Most medications used during pregnancy are considered safe or some cannot be given a clear explanation because of limited information. I do not recommend that pregnant women give up their babies so easily because they don’t know they are using medication during pregnancy. The reasons are as follows! Teratogenic studies: we know very little There are very few drugs that are clearly teratogenic because it is impossible to have information on pregnancy use for all drugs. And it is also difficult to summarize this information because some defects are not necessarily apparent around the time of birth of the fetus. For example, unless the relationship between a drug and a childhood tumor is a rare tumor, and then the drug is traced back to use during pregnancy so as to summarize the correlation between the disease and the drug used during pregnancy; if the tumor is a common one, it is likely that it will not be taken seriously at all. The drugs that are more clearly known to cause malformations or have a greater impact are mostly chemotherapeutic drugs, or hormonal drugs. In addition, at present, the study of the effect of drugs on the fetus is still confined to the structural abnormality of the fetus caused by drugs. The effects on “fetal intelligence”, “organ function”, or later “sexual orientation”, social skills are even more impossible to talk about. And people metabolize drugs differently. What I want to say is that we know very little about the effects of drugs on the fetus. Nowadays, many people are worried about the effect on the child’s intelligence, in fact, I think this is all hearsay, why don’t you worry about the effect on the child’s “sexual orientation” or “social skills”. Because a lot of people only hear about intelligence, and “sexual orientation” is something that you don’t think about, but drug research organizations are concerned about, but it’s just as difficult to do as it is to assess intelligence. What do you think is the best way to assess intelligence? IQ? Intelligence? It’s difficult for an adult, not to mention a fetus! The biggest difference between taking medication and drinking water is the dose. One of the main ideas about medication and malformations during pregnancy is that “any drug or substance can cause malformations in the fetus, including the water we drink every day. But it’s related to the dose you ingest, and it’s unlikely that you’ll drink water at a teratogenic dose.” This is translated from a foreign language, and I like it because he’s being objective. Drugs are the same way, it usually takes more than a dozen or a few dozen times the regular dose to show the possibility of causing malformations, and even then they are not absolutely teratogenic. The vast majority of drugs are safe at regular doses. Caffeine, for example, is a popular saying that you can’t drink coffee or tea during pregnancy because it contains caffeine. Caffeine does have a well-defined teratogenicity, with an increased incidence of fetal limb and palate malformations observed in experiments with pregnant mice and rats. Fetal deaths, growth retardation and skeletal abnormalities have been seen at higher doses of caffeine exposure. In primates, an increased incidence of stillbirths and miscarriages was also observed in the offspring of crab-eating female monkeys exposed to caffeine during pregnancy. In humans, however, caffeine has not been reported to cause birth defects in fetuses because it is unlikely that a person would drink hundreds of cups of coffee a day, yet in animal studies, monkeys were exposed to a much higher dose of coffee than a normal person would consume every day. In other words, “just because caffeine is teratogenic does not mean that drinking coffee is teratogenic.” Whether a drug is teratogenic or not has a strong correlation with the dose used. Usually a drug is considered a potent teratogen if it can produce toxic effects on the embryo at less than 10 times the regular dose. Therefore, drugs that pose a potential risk to the fetus must be used at doses 10 or even dozens of times the recommended dose for conventional human use. The “all or nothing” theory Whether you take the drug before ovulation or after ovulation, and secondly, the teratogenicity of the drug has a lot to do with the period of time in which you use the drug. If a fertilized egg has already formed and is implanted when you use the drug, this is when the embryo has access to body fluids, which may have an effect on the embryo. However, in the early stages there are very few fertilized egg cells, so if an undesirable stimulus such as a drug or radiation affects the embryo, the embryo will die and miscarry. If the embryo survives, it is considered unaffected, which is the current “all or nothing” theory of drug teratology. If the drug is administered before ovulation or implantation, it is currently considered to have no effect because the fertilized egg is not formed or does not come into contact with body fluids. Unless the drug has a long half-life and takes a long time to metabolize cleanly in the body. Fertilized egg contact with body fluids is often not possible until after 7 to 10 days after ovulation. FDA Drug Classification There are many more deficiencies and flaws in one of the worst drug teratology incidents in human history, the “Reaction Stop Incident.” Reactivator (a drug) was applied to pregnant women who had a significant reaction to early pregnancy, and about one-third of the babies born eventually developed physical defects. It was only because of the “Reactivation Incident” that people began to pay attention to the safety of medications used during pregnancy. The U.S. Food and Drug Administration (FDA) began to require all drugs to be labeled with studies of fetal teratogenic risk. A hierarchical evaluation system, the FDA classification, was established to categorize drugs into five categories: A, B, C, D, and X. Drugs in categories A and B are classified as “A” and “B” drugs. Drugs in categories A and B are relatively safe to use during pregnancy, and drugs in category X are contraindicated during pregnancy. drugs in categories C and D should be used when the pros and cons outweigh the cons. Many of our pregnant women are now aware of the FDA classifications through internet knowledge. Sadly, many of our medical professionals only know the FDA classification. In fact, there are many deficiencies in the FDA classification, some of which are only based on “a few case reports” or “limited animal experimental data”, and the update time is slow, may not be suitable for counseling pregnant women. For example, common oral contraceptives are categorized by the FDA as “Class X” prohibited during pregnancy. I’m sure experimenting on animals during pregnancy may induce malformations, but humans use emergency contraceptives around the time of ovulation or before fertilization of the egg, so who’s going to go on the pill when they know they’re pregnant? Right now there are no reports of fetal teratogenicity from the use of oral contraceptives. In fact, in addition to the FDA classification in foreign countries there are many standards for classifying the safety of drugs. For example, Wayne State University’s teratogenicity rating system. The system categorizes oral contraceptives into a very small risk of teratogenicity. The FDA categorization of proprietary Chinese medicines, which are not obviously effective in curing diseases, not to mention teratogenicity, has many deficiencies and needs to be changed. The Chinese government has directly adopted the existing FDA classification without making any effort on its own. We can take a look at proprietary Chinese medicines (pCms), which are three times more likely to be poisonous, so what makes us so sure that pCms do not pose a risk of teratogenicity. The instructions for proprietary Chinese medicines either prohibit, use with caution, or have no relevant data. Those that are banned and those that are used with caution do not state the reasons and provide data from animal experiments. As for the pCms issue, if you use them and the instructions say they are prohibited, I would also suggest that you don’t worry too much. The prohibition mentioned above is often due to the fact that there are some blood-activating ingredients in proprietary Chinese medicines, and from the perspective of Chinese medicine, the use of medicines with blood-activating ingredients during pregnancy may increase the risk of miscarriage, and is therefore not recommended or prohibited. The prohibition here does not mean that it has serious teratogenic risks. In fact, another point of view, pCms are more mild, many pCms themselves are not good, just the Chinese people think easy to accept, in fact, many drugs in foreign countries are not recognized. The effect of the cure is not obvious, not to mention teratogenic. For example, Cordyceps Sinensis we all know that this herb is very good, but made into a proprietary medicine after the effect of how do not know. Kimchi, monosodium glutamate (MSG), computer radiation and so on, you think too much, in addition, there are patients have asked me: pregnant eat MSG on the child has an impact? Eating kimchi has an effect on the child? Will taking pictures with a camera affect the baby? Can I turn on the flash when I’m pregnant? There is no data on the teratogenicity of MSG and kimchi in the books, nor is there any hint of it in the manuals. From the point of view of protecting the fetus, we should be less exposed to drugs and semi-processed food during pregnancy, or some food additives, but there is no need to be exposed to the nagging can not be self-conscious, and is even now misunderstood as exposure to the child will have problems. The Chinese are still worried that computer radiation is bad for children. The World Health Organization’s information is this way, so far there is no evidence to show that computer radiation increases the rate of miscarriage, but engaged in computer work of pregnant women is an increase in the rate of miscarriage, the main consideration because of the long hours of work in the computer highly concentrated, resulting in back pain, fatigue, runny nose and other symptoms of colds and flu increased the risk of miscarriage, so in foreign countries recommended that pregnant women engaged in computer workers work no more than 6 hours a day, and Often get up and change position. I think radiation protection clothing only in China has a consumer market, if in foreign countries will be involved in commercial fraud was prosecuted. In addition to medicine, there are many social problems I have witnessed many very sad stories. Because pregnant women use a little bit of drugs during pregnancy, do not yet know whether the drugs have an impact on the fetus, or even for example, amoxicillin, cephalosporins and other drugs that can be used during pregnancy. An abortion was then performed. I would like to say, “This is your baby”. Some medical personnel are also advising patients to abort their babies, and this is something that pains me. In my opinion, some medical personnel advise pregnant women to abort their babies for the following reasons. First of all, because maternal-fetal medicine is developing slowly in China, there is still no registration for geneticists to practice. The patient may have found some obstetricians and gynecologists who specialize in obstetric and gynecological surgery. Theoretically, the patient may be explained by “lack of communication experience and skills”. Furthermore, the doctor-patient conflict in China is too complex, and the government does not protect medical personnel enough. When counseling patients about medications during pregnancy, they take a great deal of risk. In the patient’s view, the process of consulting a doctor about medication during pregnancy and the doctor giving an answer is simple. But often the patient asks the question in a way that embarrasses the medical staff, “Do you think there is something wrong with my baby?” There are many patients who come to the clinic in early pregnancy who haven’t even seen a fetal heartbeat yet, and it’s important to realize that the spontaneous abortion rate in early pregnancy is 15 percent. Putting it into perspective, the question is actually a risk transfer in the eyes of the medical staff. Who dares to say there is no problem? It is recommended that you do away with it, and the baby dies without evidence. If you are not advised to do it, who will be responsible for any problems? Or simply say, this may or may not be a problem, which is very vague and puts the risk back on you. The numbers doctors really care about Given the unreliability of the limited data from teratogenicity studies of medication use during pregnancy, and the unpredictability of the risks of individualized medication regimens. I believe that the scope of medication and teratology counseling during pregnancy should be limited to situations where long-term, high-dose use of medications during pregnancy is required due to maternal conditions such as “epilepsy, gestational hypertension, diabetes mellitus, thyroid disorders, and rheumatologic disorders,” rather than the use of a medication in a regular dose before conception, before and after ovulation, on an occasional basis or on several occasions, the use of topical medications, or the use of a medication by the male partner, or the use of a medication by the male partner. Topical medications, or male medications, etc. There is no way to say whether or not the medication or adverse factor had an effect on the embryo in these cases, and in fact there is no basis for doing so. When you asked me around the 30th day of pregnancy whether the occasional inadvertent use of medication had an effect on the embryo, the following figures appeared in my eyes: you are facing a 15% spontaneous miscarriage rate inherent in nature because of your pregnancy, a 2% ectopic pregnancy incidence rate, a 3~5% birth defect rate in nature, which includes a 1/700 Down’s syndrome (Trisomy 21, mental retardation) birth rate, a 1/700 Kirschner’s syndrome (Trisomy 21, mental retardation) birth rate for baby boys, a 1/700 Kirschner’s syndrome (Trisomy 21, mental retardation) birth rate for baby boys, and a 1/700 Kirschner’s syndrome for baby boys. 700 birth rate of Crohn’s sign (47, XXY, infertile), and so on. I would like to conclude with a message to all of you: “Do good deeds, don’t ask questions”.