Oral Clefts and Diazepam Use during Pregnancy

Shiono, PH; Jl, Mills

doi:10.1056/nejm198410043111413

Cited by 79 publications

(3 citation statements)

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“…Benzodiazepines (FDA Class D) have been associated with a cleft lip and palate in animal studies. [ 2 ] But, more recent, better controlled studies have not substantiated it. [ 10 ] A single dose of midazolam has not been associated with teratogenicity and is useful to provide preoperative anxiolysis.…”

Section: Issues Of Special Concern In Pregnancymentioning

confidence: 99%

“…The incidence of such surgical procedures varies from 0.75% to 2%. [ 1 ] Acute intra-abdominal infections [acute appendicitis (1:1500 pregnancies) and acute cholecystitis (1:1600 pregnancies),[ 2 ] ovarian cysts, and trauma are the most common indications for surgical procedures in pregnant patients. Diagnosis of surgical conditions is rendered difficult and sometimes delayed due to similarity of some symptoms that may be normal during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Anaesthesia for non-obstetric surgery in obstetric patients

2018

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Anaesthesia for pregnant patients presenting for non-obstetric surgery needs a thorough understanding of the physiological changes and altered pharmacokinetics of pregnancy. Considering the effects of surgery and anaesthesia on the foetus, only essential and emergency surgeries are performed during pregnancy. Surgical procedures in second trimester have the advantage of better foetal outcome. The primary concerns of maternal and foetal safety are achieved by a focused multidisciplinary team-based approach with respect to the surgical condition. Meticulous attention to preoperative patient counselling, airway management, haemodynamic stability, and thromboprophylaxis are the key factors in anaesthetic management. Choice of anaesthesia or anaesthetic drugs has minimal impact on the foetus provided utero-placental perfusion and uterine relaxation are maintained. Foetal monitoring when feasible and when done by a trained person enables to diagnose and treat the factors responsible for foetal heart rate variability. Anaesthetic technique needs to be modified according to the type of surgery.

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Section: Issues Of Special Concern In Pregnancymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anaesthesia for non-obstetric surgery in obstetric patients

2018

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“…[ 203 ] However, this has not been a consistent finding in the later studies, with some reporting similar association,[ 204 205 206 ] while others not finding the same. [ 207 208 209 210 ] There are case reports of other malformations, however, some of these have been inconclusive because of use of other medications along with diazepam. [ 202 ] Use of high doses of diazepam (usually more than 30–40 mg/day) during labor has been associated with withdrawal symptoms starting within a few days to 3 weeks and lasting up to several months in neonates.…”

Section: Effects Of Psychotropics: Pregnancy and Lactationmentioning

confidence: 99%

Mood stabilizers in pregnancy and lactation

Grover

2015

Indian J Psychiatry

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Management of bipolar during pregnancy and postpartum is very challenging. The treating clinicians have to take into account various factors like current mental state, longitudinal history of the patient, past history of relapse while off medication, response to medication, time of pregnancy at which patient presents to the clinician, etc. The choice of drug should depend on the balance between safety and efficacy profile. Whenever patient is on psychotropic medication, close and intensive monitoring should be done. Among the various mood stabilizers, use of lithium during the second and third trimester appears to be safe. Use of valproate during first trimester is associated with major malformation and long-term sequalae in the form of developmental delay, lower intelligence quotient, and higher risk of development of autism spectrum disorder. Similarly use of carbamazepine in first trimester is associated with higher risk of major congenital malformation and its use in first trimester is contraindicated. Data for lamotrigine (LTG) appears to be more favorable than other antiepileptics. During lactation, use of valproate and LTG is reported to be safe. Use of typical and/atypical antipsychotic is a good option during pregnancy in women with bipolar disorder.

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Overdose, Poisoning, and Envenomation

Gei¹,

Suarez²

2004

Critical Care Obstetrics

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Oral Clefts and Diazepam Use during Pregnancy

Cited by 79 publications

References 1 publication

Anaesthesia for non-obstetric surgery in obstetric patients

Anaesthesia for non-obstetric surgery in obstetric patients

Mood stabilizers in pregnancy and lactation

Overdose, Poisoning, and Envenomation

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