Which over the counter medications are safe during pregnancy? Tylenol® , Robitussin®, saline nasal spray, regular strength Sudafed® and Benadryl® are safe in pregnancy. Do not take aspirin, ibuprofen (Motrin® or Advil®) or naproxen (Aleve®). What should I do if I have a sore throat? Try gargling with warm salty water, increasing fluids and rest. You may also try Tylenol® and any over- the-counter throat lozenges. What may I use for hemorrhoids? You can use Preparation H®, Tucks®, Anusol®, or Dermoplast® as needed. What should I take for heartburn? First try Tums® or Mylanta®. Avoid spicy and greasy foods. Talk with your provider if symptoms persist. What should I do if I am constipated? Increase non-caffeinated fluids and fiber (fruits, vegetables, whole grains, dried fruit, prunes). Avoid constipating foods (cheese, bananas, rice and applesauce). If dietary measures do not help, you may add fiber supplements such as Metamucil ® or Fibercon ®. You may also try Colace ® stool softener up to twice a day, Milk of Magnesia ® or Senokot ®. What can the dentist do/use when I am pregnant? Almost all dental work is safe in pregnancy. If you need an x-ray, tell the dentist and technician that you are pregnant and make sure they cover your abdomen with lead shields. If dental work is necessary, the dentist may use Xylocaine without epinephrine for anesthesia. Penicillin’s and erythromycin are safe antibiotics in pregnancy. Most pain medications are safe in pregnancy with the exception of Motrin. If the dentist has questions, please have them call our office. What foods should I avoid in pregnancy? Certain fish containing higher levels of mercury (tuna, swordfish) should be limited to two servings per week. Caffeine should be limited to one serving per day. Soft cheese (un- pasteurized) should be avoided. Raw fish and deli meats should be avoided also. Can I dye my hair? There is no data that associates hair dye with birth defects. Your hair may not respond in the usual fashion when treated with chemicals. Can I exercise? Exercise (walking, swimming, yoga) is a good idea in pregnancy. Make sure you drink plenty of water and stop if you get lightheaded or uncomfortable. Avoid exercising on your back. Be aware that you are at increased risk of joint injury because of the hormonal effects of pregnancy on your ligaments. Is it safe to have sex? Sex is safe in most pregnancies. Your provider will tell you if you should avoid sex for any reason. Signs and Symptoms to never ignore
• Severe or persistent abdominal or pelvic pain
• Menstrual cramping that is not resolved with hydration and rest
• Vaginal bleeding that is similar to a period. While spotting is generally not serious, you should
contact your provider if this is persistent
• Pelvic pressure, back pain or cramping before 37 weeks
• Painful urination or little urination
• Severe persistent vomiting or diarrhea that lasts more that 24 hours
• Persistent fever of more than 101°F that is not resolving with Tylenol
• Persistent visual disturbances: black or white spots, seeing stars, blurriness, or loss of vision
• Severe head pain not resolved with Tylenol
• Swelling that is not improving while resting with your feet raised up
High Risk Pregnancies A pregnancy is considered high risk if the mother has certain medical conditions such as high blood pressure, diabetes, lupus, thyroid disease, obesity, infertility, heart disease, or kidney disease. Women with certain problems in previous pregnancies are also considered high risk. For example, problems such as preterm delivery, preeclampsia, eclampsia (pregnancy-related seizures), or fetal death, are considered high risk. In most cases, Brown’s Women’s Care, P.A. is the perfect place for these patients to come for prenatal care. In a few cases, we obtain consultation or transfer care to specialists at the Women’s Institute at CMC Main in Charlotte Pre-pregnancy Advice While over 50% of pregnancies in the United States are unplanned, planning your pregnancy always makes things a little easier. Here are some key points to remember:
• Ideally, start a folic acid supplement (0.4 mg) 6wks before attempting to get pregnant, this
ensures folic acid levels are built up in your body before conception and prevents spinal cord defects in your baby.
• Make sure your vaccines are up to date--check with your primary car doctor or our office.
• Avoid alcohol, tobacco, or drugs when you are trying--they can affect fertility and the development
• Schedule an appointment to see us for a pre-pregnancy visit
• See the ACOG preconception pamphlet at
http://www.acog.org/publications/patient_education/bp056.cfm
and in Spanish at: http://www.acog.org/publications/patient_education/sp056.cfm
Perspectives: A View of Family Medicine in New Jersey Fibromyalgia: Practical Treatments for the Family Physician Richard N. Podell, MD Source: Perspectives: A View of Family Medicine in New Jersey (Written for Perspectives (4Q05), a journal of the New Jersey Academy of Family Physicians, and reprinted with permission.) Richard N. Podell, MD, Clinical Professor in the Department