Conception occurs about 2 weeks before a woman notices a missed period, meaning that in reality, the pregnancy could be 3 weeks along by the time she realizes she is pregnant.
 |
(Photo: TTO) |
However, the period from 2 to 8 weeks after conception is very sensitive, as the main features of the face and many important organs, such as the heart and kidneys, begin to form. Anything a woman eats, drinks, or smokes can potentially affect the fetus.
The U.S. Food and Drug Administration (FDA) has established a classification system for the safety of medications, ranging from over-the-counter drugs to prescription medications:
– Category A: There is reliable evidence indicating no increased risk of fetal abnormalities, for instance, folic acid, vitamin B6, and thyroid hormones at moderate doses.
– Category B: Animal studies show no harm to the fetus, but there is no reliable evidence for use in pregnant women, or studies in animals show adverse effects but without sufficient reliable evidence of risk to the fetus: some antibiotics, acetaminophen (Tylenol), aspartame (artificial sweetener), famotidine (Pepcid), prednisone (cortisone), insulin (for diabetes treatment), and ibuprofen (Advil, Motrin) should not be used in the last trimester of pregnancy.
– Category C: Animal studies indicate adverse effects, but there is no reliable evidence for use in pregnant women, or there are no animal studies and insufficient reliable studies in pregnant women. Medications in this category include prochlorperazine (Compazine), Sudafed, Fluconazole (Diflucan), and ciprofloxacin (Cipro). Some antidepressants also fall into this category.
– Category D: Some reliable observational studies in pregnant women show that the drug poses a risk to the fetus, but the potential benefits of treatment may outweigh the risks, such as alcohol, lithium (used to treat bipolar disorder), phenytoin (Dilantin), and most chemotherapy drugs used for cancer. In some cases, chemotherapy drugs are prescribed during pregnancy.
– Category X: There is sufficient evidence from animal or human studies indicating that the drug or product is likely to cause fetal abnormalities. There is a contraindication for use in pregnant women or those who may become pregnant. This category includes medications for skin conditions like acne (Accutane) and psoriasis (Tegison or Soriatane); sedatives (thalidomide) and drugs used to prevent miscarriage that were administered until 1971 in the U.S. and until 1983 in Europe (Diethylstilbestrol or DES).
Aspirin and many other medications containing salicylates should not be used during pregnancy. In rare cases, a doctor may prescribe these medications for women, but close monitoring is necessary. Acetylsalicylic acid is commonly found in many over-the-counter pain relievers and may prolong pregnancy and cause heavy bleeding before and after delivery. In July 1990, the FDA mandated that aspirin and other oral and rectal forms of aspirin include a warning label specifically advising against use in the last trimester of pregnancy.
In some cases, medication is necessary even during pregnancy due to the risks of untreated conditions.
Given the aforementioned examples, it is understandable to be cautious about medication use during pregnancy, which reflects a step forward in public awareness. However, some conditions, if not adequately treated, can pose serious risks or even threaten life.
For instance, parasitic infections causing toxoplasmosis (contact with cat feces, consuming undercooked red meat, or gardening with contaminated soil) usually do not harm children and adults but can cause congenital disabilities in the brain, eyes, heart, and other organs, thus requiring antibiotic treatment during pregnancy.
HIV infection in pregnant women also needs treatment with zidovudine (AZT), as studies have shown that the drug can reduce the risk of transmission to the fetus by up to two-thirds in HIV-positive mothers, and both mother and child typically experience no significant side effects other than mild anemia.
Untreated diabetes increases the risk of miscarriage and stillbirth.
Asthma reduces the oxygen available to nourish the fetus, potentially leading to fetal growth restriction and threatening the fetus’s life. High blood pressure increases risks for the placenta and can cause fetal growth delays.
Some medications can also prevent congenital disabilities, for example, insufficient folic acid can lead to serious issues in the brain or spinal cord. Folic acid should be taken before conception, as these issues can arise very early – when the pregnancy is only 3-4 weeks along, a time when a woman may not yet be aware of her pregnancy. A daily intake of 0.4 mg of folic acid is recommended. Multivitamins or consuming plenty of fruits and vegetables, oranges, bananas, dairy products, legumes, and organ meats (such as chicken liver) can help fulfill this requirement.
Therefore, it is crucial for healthcare providers to weigh the benefits of medication against the risks to both mother and fetus.
Dr. ĐÀO XUÂN DŨNG
