ABSTRACT
Your fi nal patient in clinic is a 32-year-old woman you saw 3 weeks ago. She had presented at 26 weeks’ gestation with bleeding from her vagina and contraction pains. You immediately referred her to the labour ward where she delivered prematurely. Unfortunately, the child did not survive and, regrettably, this was a scenario with which she was not unfamiliar. She had presented with similar symptoms in three previous pregnancies. Each ended in miscarriages in the second trimester. All investigations at the hospital had been normal. She comes today distressed about recent events but carrying some papers with her. She tells you she is trying for a pregnancy again and would like to be prescribed Cyclogest® pessaries (progesterone) and human chorionic gonadotrophin (hCG) injections. A friend of hers from California, who suff ered similarly, had taken it and it had resulted in a successful term birth. Th e papers are from some journals, championing progesterone and hCG use in recurrent miscarriages.
