In pregnancy or if you trying to get pregnant the first thing you should do is STOP TAKING HYDROYUREA! This medication, although good with managing sickle cell for some patients, has been shown to increase the risk of congenital birth defects and abnormalities. So for the sake of your baby, put the Hydrea away.

The second question is a lot of moms worry about taking pain pills when you are sick. You should avoid taking a lot of pain pills the first 3 months of your pregnancy. This is when the baby is just developing, and pills during the first trimester have the possibility of leading to birth defects. It is important that whatever pain regimen you are on, that you make sure the pills are Class B or Class A. The classes define whether they cross the placental barrier.

For Class C drugs (most opiates), there is no research that has followed the safe levels of narcotics during pregnancy, so use these in the smallest dose possible and only if you are in extreme pain that nothing else works. Doctors do allow narcotics in small doses and sporadically (once in a while) as long as the benefit outweighs the risk. If you need heavier doses, you may have to be admitted for pain management during a crisis (as I was). Risks to your baby include miscarriage, preterm labor, still birth, low birth weight, respiratory issues, or excessive drowsiness. Let your doctors know exactly what pain medications and how much you are taking.

Aspirin: Should not be taken routinely, unless your doctor has prescribed it for blood clots or preeclampsia.

Oxycodone: Children born to mothers who were taking oxycodone for a prolonged period may exhibit respiratory depression or withdrawal symptoms. Oxycodone is also secreted in breast  milk in small amounts, so be sure to pump and dump after you take Oxycodone.

Tylenol: Is considered safe for the whole pregnancy, in all 3 trimesters. But if you have had liver problems, you might want to limit your use of Tylenol.

Dilaudid: Is a Class C drug, and is not recommended while pregnant. However, a couple of moms reported using Dilaudid in their 3rd trimester, with no issues to the offspring.

Motrin: Is fine in the first 2 trimesters, but not in the 3rd trimester because of the risk of bleeding. This applies to other NSAIDS like Aleve, Advil & Naproxen.

Methadone: This does not cross into breast milk and because of its long-acting properties with no peak, it is preferred by high risk OBGYNs as a pain medication adjunct or a good long-acting coverage. You need to start on a low dose and gradually increase until desired effect. It has to be taken at the same time every day, never missing a dose. It takes 3-5 days to feel a therapeutic effect. You cannot stop taking Methadone suddenly, you must taper or wean off.

In the next post, we shall discuss further on managing sickle cell in pregnancy

tO BE COntinued…

Culled from Sickle Cell Warriors.