Cardiac disease in pregnancy and drug therapy

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Contraindicated Drugs

Drugs to be Avoided

Acceptable Drugs

  • ASA - low dose
  • Nitrates – use low dose to prevent fetal distress
  • Beta-1 selective Beta-blockers like lopressor, metoprolol.
  • Magnesium
  • Morphine sulfate
  • Avoid ACE inhibitors and warfarin due to teratogenicity
  • Thrombolytics mostly untested

· Greatest experience in massive pulmonary embolism


· Streptokinase does not cross placental membrane in animals, but Ab found in neonatal spinal cord fluid


· Urokinase not teratogenic in mice/rats


· Risk for maternal hemorrhage (1 case of placental abruption reported); increased risk when given at time of delivery


· Delivery best delayed at least 2-3 weeks

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