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Since its approval, Accutane has been labeled as being in pregnancy category X, meaning it should not be used during pregnancy. However, due to persistent reports of birth defects associated with use of the drug in 1988, the manufacturer, Hoffmann-La Roche, began including additional patient information in the packaging, including a drawing of a baby with birth defects associated with the drug. Before being permitted to take Accutane, a woman of childbearing age must sign a consent form stating she has been fully informed of the drug's side effects.

Another derivative of vitamin A, etretinate (or Tegison), was approved in the mid-1980s to treat psoriasis. This drug is also forbidden for use by women who are pregnant or who are likely to become pregnant either while taking it or for a certain period after they have stopped taking it.

A Nonalcoholic Toast

While pregnancy is a time for celebration, toasting with champagne, a few beers, or any alcoholic beverage is not healthy for the fetus or the mother-to-be. Alcohol can cross the placenta and in the case of heavy drinking (at least four standard drinks per day) can cause a condition known as "fetal alcohol syndrome," or FAS.

The American College of Obstetricians and Gynecologists describes babies with FAS as being shorter and lighter in weight and having the following characteristics:

• smaller heads
• abnormal features of the face, head, joints and limbs
• heart defects
• poor control of movement.

Mental retardation is common, as is hyperactivity, extreme nervousness, and poor attention span.

According to a report, "Alcohol and Health," released by the Department of Health and Human Services in January 1990, some studies suggest that the more alcohol a mother drinks during pregnancy, the greater the danger to the fetus, especially in the first trimester. Because it's difficult to determine how much alcohol puts a fetus at risk and at what stages of pregnancy the fetus is affected, it is not known whether drinking any amount of alcohol is safe. The safest course at present, therefore, is for pregnant women to abstain from drinking alcoholic beverages.

Safety of Tests

X-rays may pose dangers to the fetus. While x-ray examinations of the teeth or extremities do not generally expose the fetus to significant levels of radiation, x-rays of the abdomen, lower back, or hip areas place the fetus in the direct x-ray beam and can be hazardous. It is particularly important for a pregnant woman — or a woman who thinks she may be pregnant — to inform the doctor or technician before having an x-ray performed on these body areas.

Certain tests are routinely done to check the well-being of the fetus during pregnancy and labor. The most common of these, ultrasound, uses sound waves that bounce off internal organs to project images of the organs and the fetus on scanners. There have been no reports of harmful effects associated with ultrasound, which has been used for more than 20 years. Ultrasound does not use radiation, drugs, dyes or chemicals and is beneficial in providing valuable information. For example, it can reveal the number of fetuses and age, size, fetal position, some birth defects, and other information vital to the health care of the pregnant woman and her baby.

There are three types of ultrasound, each used during pregnancy for different purposes. The most common is real-time ultrasound, which takes still pictures in rapid succession and detects the heartbeat, placenta, movement of the arms and legs, and the number and position of the fetus(es).

The second is Doppler ultrasound, used before and during labor to provide electrical signals that are converted to audible signals of the fetal heartbeat. The third, vaginal ultrasound, can help diagnose the cause of bleeding and pain or an ectopic pregnancy, in which the fertilized egg grows outside the uterus. It can also detect some birth defects early in the pregnancy.

Prenatal care is vital to the health of both mother and baby. Mothers-to-be will find it worthwhile to educate themselves about all aspects of pregnancy and consult an obstetrics specialist to guide them through a successful pregnancy.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.