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The list of medications that should be avoided by pregnant women keeps growing.

Last month, the Food and Drug Administration (FDA) warned about potential cleft palate and clip lip birth defects in women taking the anti-epilepsy and migraine medication Topamax (topiramate) during their first trimester.

In February, the FDA updated the label for the entire class of antipsychotic medications, including Hadol, Zyprexa, and Seroquel for potential withdrawal symptoms and extrapyramidal signs or EPS in newborn babies of mothers who were taking antipsychotics during the third trimester of pregnancy.

In February, the FDA also warned that the asthma drug, terbutaline, also used to halt preterm labor, should not be used by pregnant women due to the risk of heart problems and even death of the mother.

The Center for Disease Control and Prevention (CDC) has also recently warned that opioid pain relievers like Vicodine may increase the risk of congenital birth defect, glaucoma, and other problems when taken just before or during early pregnancy.

Treating chronic conditions of pregnant women is a very challenging task and is becoming even more challenging as more drugs are added to the list of those that may be potentially harmful to the developing baby.

Many experts will agree that chronic conditions such as asthma, epilepsy, and high blood pressure may pose a great risk to both the mother and the fetus if left untreated for a period of nine months, therefore in many cases mothers and physicians are forced to weigh their options.

Much of the difficulty of determining the risks of medications on pregnant women and their growing fetuses simply cannot be attained because pregnant women are not subjected to testing of medications due to the potential risk that may be involved.

Medications are classified into different categories by the FDA based on that data they have relating to the use of the medication during pregnancy. Category A contains very few medications, as drugs in this category have been shown through large well-controlled studies to be safe for the fetus. Category B is comprised of medications that at are believed to be safe for use during pregnancy but have less available data.

Most drugs fall into Category C. Category C may include drugs that have no evidence of doing harm to animal offspring, medications that have displayed a few malformations in animal studies, and other drugs that have shown frequent and major malformations in three different species. With all of these drugs categorized the same, but likely differing greatly in the risk posed by their use during pregnancy; it is obviously very challenging for doctors and patients alike to understand the risks involved with taking a particular medication during pregnancy.

In some cases alternative treatments may be available that are thought to be safer for the fetus, but in some instances there may be no effective alternative, and doctors and patients may be forced to weigh the risks and make the decision that they believe best minimizes the risks to both the mother and child.

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