You Ask , They Answer
Q
: What are the most common problems associated with pregnancy and when should women see a doctor to check them ?
A
: Pregnancy changes take place week by week , physically as well as emotionally . Each week has new changes , new signs , developments , and its own complications . Every pregnancy is different , so are the changes and e�periences .
Some of the common early signs , even before a positive pregnancy test , include raised body temperature , breast tenderness / pain , and increased sensitivity to smell . Some mothers will feel tired and lose energy ( pregnancy fatigue ).
Some women will have light vaginal bleeding or spotting around the time that you would expect their periods . It ’ s known as implantation bleeding and is very normal . While others might have an increase in vaginal discharge , thin milky white discharge is normal .
Early pregnancy bloating is also a sign pregnant mothers notice before missing their periods . Bloating and constipation usually occur in early pregnancy due to changes in the hormones . There ’ s also heartburn and indigestion in the early weeks . Most of these symptoms are due to the hormone progesterone that ’ s very important to maintain the pregnancy . Constipation can also be due to consuming iron supplements early in pregnancy .
Morning sickness and vomiting usually appears at about �-� weeks after the last period , sometimes earlier . There ’ s also food aversion during the early stages of pregnancy . Most of these symptoms are due to the increase in the pregnancy hormones . There is also excessive salivation ( ptyalism gravidarum ).
By the fifth week , some will also present with an increase in frequency of micturition ( urination ) and an increase in urgency or even urinary tract infections ( UTI ). This is mainly due to delays in bladder emptying or an increase in overall body �uids that leads to extra pressure on the bladder .
Having regular and early antenatal checkups will ensure proper growth of the baby and a healthy pregnancy .
Q
: Which are the safest medications women could take to manage these problems ?
A
: Although some medicines are considered safe during pregnancy , the effects of other medicines on the unborn baby are unknown . Certain medicines can be most harmful to a developing baby when taken during the first three months of pregnancy , often before a woman even knows she is pregnant .
Safe medications that can be taken in the first trimester include Paracetamol , Promethazine ( anti-vomiting ), antacids ( gastritis ), fibres ( constipation ), and vitamin B� , which help with nausea and vomiting during pregnancy . All pregnant women should be on folic acid and prenatal vitamins throughout their pregnancy .
Some of the medications below , however , should be avoided as they can have an impact on foetal development :
1 . Vitamin A derivatives such as isotretinoin which is commonly used to treat acne can cause birth defects . Antibiotics such as doxycycline that ’ s commonly used to treat acne is also not recommended .
2 . Prolonged usage of antifungal medication is not recommended . However , single usage of Fluconazole 150mg to treat vaginal yeast infection has not been found to produce any abnormalities .
� . Antihistamines , commonly taken for �u and nasal congestion , are not categorised under the “ safe to take during pregnancy ” list . The guidelines do recommend chlorpheniramine , cetirizine , and loratadine as safe options after the first trimester .
4 . Psychiatric medications such as Benzodiazepines have been shown to have an effect on foetal development .
5 . Blood thinning medications , like Warfarin , used to treat and prevent blood clotting in the heart and veins can cause a rare condition called Foetal Warfarin Syndrome . This causes miscarriages .
� . NSAI�S and anti in�ammatory drugs ( pain killers ) should be avoided during all stages of pregnancy .
7 . Anti-malaria medication is also not recommended during pregnancy . They cause foetal anaemia .
Dr Somaskandar Sivasuntharam
Dr Somaskandar Sivasuntharam is a specialist in obstetrics and gynaecology at Gleneagles Hospital Penang .
12 ISSUE 6 | 2023 GlobalHealthAsiaPacific . com