Use of Medications During High-Risk Pregnancy: Evaluating the Safety and Efficacy of Different Medications

Abstract

INTRODUCTION: High-risk pregnancy involves medical conditions that increase risks for both mother and fetus, such as hypertension, gestational diabetes, infections, and autoimmune diseases. Managing these conditions often requires medication like methyldopa, insulin, and hydroxychloroquine. Methyldopa controls hypertension, insulin manages gestational diabetes without affecting the fetus, and hydroxychloroquine is used for autoimmune diseases with good results for pregnancy. Medication choices should be made carefully, based on an individualized assessment of risks and benefits. This article aims to review the safety and efficacy of these medications to guide clinical decisions and improve care in high-risk pregnancies. METHODOLOGY: The research will be a systematic review on the safety and efficacy of medications in high-risk pregnant women. It will investigate how to define safe and effective medications, which are commonly used, and their implications. The search will be conducted in databases using specific descriptors and filtering publications from 1994 to 2024 in Portuguese and English. Irrelevant, duplicate, non-English, or out-of-period articles will be excluded. RESULT: In high-risk pregnancies, managing conditions like hypertension and diabetes is essential. For hypertension, medications such as methyldopa, nifedipine, and labetalol are considered safe and effective, although they may cause side effects like sedation and headaches. For gestational diabetes, insulin is a safe and effective option, while the use of metformin is still debated regarding its safety. To treat infections, antibiotics such as penicillins and antivirals like acyclovir are generally safe. In autoimmune diseases treatment, hydroxychloroquine is safe, and corticosteroids are effective but should be used cautiously due to possible complications. Proper management of these medications is crucial to ensure the health of both mother and fetus. CONCLUSION: Managing high-risk pregnancies requires a careful and personalized approach in choosing medications based on scientific evidence. Methyldopa is safe for treating hypertension, insulin is effective for gestational diabetes without crossing the placenta, and hydroxychloroquine is used for autoimmune diseases, showing benefits without significant teratogenic effects.