I often come into contact with these two types of pregnant mothers: one type of pregnant mothers are very concerned about the use of drugs during pregnancy, and even refused to take all the drugs, so that they miss the condition. For example, patients with hypertension, diabetes, asthma and other long-term chronic diseases, if the disease is not well controlled during pregnancy, it will not only bring great harm to the pregnant mother, but also cause great danger to the fetus. All of these patients, even during pregnancy, need to take medication to control them, and they need to take the medication under the guidance of a professional doctor, not only the professional guidance of obstetricians and gynecologists, but also need to receive guidance from other specialists. Therefore, pregnant mothers with this kind of long-term chronic disease must see doctors of different specialties at the same time to control their own diseases. Another category of pregnant mothers choose to use drugs and blindly, leading to irrational use of drugs, resulting in fetal malformation or miscarriage, bringing great harm to their physical and mental health. Pregnant mothers who are sick must see a doctor, who will balance the risks and benefits of using drugs. First, determine whether the disease can heal itself without medication. If not, whether the benefits or risks of taking the medicine are greater for the pregnant mother and the fetus, and then decide what kind of medicine to use. Of course, in the reality of the medical environment, some doctors are afraid of liability, and may fall into the misunderstanding of “left” rather than “right”, and do not prescribe any medication to pregnant mothers. But the fact is, for some sick pregnant mothers, not using drugs is not the best choice, reasonable and safe use of drugs is the best treatment program. Grasp three points to avoid the hidden dangers of medication during pregnancy In order to ensure that the use of drugs is reasonable and safe, pregnant mothers should follow the following three principles: First, in the first three months of pregnancy should try to avoid the use of any medication There is no drug on the fetus is absolutely safe, only when the benefits of drugs for pregnant mothers is greater than the risk of the fetus can be considered to use this drug. In addition, the first three months of pregnancy is the sensitive period of fetal development, is the fetal body tissues and organs of the differentiation stage, the most susceptible to the influence of drugs, so this period should try to avoid the use of any drugs. Secondly, when drugs must be used as a last resort, safe drugs with long clinical use should be chosen as far as possible Emphasis on “long clinical use” is because the effect of drugs on the fetus may be different from that expected to occur in the pregnant mother, and this difference can only be discovered after long-term clinical use. For example, thalidomide (commonly known as reactive arrest), a drug that was initially marketed as an antiemetic in early pregnancy, can cause multiple limb malformations in the fetus. Reactivation was used as an antiemetic in clinical practice for a long period of time, resulting in the birth of a number of babies with arms and legs shaped like seals, before the teratogenic effect of this drug was discovered. The emphasis on “safe” refers to the use of medications that are rated A or B by the FDA for safety during pregnancy. Current references for medications used during pregnancy are based on the FDA’s safe pregnancy drug classifications. The FDA provides five levels of safe medications for use during pregnancy: Level A refers to medications that have been shown to be safe in both animal and human testing; Level B refers to medications that have been shown to be safe in animal testing or unsafe in animal testing but safe in human testing; Level C refers to medications that have been shown to be unsafe in animal testing but have not been tested in humans; Level D refers to medications that have been shown to be hazardous to the fetus in human testing but can be considered for use if the mother has a serious medical condition; and Level D refers to medications that have been shown to be harmful to the fetus in human testing but may be considered for use if the mother is seriously ill. Class D refers to drugs that have been shown to be harmful to the fetus in human trials, but may be considered for use when the pregnant mother has a serious medical condition; Class X refers to drugs that are contraindicated. There are fewer drugs in Class A, including levothyroxine, folic acid, and multivitamins during pregnancy; Class B drugs include penicillins and cephalosporins. More than 60% of the medications are classified as Class C, which are drugs for which harm cannot be ruled out, but for which the potential benefits outweigh the potential harms. However, for serious conditions, the pros and cons of using a D-rated drug during pregnancy should be weighed, such as phenytoin, which is used to treat epilepsy. X-rated drugs should never be used during pregnancy. There are not many commonly used drugs in this category. For example, the sex hormone caprylestrol, which used to be widely used in the early 1950s for the treatment of preterm miscarriages, was classified as a Class X drug when it was found that some of the girls born had vaginal adenopathy or clear-cell carcinoma of the vagina in their subsequent growth. From this we can also see that pharmacy is a science of constant updating and revision. A drug that has been used routinely in the past can only be found to be potentially harmful after it has been used extensively, and then it will be modified to take into account the latest clinical findings, and the drug’s classification as safe for use during pregnancy will be modified accordingly. For example, the most recent revision made by the FDA was on the use of magnesium sulfate injections for fetal preservation. According to the adverse reaction data collected by the FDA, continuous use of magnesium sulfate injections by pregnant mothers for more than five days could result in damage to the bones of the developing fetus. Accordingly, the U.S. Food and Drug Administration will be magnesium sulfate injection of pregnancy safety classification from the original quite safe A level to the possible teratogenic D level. For example, acetaminophen, which is widely used to reduce fever and relieve pain during pregnancy, is classified as level B in the FDA’s pregnancy safety classification. It is safe to use during pregnancy if the minimum effective dose of 500 mg is used each time the drug is used, and if the drug is taken only when there are symptoms and not when there are no symptoms. If the drug is used in excess of 1,000 mg per dose or in large quantities over a long period of time, it may affect the fetus, and there have been reports in the literature of neonatal renal failure in pregnant mothers who have taken large quantities of acetaminophen over a long period of time. Penicillin, cephalosporin antibiotics can often be used during pregnancy In addition to some of the long-term chronic illness of pregnant mothers need to use drugs under the guidance of a doctor, some acute infectious diseases during pregnancy sometimes have to use drugs. Microblogging on the netizen asked me: “I’m 4 months pregnant, coughing cough stomach ache, talking gas, had to see a doctor, prescribed some medicine (seems to be called amoxicillin), said that do not take the medicine on the baby has an impact, had to listen to the doctor’s words to eat, and now worried about the death of the teacher, ask Ji, can use antibiotics during pregnancy? Does it affect the baby?” Re-emphasize, antibiotics are drugs to treat bacteria as well as mycoplasma and other pathogenic infections, if the doctor clearly diagnosed your disease must be treated with antibiotics, be sure to tell the doctor that you are in a pregnant woman, so that the doctor can prescribe antibiotics that can be used during pregnancy. Amoxicillin belongs to the penicillin group of antibiotics and is classified as a Level B antibiotic in the FDA’s Pregnancy Drug Safety Classification, which makes it a widely used antibiotic during pregnancy. In addition to penicillin, cephalosporins are also classified as B antibiotics. If you are allergic to penicillin or cephalosporins, your doctor may consider prescribing azithromycin or clindamycin, which are also classified as B antibiotics. These are all antibiotics that can be used during pregnancy. Special attention should be paid to antibiotics that should be avoided during pregnancy. Tetracycline antibiotics should be avoided during pregnancy. The most commonly used antibiotic is doxycycline. This type of drug passes through the placenta and may accumulate on the teeth of the fetus, which can lead to discoloration of the teeth, so it should be avoided during pregnancy. In addition, aminoglycoside antibiotics should also be used with caution. These antibiotics are mainly streptomycin and amikacin, which are ototoxic and damaging to the fetal auditory nerves, and may lead to deafness in the baby born. Like the deaf and mute dancers in the dance “Thousand Hands of Goddess of Mercy” that we have seen on the CCTV Spring Festival Gala, the vast majority of them were deafened as a result of using streptomycin and such drugs as a child. There are also babies whose ear nerves have been damaged and who need cochlear implants, and the drugs that are most likely to cause damage to their ear nerves are also aminoglycoside antibiotics.