PERINATAL

• How can the placenta harm the fetus?


  By affecting the uterus or the placenta.
• What are the possible effects of medications taken during pregnancy on the fetus?


  They can have no impact, cause damage, or alter placenta function.
• What can medications do that act directly on the fetus?


  They can cause damage, abnormal development, or death.
• How can medications alter the function of the placenta?


  By causing blood vessels to constrict, reducing oxygen and nutrient supply.
• What can happen if the muscles of the uterus contract forcefully due to medications?


  It can injure the fetus by reducing its blood supply or triggering preterm labor.
• How can medications affect the fetus indirectly?


  By lowering the mother's blood pressure, reducing blood flow to the placenta.
• What is a specific example of a medication that can cause birth defects after stopping its use?


  Isotretinoin can cause birth defects if pregnancy occurs within 2 weeks after stopping.
• How long should women wait after stopping isotretinoin before becoming pregnant?


  At least 3 to 4 weeks.
• How do medications cross the placenta?


  Through the placental membrane separating maternal and fetal blood.
• What separates the mother's blood from the fetus's blood in the placenta?


  The placental membrane.
• What should a pregnant woman do before taking any medication?


  Consult a doctor.
• Why is it important for women currently taking medications to consult a doctor before pregnancy?


  To determine if those medications need to be stopped or changed.
• What factors influence how a medication affects a fetus during pregnancy?


  • Stage of fetal development
  • Strength and dose of the medication
  • Permeability of the placenta
  • Genetic factors in the pregnant woman
  • Pregnant woman's health
• Which agency provides information about drug safety in pregnancy in the United States?

  The US Food and Drug Administration (FDA).
• What are the possible fetal effects of medications taken within 20 days after fertilization?


  • All-or-nothing effect (death or no effect)
  • Fetus is highly resistant to birth defects
• What are the possible fetal effects of medications taken 3-8 weeks after fertilization?


  • Possibly no effect
  • Miscarriage
  • Obvious birth defect
  • Permanent subtle defect
  • Increased risk of childhood cancer
• What are the possible fetal effects of medications taken during the second and third trimesters?


  • Changes in growth and function of normally formed organs
  • Unlikely to cause obvious birth defects
  • Unknown long-term effects
• What do doctors consider when advising pregnant women about medications?


  Available research, importance of the medication, and alternative treatments.
• What are some medications and their possible problems during pregnancy?

  • Anti-anxiety medications: Slow breathing in newborns
  • Antibiotics: Ototoxicity and gray baby syndrome
  • Antidepressants: Birth defects and withdrawal symptoms
  • Antihypertensive medications: Kidney damage and growth restriction
• What can happen when benzodiazepines are taken late in pregnancy?


  They can cause very slow breathing or withdrawal syndrome in the newborn.
• What is a possible effect of aminoglycosides on the fetus?


  Damage to the fetus's ear, resulting in variable deafness.
• What can chloramphenicol cause in women or fetuses with G6PD deficiency?


  Breakdown of red blood cells and possibly gray baby syndrome.
• What is a possible risk of fluoroquinolones during pregnancy?


  Bone and joint abnormalities in animals.
• What can sulfonamides cause when given late in pregnancy?


  Jaundice and brain damage in the newborn.
• What are the effects of tetracycline during pregnancy?


  Slowed bone growth and permanent yellowing of teeth in the child.
• What can trimethoprim cause during pregnancy?


  Defects of the brain and spinal cord, such as spina bifida.
• What is a possible risk of factor Xa inhibitors during pregnancy?


  Possible risk of bleeding in the pregnant woman or fetus.
• What can paroxetine cause when taken during the first trimester?


  Increased risk of birth defects, particularly heart defects.
• What can sertraline cause when taken during the third trimester?


  Discontinuation syndrome and persistent pulmonary hypertension of the newborn.
• What can doxylamine and pyridoxine cause during pregnancy?


  No increased risk of birth defects.
• What can ondansetron potentially cause when taken during the first trimester?


  Possible risk of congenital heart disease.
• What can warfarin cause during pregnancy?


  Birth defects including malformed bones and bleeding problems.
• What can carbamazepine cause during pregnancy?


  Increased risk of birth defects, including neural tube defects.
• What can valproate cause during pregnancy?


  Increased risk of birth defects, including cleft palate and neural tube defects.
• What can doxorubicin cause for the mother during pregnancy?


  Heart problems.
• What are some chemotherapy drugs and their possible problems during pregnancy?


  • Actinomycin: Possibility of birth defects (seen only in animals)
  • Busulfan: Various birth defects and inadequate growth of the fetus
  • Chlorambucil: Various birth defects and inadequate growth of the fetus
  • Cyclophosphamide: Various birth defects and inadequate growth of the fetus
• What are the effects of medications on fetal development based on timing?


  • 20 days after fertilization: All-or-nothing effect
  • 3-8 weeks after fertilization: Possible birth defects and miscarriage
  • Second and third trimesters: Changes in organ growth and function
• What is a type of defect associated with meningomyelocele?


  Defects of the heart, face, skull, spine, and limbs
• What is one chemotherapy drug that can cause birth defects?


  Actinomycin
• What type of birth defects are associated with Busulfan?


  Underdevelopment of the lower jaw, cleft palate, and spinal defects