Gynecology

Hypertension in Pregnancy

Anti-hypertensives in pregnancy 🤰🏻⁠

✏️ Hypertension is defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg. Chronic hypertension occurs before pregnancy or before 20 weeks gestation and gestational hypertension occurs after 20 weeks⁠

⚠️ Complications of high blood pressure include increased risks for preeclampsia/eclampsia/stroke for the mother and preterm delivery for the baby⁠

📖 As with most medications in pregnancy, antihypertensives have not been evaluated in robust randomized controlled trials. Check out the post for the preferred anti-hypertensive drugs used in pregnancy. ⁠

⭐ Methyldopa is recommended first-line due to its proven safe and effective use in pregnancy due to its long history of safety in pregnancy but its use in clinical practice may be less due to adverse reactions (e.g., fatigue, dizziness).⁠

Hypertension in Pregnancy Read More »

Uterine Relaxant Drugs

👶🏻 Preterm labor occurs when labor begins too early. If this happens before the 37th week of gestation, the fetal organs, especially the lungs, might not be fully developed.⁠

💊 In these cases, labor can be suppressed with uterine relaxants that relax the uterine muscle and slow down contractions for up to 48 hours. It gives the fetus a few more days in the uterus as a corticosteroid is given to speed up the development of a preterm infant’s lungs. Steroids help the lungs mature and may promote the production of surfactant, a substance that prevents the collapse of alveoli (small sacs in the lungs where the air is exchanged). ⁠

💊 Uterine relaxants are also called tocolytics (toco = childbirth, lytic = terminate) and include several different types of drugs. ⁠

Uterine Relaxant Drugs Read More »

Pharmacokinetics in Pregnancy

🤰🏻 Choosing an effective yet safe antibiotic during pregnancy requires you to weigh the risks and benefits. It can often be a gray area based on limited clinical studies in pregnant patients. ⁠⠀
⁠⠀
Some tips include:⁠⠀
⁠⠀
👉🏻 Only using antibiotics when no other treatment options are available ⁠⠀
⁠⠀
👉🏻 Avoid prescribing antibiotics during the first trimester if possible. ⁠⠀
⁠⠀
👉🏻 Chose a safe medication with available clinical studies that have been tested in pregnancy⁠⠀
⁠⠀
👉🏻 Dose at the lowest possible amount proven effective.⁠⠀

Pharmacokinetics in Pregnancy Read More »