Preventing Early onset Group B Streptococcus Infection
Asthma in pregnancy
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Prescribing In Pregnancy

DR Judith  Kundodyiwa MRCOG

’Common medication prescribed and indication
Induction of labour
  • Propess (Dinoprostone)10mg Per Vagina (usually repeated if required after 24hours).
  • Good practice would be to prescribe paracetamol & codeine as required for inductions.
Group B Streptococcus Intrapartum antibiotic prophylaxis
  • Benzylpenicillin 3g IV stat at onset of labour.
  • Then Benzylpenicillin 1.2g IV every 4 hours until delivery.
  • Give Cefuroxime 1.5g stat then 750mg IV TDS if non-anaphylactic penicillin allergic.
  • If anaphylactic penicillin allergy administer vancomycin 1g every 12hours
Any patient with a raised temp post-delivery
  • – treat as endometritis (unless very obvious other source of infection). Remember to check perineum for infection
  • Cefuroxime 1.5g IV TDS and Metronidazole 500mg IV TDS until apyrexic for 24hours.
  • Then 1/52 cefalexin 500mg PO TDS and metronidazole 400mg PO TDS.
  • Antibiotic prophylaxis following third and fourth degree tears:
    • Cefalexin 500mg TDS x7/7 & Metronidazole 400mg TDS x7/7
Treatment of UTIs in pregnancy
  • Cefalexin 500mg TDS x 7/7 (first line)
  • Nitrofurantoin MR 100mg BD x7/7 – not in 3rd trimester (second line)
  • Trimethoprim 200mg BD x 7/7 – not in 1st trimester (second line)

Safe Prescribing In Pregnancy
SAFE AVOID
ANTIBIOTICS Penicillin

Cephalosporins

Metronidazole (after 12wks)

Metronidazole (before 12wks)

Trimethoprim (before 12wks)

Doxycycline

Augmentin

Nitrofurantoin in 3rd trimester

ANALGESICS Paracetamol

Codeine

Morphine (use cautiously)

NSAIDs
MISCELLANEOUS Temazepam

Lactulose

Proton pump inhibitors

Diuretics

ACE inhibitors

Atenolol

Carbimazole

References