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Doctors' Answers to "Frequently Asked Questions" - Pregnancy
Related Women's Issues
Pregnancy & Apo Sulfatrim
DS [posted 12/08/98]
Answer: It would only have an effect after conception. There are options for treatment while pregnant, penicillin is usually very safe.
Pregnancy Test [posted
Pregnancy & Medication
Answer: Probably not.
Pregnancy & Macrobid
Answer: Drowsiness and mental status changes would be very unusual. Risk to the fetus is very small, a well tolerated drug.
Pregnancy & Anxiety
Medication [posted 11/25/98]
Answer: There isn't any significant difference between Prozac and Zoloft in either effect or safety in pregnancy. Celexa is pretty new so there is no direct experience.Serzone and Buspar don't appear to be serious side effects;but, direct studies have not been done.
Pregnancy & Medication [posted
Answer: H2 blockers are probably ok. But, we don't use any medication unless there are severe problems. You will need calcium anyway, so use calcium carbonate or gluconate(Tums) which usually will address two problems.
Pregnancy While on Various
medications [posted 11/24/98]
Answer: Probably early enough, none in spite of their class seems to have many problems with human fetusus.
Pregnancy While on Retin-A [posted
Answer: Not usually a big problem except post partum addiction on the fetuses part. Unlikely to cause cleft palate;but, try to get by with as little as possible.
OTC Drugs and Alcohol While Pregnant
Answer: I'd be more concerned with the alcohol, but, you really won't know til delivery.
Will Birth Control Pills Cause a
False-Postive Pregnancy Test [posted 11/11/98]
Drug Interaction & Safety During
Pregnancy [posted 11/11/98]
Answer: Can't say, but, most advise to avoid anything you don't need during pregnancy.
Preganancy & Medications
Answer: I wouldn't worry about the medications as much as the potential for renal problems while pregnant. Glomeronephritis is a potenially serious disease if not controlled. I would ensure than there is no active renal disease prior to getting pregnant. The medications are relatively low risk;but, controlled studies have not been performed on any of these drugs.
Pregnancy & Anithistamine /
Decongestant Use [posted 11/5/98]
Answer: I would use nasal steroids. Very low absorption and very effective. Also nasalcrom-available otc-is very effective and not absorbed at all. Avoid systemic drugs if possible.
Concerns About Getting Pregnant While
on Trazadone & Zoloft [posted 10/30/98]
Answer: No clear data on pregnancies on these medications as usual. Trazadone is a class C drug with rat studies showing increased fetal deformaties. Zoloft is a class C as well with delayed ossification noted in rat fetuses. Probably best to avoid them if possible.
Concerns About Medication & New
Pregnancy [posted 10/29/98]
Answer: There is no direct information on Lamisil concerning pregnancy. However, it is classed as a Class B drug which is lower on the risk ladder. Naratriptan is too new for me to have much information concerning pregnancy yet. Do you have the manufacturer?
When to Confirm Pregnancy [posted
Answer: If you had one period you're probably not pregnant. However, check 3-4 weeks after missing a period for confirmation.
Examining Potential Problems with
Pregnnancy & Antidepressant Drugs [posted 10/28/98]
Answer: As complicated as the regimens are, I would recommend you discuss this with an Ob gyn. Long term studies of the SRI antidepressants have not really been done(babies born to mothers on SRI antidepressants). Specific studies of these medication have not(and will not) been done due to ethical problems. The problem is that you will need your antiseizure meds as well as anxiety/depression meds to get through the pregnancy. Consequently, you have little choice in taking the medications. This will take very close coordination between your psychiatrist, neurologist and ob-start now developing this coordination.
No Breastmilk After Giving Birth [posted
Answer: Pretty common 10-25% of women are unable to either breast feed at all or in adequate volumes. Sometimes this "corrects" after subsequent pregnancies, sometimes not.
Pregnancy When On the Pill [posted
Answer: If you get pregnant the bleeding will stop.
Pregnancy & Seizures [posted
Answer: Doesn't increase seizures. But, the pregnancy can change the metabolism of the seizure drugs and the levels need to be checked more frequently. There is no direct testing of Depakane on human fetuses;however, it is a class D drug with a specific warning of neurotube defects in women taking the drug. To be avoided if possible.
Safety of Sunscreen Use During
Pregnancy [posted 10/21/98]
Answer: Probably safe, but, never specifically tested.
Effects of a Father's Cocaine Use [posted
Answer: Doesn't appear to in any way that would affect the fetus.
Ibuprofen Use While trying to Get
Pregnant [posted 10/13/98]
Answer: The reason not to use any of the non-steroidal anti-inflammatories is the potential effect on different fetal tissues. That is to close or change some of the normal "holes" in the heart prematurely or affect the platelets and increase the risk of bleeding at delivery. Usually, they can be taken until the last trimester if necessary;but, we prefer acetaminophen. If this doesn't work, acetaminophen with codeine is very effective and would have minimal effect on the fetus if only used occasionally.
Pregnancy & Flu Medications
Pregnancy & Nursing while on
Lithium [posted 10/2/98]
Answer: Stop breast feeding. Your mental health will be more important to the well being of your child. Do not risk the lithium in their early development.
Pregnancy [posted 10/1/98]
Answer: Don't get pregnant for 3 months, 2 might be ok.
Pregnancy [posted 8/14/98]
Answer: Don't worry about the xanax, it should have minimal/no effect. Consider how common this drug and its cousins are - there is minimal information concerning problems for the millions of women taking it (some of whom become pregnant). Luvox is relatively new and there is much less data. Early information looks promising in terms of low risk, but still not known. Don't be too concerned about this.
Factors Affecting Pregnancy
Answer: The biggest effect of the Harrington Rod will be on your respiratory drive. You will need higher minute volumes while pregnant and the rod prevents you from using the full force of your spine to breath. Since the diaphragm is pushed up by the gravid uterus, the back becomes more of a component. Not a big issue, but you may feel a little breathy. Some women experience difficulty with labor due to the inability to flex their back. However, cesarean sections work just fine if this occurs. The inverted cervix will work just fine, it is the uterus and tubes that are critical to the pregnancy and fertilization. The pill will have little/no effect on long term fertility. Good luck.
Pregnancy and Codeine [posted
Answer: Narcotics generally have little effect on the fetus. For patients using high doses, there is a risk of addiction in the child after birth, but occasional use will not cause this problem. Also, in the 2-3 weeks before delivery you should abstain due to potentially decreasing the respiratory drive in the new born. There will be no deforming effects of this medication. Lastly, local creams (Bengay and the like) can help. Check with your doctor.
Pregnancy and Benadryl [posted
Answer: None that I am aware of.
Darvocet and Pregnancy [posted
Answer: Darvocet is a combination of propoxyphene and acetaminophen. Neither will affect the baby, although the propoxyphene should not be used in the last trimester and in minimal doses to reduce any possibility of narcotic addiction in the child.
Pregnancy and Medication [posted
Vitamins and Zinc during Pregnancy
Answer: Lots of things in excess can cause problems. Most ob/gyn recommend a vitamin with zinc (traces, not large supplements). Don't worry about this. Most things in moderation (except alcohol and smoking) are fine while you are pregnant.
Lipitor and Pregnancy
Answer: The first baby is emotionally trying-they all are. However, that one is the worst. I can't think of any reason for the Lipitor to be a factor. The antihistamines (Chlor Trimetron) absolutely won't cause a problem. The spotting is usual in women in the first 6 weeks or so and usually represents the initial stages of placental growth. However, an ultrasound will be necessary to ensure the placenta is not too close to the cervix in placement. I would guess that 20-30% of women spot in the first six weeks and it rarely means long term problems. Most of what you describe sounds pretty normal.
Using Novocain while pregnant
Answer: I wouldn't be too concerned. There appears to be little, if any, systemic absorption after local injection and if there was any problem you would have heard about it since this is such a common problem. There has not been systemic research (and won't be), but this appears to be a very low risk.
Answer: Possibly a fetal abnormality, but unlikely since they merely stimulate follicular development. There can be two pregnancies, but not separated by more than a day or two(fraternal twins).
Answer: Higher mortality rates, lower birth weights, higher rates of child abuse, poverty and long term poverty of the family unit. This is a short summary of a complex issue.
Pregnancy and Folic Acid
Answer: Folic acid is necessary for the proper energy level function of every cell in the body. In the initial stages of embryo development a lack of folate leads to several potential disorders, including neuro tube disorders. This leads to spina bifida, poor brain function, etc.
Pregnancy and Vaginal Discharge
Answer: Usually when you become pregnant there is a very dense mucous plug in the cervix which completely blocks the cervix. This would not prevent vaginal discharge, but this is usually minimal anyway. So, you continue vaginal discharge, but since most of the discharge really comes from uterine mucous and drainage - effectively, no. I'm not sure what you mean by minor signs.
Anabolic steroids and pregnancy
Answer: Shouldn't be a problem. If he was taking Accutane or some other known drug which causes deformations, then it would be a different story. His taking steroids should not effect his sperm in terms of mutations or birth defects.
Answer: Theoretically, a fetus could be implanted in a male abdomen and develop. This has never been done and is probably ethically impossible but could be attempted. This is the only way for men to "have babies". Genetic cloning would allow cloning of males, but is not exactly a "baby".
Dexatrim and Pregnancy
Answer: These is no data on this. It hasn't even been studied in rats very extensively. However, most medication problems are later in conception. As long as you avoid it in the future, I doubt that you'll have any problems.
Answer: A fairly simple technique is to check your core temperature. Ovulation is usually marked by a rise in core temperature. Keep a thermometer by your bed and take your temperature every morning. Do not get up. Do it before you get out of bed. Chart the temperature, and the day that it rises is predictive of ovulation. This is what a fertility clinic would have your do. P.S. Have intercourse that day! Good luck.
Answer: There are many reasons why women cannot carry to term. Usually they have nothing to do with genetic defects, but that needs to be tested. Actually, we really don't know all the reasons why some women have trouble carrying. There is a whole list of things for your Ob to observe and think about. There actually are special physicians who follow these problems in certain cities.
Answer: It doesn't appear to be much. There is always a risk of bleeding into the placenta, but the direct risk to the fetus, concerning birth defects, appears small to none.
Answer: There are procedures to open the fallopian tubes. They range from air insufflation to surgical procedures. The costs vary accordingly. If your tubes can be opened, you will have an increased fertility at the cost of an increased risk of tubal pregnancy due to motility problems in your tubes. Lack of ability to open the tubes will lead to in vitro fertilization and reimplantation of the egg into your uterus. This is expensive(8000 dollars or so depending on the center). Some insurances cover this and some do not. There are several potential causes for your closure of your tubes. By far the most common is infection. There are several potential types of infection- some sexually transmitted and some not. I doubt that the abortion had much to do with it.
Answer: These facial blemishes are due to high levels of estrogen and progesterone. I doubt that steroid would be helpful. Local application of small amounts would not usually present a problem.
Answer: There are no controlled studies which will answer this problem. Anafranil is listed as a Class C drug in pregnancy with no teratogenic effects found in rats and mice given this drug while pregnant. However, there are no definite advice to give.
Answer: Usually about 4 weeks after conception, which means about 2 weeks after your normal period. Blood tests will be accurate at about 2 weeks. However, both tests depend on the amount of hormones produced by the placenta and may not be accurate until 6 weeks for the home test and 4 weeks for the blood test. This means that false negatives will increase if you check too early. Delay is best for accuracy. Phentermine should be avoided during pregnancy since it is not tested. It comes from a family with similar structure to amphetamines and these should absolutely be avoided during pregnancy. There hasn't been controlled human studies and probably never will be. Zoloft causes minor problems in rats. Like phentermine, human studies will never be done. However, the drug is used extensively and no major problems have been published.
Zoloft and pregnancy
Answer: There is no absolute information on this subject. There does not appear to be excessive or unusual fetal abnormalities in rat studies. Human studies have not bee done. However, this drug is so widely prescribed to young women that abnormalities would show up in the literature fairly rapidly. This has not been seen. I would minimize the dosage, but it does not appear to be a major problem. Long term studies on children born under the influence of SRIs have not been done.
Zoloft and pregnancy
Answer: Currently there is insufficient information to answer your question. Studies in rats, etc., have not shown any severe problems although like all these studies, there are occasional minor problems noted. There are many women on this drug and its class and no major effects have been reported since it has been available in the U.S. I suspect that there are minimal problems associated with fetal change. However, there is no direct information. Drugs that can be avoided during pregnancy should be avoided. However, if you need this medication I would not be excessively worried.
Codeine and pregnancy
Answer: Narcotics in small controlled doses are of no risk to the fetus until the last few days prior to delivery. Then they can produce sedation which could impair early respirations. This effect will be completely gone within 1-2 days after stopping and could be medically reversed if necessary. Amoxicillin is of little or no risk during pregnancy and is one of the drugs of choice in pregnant women.
Answer: Many women develop dental problems with pregnancy. Most gynecologists recommend a healthy calcium intake, so that's unlikely to be the problem. Fluoride is an unknown in fetal development and I suspect that is the issue. I'd prefer oral calcium with topical fluoride rather than system fluoride.
Ans OB I would like to able to say that you will be able to have children, but the likelihood is small. You may be occasionally ovulating, but it would require in vitro fertilization to achieve this. I suspect that proper hormonal manipulation might achieve fertilization, but this would take some time and effort starting now.
Answer: Tender breasts, nausea, and occasionally flushing are symptoms of pregnancy. These are usually due to the production of hormones by the placenta. The home tests depend on this production, which rarely is detectable before 2 to 3 weeks. Serum blood tests can pick up pregnancy earlier before the loss of a period. Testing negative too early is of no help. If you desire earlier knowledge, youll need to get a blood test. This test can also have trouble early, but is better.
Birth control pill
Answer: Were your periods regular before the pill? If not they will not be significantly different after the pill. Also, sometimes the lining of the uterus needs extra progesterone to completely slough. Low progesterone levels will give scanty or no period. This is not related to the pills except that large periods are uncommon on the pill.
Steroid use during pregnancy
Answer: It should not have any effect.
Answer: The easiest way is to read the side label and see what the differences are. Usually prenatal vitamins will have much higher doses of folate, calcium and iron. Ask your pharmacist for the difference and merely add these on as extra generics. More pills but cheaper.
Answer: Amphetamines are stimulatory medications. However, they have many systemic effects in the body, in addition to the sensation they provide. Among them, vessel spasms and as a result, vessel narrowing is of particular importance in pregnant patients. In addition to increasing the risk of damage to the placenta, these medications, when taken during a pregnancy, also increase the risk of damage to the fetus, ranging from spontaneous abortion (loss of pregnancy), to defects seen prior to, at the time of, or after, birth. The nature of these potential injuries is variable, and if you are concerned about the possible effects of amphetamines on a pregnancy or baby after it is born, consult your obstetrician and/or pediatrician. They can help you determine whether there is a need for concern, and what interventions can be made.
I am wondering if there should be a specific time period I should wait before trying to get pregnant. Does the medicine stay in your system after you stop taking it? My doctor didn't think this was a problem. I just wanted a second opinion.
Answer: Pondimin is the brand name of a medication known as fenfluramine hydrochloride. It is absorbed from the intestinal tract and usually its maximum anorectic effect (its effect on suppressing the appetite) is seen 2 to 4 hours after taking the medication. The reported half-life (or, the time it takes for half the medication to be cleared from the bloodstream) of fenfluramine is 20 hours, according to the Physicians Drug Reference. Therefore, after 20 hours, 50% of the drug remains, and after 40 hours, 25% of the drug remains, and so on. After about one week, (168 hours), approximately 0.4% of the medication remains. To be assured that no significant medication remains in your bloodstream, give yourself 10-14 days time prior to trying to conceive.
Ionamin is a brand name of a medication known as phentermine, supplied in a resin form. The half-life of this medication is also approximately 20 hours, according to my hospital pharmacist. Thus, as for the Pondimin, give yourself 10-14 days prior to attempting to conceive.
Pregnancy & klonopin/prozac
Answer: Klonopin is technically a drug which is only approved for treatment of seizures. In fact, it is used for treatment of many disorders which require a benzodiazepine. There have been insufficient data to really give you information. The PDR states that there are potential risks of birth defects in women taking the drug for seizure prevention. Data in rats show several non-dose related birth defects including cleft palate, eye fold abnormalities and limb defects. There has not been shown to be a major problem with other benzodiazepines and pregnancy. You can obtain more up to the date information from the company Roche 800-526-6367.
Answer: Pitocin is naturally produced by the hypothalamus - close to the neurons that produce ADH(antidiuretic hormone). Oxytoxins' purpose is to contract the muscle of the uterus and normal labor is stimulated by a sharp rise in this hormone. Consequently, external administration will usually produce labor. It also has an effect on the mammary gland to release milk and has been used in helping milk production post delivery. It is usually given intravenously, but can be administered with nasal spray. The dose is critical and close monitoring is necessary to prevent excessive contractions.
Amoxicillin and Augmentin
Answer: Use of any medicine during pregnancy always presents some risk to the fetus. However, there are some drugs which are high risk and some which appear to be low risk. Penicillin and the penicillin like drugs(like Amoxicillin) is one of the preferred antibiotics to use during pregnancy. Clavulanic acid which is the other ingredient in Augmentin(amoxicillin and clavulanic acid) is added to block some of the penicillin resistance of some bacteria, making amoxicillin much more powerful. Studies performed in pregnant mice and rats have demonstrated no apparent problems. However, studies in women have not been performed. Consequently this drug, like most, is only used if truly necessary.
Fibroids in the Uterus
Answer: Fibroids of the uterus are medically called leiomyomas. Many women have one or more of these benign muscle growths in their uterus. They are responsible for a host of problems including painful periods, heavy bleeding, and difficulty in becoming pregnant. The number and size of these muscle growths is important since small ones generally don't cause major problems. Once pregnancy is established, they rarely cause major problems with the pregnancy. Again it is very dependent on the size and position of these tumors. Taking any drugs during pregnancy is to be avoided;but, acetaminophen is generally safe in controlled amounts.
Symptoms of Pregnancy
Answer: Several possibilities. 1) Have you lost the weight from the pregnancy? This will cause the reflux, heartburn, leg cramps etc. 2.) Did you nurse after delivery-if you tried but could not you should check your prolactin levels they could produce some of the symptoms-also produces irregular periods. 3.) Has your physician checked your estrogen-progesterone levels? 4). Are you on birth control pills? These are my initial thoughts-high steroid levels cause these problems as well as weight gain. Use these as a stepping off for a diagnosis.
Answer: First, be aware that it is not fifty-fifty to begin with. There are about 102 boys to 100 girls. this number also varies and couples in their twenties will have 104-106 boys to 102 girls. None of the mechanical things seems to work. However, male sperm is typically faster and female sperm a little more hearty-regular sex tends to bias in favor of more males. However, this difference is slight unless you plan to have 200 children or so.
Answer: I suspect that you are describing cipro which is an antibiotic. Why it would work with poorly functioning sperm is another story. It would be easy to get an prescription-whether it would work is another story.
Baby's Movement in Womb
Answer: Great question, no one knows.e easy to get an prescription-whether it would work is another story.
Answer: The risk seems to be very individual. Your doctor can give you exact numbers; but, at this dosage about 1/100 births. Only slightly higher than naturally occurring frequency
Answer: There really shouldn't be any side effects on the fetus. However, with the current legal climate any physician would tell you the same advice so as not to involve any potential for fetal damage/malformation-however slight.
Answer: Have you and your husband had genetic evaluation? Often there may be an incomplete deformation that is only transmitted 50% of the time-but, leading to miscarriages. I would consult a high risk pregnancy clinic.
Answer: There are no studies performed. In general, there are few studies performed on pregnant women since it is not an ethical study. Many women have taken these drugs during early stages of pregnancy without major effects. Drugs such as Flexeril are slightly higher risk than drugs such as Valium etc.
Benadryl & Pregnancy
Answer: Propranolol is the generic name for a medication that is in the class of drugs known as beta-blockers. The main effect of this medication is to prevent the bodys natural chemicals from attaching to, and thereby activating, its beta receptors. These receptors are present in a wide variety of bodily sites, including the heart, the kidneys, the intestinal tract, the stomach, esophagus, the bladder, as well as lungs, and blood vessels throughout the body (explaining its use in patients with high blood pressure). These medications can also have effects on the nervous system and many people take these types of medications for problems such as stage fright. Above and beyond other precautions when taking this medication, with regards to pregnancy, there are several points you should be aware of. Firstly, the Physicians Desk Reference notes that in animal studies, toxicity to the embryo (that stage of development of the baby prior to it becoming a fetus), did occur when doses ten times higher than the maximum recommended human dose were given. Despite the high doses used, and the limited human data, this medication should be used before you attempt a pregnancy only on the advise of your health care provider, and only if the benefits outweigh the risks. Close follow-up with your health care provider regarding when, and how quickly to stop the medication, as well as what can be used as a temporary substitute would be necessary.
Answer: Neurontin is the brand name of a medication known as Gabapentin, an anticonvulsant drug used to prevent seizures. There is a wealth of information about this medication in the medical literature, as well as in the Physicians Desk Reference, which can be obtained through your health care provider. In the setting of pregnancy, there are several notations in the Physicians Desk Reference. Firstly, neurontin did not impair fertility or cause fetal genetic mutation in animal studies. However, there was significant abnormalities involving fetal bone formation and development, when animals received 1 to 4 times the maximum recommended daily dose for humans. In addition, animal studies showed higher rates of fetal loss, and urinary tract developmental problems. Although there is a paucity of human data involving the use of this medication during, or prior to an attempt at pregnancy, it should be used only if the benefits outweigh the risks, and only under the direct supervision and instruction of your health care provider. In addition, withdrawal of this medication needs to be done under the direct supervision of your health care provider as well, as seizure can result if the drug is removed too rapidly. If you are concerned about this medication and a potential future, or current pregnancy, see your health care provider. He or she can discuss with you what options are available, and what the best course of action should be. As always, if you are experiencing a symptom that you feel may be related to a medication, visit your health care provider. He or she can determine whether the symptom is possibly due to the drug, and determine the best course of action to take.
Medications & Fertility
Answer: None would prevent normal sperm or egg production. Vicodin and amitriptyline can occasionally cause erectile dysfunction. Less commonly, propranolol can cause erectile dysfunction.
Andrcur & Ethinylestradiol
Answer: Probably two menstrual cycles would be sufficient. Although, children born while women are taking birth control pills don't seem to have major problems. Yes, you will probably have acne-although while pregnant your levels are significantly different. That is, you will either have much worse or much better acne. After delivery, it will depend on whether you breast feed and your weight.
Answer: Very unlikely-consider all the houses that are painted and the rarity of
problems. Lead paint could be a different issue;but, it is not sold. Unless you are
grinding or sanding lead based paint I wouldn't worry. Take common sense precautions;but,
don't drive yourself crazy-99%plus births are completely normal.
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