Prescribing in pregnancy

There are many challenges to prescribing in pregnancy and a structured approach to guide and organize clinical decision making can be very useful. Our framework considers: a detailed approach to clarifying the risk–benefit relationship; general and safe principles of prescribing medications where uncertainty often exists; and the importance of communicating clearly with patients and engaging them in decision making and treatment. We review teratogenic medications to be avoided in reproductive age women and review medication safety in common medical conditions in pregnancy. Finally, we briefly review the safety of medications used in complex medical conditions including epilepsy, bacterial infections, anticoagulation and autoimmune disorders.