Can Certain Medications or Medical Procedures Increase the Risk of Pregnancy Loss?

It’s a common concern for pregnant people whether certain medications or medical procedures can increase the risk of miscarriage — the answer is, unfortunately, not a simple yes or no. Most medications sold in the United States feature labels stating any pregnancy risk, though if you’re pregnant or planning to be, you should absolutely check with your physician prior to starting or continuing any prescription, over-the-counter medication, vitamin or supplement.

There are certain medications that should be avoided, especially in early pregnancy, as they’ve been linked to an increased risk of pregnancy loss or birth defects. These include non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin, decongestants containing pseudoephedrine or phenylephrine (Sudafed), ACE inhibitors for heart issues or hypertension, isotretinoin (Accutane) for cystic acne, and methotrexate for psoriasis or rheumatoid arthritis.

There are also certain medical procedures that are considered dangerous for pregnancy. These include X-rays, which should only be performed if absolutely necessary and with proper shielding to protect the fetus. Procedures that involve anesthesia, including most surgeries (which also carry risks due to blood clotting), should be avoided unless deemed necessary by a medical professional.

Chemotherapy and cancer treatments pose a complex issue during pregnancy. The safety of these treatments largely depends on the type of cancer and its location, the stage of pregnancy, and the specific drugs or procedures being used. Generally, chemotherapy is not recommended during the first trimester, though some chemotherapy drugs may be used during the second and third trimesters. Radiation therapy is not safe in areas near the developing baby, but may be approved in more distant areas with proper shielding. As with all medical situations during pregnancy, it’s crucial to consult with healthcare professionals to provide advice tailored to individual circumstances to ensure both parent and fetus receive proper care.

Sources 

“Medications During Pregnancy: What’s Safe and What’s Not?” What to Expect. https://www.whattoexpect.com/pregnancy/pregnancy-health/medications-during-pregnancy/ 

“More evidence of NSAID risk in early pregnancy”. Reuters. https://www.reuters.com/article/us-health-miscarriage-nsaids-idINKBN1JG2VU/

“ACE Inhibitors and Heart Disease”. WebMD. https://www.webmd.com/heart-disease/medicine-ace-inhibitors 

“Methotrexate (Rheumatrex, Trexall, and others) – Uses, Side Effects, and More”. WebMD. https://www.webmd.com/drugs/2/drug-3441/methotrexate-anti-rheumatic-oral/details 

“Things to avoid during pregnancy”. Pregnancy, Birth, and Baby. https://www.pregnancybirthbaby.org.au/things-to-avoid-during-pregnancy#x-rays “Cancer During Pregnancy”. American Cancer Society. https://www.cancer.org/cancer/managing-cancer/making-treatment-decisions/cancer-during-pregnancy.html