeks, abortion due to cervical incompetence is less common, so no need of cervical stitch after that.
-In case of normal pregnancy without any complications up to 7 months monthly visits are sufficient.
Take care.
Above answer was peer-reviewed by
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