Pregnant women should avoid which two medications for fever?

• A. Acetaminophen and aspirin
• B. Aspirin and ibuprofen
• C. Ibuprofen and acetaminophen
• D. Naproxen and acetaminophen

Answer: (B)

When treating fever in pregnancy, safety for the fetus guides medication choices. Acetaminophen is the preferred option because it has the best safety profile for most pregnant people. In contrast, aspirin and ibuprofen (an NSAID) can pose fetal risks and are generally avoided for fever during pregnancy. Aspirin can affect placental function and blood clotting, and in later pregnancy it may contribute to complications such as premature ductus arteriosus closure and other neonatal risks. Ibuprofen and other NSAIDs inhibit prostaglandin synthesis, which can also lead to ductus arteriosus constriction, reduced amniotic fluid, and potential kidney issues in the fetus, especially after mid-pregnancy. Therefore, the combination to avoid for fever is aspirin and ibuprofen, with acetaminophen preferred for fever management unless a clinician has specific reasons to recommend otherwise. If fever persists or is high, consult a healthcare provider.