Pregnant patients are generally managed by obstetricians for maternity and fetal care. However, these patients do often visit general practitioners OPD for many common conditions and illnesses. Doctors can not prescribe the same medicines to pregnant patients compared to nonpregnant patients because medicines have certain effects on developing fetuses as well. This article deals with the various appropriate treatment options for common conditions in pregnant patients.
Key points
- Avoid taking any medicine during the first trimester if at all feasible.
- Only prescribe medication if the predicted benefit to the mother outweighs the danger to the fetus.
- Take into account the risks of not treating.
- Prescribe established medications rather than novel or untested ones. Use the lowest effective dosage and avoid using several medications.
- Advise the woman to take 400 micrograms of folic acid per day during the first 12 weeks of pregnancy if she is not already doing so.
- Advise the woman to take 400 units (10 micrograms) of vitamin D per day, or 1,000 units (25 micrograms) per day if there is a significant risk of vitamin D insufficiency (e.g., darker skin, limited exposure to sunlight).
Dyspepsia
- Encourage the patient to adopt healthy lifestyle practices such as eating smaller, more often meals, staying away from caffeine and fatty and spicy foods, and lifting the head off the bed.
- If complaints are mild and not alleviated by lifestyle modifications- Antacids or alginate (e.g., alginates are particularly useful if GERD symptoms are dominant)
- Aluminium and magnesium-containing antacids may be taken as needed; calcium-containing products are only indicated for short-term or occasional usage.
- Consider an H2 receptor blocker or omeprazole if symptoms are persistent or severe.
- Do not recommend Sodium bicarbonate or magnesium trisilicate-containing products.
Constipation
- Counsel the patient on lifestyle modifications, such as increasing dietary fibre, hydration consumption, and physical exercise.
- If lifestyle modifications are inadequate: Provide oral laxatives for short-term use, beginning with a bulk-forming laxative such as Isapghula.
- If stools do not soften: Include or substitute lactulose
- Consider a brief course of senna if stools are soft yet difficult to pass or there is a sense of incomplete emptying.
- If the reaction remains inadequate- Consider prescribing a glycerol suppository.
