Safe Medication Use in Third Trimester Pregnancy

Medications to Avoid

• All NSAIDs must be discontinued after gestational week 28 to avoid premature closure of the fetal ductus arteriosus and other serious fetal risks, including oligohydramnios and pulmonary hypertension in the newborn 1
• Third trimester NSAID use is contraindicated due to the risk of premature closure of the fetal ductus arteriosus and other serious fetal risks 1, 2
• If NSAIDs were inadvertently used in the third trimester, immediate discontinuation and fetal assessment for ductal constriction and oligohydramnios is necessary 2

Supportive Medications

• Antiemetics, such as ondansetron and metoclopramide, may be safely used beyond the first trimester, according to the European Society for Medical Oncology 3, 4, 5
• Opioids have been administered in pregnant women beyond the first trimester without major adverse effects, though there is some risk of fetal respiratory depression near delivery, as noted by the European Society for Medical Oncology 3, 4, 5

Practical Approach

• Avoid all NSAIDs completely in the third trimester, as recommended by the American College of Obstetricians and Gynecologists 1