Pharmacological Interventions Practiced in Various High Risk Pregnancy Conditions and Their Appropriateness Compared to Standard Treatment Guidelines in a Tertiary Care Hospital

Abstract

Introduction: Evaluating qualitative aspects of drug use against established standards helps to identify specific areas of problem which inturn helps to plan focused interventions to facilitate rational use of drugs. Presence of high risk condition during pregnancy is most important determinant of drug use during pregnancy. Material and Methods: This prospective, observational study included 290 pregnant women high risk condition admitted to a tertiary care government hospital. Demographic data and data regarding pharmacological interventions during entire hospital stay were retrieved from medical records and by enquiring with health care professional and patients whenever deemed necessary. Results: Anaemia with hypertensive disorder of pregnancy were most common high risk conditions seen in 214/290, 73.79% qnd 125/290, 43.1% women respectively More than 90% of patients with anaemia were appropriately with oral iron parentral iron packed cell volume according to severity of anaemia. Hypertensive disorders were treated with single antihypertensive (Nifedipine or methyldopa or labetalol) in 108/125, 86.41 patients remaining patients required combination of two (30/125, 23.43%) or three (3/125, 2.4%) antihypertensive. Nearly one third (85/290, 29.31%) patients received antimicrobials. Conclusion: Majority drugs were used according with standard guidelines. The important problems identified were inappropriate use of antimicrobials, prolonged tocolysis, use of progesterone for prevention of miscarriage in patients with history recurrent miscarriages and use of sublingual nifedipine for hypertensive disorder of pregnancy.