Gastro-oesophageal reflux during pregnancy
Symptoms of gastro-oesophageal reflux commonly develop during pregnancy, and pre-existing symptoms are often exacerbated.
To treat gastro-oesophageal reflux during pregnancy, diet and lifestyle modification may be all that is required.
If drug therapy is required, antacids and H2-receptor antagonists (ranitidine and famotidine) are considered safe for use in pregnancy (see Management of mild intermittent symptoms of gastro-oesophageal reflux in adults for dosages).
Proton pump inhibitors (PPIs) are listed by the Therapeutic Goods Administration (TGA) as category B3 (except for rabeprazole, which is listed as category B1)1; observational studies have not indicated any increased risk of adverse pregnancy outcomes with PPI use. If a patient taking a PPI is planning pregnancy, consider switching to an H2-receptor antagonist, or trialling on-demand PPI therapy, at least for the first trimester. If a PPI is required during pregnancy, the greatest clinical experience is with omeprazoleThe Women's.