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Drug therapy of the fetus and neonate
1Department of Paediatrics, National University of Singapore.
The fetus and neonate are very sensitive and delicate. Events occurring during this period can therefore, have a very significant influence on later life. Drugs given to the pregnant women may have a significant impact on the fetus, as the thalidomide disaster has shown. Drug therapy of the fetus via the mother has also been proven to be effective in certain situations, especially with regard to improving lung maturity. With advances in visualisation of the fetus by ultrasonography, direct fetal treatment has been successfully performed. The neonate immediately after delivery is in a very precarious state, especially if premature. Drug therapy is sometimes indicated then to ensure his well-being. Such drug therapy will have to take into consideration absorption problems in relation to a prolonged gastrointestinal transit time as well as hepatic and renal immaturity, together with a relatively greater volume of distribution of the drug (Vd). When these considerations are taken into account, effective therapy can be instituted with successful results. Drug treatment for specific conditions in the premature baby, when tailored to their needs and limitations, have indeed been successful.
The fetus and neonate are very sensitive and delicate. Events occurring during this period can therefore, have a very significant influence on later life. Drugs given to the pregnant women may have a significant impact on the fetus, as the thalidomide disaster has shown. Drug therapy of the fetus via the mother has also been proven to be effective in certain situations, especially with regard to improving lung maturity. With advances in visualisation of the fetus by ultrasonography, direct fetal treatment has been successfully performed. The neonate immediately after delivery is in a very precarious state, especially if premature. Drug therapy is sometimes indicated then to ensure his well-being. Such drug therapy will have to take into consideration absorption problems in relation to a prolonged gastrointestinal transit time as well as hepatic and renal immaturity, together with a relatively greater volume of distribution of the drug (Vd). When these considerations are taken into account, effective therapy can be instituted with successful results. Drug treatment for specific conditions in the premature baby, when tailored to their needs and limitations, have indeed been successful.