Medications in pregnancy

Question 1

First 2 weeks exposure to teratogen will have what effect on the fetus?

Answer 1

spontaneous abortion or no effect

“all or none”

Question 2

What effect will teratogens have on a fetus during weeks 3-8 of development

Answer 2

organogenesis

this is when teratogens have their greatest effects

Question 3

Diesthystilberstrol

Answer 3

clear cell adenocarcinoma of the vagine, Mullerian duct anomalies

Question 4

Thalidomide

Answer 4

phocomelia

Question 5

Lithium

Answer 5

Ebstein anomaly
-tricuspid leaflets displaced inferiorly
-RV hypoplasia
-tricuspid regurgitation or stenosis
\+/- patient foramen ovale

Question 6

ACE inhibitors

Answer 6

Renal/CNS abnormalities, abnormal skull ossification

Question 7

NSAIDs

Answer 7

premature closure of ductus arteriosus (3rd trimester)

Question 8

Antiepileptics

Answer 8

NTD- spina bifida

Question 9

phenytoin

Answer 9

fetal hydantoin syndrome: dysmorphic face, cleft palate, VSD, hypoplastic nails

Question 10

chloramphenicol

Answer 10

gray baby syndrome

Question 11

fluoroquinolones

Answer 11

cartilage toxicity

Question 12

tetracyclines

Answer 12

yellow-brown discoloration of teeth

Question 13

warfarin

Answer 13

nasal hypoplasia, epiphyseal stipping, limb hypoplasia

Question 14

isotretinoin

Answer 14

spontaneous abortion, severe birth defects

Question 15

fetal alcohol syndrome

Answer 15

brain and face:

• dysmorphic facial features: short palpebral fissures, smooth philtrum, vermillion border
• growth retardation
• CNS abnormalities: microcephaly, intellectual deficits, behavioral problems, learning difficulties, impaired executive functioning

avoid alcohol during pregnancy

Question 16

Cocaine

Answer 16

fetal growth restriction
preterm birth
placental abruption
-premature separation of placenta
-painful vaginal bleeding, contractions, abnormal FHTs

Question 17

Opioids

Answer 17

• fetal growth restriction
• preterm birth
• fetal death
• withdrawal: seizures, irritability, tachypnea, failure to thrive

Question 18

Smoking

Answer 18

spontaneous abortion
fetal growth restriction
placental abruption
preterm birth
stillbirth
SIDS

Question 19

Supplements

Answer 19

iron- anemia

folic acid- neural tube defects

Question 20

pain and fever

Answer 20

acetaminophen

not NSAIDS

Question 21

n/v

Answer 21

pyridoxine

doxylamine

Question 22

HTN

Answer 22

methyldopa
labetalol
hydralazine
nifedipine

Question 23

diabetes

Answer 23

insulin

Question 24

anticoagulation

Answer 24

heparin

LMWH

Question 25

corticosteriods

Answer 25

betamethasone

dexamethasone