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In case menstrual phase is 28 days, it is assumable that the ovulation occurs in about 14th day from the first day of the last menstrual period. Commercially available pregnancy testing drug detects hormone named as human chorionic gonadotropin (hereinafter referred to as hCG) in the urine. hCG is secreted from chorionic tissue of implanted fertile egg and transferred into the mother body blood then discharged into the urine at 4th week of pregnancy (i.e. 4th week from last menstruation). However, depend on the sensitivity of the testing drug, detectable density of hCG in the urine may differ. Also, gestation response only shows the existence of hCG in the urine, it may show positive even with ectopic pregnancy, trophoblastic disease or hCG produced tumor, other than normal pregnancy.
Verification of normal pregnancy at hospital is made by the confirmation of fetal sac and conception in the womb with transvaginal ultrasonography and heart rate from the conception. Heart rate is able to check with 5 to 6 weeks of pregnancy.
Expected date of confinement refers estimated numbers of week when the first day of the last menstrual period is considered as origination of the pregnancy, but clinically speaking, pregnant numbers of week and expected date of confinement is made the final decision from fetal crown-rump length (length from top of head to hip) at 8 to 11th week of pregnancy (3rd month pregnancy) by transvaginal ultrasonography.
Expected date of confinement refers estimated numbers of week when the first day of the last menstrual period is considered as origination of the pregnancy, but clinically speaking, pregnant numbers of week and expected date of confinement is made the final decision from fetal crown-rump length (length from top of head to hip) at 8 to 11th week of pregnancy (3rd month pregnancy) by transvaginal ultrasonography.
Fetus gradually grows with replenishing energy, nutrition or oxygen from mother body through the placenta. Whether if it is in normal process is to be verified with vaginal and belly ultrasound inspection and fetus heart rate monitoring at gynecological checkup.
The most dramatic change before or after the delivery is said to exist in lung breathing. Lung is functionally matured at around 34th weeks of pregnancy. But depend upon fetus, there is a case where breathing control after the delivery is necessary even at the normal delivery period of 37th week of pregnancy. Also, fetus red blood cell hemoglobin will make the transition to matured hemoglobin at neonatal period, but in the process of destruction of fetus hemoglobin, bilirubin is discharged then resulted to one of the causes of icterus neonatorum.
5th to 11th week of pregnancy is called as organogenesis period in which several primary organs are rapidly produced. So that it is necessary to pay attention if they are exposed to teratogen (virus infection, drugs, radiation, high blood sugar), congenital anomaly is set up. Especially among them, when drug therapy is applied to mother body, the effect to fetus are; teratogenesis (4th to 15th week of pregnancy) and fetal toxicant (after 16th week of pregnancy). Teratogenesis means the abnormality on organ’s shape or position, and fetal toxicant means each organ’s functional abnormality.
On the other hand, in case if harmful effect is appeared to the fetus because of the usage of drugs, possible to harm fetus, fertile egg becomes unable to implantation or suffer miscarriage, or in case even when miscarriage, effects does not remain as deformed. This is therefore that to make drug administration until when it changes to positive by pregnancy testing drug is, when confirmed pregnancy continues afterwards, not necessary to strongly worry about drug effect to fetus.
The 4th to 7th week of pregnancy is the Absolute irritable Period which important organs are produced, so that it is also the most sensitive period for teratogenesis. During 8th week to 15th week period, sensitivity against the drug is decreased, but this is also external genital or mouth/jaw growth period, hence oral drug administration needs to be paid attention.
Worrying about teratogenesis becomes unnecessary from 16th week of pregnancy till the delivery, but fetus toxicant becomes an issue.
Typical drugs which is epidemic to induce teratogenesis are, thalidomide, androgenic hormone, warfarin, vitamin A derivative, antiepileptic drug, and methotrexate. Appearing malformation may differ by contents.
Main drugs or material having the risk for fetus toxicant are, alcohol, specific analgesic drug (NSAIDS: abnormality for fetus blood circulatory system), specific antihypertensive drug, antithyroid drug, massive amount of iodine, mental nervous system drug (to; breathing disorder at birth). It is not for internal use, but smoking is the possible cause for intrauterine growth restriction hence it can be said that smoking is fetus toxicant.
Regardless of in pregnancy, decision making is necessary for drug administration and whether it is actually taken upon comparing the risks for oral dosage.Judgement whether it is possible to take oral dosage should be consulted with obstetrician and gynecologist. Also, counseling offices for drug usage during pregnancy are as follows.
Regarding the drug during breastfeeding, counseling with obstetrician and gynecologist, or checking with the homepage of pregnancy and drug information center, is recommended.
