NaPro Medications in Pregnancy - Patient Education

CONTROVERSIAL NAPRO MEDICATIONS USED IN PREGNANCY:\n\n1. PROGESTERONE (injections, oral, vaginal): FDA Category B. Same chemical structure as body's progesterone, not a progestin. Used for miscarriage prevention, preterm labor, PROM, pre-eclampsia, cervical insufficiency. Controversy about type/dose and fetal effects. Studies show no significant increase in fetal malformations. Highest associated risk is hypospadias in male fetus with exposure before 11 weeks. Recommended for history of infertility, miscarriage, preterm delivery, PROM. Continue until progesterone levels consistently in Zone III or higher or until 37 weeks.\n\n2. HCG (Human Chorionic Gonadotropin): FDA Category X due to animal studies showing limb/CNS defects. No controlled human data. Use in NaPro for recurrent pregnancy loss based on research by Svigos, Harrison, Blumenfield, Quenby. Recommended through 16 weeks gestation, may continue to 37 weeks.\n\n3. NALTREXONE (Low/High dose): FDA Category C. Opioid antagonist. Animal studies show embryonic effects at 30-60x human dose. Benefits shown in autoimmune diseases and mood disorders. Use in pregnancy outside opioid addiction should be carefully weighed. May increase fetal size.\n\n4. SUSTAINED RELEASE T3 (Triiodothyronine): FDA Category A. Same structure as body's T3, formulated for slow release. Does not appear to cross placental barrier. Recommended to discontinue at 28 weeks gestation.