Pratique clinique Clinical Pract ice

Treating pregnant women with medications and other therapies must always include con-sideration of benefits and risks. Some drugs are defi nitely human teratogens (eg, isotretinoin) and should not be administered when a mother’s con-dition is not serious, urgent, or life-threatening (eg, acne).1 Human teratogens are sometimes given to treat maternal conditions, however. For example, both valproic acid and carbamazepine cause neural tube defects (in 2 % and 1 % of fetuses, respectively), yet management of epilepsy during pregnancy is often deemed essential,2 and prenatal diagnosis can detect most, if not all, cases of neural tube defects. Th ere are safe medications for many maternal conditions, but some practitioners hesitate to use them due to misperception of teratogenic risk