A 22 year old Megha comes to the doctor because of a missed menstrual period. She has hypothyroidism for which she takes thyroxine; she has an artificial heart valve, for which she takes Coumadin, and she recently started tetracycline for acne. Urine human chorionic gonadotropin (hCG) is positive. Which of the following medication should the patient continue to take during pregnancy?

LohaHridoy
  1. Thyroxine
  2. Coumadin
  3. Tetracycline
  4. Oral contraceptive pill (OCP)

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Option 1 : Thyroxine

Explanation

  • Thyroxine can be continued during the pregnancy.
  • Levothyroxine is proven that it is safe for the baby.
  • Thyroid hormone replacement is important to maintain and regulate pregnancy.

 Coumadin in pregnancy

  • Coumadin is warfarin, a form of oral anti coagulant.
  • It increases the risk of hemorrhagic complications.
  • Warfarin also interferes with fetal protein production necessary for bone and cartilage development.
  •  This condition is called warfarin embryopathy.

[ alt="F1 Utkarsha Madhuri 29.10.2021 D13" embryopathy: balancing maternal and fetal risks with anticoagulation therapy pediatrics neonatology src="//storage.googleapis.com/tb-img/production/21/11/F1_Utkarsha_Madhuri_29.10.2021_D13.png" style="height: 202px; width: 150px;">

[ alt="F1 Utkarsha Madhuri 29.10.2021 D14" embryopathy: balancing maternal and fetal risks with anticoagulation therapy pediatrics neonatology src="//storage.googleapis.com/tb-img/production/21/11/F1_Utkarsha_Madhuri_29.10.2021_D14.png" style="height: 187px; width: 138px;">

Tetracycline in Pregnancy

  • Tetracycline is a bacteriostatic antibiotic.
  • It is contraindicated in pregnancy.
  • It causes hepatotoxicity in the mother.
  • It can potentially cause permanent discolouration of teeth in the baby.
  • It can exaggerate pre-existing renal failure in the mother.
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