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Drugs to be Avoided or Used With Caution In Pregnancy Introduction • Drugs can have harmful effects on the foetus at any time during pregnancy. During first trimester they may produce congenital malformations (teratogenesis) and the period of greatest risk is from the third to eleventh week of pregnancy. All drugs should be avoided if possible during the first trimester. • During the second and third trimesters. drug may affect the growth and functional development of the foetus or have atoxic effects on foetal tissues. • Drugs should be prescribed in pregnancy only if the expected benefit to mother is thought to be greater than the risk to the foetus. Drugs Gastrointestinal stimulant laxatives Trimester of Risk 1,2,3 Sulphasalazine 3 Adverse Effect Best avoided. As they may increase uterine activity in susceptible patients. Theoretical risk of neonatal haemolysis and of kemicterus in jaundiced neonates Drugs Trimester of Risk Adverse Effect Cardiovascular; 3 Amiodaron (cordaron) Release iodine with possible risk of neonatal goiter. B-Adrenoceptor 3 Blocking Drug Neonatal hypoglycemia and bradycardia Drugs Trimester of Risk Adverse Effect Diuretics 3 Reduce plasma volume and placental perfusion Thiazides may cause neonatal thrombocytopenia Oral anticoagulants 1,2,3 Congenital malformation. Foetal neonatal haemorrhage . Subcutaneous heparin can be used in the last few weeks of pregnancy in deep vein thrombosis