Utrogestan for preventing preterm birth

Short cervix

Your cervix (waha kōpū) is the lower end of the uterus (whare tangata) that forms a canal between the uterus and vagina. The length of your cervix can be measured in the second trimester of pregnancy by doing an ultrasound scan. If you have been diagnosed with a short cervix, you have a higher chance of your baby being born early.

Previous preterm birth

People who have already had a premature birth have a higher chance of delivering preterm again in future.

Dose

In Aotearoa New Zealand Utrogestan is available as soft capsules (100mg). For some uses they are swallowed by mouth, but when used to reduce the chance of preterm birth, these capsules are inserted into the vagina. 

• The recommended dose is usually 2 capsules inserted deep into the vagina, at bedtime. Some guidelines may recommend 1 capsule. 
• Your doctor or midwife will tell you when to start the Utrogestan and when to stop it. It is usually started at 16 to 24 weeks or when you are diagnosed with a short cervix.

How to insert Utrogestan capsules

• Wash your hands well with soap and water.
• Place the Utrogestan capsule on the tip of your finger and insert as far as possible into your vagina.
• You do not need to lie flat following insertion of Utrogestan.
• You can get a heavy vaginal discharge when using the Utrogestan. You may choose to wear a panty liner or pad.

Things to consider while you are using Utrogestan

• If you forget to take it, use it as soon as you remember, but if it is almost time for your next dose, skip the dose you missed and use your next dose when you are meant to, as usual.
• Utrogestan can make you drowsy, especially when you first start taking it. Avoid driving and doing other tasks where you need to be alert until you know how this medicine affects you. It's best to use it at bedtime.
• You can still have sex if you are using Utrogestan. As Utrogestan given vaginally can cause a heavy discharge, you may prefer to insert it after you have had sex. However, it will not hurt you or your partner if you have sex with the Utrogestan tablets in place.

If you have an allergy to soya, don't use Utrogestan as the tablets contain soya. If you have an allergy to peanuts, use Utrogestan with caution. Although Utrogestan doesn't contain peanut oils there's the risk of a cross reaction and a few people with peanut allergy may also be allergic to soya.

Let your doctor know if you have had problems with fluid retention, blood clots, diabetes or depression.

Utrogestan is safe for you and your baby. However, some side effects include:

• vaginal irritation, itching and burning
• vaginal discharge
• headaches, nausea and vomiting.

Tell your doctor or pharmacist as soon as possible if you don't feel well while you are using Utrogestan.