Module Content
Medications
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Though some drugs are labeled as unsafe for pregnancy (and thus for pre-pregnancy in the case of accidental pregnancy and early exposure), the teratogenic risk of the medication must be weighed against the teratogenic risk of the condition itself (e.g. many epilepsy drugs are FDA labeled as unsafe for pregnancy; however, seizures during pregnancy are also associated with poor maternal-fetal outcomes).
Of note, the FDA labeling system for drug use during pregnancy has recently shifted from categories (A, B, C, D, and X) to informational summaries. Now drugs will be labeled with risk, clinical and data summaries both for pregnancy and lactation. For more information, see the following two resources:
If you find yourself in a situation where you are unsure about the best pre-pregnancy management of a reproductive age female patient’s medications, check the following resources:
Resources
Hospital pharmacist, particularly one working on L&D or Perinatal wards
Ob/Gyn colleague
MFM colleague
If you don’t know an MFM physician, search to find the name of one near you.
ReproTox –an online database for environmental hazards, including drugs; requires a membership, but one might be offered through your institution
Briggs Drugs in Pregnancy and Lactation
No online version available for free at this time
Cunningham FG, Leveno KL, Bloom SL, Hauth JC, Gilstrap LC III, Wenstrom KD, "Chapter 14. Teratology, Drugs, and Other Medications" (Chapter). Cunningham FG, Leveno KL, Bloom SL, Hauth JC, Gilstrap LC III, Wenstrom KD: Williams Obstetrics, 22e: http://www.accessmedicine.com (
Dunlop AL, Gardiner PM, Shellhaas CS, Menard MK, McDiarmid MA. The clinical content of preconception care: the use of medications and supplements among women of reproductive age. Am J of Obstet and Gynecol [Internet]. 2008 Dec [cited 2009 Jul 20];Suppl 2:199(6):S367-72. Available from http://www.ajog.org/.
