During Which Period of Pregnancy Are Babies Most Vulnerable to Drugs Taken by the Mother? Coursehero

More than 50% of pregnant women accept prescription or nonprescription (over-the-counter) drugs or use social drugs (such every bit tobacco and alcohol) or illicit drugs at some time during pregnancy, and use of drugs during pregnancy is increasing. In full general, drugs should non be used during pregnancy unless necessary because many can harm the fetus. Less than ii to iii% of all nascency defects effect from drugs that are taken to treat a disorder or symptom.

Sometimes drugs are essential for the wellness of the significant woman and the fetus. In such cases, a adult female should talk with her md or other health intendance practitioner nigh the risks and benefits of taking the drug. Before taking whatsoever drug (including over-the-counter drugs) or dietary supplement (including medicinal herbs), a meaning woman should consult her health care practitioner. A wellness care practitioner may recommend that a woman take certain vitamins and minerals during pregnancy.

Drugs taken by a pregnant woman reach the fetus primarily by crossing the placenta, the same route taken by oxygen and nutrients, which are needed for the fetus'southward growth and development. Even so, drugs that do not cantankerous the placenta may all the same harm the fetus by affecting the uterus or the placenta.

Drugs that a meaning woman takes during pregnancy tin can affect the fetus in several means:

• They can alter the function of the placenta, commonly past causing blood vessels to narrow (constrict) and thus reducing the supply of oxygen and nutrients to the fetus from the mother. Sometimes the upshot is a infant that is underweight and underdeveloped.

• They tin also affect the fetus indirectly. For case, drugs that lower the mother's claret pressure may reduce blood flow to the placenta and thus reduce the supply of oxygen and nutrients to the fetus.

How Drugs Cross the Placenta

Some of the fetus's blood vessels are contained in tiny hairlike projections (villi) of the placenta that extend into the wall of the uterus. The mother's blood passes through the space surrounding the villi (intervillous space). Merely a thin membrane (placental membrane) separates the mother's blood in the intervillous infinite from the fetus's blood in the villi. Drugs in the mother'southward blood can cross this membrane into blood vessels in the villi and pass through the umbilical cord to the fetus.

How a drug affects a fetus depends on

• The fetus's stage of evolution

• The strength and dose of the drug

• The permeability of the placenta (how easily substances laissez passer through it)

• Other factors related to the mother (for instance, if the mother is vomiting, she may non absorb as much of a drug, so the fetus is exposed to less of the drug)

Until recently, the Food and Drug Administration (FDA) classified drugs into 5 categories according to the degree of take chances they pose for the fetus if they are used during pregnancy. Drugs were classified from those with the to the lowest degree adventure to those that are highly toxic and should never exist used by meaning women because they crusade severe nativity defects. I example of a highly toxic drug is thalidomide. This drug causes farthermost underdevelopment of arms and legs and defects of the intestine, heart, and claret vessels in the babies of women who take the drug during pregnancy.

The FDA's classification arrangement was based largely on information from studies in animals, which ofttimes do non apply to people. For example, some drugs (such as meclizine) cause birth defects in animals, just the aforementioned furnishings have not been seen in people. Taking meclizine for nausea and vomiting during pregnancy does non announced to increase the risk of having a baby with a nativity defect. The classification system was based much less often on well-designed studies in pregnant women because few such studies take been washed. Thus, applying the classification system in specific situations was difficult.

Because of this problem, the FDA eliminated the five adventure categories. Instead, the FDA now requires that the drug label include more than information about the hazard of taking every drug during pregnancy. This information includes the following:

• The risks of taking the drug during pregnancy and breastfeeding

• The evidence that has identified these risks

• Information to help health intendance practitioners decide whether the drug should be used during pregnancy and to help them explicate the risks and benefits of using the drug to the woman

Typically, health intendance practitioners follow a general rule:

• They consider giving a pregnant adult female a drug to treat a disorder only when the potential do good outweighs known risks.

Often, a safer drug can be substituted for one that is probable to cause impairment during pregnancy. For prevention of claret clots, the anticoagulant heparin is preferred to warfarin. Several safe antibiotics, such every bit penicillin, are available to treat infections.

Some drugs can have furnishings after they are stopped. For instance, isotretinoin, a drug used to treat peel disorders, is stored in fatty below the peel and is released slowly. Isotretinoin can cause birth defects if women go pregnant inside 2 weeks afterward the drug is stopped. Therefore, women are advised to wait at least three to 4 weeks afterwards the drug is stopped before they become pregnant.

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Paroxetine appears to increase the risk of heart birth defects. And so if a pregnant woman takes paroxetine, echocardiography should be done to evaluate the fetus's middle. Withal, other SSRIs exercise not increment this risk.

Some antiviral drugs (such equally zidovudine and ritonavir for HIV infection) have been safely used during pregnancy for many years. Withal, some antiviral drugs may cause issues in the fetus. For example, some evidence suggests that when some HIV regimens with a combination of antiviral drugs are given during the 1st trimester, the risk of scissure lip and palate may be increased.

If a pregnant woman gets COVID-nineteen, her treatment team and she should discuss the risks and benefits for her and so make up one's mind whether remdesivir should be used to treat COVID-19. More often than not, experts recommend that theoretical concerns about the safety of remdesivir during pregnancy should not prevent its use in pregnant women. There are little data about the effects of remdesivir on the fetus.

If a meaning adult female gets influenza, she should seek handling as soon as possible because treating influenza within 48 hours of when symptoms begin is well-nigh effective. Withal, treatment at any point during the infection reduces the take a chance of astringent complications. No well-designed studies of zanamivir and oseltamivir have been washed in meaning women. However, many studies based on observation signal that treating meaning women with zanamivir or oseltamivir does not increment the risk of harmful effects. There is little or no information about the use of other influenza drugs during pregnancy.

Acyclovir, taken by mouth or applied to the peel, appears to be safe during pregnancy.

The most consistent effect of smoking on the fetus during pregnancy is

The more than a adult female smokes during pregnancy, the less the baby is probable to weigh. The average birth weight of babies built-in to women who fume during pregnancy is six ounces less than that of babies built-in to women who do not smoke.

Birth defects of the heart, brain, and face are more than mutual amid babies of smokers than amidst those of nonsmokers.

Also, the chance of the following may exist increased:

In addition, children of women who smoke have slight just measurable deficiencies in physical growth and in intellectual and behavioral evolution. These effects are thought to be caused by carbon monoxide and nicotine. Carbon monoxide may reduce the oxygen supply to the body's tissues. Nicotine stimulates the release of hormones that tuck the vessels supplying blood to the uterus and placenta, so that less oxygen and fewer nutrients reach the fetus.

Because of the possible harmful effects of smoking during pregnancy, pregnant women should make every effort to not smoke during pregnancy, including discussing strategies with their doc.

Pregnant women should avoid exposure to secondhand smoke considering it may similarly harm the fetus.

Often, the birth weight of babies born to women who beverage regularly during pregnancy is substantially below normal. The average birth weight is nigh iv pounds for babies exposed to large amounts of alcohol, compared with seven pounds for all babies. Newborns of women who drank during pregnancy may not thrive and are more likely to die soon later birth.

Fetal alcohol syndrome is 1 of the most serious consequences of drinking during pregnancy. Rampage drinking as few equally iii drinks a day can cause this syndrome. It occurs in well-nigh 2 of 1,000 live births. This syndrome includes the following:

• Intellectual disability

• Abnormal behavioral evolution

Whether consuming caffeine during pregnancy harms the fetus is unclear. Bear witness seems to advise that consuming caffeine in small amounts (for example, one cup of coffee a day) during pregnancy poses piffling or no chance to the fetus.

Caffeine, which is contained in coffee, tea, some sodas, chocolate, and some drugs, is a stimulant that readily crosses the placenta to the fetus.

Some experts recommend limiting coffee consumption and drinking decaffeinated beverages when possible.

Aspartame, an artificial sweetener, appears to be condom during pregnancy when it is consumed in pocket-sized amounts, such equally in amounts used in normal portions of artificially sweetened foods and beverages. For example, meaning women should consume no more than than one liter of diet soda a twenty-four hours.

Bathroom salts refers to a group of designer drugs fabricated from diverse substances that resemble amphetamine. More and more pregnant women are using these drugs.

The drugs may crusade the claret vessels in the fetus to narrow, reducing the amount oxygen the fetus gets.

Also, these drugs increment the take chances of the following:

If pregnant women employ cocaine regularly, gamble of the following is increased:

Even so, whether cocaine is the cause of those bug is unclear. For instance, the cause may be other risk factors that are common in women who employ cocaine. Such factors include cigarette smoking, utilise of other illicit drugs, scarce prenatal care, and poverty.

• Miscarriage

• Premature labor and delivery

Hallucinogens include methylenedioxymethamphetamine (MDMA, or Ecstasy), rohypnol, ketamine, methamphetamine, and LSD (lysergic acid diethylamide).

Marijuana does not cause behavioral problems in the newborn unless it is used heavily during pregnancy.

Use of opioids during pregnancy increases the risk of complications during pregnancy, such every bit

• Miscarriage

• Preterm delivery

Babies of heroin users are more probable to be small.

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Source: https://www.msdmanuals.com/home/women-s-health-issues/drug-use-during-pregnancy/drug-use-during-pregnancy