During the first three months of pregnancy, it's best to avoid all over-the- counter medications. Once you are past the first trimester, some other medications are considered safe, but always consult your doctor if you are in any doubt.
The following provides guidance on medications used for treating common pregnancy complaints and minor illnesses.
Antacids:
Heartburn and indigestion are common problems in pregnancy, particularly during the third trimester when the increased size of the baby puts pressure on your stomach. Some antacids are safe to use during pregnancy, although you should avoid sodium bicarbonate because it may increase fluid retention. Consult your doctor or pharmacist about which ones are recommended.
Antibiotics:
Many antibiotics used to treat infection are safe for use during pregnancy. This includes antibiotics containing penicillin, although there are safe alternatives if you’re allergic to penicillin. The following antibiotics should be avoided during pregnancy:
Antiemetics:
If you have severe nausea and vomiting and natural remedies suchas gingersnaps or ginger tea don’t relieve the problem, your doctor may recommend an antiemetic medication that is safe to use during pregnancy.
Antifungal remedies:
You should avoid over-the-counter antifungal remedies, including oral and local remedies, for treating yeast. Consult your doctor, who can recommend an antifungal medication that is appropriate for use in pregnancy.
-Cold remedies Remedies for coughs and colds often contain a range of ingredients, such as caffeine, antihistamines, and other decongestants, many of which aren’t safe in pregnancy. Ideally, avoid all cold remedies and instead have steam inhalations and hot caffeine-free drinks. If you need relief, talk to your doctor before using any over-the-counter treatments.
Diuretics:
It’s normal to experience some swelling in the hands and feet during pregnancy, and you shouldn’t attempt to deal with this by taking diuretics, including herbal diuretics. If you have sudden swelling in the face, hands, or feet, you should consult your doctor immediately because this can be a sign of preeclampsia.
Laxatives:
The first step in dealing with constipation is to take dietary measures by increasing your intake of fiber and drinking plenty of fluids. If this isn’t enough to ease constipation, then some over-the-counter laxatives may be safe to take during pregnancy, including laxatives that contain bulking agents. Those containing castor oil may cause uterine contractions. Check with your doctor before taking any laxatives.
Analgesics:
The general advice is to avoid all analgesics during pregnancy, especially during the first trimester. Before using pain medication for a common
problem, such as a headache or backache, first try natural remedies; massage or a warm bath are often effective in relieving aches and pains. If these aren’t sufficient, call your doctor for advice. Aspirin and anti-inflammatories such as ibuprofen should be avoided throughout pregnancy.
The pain medicine codeine can sometimes be used for a short period to treat specific pain, but should only be taken on the advice of a doctor.
Rehydration solutions:
If you have a stomach upset resulting in a severe bout of diarrhea that lasts for an extended period, your doctor may recommend a rehydration solution that is safe to use in pregnancy.Steroids If you have eczema, or find that this condition develops or worsens during pregnancy, talk to your doctor about appropriate medications. Corticosteroids, which are used to treat eczema, aren't associated with birth defects, but they are known to cross the placenta, so both topical and oral corticosteroids aren't recommended during pregnancy.
Steroid inhalers:
Used to treat asthma are safe in pregnancy, and it’s important to control your asthma while you’re pregnant. Oral steroids may also be prescribed for certain other conditions, and these may be safe to continue with under the guidance of your doctor. Anabolic steroids should not be taken during pregnancy.
Common concerns in pregnancy
Pregnancy hormones affect every system in your body. here you will find a common concerns with an explanation of the adaptation process that may cause these symptoms, information on whether medical help is likely to be required, and advice on measures you can take yourself to alleviate symptoms.
Fatigue:
An overwhelming feeling of fatigue is often one of the earliest signs of pregnancy. Such feelings usually subside during the second trimester, but are likely to return in the third trimester.
CAUSES:
The main causes of extreme fatigue in early pregnancy are massivehormonal changes and the extra demands on the body made by an increase in blood volume of up to 50 percent. It’s this increase in blood volume that helps the lining of the uterus to thicken and the placenta to develop. In the second trimester, energy levels usually return to normal as hormone changes settle down. Late in pregnancy, fatigue may recur because your extra size and weight and the demands of the growing baby means that your body systems need to work harder. In both early and late pregnancy, difficulty sleeping can contribute to feelings of fatigue. Fatigue in pregnancy can also be caused by anemia .
WHAT TO DO?
If you are working, take regular breaks and get some fresh air at least once a day. Ensure that your fluid intake is adequate; caffeine is not helpful because it dehydrates your body and will leave you feeling worse. Take more time for sleep if you need to; housework can wait and you may need to cut back on social commitments.
Difficulty sleeping:
It’s very common to have sleeping difficulty in pregnancy, especially in the first and third trimesters.
CAUSES:
A common cause of disturbed sleep is the need to urinate frequently. Early in pregnancy, this is due to the amount of blood in your body, leading to the kidneys filtering out more fluid, which ends up in your bladder. As pregnancy progresses, another factor is expansion of the uterus within the pelvic cavity, so that it competes for space with the bladder. This leads the bladder to require more frequent emptying, which will interrupt your sleep. Many women also feel hungry during the night and need to snack, while others find that nausea and vomiting interrupt their night or lead to early waking. From about 20 weeks of pregnancy, the uterus moves up out of the pelvis, taking pressure off the bladder, and nausea often subsides, which means that sleep improves. Toward the end of pregnancy, sleep patterns can once again be disturbed. Unborn babies are often active just when you want to rest; your body is bulky and finding comfortable sleeping positions becomes difficult; and as the baby becomes bigger and heavier pressure on the bladder may return.
WHAT TO DO?
If frequent urination is keeping you awake, don’t drink large quantities of fluid close to bedtime, and to avoid waking up hungry include foods high in unrefined carbohydrates, such as whole-wheat bread, in your evening meal. If you do wake up, don’t lie there for long periods, since this is frustrating and may lead to habitual sleeplessness. Get out of bed and engage in a simple activity that won’t overstimulate your brain, have awarm, caffeine-free drink, and return to bed when you’re sleepy. Later in pregnancy when you find it difficult to get comfortable, experiment with different sleeping positions: use plenty of pillows, under your head and belly and between your knees. A rest during the day is essential during late pregnancy, but limit this to a 20-minute power nap or an hour reading or watching television with your feet up. If you sleep for long periods during the day, you will further lessen your ability to sleep at night.
Headaches:
Headaches are common in pregnancy, especially in the first trimester.
CAUSES:
Most headaches are unlikely to be a cause for concern and are probably due to hormonal changes and the need for additional fluids. Headaches occurring in the third trimester that are accompanied by other symptoms, such as abdominal pain or nausea, may be a sign of preeclampsia and should be assessed by a doctor.
WHAT TO DO?
Making sure you drink enough clear fluids (around five cups a day) and avoiding caffeine should help reduce the number and severity of headaches. If you’re working or concentrating on a task, have a break every two to three hours, and get some gentle exercise in fresh air. For a sinus headache, apply a warm compress to the front and sides of your face. For tension headaches, place a cool compress on the back of your neck. If you suspect your headache is due to lack of sleep, get more sleep. And make sure you’re eating enough, since hunger and low blood sugar can cause headaches. Relieve stress another headache trigger with deep breathing, meditation, yoga, or massage Always discuss your symptoms with your doctor before taking medication. If you have a headache in late pregnancy that is accompanied by swelling of the legs and ankles, generalized body swelling, abdominal pain, or nausea and vomiting, contact your doctor immediately.
Swollen feet and ankles:
Some women experience a small amount of swelling in their feet, ankles, hands, and wrists, which can be particularly pronounced in hot weather.
CAUSES:
Swelling is the result of fluid retention, which in turn results from the extra blood produced during pregnancy to provide for the growing baby.
WHAT TO DO?
This is best managed by alternating light activity with periods of rest during which your feet are elevated. However, staying in bed or sitting in a chair for very long periods may increase the risk of deep vein thrombosis (DVT). DVT is a potentially serious condition in which a blood clot forms in a vein; if the clot breaks off, it may travel to the lungs and block a major blood vessel.
Swollen feet and ankles can also be a sign of other problems such as preeclampsia, so should always be reported to your doctor who can check for other symptoms. Skin changes Itching and dry skin Many pregnant women suffer from itchy, dry patches of skin that worsen in late pregnancy. Such skin irritation is a reaction to hormonal changes and can be eased by a perfume-free moisturizer. Rarely, itching in late pregnancy may be due to a serious condition called obstetric cholestasis. Itching caused by this condition is much more severe, usually constant, and often concentrated on the hands and feet. Spider veins Clusters of broken capillaries (tiny red blood vessels) called spider veins may appear during pregnancy, mainly on the cheeks. These occur as a result of increased blood circulation and the softening effect of pregnancy hormones on blood vessels. Spider veins are painless, but if you are worried about their appearance you can cover them with makeup. They usually disappear soon after the birth. Increased pigmentation An increase in skin pigmentation is common in pregnancy, probably due to the increased production of hormones. Most women notice a darkening of the area around the nipple (the areola), and a dark line, called the linea nigra, forming vertically through the middle of the belly from the umbilicus to the pelvis. Also common are dark patches on the cheeks, nose, and chin, known as melasma (also known as chloasma, or the “mask of pregnancy.”) On women with dark skin, the patches may appear lighter than surrounding skin. Exposure to sunlight can make the patches more obvious, so use a high-protection sunscreen on your face.
Stretch marks:
Rapid stretching of the skin during pregnancy often leads to the development of pink or purple lines, known as stretch marks. These marks, which can look quite alarming, with a scar like appearance, usually appear in late pregnancy, commonly on the abdomen, hips, thighs, and upper breast.
There is no clear evidence that any cream will prevent or remove stretch marks, although a light unscented moisturizer can help keep the skin supple, as will staying well hydrated and avoiding excessive weight gain. As time passes after the birth, stretch marks become silvery and almost invisible.
Breast problems:
Breast tenderness:
For many women, breast tenderness and an increase in the size of their breasts are the first signs of pregnancy. Sometimes breasts are so painful that you can’t bear them to be touched, and they may also throb and feel hot. Breast tenderness usually subsides by the end of the first trimester.
CAUSES:
Tenderness is a sign that the breasts are preparing for their role of feeding your baby after the birth: the milk ducts are starting to enlarge and blood flow increases.
WHAT TO DO?
Wearing a properly fitting bra will help support your breasts and reduce discomfort. An ill-fitting or tight bra will be uncomfortable and may put pressure on the milk ducts. You may also find it helpful to wear a soft sleep bra at night. If your breasts feel hot, applying a cool washcloth to them may bring relief. If you have a painful or red patch on a breast, you should report this to your doctor because it could be a sign of mastitis.
Nipple problems:
Each woman has breasts and nipples individual to her. Women who have flat nipples that do not protrude or whose nipples are inverted (concave) may worry that they may not be able to breast-feed. However, all healthy women can breast- feed because babies feed by taking in a mouthful of breast, not just the nipple.
CAUSES:
Inverted or flat nipples are thought to be due to shorter ligaments in the underlying breast tissue that pull the nipples inward.
WHAT TO DO?
If you have any concerns about the suitability of your nipples for breast- feeding, talk to your doctor who can refer you to a lactation consultant. There are also products available that will draw out nipples in preparation for breastfeeding.
However, these are by no means essential because when babies latch on to the breast they are able to draw out even a flat or inverted nipple (although you may eventually need help by a lactation consultant to show you the best way to help your baby do this).
Digestive problems:
Nausea and vomiting:
Approximately 80 percent of women are troubled by the unpleasant symptoms of nausea and vomiting in early pregnancy. During this period it can be difficult to eat large meals, and strong smells and tastes can become unbearable. Many women also find some vegetable and acidic foods more difficult to digest and worry that their usually healthy eating pattern has deteriorated. Early pregnancy nausea and vomiting usually subside between 12 and 20 weeks; however it’s not uncommon to experience some return of these problems late in the pregnancy.
CAUSES:
Early in pregnancy, the pregnancy hormones interact with hormones that control other body systems, particularly those involved with blood sugar regulation, and this results in feelings of nausea and vomiting. Late in pregnancy, problems with digestion may occur because the uterus takes up most of the space in your abdomen, displacing your intestines and stomach and leaving little room for the digestion of large amounts of food.
WHAT TO DO?
The best way to manage the nausea and vomiting of pregnancy is to drink plenty of water throughout the day and also eat small amounts of food on a regular basis, which will help to avoid long gaps between meals, and snacking on complex carbohydrates such as wholewheat and whole-grain products, wholegrain cereals, and brown rice dishes.
Avoid snacks with a high sugar content because, although these will give you a quick boost, they will soon leave you feeling worse than before because your blood sugar plummets.
Reducing your overall intake of the refined sugar found in candy, cake, cookies, and sugary drinks will help reduce the symptoms of nausea and vomiting and will also lessen your risk of developing gestational diabetes.
The “little and often” principle, coupled with healthy snacks is equally good advice for the late phase of pregnancy.
Gastroenteritis:
This is inflammation of the lining of the stomach and intestines, most commonly due to infection. It causes vomiting and diarrhea that usually come on suddenly. In most cases, the condition clears up on its own and is not a cause for concern.
However, if it’s severe, you could become dehydrated, and this can affect blood f low to your baby through the placenta. Infection with listeria bacteria can, rarely, cause late miscarriage.
CAUSES:
Gastroenteritis is caused by infection contracted either through contact with an infected person, or by consuming contaminated food or drink (food poisoning). Food poisoning is often the result of poor food hygiene.
WHAT TO DO?
Drink plenty of water, and try to avoid cross infection with other members of the household.
If you’re unable to retain even small sips of water, or your vomiting and diarrhea have lasted for 24 hours, you should seek medical advice from your doctor.
If you can’t reach your doctor, go the nearest hospital emergency room for treatment.
If you have a preexisting medical condition such as diabetes, you should seek help immediately. You may be treated with intravenous fluids if you are dehydrated, and fetal monitoring may be done to check the health of your baby. Infection with listeria is treated with antibiotics.
AVOIDING GASTROENTERITIS:
It is important that you try to avoid gastroenteritis by practicing good food hygiene . If someone else in your household has gastroenteritis, avoid infection by using separate soap, towels, cutlery, and dishes. If you have more than one toilet, get the infected person to use one separate from the rest of the household. Wipe toilets, sinks, and faucets with a mild bleach solution after each use.
Infected individuals should also avoid preparing food for others.
Indigestion and heartburn:
Many women start to experience episodes of indigestion and heartburn during the second trimester.
CAUSES:
Indigestion results from slower movements of the digestive tract under the influence of pregnancy hormones combined with reduced space in the stomach from the growing baby. The muscular valve at the top of the stomach is also softened by hormones and this can allow stomach acid to flow up into the esophagus, causing heartburn.
WHAT TO DO?
Avoiding large meals, especially late at night, helps prevent indigestion and heartburn. If you suffer from heartburn at night, try sleeping in a propped up position with your head higher than your feet. For relief from heartburn, a liquid antacid preparation can be helpful; ask your doctor for advice on which medications are safe. Some women find that slowly drinking a glass of milk eases the discomfort. Constipation During the second trimester, constipation often becomes a problem.
CAUSES:
Under the influence of the softening effect of pregnancy hormones, the digestive tract becomes less active. As a result, fecal matter spends more time in the large intestine, allowing reabsorption of fluids and leaving solids hard and difficult to pass. Not drinking enough fluids increases the likelihood of constipation.
WHAT TO DO?
Dietary fiber in the form of vegetables and whole foods, with an increase in fluid intake usually corrects the problem. Laxatives are not recommended during pregnancy. They can stimulate contractions and lead to dehydration. Talk to your doctor if these steps don’t resolve your constipation.
Hemorrhoids:
Hemorrhoids are dilated blood vessels around the inside of, or protruding from, the anus. Their constriction by the anal muscles and sensitivity to the acidic environment leads to a feeling of discomfort in mild episodes and pain in more severe cases. They are more likely to occur during the third trimester.
CAUSES:
The hormonal softening of the tissues around the anus increases the risk of developing hemorrhoids. Pressure of the baby’s head on the blood vessels is also a factor, as is constipation.
WHAT TO DO?
Treatment of constipation and avoiding pushing or straining to pass a stool are important in the prevention of hemorrhoids. Ask your doctor which over the- counter creams for relieving discomfort are safe. If hemorrhoids are protruding and causing great discomfort, it’s often possible for a health professional to “reduce” them by pushing them gently back into place.
Heart & circulation problems:
Dizziness and faintness:
Throughout pregnancy, occasional dizziness or feelings of faintness can be a problem.
CAUSES:
In early pregnancy, feeling faint may occur even when you are sitting down and is likely to be due to low blood sugar. This can happen as a result of not eating enough, a common problem at this stage of pregnancy when many women suffer from morning sickness. In the second trimester, dizziness or faintness that comes on when getting up from a sitting position or as a result of standing for long periods is likely to be caused by low blood pressure.
Blood pressure is lowered in pregnancy because the pregnancy hormone progesterone softens blood vessels to enable blood to flow more freely to your baby. When you stand, the low blood pressure may mean that not enough blood reaches your brain, leading to dizziness and faintness. As pregnancy advances, you may find that you feel dizzy lying on your back. This happens because in this position the heavy uterus puts pressure on the main blood vessels running through the trunk and reduces the blood flow to the brain.
WHAT TO DO?
To help prevent low blood sugar, have small snacks of foods high in complex carbohydrates. Staying well hydrated, taking regular breaks from work, not standing in one position for too long, and getting fresh air are also helpful in preventing faintness. If you start to feel dizzy, sit down and put your head between your legs, which will relieve the unpleasant feeling. Stay seated until you feel completely recovered and then get up slowly. Any time you feel dizzy or faint, call your doctor immediately, especially if you also have stomach pain, vaginal bleeding, blurry vision, headaches, or heart palpitations, or the dizziness is persistent. If you have fainted and bumped your head or injured any part of your body then you should go to the hospital for a checkup. If you experience dizziness when lying on your back, turning onto your side will quickly help you feel better. Lying on your left s