Pregnancy is a normal physiological phenomenon in women. It is accompanied by changes in the body giving rise to certain abnormal symptoms like nausea, vomiting, and discomfort. These symptoms are collectively called 'morning sickness' because of their greater frequency during morning hours. In pregnancy, except for certain vitamins (which are adequate in a good nutritious diet), no other drugs should be ordinarily given. However, if symptoms of morning sickness become unbearable, or there is some associated disease, drugs may become necessary. In recent years, information about possible adverse effects of drugs on pregnant women and her unborn baby (embryo or foetus) have been causing serious concern.

Till the early 1970s, there were no such problems in India because firstly, only very few drugs were available, and secondly, the pregnant woman enjoyed great emotional stability under the loving care of elders. In present times, the problem has become acute with the introduction of innumerable drugs and the woman's dual responsibility of working in and outside the home. She suffers from a lack of the much-needed physical and mental rest, and for every complaint, takes a pill or two to keep herself going.

Concern about the use of drugs during pregnancy started in 1961 in West Germany when an apparently innocent sedative, thalidomide, became popular among pregnant women. It caused Congenital deformities of the long bones of the limbs (arms and legs) in thousands of babies and had to be withdrawn. Concern about safe drugs for pregnant women was the only logical solution to the thalidomide disaster.

Since most of the drugs taken by a pregnant woman reach the unborn baby through the circulating blood, and our knowledge is based primarily on animal studies, it is best to minimize the use of drugs during pregnancy. If symptoms like vomiting due to pregnancy, or due to an associated disease become unbearable, and it becomes necessary to take medication, then at east the drugs listed at the end of this chapter should be avoided.

Drugs to Be Avoided During Pregnancy

Aspirin (Disprin): It is commonly used for headache, fever, and pain. Large doses, if taken during the first trimester, may cause physical defects in the developing foetus, while large doses, during the latter part of the pregnancy, may lead to a bleeding tendency in the newborn baby, prolong pregnancy and labour.

ACE-inhibitors (Captopril): Use of these drugs may cause underdevelopment of lungs, kidneys and other organs.

Bishydroxy­coumarin: This drug is an oral anticoagulant. lf taken during the last three weeks of pregnancy, it may cause a bleeding tendency in the newborn child, which may prove fatal.

Busulphan: It causes physical defects in the developing foetus during early pregnancy.

Carbimazole (& methimazole) : This is used in a hyper-functioning thyroid. It is best to stop this drug four weeks before the expected date of delivery as it may alter the activity of the thyroid in the newborn baby.

Chloramphenicol: It is used in typhoid. If taken during the last few weeks of pregnancy, foetus may die due to circulatory collapse or bone marrow depression.

Chloroquine: It is used in malaria. It may be responsible for permanent deafness and defects in vision in the newborn baby.

Clomiphene: This drug is used in cases of sterility to induce ovulation. It may cause multiple pregnancies and foetal malformations.