Lecture 11 - Prescribing in Pregnancy

Question 1

What is a child bearing age?

Answer 1

12-50 year olds

Question 2

What questions should be asked what prescribing in pregnancy?

Answer 2

• Is the drug safe?
  
  • Is the drug necessary?
  • Are there alternatives that are as effective/ safer?
  • Effect of pregnancy on drugs and drugs on pregnancy
  • Assess need for extra monitoring of mum and baby

OFFER PREPREGNANCY COUNSELLING

Question 3

Explain the 3 trimesters of pregnancy

Answer 3

1st is up to 13 weeks
2nd is 13-28 weeks
3rd is after 28 weeks

Question 4

Name the 4 main contraindications

Answer 4

methotrexate, radioactive iodine, lithium, isotretinoin
and relative contraindications - spironolactone

Question 5

What can alcohol use in pregnancy cause?

Answer 5

Foetal alcohol syndrome

Question 6

Define teratogenesis

Answer 6

Causes congenital disorders

Question 7

Define hyperemesis

Answer 7

Morning sickness - affects up to 80% of pregnant women in the 1st trimester

Question 8

What is the main reasons for neural defects?

Answer 8

Folic acid deficiency

Question 9

Give examples of minor malformations associated with use of anti-convulsants in pregnancy

Answer 9

• low-set ears
  * broad nasal bridge
  * irregular teeth
  Hypoplastic nails and digits
  Even untreated maternal epilepsy is associated with an increased risk of congenital abnormality - even stopping the meds there is still an increased risk compared to the background population