Pregnancy therapy during

For women with 140 to 179 mm Hg systolic or 90 to 109 mm Hg diastolic, the decision to continue or stop antihypertensive therapy during pregnancy is controversial. Antihypertensive drugs may be continued during pregnancy except for ACEIs and angiotensin II receptor blockers. 

The safety of acyclovir therapy during pregnancy is not established, although there is no evidence of teratogenic effects in humans. 

In patients with significant bacteriuria, symptomatic or asymptomatic, treatment is recommended in order to avoid possible complications during the pregnancy. Therapy should consist of an agent with a relatively low adverse-effect potential (a sulfonamide, cephalexin, amoxicillin, amoxicillin/clavulanate, nitrofurantoin) administered for 7 days. 

There is no indication for estrogen therapy during pregnancy or during the immediate postpartum period. Estrogens are ineffective for the prevention or treatment of threatened or habitual abortion. Estrogens are not indicated for the... 

Must have selected and has committed to using 2 forms of effective contraception simultaneously, at least 1 of which must be a primary form, unless absolute abstinence is the chosen method, or the patient has undergone a hysterectomy. Patients must use 2 forms of effective contraception for at least 1 month prior to initiation of isotretinoin therapy, during isotretinoin therapy, and for 1 month after discontinuing isotretinoin therapy. Counseling about contraception and behaviors associated with an increased risk of pregnancy must be repeated on a monthly basis. 

Impastato, D.J., Gabriel, A.R., and Lardaro, H.H. (1964) Electric and insulin shock therapy during pregnancy. Dis Nerv Syst 1 542-546. 

Miller, L.J. (1994) Use of electroconvulsive therapy during pregnancy. Hosp Community Psychiatry 45 444—450. 

Wisner, K.L. and Perel,J.M. (1988) Psychopharmacologic agents and electroconvulsive therapy during pregnancy and the puerperium. In Cohen, R.L., ed. Psychiatric Consultation in Childbirth Settings. New York Plenum, pp. 165-206. 

Walker R, Swartz CM. Electroconvulsive therapy during high-risk pregnancy. Gen Hosp Psychiatry 1994 16 348-353. 

However, first trimester in utero exposure to a glucocorticoid was associated with a small risk of major neonatal malformations, according to the results of a Canadian meta-analysis (383). Six cohort studies and one case-control study were analysed, and the results showed that women who had taken long-term glucocorticoid therapy during pregnancy were more likely to have a baby with a major malformation than women who had not (OR = 2.46 95% Cl = 1.41, 4.29). 

Bihan H, Vazquez MP, Krivitzky A, Cohen R. Aplasia cutis congenita and dysmorphic syndrome after antithyroid therapy during pregnancy. Endocrinologist 2002 12 87-91. 

Charbonneau M, Falcone T, Cosio MG, Levy RD. Obstructive sleep apnea during pregnancy therapy and implications for fetal health. Am Rev Respir Dis 1991 144 461 163. 

Therapy during pregnancy is warranted, particularly in light of the dramatic reduction in transmission seen with zidovudine monotherapy. In general, pregnant women should be treated similar to nonpregnant adults if possible, zidovudine should be used for both mother and infant. Efavirenz should not be used, particularly in the first trimester, because of the risk of teratogenicity. 

There are two compelling reasons for studying drugs and drug therapy during pregnancy. The first... 

Since morning sickness of pregnancy occurs during the time when the fetus is vulnerable, it is specially important to restrict drug therapy of this symptom to a minimum but severe vomiting with its accompanying biochemical changes may itself harm the fetus. 

Mechanisms of action Actions mineralocorticoid, glucocorticoid Individual adrenal steroids Pharmacokinetics Dosage schedules Choice of adrenal steroid Adverse effects of systemic pharmacotherapy Adrenal steroids and pregnancy Precautions during chronic therapy treatment of intercurrent illness Dosage and routes of administration indications for use... 

The authors concluded that when a woman taking glaucoma therapy becomes pregnant, it is usually possible to interrupt therapy during pregnancy. Treatment may be deferred until delivery of the infant. 

Bar Oz B, Hackman R, Einarson T, Koren G. Pregnancy outcome after cyclosporine therapy during pregnancy a meta-analysis. Transplantation 2001 71(8) 1051-5. 

Olwin JH, Koppel JL. Anticoagulant therapy during pregnancy. A new approach. Obstet Gynecol 1969 34(6) 847-52. 

Anderson DR, Ginsberg JS, Burrows R, BrUl-Edwards P. Subcutaneous heparin therapy during pregnancy a need for concern at the time of delivery. Thromb Haemost 1991 65(3) 248-50. 

Douketis JD, Ginsberg JS, Burrows RF, Duku EK, Webber CE, Brill-Iidwards P. The effects of long-term heparin therapy during pregnancy on bone density. A... 

Ginsberg JS, Kowalchuk G, Hirsh J, BrUl-Edwards P, Burrows R. Heparin therapy during pregnancy. Risks to the fetus and mother. Arch Intern Med 1989 149(10) 2233-6. 

Kimby E, Sverrisdottir A, Elinder G. Safety of rituximab therapy during the first trimester of pregnancy a case history. Eur J Haematol 2004 72(4) 292-5. 

Retinoids are strongly teratogenic (21). Pregnancy should be ruled out and an effective form of contraception must be used for at least 1 month before starting therapy, during therapy, and for at least 1 month (isotretinoin) or 2 years (acitretin) after therapy is stopped. Retinoid-induced teratogenicity has been reviewed (22,23). 

Estrogens. The synthesis of AAT is stimulated by estrogens elevated levels are seen particularly during late pregnancy and during estrogen therapy. 

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