Q&A
1
Stage 1
Before pregnancy
Pre-conceptional exposures and family planning considerations
A couple is planning a pregnancy and is being exposed to drugs/chemicals.
- What is the risk?
- Should this exposure be changed or stopped?
- Does this exposure decrease fertility?
2
Stage 2
During pregnancy
Gestational safety, inadvertent exposures, and acute clinical scenarios
A pregnant woman has taken a drug before she realises that she is pregnant
- What is the risk?
- Would recommending termination of pregnancy be justified?
- What prenatal diagnostic procedures can be offered?
A drug has to be prescribed to a pregnant woman
- Is it safe?
- Is there a less toxic/teratogenic drug with comparable therapeutic efficacy to which the woman should be transferred?
- Is the risk of taking a drug greater than the risk of the disease for which the drug is taken?
- Are there risks acceptable to the patient when compared with the spontaneous risk of developmental disorders?
A pregnant woman has attempted to commit suicide by taking an overdose of a drug.
- What information should be given to the physician at the emergency department?
- Can the appropriate antidote be given to her?
A pregnant woman is addicted to drugs/alcohol.
- Do they have an adverse effect on the course of pregnancy?
- What are the effects on fetal development?
- Can neonatal problems be expected or are there any long-term consequences for the child?
A pregnant woman is exposed at work to certain chemicals.
- What is the risk?
- Should she continue this work?
A pregnant woman is exposed to an infectious agent.
- What are the risks of a maternal infection for the fetus?
- Are techniques available for the diagnosis of a fetal infection and what are the management options?
- Similar questions are made for non-infectious maternal diseases.
A pregnant woman has been exposed to…
- What are the risks of certain physical exposures such as heat and radiation (especially x-rays and radioactive materials), vaccinations or environmental pollution?
A man has been exposed to chemicals or has been treated with drugs.
- Are there any paternally mediated risks for the fetus or baby?
3
Stage 3
After Pregnancy
Lactation pharmacology and neonatal outcome evaluations
A baby is born with a birth defect or a neonatal disorder.
- Can this be attributed to a drug or chemical to which the mother was exposed before or during pregnancy?
A drug has to be prescribed to a mother while she is breastfeeding. A mother uses a prescription drug or is exposed to an other exogenous agent, while breastfeeding.
- What is the (relative) dose the neonate (infant) is exposed to?
- Is this acceptable for its age?
- What is the treatment of choice during breastfeeding?
