Q: My wife is 12 weeks pregnant. Last week she had severe pain in her abdomen. The doctor advised an ultrasound scan, wherein nothing notable was seen. The age of the fetus matched with the periods, the heart beat was OK and no blood clot was seen. The doctor said that the pain could be due to the contractions of the uterus and such contractions can cause a threatened abortion. The doctor prescribed Susten 200 injection to be taken every alternate day. My wife has had 3 injections in the last one week. Now the doctor has advised her to take the injection twice a week. The doctor has also prescribed Susten tablets, which have to be taken orally or vaginally twice a day. Do these medicines have a harmful effect on the fetus? I came to know that excessive intake of proteins can cause some acid secretions in the stomach. Can this be the cause of the pain in abdomen?

A:No medicine should be given to a pregnant woman unless it is absolutely essential. There can be serious consequences to mother and/or baby if this elementary precaution is not observed. There can be various causes of abdominal pain; to reach a conclusion that the pain originated in the uterus would be scientifically incorrect unless there is firm evidence. Abdomen has so many organs - stomach, liver, pancreas, kidneys, intestine, bladder just to mention a few. The most common cause of acute pain in abdomen is related to intestine including indigestion, consumption of infected food/water etc. Simply because a woman is expecting does not mean that every abdominal pain is related to pregnancy. Unless the cause of pain is firmly established, it would be unwise to use drugs. Susten is the brand name of a hormone called progesterone. It is used for the treatment of dysfunctional uterine bleeding. It is also used for the maintenance of early pregnancy (up to 12th week only) in cases of documented history of repeated miscarriages due to luteal phase defect. In other words there should have been repeated miscarriages in the past and there should be documented luteal phase defect (i.e. progesterone deficiency). Unless these two conditions are met, it should not be given. The use of this hormone during the second (12-24 months) and third (24-36 months) trimester of pregnancy can lead to the development of cholestatic jaundice of pregnancy or hepatocellular (liver) disease. Unfortunately many companies, due to their commercial interests, are actively promoting the use of progesterone to help pregnancy as if it is a vitamin. The side effects of progesterone are: weight gain, fluid retention, acne, chloasma, allergic skin rash, mental depression, hair loss, hirsutism (facial hair), fatigue, drowsiness, fever, alterations in lipids, etc.