Most cardiovascular medications can be safely used during pregnancy, according to a review

According to a new review, doctors should not be afraid to take most drugs to treat cardiovascular disease in pregnant women.

Since it has been shown that thalidomide was the cause of birth defects in babies born to pregnant women taking the drug in the morning, there was a lot of concern about how the thalidomide was born. use of various drugs during pregnancy could harm the mother, the fetus. Dan Halpern, MD, lead author (NYU Langone Health, New York, NY), told TCTMD that the authors, or both, were sometimes reluctant to treat.

Halpern said he hoped that this new "state-of-the-art" magazine, published online before February 5, 2019, will appear in Journal of the American College of Cardiology, willEliminates some of the fears of using drugs during pregnancy, "At least as regards the treatment of cardiovascular diseases.

"A minority of drugs have proven to be teratogenic, causing real defects," said Halpern, director of Conbad heart disease program in adults at its center. Although there are always risks and it is a good idea to minimize the use of drugs during pregnancy, he fears side effects and potential legal consequences.created a fear that is probably greater than the truth. "

It is increasingly important for clinicians to use cardiovascular medications during pregnancy with increasing average age at first pregnancy, increased prevalence of cardiovascular risk factors in women of childbearing age, and progress in the treatment of conbad heart disease more women the opportunity to conceive.

The goal of this review is to make clinicians more comfortable in treating cardiovascular disease during pregnancy by providing them with the information they need to use drugs safely, Halpern said.

Her team summarized the available data, recommendations and recommendations regarding the use of cardiovascular drugs during pregnancy, the first part of the document outlining the magnitude of the CVD problem in this context and changes. hemodynamic and pharmacological effects occurring during pregnancy. .

They then highlight different types of drugs, including antiarrhythmics; medicines for hypertension and heart failure; statins and other lipid-lowering drugs; antiplatelet agents and anticoagulants; and therapies for valvular heart disease, ischemic heart disease, pulmonary hypertension, and connective tissue diseases.

There is also a central color coded illustration that allows clinicians to quickly see which drugs are considered safe during pregnancy or badfeeding. . For reference, the authors include the clbadification of drugs in the now-defunct US Food and Drug Administration's ABCDX system to refer to safety during pregnancy.

"We have tried in groups to create a tool to simplify the use, "said Halpern.

In their article, the authors describe a general approach to the use of cardiovascular drugs during pregnancy and badfeeding, starting with a need.determine the necessity, urgency, timing of pregnancy and adverse effects of the drug on the fetus.

"Since most drugs are transferred to milk, the effects on newborns should be taken into account," they continued. "The lowest effective dose should be used. The woman must be informed of the risks and benefits and must have updated data, taking into account the limitations. Internet databases and manufacturers' instructions containing prescription information are useful for obtaining the most up-to-date information. Specialists in maternal fetal medicine should be consulted to help with medication management during pregnancy and postpartum pediatrician during badfeeding. In case of cardiopulmonary arrest, standard treatment [advanced cardiac life support] protocols must be followed, including medication use and defibrillation. "

In particular, the involvement of a multidisciplinary team – also recommended in updated guidelines on the management of cardiovascular disease during pregnancy The European Society of Cardiology, published last year, is essential and should involve cardiologists, obstetricians, pediatricians and other specialists, Halpern said. "It's very important to keep everyone informed."