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Drugs in Pregnancy and Lactation - Medications Used in Swiss Obstetrics


Schenkel, Larissa; Simões-Wüst, Ana Paula; Hösli, Irene; von Mandach, Ursula (2018). Drugs in Pregnancy and Lactation - Medications Used in Swiss Obstetrics. Zeitschrift für Geburtshilfe und Neonatologie, 222(04):152-165.

Abstract

BACKGROUND In order to improve the safety for drugs in pregnancy and lactation, data on the clinical practice must be collected and validated. METHODS Data on the medications routinely used were requested from the university hospitals for obstetrics and the non-university perinatal centres in Switzerland and recommendations and guidelines of scientific societies for the various fields of application were sought. RESULTS Part I: For during pregnancy and the peripartal period respectively, 69 and 21 different active constituents of medications were identified from at least 4 centres. For during pregnancy, the active constituents used in most of the centres are nifedipine, iron i. v. and oral, labetalol and magnesium sulphate, amoxicillin with clavulanic acid, paracetamol, dalteparine, metoclopramide as well as atosiban and hexoprenaline; for during the peripartal period betamethasone, misoprostol, oxytocin, clindamycin as well as fibrinogen, sulprostone and tranexamic acid were most frequently cited. Recommendations of various scientific societies were found primarily for pregnancy-specific fields of application. CONCLUSION The same active constituents of medications are consistently used in Swiss perinatal centres for the main indications in pregnant women. Despite the existing experience and available evidence, they are mainly used off-label. Official authorisations for frequently or consistently used active ingredients should be granted.

Abstract

BACKGROUND In order to improve the safety for drugs in pregnancy and lactation, data on the clinical practice must be collected and validated. METHODS Data on the medications routinely used were requested from the university hospitals for obstetrics and the non-university perinatal centres in Switzerland and recommendations and guidelines of scientific societies for the various fields of application were sought. RESULTS Part I: For during pregnancy and the peripartal period respectively, 69 and 21 different active constituents of medications were identified from at least 4 centres. For during pregnancy, the active constituents used in most of the centres are nifedipine, iron i. v. and oral, labetalol and magnesium sulphate, amoxicillin with clavulanic acid, paracetamol, dalteparine, metoclopramide as well as atosiban and hexoprenaline; for during the peripartal period betamethasone, misoprostol, oxytocin, clindamycin as well as fibrinogen, sulprostone and tranexamic acid were most frequently cited. Recommendations of various scientific societies were found primarily for pregnancy-specific fields of application. CONCLUSION The same active constituents of medications are consistently used in Swiss perinatal centres for the main indications in pregnant women. Despite the existing experience and available evidence, they are mainly used off-label. Official authorisations for frequently or consistently used active ingredients should be granted.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Pediatrics, Perinatology and Child Health
Health Sciences > Obstetrics and Gynecology
Health Sciences > Maternity and Midwifery
Language:English
Date:1 August 2018
Deposited On:10 Jan 2019 13:07
Last Modified:07 Apr 2021 14:06
Publisher:Georg Thieme Verlag
ISSN:0948-2393
OA Status:Closed
Publisher DOI:https://doi.org/10.1055/s-0043-124975
PubMed ID:29421836

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