Pregnancy brings about significant hormonal changes, resulting in a weakened immune system and an increased risk of infections. Many women find themselves taking antibiotics during the first one to two weeks of pregnancy, before realizing they are pregnant. What should they do in this case?
1. Is Taking Antibiotics Risky Before Confirming Pregnancy?
As a woman enters pregnancy, her immune resistance decreases, making the risk of infections more likely to happen. Antibiotics are crucial for treating bacterial infections effectively. However, when antibiotics are taken during the first one to two weeks of pregnancy, some pregnant women concern about the medication's potential impact on fetal development.
It’s important to know that pregnancy is divided into three stages:
The first stage: lasts about two weeks (pre-embryonic period).
The second stage: lasts from two weeks to the end of the second month (embryonic period)
The third stage: the remaining duration of the pregnancy.
If antibiotics are consumed during the pre-embryonic period (one to two weeks after conception), there is a serious risk of miscarriage or fetal death. If the pregnancy progresses beyond this stage, the likelihood of birth defects diminishes.
Any pregnant woman who takes antibiotics during the first stage should prioritize regular antenatal check-ups to closely track fetal development. Important pregnancy check-up milestones include weeks 11-13 and 18-22, where various screenings for potential congenital defects can be conducted.
At weeks 11 - 12, ultrasound helps detect serious congenital defects such as anencephaly (brainless fetus) and screen for Down syndrome by measuring the nuchal fold thickness and performing the PAPP-A test. At weeks 20 - 22, ultrasound helps fully evaluate the organs of the fetus. In addition, pregnant women should use other diagnostic tests such as: Biochemical tests, amniocentesis tests,...
2. Guidelines for Medication Use During Pregnancy
During the first trimester, it is critical that pregnant women refrain from using unnecessary medications. Additionally, women should avoid medications in the second half of the menstrual cycle, from ovulation until menstruation, due to the high possibility of conception. Some medications have slow elimination rates from the body, leading to potential risks if a pregnancy occurs after their use.
In the later stages of pregnancy, minimizing medication intake remains essential. Opt for non-pharmacological approaches for common ailments. For example, massage for headaches, and relaxing instead of taking pain relievers. Pregnant women who are constipated should drink plenty of water and eat lots of fruits and vegetables instead of taking laxatives. While some medications may be deemed safe, limiting their use is the best practice to protect the fetus.
Should medication be necessary, pregnant women must consult with their healthcare professionals, who will assess the risks and prescribe the lowest effective dose for the shortest duration to mitigate potential harm to the fetus.
A woman who takes antibiotics during weeks 1-2 of pregnancy should notify their healthcare professionals to regularly follow up.
3. Medications Pregnant Women Must Avoid
Certain medications pose a higher risk to fetal health, and it is imperative for pregnant women or those planning to conceive to avoid them:
Tetracyclines may damage tooth enamel: Tetracyclines are commonly used to treat diarrhea caused by cholera, dysentery, E. coli infections, or other gastrointestinal infections. These antibiotics may severely damage tooth enamel in children if taken after the 7th month of pregnancy, resulting in discolored or stained teeth.
Quinolone antibiotics may damage cartilage: This category of broad-spectrum antibiotics is very effective in combating bacteria in the urinary and reproductive systems. However, there is a risk that these antibiotics can lead to bone and joint issues in children. If a mother takes quinolone antibiotics while pregnant or breastfeeding, the child may absorb the antibiotic, resulting in a higher concentration within the child's body. Consequently, the child’s bones and cartilage may not develop properly, potentially causing the Achilles tendon to rupture. The child might then struggle to walk, with their feet remaining in a folded position. Even children under 10 years old who take this antibiotic may experience similar adverse effects due to its detrimental impact on bones and cartilage.
Aminoglycoside antibiotics can lead to permanent hearing loss: Commonly used to address abdominal infections, ear-nose-throat infections, meningitis, and pneumonia. Aminoglycoside antibiotics can also be found in eye drops. Pregnant women or those planning to conceive should avoid them, as they can result in kidney damage and are harmful to the inner ear of the fetus, leading to irreversible hearing loss.
Biseptol may cause severe anemia: This essential broad-spectrum antibiotic is utilized for treating gastrointestinal infections, diarrhea, and E. coli infections. Pregnant women should not take this medication, as it can lead to significant anemia in the mother and malnutrition for the fetus.
Ketoconazole: Recent FDA warnings highlight the risks associated with high doses of ketoconazole (400-800 mg/day) in pregnant women, especially during the first trimester, as it can result in congenital defects. These defects may include brachycephaly, facial anomalies, cleft lip and palate, abnormal skull formation, thin ribs, femoral deformities, joint stiffness, congenital heart defects,... This risk does not apply to those taking a single dose of 150 mg/day for vaginitis treatment. Consequently, pregnant women, particularly in the first trimester, should refrain from using ketoconazole unless prescribed by a doctor in critical situations.
Other drug classes: Medications for hypertension, anticoagulants, cancer treatments, and high-dose vitamin A derivatives should prompt women to wait three months after usage before trying to conceive to ensure the safety of the developing fetus.
In conclusion, if you have taken antibiotics during early pregnancy without realizing it, promptly consult your healthcare professionals for thorough monitoring and necessary evaluations. Keeping informed and vigilant is crucial for both your health and the healthy development of your baby.
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