| Condition |
Medication |
Reference(s) |
| Asthma |
Albuterol is rescue therapy of choice
Budesonide is the preferred inhaled
corticosteroid
Long-acting
b2-agonists salmeterol is the preferred add-on controller
therapy
|
1 |
| Bacterial
Vaginosis |
Treatment is recommended for all pregnant women with symptoms.
Metronidazole OR
Clindamycin |
2 |
| Chlamydia |
Azithromycin |
2
|
| Cholestasis of
pregnancy |
Ursodeoxycholic
acid (UDCA) |
14 |
| Chronic hypertension |
Labetalol OR / AND
Methyldopa
OR / AND
Nifedipine slow-release
preparation |
3.
|
| Depression , mild |
Psychotherapy such as
cognitive-behavioral therapy (CBT) OR interpersonal therapy |
18 |
| Depression ,
severe |
Psychotherapy
AND fluoxetine.
Alternative medications: sertraline or tricyclic
antidepressant |
18 |
| Depression with
psychosis |
Electroconvulsive therapy OR
Haloperidol AND antidepressant as above |
18 |
| Depression mild,
postpartum while breast-feeding |
Psychotherapy with or without
antidepressant (sertraline or paroxetine) |
18 |
|
Depression severe, postpartum while
breast-feeding |
Supportive services AND
sertraline
Alternative medication:
Paroxetine |
18,
19 |
| Diabetes |
Insulin |
4 |
| Gonorrhea;
uncomplicated genital, rectal, and pharyngeal |
Ceftriaxone 250 mg as a single intramuscular
dose, plus either azithromycin 1 g orally in a single dose
|
5. |
| Herpes |
Acyclovir OR
Valacyclovir |
6.
|
| Hypothyroidism |
Levothyroxine
|
7,15 |
| Hyperthyroidism |
Propylthiouracil (PTU). in the first
trimester of pregnancy.
Methimazole after
first trimester
Beta adrenergic blocking agents, such as
propranolol may be used for controlling hypermetabolic symptoms. |
7 |
| Idiopathic thrombocytopenic
purpura (ITP) |
Prednisone.
IVIg may be
used with corticosteroids when a more rapid increase in platelet count is
required, or corticosteroids are contraindicated [ |
8.
|
| Malaria |
Chloroquine ,
hydroxychloroquine
For chloroquine-resistant P. falciparum infection, treat with either
mefloquine or a combination of quinine sulfate and clindamycin |
16,17 |
| Nausea and vomiting of
pregnancy |
Diclegis (doxylamine succinate and pyridoxine
hydrochloride)
Refractory cases add promethazine or dimenhydrate . If still no response
add metoclopromide . |
9.
|
| Pediculosis
Pubis |
Permethrin 1%
cream OR
Pyrethrins with piperonyl butoxide |
2,
|
| Preeclampsia
prevention |
Low-dose aspirin
(81 mg/d) after 12 weeks of gestation in women who are at high risk for
preeclampsia. |
20-26 |
| Pyelonephritis |
Cefriaxone OR
Ampicillin AND genatmicin
OR
Cefazolin OR
Cefotetan
OR
Aztreonam
(Several other regimens are also acceptable ) |
10,11 |
| Seizure ,
eclamptic |
Magnesium |
21 |
| Scabies |
Permethrin cream
5% |
2 |
| Syphilis |
Benzathine penicillin |
2 |
| Trichomoniasis |
Metronidazole |
2 |
| Ulcer
|
Sucralfate
Ranitidine |
13 |
| Urinary tract
infection |
Nitrofurantoin (
Avoid in first trimester)
Cephalexin |
11 |
| Venous thromboembolism (VTE)
|
Low Molecular Weight
Heparin
Enoxaparin
OR
Dalteparin
OR
Tinzaparin |
12. |
| Vulvovaginal
Candidiasis |
Only topical
azole therapies, applied for 7 days, are recommended
Terconazole 0.4% cream |
2 |
|
REFERENCES
1.ACOG practice bulletin: clinical management
guidelines for obstetrician-gynecologists number 90, February 2008: asthma in
pregnancy.Dombrowski MP, Schatz M; ACOG Committee on Practice
Bulletins-Obstetrics. Obstet Gynecol. 2008 Feb;111(2 Pt 1):457-64. PMID:
18238988
2.
CDC Sexually Transmitted Diseases Treatment
Guidelines , 2010 December 17, 2010 / Vol. 59 / No. RR-12
Morbidity and Mortality Weekly Report PMID: 21160459
3.
Chronic hypertension in pregnancy.
Practice Bulletin No. 125. American College of Obstetricians and
Gynecologists. Obstet Gynecol 2012;119:396–407.
4. Pregestational diabetes mellitus. ACOG Practice Bulletin No. 60. American
College of Obstetricians and Gynecologists. Obstet Gynecol 2005;105:675–85.
5.
Update to CDC's Sexually transmitted diseases
treatment guidelines, 2010: oral cephalosporins no longer a recommended
treatment for gonococcal infections.
Centers for Disease Control and Prevention (CDC).MMWR Morb Mortal Wkly Rep. 2012
Aug 10;61(31):590-4.PMID: 22874837
6.
Management of Herpes in
Pregnancy. ACOG Practice Bulletin No. 82. American College of
Obstetricians and Gynecologists. Obstet Gynecol 2007; 109:1233–48.
7.
Stagnaro-Green A, ert al.
American Thyroid Association Taskforce on Thyroid Disease During Pregnancy
and Postpartum.Guidelines of the American Thyroid Association for the
diagnosis and management of thyroid disease during pregnancy and
postpartum.
Thyroid. 2011 Oct;21(10):1081-125. doi: 10.1089/thy.2011.0087. PMID:
21787128
8.
Neunert C, et al., The American Society of Hematology 2011
evidence-based practice guideline for immune thrombocytopenia. Blood. 2011 Apr
21;117(16):4190-207. Epub 2011 Feb 16. PMID: 21325604
9.
Nausea and vomiting of pregnancy. ACOG
Practice Bulletin No. 52. American College of Obstetricians and
Gynecologists. Obstet Gynecol 2004;103:803–15
10.
Jolley JA, Wing DA.Pyelonephritis in
pregnancy: an update on treatment options for optimal outcomes.
Drugs. 2010 Sep 10;70(13):1643-55. PMID: 20731473
11.
Cunningham FG,
Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Renal and Urinary
Tract Disorders. In: Williams obstetrics. 23rd ed. New York:
McGraw-Hill, 2010:7 1035-1037
12.
Inherited thrombophilias
in pregnancy. Practice Bulletin No. 124 American College of
Obstetricians and Gynecologists. Obstet Gynecol 2011;118:730-40.
13.
Cunningham FG,
Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Renal and Urinary
Tract Disorders. In: Williams obstetrics. 23rd ed. New York: McGraw-Hill, 2010:7
1053
14. Bacq Y, Efficacy of Ursodeoxycholic Acid in Treating Intrahepatic
Cholestasis of Pregnancy: A Meta-analysis.Gastroenterology. 2012 Aug 11. doi:pii:
S0016-5085(12)01187-0. 10.1053/j.gastro.2012.08.004.
PMID: 22892336
15. Thyroid disease in pregnancy. ACOG Practice Bulletin No. 37. American
College of Obstetricians and Gynecologists. Obstet Gynecol 2002;100:387–396
16. Griffith KS, et al. Treatment of malaria in the United States: a systematic
review. JAMA. 2007 May 23;297(20):2264-77. PMID: 17519416
17. Centers for Disease Control and Prevention. Treatment of Malaria: Guidelines
For Clinicians (United States) .Part 3: Alternatives for Pregnant Women and
Treatment of Severe Malaria
http://www.cdc.gov/malaria/diagnosis_treatment/clinicians3.html. Accessed
10/27/20
18. Altshuler LL, et al., Treatment of depression in women: a summary of the
expert consensus guidelines.
J Psychiatr Pract. 2001 May;7(3):185-208. PMID: 15990522
19. Berle JO, Spigset O.Antidepressant Use During Breastfeeding. Curr Womens
Health Rev. 2011 Feb;7(1):28-34. PMID: 22299006
20.Final Recommendation Statement: Low-Dose Aspirin Use for the Prevention of
Morbidity and Mortality From Preeclampsia: Preventive Medication . U.S.
Preventive Services Task Force. December 2014.
http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication
21.
Hypertension in pregnancy: executive summary. Obstet Gynecol. 2013 Nov;122(5):1122-31. doi:10.1097/01.AOG.0000437382.03963.88.PMID:24150027
22.
Duley L, et al., Antiplatelet agents for preventing pre-eclampsia and its
complications. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004659. PMID: PMID:17443552
23. Diagnosis, evaluation, and management of the hypertensive
disorders of pregnancy. Society of Obstetricians and Gynaecologists of Canada (SOGC)Clinical
Practice guideline. J Obstet Gynaecol Can. 2008 Mar;30(7):S
Available at : http://www.sogc.org/guidelines/documents/gui206CPG0803_001.pdf Accessed
7/12/2010
24.
Bates SM, VTE, thrombophilia, antithrombotic therapy, and pregnancy:
Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of
Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012
Feb;141(2 Suppl):e691S-736S.PMID:PMID:22315276
25.
Hypertension in pregnancy:the management of hypertensive disorders during
pregnancy
August 2010 (revised reprint January 2011)
http://www.nice.org.uk/nicemedia/live/13098/50475/50475.pdf .Accessed
7/12/2012
26.
NICE clinical guideline 107 – Hypertension in pregnancy: the management of
hypertensive disorders during pregnancy
Available at :http://www.nice.org.uk/nicemedia/live/13098/50418/50418.pdf
Available at :http://www.nice.org.uk/nicemedia/live/13098/50475/50475.pdf Accessed
7/12/2012
|
