Impact of Early Pregnancy Medication on Fetal Development: What You Need to Know

Taking menstrual-inducing medication during early pregnancy..?

Hello, doctor.
I have a question to ask you.
My last menstrual cycle started on July 26.
On September 5, I went to the hospital for a pregnancy test, which showed one line, indicating I was not pregnant.
Therefore, the doctor prescribed me a 5-day course of medication to induce menstruation, with one capsule taken in the morning and one in the evening (1.
Peili "Fuanmeng Soft Capsule 100 mg, 2.
Yiside Tablet 2 mg (Hydroxyprogesterone)).
However, my period did not come by September 21, so I went back to the hospital, and this time the test showed two lines, indicating I was pregnant.
The doctor mentioned that the medication for inducing menstruation would not have a significant impact on the embryo (since the dosage was low) and advised me to return in two weeks for a heartbeat check.
Yesterday, I went to another hospital for the heartbeat check, and the baby had a heartbeat, but the doctor said that the medication could potentially cause congenital abnormalities (I did not show the doctor the names of the medications because I forgot to look them up).
He mentioned that this medication should not be taken during pregnancy and asked me to consider whether to continue with the pregnancy.
Could you please help me check if the medications I took could indeed affect the embryo? Thank you for your response!

Ying, 30~39 year old female. Ask Date: 2020/10/04

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the use of Estrogen tablets is not recommended for pregnant women.
However, if the dosage is not high and the duration of use is short, it is generally not advised to abandon pregnancy due to this.
It is usually recommended to have the obstetrician arrange for relevant examinations and to closely monitor the development of the fetus.
Thank you! Wishing you safety and health.
Dr.
Chang

Reply Date: 2020/10/04

More Info

The use of medications during early pregnancy is a significant concern for many expectant mothers, particularly regarding their potential impact on fetal development. The question you've posed highlights the complexities surrounding the use of medications like "培力" (Pill for inducing menstruation) and "益斯得" (a hormone-related medication) during a time when the pregnancy may not have been confirmed.

Firstly, it's essential to understand that the first trimester of pregnancy, particularly the first few weeks, is a critical period for fetal development. During this time, the embryo undergoes rapid cell division and differentiation, laying the groundwork for all major organ systems. Therefore, any exposure to medications can raise concerns about potential teratogenic effects (the ability of a substance to cause malformations in a developing fetus).

In the case of the medications you mentioned, it is crucial to look at their classifications and known effects. Generally, medications are categorized by the FDA into five categories (A, B, C, D, X) based on their safety during pregnancy:
1. Category A: Controlled studies show no risk to the fetus in the first trimester.

2. Category B: Animal studies show no risk, but there are no well-controlled studies in pregnant women.

3. Category C: Animal studies show an adverse effect, but there are no adequate studies in humans. Medications in this category should only be given if the potential benefit justifies the potential risk to the fetus.

4. Category D: There is evidence of risk to the human fetus, but the benefits may outweigh the risks in certain situations.

5. Category X: Studies in animals or humans have demonstrated fetal abnormalities, and the risks involved in use of the drug in pregnant women clearly outweigh any possible benefit.

Regarding the specific medications you mentioned, "培力" (likely a form of progesterone) and "益斯得" (which may refer to a hormone-related treatment), it is essential to consult the specific product information for each medication. Generally, medications that induce menstruation or alter hormonal levels can have implications for early pregnancy, especially if taken without knowledge of an existing pregnancy.

In your case, since the pregnancy was confirmed after taking these medications, it is understandable to be concerned about their effects. The doctor’s reassurance that the dosage was low and that the impact may not be significant is a common perspective, but it is also essential to monitor the pregnancy closely. The presence of a heartbeat is a positive sign, but ongoing monitoring is crucial.

If there are concerns about potential teratogenic effects, it is advisable to have a detailed discussion with your healthcare provider. They can provide insights based on the specific medications taken, their classifications, and any available research on their effects during early pregnancy. Additionally, they may recommend further ultrasounds or tests to monitor fetal development and ensure that everything is progressing normally.

In conclusion, while some medications can pose risks during early pregnancy, many factors influence their impact, including dosage, timing, and the specific medication used. Continuous communication with your healthcare provider is vital to navigate these concerns and ensure the best possible outcomes for both you and your baby. Always prioritize discussing any medications you are taking or considering with your healthcare provider, especially during pregnancy.

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