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Low-risk pregnancy: how to help the doctor prescribe?

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European Statement

Clinical Pharmacy Services

Author(s)

Ana Rita Silva, Cláudia Santos

Why was it done?

Low-risk pregnant women are also prone to suffer from minor pathological conditions, such as migraines, low back pain, gastrointestinal disorders. In view of this particularity, collaboration was requested from the pharmaceutical services to prepare a therapeutic guide to make available to all doctors in the hospital, in particular general and family medicine.

What was done?

Develop a pocket guide with OTC medicines classification in pregnant women for the following symptoms: pain control; colds; gastrointestinal changes and skin changes, according to Food and Drug Association (FDA) classification, for general and family practice physicians in the hospital.

How was it done?

It was necessary to define which pathologies/symptoms we would focus on, this choice was made in collaboration with the person responsible for the obstetrics service. Then, focusing our work on low-risk pregnant women, we selected some drugs that are prescribed to non-pregnant women for chosen pathologies/symptomatologies. These drugs were thus analysed in view of their safe use in low-risk pregnant women using tools such as the summary of drug characteristics, the FDA website, the UpToDate online platform. The guide was made available to general and family physicians.

What has been achieved?

The drug classification was compiled in a table organised by INN, divided by pathology/symptomatology, with the FDA classification and also a column with a pictogram indicating the safety of the drug for use during pregnancy. The acceptance by clinicians was very positive, reinforcing that it is important to pay special attention when prescribing in the 1st and 3rd trimester of pregnancy, use the lowest effective dose and for the shortest possible period, avoid using “new” drugs unless there are safety studies.

What next?

The next step to support clinicians will be to develop other tools to help prescribe other classes of drugs as well as another population group, such as safe drugs in breastfeeding.

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