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Pregnancy Medication and Health Issues
 
 

Pregnancy Medication and Health Issues


Common Medications

All medications that you intend to take during pregnancy MUST be discussed with your health care provider. Do not take anything without consulting with him or her first.

For prescription medications that you are on for chronic conditions such as high blood pressure, diabetes, depression, hypothyroidism, or other conditions you must speak with your doctor about the safety of the drug on your unborn child.

Pain Relievers:

Acetaminophen or Tylenol is considered safe to take during pregnancy, and is the drug of choice for pain and fever during pregnancy.

Aspirin, naproxen (Aleve), and ibuprophen (Advil, Motrin) at high doses can cause closure of the fetal vessel ductus arteriosus. Avoid these pain relievers during pregnancy.

Antacids:

Most pregnant women suffer periodically from heartburn. This is best relieved by taking antacids. Antacids that contain magnesium hydroxide plus aluminum hydroxide found in Maalox, Mylanta, and Gaviscon or calcium carbonate found in TUMS, Rolaids, and Di-Gel are not contraindicated during pregnancy. Antacids with calcium carbonate are especially preferred because of the additional calcium to your diet. If your acid reflux is not managed well you might be tempted to try a stronger medication.

While some studies indicate that taking such medications as H2 blockers for acid reflux results in very little risk to the fetus, most doctors recommend lifestyle changes first. Try elevating the head of your bed, not eating late at night, eating low-fat foods, no smoking, and avoiding spicy foods. At all costs, avoid Tagamet which can sometimes have a hormonal effect on the fetus.

Allergy Medications:

Medications such as diphenhydramine HCl (Benadryl) is considered safe during pregnancy. Zyrtec is probably safe, as is Claritin.

Cold Medications:

Most cold medications are a combination of several drugs. It is never wise to take a combination medication. It is far better to take a safe medication (with your doctor's consent) for the most appropriate symptom.

Cold medications handle pain and fever, and you can take Tylenol. For sneezing and runny nose you can take Benadryl. A stuffy nose is more difficult as most decongestants are dangerous to the baby or their effect is unclear. Try saline washes instead.

Laxatives:

When you are pregnant, you can sometimes experience constipation due to the increased level of progesterone. Eating a diet high in fiber and taking a psyllium supplement such as Metamucil is perfectly safe for periodic episodes.

Vaccinations;

There are certain vaccinations that you need to make sure you have had prior to getting pregnant. The most important one is Rubella, otherwise known as German Measles. If you have not been vaccinated for these prior to pregnancy, you must exercise extreme caution to not be exposed to anyone with measles during your pregnancy as it can result in serious complications.

Vaccinations to AVOID during pregnancy include:

MMR, measles, mumps, rubella

Varicella chicken pox

Yellow fever

Oral polio

Lyme Disease

Smallpox

Vaccinations that are safe to have during pregnancy include:

Flu

Tetanus

Diptheria

Hepatitis A and B

Rabies

Pneumonia

Typhoid fever

Inactive polio vaccine (talk to your doctor first)

Vitamins:

Many prenatal caregivers prescribe a vitamin for your safety and the safety of your baby during pregnancy. It is important that you take this every day. Be sure to take it with meals as taking vitamins on an empty stomach during pregnancy can certainly cause extreme nausea.

Folic Acid:

Folic acid is a B vitamin that is vital to the baby's normal development early in pregnancy. In fact, if you know ahead of time that you intend to become pregnant, taking a folic acid supplement or eating foods high in folic acid is a very good idea. CDC and U.S. Public Health recommend that all women of childbearing years take in at least 600 micrograms of folic acid every day.

Adequate intake of folic acid has been shown to minimize the risk of neural tube defects in the baby. A neural tube defect is an incomplete closure of the spinal cord, called spina bifida and a partially or completely missing brain anencephaly. The reason it is necessary to take folic acid prior to pregnancy is that the neural tube development occurs within the first four weeks of pregnancy, and many women do not know for four weeks that they are pregnant and the damage has already occurred.

Previous pregnancies that ended with a baby with a neural tube defect automatically make you a candidate for a daily supplement of 4000 micrograms of folic acid, starting one month before you plan to become pregnant. This, however, is only under the care of a physician. Do not consume more than 1000 micrograms unless prescribed by a doctor.

Sources of Folic Acid:

Fortified breakfast cereals

Fortified whole grain breads

Dried beans, peas and other legumes

Vegetables, especially leafy greens

Tomatoes

Citrus fruits and juices

Bananas

Cantaloupe

Calcium:
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Calcium helps to form strong bones and teeth. Normal daily requirements for a pregnant and nursing mother are 1000 to 1500 mg per day. This is nearly a forty percent increase over the normal requirements. Dairy products are the easiest sources for calcium intake, but if you do not eat dairy products you must get your calcium from other sources.

Your prenatal supplements will probably contain some calcium, but usually not enough for your pregnancy and nursing needs. When looking for a calcium supplement, be sure that it is either calcium carbonate or calcium citrate, these are the best because they are easily absorbed into the body.

Sources of Calcium:

Milk

Cheese

Yogurt

Salmon

Canned sardines with bones

Spinach

Broccoli

Dried beans

Oranges

Calcium fortified foods

Iron:

Iron is a mineral that is found in your red blood cells. Iron is important during pregnancy because your blood volume expands to accommodate your pregnancy, and you have to ensure that you have enough iron. If you do not, you can develop a condition called iron deficiency anemia that is responsible for fatigue, and a lowered resistance to infections. Iron is also necessary for the formation of fetal tissue and placenta. If you have adequate iron during your pregnancy, your baby will actually have enough iron to sustain him or her for the first six months of life.

The truth is that it is very difficult to eat enough foods to get an adequate dose of iron. You need approximately 30 mg of iron during pregnancy. An iron supplement during pregnancy is almost always prescribed. Take it. It is important.

In order for your body to adequately absorb the iron, you will need to eat vitamin C rich foods at the time that you take your iron supplement. You can also meet this need by eating vitamin C containing foods with other iron-containing foods. Consider the benefits of eating strawberries on top of your iron-fortified cereal.

Some people increase their iron consumption by cooking in iron skillets, especially foods such as spaghetti sauce because of the vitamin C in the tomatoes leaching iron from the skillet.

Sources of Iron:

Lean red meat

Fish

Poultry

Spinach

Tofu

Dried Fruits

Nuts

Fortified Whole-grain Breads

Fortified Cereal

Herbals:

Herbal remedies during pregnancy need to be approached with the utmost caution. Herbs are not studied for standardized results in a scientific manner therefore it is impossible to tell what the affect will be on your baby. The concentration of different herbal supplementations differs widely, and if you consult various books on pregnancy, the suggested dosages are just as varied.

For the most part, herbal medicines can possibly be harmful, and should be avoided during pregnancy. It is wise to avoid all herbal remedies whose effects are totally unknown during pregnancy. There is little to no regulation of herbal supplements. If you are tempted to take an herbal remedy during your pregnancy, please speak specifically about it with your caregiver first. If the benefit is not known, why take the risk of damaging your baby?
Prenatal Tests and Analysis Methods



Prenatal Testing:

With the advance in twenty-first century medicine, science is interested in every test known to man to determine just how healthy a baby is likely to be when he or she is born. Because of this, nearly all women are expected by their caregiver to submit to every form of testing presented. This is something you may not really have considered, and in order to make informed decisions about what your doctor is likely to suggest, it is time to educate yourself about the available tests and what they are likely to tell you about the health of your baby.

Genetic Testing:

Genetic testing is undertaken when couples do not want a deformed or debilitated child and wish to know well in advance whether or not their baby could be affected.

If, however, you will accept your baby in any condition and have prepared yourselves for the natural outcome, you do not have to submit to genetic testing. Two conditions that can be discovered are Down syndrome and a neural tube defect.

A word about genetic testing. While your doctor may have an acquaintance with genetic testing and its ramifications, it is far better to discuss your concerns with a specialist

Family History:

There are families who have a history of a child with Down syndrome, a neural tube defect, Tay-Sachs disease, cystic fibrosis, hemophilia, thalassemia, or mental retardation that could possibly be hereditary. Being worried that your baby could have one of these disease could increase your anxiety during pregnancy. Sometimes knowing what you are likely going to face at the birth of your baby can calm your anxiety.

Chronic Villus Sampling:

This is one of the earliest tests that can be done in pregnancy, usually between the ninth and twelfth weeks of gestation. This procedure is done vaginally with a collecting tube and an ultrasound to accurately place the tube against the placenta. The major disadvantage of CVS is that it does not indicate neural tube defect, and it carries with it the increased risk of miscarriage.

TMS – Triple Marker Screening:

Between the fifteenth and twentieth week of gestation you will be approached for the basic genetic testing called TMS, or Multiple Marker Screen, or Maternal Alpha-Fetoprotein and Triple screen. The purpose of this test is to identify the women who have a higher risk of bearing a Down syndrome baby or one who may have a neural tube defect. This is not a diagnostic test.

It is vital that the mother know this.

Sometimes the results for this test are abnormal, and then a retest shows that there is no abnormality. The end result is that the pregnancy will progress normally, but the mother will have experienced anxiety. Reasons for the results of this test being inaccurate are incorrectly determining the gestational age of the mother. This test must be conducted precisely between fifteen and twenty weeks from the last menstrual cycle, and it must be accurate to within one week. If the gestational age is inaccurate, results will be abnormal.

When the alpha-fetoprotein portion of the test comes back abnormal, there is an increased risk for an underdeveloped baby, twins, premature labor, preeclampsia, stillbirth, placental separation, and other fetal abnormalities. The higher the result, the higher the risk of the problems.

You can also have a false positive with this test if you have had vaginal bleeding anytime within the previous two weeks. Be sure to tell your caregiver if you have experienced any vaginal bleeding.

If you have an abnormal result and have a normal ultrasound showing no neural tube defect, a second TMS is required. If that comes back normal, then there is no indication for further testing.

Should the TMS indicate that there is a likelihood of Down syndrome the only way to verify it is with an amniocentesis as that is the only definitive test for Down syndrome. If the amniocentesis results come back normal, no further testing needs to be done.

The biggest problem with the TMX is the amount of anxiety that it produces in the mother the first time the test comes back abnormal, nearly ninety-five percent of the time the retest comes back perfectly normal. All that has been accomplished is to worry the mother and cause unnecessary anxiety.

Remember, genetic choices about testing are yours alone. No one can force you to have a test done if you do not wish to have it done.


Amniocentesis:

Amniocentesis is the use of a needle inserted into the abdomen, through the amniotic sac to sample amniotic fluid. An amniotic fluid sampling carries numerous tissue cells from the baby from which tissue cultures are created in a genetics laboratory. This is not a risk-free procedure, as it can cause miscarriage in every one out of three hundred women. It is very common to use an ultrasound in order to keep the needle from injecting the baby in a vital organ such as the liver or the brain. Most women experience some uterine cramping after an amniocentesis that subsides shortly.

Ultrasound:

Ultrasound is considered to be one of the greatest inventions of the past fifty years. This is a noninvasive procedure that is sensitive enough to see the valves of the heart, but usually is used to determine fetal age, multiple pregnancies, and the possibility of a physical abnormality that can be seen on ultrasound.

Ultrasound is a time of bonding, not for the mother, but for the father of the baby. Up until this point, the baby has been inside the mother, and while the baby's father has been able to see physical changes and experience the emotional changes of his partner, he usually has not bonded with the baby. When the baby's father sees the ultrasound, suddenly the prospect of having a baby becomes very real and is often a very emotional experience for the men.

This is a time when the parents can often choose to learn the sex of their baby. If you really do not wish to know, be sure to tell your ultrasound radiologist to keep that information to themselves.

It is important to realize that detection of fetal abnormalities is not always a prescription for abortion. There are times when a baby can benefit greatly from early detection of an abnormality. Medicine has advanced to such an extent that often intrauterine surgery can be accomplished and save the parents and baby much grief.

 
 
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