Taking Progesterone in pregnancy

Information for patients

WHO

Progesterone pessaries are offered to patients who have had a previous miscarriage, are experiencing vaginal bleeding in a new pregnancy and are less than 16 weeks pregnant. You will first be offered an ultrasound scan to confirm that the pregnancy is inside the uterus (intrauterine).

WHY

Progesterone is a hormone which maintains pregnancy. The PRISM trial is a randomised controlled trial which studied 4153 women who had experienced early pregnancy bleeding at 48 hospitals in the UK. They found that women who had previously had one or more miscarriage, had bleeding in a current intrauterine pregnancy and took progesterone, had a 5 % increase in the number of live births compared to women who took a placebo (dummy tablet). This percentage increase was higher in women who had 3 or more miscarriages. For more information on the PRISM trial please visit the link supplied below.

HOW

Patients are advised to take 400mg of progesterone in the form of a vaginal pessary twice a day. The tablets should be placed into the vagina as far back as is comfortable, once in the morning and once at night. It is normal to experience white discharge whilst using the pessaries. The pessaries should be continued until 16 weeks of pregnancy. Common side effects include tiredness, stomach discomfort and breast pain. Stop using the pessaries if you think you are having an allergic reaction. Signs of allergy may include an itchy skin rash.

PRESCRIPTION

The hospital will provide you with a limited supply of progesterone pessaries. You will need to make an appointment with your GP to have the pessaries placed on a repeat prescription until 16 weeks of pregnancy.

PAIN or BLEEDING

If you experience worsening pain or bleeding it is important that you speak to a health care professional. Within the hours of 9-5pm on weekdays you may contact the early pregnancy unit using the contact details below. Outside of these hours you may visit an out-of-hours GP or the Emergency Department.

Further information:

PRISM trial - https://www.miscarriageassociation.org.uk/research/the-prism-trial/

Tommy’s pregnancy charity https://www.tommys.org

Useful contacts:

West Middlesex Hospital Early pregnancy unit office: 0208 321 6506/6070

Chelsea and Westminster Hospital Early pregnancy unit: 020331 55070/55073