DRUG THERAPY DURING PREGNANCY:

Basic considerations

Drug use during pregnancy is common: between 50% and 70% of pregnant women take at least one medication, and majority take more than one. Some drugs are used to treat pregnancy-related conditions such as nausea, constipation and pre-eclampsia. Some are used to treat chronic disorders such as hypertension, diabetes, and epilepsy. And some are used for infectious disease or cancer. In addition to taking these therapeutic agents, some pregnant women frequently take drugs of abuse such as alcohol, cocaine and heroin.

Drugtherapy in pregnancy presents a vexing dilemma. In pregnant patients as in all other patients, the benefits of treatment must balance the risks. Of course when drugs are used during pregnancy, risks apply to the featus as well as the mother. Unfortunately, the risks for most drugs used in pregnancy have not been determined, hence the dilemma: the clinician is obliged to balance risks versus benefits, without knowing what the risks really are.

Despite the Imposing challenge of balancing risks versus benefits, drug therapy during pregnancy can not and should not be avoided. The health of th featus depends on the health of the mother. Hence conductive that threatens the mothers's health must be addressed for the sake of the baby as well as the mother. Chronic asthma provides a good example. Uncontrolled maternal asthma is far more dangerous to the featus than the drugs used to treat it. Among asthmatic women who fail to take medication, the incidence of stillbirth is doubled. If all women with asthma took medication, an estimated 2000 babies would be saved each year.

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