Emobileclinic Trending Topic:,DRUG USE DURING PREGNANCY
Drug use during pregnancy is generally dangerous. A teratogen is an agent that can disturb the development of the embryo or fetus. Teratogens which are present in some drugs can halt the pregnancy or produce a congenital malformation (a birth defect). Other classes of teratogens include radiation, maternal infections and chemicals.
More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy, and use of drugs during pregnancy is increasing. In general, drugs should not be used during pregnancy unless absolutely necessary because many can harm the fetus. About 2 to 3% of all birth defects result from drugs that are taken to treat a disorder or symptom.
Sometimes drugs are essential for the health of the pregnant woman and the fetus. In such cases, a woman should talk with her doctor or other health care practitioner about the risks and benefits of taking the drug. Before taking any drug (including over-the-counter drugs) or dietary supplement (including medicinal herbs), a pregnant woman should consult her health care practitioner. Drugs taken by a pregnant woman reach the fetus primarily by crossing the placenta, the same route taken by oxygen and nutrients, which are needed for the fetus’s growth and development. How a drug affects a fetus depends on the fetus’s stage of development and the strength and dose of the drug.
Drugs that are capable of acting as teratogens include:
Antianxiety drug (e.g.Diazepam); When the drug is taken late in pregnancy, depression, irritability, shaking, and exaggerated reflexes in the newborn
Antibiotics;
Fluoroquinolones (such as ciprofloxacin, ofloxacin, levofloxacin, and norfloxacin); Possibility of bone and joint abnormalities (seen only in animals).
Streptomycin;Damage to the fetus’s ear, resulting in deafness.
Sulfonamides (such as sulfasalazine and trimethoprim- sulfamethoxazole); When the drugs are given late in pregnancy, jaundice and possibly brain damage in the newborn
Tetracycline;Slowed bone growth and permanent yellowing of the teeth. Occasionally, liver failure in the pregnant woman
Anticoagulants (e.g.Heparin); Thrombocytopenia (a decrease in the number of platelets, which help blood clot) in the pregnant woman, possibly resulting in excessive bleeding
Anticonvulsants (e.g.Carbamazepine, Phenobarbital, phenytoin); Some risk of birth defects, including neural tube defects (such as spina bifida),Bleeding problems in the newborn (hemorrhagic disease of the newborn), which can be prevented if pregnant women take vitamin K by mouth every day for a month before delivery or if the newborn is given an injection of vitamin K soon after birth
Antihypertensives
Angiotensin-converting enzyme (ACE) inhibitors;When the drugs are taken late in pregnancy, kidney damage in the fetus, a reduction in the amount of fluid around the developing fetus (amniotic fluid), and defects of the face, limbs, and lungs
Beta-blockers; a slowed heart rate, a low blood sugar level, and possibly slowed growth in the fetus. Low blood pressure in the mother
Calcium channel blockers; Inadequate growth before birth (growth restriction)
Thiazide diuretics; A decrease in the levels of oxygen, sodium, and potassium and in the number of platelets in the fetus’s blood, Inadequate growth before birth.
Chemotherapy drugs (e.g.Busulfan) Birth defects such as underdevelopment of the lower jaw, cleft palate, abnormal development of the skull bones, spinal defects, ear defects, and clubfoot.
Nonsteroidal anti-inflammatory drugs (NSAIDs)(e.g. Aspirin and other salicylates, Ibuprofen, Naproxen); When the drugs are taken in large doses, possibly miscarriages during the 1st trimester, a delay in the start of labor, premature closing of the connection between the aorta and artery to the lungs (ductus arteriosus), jaundice, necrotizing enterocolitis (damage to the lining of the intestine), and (occasionally) brain damage in the fetus and bleeding problems in the woman during and after delivery and/or in the newborn. When the drugs are taken late in pregnancy, a reduction in the amount of fluid around the developing fetus
Oral antihyperglycemic drugs (e.g.Chlorpropamide, Glyburide, Metformin); A very low blood sugar level in the newborn
Sex hormones (e.g. Diethylstilbestrol (DES); Abnormalities of the uterus, menstrual problems, and an increased risk of vaginal cancer and complications during pregnancy in daughters. Abnormalities of the penis in sons
Skin treatments (e.g.Etretinate, Isotretinoin); Birth defects, such as heart defects, small ears, and hydrocephalus (sometimes called water on the brain)
Vaccines (live virus); (e.g.Vaccine for German measles (rubella) and chickenpox (varicella )Potential infection of the placenta and developing fetus
Opoids (e.g. Buprenorphine and methadone) Drowsiness in the newborn shortly after birth, Irritability and shaking (symptoms of drug withdrawal) in the newborn because at birth, passage of the opioid from the mother is stopped
Vitamin K; In women or fetuses with G6PD deficiency, destruction of red blood cells (hemolysis)
Unless medically necessary, drugs should not be used during pregnancy. However, drugs can be essential to maintain the health of the pregnant woman and the fetus. In such cases, a woman should talk with her health care practitioner about the risks and benefits of the prescription drugs she is taking before she stops taking them. She should not stop taking them on her own.
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