The Treatment of Illnesses Arising in Pregnancy

Abstract

Background: The treatment of pregnant women who have illnesses unrelated to pregnancy can cause uncertainty among physicians.

Methods: We searched the PubMed database and specialty guidelines from Germany and abroad (the guidelines of the German Society for Gynecology and Obstetrics, the American Congress of Obstetri cians and Gynecologists, and the Royal College of Obstetricians and Gynaecologists) over the period 2007-2016 for information on standards for the diagnosis and treatment of five illnesses that can arise in pregnancy: bronchial asthma, migraine, hypothyroidism, hyperthyroidism, and varicose veins.

Results: Any diagnostic tests that are carried out in pregnant women should be simple and goal-directed. The choice of drugs that can be used is limited. For many drugs, no embryotoxic or teratogenic effect is suspected, but the level of evidence is low.

Conclusion: When illnesses unrelated to pregnancy arise in pregnant women, attention must be paid to potential diver gences from the typical disease course and to pos sible drug side effects on the fetus in order to prevent serious complications for both mother and child.

FIGURE

The passage across the placenta of thyroid hormones and related substances (21). xxx indicates that TSH and rT3 do not cross the placenta. The dashed arrow for T3 and T4 indicates that the thyroid hormones cross the placenta only to a limited extent. TSH, thyroid-stimulating hormone