Tratamiento de los trastornos comunes durante el embarazo

Treatment of common medical concerns during pregnancy

• The use of medications during pregnancy can induce alterations in the fetus/embryo, although only 2-3% of congenital malformations are associated to exposure to therapeutic agents.
• During pregnancy, whenever possible, it is advisable to treat minor symptoms with non-pharmacological measures, to avoid potential teratogenicity.
• When pharmacological treatment is required, prescribe medications with the greatest experience of use and best safety profile (in mother and fetus) at the lowest dose and for the shortest possible duration.
• Combination of pyridoxine and doxylamine is proposed for early treatment of nausea and vomiting. Antidopaminergic medication (metoclopramide and domperidone) should be reserved for more severe cases.
• Antacids and alginates are recommended in the case of heartburn.
• Bulk-forming laxatives are the treatment of choice for constipation, because they are not absorbed by the body.
• Topical antihaemorrhoidal agents represent an option to be considered, because of the small doses and limited systemic absorption.
• Iron deficiency is the most common cause of anaemia during pregnancy. Iron supplementation with ferrous salts is recommended rather than with ferric salts.
• Paracetamol is considered the analgesic of choice throughout pregnancy. The benefit-risk ratio of the use of non-steroidal anti-inflammatory agents (NSAIDs) depends on the dose, gestational age of the fetus and duration of treatment.
• The limited evidence available does not allow establishing recommendations on the use of pharmacological therapy for insomnia and cramps.
• The Andalusian Public Health System recommends pregnant women get the flu vaccine and the whooping cough vaccine (included in the Tdap vaccine: tetanus-diphtheria-whooping cough).