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Risks of commonly used drugs
Risks of Cammog Used Dregs Potential human teratogenicity of frequently prescribed drugs. Friedman J, Little B, Cordero J, et al. OBslEr CXNECOL75z594.1990. This paper reports the results of a comprehensive evaluation of published data regarding the potential teratogenicity of 157 commonly prescribed drugs. After review of the data, a team of teratologists rated each drug for its magnitide of tera togenic risk. They also assessedthe quality of the data upon which this rating was based. Seven@-seven(49%) of these 157 frequently prescribed drugs had insufficient information to permit assessmentof the risk. Of the 80 drugs for which good data was available, 92.5% had a dsk rating of minimal to small. Moderate and high xi+ ratings were -&zd tv vniy six drugs (tetracycline, doxycycllne, carbamazepine, phenytoin, warfain, and norethindrone). The authors also correlated their ris!i ratings with the FDA Pregnancy Categories as found in the Physician’s Desk Reference and found no greater correlation than that expected by chance. They conclude ihat neither rating syst& is adequate for counseling patients or for therapeutic guidance. that much
more information must be considered when counseling a patient or prescribing for a pregnant woman, and that more and better research needs to be undertaken. They suggest several books that would t;e good references on the potential teratogenic lisks of particular drugs.
Neonatal Outcomes Amons Older Mothers Delayed childbearing and the outcome of pregnancy. Berkowitz G, Skovron M. Lapinski R. et al. N ENGL J MED 322:659,1990. This study tried to assess whether older plimiparas have higher complication rates, poorer neonatal O”,comes, or any increasesin lisk associated with their older ace. A group of 3,917 women were included in this retrosoective studu of p&ate patients agei 20 to 45. idvancing maternal age was not found to appreciably increase the risk of adverse outcome in singleton pregnancies. “Specifically, the dsks of a preterm delivery. delivey of a smallfor-gestatiolral-age Infant, periw&l death, or having a” infant with a low Apgar xore were not significantly elevated either for women 30 to 34 years old or for women over 35.” However. the older women were
Journal of Nurse.MLdwifery
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more likely to have specific complications such as gestational diabetes, pregnancy-induced hypertension, bleeding, abruptton, and placenta prevla. They also had en increased risk of cesarean section, e!though examining the Indications for the surgical intervention revealed no hcrease in any specific problems. Older mothers also showed slight increases in risk for prolonged second stage of labor (longer than two hours) and for neonatal intensive care unit admiaions. The authors conclude that delaying childbearing, at least for worma such as these well-educated subjects,poses little, if any. hcreased risk of adverse neonatal outcome. The higher rates of complicationsare readily handled by current medical standards, though they may Increase health care costs.
Hysterectomy Not Always Effective for Relief of Chronic Pelvic Pain Hysterectomy for chronic pelvic pain of presumed uterine etiology. Stovall T, Ling F, Crawford D. OBSTETGYNECOL 75:676,1990. This study evaluates the long-term results among women who underwzt hysterectomy for the relief of
Vol. 35. No. 5, SeptemberlOdobsr
1990
more information must be considered when counseling a patient or prescribing for a pregnant woman, and that more and better research needs to be undertaken. They suggest several books that would t;e good references on the potential teratogenic lisks of particular drugs.
Neonatal Outcomes Amons Older Mothers Delayed childbearing and the outcome of pregnancy. Berkowitz G, Skovron M. Lapinski R. et al. N ENGL J MED 322:659,1990. This study tried to assess whether older plimiparas have higher complication rates, poorer neonatal O”,comes, or any increasesin lisk associated with their older ace. A group of 3,917 women were included in this retrosoective studu of p&ate patients agei 20 to 45. idvancing maternal age was not found to appreciably increase the risk of adverse outcome in singleton pregnancies. “Specifically, the dsks of a preterm delivery. delivey of a smallfor-gestatiolral-age Infant, periw&l death, or having a” infant with a low Apgar xore were not significantly elevated either for women 30 to 34 years old or for women over 35.” However. the older women were
Journal of Nurse.MLdwifery
l
more likely to have specific complications such as gestational diabetes, pregnancy-induced hypertension, bleeding, abruptton, and placenta prevla. They also had en increased risk of cesarean section, e!though examining the Indications for the surgical intervention revealed no hcrease in any specific problems. Older mothers also showed slight increases in risk for prolonged second stage of labor (longer than two hours) and for neonatal intensive care unit admiaions. The authors conclude that delaying childbearing, at least for worma such as these well-educated subjects,poses little, if any. hcreased risk of adverse neonatal outcome. The higher rates of complicationsare readily handled by current medical standards, though they may Increase health care costs.
Hysterectomy Not Always Effective for Relief of Chronic Pelvic Pain Hysterectomy for chronic pelvic pain of presumed uterine etiology. Stovall T, Ling F, Crawford D. OBSTETGYNECOL 75:676,1990. This study evaluates the long-term results among women who underwzt hysterectomy for the relief of
Vol. 35. No. 5, SeptemberlOdobsr
1990