Khadijat was two months pregnant and felt very ill. After enduring for a day, she decided to get the drugs she often takes for fever. She said she regretted that decision as it led to the loss of the baby.
A medical expert, Dr. Victor Ohenhen, Consultant Gynaecologist, at Central Hospital, Benin has advised pregnant women to be mindful of drugs they take because of the effect they may have on them and their babies.
Asked if drugs for illnesses like pains, malaria, typhoid etc affect pregnant women differently from other people, he said, “For a long time, women have been advised to avoid drug usage in pregnancy because of possible harm to the baby (fetus).
“Even though the womb (uterine) environment is privileged, it is not totally immune to exposure from exogenous substances.
“Therefore, the major fear about drugs in pregnancy is the effect on the development and growth of the fetus while in the womb.
“The Thalidomide tragedy in the 1960s showed that the placenta was capable of transferring drugs ingested by mother to fetus, with potential for great harm,” he added.
Dr Ohenhen advised women to, as much as possible, avoid drugs in pregnancy. “However, if symptoms persist, it’s best to see a doctor,” he said.
Many pregnant women feel ill during the first trimester. Dr Ohenhen, who is also the Chairman, Medical and Dental Consultants Association of Nigeria in Edo State, also outlined what they should do when they feel regular pregnancy cramps, vomiting, headache and fever.
According to him, the first trimester begins on the first day of the last menstrual period and lasts until the end of week 13 of pregnancy.
He said illnesses during the period which many pregnant women experience include:
Nausea and vomiting
Commonly referred to as morning sickness, this unpleasant symptom can actually strike at any time of the day. Most medical professionals associate nausea and vomiting with rising levels of the human chorionic gonadotropin hormone (HCG).
Women with such experience are advised to try eating small, frequent meals to help manage the nausea and vomiting.
Hormonal changes may be the cause of headaches during pregnancy, especially during the first trimester. Therefore, rest, proper nutrition and adequate fluid intake may help ease the symptoms.
Abdominal pains or cramps are quite common in pregnancy and usually nothing to worry about.
Mild stomach pain in early pregnancy (during the first 13 weeks) is usually caused by the womb expanding, the ligaments stretching as the bump grows, hormones, constipation, or trapped air.
It may sometimes feel like mild period pain. It is probably nothing to worry about if the pain is mild and goes away with a change of position.
There are various causes of fever in pregnancy.
Pregnant women who experience fever in their first trimester should quickly see their doctor/obstetrician for evaluation.
Best month for a woman to start antenatal
The gynaecologist said women should start antenatal care as soon as pregnancy is confirmed.
He said the World Health Organisation (WHO) recommends that women start antenatal care when they are less than 12 weeks (3 months) pregnant, referred to as ‘early antenatal care’.
For some women with background issues such as a previous ectopic pregnancy, they are advised to start antenatal as early as possible, he added.
Pregnancy with comorbidities
Dr Ohenhen said managing a pregnant woman with other comorbidities such as ulcer, high blood pressure, diabetes or serious ones like kidney, heart disease etc is entirely within the purview of specialists (obstetrician, in collaboration with the physicians).
He said, “When a woman with already established comorbidities discovers that she’s pregnant, the best thing is to report to her doctor who will be knowledgeable enough because some modifications may need to be made with regards to her drugs and the doses, as some drugs are harmful in pregnancy to the developing fetus.”
He added that for those who have a chronic health condition (such as hypertension, diabetes, kidney disease, seizure disorder, mental health disorder) and are already on drugs prior to conception, the advice is for them to go back to their managing physician with the news of conception, and the physician will know how to make necessary adjustments.
“For those who are on drugs for medical complications of pregnancy, they should ensure compliance with prescribed medications and alert their doctor when they have any danger signs,” he added.
Self-medication in pregnancy
Dr Ohenhen said self-medication is quite common among pregnant women in our environment, adding however that the practice is entirely wrong and should be discouraged.
He said the habit of self-medication can disturb the development of the embryo or fetus and may cause serious structural and functional adverse effects, including low birth weight, premature birth, feeding problems, breathing problems, malformations, and other potential harm to the fetus and mother.
Taking ‘agbo’/ traditional medicines in pregnancy
Dr Ohenhen said pregnant women are strongly advised against taking traditional medicines.
“In most parts of Africa, cultural and traditional health practices play a significant role in maternal health care.
“Though traditional medicines are a major part of our culture as Nigerians, however, the major problem remains that the constituents of some of these mixtures are unknown and their alleged benefits are not well documented.
“So those using traditional/herbal medicines are advised to desist from such practice as it may be harmful to the developing fetus,” he advised.