Drugs Affecting Pregnancy and the Fetus

December 14, 2007

Antibiotics, Narcotics, and Anesthetics In Pregnancy

Unless there's a specific allergy, the penicillins (penicillin G, ampicillin, etc.) are safe in pregnancy. The same goes for the cephalosporins (Keflex, etc.). Most types of erythromycin can also be uses as antibiotics, as well as vancomycin (in penicillin allergies). In my practice, Macrodantin has been a favorite for urinary tract infections in pregnancy. Although it's been known to rarely cause a serious anemia, this would not have a risk that would outweigh the benefit.

The drug of choice for upper respiratory infections involving sinusitis, pharyngitis, or other non-viral infections is still penicillin.

Questions regarding dental care constatnly crop up in pregnancy. This is because the patient fears being exposed to anesthetics (numbing shots) and pain relievers. If drug exposure can be delayed to after organogenesis (weeks 6 through 9), this is preferable. Nevertheless, if dental work must be done, even during the first trimester these drugs are fairly harmless. The narcotics, especially, are time-honored, as they've been around for a long time. Anesthetics containing adrenaline may make a patient jittery and create palpitations, especially with the normal changes in the heart that accompany pregnancy, but this is merely a symptomatic inconvenience in the absense of true heart valve pathology.

If surgery is needed, the best time to go is during second trimester (weeks 13-24), because this will not expose an early fetus to drugs, and it's still too early to provoke a premature labor.

Illegal and Recreational Drugs in Pregnancy

Heroin, Cocaine, and other addictive drugs are not necessarily deforming substances, but use can cause withdrawal in the newborn as well as growth retardation in the unborn baby. There are indications cropping up in the literature about sociopathic behavior of children born of mothers who used crack and other types of cocaine.

Certainly sociopathic behavior seen in some young is multifactorial--poverty, fatherless families, abuse,etc. But is it me, or has there seemed to be a surprising rise in sensless violence by young people that has coincided with the growing popularity of crack cocaine in this country? We can talk about deforming the body of a developing baby; we never talk about deforming the soul.

Alcohol abuse can cause what's called Fetal-Alcohol Syndrome, associated with deformed teeth and facial features and mental retardation. Marijuana, like cigarettes, has many chemicals in it besides THC. If you get stoned, your baby gets stoned--all at a time when neural cells are busy developing so that they can handle all of the neurotransmitters used in proper central nervous system functioning. I don't know about you, but this would make me very nervous. Also, THC is stored in fat cells, and the weird sugar metabolism shifts that take place in pregnancy may recycle this substance over and over.

Almost any drug you look up is associated with cleft lips and other facial deformities when used in early pregnancy. The caveat to follow in pregnancy is to live sqeaky clean and clear all drugs with your doctor before use. That's the best way to prevent parental guilt if your child makes his or her Rs backwards in the fourth grade. You have your life--it's unfair to take a chance with someone else's. Female drug users who have gotten pregnant should immediately stop using drugs and get the drug treatment they need.

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