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Prescribing medicines in pregnancy

Lookup NU author(s): Dr Laura Yates, Professor Simon Thomas

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Abstract

Prescribing in pregnancy is complex; it needs to take into account the effects that physiological changes associated with pregnancy may have on the drug's pharmacology and the impact of these changes on the benefits and risks of treatment in the mother, as well as the benefits and risks to the developing fetus. Fetal effects are sometimes predictable, given the mechanism of action of a drug, but often may be unpredictable and unexpected. Identifying therapies that are safest for the fetus, yet do not compromise effective treatment of the maternal condition, is essential but challenging. Experience of safe use in pregnancy is available for many older drugs used in the treatment of common conditions, but often little is known about the fetal risk of the newer preparations increasingly preferred due to improved efficacy or adverse effect profiles. Some drugs essential for management of long-term maternal conditions are known to have teratogenic properties and there may be no effective alternatives. Weighing up the risks and benefits for mother and fetus in such circumstances is particularly difficult. Teratology information services are now well-established worldwide and provide up-to-date, evidence-based advice to support safe and informed prescribing in pregnancy.


Publication metadata

Author(s): Yates LM, Thomas SHL

Publication type: Review

Publication status: Published

Journal: Medicine

Year: 2012

Volume: 40

Issue: 7

Pages: 386-390

Print publication date: 01/07/2012

ISSN (print): 0304-5412

ISSN (electronic): 1578-8822

URL: http://dx.doi.org/10.1016/j.mpmed.2012.04.007

DOI: 10.1016/j.mpmed.2012.04.007


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