Pregnancy: a therapeutic dilemma

Abstract

Treatment during pregnancy is problematic. The Food and Drug Administration established drug categories to help in the treatment process. First-generation antihistamines are considered safe but they have sedative properties. Second-generation antihistamines cause less adverse reactions but besides cetirizine and loratadine they belong to category C. All retinoids should be avoided during pregnancy due to the risk of fetal malformations. Antimalarial drugs should be considered based on the clinical data. Sulfones can be considered as safe for use during pregnancy only with proper monitoring. Prednisone is administered in pregnancy. Other glucocorticosteroids have a different safety profile. Cyclosporine A treatment should be reserved as rescue therapy in severe stages of the disease. Treatment during pregnancy should be precise when it comes to pregnant woman and safe for the fetus.

Teratogenicity of drugs used in dermatological diseases

“…W terapii chorób dermatologicznych najczęściej stosowane są: prednizolon, prednizon oraz deksametazon. Dwa pierwsze w niewielkim stopniu (10%), natomiast deksametazon niemalże w całości, przechodzą przez łożysko [42,45,46]. Z tego powodu prednizolon stosowany jest w leczeniu ciężarnych, a deksametazon wtedy, gdy konieczne jest działanie na organizm płodu.…”

“…Przyjmowanie GKS przez kobiety w ciąży wiąże się także z ryzykiem wystąpienia niskiej masy urodzeniowej noworodka, a u matki -nadciśnienia tętniczego lub cukrzycy. Dzieci matek stosujących GKS podczas ciąży powinny być monitorowane ze względu na ryzyko rozwoju niewydolności nadnerczy [46]. Kobiety w okresie laktacji także nie powinny zażywać GKS, jednak, w razie wystąpienia bezwzględnych wskazań, można je podawać, najlepiej przez krótki okres ze względu na możliwość spowolnienia rozwoju kości u dzieci [3].…”

Evaluation of drug prescriptions for pregnant women in the Legal Amazon Region

“…Studies show that in other regions, such as Rio Grande do Sul, prenatal coverage in the first trimester reaches 80% of pregnant women. 17 Women who started prenatal care in the first trimester, and consequently have a higher frequency of medical appointments, are more likely to follow medical guidelines and correctly use prescribed medications.…”

“…1 Although the need for this administration by healthy pregnant women is questioned, its use may be beneficial for populations with low nutritional status, where the prevalence of anemia and malnutrition is common. 17 The high number of prescriptions of this mineral can be justified because the cost of diagnosis and follow-up of the table are higher than the costs of supplementing with iron salts. 21 In addition, its use is advocated by the WHO due to the high rates of anemia in developing countries.…”