Using Medications in Pregnancy According to Risk Category

M Asceric1, S Loga - Zec0,2. 1University of Tuzla, Faculty of Medicine, Department of Pharmacology, 75 000, Bosnia and Herzegovina, 2Univeristy of Sarajevo, Faculty of Medicine, Department of Pharmacology 71 000, Bosnia and Herzegovina

Prescription of medications in pregnancy has been a challenge for modern medicine and gynecological practice. It requires balancing the optimal treatment for the mother without harming the fetus.

Aim – Frequency of medication use by trimesters in line with the FDA classification of fetal risk categories.

Subjects - We have conducted a retrospective, observational cross-sectional study which included 1000 women who gave birth at the OBG Clinic of the University Clinical Center Tuzla in the August –November 2009 period. The sample was comprised of women who gave birth after 24 weeks of gestation period.

Methods – The study was conducted by the virtue of questionnaires. The questionnaire was designed in accordance with and adapted to the Guide to Use of Medications during Pregnancy by the European Medicines Agency

Results – 940 out of 1000 pregnant women (94%) used medications. The majority used category B medications (654 or 69%), followed by A category medications (525 or 55,9%), category C medications (472 or 50,2%) and finally, category D medications (221 or 23,5%).

During the first trimester the medications were prescribed 1242 times, mainly those belonging to the category B medications (634 or 51%). Category A medications were prescribed 412 times, that is in 33,2% cases; category C medications 138 times , that is, 11,1% of the prescriptions; category D medications 58 times, that is, in 4,7% of the cases.

In the second trimester the medications, mostly belonging to category B (690 or 33,4%), were prescribed 2066 times. Medications from category C were prescribed 638 times, which accounts for 30,9% of the cases; category A medications were prescribed 543 times, which makes up for 26,3% of the cases; category D medications were prescribed 195 times, which accounts for 9,4% of the prescriptions.

During the third trimester the medications were prescribed 2206 times; with category B medications making up for 908 or 41,2% of prescriptions. Category C medications were prescribed 664 times or in 30,1% cases; category A medications were prescribed 343 times, or in 15,5%, cases and category D medications were prescribed 291 times or in 13,2% cases.

Conclusion: The study showed insufficiently rational, possibly harmful use of mediations in pregnancies and has created the need for pregnancy treatment quality improvement. A high percentage of category D medications prescribed can be ascribed to a significant use of diazepam prescribed for prevention of unwanted contractions during pregnancy.