Medication, Vaccinations and Pregnancy
By Julia Cruz
Beth Israel Deaconess Medical Center correspondent
First you find out you're pregnant. Then you find out what you can't do anymore. Caffeine, alcohol, sushi and a host of other foods will likely become fond memories for the next nine months or so.
Rx for a Healthy Baby
But just as important as what you're eating (or not eating) is the medication you might be taking. Many prescription drugs and even over-the-counter medicines are not safe for an unborn child.
"The truth is, no drug has been proven to be 100 percent safe to use during pregnancy," says
Dr. Sandra Mason, an obstetrician at
Beth Israel Deaconess Medical Center. "If you're thinking about getting pregnant or are already pregnant, you should review your medications with your doctor as soon as possible."
That doesn't mean you should immediately stop taking your meds. Talk to your doctor first.
"A lot of times, expectant moms will stop taking medications we don't want them to stop," notes Dr. Mason. "Anti-depressants are very common in that category. But women need to understand the implications of coming off of their medications first. You don't have to tough it out with depression."
Other examples are ACE inhibitors and ARBs used to treat high blood pressure.
"These medications can be harmful to the fetus," notes
Dr. Celeste Royce, an obstetrician at BIDMC. "A pre-conception visit to your doctor to change your medications is the best way to prevent complications due to medications."
Doctors warn that some prescription medications that treat skin conditions can also be dangerous for pregnant women - including Accutane and Retin-A.
"We can't say it enough - check with your prenatal provider as to the safety of any drug you are taking, and inform the provider about any new medication prescribed by another provider," stresses Dr. Royce.
What if you're pregnant and your hay fever allergy is making you miserable? Over-the-counter (OTC) medications such as Claritin and Zyrtec are safe to use and can help relieve symptoms. However, doctors warn that another popular allergy medicine, Allegra, has shown adverse effects when used in animal studies.
For pain, headaches and fever, acetaminophen, usually sold under the brand name Tylenol, is your best bet.
"Tylenol is okay the whole way through your pregnancy as long as you don't exceed the recommended dose," says Dr. Mason.
Avoid aspirin throughout your pregnancy (stick with Tylenol) and ibuprofen, especially during your third trimester.
Even some over-the-counter creams and gels can cause harm to your unborn baby. Most notably, hair loss treatments like Rogaine should be avoided as they contain testosterone. Skin creams or peels such as salicylic acid should also be avoided.
You probably got your vaccinations as a child, but those vaccinations don't protect you forever. Vaccinations can help protect you and your baby from any harmful infections or serious diseases during pregnancy. But not all vaccines are safe to have when you are pregnant. So if you're pregnant or thinking about getting pregnant, you should review and update your vaccinations with your doctor.
Vaccines every mother-to-be should be up to date on include:
MMR (Measles, mumps, rubella) - safe before and after pregnancy, but not during
Tdap (Tetanus, diptheria, pertussis) - safe before, during and after pregnancy
Varicella (chicken pox) - safe before and after pregnancy, but not during
Flu - Once a year; safe before, during and after pregnancy (by injection only)
In addition, women who are at high risk for Hepatitis-A and Hepatitis-B may need to get vaccinated before they become pregnant or after they deliver.
Whatever you do, don't skip your flu vaccine. It is especially important for pregnant women and their babies.
"Pregnant women are one of the high risk groups when it comes to the flu. If a pregnant woman gets the flu she is at risk for complications, such as pneumonia, that could require hospitalization," cautions Dr. Mason.
Because the nasal-mist form of the vaccine contains the live flu virus, pregnant women should only receive the flu vaccine by injection.
If you are thinking about getting pregnant, now is the time to talk to your doctor and make sure all your vaccines are up to date.
"It's challenging sometimes to convince a person to get a vaccine once they're pregnant," notes Dr. Mason. "But the truth is, the chances of you getting sick from not getting vaccinated are much greater than your chances of having a reaction to the vaccine. Mothers need to be healthy. Healthy mom, healthy baby."
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted September 2012