A young woman in only the third week of her pregnancy develops a fever of 104°F but refuses to take any medication because she is afraid that drugs will harm her baby.
Is she correct?
WHY?
ORGANOGENESIS: Hyperthermia VS Antipyretic agents
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I don’t feel she’s entirely correct because the period of organogenesis begins from the 4th – 8th week of intrauterine development, hence the drugs won’t have a great impact acting as a teratogen. Also, if she’s ill an indication from her high fever, she should endeavor to take medication, as her unborn child won’t survive either if she died as a result of illness.
I would strongly suggest she takes drug substitutes which have none or the least teratogenic effect as prescribed by her physician.
Most major malformation are produced during the period of embryogenesis i.e the third to eighth week and not the fourth to eighth week.
Meeting her physician for drug prescription would be the first step in the right direction.
Thank you
First, No she isn’t correct in the sense that not all drugs will harm her baby though some might.
Second, her reasoning might have stemmed from the fact that the third week of pregnancy, also called the embryogenetic or critical period is the period of embryonic development and also a period when the embryo is most susceptible to the influence of teratogens. Teratogens are toxic substances that could also be in the form of drugs. They cause abnormalities or defects in the developing embryo known as teratomas. An example of a drug that uses to be administered as an antinauseant to pregnant women but isn’t anymore due to fatal side effects is Thalidomide. It worked like a teratogen leading to the loss of limbs in the embryo. Hence, some drugs might harm a developing embryo in the third week of pregnancy but not all will.
Hi,
I have one important question for you;
Can increased body temperature in a pregnant woman be considered teratogenic?
I think the pregnant woman is wrong, though her fears is due to the fact that some drugs used during pregnancy might affect the fetus..But in this case, antipyretics cannot induce teratogenesis..If she doesn’t use antipyretics,her fever would give hyperthermia (elevated temperature)which favors the formation of Spina bifida, anencephaly, cardiac and oral cleft defects
Correct.
Severe hyperthermia such as this is known to cause neural tube defects e.g Spina bifida and anencephaly at this stage of gestation.
Thank you for attempting today’s review question.
Warm regards
Yes, because fever doesn’t necessarily cause pregnancy loss, but may enhance the likelihood of congenital irregularities and autism.
It can also be a sign of an infection. And infections are more likely to cause pregnancy loss. Based on my perspective, I think she should contact her physician for a reasonable decision.
Correct.
I especially love where you noted that hyperthermia have the potential to cause autism.
Thank you for attempting today’s review question.
Warm regards
Yes she is correct.
During the third week of pregnancy the cells of the zygote undergo the process of cell division and multiply till an embryoblast is formed and the process of gastrulation begins.
The third to the eight week is usually referred to as the period of organogenesis in which the organs of the body develop. In this period the developing embryo is highly susceptible to several birth defects.
It is usually advised that all medications should be withdrawn during this period.
Studies of the effects of drugs on the embryo are mostly done using lab animals such as mouse or sheep but due to ethical reasons no direct studies are performed on the human embryo so it’s hard to tell how drugs affects the human embryo during this period.
All medications as noted by you are not withdrawn from pregnant women.
As a matter of fact, pregnant women consume a lot of medications during pregnancy to reduce the risk of teratogens. A good example of such medications are multivitamins like folate.
A daily dose of 400ug is recommended for pregnant women as well as women of child bearing age considering to get pregnant to prevent the risk of neural tube defects as well as facial clefts.
Thank you
Yes she maybe correct because many drugs are teratogenic which might cause congenital defect during the period of organogenesis (week3-8)
Hi Isaolamide,
I have an important question for you;
Can increased body temperature (Hypethermia) as seen in this lady be teratogenic to the unborn child?
Yes, the woman is correct that the drugs may be teratogenic. A temperature as high as 104F (hyperthermia) is well known to cause spina bifida otherwise known as neural tube defects at this gestational stage (embryogenic or critical period). It is advisable to evaluate the risk of teratogenicity of an antipyretic drug (drugs used to reduce fever) and preferably settle for one with low teratogenic potential.
Spina bifida is a form of neural tube defect and not an alternate name for the condition.
Neural tube defects are anomalies that form as a result of failure for either the anterior or posterior neuropores to close. Closure of the neuropores of the neural tube occur during the period of neurulation
Failure of the anterior neuropores to close results in brain anomalies such as anencephaly (partial/complete absence of the brain) whereas failure for the posterior neuropores to close results in spinal cord abnormally e.g Spinal Bifida.
I must note that there are several forms of Spinal Bifida with Spinal Bifida Occulta being the safest and most compatible with life.
Thank you
The woman is correct that drugs may be teratogenic but. . .
Severe hyperthermia such as this is known to cause neural tube defects e.g Spina bifida and anencephaly at this stage of gestation.
Therefore, one must weigh the risk of teratogenicity of an antipyretic agent with a low teratogenic potential such as low dose aspirin against the risk of hyperthermia.
Malformations are also associated with hyperthermia induced by steam/hot bath in tubs.
Nooo
Because fever can be cause by many factors been it viral or bacterial but a test is required to know what exactly cause the fever and the drugs that are prohibited mostly by pregnant women are aspirin and ibuprofen.
Hi hafsat,
Kindly review the Responses that came in and corrections made and find out if u are correct