The document discusses several physiological changes that occur during pregnancy and their implications for dental treatment. It notes increased blood flow to the kidneys and liver for drug detoxification during pregnancy. Common complaints include nausea, increased urination, and potential complications like preeclampsia. For dental treatment, it recommends obtaining a thorough medical history, consulting the obstetrician, keeping appointments short, and deferring elective treatment until after pregnancy. Drug administration requires consideration of potential fetal abnormalities and FDA categories.

13. by an abrupt fall in BP,
-Bradycardia
-Sweating
- Nausea
-Weakness
-Air hunger

17. • Reduced expiratory reserve volume
• Increased rate of respiration.
• Dysponea at supine position.
• Hyperemia and edema of respiratory tract.

18. Renal blood flow & glomerular filtration rate
increases about 50% from 4th to 7th months of
gestation.
• Creatinine levels drop & increase frequency of
urination.
• Blood flow to maternal liver is essentially unchanged
during pregnancy
• During pregnancy - kidney & liver of mother & fetus
are primary organs responsible for drug
detoxification.

19. • Increase appetite & craving for unusual food. •
Taste alterations & increased gag response.
• 90% of pregnant women vulnerable to nausea
& vomiting.
• Glycosuria & impaired glucose tolerance –
gestational diabetes.

20.  Infection
 Glucose abnormalities
 Hypertension
 Rare complication (5%)-Preclampsia
Albuminuria
Edema
Pre-eclampsia progresses Eclampsia
If seizures & coma develop.
Malignant hypertension
Blurred vision
Seizures
Coma
 Spontaneous abortion

21. DENTAL MANAGEMENT

22. • Determination of general health with through a
thorough history.
• Current physician.
• History of Gestational Diabetes.
• Miscarriage
• Hypertension
• Morning sickness
• Contacting patients obstetrician for discussion about
1.Medical status
2.Dental need
3.Proposed dental treatment

23. • Detailed history about the number of times patient
has been pregnant, number of children conceived,
history of abortion ( spontaneous and elective).
• Appointments to be kept short and the best chair
position is sitting up or left lateral position with the
head of the chair elevated.
• Elective dental treatment should be deferred to post
term.
• Dental radiographs are best avoided. If unavoidable
then second trimester is preferred.
• Prescription of drugs to be done with care .

24. Reduction in
S.mutans

29.  Capacity of drug to cause fetal abnormalities when
administered to pregnant mother
 Thalidomide disaster (1558-1961) resulting in thousand of
babies born with PHOCOMELIA.
 Drug
 Stage of exposure of teratogen
 Blood level
 Duration for which drug remains in maternal circulation.

30. ¥ Before implantation (14days) (death of the ovum )
¥ 14-60 days major morphologic defects (organogenesis)
¥ 60 days later function impairment ( )

31. DRUG ADMINISTRATION

33. FDA CATEGORY

39.  During the first trimester: included reports of
increased risk of cleft lip, with or without cleft
palate .

42.  FDA C
 Avoid use during last
trimester of pregnancy.
 Prior to 30 weeks gestation:
Use only if potential benefit justifies the potential
risk to the fetus.
 It may cause premature closure of the ductus
arteriosus.

47. Corticosteroid

48. HEPARIN AND PREGNANCY

61. MORNING SICKNESS
(HYPEREMISIS GRAVIDARUM)