[Effect of drug therapy during pregnancy on the clotting potential of the newborn]

Abstract

Drug therapy in mothers may lead to various disturbances of the hemostasis of the newborn. Some authors reported on severe hemorrhages in newborn after coumarin treatment of the mothers, others had not or only seldom observed such events. Our examination did not reveal any significant clotting disorders in 4 newborns whose mothers had received Athrombom. Perhaps the indandion derivative does not significantly penetrate the placental barrier. However, therapy with anticoagulants of the vitamin K antagonist type may be instituted during pregnancy only in cases where it is strictly indicated. Streptokinase and heparin will certainly not enter the fetal circulation, therefore they may be used without risk for the child. Furthermore the clinican must known severe bleeding conditions of the vitamin K deficiency type in newborns of mothers with anticonvulsive therapy. Preventive administration of vitamin K to pregnant women and newborns or, in the presence of bleedings, instantaneous and exact substitution may bring under control the critical situation. Acetylsalicylic acid given during the last weeks of pregnancy causes an inhibition of the aggregation of thrombocytes of the newborn. Bleedings occur only seldom. Other drugs administered during pregnancy may induce neonatal thrombocytopenia through immunological or toxic mechanisms, such for instance quinine, quinidine, tolbutamide and thiazides.