USE OF HYOSCINE IN PREGNANCY

Hyoscine (scopolamine) is an anticholinergic agent used to relieve symptoms of smooth muscle spasm. There are two derivatives: hyoscine butylbromide (butylscopolamine, buscopan), used for the symptomatic relief of irritable bowel syndrome, and hyoscine hydrobromide, which is used preoperatively to control secretions and for prevention of travel/motion sickness.

There are limited data on the use of hyoscine during pregnancy, with the available data predominantly relating to use at the time of delivery. Two small studies have not described associations between first trimester hyoscine exposure and an increased risk of malformation. No studies have investigated risks of miscarriage, stillbirth, preterm delivery or impaired fetal growth. Maternal administration of hyoscine derivatives during labour has been inconsistently associated with fetal tachycardia, and anticholinergic symptoms may occur in the neonate. The use of hyoscine during pregnancy may be justified if there is a clear clinical indication.

Exposure to hyoscine derivatives at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.