Fetal risk
Fetal risk should be considered in terms of two factors:
11 Factors which put the mother at risk
22 Adverse effects from maternal drugs:
- ACE inhibitors should be discontinued prior to conception
because of the risk of embryopathy
- Limited or unfavourable data on fetal effects of many antiar-
ryhthmics
- Beta blockers may be associated with maternal hypotension,
and hence reduce placental perfusion. They may thus
contribute to premature labour
- Warfarin – see Q93 (page 196) and Q95 (page 202).
Note that digoxin and verapamil are safe to use.
FFuurrtthheerr rreeaaddiinngg
Oakley CM. Management of pre-existing disorders in pregnancy: heart
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Salazar E, Izaguirre R, Verdejo J et al. Failure of adjusted doses of sub-
cutaneous doses of heparin to prevent thromboembolic phenomena in
pregnant patients with mechanical cardiac valve prostheses. J Am Coll
Cardiol 1996; 2277 : 1698–703.