The Effect of Antihypertensive Drugs on the Fetus

Abstract

Until the thalidomide disaster there had been relatively little interest in the effect of drugs on the embryo or fetus. Before this most drug studies had been carried out on adult animals. Thalidomide changed all this, and it is now mandatory for new drugs to be screened for their effects in pregnancy. However, the effects sought are morphological changes in the embryo; there has been little interest in the more subtle effect of drugs later in pregnancy, when morphogenesis is largely complete and the fetus is growing rapidly. Indeed, in clinical obstetrics there is much the same casual attitude towards the use of new drugs in the last trimester of pregnancy as once there was towards the use of new drugs in the first trimester. Systematic animal fetal pharmacology is not carried out on new drugs; the sum of knowledge on the effect of drugs on the fetus is small. There are some signs that interest in this field is beginning. Symposia are being held (e.g. Boreus, 1973) and incidental observations on fetal pharmacology made during the course of physiological experiments are now beginning to be collated.