Pregnancy and Lactation Therapeutic Considerations

Therapeutic considerations associated with pregnancy and lactation encompass many complex issues that affect both the mother and her child, from planning for pregnancy through lactation. Resources on the use of drugs in pregnancy and lactation include the FDA categorization system, the primary literature, textbooks, and computerized databases (e.g., the Canadian database, http //www.motherisk.org). 

The duration of pregnancy is approximately 280 days this time period extends from the first day of the last menstrual period to birth. Pregnancy is divided into three periods of three calendar months each 3-month period is called a trimester. 

Lipophilic drugs (e.g., opiates and antibiotics) cross more easily than do water-soluble drugs. Certain protein-bound drugs may achieve higher plasma concentrations in the fetus than in the mother. 

The incidence of congenital malformation is approximately 3% to 5%, and it is estimated that 1% of all birth defects are caused by medication exposure. Adverse fetal drug effects depend on dosage, route of administration, concomitant exposure to other agents, and stage of pregnancy when the exposure occurred. 

Preconception interventions have been shown to improve pregnancy 

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Chap. 44 - Pregnancy and Lactation Therapeutic Considerations Universal Program Number 014-999-07-059-H04... 

See Chap. 81, Pregnancy and Lactation Therapeutic Considerations, authored by Denise L. Walbrandt Pigarelli, Connie K. Kraus, and Beth E. Potter, for a more detailed discussion of this topic. 

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