November 2007 · Vol. 19, No. 11What you need to know about medication safety in pregnancy
Few drugs are major teratogens, but heightened vigilance is crucial to protect your pregnant patient
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Fast Track
Detrimental effects can occur beyond the critical embryo stage as cells continue to divide in the hematologic, reproductive, and central nervous systems
During gestation, medications are taken at the same frequency—or more often—as before pregnancy
First-trimester screening, CVS, maternal serum quadruple screening, amniocentesis, and fetal blood sampling are not predictive of a drug’s fetal effects
When reviewing or planning maintenance drug therapy, follow the same principles as in a nonpregnant patient
Suspect a drug- related effect when a newborn shows signs of anemia, hepatitis, hepatotoxicity, hepatorenal dysfunction, and hyperbilirubinemia
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William
F.
Rayburn,
MDDr. Rayburn is Seligman Professor and Chair, Department of Obstetrics and Gynecology, at the University of New Mexico Health Sciences Center in Albuquerque. With a background in pharmacology, he has authored many studies reporting drug trials during pregnancy, as well as several texts on the subject.
The author reports no financial relationships relevant to this article.
Fifty years ago, the thalidomide experience—a high incidence of major birth defects following prenatal use of the drug—made clear the devastating potential of drug exposure during pregnancy. Since that disaster, healthcare providers and patients have adopted a conservative approach to medication use during pregnancy, especially during the first trimester and lactation. That is a wise strategy, although very few medications are associated with abnormal fetal development.
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