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