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Medication In Pregnancy-any Experience


Ianankatie
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Hi all

Just wondering if you can help. I am 27 weeks pregnant and after a great initial 5 months am now stuck on bed rest til D day! Unfortunately after putting it off this long it looks like I have no choice but to start meds on Friday so I am looking for some tips. Beta Blockers have been dismissed as my BP is so low that they would cause growth issues so we're looking at Fludrocortisone but I am really not happy about it. Does anyone have any experience of drugs in pregnancy, good or bad, and/or any experience of coping with the effects on the baby once born. Obviously if the benefits out way the risks I am willing to go ahead but I need more information and I am just disapointed that bed rest in itself will not do the job as I had hoped.

Please let me know even if your story is not so positive as my doctors have no experience of POTS/VVS and pregnancy so are looking to find out how others have coped. Your experience good or bad can help me to way up the risks and benefits.

Many thanks

Katie

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Hi Katie

Boy can I relate, I was not diganosed with dsyautonomia until after my daughter was born. Therefore, they had no idea what was wrong with me and I was on numerous medications throughout my pregnancy.

Toprol XL- took this throughout due to heart rate issues

Reglan- as needed (I don't react well to this pregnant or not pregnant)

Vicodin (was given at the hospital)

Zoloft- I believe the last trimester only

Protonix- entire pregnancy

Nulev- as needed

Lots of acetominephin (sp?)

I have a beautiful one and a half year old daughter. Due to severe pain which turned out to be my gallbladder, I was forced to have a test where they inject dye to check for embolisms. I was very very nervous about this although no effects to my daughter that I know of.

Abby's birth was uneventful for the most part. However, after she was born she was very jittery for two days. The nurses just said it was her nervous system adjusting, however, my gut feeling has always thought it was a side effect of all the meds I was on.

Abby has had some cyanosis episodes over the past year which are not cardiac in origin. My doc thinks she may be showing early signs of some autonomic issues. She has been to specialists that assure me not to worry and it is not due to medication. Otherwise, she is very active and healthy.

I really don't know what advice to give you. Could her autonomic issues be related to medication? unlikely due to family history but you just don't know. It was very nervewracking going through this but my high risk specialist monitored me and the baby the whole way through. Just remember that if you are not feeling well it is not good for the baby either. Your gut instincts will tell you what is right for you.

My best to you and your baby.

Susan

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Thank you for your story Susan. It is really great to speak to someone who was in something of a similar position and to hear that everything worked out for the best. After having such a great first 2 trimesters I was not very prepared for such a quick downfall!

Was there one particular medication/activity that helped you most during pregnancy? Were you put on bed rest or did the medications manage your condition? Did you make it to 40 weeks?

Also, I hope you don't mind me asking, but did Abby suffer any symptoms of stunted growth at all and if so how did it effect her/how quickely did she get back to 'normal'? I have been told that the main effect of the medications will probably be stunted growth in my case.

I really hope that Abbys suspected autonomic problems come to be just a phase she is going through and she makes a full recovery very soon. I know that before I went ahead to try for a baby I was told that if I was to have a girl she would be very very likely to inheret my condition as I have been proven to suffer from an inherited form of POTS/VVS. It was a difficult decision to make as to whether to take that risk but after long discussions with both my neurologist and cardiologist it was aggreed that it was a risk worth taking. It should be easily treated if they know whats wrong, unlike the years of tests many of us have gone through, and besides, most people don't really suffer until their late teens- by then my docs hope for a cure!!!!

Thank you again for all of your advise and I am sorry for all of the questions!

Best wishes to both you and Abby!

Katie

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I didn't feel well from week 23 on to almost the end. I had a few weeks here and there of being pretty functional--especially after getting re-hydrated by IV. Post-partum was my worst time although I was bed-ridden for several weeks in late pregnancy as well. Are you on bed rest under doctors' orders or because you don't have the energy/feel well?

This question is very hard. I did not use any meds during my pregnancy. I felt horrible at times, but my daughter was born absolutely healthy at term (40 weeks and 2 days) at 10 lbs 2 oz. So I do not think it is true that if you feel ill it is not good for the baby either--necessarily. Obviously, some conditions, like PIH, preeclampsia, etc. can make you feel unwell and are not good for the fetus/baby. Using medications during pregnancy does not come without risks as you are well aware.

I did not have a diagnosis so was not put on any meds, other than a highish salt diet. And like I said, I had a couple of sessions of re-hydration via IV and felt great for up to 48 hours each time afterwards. Didn't know why at the time.

My new ob-gyn says that there is now a good amount of data on certain SSRI's--like Prozac, zoloft -- and it is believed that it is safe to take during pregnancy--particularly after the first trimester. However, she told me, your baby will experience withdrawal symptoms after birth--be very jittery, hard to settle, etc. for the first several days.

Good luck with your decision and take care.

Katherine

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I've been thinking about this topic lately, because my husband and I are trying to conceive. I feel strongly that medications during pregnancy should be avoided unless the mother's life is in danger. I don't know what your most troublesome symptoms are, so I'm not sure what medications you are considering. If you are trying to keep BP up, have you exhausted all the basic, non-invasive options, like high-salt diet, extra fluids, etc?

My OB said unless my heart rate is consistently over 150 resting (sitting or lying down), he will not put me on any meds. He thinks going nine months with a higher heart rate is not going to do damage to my heart, and he thinks playing it safe for the baby makes more sense. He also told me, though, that he has had many patients who have had no choice but to take beta blockers. Some have taken pretty high doses. And only rarely does he see problems in the fetus.

What happens when you are lying down or sitting -- do you still have a high heart rate? Can you do modified bed rest? Believe me, I know this is horrible. I had the beginnings of preeclampsia that started at 35 weeks and had to bed rest for two and a half weeks, and still my daughter was born with intrauterine growth restriction. So there's obviously no guarantees. But maybe this will buy you even a couple more weeks. I do remember my OB telling me the second trimester, though, is better than the first or third for taking meds in terms of effects on the fetus.

Good luck, and keep us posted.

Amy

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Hi,

Abby was born at 39 weeks and I was not put on bedrest amazingly enough. The stunted growth issue is interesting. Her doc does not say she has any stunted growth because she is growing normally. However, she is on the short side!! She is only in the fifth percentile and is a little shrimp. (but very fiesty let me tell you)

For me, I would not have made it through the pregnancy without Toprol. The second I miss a dose, I have racing heart and palps that are just awful. However, I do regret taking Zoloft during the pregnancy. I too feel that this was part in cause of her jitters. During the pregnancy I never had a diagnosis yet. I know my docs were beginning to think it was in my head and that I was just the "hormonal pregnant lady". It was actually an ob/gyn I had seen in the ER that prescribed the Zoloft when they could find nothing else wrong!

I don't know what medications your doctor is considering, but I always took the advice of my ob/gyn over the other specialists. I figure her main concern is the baby and not our illness, so she will give her opinion in best interest of the child.

Hope you are feeling well.

Susan

One other thing- don't know if you are considering an epidural but this naturally lowers your blood pressure. My cardio was aware of this and was on call during my delivery. (since they really didn't know the problem yet) I did have an epidural but they gave me a shot of epinephrine to counteract that. Make sure the anethesiologist knows your health history.

Hi,

Abby was born at 39 weeks and I was not put on bedrest amazingly enough. The stunted growth issue is interesting. Her doc does not say she has any stunted growth because she is growing normally. However, she is on the short side!! She is only in the fifth percentile and is a little shrimp. (but very fiesty let me tell you)

For me, I would not have made it through the pregnancy without Toprol. The second I miss a dose, I have racing heart and palps that are just awful. However, I do regret taking Zoloft during the pregnancy. I too feel that this was part in cause of her jitters. During the pregnancy I never had a diagnosis yet. I know my docs were beginning to think it was in my head and that I was just the "hormonal pregnant lady". It was actually an ob/gyn I had seen in the ER that prescribed the Zoloft when they could find nothing else wrong!

I don't know what medications your doctor is considering, but I always took the advice of my ob/gyn over the other specialists. I figure her main concern is the baby and not our illness, so she will give her opinion in best interest of the child.

Hope you are feeling well.

Susan

One other thing- don't know if you are considering an epidural but this naturally lowers your blood pressure. My cardio was aware of this and was on call during my delivery. (since they really didn't know the problem yet) I did have an epidural but they gave me a shot of epinephrine to counteract that. Make sure the anethesiologist knows your health history.

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In my last pregnancy almost 5 years ago I took my beta blocker daily and klonopin as needed I was on bed rest from Mother's Day till mid July, so then I needed injections to speed up his lung maturity in case I went into labor. I worked for an ob/gyn for a number of years. There were many meds, though I don't remember them, that patients took while pregnant since the Dr's felt the benefits to the mother, who they needed to either remain calm, keep their blood pressure under control, control the blood sugar,,etc, was important for the Mom and the baby. That is the way my Dr. felt for me also, that they needed me to be in as a good a state as I could be so it would be beneficial to both me and the baby.

My little guy came a week early while I was back to work. He is a little shorter than my other two, but he seems to take after my hubby who has shorter legs but a longer torso and I am the opposite. My other two kids have longer legs. Believe me, he is as active if not more so than my other two :)

I bet you and the baby will do just great. Just remember your limits and keep your OB informed of any changes so they can keep a close eye on you both. :)

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I think I forgot to add that I took two medications for part of my pregnancy, though they were POTS-unrelated (but these two meds are used by many who have POTS). I took 0.25 mg clonazepam (Klonopin) and 25 mg Zoloft, both for pre-existing anxiety disorder. I didn't expect to get pregnant on the first try, so I weaned off the meds one at a time -- first the Zoloft in the third month or so, then clonazepam in the fifth month. I found I didn't even need the anxiety meds because for whatever reason, I felt great while pregnant.

Amy

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Thank you everyone for your replys. It is good to hear that some of you did have success without meds and even though you were unwell your baby didn't suffer.

The big concern for my docs now is that my BP is so low that it could be effecting the baby. In the past I have suffered the drop in BP when standing but as soon as I lay down it would go up again. Because it used to go up again we had planned on just using bed rest, therefore preventing the vasovagal episodes and avoiding any risk to the baby. Also avoiding the need to risk taking meds. Now that even in bed my BP often stays low they feel they have little choice but to give me meds to increase it.

The problem in my mind is that by taking tablets I know that I am putting my baby in danger but by resting we don't really know, there is a chance that he'd be fine. The docs like the idea of the controlled risk involved with the meds where I prefer to take the chance on no meds and hope he is okay. I am particually pleased to see that one of you managed without meds and although clearly suffered the effects of the condition the baby managed ok. Its all so confusing!

I have tried everything to increase my BP that I can without drugs and nothing is working.

As for the epidural, I do hope to be able to have one but that is another debate I am facing. I am booked in for a c/section several weeks early as my condition is effected by pain and exhaustion as well as posture and many other things therefore it would be physically impossible for me to manage naturally. As none of my local docs have ever had a pregnant patient before they don't really know what to do and are very wary of giving me an epidural. They would really like to do the c/section under general anaethetic which is something that I am really not happy about for many reasons so I am fighting for an epidural. The tip of epinephrine is great, if anyone else has any ideas of how to manage an epidural please let me know!

Thanks again for all of your help!

Katie

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Good luck with your decision.

One question I would have for the doctor would be if complete bed rest is really best--in that, most POTS patients tend to get worse on bed rest, instead of better. Bed rest for POTS is not usually recommended--in fact prolonged bed rest can bring on temporary POTS in people who would not otherwise have it. Are you lying down most of the day now?

I would be wary of an epidural too--don't have any advice on that unfortunately. I believe many patients here have had epidurals though.

Katherine

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Thanks Katherine

We are aware that complete bed rest is bad. At present as I am home I am having a combination of bed rest (9pm to 11am) and then the rest of the time resting but up and about to keep me upright. When I am downstairs in the day I sit as much as possible but am currently still able to make myself a drink etc. When I go to hospital they hope to monitor me walking for short periods and after the birth will gradually increase my activity. All of this will hopefully prevent rest induced pots/vvs.

Anyway I think I have come to a decision! After resting this week I am not feeling as bad so I am going to avoid meds for another week and then re-assess each week. Hopefully I will be able to put off meds until I reach 30 weeks (2 weeks time) as then I know that he will be well developed and able to survive with help if born.

Thanks everyone for all of your help and I would still welcome any new advise!

Hope you are all doing well!

Katie

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