Treatment with Medications during Pregnancy: What You Need to Know?

The use of medications for pregnant women in each case requires a carefully considered approach. Some of the drugs can adversely affect the course of pregnancy, the development of the fetus, up to the formation of congenital defects. They can also cause complications in the fetus and newborn. It is estimated that about 1% of all congenital anomalies are caused by drugs.

Medications are especially dangerous in early pregnancy

Trust Pharmacy points out that from the 13th to the 56th day after conception the organs are actively formed in the future child. If something unexpected happens at this time, it can lead to developmental defects. Only a few medications have the property of disrupting the correct course of events. That is why you should not worry if you took a pill, not knowing that you are pregnant. You will feel much calmer after the first trimester ends, that is, 12 weeks of pregnancy: the risk that the medications will somehow affect the child will noticeably decrease.

Do not interrupt the prescribed course of treatment

If we are talking about chronic diseases, the therapy should not be interrupted in no case, as the child needs a healthy mother during and after pregnancy! It is much better in this situation to warn the doctor that you are going to have a baby. Then, he will be able to determine, even before conception, how your pregnancy will affect the disease. Perhaps a specialist will prescribe treatment with other drugs that will not harm the child. This usually happens if, for example, the future mother suffers from asthma, allergies, diabetes, stomach ulcers, heart disease, high blood pressure. If it happens that you get pregnant, and new safe drugs are not yet selected, it should be done as soon as possible. The correct treatment should be chosen by your doctor together with an obstetrician-gynecologist who manages a pregnancy.

Drugs are more dangerous for the child than for the mother

During pregnancy, the medication is received immediately by two “patients”, one of whom is still very vulnerable. That is why the future fetus should be protected from the so-called side effects because they can affect its development. If, by taking the prescribed medication, a mother feels unwell, consult a doctor as soon as possible.

Alcoholic beverages are just as dangerous as some drugs

If a pregnant woman will regularly allow drinking some wine, beer, vodka or whiskey, this can affect the baby’s health. It is known that under the influence of alcohol, children are born with low weight, developmental defects and other health problems.

To reduce the temperature, during pregnancy it is better to take paracetamol, and not aspirin

In small doses (50-100 mg), aspirin is prescribed in order to reduce blood viscosity. It is proved that it does not harm the child. But in order to get rid of temperature or pain, this amount is not enough, and doses of more than 500 mg are considered unacceptable. As for paracetamol, it is recommended to expectant mothers as a safe analgesic and antipyretic agent. By the way, it is good for headaches and toothaches.

Be careful with ointments, creams and gels

Any substance that is applied to the skin enters the body. Especially if the surface you decide to treat with an ointment or gel is large. That is why, before you apply anti-inflammatory cream to the affected area, consult your doctor.

You need to take vitamins during pregnancy

In the first trimester, women should pay attention to folic acid. The doctor usually prescribes multivitamin complexes that contain all the necessary substances in the right proportions and are intended for expectant mothers during the second trimester.

In what situations cannot a woman do without drugs?

• The future mother fell unwell, and her temperature rose above 38 °C. Most likely, the doctor will prescribe paracetamol, which will relieve the heat because the high temperature not only weakens the woman but also is dangerous for the child.
• If the expectant mother has an increase in blood pressure, the doctor will ensure that it does not happen again.
• Before conception, a woman took medications for chronic diseases, such as asthma, allergies and many others.
• The blood test showed a low level of hemoglobin – then the expectant mother will be prescribed herbal supplements containing iron.
• During the third trimester, the woman had an inflammation of the kidneys – pyelonephritis. This disease is accompanied by fever and back pain, and to get rid of it, the doctor will most likely prescribe antibiotics to the patient.
• It is proved that antibacterial agents that are allowed during pregnancy do not harm the baby.
• Usually, in the 2nd trimester, expectant mothers are examined for sexually transmitted infections. If microorganisms are found, it will require antibiotic treatment.

What does the doctor consider when prescribing medication for pregnant women?

The danger arising after the use of drugs depends on a number of factors: on the need for careful drug selection and its dose in each individual case, on the way drugs enter the body of the pregnant woman.

During pregnancy, the absorption of drugs is slowed down due to a deterioration in the blood circulation of the gastric mucosa, a decrease in the motor activity of the gastrointestinal tract, and a decrease in the secretion volume and intestinal contents in most cases. Slowing the stomach motor activity reduces the rate of medication in the small intestine, in which the absorption of most drugs takes place. The time of the gastric juice acidity effect on drugs is increasing, so a number of substances are destroyed already in the stomach of a pregnant woman. The decrease in intestinal motor activity makes it difficult to “mix” the contents of the intestine. It also reduces the area of contact of the intestinal surface with the contents of the intestine, including the medications taken. All this reduces the possibility of complete absorption of medications and the rate of their accumulation in the therapeutic concentration in the blood. This problem becomes especially important with a single use of drugs, such as painkillers or even sleeping pills.

An important factor in the impact of drugs on the body of a pregnant woman is the way to apply drugs.

When medications are dissolved under the tongue are not exposed to digestive and microbial enzymes, and therefore begin to affect the body 2-3 times faster than ingestion. Therefore, if it is necessary to achieve a more rapid action of the drug, the medicine is placed under the tongue.

When using suppositories, it is necessary to take into account that there are no digestive enzymes in the rectum and then the medicine enters the bloodstream bypassing the liver, that is, it does not break down in it and enters the body in an active state. On the other hand, mechanical pressure of the uterus on the pelvic veins and the inferior vena cava occurs during pregnancy. This makes it difficult for blood to outflow completely from the rectum. It results in the reduction of the full penetration of the drug into the blood flow.

When using drugs in the form of ointments, creams – both for therapeutic and cosmetic purposes – the active biological substances can accumulate and linger in the subcutaneous tissue due to an increase in the thickness of the fat layer by 3-4 kg. It contributes not only to an expressed local action but also to the gradual flow of drugs into the general circulation. They gradually show a general effect on the organism as a whole. It is necessary to be especially careful when applying to the skin of pregnant potent substances, in particular, adrenal cortex hormones, antibiotics, etc. Even with a slight excess of the drug concentration in the blood, the undesirable (toxic) effect of the drug may appear.

Injections allow drugs to quickly enter the body (intramuscular or intravenous route of administration). With this method, it becomes possible to introduce an exact dose of the active substance, and in most cases, it is several times less than when taking the medicine orally. However, if this drug has an adverse side effect after the injection, it is extremely difficult to reduce its effect. The inflammatory process can occur in some women at the injection site. When an intravenous drug is administered, even if it was carried out absolutely correctly, damage to the vascular wall can sometimes occur.

Therefore, the choice of medication, the recommended dose, route of administration, and duration of administration must be taken into consideration when prescribing a drug to a pregnant woman. This is the gestational age (fetal development and therefore suspected drug sensitivity), the presence of diseases of the organs through which the drugs (kidneys, intestines) are released, the age of the pregnant woman (the older the woman, the greater the risk of complications from ingestion).

All over the world, the following risk categories developed by the American Food and Drug Administration (FDA) are widely used:

• A – drugs that have been taken by a large number of pregnant women and women of childbearing age without any evidence of their influence on the incidence of congenital anomalies or the damaging effects on the fetus. (Paracetamol, clotrimazole – local, penicillins, antacids and etc).
• B – drugs that were taken by a limited number of pregnant women and women of childbearing age without any evidence of their influence on the incidence of congenital anomalies or the damaging effects on the fetus. At the same time, in animal studies, no increase in the frequency of damage to the fetus was revealed. (Heparin, diclofenac, ibuprofen, azithromycin, acyclovir, metronidazole, etc.)
• C – drugs that have shown teratogenic or embryotoxic effects in animal studies. There are suspicions that they may have a reversible damaging effect on the fetus or newborn (due to pharmacological properties), which does not cause the development of congenital anomalies. Controlled human studies have not been conducted. (Aspirin, dexamethasone, Duphaston, diuretic drugs, etc.)
• D – drugs that cause or suspect that they can cause congenital anomalies or irreversible damage to the fetus. The risk to the fetus should be correlated with the potential benefit of the drug. (Hypnotic-barbiturates, doxycycline, tetracycline, etc.)
• X – drugs with a high risk of developing congenital anomalies or persistent damage to the fetus, since there is evidence of their teratogenic or embryotoxic action in both animals and humans. They should not be used during pregnancy.