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Pregnancy
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Drugs in Pregnancy
The thalidomide tragedy, 40 years ago, leads to general
perception that all drugs, chemicals and environmental
exposures during early pregnancy are harmful to the
fetus
In reality, relative few proven human teratogens and
an increasing number of agents are shown to be safe
for use during human pregnancy
In the USA
3% are detectable at birth
12 14% by time at school
17% before the age 18 years
the PROBLEMS
More than half of pregnancies are unplanned
Should women with chronic illnesses - to stop
or not to stop medication
Up to date information is required
Balanced counseling about the safety of their
medications during pregnancy and lactation
Teratogens
Interfere with the development of the fetus
inducing or in increasing the incidence of
congenital structural malformation, e.g. drugs,
illness.
Multiple Effects
e.g. rubella is teratogenic, hadegenic and fetotoxic
in the first trimester, but only hadegenic after 16th
weeks of pregnancy
Case reports
Epidemiological studies
No single approach
C. Categorization of Drug
Drugs are classified with regards to their safety
Categories on the basic of critical evaluation of the
available data ( human & animal )
Thing to be considered :
Risk perception
Counseling before pregnancy, during pregnancy
Retrospective counseling
Information Services
References
Beischer. NA, Mackay EV., Obstetrics and the Newborn,
ch.65 p.618-639, WB Saunders Comp. 2nd Ed.
Tamizian. O, Arulkumaran. S, Drug Use in Pregnancy, J.of
Pediat. Ob & Gynec, Jul/Aug 2001, vol. 27 no. 4, p. 30 41.
Kennedy. D, Drugs in Pregnancy., J. Of Pediat. Ob & Gynec.,
Sept/Oct 2002, vol 28 no. 5, p.29-35.
Kennedy. D, Drugs in Pregnancy., J. Of Pediat. Ob &Gynec.,
Sept/Oct 2002, vol 28 no. 5, p.29-35.