Evaluation of Medicine Exposure During Pregnancy at a Tertiary Center of an Indian State

Abstract

Context:Prescribing drugs in pregnancy is a challenging approach for doctors. Objective:To evaluate drugs used in pregnancy. Method:A prospective, cross-sectional, descriptive study was carried out by collecting and evaluating prescriptions on various parameters. Results:More than 50% of antenatal care attendees belonged to the 18-24 age group, and 102 (41.46%) were primigravidae. The main presenting complaints were abdominal pain (25.16%), followed by nausea and vomiting (22.60%) and fever (11.14%); the maximum number of visits to hospital was seen in the first trimester (40.53%), followed by the third trimester (38.42%). It was observed that 25.78% of prescriptions did not contain any medicine. The average number of prescribed medicines was 2.32, with the lowest in the first trimester (1.77) and the highest in the second trimester (2.78). It was noticed that 74.11% and 71.26% of all prescribed medicines were from essential medicine list and generics, respectively. Of all prescribed drugs, 11.52% were antimicrobials, and 4.11% injectable dosage forms. Vitamins and minerals were the preferred prescribed medicines (34.82%), followed by antimicrobial agents (11.52%) and doxylamine plus pyridoxine (10.16%). Also, doctors who made the drug choice during antenatal visits were more confident in evidence-based safety as per New Pregnancy and Lactation Rule (PPLR); 45.37% of drugs were prescribed from category A, followed by 38.25% from category B and none from group X. Conclusion:Doctors were concerned about prescribing safer drugs in pregnancy and were more confident in evidence-based medication.

TABLE 1.

Demographic profile of antenatal care attendees

TABLE 2.

Reason for visiting antinatal care (ANC)

TABLE 3.

Prescribing pattern and frequency of visits to hospital

TABLE 4.

Drug prescribed during pregnancy

TABLE 5.

Pregnancy categories as per Food Drug Administration (FDA), non-FDA and PPLR

TABLE 6.

Unprescribed drugs and remedies taken by pregnant women

ANNEX 1.

Case record form

ANNEX 2.

Prescribing indicator form