People often ask about the use of a certain drug in early pregnancy and wonder if it will have any effect on the baby. First of all, I advise the person to read the drug instructions in detail, whether the drug is prohibited for pregnant women, cautious for pregnant women, etc.. If it is prohibited, try not to use it during pregnancy, and if it is used with caution, try to use it under the guidance of an obstetrician and gynecologist. If you have already used the drug, you have to recall the exact last menstrual period, the time of intercourse, the time of medication, and determine the time range of medication in the pregnancy week. The risk of fetal miscarriage and malformation increases after the use of certain teratogenic drugs at this stage because the period of 3-8 weeks of pregnancy is just the sensitive period for fetal teratogenicity. If certain teratogenic drugs have been used, the person concerned should discuss with his family: the risk of fetal malformation is significantly higher than without the drugs, and there is a risk of miscarriage or birth of an unhealthy baby (although the probability is not high, it is significantly higher than in the general population). If the child is not wanted and an abortion is performed, there are risks of abortion (e.g., uterine perforation, abortion syndrome), complications of abortion (secondary uterine adhesions, cervical adhesions, amenorrhea, etc.), and the risk of future infertility. This is a decision that must be made by the person concerned and her family, and the obstetrician and gynecologist is merely providing expertise and advice. There are several ways to classify the safety of drugs for pregnant women during pregnancy, among which the standard developed by the U.S. Food and Drug Administration (FDA) has been widely accepted by doctors in various countries because of its clear meaning and scientific objectivity. Some drugs have two different risk levels, one is the commonly used dose level, and the other is the extraordinary dose level. The five classes of F D A classification criteria are described below. Category A: No risk to the fetus has been demonstrated in women with early pregnancies with controls (and no evidence of risk in intermediate or late pregnancies), and there is likely to be minimal harm to the fetus. Classification B: No risk to the fetus in animal reproduction tests without maternal controls, or with side effects (less severe than sterility) in animal reproduction tests, but no certainty of side effects in controls of early pregnant women (and no evidence of risk in mid- and late-term pregnancies). Class C: Side effects on the fetus (teratogenic or embryonic lethal or otherwise) have been demonstrated in animal studies, but there are no controls in women or no available information in women and animal studies. Drugs are given only when the balance of benefits to the fetus outweighs the harms. Classification D: Positive evidence of risk to the human fetus, but although harmful, the benefit to the pregnant woman needs to be certain before it is given (if a safer drug cannot be applied or the drug is ineffective for a life-threatening or serious illness). Classification X: A drug that has been shown to cause fetal abnormalities in animal or human studies or is known to be dangerous to the fetus based on human experience, harmful to humans or to both, and whose use in pregnant women clearly outweighs any beneficial effects. The drug is contraindicated in women who are pregnant or who are about to become pregnant. What are the class drugs? Class A: There are very few drugs in Class A. Vitamins fall into this category, such as various vitamins B and C. However, vitamin A in normal range doses is a Class A drug, while large doses of vitamin A, 20,000 IU per day, can be teratogenic and become a Class X drug. Class B: There are not many drugs in Class B. Happily, all daily antibiotics are in this category. For example, all penicillins and most cephalosporins are class B drugs, such as ampicillin, cefradine, cefatrizine, and ceftazidime, all of which are class B drugs. In addition, Zithromax, chlorambucil, erythromycin, and furantoin are also class B drugs. Here, it is necessary to make some introduction to metronidazole, which is known to be a kind of drug for trichomoniasis, but it is also a drug for the restoration of the clock pa cynicism and distress. Fishy jiong shoulder〉bag or crippled K murmur Hui wit? The spade sculls the school? Read the replacement of the coronary heart? The following is a list of drugs that can be used to treat trichomoniasis also? The various dead boats? The place to be The problem is that the FDA does not have the ability to provide the necessary information. In the FDA pregnancy drug classification, metronidazole is placed in category B. In the anti-tuberculosis drugs, ethambutol is a class B drug. Among the commonly used antipyretic and analgesic drugs, indomethacin (anti-inflammatory pain), diclofenac (furosemide) and ibuprofen (fenpropathrin) are all in category B. However, it should be noted that indomethacin may cause fetal arterial stenosis or atresia after 32 weeks of gestation, resulting in fetal death. indomethacin should not be taken after 32 weeks. Among the cardiovascular system drugs, digitalis, digoxin and trichothecene are all class B drugs. Prednisone is also a class B drug among the adrenocorticotropic hormones that are harmful to the fetus. Class C: There are more drugs in Class C. These drugs have either not been introduced for a long time or are rarely used in pregnant women, and it is difficult to draw a definite conclusion as there are no reports on whether they can cause damage to the fetus mainly in early pregnancy. Take the antibiotic quinolones as an example, this class of drugs in animal experiments found oxyfloxacin damage to cartilage, in humans there are reports of more than 6 0 0 cases of early pregnancy taking the drug, after the delivery of children in the growth period of 6 cases have leg pain, but soon after the symptoms disappeared, none of the sequelae, so the argument of the data, the drug is still safe. However, the clinic still has to wait for more reports to confirm its harmlessness. Caution should be exercised in the use of Class C drugs. If an alternative drug is available, choose the alternative drug; otherwise, after weighing the pros and cons, explain to the patient or the patient’s family the reasons for choosing the drug. Take tuberculosis as an example: since ethambutol is the only class B drug among the commonly used anti-tuberculosis drugs, and anti-tuberculosis treatment is often a combination of several drugs, it is necessary to consider the use of class C drugs such as sodium para-aminosalicylate, isoniazid, etc. If the patient is in early pregnancy and has combined tuberculosis, the patient should be informed of the situation. The patient should be informed of the situation. Antivirals, most of which belong to category C, such as acyclovir (acyclovir) and zidovudine (zidovudine) for AIDS disease. Some antiepileptic drugs and sedatives such as ethosuximide, felbamate, barbiturates, pentobarbital, etc. Among the autonomic nervous system drugs, cholinergic and anticholinergic drugs belong to class C. Some of the adrenergic drugs belong to class C, such as epinephrine, ephedrine, dopamine, etc. Among the antihypertensive drugs, methyldopa, prazosin and all the commonly used vasodilators, such as phenelamines, alazoline and pentoxifylline, are all class C. Among the diuretics, furosemide (tachyphylaxis) and mannitol are all class C drugs. Among the adrenocorticosteroids, betamethasone and dexamethasone are all Class C drugs. Class D: Because of the available experimental and clinical evidence, drugs classified as Class D are not used during pregnancy, especially in the early stages of pregnancy, if possible. Among antibiotics the tetracycline family is a typical one. The use of tetracycline or hygromycin during pregnancy destroys the fetal tooth enamel and results in yellowing of the teeth by the time of adulthood, which is a consequence of the use of tetracyclines. Aminoglycosides are not used during pregnancy as much as possible, such as streptomycin, which may damage the eighth pair of cranial nerves and cause hearing loss. As for antineoplastic drugs, almost all of them are class D drugs, taking methotrexate (MTX) as an example, in the late 1940s, it was recognized that the application of MTX in leukemia combined with pregnancy could lead to miscarriage due to chorionic villous necrosis, so in the early 1950s, Hertz et al. developed the idea of treating choriocarcinoma with MTX and achieved success. MTX has been widely used for the treatment of trophoblast-related diseases such as ectopic pregnancy and placental implantation; other antineoplastic drugs such as cisplatin and 5-fluorouracil have also joined the ranks. Therefore, antineoplastic drugs are contraindicated during pregnancy. Analgesics in the central nervous system drugs, used in small doses as class B drugs, and in large doses as class D drugs, especially long-term application is harmful to the fetus, mainly manifested by poor fetal growth and development and addiction to drugs after delivery, irritability, crying, etc. Many of the antiepileptic drugs are class D drugs, such as primidone, trimethadione, etc., have teratogenic effects, and it should be noted that the rate of fetal malformation after pregnancy is higher in patients with epilepsy than in the general population. The use of antiepileptic drugs can increase the rate of fetal malformations, especially when several antiepileptic drugs are used together in difficult-to-control seizures, increasing the rate of fetal malformations. Among the sedative and hypnotic drugs, diazepam, chlordiazepoxide, meprobamate and oxazepam are all class D drugs. Among diuretics, hydrochlorothiazide, ethacrynicacid and benzothiazide are all class D drugs and should not be used during pregnancy. As for the antipyretic and analgesic drugs, aspirin, bisalicylic acid and sodium salicylate are Class C drugs when used in small doses, but when taken in large doses for a long time, sometimes even addictive, they are not good for the fetus and become Class D drugs. In fact, there are thousands of drugs available for people to use, and there are B, C and D drugs in all kinds of drugs, so people can choose B drugs or C drugs instead of D drugs. Class X: There are not many of these drugs in common use, but they are prohibited during preconception and pregnancy because of their high teratogenic rate or danger to the fetus. The most famous of these drugs is thalidomide, which was taken by women in the late 1950s and early 1960s in the vicinity of the Allied stations in Europe during early pregnancy to reduce pregnancy reactions, and later found that many fetuses were born with short upper limbs and combined lower limbs in the shape of seals. This is the early recognition of the X class of drugs. The sex hormone stilbestrol, which was commonly used in the early 1950s for the treatment of pre-eclampsia, was found to cause vaginal adenopathy or vaginal clear cell carcinoma in the offspring of women between the ages of 6 and 26, and the consequences were serious. These are two famous cases in drug teratogenesis. Vitamin A can also be teratogenic when taken orally in large doses, and is also a class X drug. Vitamin A derivative, retinoic acid, is a drug for skin diseases and is also a class X drug. However, what is often overlooked is heavy alcohol consumption, such as heavy alcohol consumption in early pregnancy, and intake of large amounts of ethanol, 150 ml or more per day can cause fetal dysplasia or developmental malformations. Therefore, ethanol in the FDA classification of alcohol consumption in small amounts belong to category D, the amount of more that is classified as X category. In addition, among the sedative drugs, flurazepam (f l u r a z e p a m , fluor Valium), flunitrazepam (flunitrazepam, flunitrazepam) are in category X. The antineoplastic drug aminopterin is also in category X. Here, the following points of attention are proposed for the use of drugs during pregnancy: ( 1 ) Avoid multiple drug prescriptions during pregnancy, and choose class B drugs as much as possible. ( 2 ) Do not think only about the medication, but should focus on the disease, which can pose additional risks to the mother and fetus. ( 3 ) It is not only drugs that can cause teratology, but also various other teratogenic possibilities that should be carefully explained to the patient when administering drugs. ( 4 ) It is important to note that early pregnancy is the stage of differentiation of fetal body parts and organs, and drug teratogenicity is likely to occur at this stage. The safety of drug use increases in middle and late pregnancy, but certain drugs, such as ethanol, are harmful to the fetus, especially the nervous system, throughout pregnancy. In conclusion, please note the general principle that the healthiest mothers can deliver the healthiest newborns. Class classification of some common drugs Class A: B1, B2, B6, folic acid, V-E; Class B: bromocriptine, gastrofacial, INS, metformin, penicillin, ampicillin, amoxicillin, cephalexin, rotenone, vanguardine, lymphocyte, erythromycin, azithromycin, clindamycin, gammazine, furantadine, metronidazole, naloxone; Class C: aspirin, paracetamol, atropine 654-2, HCT, cisapride, senna, prednisone, dexamethasone, HCG, gentamicin, fluconazole, itraconazole, SMZ, fluoperazine, ciprofloxacin, ofloxacin, rifampin, acyclic guanosine, vaccine, immunoglobulin, B12, V-C, V-D, K1; Class D: alprazolam, spironolactone, progesterone, tetracycline, doxycycline; Class X: misoprostol, drug Mifepristone, Clomiphene, HMG, Virazole; Caution: Roxithromycin, Morpholine. Generally, we try to use Class A or B drugs when giving medication to pregnant mothers, and use Class C drugs with caution. Consult your doctor? There are many kinds of drugs that can act not only on the pregnant mother herself, but also directly into the fetus through the placenta, and indirectly affect the fetus through maternal metabolism. The degree of influence of drugs depends on the nature of the drug, the dose and duration of administration, the toxicity of the drug, the permeability of the placenta and the sensitivity of the fetus to the drug. Although some drugs are not harmful to the mother, they have a damaging effect on the fetus. Dr. Chen Fangyi reminds that pregnant mothers should consult a professional doctor before taking any drugs and use them with caution in order to ensure their own safety and health and to avoid the fetus being affected. Cautious medication ≠no medication Many pregnant mothers have the misconception that medication during pregnancy will definitely affect the fetus and are therefore afraid of using medication. Experts emphasize that medication during pregnancy should be “used with caution, but not completely inaccessible!” As long as you consult your doctor and use your medication carefully, medication during pregnancy will not necessarily affect the fetus, and not all medications may be harmful to the fetus. Some pregnant mothers are afraid to take medication for fear that it will affect the fetus, which delays the condition and is detrimental to their own development and that of the fetus. For example, if a urinary tract infection occurs during pregnancy and requires antibiotic treatment, if you do not follow medical advice and refuse to use antibiotics, it may develop into pyelonephritis or sepsis, which is very dangerous. Therefore, pregnant mothers should not be too busy to take medication whenever they are sick, nor should they refuse to take medication, but most importantly, “take medication correctly under the guidance of a doctor”.