Antidepressants In Pregnancy. Are they Safe?

Depression is a common condition that afflicts women. Depressed pregnant women are at risk of preterm labor and worsening of their depression. Hence, treatment of these patients is important. That is why two recent articles that appeared in the New England Journal of Medicine about drug treatment of depression in pregnancy are important.

Previous studies implicated the selective serotonin reuptake inhibitors (SSRI's) like Paxil, Prozac and Zoloft in causing birth defects. These two new studies agree that the SSRI's have low risk of causing fetal abnormalities. Pregnant women who have depression should take comfort that they can take the SSRI's without having to worry about having abnormal babies. The abnormalities found in previous studies are rare.

Reference: New England Journal of Medicine.

Cardio Pulmonary Resuscitation In Patients Who Have Had Recent Heart Attack. Is It Necessary?

Many people do not like to give mouth to mouth resuscitation to a stranger who has had a heart attack. A recent article in the Lancet, a British Medical Journal claims that mouth to mouth resuscitation is not necessary in heart attack victims because their blood contains enough oxygen to sustain them for several minutes until the heart recovers. Chest compressions are far better than rescue breathing which requires regular pauses in the chest compressions.

The authors believe the benefit from continuous chest compressions far outweighs that from so-called "rescue breathing", which necessitates regular pauses in the compressions. Studies show less than a third of people who collapse in public are helped by people because of the “yuk” factor. If people realize that they don’t have to give mouth to mouth resuscitation they will be more willing to help a heart attack victim. On the other hand near drowning patients will need chest compression and mouth to mouth resuscitation

"The forward blood flow that you get from pumping on the chest is so marginal that if you stop for anything it's bad for the brain," Gordon Ewy

Reference:

The Lancet 2007; 369:920-926

DOI:10.1016/S0140-6736(07)60451-6

Articles

Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study

SOS-KANTO study group