Pharmacotherapy in pregnant women

Abstract

E.A. Sandakova1, I.G. Zhukovskaya2, M.V. Semenova2, A.F. Vaganova3, A.V. Kuznetsova1, T.E. Kazymova1, O.A. Belousova2, L.P. Makarova2 1Academician E.A. Vagner Perm State Medical University, Perm, Russian Federation 2Izhevsk State Medical Academy, Izhevsk, Russian Federation 3F.Kh. Gral City Clinical Hospital No. 2, Perm, Russian Federation Aim: to analyze the prescription of medications in pregnant women based on outpatient charts of women’s clinics. Patients and Methods: retrospective cohort study was conducted in three women’s clinics of Perm and two women’s clinics of Izhevsk. Data on the prescription of medications in 361 pregnant and postpartum women during pregnancy (2017–2018) were obtained by copying individual medical charts. Additionally, we compared our findings with the results of the Russian Pharmacoepidemiologic Study (2007). Results: pharmacotherapy was prescribed in 100% of women. On average, 12.6 medications were prescribed during gestation. Most medications were prescribed in the second trimester (on average, 5.5 medications). In the first and third trimesters, 2.4 and 4.7 medications were prescribed, respectively. The most prescribed drugs were vitamins and minerals (70.4%), feminine hygiene products (37.1%), progestogens (33.1%), herbal urinary antiseptics (29.8%), and systemic antibiotics (14.2%). Pharmacotherapy defects included medications inconsistent with diagnosis (48.6%), a combination of several drugs with similar pharmacological effects (16.5%), and polypharmacy defined as the use of five or more medications (25.8%). A two-fold reduction in drug aggression as well as an increase in the dotation of vitamin-mineral complexes compared to 2007 were reported. Conclusions: our findings illustrate positive trends for treating pregnant women in the last 9–10 years and increased safety of treatment (the lack of drugs with potential teratogenic or embryotoxic effects) but also indicate the need in the permanent audit and adjustment of prescriptions based on clinical guidelines. Pre-pregnancy preparation is a perspective way to reduce the intensity of drug therapy during pregnancy. As a result, drug burden shifts to a pre-gestational period. Pre-pregnancy preparation provides favorable conditions for developing an embryo and fetus. Keywords: pharmacotherapy, pregnancy, polypharmacy, micronutrients, vaginal hygiene, progestogens, urinary antiseptics. For citation: Sandakova E.A., Zhukovskaya I.G., Semenova M.V. et al. Pharmacotherapy in pregnant women. Russian Journal of Woman and Child Health. 2021;4(2):115–118. DOI: 10.32364/2618-8430-2021-4-2-115-118.