Health care providers’ requests to Teratogen Information Services on medication use during pregnancy and lactation

Gendron, Marie; Martin, Brigitte; Oraichi, Driss; Bérard, Anick

doi:10.1007/s00228-008-0611-6

Cited by 31 publications

(22 citation statements)

References 26 publications

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“…Além do uso dos medicamentos orientados pelos protocolos citados anteriormente, outros medicamentos também são comumente utilizados durante a gravidez, em especial para o manejo dos sintomas comuns durante a gestação 4 . A utilização de medicamentos durante gravidez se integra a alguns problemas de saúde maternos, dentre os quais se destaca o diabetes mellitus, diabetes gestacional, hipertensão arterial sistêmica, cardiopatias, asma, toxoplasmose, sífilis, hipertireoidismo, alterações nos sistemas renal, hepático e ginecológico e ansiedade [5][6][7][8][9][10][11] . As taxas de exposição a medicamentos de risco durante a gravidez variam de acordo com o período gestacional analisado e a forma de coleta de dados adotada nas pesquisas, sendo estimada entre 28 e 96,9% 6,12 .…”

Section: Em 2002 O Ministério Da Saúde Criou O Programa Nacional Dunclassified

Uso de medicamentos no primeiro trimestre de gravidez: avaliação da segurança dos medicamentos e uso de ácido fólico e sulfato ferroso

Lunardi-Maia¹,

Schuelter-Trevisol²,

Galato³

2014

Rev. Bras. Ginecol. Obstet.

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Houve diferença entre as proporções de medicamentos utilizados segundo a ATC, e os principais grupos anatômicos identificados foram os dos medicamentos que atuam no sangue e órgãos hematopoiéticos e anti-infecciosos de uso sistêmico. Na época do diagnóstico da gravidez, observou-se expressivo uso de medicamentos que atuam no sistema geniturinário e hormônios sexuais (16,2%), como anticoncepcionais orais, o que provavelmente está relacionado ao percentual de gestações não planejadas (67,0%), nessa mesma ocasião 4 gestantes utilizaram ácido fólico e 3 utilizaram o sulfato ferroso. CONCLUSÃO: Os resultados demonstram uso expressivo de medicamentos durante a gravidez. Mesmo que haja menor exposição aos medicamentos no momento do diagnóstico da gravidez, observa-se maior consumo de medicamentos de risco e da prática de automedicação nesse período. Abstract PURPOSE:To identify the profile of use of medication during the first trimester of pregnancy with emphasis on safety assessment and on the adoption of folic acid and ferrous sulfate by pregnant women attended at a Basic Health Unit in Brazil. METHODS: This was a cross-sectional study nested in a cohort of pregnant women. Medications were classified according to the Anatomical Therapeutic Chemical (ATC), and their safety was evaluated according to the Food and Drug Administration (FDA) and the Brazilian Health Surveillance Agency (ANVISA). The adoption of ferrous sulfate and folic acid was investigated according to the protocol set forth by the Brazilian Ministry of Health. RESULTS: The survey included 212 pregnant women, 46.7% of whom were taking medications at the time of pregnancy diagnosis, and 97.6% used medication during the first trimester after diagnosis. The highest percentage of self-medication occurred before the beginning of prenatal care (64.9%). According to the FDA criteria, there was a high level of exposure to D and X risk drugs before the beginning of prenatal care (23.0%), which was also observed for drugs not recommended by ANVISA (36.5%). Of the surveyed sample, 32.5% did not follow the protocol of the Brazilian Ministry of Health. In all, 67.9% of pregnant women had inadequate drug exposure. There was a difference between the proportions of

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Section: Em 2002 O Ministério Da Saúde Criou O Programa Nacional Dunclassified

Uso de medicamentos no primeiro trimestre de gravidez: avaliação da segurança dos medicamentos e uso de ácido fólico e sulfato ferroso

Lunardi-Maia¹,

Schuelter-Trevisol²,

Galato³

2014

Rev. Bras. Ginecol. Obstet.

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“…Many women are exposed to different xenobiotics such as drugs or environmental pollutants during their pregnancy 8 . For some drugs which were already administered regularly during pregnancy, in vivo studies can be performed by comparison of the maternal blood concentration with that in umbilical cord blood.…”

Section: Introductionmentioning

confidence: 99%

Determination of the Transport Rate of Xenobiotics and Nanomaterials Across the Placenta using the <em>ex vivo</em> Human Placental Perfusion Model

Grafmüller

Manser

Krug

et al. 2013

JoVE

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Decades ago the human placenta was thought to be an impenetrable barrier between mother and unborn child. However, the discovery of thalidomide-induced birth defects and many later studies afterwards proved the opposite. Today several harmful xenobiotics like nicotine, heroin, methadone or drugs as well as environmental pollutants were described to overcome this barrier. With the growing use of nanotechnology, the placenta is likely to come into contact with novel nanoparticles either accidentally through exposure or intentionally in the case of potential nanomedical applications. Data from animal experiments cannot be extrapolated to humans because the placenta is the most species-specific mammalian organ 1 . Therefore, the ex vivo dual recirculating human placental perfusion, developed by Panigel et al. in 1967 2 and continuously modified by Schneider et al. in 1972 3 , can serve as an excellent model to study the transfer of xenobiotics or particles.Here, we focus on the ex vivo dual recirculating human placental perfusion protocol and its further development to acquire reproducible results.The placentae were obtained after informed consent of the mothers from uncomplicated term pregnancies undergoing caesarean delivery. The fetal and maternal vessels of an intact cotyledon were cannulated and perfused at least for five hours. As a model particle fluorescently labelled polystyrene particles with sizes of 80 and 500 nm in diameter were added to the maternal circuit. The 80 nm particles were able to cross the placental barrier and provide a perfect example for a substance which is transferred across the placenta to the fetus while the 500 nm particles were retained in the placental tissue or maternal circuit. The ex vivo human placental perfusion model is one of few models providing reliable information about the transport behavior of xenobiotics at an important tissue barrier which delivers predictive and clinical relevant data. Video LinkThe video component of this article can be found at

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“…13 Another study reviewed 3 years' experience of a Canadian Teratology Information Service, revealing that the most common questions regarding medication exposure in pregnant women involved antidepressants, antibiotics, and benzodiazepines. 14 Finally, an analysis of practices in Europe documented that the most common reasons for contacting a Teratology Information Service include psychiatric diseases, allergies, and airway diseases (excluding asthma). 15 A common facet of each of these studies is the perception of increased fetal risk from use of antidepressant medications.…”

mentioning

confidence: 99%

Antidepressants in Pregnancy: A Review of Commonly Prescribed Medications

Patil

Kuller²,

Rhee³

2011

Obstetrical &Amp; Gynecological Survey

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Health care providers’ requests to Teratogen Information Services on medication use during pregnancy and lactation

Cited by 31 publications

References 26 publications

Uso de medicamentos no primeiro trimestre de gravidez: avaliação da segurança dos medicamentos e uso de ácido fólico e sulfato ferroso

Uso de medicamentos no primeiro trimestre de gravidez: avaliação da segurança dos medicamentos e uso de ácido fólico e sulfato ferroso

Determination of the Transport Rate of Xenobiotics and Nanomaterials Across the Placenta using the <em>ex vivo</em> Human Placental Perfusion Model

Antidepressants in Pregnancy: A Review of Commonly Prescribed Medications

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