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Pregnancy

Urgent Q re: Trimethorim when pregnant

23 replies

fuzzyfelt · 12/04/2005 13:29

Hi - I'm asking this q on behalf of a friend. She has been prescribed the above antibiotic in error and she is 5/6 weeks preg. She has been told there is a chance of the baby being malformed and if this happens, she will prob. miscarry.

Has anyone experienced this? How likely is the baby to be malformed? The doctor has admitted his error - so what should she now ask for - can she have weekly scans? Where is the best place to go to have the best scans that can tell her if there are problems? Harley St?

Any advice gratefully received.

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Marina · 12/04/2005 13:32

No experience, just very sorry to hear about this scare for your friend fuzzyfelt.
I would say the best place to go for a referral in London was the Harris Birthright Centre at King's Hospital, SE5. I believe Professor Nicolaides also has a private clinic, not sure if that is held at King's or elsewhere in London.
Hope she and the baby are OK.

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fuzzyfelt · 12/04/2005 13:41

Thanks Marina. It's a shocking situation - she told the doc. she was trying for a baby and he prescribed it anyway. Only after she had finished the course did another doctor tell her that it absolutely must not be prescribed during preg., esp. early preg. She is gutted.

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Marina · 12/04/2005 13:53

I found This when googling Trimethoprim and pregnancy for you (can you tell I am Health Moderator on my lunch hour? )
If your friend was TTCing she might already have been taking folic acid? It seems that Trimethoprim's contraindication in early pregnancy is linked to its effects on folic acid levels in the body, so I would guess that the birth defect they are concerned about would be spina bifida. BUT if you are taking extra folic acid, then this may help offset the Trimethoprim risk.
I can see why she is so very concerned though - most of the pharmaceutical info on the net is frank about the risks, but without giving one an idea of the percentage of affected cases. I hope she feels able to take this up with the doctor in question. And that everything turns out OK in the end.

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fuzzyfelt · 12/04/2005 14:08

Thanks again. Yes it does seem to be the interference with folic acid that is the problem and yes she is / was taking a supplent so hopefully this will reduce the risk back again. Like you say tho', no-one can tell us any percentages of risk involved. One can only assume it is a small risk, but we all know that that is not good enough in pregnancy - everything is worrying. Also, the second doctor has been very grave about it and has asked ger to go back today to 'discuss her options'. Sounds ominous?

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Marina · 12/04/2005 14:12

Oh dear but even doctors are not immune to Cassandra Syndrome...maybe he was sounding grim to ensure she took the matter seriously and got herself properly monitored.
You won't want to pass this on to your friend but I am terribly sorry to say that the only person I knew who mistakenly took Trimethoprim during early pregnancy did lose her baby, sadly. Her pregnancy was unplanned, so there was no question of malpractice. Just rotten bad luck.
She went on to have a gorgeous daughter. Oh, I have my fingers crossed for her fuzzyfelt.

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anchovies · 12/04/2005 14:13

Think the risk of birth defects is minimal, especially as marina says if she has a good diet/has been taking folic acid supplements. Hope everything works out ok for her.

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FastasleepTheInsomniac · 12/04/2005 14:17

Aww that's awful my son took trimethoprim for a year, and I had read about the contraindication with pregnancy... I hope that she's ok!!

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anchovies · 12/04/2005 14:18

Sorry bit slow.

There has been research done on this, see here
for a summary. Sounds like percentage wise most of the research reckons on the risk not being much greater. Let us know how she gets on at the doctors.

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Marina · 12/04/2005 14:24

Anchovies, "slow" but really reassuring news! I do find it interesting the way you have to dig around so hard to find the actual percentaged risk.

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Marina · 12/04/2005 14:25

My dd is on a low dose for ear infections at the moment, it seems to be helping a lot. And as a cystitis veteran I am very familiar with this drug. Keep us posted fuzzyfelt.

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fuzzyfelt · 12/04/2005 14:30

Thanks so much everyone. She has calmed down a bit now and gone to the docs armed with lots of questions. She wants to know firstly what the chances are of malformation and secondly if she can have weekly scans to monitor things.
I can't believe the first doctor actually prescribing the drug knowing she was actively TTC. So unprofessional and negligent in my opinion.

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fuzzyfelt · 12/04/2005 14:33

The irony is that she still has the water infection despite taking Trimethoprim.

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Marina · 12/04/2005 14:33

I suppose at least if spina bifida is the issue then it is a condition that can be identified and monitored safely via ultrasound. AND it is a condition with degrees of severity...not always a major, disabling birth defect. Ds was at nursery with a little boy whose mum had spina bifida. She had very, very minor mobility problems (slight stiffness of gait) and that was it.

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Marina · 12/04/2005 14:34

honestly fuzzyfelt. Now that really IS the pits in the circumstances. I do hope she feels OK soon.

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fuzzyfelt · 12/04/2005 14:45

Yes - hope you're right M! Thanks for the info. re: risk factor M and Anchovies. Looks promising. Still a bit worrying that not much research has been done yet - hence the warning not to take it I guess. Will kepp you posted. X

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fuzzyfelt · 12/04/2005 20:51

Hi - Just to let you know that my friend went to the docs and his view is that the research that has been done is not extensive enough to be conclusive. Therefore, they just don't know what it does to a human pregnancy - only that it has caused birth defects in some pregnant rats.
He has offered her a scan at 10 weeks and has agreed to refer her to Kings College Hospital. He also offered her the chance to terminate the preg. now 'and start again' were his words!
However, armed with the information from the internet (and from here)she believes, and so do I, that the doctor is being over-cautious and looking at the bleakest possibility. He didn't even know that the problem with the drug was to do with folic acid! Thanks goodness for the internet I say! Anyway, she is being philosophical about it and balancing the docs pessimism against the research she has done herself. Fingers crossed all will be OK.

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FastasleepTheInsomniac · 13/04/2005 08:55

Terminate and start again?! That doctor is seriously insensitive and should have given her all the info on trimethoprim from the start! She could have a case for malpractice if he knew that she was pregnant and didn't advise her in any way about the research...

Best of luck to your friend! None of us need doctors like that when we're pregnant

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Marina · 13/04/2005 10:42

how sensitive of him! Thank goodness he was at least willing to refer her to King's. They really know their stuff there and will monitor her very carefully. Best of luck to her fuzzyfelt.

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fuzzyfelt · 14/04/2005 17:57

Quick update - good news. A member of staff from Harris Birthright at Kings rang her up today 10 mins after receiving an e mail from her! They were able to give her lots of reassurance with info. along the lines of what was advised here and other info we have got from the web. The risk is indeed tiny - a fraction of 1% she has been told.
It makes the GPs look even worse tho' - not only the first one for prescribing the drug but also the second one for offering a termination so quickly. Thanks again all, esp. Marina for recommending Harris Birthright Centre.

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fastasleep · 14/04/2005 18:09

It sounds really hopeful I'm glad that they got back to her so quickly - fingers crossed that she can put all this behind her really soon!

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VirtualFairy · 19/04/2005 11:42

wow i can't belive there is a 1% risk - i terminated a pregnancy a few years ago as i was told that there was a 50% chance of my baby having spina bifida, so i was given a choice of waiting till 20 weeks so they can do an scan and amnio and then making a desition. or terminating early, i chose the terminating early as i thought the risk was so great and waiting to find out for sure and then the nightmare of late termination etc!
well i am shocked to find out the real risk years later and upset that i was given the wrong information by the health professionals we are suppose to trust.
thank god there is such thing as the internet now - you no longer have to take a doctors word for it!

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ModeratorMarina · 19/04/2005 12:07

VirtualFairy, so sorry to hear this. But it could be that when you were given this advice less was known about Trimethoprim in pregnancy, so a much more cautious approach was taken

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fuzzyfelt · 19/04/2005 20:48

VirtualFairy - so very sorry to hear about what happened to you. It seems that the GPs that my friend saw are STILL dishing out advice in favour of termination in this situation. It is only research on the Internet and speaking to the Harris that have proved otherwise. Frightening that GPs can be so badly informed. But as Marina says a few years ago they would have been more cautious anyway.

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