High-Risk Pregnancy
Ibuprofen in the first trimester
I've been reading, and hearing
from everyone (it was even on the NBC nightly news recently) that
ibuprofen in the first trimester is a bad idea because it can cause a
miscarriage. However, my OB today recommended 600 mg of ibup. every 8
hrs to manage my severe lower abdominal pain. If I had any other choice I
would have opted not to take it, but I've been in excruciating pain
since Friday, and all the Tylenol extra strength I took was not able to
make a dent in the amount of pain. Has anyone taken ibuprofen in the
first trimester with no negative impact on their pregnancy?? (If you
have a not too positive story you can share that too; I'm looking for
complete information).
This discussion has been closed.
Re: Ibuprofen in the first trimester
Ibuprofen (at the time I am posting this), is a class B drug in the fist and second trimester. It is class D in the third trimester. Ibuprofen has been studied extensively in pregnancy. It's an NSAID, like toradol and aleve and indocin, and the reason these drugs are contraindicated after about 28 weeks is because they can cause low amniotic fluid and can cause premature closure of the patent ductus arteriosis (shunt in the heart that is supposed to be open during pregnancy, closes shortly after birth).
There is a large group of perinatologists here, as well as one perinate I used to work with, that use ibuprofen in the 2nd trimester to quiet preterm labor (especially contractions after a cerclage is placed). Indocin is also used quite commonly to stop preterm labor. These drugs are only given in very short courses (less than 5 days) because of their potential complications. No reports of premature PDA closure, but reports of low fluid in the second trimester.
I'm not aware of any data of adverse reactions in the first trimester, but I have not really been looking. In my brief search, I could not find anything.
The reason pregnant women are counseled to not take ibuprofen or other NSAIDs at all during pregnancy is because there's too much confusion about a medication you can only take part of the time and not too long in duration. People abuse their medications and then they like to place blame. So it's better to err on the side of caution.
If you're really concerned, bring this up with your doctor at your next appointment. I am sure he/she will be happy to explain any decisions they make with you and/or recommend a different medication if you wish.
Yep, narcotics (used properly and in judiious amounts) don't have any lasting effects that have been documented. The flipside of that is addiction, but if you only take them for a short time and as prescribed, it shouldn't be an issue. I did have one patient we followed for a while in my residency who was a drug-seeker and was on 1mg of dilaudid every hour and she'd get mad if you didn't "push" it. You could see her twins withdrawing from the narcs on the monitor about 5 minutes before she was on her call light, asking for her next dose. Very sad.
As I said, ibuprofen is very controversial. Many ob's do not recommend it at all, but honestly, this is because they don't trust their patients to follow explicit instructions. if you have concerns, talk to your doctor. They will either allay your fears or they won't. And you can make whatever decision you want at that time.
Thanks everyone for the advice. The OB wanted me to take the ibuprofen for 48 hrs only; it worked so well in reducing the pain that I asked if I could extend the time but she said no. She's given me a prescription for Vicodin but unfortunately it's not working as well. I have a first appointment with a high risk OB this week; I hope she'll be able to offer some other solutions. I'm not sure how I'm going to make it through if the pain doesn't subside...
I've been dealing with a chronic pain condition and I am now 21 weeks. As everyone else has mentioned there is a lot of concern with nsaids especially in trimester 1 and 3. I was lucky that I managed to get through the first trimester with relatively mild pain. But, the second trimester has been horrible. I am taking naprosyn here and there when needed as it is category B at this time. I agree with you the narcotics do not work as well. I am not sure what I will do in the third trimester if I am still in pain. It's a little worrisome.
Hang in there! It's hard to find really concrete evidence about some medications. We just have to try to do what's best for both mama and baby.