I Just Found Out I’m Pregnant – What’s Next?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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You just took a urine pregnancy test and it’s positive, what should you do now? As a primary care doctor, many patients contact me before they’ve picked out an OB/GYN. The news of a positive test is an exciting time that often sends patients into a panic about what they should and shouldn’t be doing.

Here are the questions I’m asked all the time.

My urine test was positive. Do I need a blood test?

Generally, the urine tests are accurate enough to eliminate the need for a blood test.

What supplements should I start taking?

You may have been taking iron or folic acid 400 mcg before you got pregnant, so you will now replace that with a single prenatal vitamin. The American College of Obstetricians and Gynecologists (ACOG) recommends pregnant women take at least 200 mg of DHA a day in addition to their prenatal vitamins. Prenatal vitamins + DHA can be purchased over the counter or with a prescription.

What medications should I not be taking?

You should talk to your doctor about any medications you’re taking.

What are some drugs that you should immediately discontinue when you find out you’re pregnant? Non-steroidal anti0inflammatory medications (Motrin, Advil, and ibuprofen) and Retin-A (tretinoin).

There is good news though. You should be fine continuing the use of Claritin (loratadine) and Zyrtec (cetirizine) for allergies, omeprazole, and acetaminophen (Tylenol).

Do I need to stop my antidepressant?

As much as 16% of pregnant women meet the criteria for depression, and this question arises a bit. If women discontinue their antidepressant during pregnancy, 68% have a relapse of their depression. Guidelines about the SSRI antidepressants (escitalopram, citalopram, sertraline, fluoxetine) suggest they be continued but that needs to be discussed on an individual basis. There is an exception though – Paxil (paroxetine) should be avoided by pregnant women and women who plan to become pregnant.

When should I have my first prenatal visit?

Your OB/GYN might not schedule your appt until 8-10 weeks of pregnancy partly due to the fact that most miscarriages occur between 6 and 8 weeks and you don’t want to do all of your screening during a prenatal visit until your pregnancy is more “certain.”

The nausea is bad. What can I do?

The nausea peaks at 8 weeks and Vitamin B6 at doses of 75-100 mg a day has been shown to help. Asking your friends what helped for them is also beneficial: ginger, frequent small meals, more protein (eggs, chicken), sucking on lemon candies, cinnamon gum?

Hope this helps.

Dr O.

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