 In general, drugs should not be used during pregnancy unless absolutely necessary because many can harm the fetus. About 2 to 3% of all birth defects result from the use of drugs other than alcohol.  Sometimes drugs are essential for the health of the pregnant woman and the fetus.

 a pregnant woman should consult her health care practitioner. A health care practitioner may recommend that a woman take certain vitamins and minerals during pregnancy.

Drugs that a pregnant woman takes during pregnancy can affect the fetus in several ways: They can act directly on the fetus, causing damage, abnormal development (leading to birth defects), or death. They can cause the muscles of the uterus to contract forcefully, indirectly injuring the fetus by reducing its blood supply or triggering preterm labor and delivery.

They can alter the function of the placenta, usually by causing blood vessels to narrow (constrict) and thus reducing the supply of oxygen and nutrients to the fetus from the mother. Sometimes the result is a baby that is underweight and underdeveloped.

 Antianxiety drug › Diazepam Some Trade Names VALIUM  When the drug is taken late in pregnancy, depression, irritability, shaking, and exaggerated reflexes in the newborn

 Tetracycline › Slowed bone growth, permanent yellowing of the teeth, and increased susceptibility to cavities in the baby › Occasionally, liver failure in the pregnant woman

 Nitrofurantoin › In women or fetuses with G6PD deficiency, the breakdown of red blood cells  Streptomycin &kanamycin › Damage to the fetus's ear, resulting in deafness

 Chloramphenicol › Gray baby syndrome › In women or fetuses with glucose-6- phosphate dehydrogenase (G6PD) deficiency, the breakdown of red blood cells

 Fluoroquinolones (such as ciprofloxacin) › Possibility of joint abnormalities (seen only in animals)

 Heparin › When the drug is taken a long time, osteoporosis and a decrease in the number of platelets (which help blood clot) in the pregnant woman  Warfarin › Birth defects › Bleeding problems in the fetus and the pregnant woman

 Carbamazepine Some Trade Names TEGRETOL › Some risk of birth defects › Bleeding problems in the newborn, which can be prevented if pregnant women take vitamin K by mouth every day for a month before delivery or if the newborn is given an injection of vitamin K soon after birth

 Phenobarbital &phenytoin › Same Like carbamazepine  trimethadione › Increased risk of miscarriage › High (70%) risk of birth defects, including a cleft palate and defects of the heart, face, skull, hands, and abdominal organs

 Valproate › Some (1%) risk of birth defects, including a cleft palate and defects of the heart, face, skull, spine, and limbs

 Drugs to lower high blood pressure may be needed by pregnant women who have had high blood pressure before pregnancy or who develop it during pregnancy. Either type of high blood pressure increases the risk of problems for the woman and the fetus  Antihypertensives can markedly reduce blood flow to the placenta if they lower blood pressure too rapidly in pregnant women. So pregnant women who have to take these drugs are closely monitored.

 Angiotensin-converting enzyme (ACE) inhibitors › When the drugs are taken late in pregnancy, kidney damage in the fetus, a reduction in the amount of fluid around the developing fetus (amniotic fluid), and defects of the face, limbs, and lungs

 Beta-blockers › When some beta-blockers are taken during pregnancy, a slowed heart rate and low blood sugar level in the fetus and possibly slowed growth  Thaizide diuretics › A decrease in the levels of oxygen, sodium, and potassium and in the number of platelets in the fetus's blood › Slowed growth

 Actinomycin, Bulsufan,chlorambucil, cyclophosphamide,methotrxate › Birth defects such as underdevelopment of the lower jaw, cleft palate, abnormal development of the skull bones, spinal defects, ear defects, and clubfoot › Slowed growth

 Asprin and others salicylates, ibuprofen and naproxin › When the drugs are taken in large doses, a delay in the start of labor, premature closing of the connection between the aorta and artery to the lungs (ductus arteriosus), jaundice, and (occasionally) brain damage in the fetus and bleeding problems in the woman during and after delivery and in the newborn › When the drugs are taken late in pregnancy, a reduction in the amount of fluid around the developing fetus

 Danazol › When this drug is taken very early in pregnancy, masculinization of a female fetus's genitals, sometimes requiring surgery to correct  Synthetic progestins (but not the low doses used in oral contraceptives) › Same as those for danazol

 Diethylstilbestrol(DES) › Abnormalities of the uterus, menstrual problems, and an increased risk of vaginal cancer and complications during pregnancy in daughters › Abnormalities of the penis in sons

 methimazole › An enlarged or underactive thyroid gland in the fetus › Scalp defects in the newborn  Propylthiouracil › An enlarged or underactive thyroid gland in the fetus  Triiodothyronine › An overactive and enlarged thyroid gland in the fetus

 Destruction of the thyroid gland in the fetus  When the drug is given near the end of the 1st trimester, very overactive and enlarged thyroid gland in the fetus

 Vaccine for German measles (rubella) and chickenpox (varicella) › Potential infection of the placenta and developing fetus  Vaccines for measles, mumps, polio, or yellow fever › Potential but unknown risks

 Other vaccines (such as those for cholera, hepatitis A and B, plague, rabies, tetanus, diphtheria, and typhoid) are given to pregnant women only if they are at substantial risk of developing that particular infection. However, all pregnant women who are in the 2nd or 3rd trimester during the influenza (flu) season should be vaccinated against the influenza virus.

 Opioids, such as heroin, methadone and morphine: readily cross the placenta, the fetus may become addicted to them and may have withdrawal symptoms 6 hours to 8 days after birth  However, use of opioids rarely results in birth defects.  Use of opioids during pregnancy increases the risk of complications during pregnancy, such as miscarriage, abnormal presentation of the baby, and preterm delivery. Babies of heroin users are more likely to be small.

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