Note: this transcript is not 100% accurate.
00:01
You could eat celery all day and get gestational diabetes. Really, truly. You could also eat cupcakes all day and not get gestational diabetes. If you’re pregnant and you’re having bleeding, bright red blood, it’s always a problem. I wanna know. I wish you knew that doctors are here to help you. I wish you knew that if you don’t feel listened by a doctor to find another one.
00:32
Welcome to Uncover Your Eyes, where we break down the most pressing health topics shaping lives today. Today, we’re gonna talk about literally something that shapes a life, the most powerful and delicate journey, pregnancy. Did you know that nearly one in 10 babies in the US is born preterm? And up to 8 % of pregnancies are affected by gestational diabetes.
00:58
A condition that when undiagnosed can significantly impact both maternal and fetal health. Let’s uncover the truth about pregnancy and fetal health and bring wellness back to the womb with Dr. Sarah Pachtman, who is an OB-GYN and medical fetal expert. Thanks, Sarah, for being on today. I really appreciate your time. Thank you so much for having me. I’m super excited. I’ve been looking forward to it. Thank you. So tell me, like, I mean,
01:28
What are we looking for in a healthy pregnancy? want to say, know, especially in the first, know, correct me if I’m wrong, but the eight to 11 type week period, you know, where sometimes we can be told, you know, that there will be there’s an early miscarriage or whatnot. So what are we looking for and signs of it? So the most important thing to establish a healthy pregnancy from the beginning is to make sure that you
01:56
have a healthy body before you’re going into pregnancy. That gives you the best chance of avoiding a miscarriage, avoiding an early miscarriage. Of course, there’s reasons why people have miscarriages that are outside of their control and outside of the realm of putting it into pre-conception health. But if you set yourself up for a healthy pregnancy, you’re more likely to have one. There’s a few tests that we run in the beginning.
02:25
We look at a cell-free fetal DNA screen. Most patients are offered this, at least in pregnancy. That screens for the three most common aneuploidies, things that are a deletion or absence of one of the chromosomes. That’s done between around 10 weeks, is usually the earliest that can be done. At 12 weeks, we do a nuclear translucency ultrasound. Really, it can be done between 11 and 13 weeks.
02:52
And that measures the skin fold at the back of the fetal neck. And that screens for heart defects. We can also look now on ultrasound. It’s incredible at so much anatomy, even that early. It’s amazing. Wow. It’s really fantastic. And also it’s an older screening for Down syndrome prior to what the time when we had the cell-free fetal DNA that’s also commonly known as NIPS or NIPT. So those are really like the first trimester
03:23
to do’s and once you pass those big milestones, the chance of a miscarriage is so much lower, so significantly decreased after those are found to be normal. And how do I know like as a mom, you know that, hey, there might be something wrong, are there warning signs where like, yeah, I should be going to my OB sooner? So any vaginal bleeding or pelvic cramping in early pregnancy especially is abnormal.
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And it really, there’s nothing you can do about it, which is really scary and provokes a lot of anxiety and fear because it feels so helpless and so out of control. And I think that that’s the thing that we’re all worried about. Okay, let’s make this better for us as best we can, but you really, it’s kind of up to where the embryo implanted. And if there’s a separation of the portion of the placenta and a blood clot forms, which is
04:20
called a subchorionic hematoma. It’s a very common finding in an early pregnancy. It’s usually associated with vaginal bleeding, but doesn’t have to be. If you have those symptoms, those are concerning, but it’s, I don’t know the right word even to say, it’s frustrating because we as providers and doctors can’t do anything about it. We just have to say, hope this doesn’t go poorly for you. And,
04:49
counsel about the signs of miscarriage and hope and pray for the best. And there’s nothing that the mom really can do to change the outcome. Absolutely. And are there tests that we’re looking for in the second and third trimester just for the health of the baby? Oh, absolutely. So in the second trimester, we do the fetal anatomical survey. It’s the most important ultrasound of your entire pregnancy. We look at the brain structures.
05:19
the lenses of the eyes even, the nose, the lips, the palate. We look at the fetal neck, the thoracic structures like the heart. We look at all of the chambers of the heart, the outflow tracts of the heart. We look at the valves and how they’re beating and how the rate and the rhythm of the heart. We look at the lungs and we look for signs of…
05:45
anomalies. We look at the abdominal wall. We look at the spine. We count fingers and toes. It’s really quite amazing. And it is traditionally the ultrasound where moms will find out the sex of their fetus. We do try to take that. It’s fun. Yes, it’s a fun ultrasound, but we do try to take that out of it a little bit because it’s really like a medical test that we’re looking for structural anomalies.
06:15
And while it’s really cute and fun to see your baby, the purpose of the test is really to screen for birth defects. And so that’s one of the major big tests in the second trimester. The glucose screening that happens at 26 to sometimes into the early third trimester that screens for gestational diabetes. It’s called a GCT or glucose challenge test. There’s several different ways to administer the test, take the test.
06:44
People do it differently. It’s regionally or by doctor preference. That’s a very important test because we screen for diabetes that can affect the outcome of a pregnancy significantly and the amount of testing that we do significantly. And I did forget to tell an important second earlier second trimester test, the AFP screening test. This is a test where we, it’s traditionally a test to screen for spina bifida.
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and for abdominal wall defects. But that was kind of before we had the high resolution ultrasound that we have now. And since we have that ultrasound now, we don’t really need this test as much because actually the sensitivity of ultrasound is better than the sensitivity of the AFP test. It’s been between about 16 to 20 weeks. But I still run it and I still use it in my practice because it screens, it also can look and predict
07:44
placental dysfunction. So if you have a high AFP and there’s no other reason why, or you have a history of surgery on your uterus, and it can screen for things like placental implantation disorders or placenta accretus spectrum disorders. It can screen for just, it can be a herald for later placental insufficiency. So that’s something that I always like to run on my patients.
08:13
I want to ask you, just go back to the gestational diabetes thing, because that’s something that hits close to home. I actually did not have the glucose test done on my first pregnancy and I was likely gestational diabetic. I had a really complicated first pregnancy. So I want to just get into what are the risks and for people to start self-advocating because sometimes things get missed, that they need this sugar test.
08:42
what can happen or go wrong if they are gestational diabetic and they’re not getting treated or put on insulin. Yeah. Okay. So that’s really important. I’ll start with the advocacy part because being your own advocate is something that I think maybe 40 or 50 years ago, as women didn’t do as much. And we went to the doctor and kind of just did what we were told and said, oh, the doctor knows best. And we are trained in science. Yes.
09:12
But also, there’s a lot going on and to say like, hey, I’m not sure about this or I miss this or is this something that I should be concerned of is only beneficial to you and it’s actually helping your doctor out too. I love when my patients come to me and say like, I wanna know more about this and can you teach me more? I wanna be more empowered and to know, they’re advocating for themselves and you are in your family’s best advocate. And I’m like, yes, more power to you.
09:41
Get it, get it. I think speaking up and just educating yourself and knowing when the tests are done, what the tests are done, it’s really important to understanding yourself and your health and understanding the health of your pregnancy. And so there’s, I mean, it’s very easy to find. I talk about it on social media. It’s available. It’s not like a secret.
10:09
service situation where nobody can find out which tests are done and who needs what. yeah, it’s something that you should look into and find out and ask about. And so the gestational diabetes test is really important and there’s different schools of thought, I’ll say, about if the test should be done early and on which subset of patients the test should be done early to screen for underlying diabetes or pre-existing diabetes. Because a lot of times,
10:39
we won’t have gone to the doctor before we found out we’re pregnant. I mean, we’re youngish healthy women and we got pregnant and it’s like, why were we going to the doctor so much before? So we may have not had the screening tests that we needed to screen for underlying diabetes. And then if we have that test in early pregnancy, it’s debatable what we call it. Is it really preexisting like a type two picture of diabetes or is it?
11:07
glucose intolerance of pregnancy that comes from a placenta early on, we don’t know, but it doesn’t really matter. The treatment can affect the outcome. There’s newer data to suggest that treatment earlier on in pregnancy isn’t as important as treatment later in pregnancy. So that’s why the 25, 26, 27, 28 week screening test is really, really the most important test. And if you have an…
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earlier test that’s normal, you do need to repeat the test around 28 weeks to make sure because gestational diabetes is not a disease that’s caused by food. It’s not. It’s a disease that’s caused by placenta. And you, by nature of being pregnant, have a placenta. And placentas are amazing organs. They secrete hormones. They give blood and nutrients to your growing fetus.
12:02
They filter waste from your growing fetus, but they also secrete hormones that make your body more resistant to the insulin that your pancreas is already making. Right. So you could eat celery all day and get gestational diabetes. Really, truly. And it’s not something that you- Should’ve eaten the ice cream. It’s not like that. You could also eat cupcakes all day and not get gestational diabetes. It’s about how your muscle tissue responds to insulin.
12:31
and how those receptors respond to the insulin that’s dictated a lot by the hormones secreted by your placenta. So having the test is important because if it’s diagnosed and properly treated, and insulin is the gold standard first line treatment because it doesn’t cross the placenta and affect a growing fetus. Right. So that’s important because the risks of uncontrolled gestational diabetes are things like macrosomia,
13:00
or a baby who’s too large. Polyhydramnios are having too much fluid in the amniotic sac around the baby. Obstetrical complications like needing a C-section because the baby’s too large. Too large, yeah. A shoulder dystocia. And the most feared complication, I mean, also there can be metabolic derangements in a fetus that can affect the neonate in the baby once the baby’s born for the rest of his or her life.
13:30
And it can cause thickening of the heart muscles and diabetic phytopathy is the term for what too much sugar in the mom’s bloodstream causes to a baby. And I tell my patients sometimes glucose in your bloodstream that’s too high is a teratogen. It is more dangerous than, I don’t know, microplastics that we know of right now or whatever other environmental exposures that you’re seeing and facing.
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decreasing the risk of some of those complications is the reason we treat gestational diabetes. And it can lead to healthier pregnancy outcomes and healthier outcomes for mom because it avoids interventions in the hospital that we don’t want to do like a C-section. Right. I’m glad you made that clear that it’s not from, you know, eating a lot of sugar and things like that, because I think there are that sort of that group of women that are on the side of, hey, if I
14:29
My sugar’s a little high. I’m going to diet control it such that I won’t have to be on that insulin because, you know, some people obviously believe in no medication and they feel it’s a form of medication. So, you know, thank you for clearing that up. Also about the insulin being the best treatment. Yeah, sure. Lifestyle interventions are a great start and having a well-rounded, glycemic controlled, fiber and protein forward diet and just mixing your, anytime you eat
14:58
sugar or carbohydrate, eat protein and fat along with it so that your body processes it more slowly and it doesn’t show your bloodstream this huge load of sugar that it has to then work to decrease with insulin secreted from your pancreas. But sometimes that’s out of your control and you really eat only a keto diet and still have high blood sugars and that’s not something to be ashamed of.
15:28
It’s not because of you, it’s because of your placenta and your body’s response to having a placenta. And you need that placenta. Absolutely. Like what other complications do you see where you feel that they could have been, I don’t want to say prevented, but there’s that word for it, know, where not as complicated, right? Things that you feel like, man, I wish, you know, this happened and I wish this patient did this.
15:57
Are there those common complications? There are some things that I see more frequently than other things. I would say that I don’t know what is, are we having 2025 vibes? I can’t tell. The anxiety in our culture, in our society today is next level. And I understand anxiety around health and anxiety around pregnancy. I did IVF for
16:26
four years to get my son and I get it. It’s really scary and hard and it feels out of control because a lot of it is. Right. It’s out of your hands. Yes. A biological process like pregnancy is very much out of your hands and I think that a lot of, I see a lot of patients every day in my office who work themselves up so much over small things, small, small things that I say, look,
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This is something we have to take the test. If it comes back positive, we’ll cross that bridge when we get there and we’ll work on it together. We’ll find the best treatment together. And they worry themselves sick. I really think that anxiety and plays as much of a burden to the health of a pregnancy. That’s I guess the best way can say it as having a high blood pressure or diabetes or a preexisting medical condition.
17:25
I truly believe that. Other things that I see commonly are fetal kick counts and fetal movement monitoring. There’s not one number of kicks per hour that’s normal. Every baby’s different. Right. Every fetus is different. Knowing your fetus is really important. So if you detect or you’re noticing a difference in your fetus’s movement pattern,
17:55
That’s important to speak up right away. And if you aren’t comfortable with the answer that you get, you go to the hospital. And if you don’t like the answer that you go there, get there, go to find a different hospital. Truly, honestly. Stillbirth is, I am like getting chills even saying it because it’s the only, like it’s the reason for me to be here. As a maternal fetal medicine physician, my job is to, and my life’s work is to,
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prevent stillbirth and make sure that mom and baby are delivered and leave the hospital healthy. That’s it. And I hear things like, well, I have an anterior placenta so I didn’t know that the, I thought the movements were going to be less. No, no. The movements are what your fetus moves. And if your fetus is moving less, I need to know before the next day.
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I need to know before four hours have passed. I need to know right away. That is an emergency. After 28 weeks especially, that is an emergency. Vaginal bleeding, it’s always a problem. If you’re pregnant and you’re having bleeding, bright red blood, it’s always a problem. I want to know. If you’re feeling pain, pelvic pain, if it’s not like a pulling, tugging sensation pain, if it’s like a different…
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type of sensation, I need to know. In the third trimester, if you have a headache and you take Tylenol and it doesn’t go away, or you rest and it doesn’t go away, if you are seeing blurry vision or flashing lights or stars in the sky, if you have new nausea and vomiting that’s different, if you have pain high up in your belly, if you’re just feeling general malaise or unwell, I need to know. That is a sign of preeclampsia.
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and you need to speak up right away. Those are kind of the top most frequent things that I, my soapbox speech in my office. Wow. Oh my gosh. Well, I got chills with listening to that. You know, it’s scary that you actually deal with this daily, right? I mean, we just hear about it, but you’re dealing with it daily. So, you know, kudos to you. And, um, you know, you talked a little bit about the health of the mom prior to getting pregnant, right?
20:24
What does that mean? So first things first, prenatal vitamins, the whole purpose of a prenatal vitamin is for the folic acid. You can have vitamin A, D, E, C, whatever else you want, all the B vitamins. Great, love it, take it. I’m here for it. In pregnancy and mostly before pregnancy,
20:50
Folic acid is the single most important thing that can prevent a birth defect. And that’s a neural tube defect like spina bifida or anencephaly. It only works if you take it before pregnancy, really, truly. So a lot of times you’ll not realize that you’re pregnant or you’ll miss a period. By the time the beginning processes of organ formation have already started, the blueprint has been laid.
21:20
And you can’t go back in time and change that. You can’t take 20 prenatal vitamins a day and fix that. It’s done. And if you take a prenatal, if you’re a person who has a uterus who might have a chance of getting pregnant ever, you should take a prenatal vitamin every day. Why not? It’s good for your hair and nails anyway. American diets are like a little sus on the vitamin content. I mean, when I think about, okay,
21:48
Pastas and breads and grains and pancakes and waffles in the United States are fortified with folic acid. That’s fantastic but I don’t really eat a lot of bread and pasta and cookies and bagels because I’m trying to live a balanced and eat a healthy diet overall. Right. So if you’re eating a ton of those foods, probably okay. Green leafy vegetables. I also don’t eat so much of that because as much as I try to have a balanced diet,
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I’m vegetarian, so can’t say that to me. do the best I can, but here we are. Taking your prenatal vitamin before pregnancy is so important. Also, just feeding your body nourishing food and getting enough sleep and controlling your stress and your external triggers for your stress as much as you can, exercise, managing your preexisting health conditions.
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If you have high blood pressure and you’re just like letting it ride and not going to the doctor and seeing what happens, you’re going to cause damage to your kidneys and your eyes and guess what? Your uterus that’s going to hold the placenta and you’re growing fetus. It’s not going to work well for you. Taking care of your body. Your body is the house for your future baby. So taking care of it before pregnancy is the most important thing that you can do to ensure that you
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can have a chance at a healthiest pregnancy. I wanna touch on the science behind the folic acid. So, you know, I’ll be honest, like I was uneducated about it and I probably didn’t take as much as I supposed to, skipped all those days, but like, you know, just so moms and healthcare providers really understand the benefit of it, what is it really doing? So folic acid is a B vitamin and it works in your
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body in different parts of, how do I explain this, in context to brain development? Folic acid helps with the way the neural tube, which becomes the spinal cord, make sure it closes, make sure the brain cells and the neuron tubes have the cofactors that they need to properly form.
24:15
It’s a complex process that starts from, it’s a cellular metabolism process. And that’s how it kind of, had like a biochemical standpoint as evolved. But that’s the real crux of it and the importance of it is it helps that fold, that ridge of tissue that creates the spinal cord column and the sheaths that your spinal cord, which is your
24:45
all the nerves in your body come from your brain, spinal cord, and then shoot out into your peripheral nervous system. It forms that, and also the overlying skin layer, and if you want to get into like embryonic, it’s called the mesoderm and ectoderm, the different layers of tissue, and it helps them find each other, close, and form properly. And then also later, it helps for the neurons that are
25:12
will then become gray matter and white matter move to the correct places that they need to be. And so that’s really what it is doing from that aspect. It does a lot of other things for cardiovascular health and cellular health and even maternal brain health and adult brain health. But that’s what it’s doing from an a fetal development standpoint. So there’s also this conversation around
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methylfolates and all the different types of folic folates that are available. And there are many different five methyl tetrahydrofolate, methylfolate, this folate, that folate. I’m here for it all. And if you have MTHFR, which is not something bad to have, it’s not a mutation, it’s a variant. And it’s about
26:09
30 % of white people have that. So it doesn’t cause adverse pregnancy outcomes at all. It doesn’t even really change to, at least from a pregnancy standpoint or a fetal development standpoint, the way that the fetus is developing from how your body can metabolize it, there’ll be enough. There will be enough. Folic acid in itself is the only
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version of the folate vitamin groups that has been studied and proven to show a benefit in decreasing the risk of neural tube defects. And so that’s why my patients say, okay, I want to take methyl tetrahydrofolate because I have MTHFR and I heard it was better on TikTok. Please do, but also can you take folic acid? Just do it. You’ll have very expensive pee and that’s fantastic. You’ll pee it all out.
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but just do it so I can feel, just do it for me. Okay, take home, everybody take folic acid. 800 micrograms a day. Okay, good. That’s good to know. In terms of like the fetal health, right? Like, cause we’re talking about the neural tube formation and all of that. When is like in which trimester is, does the brain, the nervous system, those key structures develop? The blueprint is laid early on.
27:37
By eight weeks, the blueprint has been set, it’s formed, the things are happening. You can’t really affect the outcome after then. And most of us, mean, if I hadn’t done IVF, I don’t know that I would have remembered when my last period was and been tracking it and worried about it so much that I would have been like, oh, hey, I didn’t get my period this month. By then you’re here’s six, seven, eight weeks already.
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to 11 weeks is the main formation and closure of the neural tube and formation of the brain structures. But the fetal brain is quite interesting in that it is continuing to mold itself, form, evolve. Neurons are moving to their final resting places where they’ll live for the rest of the neonates and child’s adult life into the late 20 to 30 weeks, so into the third trimester.
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So it’s not like some of the other organ structures that just form and then grow. It still is molding and modeling and changing and being plastic, we call it, so much. So some of the neural migration disorders, it’s like a little maybe getting into the weeds, but those can’t even really be seen on ultrasound or diagnosed until much later.
29:03
because then that’s when you start looking at the contour and the gyri and sulci of the brains. And if that doesn’t form correctly, you won’t even see that till later. There’s some structures in the brain that we can’t even reliably see on ultrasound till 18 to 20 weeks. Because it’s continually changing its structure. I know there’s that measles outbreak.
29:30
I’m sure you’re counseling your patients slightly about that, but what is your advice to your patients or women that are obviously pregnant, you know, about signs, symptoms of measles? So my first advice, and I’m not paid by any pharmaceutical company to say this, I just don’t like sickness and preventable infectious diseases that can kill people and…
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can be completely avoided is to be vaccinated if you aren’t. And don’t be afraid of vaccines. I don’t think that the scientists who developed these vaccines were trying to hurt you or your family. I don’t think that as horrible as drug companies are made out to be, they’re putting in crazy aluminums or toxic chemicals into
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and injectable to do some sort of malice. They’re just safely delivering a form of a virus that your body won’t get sick to, but will develop antibodies against so that you can see that and fight that later on if you ever see it again. If you’re not vaccinated, know the signs and symptoms, although there’s really nothing that we can do besides supportive care to treat the measles.
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Symptoms of the measles are things like a rash and runny nose, cough, headache, general body aches, malaise, pneumonias. mean, people can get very, very sick from the measles. So if you feel like you’ve been exposed or have symptoms or a rash that looks like a measles rash, and you can Google it, there’s pictures, there’s…
31:24
I mean, my social media is filled with pictures of little children with measles rashes right now. You need to tell your doctor and see what their recommendation is. And unfortunately, there’s not like so many recommendations and treatment of measles because it was previously an eradicated disease. So here we are. 2025. Bye bye. Like you said, it’s a crazy year or something, right?
31:50
I thought it was going to be better. I had a rough 2024 and then I was like excited for 2025 and it’s not like really shaping up the way I… It never does, right? Right. What are some common myths that you want to kind of debunk about pregnancy that you hear all the time and you’re like, oh my God, and you roll your eyes? When I was pregnant, I don’t know if it’s a myth, so you’re going to have to tell me is…
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the taking of medications like the Tylenol and Advil. Like I always avoided it like the plague because I was always thought that I can’t take a Tylenol. So, you I always had these sinus colds and I’d be like, no, I can’t take a Tylenol. So I suffered through it. Myth or what? Total myth. So Advil, Ibuprofen and Motrin, those are like different brand names for the same thing that’s Ibuprofen.
32:39
Those are NSAIDs. It’s a class of medication that is not recommended in pregnancy for extended courses, especially in the third trimester because it can have effects on the fetal cardiac, not development, but it can prematurely close one of the holes that we need in the fetal circulation. There are certain, you know how everyone says, it might be on a hole in its heart. Well, some of those holes are required for
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fetal circulation and then close once the baby transfers, changes and becomes a neonate and is born. So it can cause premature closure of one of those holes. It’s called the ductus arteriosus if you want to look it up. It can also lead to kidney issues with the baby and their decreased amniotic fluid, which is just fetal pee. And so when your baby’s kidneys are suffering, they don’t pee as much and then you don’t have as much of that protective amniotic fluid around, it’s not good.
33:39
So, Motrin, ibuprofen, and Advil, I’d say just stay away from those. So that’s not a myth because you don’t want to accidentally take too much or accidentally not remember that you took it every day for the last five days and then continue to take it. Okay. There are some pregnancy conditions that I treat with short courses of NSAIDs. Also, I give low dose aspirin, which is an NSAID, every day for your whole pregnancy to protect against preeclampsia. So it’s not like they’re like toxic
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poison. They’re just poison and toxicity is all about the dose, right? So we just have to like limit that. So I just say stay away from it because we have Tylenol, which is safe that we can take. It’s not associated with autism. It’s not associated with any adverse pregnancy outcomes or neonatal outcomes. Things that are associated with autism that we know may be true are maternal fevers in pregnancy.
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So if you have a fever and you aren’t lowering it with Tylenol, that’s actually more dangerous than taking a Tylenol. So please take your Tylenol. It’s okay. It’s not going to hurt you. It’s not going to hurt your baby. If you’re taking more than three grams a day, I would like to know because it can be toxic to your liver at those high doses. And then we got to figure out what’s hurting you so that we can treat that and treat the underlying cause instead of putting a band-aid over it. But that’s like a different.
35:07
That’s not like, oh, I have a headache. I could take a Tylenol. Are all other medications big no-nos? You know this thing about Robitussin DM and Robitussin DR and whatever the letter? That’s a myth. The issue with taking cough syrups is that there’s a small amount of alcohol in them. Ah, okay. Yeah.
35:28
We also really don’t like you to take pseudoephedrine, which is the old Sudafed that now you have to give like your license and your passport and your left arm to get behind the counter because that can cause constriction of some of your blood vessels, including the blood vessels that run to your uterus. And so you don’t have as much blood flow to your uterus. So it can lead to placental insufficiency, but you also have to take a whole lot of it.
35:52
And please don’t do that anyway, because then I would like to prefer to fix whatever is going on with the reason why you need to take that much Sudafed. So things, also phenylephrine, the other medication that’s in the drying out your nose class of medications. Right. That is totally safe in pregnancy, but it doesn’t really work outside, inside, anytime. So the whole thing with the Robitessin is just…
36:23
a myth, like an old wives tale. I don’t know. You can take gwyfenicin. You can take X-spectrin. You can take those medications in pregnancy safely. You can take Zyrtec or Claritin. You can take Benadryl. Yeah, it’s safe. I should talk to you before. I wouldn’t have suffered through my allergy season. You can take Miralax, Colace.
36:50
I love a magnesium supplement for constipation or headaches. You can take, what are some common ones that we take? Don’t take a 325 or 650 milligram dose of aspirin because that’s in the class like ibuprofen, but you can take most other over-the-counter medications safely. If you have a question, just ask, but they’re not poison. Okay. Good to know.
37:17
You you talked about autism a little bit, so I’m glad you touched on that because I didn’t know that maternal fevers can be associated with it. Are there other associations that you guys have found? So everybody associates a lot of things with autism. And I like to bring us back to the correlation and causation argument because we know we can’t do great research on
37:42
Women are excluded from research and then pregnant patients are really excluded from research because it’s an ethical issue, right? We can’t really like be testing things on pregnant patients and their fetuses. It’s not ethically appropriate, which is a good thing, but it also leads to big debts in our available data. And all of the data that we have is recall of pregnant patients and retrospective data saying, did you take this medication in pregnancy? Well, I don’t.
38:11
I think, yes, I took it, must have. And when you have a baby who has autism, you’re poking and pining at every little thing that you could have done to cause that. So you’re like, yes, it must have been the Tylenol. So you recall that you took Tylenol more than someone with a baby who doesn’t have autism, like I don’t remember, sure, no, I didn’t take it. So it’s very, very biased and it creates…
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associations that aren’t really valid causes, right? And so that goes along with a lot of the pregnancy related and pregnancy and autism related discussion. But when we have data that you came, you had a documented fever and here’s the incidence of outcome versus you didn’t have a documented fever and here’s the incidence of outcome.
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And fevers, especially in earlier pregnancy, are associated with an increased risk of autism. Do we know why a maternal fever causes that? Not really, because we don’t really know what autism has caused. It’s multifactorial. It’s kind of nature and nurture this, that, genetics, not genetics. There’s different, and also autism is labeled, I think, more frequently and for different spectrums of
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the neurodiversity spectrum disorders. And I really wish we’d like move away from using the word autism. Like, first of all, it has like hateful roots if you look up the root of the word. Second, neurodiversity, makes the world go around a little bit, right? Everyone’s has a little, is somewhere on this spectrum from neuro-typical to neuro-diverse. And
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where you are, where you’re pointed, and now we’re calling ADHD neurodiverse. I mean, that I am neurodiverse girlfriend. We all are neurodiverse. That’s right. Yeah. It’s a more positive way to look at it. Absolutely. Absolutely. So do you know exactly what you do in pregnancy that causes it or what associations? We have some data suggesting certain exposures
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pollution, living here versus living there. Does it really, it all comes out in the wash at the end, right? Because you can’t really 100 % control your environment. Absolutely. Is there like one piece of advice, I know this is gonna be hard, but like one piece of advice that you wish like you could stand on the top of that building behind you and just scream out to all the pregnant women, like something you just wanna tell everybody to look out for, to do.
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besides the folic acid, something that you wish everybody knew. I wish you knew that doctors are here to help you. I wish you knew that if you don’t feel listened by a doctor to find another one. I wish you knew that there’s not a best doctor out there, that there’s the best doctor for you. I wish you knew that you
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can’t control everything and gotta let things go and just like live your life to the fullest and life is a mix of ups and downs and good and bad and that’s what makes the sunshine brighter is when you have seen the dark days. So just like embrace it all and don’t let your anxiety get the best of you because it takes so much away from you and I wish you could just enjoy you only have however many chances you want but those chances to be pregnant.
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Enjoy it. That’s so great. Thank you so much, Sarah, for your time today. Can you tell our listeners where they can find you? Thank you so much for having me too. It’s been amazing. I’m on Instagram, HealthyMamadoc. I try to post empowering educational content for everyone who’s looking for real factual evidence-based pregnancy-related information. I’m on TikTok, but I’m getting better.
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I’m getting better at the You too. worry. Wasn’t our generation thing. Yeah, yeah. I’m like an old, I’m an old millennial. We’re like wannabe TikTokers. I need like, I did a dancing video with this nine-year-old girl and I was like, you’ve got it. You’ve got the magic. I don’t really have the magic. So I’m trying, but Instagram is where I am. Perfect. And I follow you and it’s great advice. So thank you so much, Sarah.
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Thank you so much for having me. It’s so wonderful to be here. Thank you listeners and viewers for tuning in. If you want to catch more episodes of Uncover Your Eyes, make sure to follow or subscribe on your favorite podcast platform and on YouTube. To learn more about me, follow me on Instagram @Dr.MeenalAgarwa. Until next time, keep those eyes uncovered!
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