[Drug therapy safety during pregnancy and breastfeeding].

Dermatologie (Heidelberg, Germany) Pub Date : 2024-11-01 Epub Date: 2024-09-24 DOI:10.1007/s00105-024-05416-6
Johannes Wohlrab, Antonia Schmidt, Adina Eichner
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Abstract

The treatment of dermatological diseases during pregnancy and breastfeeding poses particular challenges for the therapist for medical and legal reasons. Maternal and fetal influencing factors must be taken into account and the special need for protection of the fetus, infant, and mother must be considered in the treatment decision, usually outside of the approval process. Due to the lack of or insufficient evidence for most therapies during pregnancy and breastfeeding, an individual risk-benefit assessment should always be carried out, which also takes into account the risk of nontreatment. In the case of difficult or potentially momentous decisions, information from relevant databases, intercollegiate consultation and, if possible, advice from a clinical ethics committee should be obtained. In any case, the parents, and in particular the mother, should be carefully informed and their consent should be obtained and documented. Recommendations can be made for common chronic inflammatory and infectious dermatoses, but these should be reviewed on a case-by-case basis. For other therapy situations, an individual analysis and decision-making process is necessary. Overall, however, it can be stated that digital data processing and availability, combined with careful analysis, empathetic consideration and information for those affected, enables a successful treatment decision to be made in the vast majority of cases.

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[孕期和哺乳期的药物治疗安全性]。
由于医学和法律方面的原因,孕期和哺乳期皮肤病的治疗对治疗师提出了特殊的挑战。治疗决定必须考虑到母体和胎儿的影响因素,并且必须考虑到保护胎儿、婴儿和母亲的特殊需要,通常是在审批程序之外。由于大多数孕期和哺乳期治疗方法缺乏证据或证据不足,因此应始终进行个体风险效益评估,同时考虑到不治疗的风险。在做出困难的或可能是重大的决定时,应从相关数据库中获取信息,进行校际咨询,如有可能,还应征求临床伦理委员会的意见。在任何情况下,都应仔细告知父母,尤其是母亲,并征得他们的同意和记录在案。可以针对常见的慢性炎症性和感染性皮肤病提出建议,但应根据具体情况进行审查。对于其他治疗情况,有必要进行个别分析和决策。不过,总的来说,数字化数据处理和可用性,再加上仔细分析、换位思考和为受影响者提供信息,可以使绝大多数情况下的治疗决策取得成功。
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