Thursday, April 16, 2020

First trimester COVID

Q: How simple use of acetaminophen (Tylenol) can help in COVID-19 patients in first trimester of pregnancy?

Answer: The biggest risk during the first trimester in COVID patients is from hyperthermia/fever, one of the cardinal symptoms of COVID-19. The first trimester is crucial for organogenesis. Increase core maternal temperature may lead to increased congenital anomalies, particularly neural tube defects, congenital heart diseases, and cleft palates. It also increases the chances of miscarriage. Acetaminophen is considered safe during first trimester of pregnancy. It can be the most cost-effective measure.




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2. Dreier JW, Andersen AM, Berg-Beckhoff G. Systematic review and meta-analyses: fever in pregnancy and health impacts in the offspring. Pediatrics 2014; 133:e674. 

3. Graham JM Jr, Edwards MJ, Edwards MJ. Teratogen update: gestational effects of maternal hyperthermia due to febrile illnesses and resultant patterns of defects in humans. Teratology 1998; 58:209. 

4.  Waller DK, Hashmi SS, Hoyt AT, et al. Maternal report of fever from cold or flu during early pregnancy and the risk for noncardiac birth defects, National Birth Defects Prevention Study, 1997-2011. Birth Defects Res 2018; 110:342. 

5.  Feldkamp ML, Meyer RE, Krikov S, Botto LD. Acetaminophen use in pregnancy and risk of birth defects: findings from the National Birth Defects Prevention Study. Obstet Gynecol 2010; 115:109.

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