Maternal medication and its effect on the fetus

Abstract

A P P R O X I M A T E L Y 27 years ago, diethylstilbestrol came into widespread use in support of high-risk pregnancy. 316 Only 2 years ago, the relationship between adenocarcinoma of the vagina in young women and their exposure to stilbestrol while-still in utero came to light, 146 and in many ways even this discovery was fortuitous. Adenocarcinoma of the vagina in adolescent females had been an extremely rare disease. If maternal stilbestrol therapy had been the cause of an increase in the incidence of some relatively more common and slightly less dramatic adolescent disease, say diabetes, it probably would still be undetected today. And so the age of long-range complications of fetal drug therapy has been ushered in. The implications of this are enormous. We are caught between therapeutic nihilism and the eternal truth of the drug l abe l When this preparation is used in women of childbearing age, the potential benefits should be weighed against the possible hazards to the Where is there a scale so fine?.Not only are the benefits often unproved but the hazards, for the most part, are not known. It is the purpose of this monograph to condense a major portion of the literature concerning drugs administered during pregnancy as they pertain to the unintended pat ient the fetus. In so doing, it is hoped that the practicing physician will be made more aware of the effects that drugs have on fetal outcome and therefore will be better able to prevent unnecessary fetal exposure as well as being better