Organized by Anita Pitock, Esquire a nurse attorney at Anapol Schwartz. Contact Greg Spizer, Esquire Email: gspizer@anapolschwartz.com apitock@anapolschwartz.

com Toll Free: (866) 735-2792 Read more information online at: www.anapolschwartz.com 2011 All Rights Reserved.

First Trimester Pregnancy and Womens Health

Dos and Donts, Nutrition, Harmful Prescription Drugs, Birth Defects

CONTENTS
Youre pregnant. Dos and Donts What happens during the rst trimester week by week? What are rst trimester symptoms? How to effectively handle some rst trimester symptoms? Prenatal nutrition Teratogenicity Prescription drugs Birth defects WARNING: Topamax Birth Defect Risk Resources 2 2 3 3 4 5 6 6 6 7

MeDIcaL DIscLaImer: This PDF

is not designed to and does not provide medical advice, professional diagnosis, opinion, treatment or services or otherwise engage in the practice of medicine, to you or to any other individual. Please use this information to help in your conversation with your physician. This is general information and always seek the advice of your physician or other qualied health provider with any questions you may have regarding a medical condition. Never disregard or delay seeking professional medical advice or treatment because of content found in the PDF, website, or newsletter.

AttorneY DIscLaImer: This PDF is dedicated to providing general public information regarding legal
rights. None of the information on this PDF is intended to be formal legal advice, nor the formation of a lawyer or attorney client relationship. Please contact a Lawyer for information regarding your particular case. This PDF is not intended to solicit clients outside the states of Pennsylvania, New Jersey, Ohio, West Virginia and Arizona.

Youre going to have a baby. Youre going to be a mother. Youre going to start a family or extend your family and couldnt be happier and more excited or more stressed and conicted. Every woman will experience pregnancy differently.

YOURE PREGNANT. DOS AND DONTS

Stop smoking cigarettes, if you do. Stop using drugs, if you do. Stop drinking beer, wine, and cocktails. Discuss all your medications, vitamins, and supplements with your doctor. Stop tanning treatments and dont dye/perm/straighten your hair with chemical solutions. Avoid x-rays and MRIs. Avoid eating sushi, partially cooked meat or sh, deli meats, or soft cheeses (because of the possibility for bacteria). Tell your doctor, nurse, or dentist that you are pregnant. Do get prenatal care, practice good nutrition, and get adequate rest as soon as possible.

WHAT HAPPENS DURING THE FIRST TRIMESTER wEEK BY wEEK?

Weeks 1 & 2 are calculated as the rst two weeks of pregnancy even though the pregnancy does not actually exist. Weeks 1 & 2 are before conception and include the womans last period. Week 3fertilization occurs Week 4implantation happens Week 5embryonic period; the babys brain, spinal cord, heart and other organs begin to form; a baby is between 1/8 and 1/16 inches long [Ultrasound at 9 weeks] Week 6 & 7baby develops basic facial features; arms and legs start to grow; at week 7 baby weighs less than half an ounce Week 8the baby starts moving but you wont feel it Week 9, 10, 11 & 12the babys toes, neck, and genitals develop
FIRST TRIMESTER PREGNANCY AND WOMENS HEALTH Copyright 20042011 All rights reserved. Anapol Schwartz. Read more information online at www.anapolschwartz.com.

According to the American Pregnancy Association, by the end 12 weeks, the fetus will be about 3 inches.
2

WHAT ARE FIRST TRIMESTER SYMPTOMS?

Nauseamorning (morning sickness), noon, and night (hang in there!) Nipples and areolas darken due to a temporary increase in hormones Cramping is normal; spotting and bleeding is not; contact your doctor if this happens Weight gain Frequent urination Breast tenderness Headaches & dizziness Tired all the time or increased energy Overly emotional or an incredible sense of well-being

HOw TO EFFEcTIVELY HANDLE SOME FIRST TRIMESTER SYMPTOMS?

NauseaAn empty stomach or too full stomach creates problems; eat smaller meals more frequently and drink less liquids with meals; avoid unpleasant smells or odors; get more rest. Weight gainYou will probably gain about 3 or 4 pounds; thats a good thing. Frequent urinationDo not restrict liquids during the day because you need to stay hydrated but avoid drinking anything prior to bedtime. Frequent urination should diminish around the fourth month. Breast tendernessBuy a good support bra that is comfortable and possible to sleep in at night. HeadachesLearn breathing exercises and meditation which can help relieve stress and provide relaxation; avoid taking pain killers if possible or ask your doctor about safe options. Never take any over-the-counter herbs or drugs without consulting a health professional. DizzinessKeep your blood sugar level (healthy snacking helps in that respect); avoid getting up from the chair or bed too quickly. Tired all the time or increased energyIndulge in plenty of rest. Overly emotional or an incredible sense of well-beingIts a hormonal thing.

FIRST TRIMESTER PREGNANCY AND WOMENS HEALTH Copyright 20042011 All rights reserved. Anapol Schwartz. Read more information online at www.anapolschwartz.com.

PRENATAL NUTRITION
A balanced diet is very important for healthy pregnancy. Eat carbohydrates, fat, and proteins, and a variety of fruits and vegetables. Folic acid, folate or vitamin B9 (all the same) has been proven to limit a serious birth defect, spina bida. Calcium, vitamins, other micronutrients like iron Consume adequate amounts of DHA omega-3, a major structural fatty acid that supports a mothers well-being and the health of her infant. In a study of nearly 9,000 pregnant women, researchers found women who ate sh once a week during their rst trimester, had 3.6 times less risk of low birth weight and premature birth than those who ate no sh. Low consumption of sh was a strong risk factor for preterm delivery and low birth weight. Fish should be low in mercury. Note: Other studies do not have the same conclusion.

Avoid tuna, swordsh, shark, king mackerel and tilesh.

Now is not the time to pig out on junk food. Always ask your doctor or nurse practitioner for nutrition advice.

FIRST TRIMESTER PREGNANCY AND WOMENS HEALTH Copyright 20042011 All rights reserved. Anapol Schwartz. Read more information online at www.anapolschwartz.com.

TERATOGENIcITY
What is teratogenicity (teratogenicity)? Substances with teratogenic effects can damage the DNA of a developing fetus. It is estimated that 10% of all birth defects are caused by prenatal exposure to a teratogenic agent including but not limited tomedication or drug exposures, maternal infections and diseases, and environmental and occupational exposures. Teratogen-caused birth defects are potentially preventable. Studies have shown that nearly 50% of pregnant women have been exposed to at least one medication during gestation. A wide range of different drugs, chemicals, and environmental factors are known to be teratogenic in humans and in animals. Here is a smattering: DrUgs anD meDIcatIons: tobacco, drinking alcohol, androgenic hormones, lithium, tetracyclines, Dilantin, coumarin, methoxyethyl ethers, busulfan, valproic acid, enalaprin. A single dose of Roaccutane for acne may result in serious birth defects. EnvIronmentaL chemIcaLs: PCB, dioxin, hexachlorobenzene hexachlorophene, organic mercury, ethidium bromide IonIZIng raDIatIon: atomic weapons fallout, background radiation, diagnostic x-rays, radiation therapy InfectIons: herpes virus, parvovirus B19, German measles, syphilis, toxoplasmosis, CMV, HSV MetaboLIc ImbaLance: alcoholism, endemic cretinism, diabetes, folic acid deciency, iodine deciency, hyperthermia Additional agents include Agent Orange, nicotine, other NSAIDs, and aspirin. This list is under debate mainly because pregnant women cannot be subject to the above agents so there is very little documented data as to cause and effect. Teratogenic effects also help to determine the FDA (Food & Drug Administration) pregnancy category for drug safety. A pregnancy category of C, D, or X may be assigned if teratogenic effects are documented or cannot be excluded. The period from the 8th day to the end of 8th week (second month) is the period during which the organs are formed in the fetus. This is the most crucial time with regard to structural malformations and concerns from dangerous drugs.

FIRST TRIMESTER PREGNANCY AND WOMENS HEALTH Copyright 20042011 All rights reserved. Anapol Schwartz. Read more information online at www.anapolschwartz.com.

PREScRIPTION DRUGS
The FDA has developed a rating system to provide therapeutic guidance based on potential benets and fetal risks. Drugs have been classied into categories A, B, C, D and X. Multivitamins that have demonstrated no fetal risks after controlled studies in humans are classied as Category A. Category B includes (not inclusive) penicillin, cephalosporins, azithromycin, erythromycin, acetaminophen (Tylenol), and caffeine Category C includes (not inclusive) uconizole, heparin, aspirin, Vioxx Category D includes (not inclusive) valproic acid, valium, lithium, Topamax* ACE inhibitors, ARBs, coumarins, and central nervous system drugs Category X includes (not inclusive) thalidomide *Topamax moved from Category C after the birth defect risk of cleft palates and cleft lips almost doubled in newborns.

BIRTH DEFEcTS
Birth defects are known to occur in 35% of all newborns. They are the leading cause of infant mortality in the United States, accounting for more than 20% of all infant deaths. Seven to ten percent of all children will require extensive medical care to diagnose or treat a birth defect. A congenital disorder, or congenital disease, is a condition existing at birth and often before birth, or that develops during the rst month of life regardless of the cause. Exposure to teratogens can result in a wide range of birth defects such as cleft palate, cleft lip, ventricular septal defect, dysmelia (congenital limb disorder), anencephaly disorder (a rare birth defect in which the baby has a malformed skull and little or no brain).

WARNING: TOPAMAX BIRTH DEFEcT RISK

The North American Antiepileptic Drug Pregnancy Registry (NAAED) has shared data with the FDA showing an increased risk of cleft palates and cleft lips in infants exposed to Topamax or its generic topiramate during the rst trimester of pregnancy. Topamax is prescribed for anti seizures and to prevent migraine headaches.

The relative risk for developing cleft palate in infants of mothers who take Topamax or its generic equivalent, compared to infants of mothers not taking anti-seizure medication, is more than double the risk.
If you want to discuss your childs legal rights for a cleft palate injury that you suspect was caused by Topamax (topiramate), please contact the lawyers at Anapol Schwartz at 866.735.2792 or visit our web site at www.anapolschwartz.com.

FIRST TRIMESTER PREGNANCY AND WOMENS HEALTH Copyright 20042011 All rights reserved. Anapol Schwartz. Read more information online at www.anapolschwartz.com.

RESOURcES
American Pregnancy Association FDA Pregnancy Drug Categories & Teratogens Net Wellness Pregnancy Support Groups WebMD Topamax Birth Defects Lawsuit The Cleft Lip and Palate Foundation of Smiles Network for people to join to get support, meet families, build relationships, ask questions and get answers!

FIRST TRIMESTER PREGNANCY AND WOMENS HEALTH Copyright 20042011 All rights reserved. Anapol Schwartz. Read more information online at www.anapolschwartz.com.