◎Drug that can affect fetal growth and development
‧Angiotensin converting enzyme inhibitors---fetal or neonatal renal failure
‧Antithyroid drug---fetal hypothyroidism
‧Benzodiazepines---drug dependence in the fetal
‧βblockers---growth retardation may occur if used throughout pregnancy
‧Barbiturates--- -drug dependence in the fetal
‧Non-steroidal anti inflammatory drug---constriction of ductus arreriosus
‧Tetracyclines--tooth discoloration may inhibit bone growth
(brief exposure early in first trimester not shown to be harmful)
‧Warfarin---bleeding into fetal brain
◎Commonly used drug that are teratogenic:
Phenytoin、Carbamazepine、Valproate、Lithium、Warfarin、Retinoids、Danazole
◎Drug that should be avoided while breast feeding
‧Amiodarone hydrochloride---iodine content may cause neonatal hypothyroidism
‧Aspirin---theoretical risk of reye‘s syndrome
‧Barbiturates---drowsiness
‧Benzodiazepines---lethargy
‧Carbimazole---hypothyroidism
‧Combined oral contraceptives---may diminish milk supply and reduce nitrogen and protein content of breast milk
‧Cytotoxin drug---immune suppression and neurtropenia
‧Ephedrine---irritability
‧Tetracyclines—theoretical risk of tooth discoloratio
◎Misconceptions about drug treatment during pregnancy:
‧Corticosteroid:持續以來,認為Corticosteroid有致畸胎的可能性,但人類並無任何的證據證明,只有顯示出於高劑量的Corticosteroid治療下有口腔黏膜潰瘍。Corticosteroid在數千個婦女中,用於治療自體免疫性疾病、嚴重性氣喘、發炎性疾病、及器官移植上,無任何證據顯示初期有較高的致畸胎的發生。Corticosteroid於胎盤中代謝,無證據顯示其影響胎兒的內分泌系統。
‧Warfarin:一直以來,一些醫師認為Warfarin於孕婦及哺乳婦中為一禁忌。但事實證明Warfarin於乳汁中的含量極低,且於多方面的臨床經驗的佐證下,認為Warfarin是安全的。
‧Oral contraceptives:懷孕最初的三個月中,若不慎服用Oral contraceptives,最初認為可能會對胎兒造成危險。但一些證據的資料分析,並不能證明及顯示。
‧Avoiding risk:所有醫師開處方前,應對於生育年齡的婦女需記得詢問其是否懷孕或是計劃懷孕。對於婦女是否持續接受治療的決定是較複雜的,應對於治療的危險及益處,並且對於是否應於懷孕前停止治療提出警告。