Pregnancy Flashcards
when should elective care be given to a pregnant woman?
2nd trimester and early 3rd trimester is best
which trimester should elective care be avoided?
1st
when is emergency care of pregnant woman okay?
anytime in coordination with OB
chair positioning is important for pregnant women and can lead to what?
supine hypotensive syndrome
supine hypotensive syndrome
- pressure on inferior vena cava causes impaired venous return to heart
what happens if BP of mom abruptly falls?
- bradycardia
- sweating
- nausea
- air hunger
- loss of consciousness
how do you txt pts with supine hypotensive syndrome?
- roll pt on side so pressure off IVC
- BP rapidly returns to normal
dental mods for pregnant women
- semi-reclined
- short appts
- allow pt to change positions frequently
can you take radiographs on pregnant women?
yes, but limit exposure (i.e. PA instead of pano) for diagnosis and txtment
should you take radiographs of a pregnant woman in the 1st trimester?
NO, nothing but prophys
what is the concern of giving pregnant women drugs?
- cross placenta
- toxic/teratogenic effects on fetus
ideally should you give pregnant women drugs?
no, especially in 1st trimester but most dental drugs can be given with relative safety
FDA pregnancy risk category A
controlled human studies, no demonstrated risk, remote possibility of fetal harm
FDA pregnancy risk category B
animal studies, no demonstrated risk-or-animal studies shown risk but human have not
FDA pregnancy risk category C
animal studies demonstrated risk-or-animal/human studies not available
FDA pregnancy risk category D
positive evidence of human fetal risk
FDA pregnancy risk category X
evidence of fetal abnormalities, risk outweighs any benefit
most of the drugs we prescribe are in what FDA pregnancy risk category?
category C
can you give pregnant women local anesthesia?
yes, but do not exceed manufacturer’s max dose
can you give pregnant women antibiotics?
yes, can prescribe PCN, clindamycin, metronidazole
which antibiotics should you NOT prescribe pregnant women?
tetracycline
which analgesics can pregnant women take?
acetaminophen
should pregnant women take NSAIDs (ibuprofen or aspirin)?
NO
what happens if a pregnant woman take NSAIDs?
can cause early closure of patent ductus arteriosus (PDA)
can pregnant women take narcotics?
consult with OB
can pregnant women use sedatives?
no, maybe short exposure to nitrous
how much of the drug is excreted in milk?
1-2% of maternal dose
when should pregnant women take their meds if they’re worried about it getting into their milk supply?
- take them right after breast feeding
- supplement with formula if really concerned
