Pregnancy Do's and Don'ts

Excerpted from
Pregnancy Do's and Don'ts: The Smart Woman's A-Z Pocket Companion for a Safe and Sound Pregnancy
By Elisabeth Aron, M.D.

Amniocentesis

During an amniocentesis, a procedure that is usually performed by an OB/GYN, a needle is placed through the mother's abdomen and uterus into the amniotic fluid cavity to withdraw a small amount of amniotic fluid for analysis. Several things can be determined from the amniotic fluid including signs of infection, fetal chromosomes, and alpha fetoprotein (AFP) levels. Genetic amniocentesis, most often performed at 16-20 weeks, is used to detect certain birth defects, specifically chromosomal abnormalities such as Down's syndrome (trisomy 12) and trisomy 18. Amniocentesis can be performed at other gestational ages to obtain information in the event of a pregnancy complication.

Since amniocentesis is performed for a variety of reasons, you should be fully counseled prior to proceeding. For example, if you are having the amniocentesis to test for Down's syndrome, you should have an idea about what you would do with that information. Some families would want this information to prepare for the child's life while other families may consider terminating the pregnancy if the results were not normal. A second scenario may be testing the fluid for signs of fetal infection in the third trimester. In this case, if an infection were present your physician might suggest an early delivery to minimize the risks to the baby.

Concerns: Since amniocentesis is an invasive procedure, the main concern centers on risks of complications from the procedure including risks of miscarriage, damage to the baby, infection, and rupture of membranes. A recent review of over 30,000 amniocentesis procedures done at a single institution showed a pregnancy loss rate of 0.83 percent. the bottom line: Amniocentesis is not without risk. However, if the benefits outweigh the risks, it may be warranted.

Amoxicillin

Amoxicillin is a penicillin antibiotic. Amoxicillin is an antibiotic that is commonly prescribed in pregnancy. It has been used as part of a multidrug regimen to prolong pregnancy in cases of preterm rupture of membranes and for urinary tract infections Amoxicillin has been assigned a risk factor category of B. the bottom line: Amoxicillin is safe in pregnancy.

Amphetamines

Amphetamines are a group of drugs that function as central nervous system stimulants. Brand names include Adderall, Desoxyn, and Dexedrine. They are used for medical conditions such as narcolepsy (a sleep disorder) and attention deficit hyperactivity disorder (ADHD), and as an appetite suppressant. Amphetamines may also be abused by women with substance abuse issues (see Drugs of abuse), concerns: Infants born to women with recent amphetamine use show signs of agitation and can experience withdrawal symptoms. Although no increase in birth defects has been noted with amphetamine use, there does seem to be an increased risk of preterm labor, intrauterine growth restriction (low birth weight), and fetal cerebrovascular events (events relating to the blood vessels of the brain, i.e., strokes). This drug has been assigned a risk factor category of C.

Illicit or recreational use of amphetamines during pregnancy is not advised. However, if you need to take this medication for a medical condition, you should continue to do so and notify your OB/GYN. With close supervision and monitoring of the baby, the benefits may outweigh the risks.

Amusement park rides

Amusement park rides include Ferris wheels, roller coasters, bumper cars, and bungee jumping (see Bungee jumping), concerns: Disney, Six Flags, Busch Gardens, and even your local state fair may have warning signs not to ride certain rides during pregnancy. The concern with these rides is that sudden starts and stops may be associated with placental abruption (premature separation of the placenta from the uterus). The jarring force from even slow automobile accidents has been shown to cause placental abruption and other complications for women who are pregnant, even when the trauma is not directly to the uterus.

A study of thrill ride injuries in the United States observed that of the 900 million rides taken each year, 1 in 124,000 results in a significant injury Further, 1 in 15 million rides requires hospitalization and 1 in 150 million rides taken results in a death. Most of the worst injuries are from internal bleeding or from brain damage.

The safest course of action is to avoid amusement park rides that cause jarring during pregnancy.

Anesthetic, local

Local anesthesia is used to numb an area prior to a surgical or dental procedure. Local anesthetic agents are also used for regional anesthesia, such as epidural, spinal, and pudendal blocks. Commonly used local anesthetics include lidocaine and 2-chloroprocaine. concerns: Toxic effects of local anesthetics are rare but include seizures, hypotension, and cardiac arrhythmias. These risks can be minimized by using only the recommended doses and avoiding injection of drugs into blood vessels.

The use of local anesthetics is safe during pregnancy.

Anesthetic gases, exposure to

Anesthetic gases are commonly used in operating rooms, dental offices, and veterinary clinics. Exposure to gases can occur when working within these environments.

Studies have shown a possible link between prolonged exposure to anesthetic gases and miscarriage. This is of particular concern to pregnant women who work in hospitals, operating rooms, dental clinics, or veterinary clinics,

Although many of the studies that are quoted are retrospective and were performed prior to increased safety measures, there does appear to be a link between miscarriages and prolonged exposure to anesthetic gases. The U.S. Department of Labor's Occupational Safety and Health Administration has outlined appropriate precautions for workers. Limiting your exposure will help to decrease your risk. Check that your workplace follows these guidelines, and inform your supervisor and human resources office that you are pregnant.