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Medications, Infections, and Other Exposures in Pregnancy

by Robert Needlman, M.D., F.A.A.P.
reviewed by Marjorie Greenfield, M.D. and Marjorie Greenfield, M.D.
When you know some of the risks that face your developing baby, you can avoid them.

Medications
Many prescription medications are safe for use in pregnancy, but some are not. Before taking any medication, you should check with your doctor, especially if there is any chance that you might become pregnant while on the medication. The most vulnerable time for the fetus is during the first weeks, when you might not even know that you are pregnant.

Nutrition
The importance of nutrition, and especially of a good intake of folate, is very well documented. See Folate for more on this important topic.

Infections
Rubella ("German measles") is a mild illness, but quite dangerous to the developing fetus. Children in the US are routinely immunized against Rubella, but if you have any doubt, it is safe to have the immunization again, before you become pregnant.

Toxoplasmosis is another infection that has few symptoms for an adult, but can cause serious illness for a fetus. Many adults have been exposed to the parasite that causes the disease, and have developed immunity to it. But if you are not immune, and get your first bout of toxoplasmosis while pregnant, your child could be affected. "Toxo" can be gotten from raw meat, and from cat and kitten feces. So, if you have cats, you might want to ask your doctor for a blood test to make sure you are immune to toxo. (See Food to Avoid in Pregnancy.)

Cytomegalovirus (CMV) is another infection that can cause serious fetal problems, but is pretty harmless to adults. Many, but not all, adults are already immune--and so have no reason for concern. If you're not immune, your chances of getting the infection are higher if you spend a lot of time around children (who tend to pass it amongst themselves). So, if you are a child-care provider or teacher, you might want to make sure that you are immune to CMV before becoming pregnant.

Sexually-transmitted diseases
Many sexually-transmitted diseases are potentially very dangerous to the fetus and newborn. These include syphilis, genital herpes, and HIV. In all cases, there are things that can be done to reduce the risk to the babies. For syphilis, for example, a course of antibiotics during pregnancy can take care of the infection, and simple blood tests can make certain that nothing gets passed on to your baby.

If you are HIV positive and pregnant, it is extremely important for you to receive proper treatment, because this can dramatically reduce the chance that your infant will get the disease from you.

Other risks
During pregnancy its best to avoid exposure to radiation, such as X-rays. Be sure to speak up before getting dental X-rays, or X-rays of any other part of your body (especially your pelvis) if you are or might be pregnant.

Very high temperatures may increase the risk of birth defects. Usually this is only a problem with serious infections. If you get a fever, particularly if it is in the first trimester, Tylenol® is recommended to bring your temperature down. On hot days, try to limit your activity and drink lots of water, to avoid becoming dehydrated and overheated.
 RELATED INFORMATION
*  Medications in Pregnancy: General Principles
*  You Are a Key Participant in Your Care
*  Fetal Development
*  Medications in Pregnancy


Created September 22, 2000
Reviewed September 21, 2004
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