Pregnancy is an exciting and joyous time for many women. It can be a time of anticipation, joy, and excitement as you prepare to welcome a new life into the world. During pregnancy, you will experience a range of emotions, from the thrill of seeing your baby’s ultrasound to the anxiety of  labor and delivery. You may also feel overwhelmed by all the changes that come with pregnancy. But  When you are pregnant you have to be aware that everything that goes into your body has the  potential to have an effect on your unborn baby.Some things you take into your body can have harmful effects on your pregnancy. Smoking, drinking alcohol, abusing prescription drugs or using  illicit drugs can all pass through the placenta and have a negative effect on mother and baby More than 50% of pregnant women take prescription or nonprescription (over the counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy, and use of drugs during pregnancy is increasing. In general, drugs should not be used during pregnancy  unless necessary because many can harm the fetus. Less than 2 to 3% of all birth defects result from  drugs that are taken to treat a disorder or symptom. So,Pregnancy is considered a stressful and  difficult period for the pregnant woman, that requires special care and continuous medical  supervision, which involves not only physicians, but also pharmacists, who play a major role in  placing an appropriate care plan and increasing awareness of this stage of a woman’s life. Furthermore, pharmacists play a role in preventing the exposure of pregnant women to possible  teratogens, given that exposure of a fetus to a wide variety of drugs or substances can lead to harmful consequences such as malformations, growth retardation, functional disorders, or death. Susceptibility to teratogenesis varies with the dose and the duration of the exposure, as well as the developmental stage of the fetus at the time of exposure.

Hence came the idea of our project, EPCA.

According to the former studies, we can conclude that the use of Methimazole should be limit ed for pregnant women. Usage of Methimazole can be associated with several congenital defects, therefore, pregnant women who are required to take Methimazole should be on contraceptives as a preventative measure. For the management of hypertension, Lisinopril showed several side effects to infants. These side effects include malformations, cardiovascular irregularities, and central nervous system damage. To avoid these side effects, pregnant women who are treated for hypertension should consult the physician to stop the medication and prescribe an alternative treatment for hypertension. For the management of blood disorders, Warfarin should be avoided during pregnancy as it can cause fetal warfarin syndrome to the baby if taken within the first 6 - 12 weeks of pregnancy. Among the disorders that can affect the child are behavioral problems where the baby's brain is affected and can slow the learning process, and bleeding problems that can increase the likely of the child to bleed after birth. For the management of Rheumatoid arthritis, the usage of Methotrexate should be avoided as it can cause congenital disorders especially Methotrexate Embryopathy. Women who are taking Rheumatoid after birth should avoid breast feeding atleast 1 week after the last dose of  methotrexate. Taking Folic Acid supplmentation during pregnancy decreased the likelihood of birth  defects compared to women who were not taing folic acid. For pain management, the usage of  NSAID in the third trimester of pregnancy should be limited as it is associated with rsik of premature closure of te fetal ductus. However, unlike most pain supressors mentioned, there are no conclusive data about the effect of NSAID in the first trimester of pregnancy, therefore it can be taken with caution and under physician supervision. Usage of NSAID in the 20th week of pregnancy can cause fetal renal dysfunction (oligohydramnios). To ensure safety, parecetamol can be used during pregnancy as it is not associated with any fetal effects. The usage of Caffeine had an effect on pregnant women which led to birth defects, increased risk of premature labor, and other reproductive problems. Some studies showed linkage between caffeine consumption and delayed contraception time. However, there are no conclusive data about pregnant women and the usage of caffeine, therefore it is recommended to limit caffeine consumtion to 200mg daily. Pregnancy complications such as pre-clampsia, gestational hypertension, and preterm birth is largely associated with vitamin defeciencies in Vitamin D, folic acid, and Vitamin B12. To avoid such complications the National Health and Medical Research Council of Australia (NHMRC) recommends taking folic acid and iodine as a routine supplementation for all pregnant women. Pharmacists should raise awareness and guide pregnant women to take the appropriate medications to avoid any birth defects that can occur.