It is not always possible to avoid taking medicines during pregnancy. Some women have conditions which need ongoing treatment, while others may develop or experience a new condition which may require medicine management. It is recommended that healthcare professionals are involved in decisions relating to medicine use in pregnancy. The following are points of consideration when medicines are required during pregnancy.
There is a 3 to 4 % baseline risk of having a baby with a birth defect. It should be noted that only a small proportion of these birth defects are attributed to maternal medicine use during pregnancy.
If a pregnant woman requires a medicine, it may be of less concern if her pregnancy is beyond the first trimester.
A medicine with a category A has a better safety profile compared to those in other categories. If a category A medicine is not appropriate for the condition or patient, a category C medicine may be considered as an alternative.
Pregnancy can alter the pharmacokinetics of medicine. This may potentially lead to changes in absorption, distribution, metabolism and elimination of medicines during pregnancy.
Maternal medical conditions must be considered, particularly renal or hepatic impairment. These conditions may affect the route and rate of medicine excretion.
If treatment cannot be delayed until the baby is born or urgent treatment is required, relative risks to the developing fetus and benefits to the mother must be considered.
Pregnant women should not be exposed to category X medicines. In situations where this may have occurred, immediate discontinuation of the medicine is recommended, and referral to a genetics clinic is advisable.
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Summarises key findings and provides detailed, practical recommendations on the use of medicines during pregnancy and breastfeeding to support the clinical decision making process
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The Therapeutic Goods Adminsitration (TGA) pregnancy categories and manufacturer’s product information are sometimes difficult to interpret. The Women’s PBMG has developed a series of practical recommendations for medicines used during pregnancy and breastfeeding.