I am 12 weeks pregnant and during my first trimester

Patient : Hi there, I am 12 weeks pregnant and during my first trimester there were a few occasions when I took a supplement called Nordic Naturals Complete Omega 3 6 9. There is no pregnancy contraindication on the label but I just discovered that this product contains Borage oil (180mg per tablet) and I have read that this may have teratogenic effects. I am extremely worried now. I wasn't taking these pills regularly every day, but there were a few occasions when I took 2 tablets a day and I am terrified that I may have harmed my baby. Any advice would be much appreciated. Thank you.
Doctor :   Hello, Thanks for the query to ATD for an opinion, As is understood that you have been taking nutritional suppleme nts regularly in the first trimester which had borage oil. Borage oil is contraindicated in pregnancy given its potential for inducing labor and causing birth defects. Borage oil may lower the seizure threshold in certain patients, thereby increasing the likelihood of seizure. It also has the potential for interaction with warfarin, a common blood thinner. Therefore, patients on seizure medications or warfarin should not use borage oil. Women in the childbearing years should not use this supplement. Considering that you are already 12 weeks now, it is advised and suggested that you should stop the supplement with immediate effect and just stick to folic acid, calcium+ vitd3 and iron tabs hence forth. It is difficult to ascertain at this particular gestational age to learn as to whether it has has caused any damage to fetus or not but there are multiple level level scans and blood screening available which can give an idea of any birth defect. At 12 weeks now, a level scan for birth defects and nuchal translucency may be done followed by a quadruple screening for any aneupliodies. Then at 15-18 weeks amniocentesis can be offered for DNA analysis and karyotyping of the fetus from the fetal cells in the amniotic fluid which can give an idea if the conception had been affected or not. Then in the end at 18-20 weeks of gestation, you should get a level 2 anomaly scan done which can detect any structural deformities easily in the fetus. This is the last scan which can detect any abnormality and allows you to decide if you want to abort the pregnancy if fetus is affected, as pregnancy beyond 20 weeks cannot be aborted as per law and also it increases the maternal morbidity. So considering the situation, it is suggested that you undergo this protocol of investigations at due time and stop that medication with immediate effect. You may discuss the plan with your obstetrician in detail and take an informed decision. I hope i have answered your query and concerns in detail, Wishing you good health, Regards

Comments / Follow Ups

Patient: Thank you for your quick response. I will talk to my obstetrician about these concerns at my next appointment. I am very concerned and astounded that this company would not put any warning on the product. I only took this supplement on maybe 4 isolated days during my first trimester (2 tablets a day) so do you think that is still cause for concern?
Doctor: Hello,
Thanks for the follow up,
If you have taken it for just 4 isolated days ( 2 tabs each) unlike what you mentioned in your query regarding regular use, then the chances of anomalies are fairly less but it would be difficult to comment for sure. So it is suggested that follow up scanning and screening protocol should be adhered to and we should hope for the best.
Regards

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