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Medical Use in Pregnancy

Medication should not be used in pregnancy unless necessary. Those with underlying conditions may require continued medication use in pregnancy. Medications listed below have been shown to not cause birth defects. Most other medications fall into an “unknown category” meaning there have been no studies documenting their safety in pregnancy. Please speak with your provider about all your medications, including over the counter, herbs and supplements.

Medical Conditions Requiring Medication Use in Pregnancy

If you are unsure about continuing a medication in pregnancy, please contact our office to review your medial history. This can be done through the FollowMyHealth patient portal, by phone, or office visit. Do not discontinue any medication without consulting with your doctor.

Asthma

Use your inhalers routinely or as needed. Asthma symptoms can worsen in pregnancy. Ventolin, Asthmacort, Proventil, Advair, Nasonex or Flonase help keep the breathing passages open. Claritin, Benadryl, and Zyrtec are antihistamines that are safe during pregnancy. Let your doctor know if your asthma is not responding to your routine inhalers. Occasionally oral steroids may be necessary.

Depression

Your mental well-being is very important for a healthy pregnancy. If you are on antidepressants you may continue them under the advice of your doctor. Safe mediations include Prozac, Zoloft, and Wellbutrin. Please monitor your mood and emotional symptoms closely for worsening of depression or postpartum depression.

Diabetes

If you have Type I or Type II diabetes before pregnancy, continue managing your blood sugars closely. It is important to be closely monitored, alter your diet as needed, and check your blood sugars frequently. Your provider will discuss using oral medication or insulin as needed to keep your blood sugar in the appropriate range.

High Blood Pressure

Continue your blood pressure medication. Blood pressure medications commonly used during pregnancy include Nifedipine, Labetolol, and Methyldopa. You may require a higher dose or change to different medication in pregnancy. Preeclampsia is more common in patients with pre-existing high blood pressure. Please discuss medications with your provider or care team. With the mobile Babyscripts app you can monitor your blood pressure, for more information please see Babyscripts blood pressure FAQs.

Thyroid Disease

Continue any regular thyroid medication (Synthroid, Thyroxine). Blood tests for thyroid may be monitored by your obstetrician, primary care doctor, or your endocrinologist during pregnancy. The thyroid medication dose may need to be adjusted. Please let your provider or care team know if you are on any overactive thyroid medication.

For a full-list of safe over the counter medications during pregnancy, please refer to page 17 of the GW Obstetrics Guide.

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Clinical Trials

  • This study is looking at the relationship between sleep and perinatal mood disorders such as depression and anxiety. Participants will wear a wrist monitor like a fit bit for 10 days to help researchers gain information into sleep patterns during pregnancy and postpartum and will answer questionnaires about their mood.
  • Preterm birth is one of the leading causes of neonatal morbidity and mortality. One of the most significant risk factors is a history of a prior spontaneous preterm birth. Intramuscular progesterone is the only FDA approved medication for the prevention of recurrent preterm birth. Vaginal progesterone is not FDA approved for the prevention of recurrent preterm birth, but has been found to beneficial. Given the presence of trials demonstrating efficacy for both intramuscular and vaginal progesterone in the prevention of recurrent preterm birth, but limited information one being more superior to the other, we are performing a trial comparing vaginal progesterone and intramuscular progesterone for the prevention of recurrent spontaneous preterm birth in women with a history of prior spontaneous preterm birth.
  • [This study is no longer recruiting.] The SONATA Study is an FDA-approved clinical study designed to establish the safety and effectiveness of a new, investigational device to reduce heavy menstrual bleeding caused by uterine fibroids. The device, called the SONATA System, targets fibroids rather than treatment or removing the entire uterus. If effective, this device will provide an alternative to hysterectomy that is: incision-free, preserves the uterus, does not require general anesthesia and is an outpatient procedure.
  • Women with twin pregnancy who have a dilated (open) cervix detected on physical exam before 24 weeks are at increased risk for delivering their babies preterm (before 37 weeks gestation). Prematurity is associated with many complications for the babies including respiratory (breathing) problems, bleeding inside of the brain (a form of stroke), increased risk of infection, kidney, temperature and feeding problems. The primary objective of this study is to determine if physical exam indicated cerclage use reduces the incidence of spontaneous PTB in asymptomatic women with twin gestations with cervical dilation diagnosed on pelvic exam before 24 weeks of gestation.
  • Tranexamic acid was shown to significantly reduce risk of mortality when given to women with diagnosed postpartum hemorrhage in the recent Lancet WOMAN Trial.* The purpose of this study is to determine the optimal dose for using tranexamic acid to prevent postpartum hemorrhage during routine cesarean section. Women undergoing cesarean section will be eligible and must not have a history of blood clots or a known clotting condition. *http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31111-X/fulltext
  • In this study, we are developing non-invasive tools to identify early signs of abnormalities of the placental function using arterial spin labeling (ASL) based on fetal MRI. ASL is a particularly attractive method for early and safe monitoring during pregnancy given that ASL is completely non-invasive and does not require contrast agents or exposure to ionizing radiation. Our specific aim is to develop and validate placental perfusion imaging with substantially improved image quality and sensitivity to abnormalities.
  • This study is being performed at Children's National Health System. We are trying to understand how the normal fetus controls blood flow to the different parts of the body such as the lungs and brain. We will measure your baby's blood flow using the same ultrasound approach used by your obstetrician. We will test your baby's control of blood flow by measuring the responses to changes in your (the mom's), levels of oxygen and carbon dioxide. We will make these changes by asking you to breathe extra oxygen for short periods of time. If your obstetrician determines that your pregnancy is uncomplicated, you and your baby are eligible for this study.