임신부에서 해열제를 사용하게 된다면 아세트아미노펜

가끔 임신부가 내원합니다.

임신부여서 약에 대해 경계를 하는 것은 좋은 현상이지만

꼭 필요한 경우인데도 사용하지 않으려 하는 사람도 보게 됩니다.

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임신부에서 열이 나는 경우 참을 것인가?

임신부에서 열이 나는 경우 아세트아미노펜 (acetaminohen)을 사용하는 것이 중요합니다. 임신 1분기에서 열은 neural tube defects와 다른 출생 결함과 관련이 있습니다. 게다가 출산 중 열은 신생아 경련, encephalopathy, cerebral palsy, 신생아 사망의 위험 인자입니다.

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아스피린, 이부프로펜과 같은 다른 해열제는 이상 임신 결과, 이상 유아 결과와 관련이 있습니다.

따라서 아세트아미노펜이 best option입니다.

임신부에서 해열제를 사용하게 된다면 아세트아미노펜 (타이레놀, 써스펜ER....)

REF. UpToDate 2020.10.07

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Pregnancy Considerations ​ Acetaminophen crosses the placenta (Naga Rani 1989). Based on epidemiological data, an increased risk of major congenital malformations has not been observed following maternal use of acetaminophen during pregnancy. Although not considered a major birth defect, an association between maternal acetaminophen use and cryptorchidism (undescended testis) has been observed (Fisher 2016; Jensen 2010; Kristensen 2011; Snijder 2012). The use of acetaminophen in normal doses during pregnancy is not associated with an increased risk of miscarriage or still birth; however, an increase in fetal death or spontaneous abortion may be seen following maternal overdose if treatment is delayed (Li 2003; Rebordosa 2009; Riggs 1989). Prenatal constriction of the ductus arteriosus has been noted in case reports following maternal use during the third trimester (Allegaert 2019); although this association was not confirmed in a large observational study (Dathe 2019), acetaminophen has been evaluated for the treatment of a persistent patent ductus arteriosus in preterm neonates (Terrin 2016). Additional adverse events such as wheezing and asthma in early childhood and adverse neurodevelopmental effects such as ADHD following in utero acetaminophen exposure have been evaluated in multiple studies; outcome information is inconclusive, and a causal association has not been established (Cheelo 2014; Fan 2017; Lourido-Cebreiro 2017; Scialli 2010; SMFM 2017). It should be noted that maternal fever is also associated with adverse fetal outcomes, including neural tube defects, oral clefts, and congenital heart defects. Treatment of maternal fever with an antipyretic may reduce these risks (Drier 2014). ​ Due to pregnancy-induced physiologic changes, some pharmacokinetic properties of acetaminophen may be altered. Dose adjustments are not recommended (Kulo 2014). Acetaminophen is considered appropriate for the treatment of pain and fever in pregnancy (SMFM 2017). Acetaminophen may be used as part of a multimodal approach to pain relief following cesarean delivery (ACOG 209 2019), for the treatment of acute migraine in pregnant patients (Burch 2019; Hamilton 2019a; Marmura 2015) and is recommended for the treatment of fever in pregnant women diagnosed with influenza (ACOG 753 2018). Acetaminophen is recommended to be used at the lowest effective dose for the shortest duration of time to effectively treat the mother and protect the health of the fetus (Kilcoyne 2017).