Q: My wife is in the 5th week of pregnancy. She is having brownish discharge. We went to the doctor who did a scan and told us that the fetus is only 4 weeks developed. My wife is advised bed rest and is constantly facing pain in lower abdomen. She was given injection Gemgest 200. Also she is advised of the following medicines: 1. Vitex X 1 X for 15 days 2. Pravy X 1 X for 15 days 3. Neogest X 1 X for 10 days. Further she is being advised for Profasi and Pranerest 1 tts X 3 X for 3 days. I am confused about the prescription and the diagnosis. Is the treatment alright? If the fetus is not developing, should we go in for abortion?

A:It is not only important that correct medicines are given but equally important that brands of good, quality manufacturers are used. Please see statement at the bottom of this reply. Pravy and Pranerest brands do not appear on the international and Indian national data bank of quality brands. Hence we do not know what they contain and the name of their manufacturers. Gemgest is the brand name; it contains progesterone. Neogest is also the brand name and it also contains progesterone. I do not know why the same medicine of two different, small scale companies have been given to the patient instead of well known and well accepted brands such as Maintain. Progesterone is given to maintain pregnancy if there is danger of abortion. Profasi contains human chorionic gonadotrophin. It is used when there is corpus luteum deficiency to help maintain pregnancy. It is manufactured by a good quality producer (Serum Institute of India). Its use appears to be appropriate in your case. It is very difficult for us to give advice without full information on various tests. Due to the possibility of complication, you may wish to get a second opinion as soon as possible. General statement on selection of brands: There are scores, sometimes hundreds, of brands of the same medicine. Against about 300 pharmaceutical manufacturers in western countries like Britain, there are over 20,000 producers in India that market more than 40,000 brands. Most manufacturers do not have quality testing laboratories. Hence selection of brands is important. Many companies give incentives to prescribers to patronise their products. Patients should check the reputation of manufacturers before consuming medicines.