Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be talking to you about medications and pregnancy.

And you can find written notes on this topic at zero to finals.com slash medications and pregnancy or in the antinatal care section of the zero to finals

obstetrics and gynecology book. So let's get straight into it. The effects of certain medications

during pregnancy may be tested in exams and they're also worth being aware of when you're prescribing

for women that are

or could be pregnant. This is not an exhaustive list, and when in doubt, always check with the

BNF, guidelines and seniors when prescribing in pregnancy. First let's start by talking about

non-steroidal anti-inflammatory drugs or ensades.

Some examples are ibuprofen and naproxin.

These medications work by blocking prostaglandins.

Prostaglandins are important in maintaining the ductus arteriosis in the fetus and the neonate.

They also soften the cervix and they stimulate uterine contractions at the time of delivery. Enseys are generally avoided in pregnancy unless they're

really necessary, for example in severe rheumatoid arthritis. They're particularly avoided in the third trimester as they can cause premature

closure of the ductus arteriosis in the fetus. They can also delay labor. Next let's talk about

beta blockers. Beta blockers are commonly used for hypertension, cardiac conditions and migraine.

Lebitolol is the most frequently used beta blocker in pregnancy

and its first line for high blood pressure caused by preeclampsia.

However, beta blockers can cause fetal growth restriction, hypoglycemia, or low blood sugar levels in the neonate, and bradycardia, or a slow heart rate in the neonate.

Next let's talk about ACE inhibitors and angiotensin-2 receptor blockers.

Medications that block the renin angiotensin system, such as ACE inhibitors and

angiotensin receptor blockers, can cross the placenta and enter into the fetus.

In the fetus, they mainly affect the kidneys and they reduce the production of urine and therefore the amniotic fluid.

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