Common drugs given to women in labor

Common drugs given to women in labor

(all information below may be found at www.safefetus.com)

Stadol

• Limited human data.
• Use of the drug during labor may cause sinusoidal fetal heart pattern without fetal hypoxia or neonatal adverse effects.
• Prolonged use of the drug may cause neonatal withdrawal symptoms.
• (www.safefetus.com)

Demerol (Meperidine)

• Crosses the placenta.
• Maternal addiction causes neonatal withdrawal.
• No adequate data in first trimester exposure but reported association with inguinal hermia, polydactyly and hypospadias.
• Causes neonatal respiratory depression if used in labor.
• Because of slow elimination of the drug from the neonate, impaired behavioral response and EEG changes may persist for several days.
• (www.safefetus.com)

Cytotec and Pitocin (used for induction of labor)

cytotec

• Positive evidence of human fetal risk exists.
• Potential benefits may warrant use of the drug in pregnant women despite potential risks (e.g. life threatening situations or serious illness).
• Studies in animals and/or humans have demonstrated fetal abnormalities.
• Fetal risk involved in use of drug, clearly outweighs potential benefit.
• Contraindicated in women who are or may become pregnant. Don’t use.
• Not teratogenic, mutagenic or toxic in animals.
• Contraindicated in pregnancy because it induces abortion.
• Following unsuccessful first trimester abortion, it is teratogenic producing limb, digital, skull defects, gastroschisis, bilateral palsy of cranial nerves (moebius sequence) and cleft lip and palate. Alll the anomalies were attributed to misoprostol-induced fetal vascular disruption.

pitocin

• Contraindicated during pregnancy because it causes abortion.
• It can cause fetal bradycardia, neonatal retinal hemorrhage and neonatal jaundice.
• If administered to hypertensive patients or in excessive amounts it can cause tetanic contractions resulting in abruptio placenta, and fetal trauma including cardiac arrythmia, intracranial hemorrhage and asphyxia.

Morphine

• Crosses human placenta rapidly.
• No adequate data in first trimester exposure but reported association with inguinal hernia after anytime use during pregnancy.
• Chronic maternal use of the drug causes neonatal withdrawal and respiratory depression.

fentanyl and sufentanil, ropivacaine (Naropin) or lidocaine (Xylocaine) (most common drugs put in the epidural)

fentanyl:

• Can cause loss of fetal heart rate variability without hypoxia.
• With epidural fentanyl, neonatal respiratory depression may occur.

ropivacaine (Naropin):

• Not teratogenic in animals.
• Crosses human placenta.
• No adequate human data, but use of this agent for analgesia during labor and delivery may result in maternal hypotension, fetal hypotension, bradycardia, tachycardia and fetal distress and neonatal cardiovascular and neurologic effects, jaundice, respiratory depression, fever, tachypnea and vomiting.

lidocaine (Xylocaine)

· No adequate and well-controlled studies done on pregnant women.

nalbuphine (Nubain)

• Not teratogenic in animals.
• Crosses human placenta.
• No adequate data in 1st trimester of human pregnancy, but no association with congenital anomalies has been reported.
• Chronic use of the drug in pregnancy can cause neonatal with drawal.
• Use of Nalbuphine in labor may cause fetal distress, sinusoidal fetal heart rate pattern with variable decelerations, neonatal respiratory depression.