Pregnancy is a special period in a woman's life. During this long process, fever and pain are inevitable. The application of non-steroidal anti-inflammatory drugs such as ibuprofen and loxoprofen (a commonly used antipyretic analgesics) can affect the relief of discomfort symptoms, but will the application during pregnancy have adverse effects on the fetus?
Animal safety study
NSAIDs mainly take effect by inhibiting the synthesis of prostaglandins. Animal experiments show that prostaglandin plays an important role in endometrial vascular permeability, blastocyst implantation and decidulisation. The use of prostaglandin synthesis inhibitors, such as nonsteroidal anti-inflammatory drugs, has been shown to affect fertilized egg implantation implantation . Data from the epidemiological study show that the risk of miscarriage, heart malformation and gastric fissure is increased after the use of prostaglandin synthesis inhibitors in the early stages of pregnancy. Data from epidemiological studies show that there is an increased risk of miscarriage, cardiac malformation and gastric fissure after the use of prostaglandin synthesis inhibitors in the early stages of pregnancy. The absolute risk of cardiovascular malformation increases from less than 1% to about 1.5%, which increases with the increase in treatment dose and duration.
Human Safety Study
As of 2017, FDA has received 35 reports that mothers who take NSAIDs during pregnancy have low amniotic fluid levels or kidney problems. Five newborns died, two cases of renal failure and confirmed low amniotic fluid, and three cases of renal failure but no confirmed low amniotic fluid. Eleven cases reported low amniotic fluid levels during pregnancy, and the amniotic fluid volume returned to normal after discontinuing the NSAID.
The U.S. FDA requires the addition of a new warning to the instructions for NSAIDs, describing the risk of fetal kidney problems that may cause insufficient amniotic fluid. The FDA recommends that pregnant women who are 20 weeks pregnant or later avoid NSAIDs.
Recommended
(1) Before 20 weeks of pregnancy
Before 20 weeks of pregnancy, use of non-steroidal anti-inflammatory drugs should be based on benefits-risk assessment; some authoritative people recommend avoiding taking non-steroidal anti-inflammatory drugs as much as possible during pregnancy.
(2) Pregnancy exceeds 20 weeks
NSAIDs should be avoided at 20 weeks of pregnancy and later, and the last three months of pregnancy are contraindicated.
If NSAIDs are required to be used during the 20-30 weeks of pregnancy, the use should be limited to the minimum effective dose for the shortest time possible; if the use of NSAIDs exceeds 48 hours, ultrasound monitoring of amniotic fluid should be considered; if too little amniotic fluid occurs, stop the NSAIDs and treat appropriately.
(3) During delivery
Disposal is not recommended during delivery. If the start time of application of delivery may be delayed, the duration will increase, and the tendency of maternal and infants to bleeding is greater.
(4) For women with difficulty in pregnancy or being tested for infertility
NSAIDs may damage women's fertility; for women with difficulty in pregnancy or being tested for infertility, non-steroidal anti-inflammatory drugs should be considered to stop treatment.
