In pregnancy, which analgesic class is generally preferred for pain or fever, and which is usually avoided especially in late pregnancy?

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Pain relief in pregnancy is best achieved with acetaminophen because it provides effective fever and pain control with a safety profile that is favorable for both mom and fetus when used at the recommended dose. NSAIDs, such as ibuprofen or naproxen, cross the placenta and can cause problems for the fetus, especially later in pregnancy. They can interfere with prostaglandin synthesis, which can lead to premature closure of the ductus arteriosus, reduced kidney function, and lower amniotic fluid. Because of these risks, NSAIDs are generally avoided in late pregnancy. Aspirin has specific uses in some conditions, but it is not used routinely for analgesia during pregnancy. So the approach is to use acetaminophen for pain or fever, and avoid NSAIDs in the late stages of pregnancy.