"Doctor, I have been inflamed in my tonsils. I have been eating Azithromycin these days. I just found that I am pregnant. Can this child still ask now?"
"Doctor, I have been allergic some time ago. I have eaten chlorine for two weeks. Will I have an impact on the fetus? I am almost 40 years old this year.
I injected botulinum toxin 2 months ago, and now I am 1 month of pregnancy. Can this child want it?
Doctor, I took a breasts two days ago. Can I still prepare for pregnancy this month?
For pregnant women, getting sick and taking medicine seemingly simple, it has become the biggest problem!
As an obstetrician and gynecologist, I often encounter such problems: relatives and friends around me often ask "I am pregnant, can I use the medicine when I get sick?", "I don’t know that I am pregnant.Can children still ask? "Wait, we come to study how to take medicine during pregnancy today.
1. The basic principles of pregnant women use drugs
The following principles need to be followed during pregnancy:
① The medication must have clear indications to avoid unnecessary medication;
② According to the condition, use effective and relatively safe drugs for the fetus under the guidance of the doctor;
③ Should choose a separate medication to avoid combined medication;
④ Drugs that should be more positive for conclusions should be selected;
⑤ Strictly grasp the dosage and duration of medication, pay attention to stop the drug in time;
⑥ In early pregnancy, if the condition allows, try to postpone the reuse of the middle and late pregnancy.
2. In different periods of pregnancy, the effect of drugs on the fetus
Drugs can affect the mother’s endocrine and metabolism, indirectly affect the fetus, and can also directly affect the fetus through the placenta barrier.The most severe drug toxicity is to affect embryonicization and development, leading to fetal malformations and dysfunction, which is closely related to the age of fetal age when medication.
Early early in bed: It is a period when the egg is fertilized to fertilized eggs in the period before the endometrium.The fertilized eggs in this period have not been directly contacted with the mother tissue, and they are still in the ovary or uterine secretion.Only by. If the drug is extremely toxic for the blastocyst, it can cause extremely early abortion.
The effect of drugs on the embryo during this time is "all or nothing."Full: Drugs have an impact on embryos. If the drug toxicity is enough to cause a large amount of necrosis of embryo cells, it may cause embryo death and abortion.Fetal malformations can continue to differentiate and grow into normal babies.
After the bed in the late stages of the bed to about 12 weeks: It is the teratogenic period of the drug. It is a stage when the embryo and the organ of each fetus are highly differentiated, rapidly developing, and constantly forming.wait.At this time, pregnant women’s medication, the toxicity of the toxicity interferences the normal differentiation of embryos and fetal tissue cells. The cells in any part of the cells are affected by the toxicity of the drug, which may cause tissue or organs in a certain part to cause deformities.The earlier the toxicity of the drug, the more severe the deformity occurs.
After 12 weeks of pregnancy until childbirth: the organs of the fetus have been formed, and the teratogenic effect of drugs has weakened significantly.However, some drugs may have an impact on it, such as reproductive systems, such as reproductive systems, and the nervous system can always exist on the effects of the nervous system due to the continuous differentiation and development of the nervous system during the entire pregnancy.
3. The characteristics of metabolism of maternal drugs or compounds during pregnancy
(1) Absorption: Affected by the level of females and progesterone during pregnancy, the tension of the digestive system decreases, the power decreases, and the gastrointestinal peristalsis slows down, making the absorption more complete.In addition, early pregnancy and vomiting can also affect the absorption of oral drugs.If you need to play quickly, injection should be used.
(2) Distribution: Starting from early pregnancy, the blood capacity has gradually increased, the peak of 32-34 weeks of pregnancy and continuous delivery, the drug distribution volume increases, and the concentration of the blood drug decreases.
(3) Drug metabolism: Due to the changes in hormones, the increase in the volume of the fetus, the increase in liver load of women during pregnancy, the increase in drug metabolism, and different effects of different drugs, which is currently no conclusion.
(4) Expedition: Starting from early pregnancy, kidney blood flow and glomerular filtration rate have gradually increased, which accelerates the excretion of the drug through the kidneys and shorten the drug in the half -life of the drug.
Fourth, the transfer and metabolism of the drug in the placenta
The placenta, which is completely formed around 12 weeks of pregnancy, can play a role in the placenta barrier.Therefore, the risk of medication was greater before 12 weeks.Under normal circumstances, drugs with high fat -soluble, small molecular weight, and high degree of ionization are prone to through the placenta barrier.
Fifth, the characteristics of pharmaceutical dynamics in the fetus
The fetal lungs are not open, so the fetal lung cycle is very low.The fetal brain has a large amount of blood circulation. Once the drug enters the fetus, it has a greater impact on the fetal brain.
Common issues of examples are:
Q: Can the baby get pregnant when taking emergency contraceptives?
A: At present, a large amount of data studies have shown that taking emergency contraceptives such as Yuting does not increase the malformation rate of this pregnancy fetus. Therefore, pregnant mothers do not need to terminate pregnancy because of taking this medicine.
Q: Without knowing pregnancy, I took a breasts/CT once, can the baby still want now?
A: X -rays are divided into harmful doses, therapeutic dosage, damage dosage and mortality dosage.Generally speaking, the maximum dose of the fetus received X-ray is 5000 mm RAD, while the pregnant mother’s single-chest X-ray tirled fetal receiving radiation amount is 0.02-0.07 mm RAD. It takes more than 7,000 times to exceed the standard.The radiation amount of a single abdomen and pelvic X -ray tirled fetus is 100 mm RAD.The single dose of the abdomen is 2.6rad, which exceeds the standard 2 times.
However, if you take 10,000 steps, you have n’t used any medicine during pregnancy. His habits and a happy mood. There are still pregnant women who have a problem with problems, but what is the reason, the doctor does n’t know how to answer. Science is always a one.No bottom hole!
Therefore, once you find that he is pregnant, smart pregnant women should do this:
(1) Remember your last menstrual period, remember how long it takes to start using the medicine someday;
(2) In order to save medical resources, try to go to the hospital as soon as possible with the manual;
(3) Listen carefully to explanations and weigh the advantages and disadvantages;
(4) The blood HCG should be dynamically monitored, the B -ultrasound should be reviewed regularly, and the production inspection work should be done;
(5) Doctors cannot make a decision for you, and the final decision -making power is in the hands of you and your family!