Motherisk Old

Motherisk® articles are prepared by the Motherisk team at the Hospital for Sick Children in Toronto and are published monthy in Canadian Family Physician (CFP).

These articles represent answers to questions that patients have asked their family physicians.

Articles are intended to provide information on the effects of drugs, chemicals, radiation, or infections in women who are pregnant or breastfeeding; they do NOT represent specific medical advice to patients.

Patients with specific questions about their own health, or that of their unborn or newborn children, should in all cases consult with their own family physicians or other medical specialists.

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Antidepressant use during pregnancy: Navigating the sea of information

When some of my patients who are taking antidepressants learn they are pregnant, they become anxious and confront me with the following statement: “I need this medication, but have heard so many conflicting stories from my friends and on the Internet and in the media that I am not sure if I should continue taking it.” How do I advise them, as I have also seen conflicting evidence in the scientific literature?

September 2013

    Antiepileptic drugs in pregnancy and hemorrhagic disease of the newborn

    What is the current evidence regarding the association between hemorrhagic disease of the newborn and maternal use of hepatic enzyme-inducing antiepileptic drugs (eg, carbamazepine,phenobarbitone, topiramate)?

    December 2010

      Appendicitis during pregnancy

      A 26-year-old patient in our clinic, who was 18 weeks pregnant at the time, experienced acute abdominal pain and was diagnosed with appendicitis. The inflamed appendix was successfully removed. Is her pregnancy at risk?

      March 2004

        Are new agents used to treat rheumatoid arthritis safe to take during pregnancy?: Organization of Teratology Information Specialists (OTIS) study

        I have a patient planning pregnancy who has resistant rheumatoid arthritis that will require treatment with some of the “new” medications. Which ones are safe to use during pregnancy, and which ones do we know enough about to tell whether they are safe or not?

        March 2007

          Are probiotics safe for use during pregnancy and lactation?

          There has been a great deal of discussion in both the medical and lay literature about the use of probiotics to improve general health. Subsequently, pregnant women have been asking me if probiotics used for treating conditions such as bacterial vaginosis and diarrhea are safe to use during pregnancy and lactation.

          March 2011

            Bias against the null hypothesis: Scaring pregnant women about drugs in pregnancy

            Since the thalidomide disaster, medicine is practised as if every drug is teratogenic, when in fact very few medications are. Pregnant women are often ready to refuse treatment even for life-threatening conditions owing to misinformation and misperceptions about fetal risks. How can I reassure my patients and prevent misinformation from affecting their treatment?

            May 2014

              Botulinum toxin type A in pregnancy

               My patient received 62 units of botulinum toxin type A (BTX-A) for facial lines. Two weeks later, she found out that she was pregnant. Will this cause any harm to her fetus?

              November 2013

                Breastfeeding and radiologic procedures

                Recently, some of my patients were instructed not to breastfeed for 24 to 48 hours after magnetic resonance imaging scans. Is this based on scientific evidence?

                April 2007

                  Can herbal products be used safely during pregnancy? Focus on echinacea

                  Many of my patients are now using herbal medicines; some even use them during pregnancy. As we enter the “cold and flu” season, many are inquiring about use of the herb echinacea to prevent these ailments. Is there any evidence to suggest that use of echinacea during pregnancy is safe?

                  September 2001

                    Can we use anxiolytics during pregnancy without anxiety?

                    One of my patients suffers from anxiety and was using lorazepam to treat it. When she became pregnant, she stopped the medication immediately, but now she is worried about the potential effect on the baby because she was using the drug just after conception. Is this class of drugs safe during pregnancy? What should she do if she needs antianxiety treatment during the rest of her pregnancy?

                    March 2000
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