Are Pregnant Women Taking Unsafe Medicine?

There are few times that I become gravely concerned about the way medicine is practiced and this is one of them. A recent medical study in the Journal of Hypertension reported some startling facts: pregnant women are receiving blood pressure medication that might be harmful to their babies.

When physicians decide to specialize in obstetrics, we know exactly what we’re getting into. We have two patients, both mother and unborn baby and we don’t want either to die. Each year 4 million babies are born in the U.S. and between 6 to 8% of their mothers will have high blood pressure. Why are physicians and healthcare providers concerned about high blood pressure? Because if untreated, it can cause a stroke leading to death.

During pregnancy, a patient can have there are 3 types of high blood pressure: (1) chronic hypertension that occurs before 20 weeks, (2) gestational hypertension that occurs after 20 weeks but is not associated with protein in the urine and (3) pre-eclampsia that occurs after 20 weeks and is associated with protein in the urine. Pre-eclampsia, if untreated can lead to seizures (also known as eclampsia) and strokes. It is one of the most common reasons for death as a result of pregnancy. The treatment for pre-eclampsia is the delivery of a baby because the placenta is causing a problem. If the patient’s blood pressure is extremely high and life-threatening, medicine is also given to prevent the woman from having a stroke until she is delivered.

On the other hand, chronic hypertension is treated with medication during pregnancy to prevent strokes from occurring.  But what type of medicine? The FDA classifies medicines in 5 categories from “A” to “X” to describe how they will affect the unborn baby. Category A poses no harm to the baby and Category X should never be given because it has been proven to cause birth defects. The blood pressure medication Lisinopril is a category X medication. It should never, never be taken during pregnancy.

Pregnant moms please read those labels and ask questions before taking medication.  A healthy pregnancy doesn’t just happen. It takes a smart mom who knows what to do.

Are Pregnant Women Taking Unsafe Medicine?

There are few times that I become gravely concerned about the way medicine is practiced and this is one of them. A recent medical study in the Journal of Hypertension reported some startling facts: pregnant women are receiving blood pressure medication that might be harmful to their babies.

When physicians decide to specialize in obstetrics, we know exactly what we’re getting into. We have two patients, both mother and unborn baby and we don’t want either to die. Each year 4 million babies are born in the U.S. and between 6 to 8% of their mothers will have high blood pressure. Why are physicians and healthcare providers concerned about high blood pressure? Because if untreated, it can cause a stroke leading to death.
During pregnancy, a patient can have there are 3 types of high blood pressure: (1) chronic hypertension that occurs before 20 weeks, (2) gestational hypertension that occurs after 20 weeks but is not associated with protein in the urine and (3) pre-eclampsia that occurs after 20 weeks and is associated with protein in the urine. Pre-eclampsia, if untreated can lead to seizures (also known as eclampsia) and strokes. It is one of the most common reasons for death as a result of pregnancy. The treatment for pre-eclampsia is the delivery of a baby because the placenta is causing a problem. If the patient’s blood pressure is extremely high and life-threatening, medicine is also given to prevent the woman from having a stroke until she is delivered.

On the other hand, chronic hypertension is treated with medication during pregnancy to prevent strokes from occurring. But what type of medicine? The FDA classifies medicines in 5 categories from “A” to “X” to describe how they will affect the unborn baby. Category A poses no harm to the baby and Category X should never be given because it has been proven to cause birth defects. The blood pressure medication Lisinopril is a category X medication. It should never, never be taken during pregnancy.

Pregnant moms please read those labels and ask questions before taking medication. A healthy pregnancy doesn’t just happen. It takes a smart mom who knows what to do.

Dr. Linda Cares: Why are More Pregnant Women Having Strokes?

According to CDC, there has been a 54 percent increase in the number of pregnant women who’ve had strokes in 1995 to 1996 and in 2005 to 2006. While this may surprise some researchers, it certainly would not surprise clinicians who take care of pregnant women who have risk factors such as obesity, chronic hypertension or a lack of prenatal care. Ten percent of strokes occur in the first trimester, 40 percent during the second trimester and more than fifty percent occur during the post partum period and after the patient has been discharged home. Hypertension was the cause of one-third of stroke victims during pregnancy and fifty percent in the post partum period. Hypertension accounted for one-third of stroke cases during pregnancy and fifty percent in the post partum period. Many stroke cases might be prevented if blood pressure problems were treated appropriately during pregnancy.

Pregnant women who have high blood pressure during the first trimester are treated with medication and are classification as having chronic hypertension. The problem occurs when patients begin their prenatal care late and have high blood or when a diagnosis of pre-eclampsia is missed. Pre-eclampsia is a clinical condition that includes high blood pressure, protein in the urine and swelling of the hands, face, ankle or feet. Should patients be treated with medication or should their babies be delivered? The diagnosis may not be straight forward. The patient’s blood pressure could be high but there’s no protein in the urine. Or the patient may have high blood pressure that returns to normal with bed rest. Or the patient is only 26 or 27 weeks but has high blood pressure and a diagnosis of pre-eclampsia but the practitioner is hesitant to deliver the baby based on its prematurity. Or the patient is hospitalized for high blood pressure and then the blood pressure returns to “normal” so the healthcare provider inadvertently sends the patient home. Or the patient had high blood pressure, delivered a baby, is sent home and then has a seizure and ultimately a stroke.

What should a pregnant mom do to prevent a stroke? If you have blood pressure problems during your pregnancy, insistent on obtaining a consultation from a high-risk obstetrician (aka maternal fetal medicine specialist) even if you think your present obstetrician or midwife is managing your prenatal care appropriately. A second opinion never hurts and in some cases, it can save a life. Two heads are always better than one.