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Common Problems in Pregnancy |
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| Use of Antibiotics in Pregnancy | During
pregnancy, drugs have to be prescribed with great caution
as some drugs can harm the developing foetus while others
can affect the course of pregnancy. Some of the common
problems women can face during pregnancy and the
guidelines for managing these situations are listed
below: Nausea and vomiting Nausea and vomiting are the most frequent symptoms in pregnancy and can be quite distressing though these symptoms usually disappear by the fourth month. Women should be reassured and advised to take smaller, more frequent meals and to avoid large volume drinks. Nausea in the first three months of pregnancy does not normally require drug therapy. On some occasions when the symptoms are severe or prolonged, antiemetics such as doxylamine or phenothiazines e.g. prornethazine can be given. Heartburn For heartburn, antacids are widely prescribed in all trimesters. There is no evidence of foetal abnormalities. Constipation The inclusion of more fibre and fluids in the diet may be sufficient to relieve constipation. Laxatives should only be used when dietary changes prove ineffective. Bulk forming laxatives should be first tried such as Ispaghula. Stimulanat laxatives such as senna are best avoided. Bisacodyl, Lactulose and docusate are all thought to be safe during pregnancy. Asthma The drug treatment of Asthma is essentially unchanged by pregnancy. There is no evidence that the commonly used drugs by asthmatics harm the foetus and women. Inhaled medication should be preferred. There is no evidence that the inhaled corticosteroids are harmful to the foetus. Short courses of systemic steroids may also be given. Vaginal discharge For vaginal discharge, topical agents are to be preferred over oral medications. Discharge due to candida can be treated with clotrimazole. Topical clindamycin is effective in bacterial vaginosis and may be considered for women in the first trimester. Oral metronidazole can be given if required during second and third trimester if trichomonas infection is confirmed. However, it should not be administered during first three months. Oral antifungal drugs such as fluconazole and itraconazole should be avoided. Allergy Promethazine and chlorpheniramine are the antihistamines of choice in pregnant women with allergic rhinitis and urticaria. Non- sedating compounds such as cetirizine are best avoided because of lack of experience in pregnancy. Use of loratidine is contraindicated during pregnancy. Antibiotics Urinary tract infections
are the most common reason for prescribing antibiotics
during pregnancy, although they are ftequently needed for
many other infections. Pain For pain, paracetamol is the analgesic of choice. Aspirin is not recommended as it can cause bleeding in late pregnancy. At present there is insufficient evidence of safety to recommend the use of ibuprofen in pregnancy. NSAID painkillers are best avoided in late pregnancy as they can cause premature closure of ductus arteriosus (foetal heart opening). Hypertension Hypertension is fairly
common during pregnancy. Severe hypertension in the
mother carries a risk of cerebrovascular accident and
cardiac problems. It can lead, to eciampsia (convulsions)
during pregnancy. |
Pregnant women can drink a couple
of cups of coffee per day without raising the danger of a miscarriage, but six or more cups can double the risk, a study found. |
| Use of Antihypertensive drugs in Pregnancy | Women of childbearing age are
advised to take a vitamin,400 micrograms of folic acid each day in order to reduce the risk of a birth defect called spina bifida in their babies should they become pregnant. Now, a new study provides another reason for women to take vitamins: US researchers report that women who took multivitamins before becoming pregnant or during the first month of pregnancy were less likely to have babies with heart defects. |
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