INTRODUCTION

Most of the pregnant women take medicines.

FETAL AGE AND EFFECT OF THE MEDICINES

• The period of the organogénesis (between the 3rd one and the 8th week) is the most critical as for the malformations production.
• The medicines administered during the phase of embryo (before the 20th day after the conception) kill to the embryo or do not affect it by no means.
• The medicines administered after the organogénesis (that is to say, during the 2nd one or the 3rd trimester) it is slightly probable that they produce malformations, although they can alter the growth of the normal fetal organs.

MEDICINES TO BE AVOIDED IN THE PREGNANCY

The following medicines or drugs must never take in the pregnancy, except for strict medical indication, especially during the called period of the organogénesis (between the 3rd one and the 8th week), under risk of producing serious malformations or other fetal problems of growth and development.

• Antineoplastic medicines (chemotherapy for the cancer)
• Thalidomide. It was commercialized in 1956 like remedy against the flu and like sedative. Soon an absence of the extremities was described, and other malformations, in women's fetuses that had taken thalidomide during the organogénesis.
• Isotretinoína and etretinato (products against the acne).
• Hormones: androgen (masculine sexual hormones), etc.
• Thyroid medicines (thyroid hormones and antithyroid medicines).
• Anticonvulsivantes.
• You vaccinate with living viruses (example: vaccine of the German measles)
• Antidiabetic oral
• Sedatives and analgesics.
• Antibiotics. The tetraciclinas cross the afterbirth and concentrate and deposit in the bones and the fetal teeth, giving a permanent yellowish bleaching of the teeth. The aminoglucósidos (streptomycin, gentamicina, etc) can injure the fetal internal ear. The cloramfenicol can produce a respiratory collapse on the newborn baby ("syndrome of the gray child"). The sulfamidas given close to the childbearing can provoke a jaundice. The penicilinas seem sure in the pregnancy, although allergy can appear inside the womb.
• Oral anticoagulants (type Sintrom ®). The heparina does not spend the afterbirth and it is the election anticoagulant during the pregnancy.

MEDICINES USED DURING THE CHILDBEARING

• Local anesthesia and/or epidural: It has collaborated to depression of the nervous system of the fetus and bradicardia (decrease of the fetal pulse).
• The oxitocina administered to the mother (to stimulate the contractions) can affect to the fetus producing anoxia or asphyxiates.
• The general anesthesia (necessary in some childbearings or Cesarean sections) affects much more to the fetus: the opiates, the escopolamina, the barbiturate ones, the ketamina and the analgesics cross the afterbirth.

PREGNANCY AND LEGAL AND ILLEGAL DRUGS

• Nicotinism. The middleweight to the birth of the children of smoking mothers during the pregnancy is 170 g minor that that of the children of not smoking mothers. In the pregnant women who smoke there is major also the incidence of miscarriage, premature childbearing and the syndrome of sudden death of the nursing one.



• Caffeine. The consumption of more than 7 or 8 daily cups of coffee collaborates to a major incidence of fetal deaths, newborn babies of low weight and miscarriages. The decaffeinated drinks raise theoretically little risks.



• Alcohol. The fetal alcoholic syndrome observes in the mothers' children that they consume alcohol. It consists of delay of the growth, microcephaly (small head), mental deficiency and other anomalies. There is not known the critical volume of the alcoholic ingestion that provokes it.



• Opiates (heroine, morphine, etc). The newborn babies of mothers addicted to the opiates can present abstinence symptoms between 6 hours and 8 days after the birth.



• Cocaine. His consumption during the gestation has collaborated to an increase of abortions, malformations of the nervous system and of the tract genitourinario fetal and depression of the interactive conduct in the newborn babies.



• Marijuana. Although there do not exist tests that demonstrate that the marijuana is teratógena or collaborate to a bad fetal growth and development, the studies point out that a high consumption collaborates to anomalies of the neurological conduct in the newborn babies.

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