![]() ![]() University of Toronto, The Hospital for Sick Children, Motherisk Program (medication summaries membership required) Organization of Teratology Information Specialists (medication reference for physicians, membership required) ![]() (information for physicians and patients more current than U.S. (medication summaries, used by most pharmacies, membership required) (facts sheets for patients link to LacMed, a database of medications that might be used during lactation) Because of the expanding OTC market, formalized studies are warranted for patients to make a safe and informed decision about OTC medication use during pregnancy.Ĭenters for Disease Control and Prevention All OTC medication use should be discussed with patients, and the effects of the symptoms should be balanced with the risks and benefits of each medication. Topical creams are considered safe based on small studies and previous practice. Ginger is considered safe and effective for treating nausea in pregnancy. There is even fewer data regarding use of individual herbal supplements. Nonsteroidal anti-inflammatory drugs are generally not recommended in pregnancy, especially during organogenesis and in the third trimester. Histamine H 2 blockers and proton pump inhibitors have not demonstrated significant fetal effects. Many gastrointestinal medications are now available OTC. Cold medications are also commonly used and are considered safe for short-term use outside of the first trimester. Acetaminophen, which is used by about 65% of pregnant women, is generally considered safe during any trimester. Most OTC medications taken during pregnancy are for allergy, respiratory, gastrointestinal, or skin conditions, as well as for general analgesia. Food and Drug Administration began reviewing all prescription and OTC medications to develop risk categories for use in pregnancy. ![]() Most data come from case-control and cohort studies. Pregnant women who have severe vomiting may require hospitalization, orally or intravenously administered corticosteroid therapy, and total parenteral nutrition.Many pregnant women take over-the-counter (OTC) medications despite the absence of randomized controlled trials to guide their use during pregnancy. Several medications, including pyridoxine and doxylamine, have been shown to be safe and effective treatments. Women with more complicated nausea and vomiting of pregnancy also may need pharmacologic therapy. Initial treatment should be conservative and should involve dietary changes, emotional support, and perhaps alternative therapy such as ginger or acupressure. Once pathologic causes have been ruled out, treatment is individualized. Physicians should carefully evaluate patients with nonresolving or worsening symptoms to rule out the most common pregnancy-related and nonpregnancy-related causes of severe vomiting. ![]() Unlike morning sickness, hyperemesis gravidarum may have negative implications for maternal and fetal health. A small percentage of pregnant women have a more profound course, with the most severe form being hyperemesis gravidarum. Nausea and vomiting of pregnancy is generally a mild, self-limited condition that may be controlled with conservative measures. Recent research has implicated Helicobacter pylori as one possible cause. Although several theories have been proposed, the exact cause remains unclear. Nausea and vomiting of pregnancy, commonly known as “morning sickness,” affects approximately 80 percent of pregnant women. ![]()
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