1. Drugs in Pregnancy 2010.04.13 Liu Yinglin M.D. & PhD / Associate Professor The 2 nd affiliated hospital of S.Y.S.U.

2. Drugs in Pregnancy □ Metabolism of drug in pregnancy □ Influence of Drugs on fetuses □ Teratology □ Classifications of Medicine □ Counseling for Teratogen Exposure □ Known Teratogens □ Drugs Commonly Used in Pregnancy □ Quiz

6. Teratology Evaluation of Potential Teratogens

22. Known Teratogens Table 4. Teratogenic Effects of Common Antiepileptic Drugs Drug Teratogenesis Affected Phenytoin Fetal hydantoin syndrome: craniofacial anomalies, fingernail hypoplasia, growth deficiency, developmental delay, cardiac defects, facial clefts 5–11% Carbamazepine Fetal hydantoin syndrome; spina bifida 1–2% Valproate Neural-tube defects 1–2% Trimethadione, paramethadione Craniofacial anomalies, including cleft palate, V -shaped eyebrows, microcephaly, growth deficiency, mental retardation, speech disturbance, cardiac defects 70% Phenobarbital Clefts, cardiac anomalies, urinary tract malformations 10–20% Lamotrigine Theoretical—lowers fetal folate levels by inhibiting dihydrofolate reductase ? Topiramate Theoretical—has produced defects or abnormal pregnancy outcomes in all animals tested, even at low or therapeutic doses ?

44. Thank You !