As a doctor in the gynecology department, the most frequently asked questions by pregnant women carrying their babies may be”I am pregnant, but I accidentally had contraceptives. What should I do ?”. It will definitely rank in the top three. Today, we have invited the Dr Kathleen Smith to talk with us about this issue.
Impact of Emergency Contraception
For emergency contraception, a synthetic progestogen (usually norgestrel and mifepristone) is commonly used. In terms of drug classification, both of these are X classes. That is to say, clinical diagnosis is banned if pregnancy is clearly defined. But the time to have emergency contraception is usually within 72 hours after sexual life. Therefore, during this time, the embryo might not be on the bed or just on the bed. The impact on the embryo should be followed by “all or nothing”. If the drug works, it will directly affect the embryonic cells, causing the death of the embryo or the number of cells affected is not enough, without any serious consequences.
Hence, if you take an emergency contraceptive immediately after your sexual life and you still get pregnant, you can continue your pregnancy. However, some people may take the drug after the time, or have a continuous medication within a month. In these cases, the impact on the fetus is hard to say.
Teratogenic Risk of Drugs During Pregnancy
In fact, things are not so simple. There are still many problems about medication during pregnancy. Some pregnant women need to continue medication during pregnancy due to their pregnancy complications. When a doctor gives a medical advice, the first reaction of many pregnant women is not the detailed works of the drug on their own disease, but the drug’s effect on the fetus. This sounds like a natural idea. After all, everyone will pay attention to the fetus in the belly. However, most people’s concerns have changed in 180 degrees if you talk about abortion.
When many people are pregnant, they are afraid that the embryo that they just harbor is not stable, so many people will want to get some insurance. At this time, everyone’s attention is placed on the protection of the embryos. There is no entanglement in the drug during pregnancy. As a result, extreme contradictions will occur from time to time. That is, Some women have just consulted a doctor whether it is unsafe to take a certain drug, and then let him to make a medical prescription for embryo protection. The biggest problem here is to amplify the known risks, but ignore the unknown hazards.
Many drugs have a potential risk of teratogenicity. For example, many commonly used drugs are classified into Class C and D in terms of the grading standards of drugs during pregnancy. That is to say, some teratogenic effects of this drug on embryos are found in zoological tests. However, the risk of this teratogenicity may not be as great as you might think through clinical observations of humans.
Let’s take a look at the problem of teratogenic drugs. In fact, the risk of teratogenicity in most commonly used drugs is not very large, and it will be within 5%. This means, you are using a drug with a teratogenic risk that can cause your embryo to have a 5% risk of malformation. Of course, we should think that no external factors make your embryos malformed. eg. no pollution of water, soil and air in your environment, no radiation and no genetically modified foods. Currently, most of drugs have a risk of teratogenicityare less than 5%, and may be even less than 3%.
Many drugs put your embryos at a risk of malformation. In fact, this risk is even lower than the background teratogenic rate or equivalent to it. To be honest, there is still the possibility of embryo malformation even if you haven’t used any medicine. Sometimes this risk is not much smaller than your drugs.
From another point of view, what are the factors that have caused the deformed fetus? There are many factors influencing this result, such as genetic factors, environmental factors, drug factors and so on. Among these factors, the highest proportion is unexplained cause, accounts for 50-60% of all teratogenic factors. – we have not known more than half of the teratogenic factors. What about the drug factor? NO MORE THAN 1%! In other words, the teratogenicity of drugs only account for a tip of the iceberg. There are more dangers exist in those unknowns! You just ignore them as you don’t know.
Therefore, There is one principle of medication during pregnancy. If pregnant women have diseases that require medication, they should not give up treatment because of pregnancy. Under the guidance of this principle, the use of chemotherapy drugs during pregnancy is not an absolute contraindication if the benefits of medication outweigh the risks! In this case, those women have no reason to kill the child when accidentally misused a certain drug during pregnancy.