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Ketamine and Pregnancy

The FDA has classified ketamine (Ketalar) as a pregnancy Category B medication, meaning this drug is generally considered safe for use during pregnancy. However, some studies have shown that when pregnant women received this drug, it increased muscle tone and slowed down breathing in newborns. Before receiving this anesthetic, pregnant women should talk to their healthcare providers about other potential risks.

Can Pregnant Women Receive Ketamine?

Ketamine hydrochloride (Ketalar®) is an injectable prescription medication approved for use as an anesthetic (a medicine that causes loss of sensation or awareness) before certain diagnostic or surgical procedures. It is generally thought that this medication is safe for use during pregnancy.

What Is Pregnancy Category B?

Ketamine is classified as a pregnancy Category B drug. The U.S. Food and Drug Administration (FDA) uses a pregnancy category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. Pregnancy Category B is given to medicines that have not been adequately studied in pregnant humans but do not appear to cause fetal harm in animal studies.
In addition, medicines that have been shown to be safe for use in pregnancy in humans but have caused problems in laboratory animals are given a Category B rating.
Ketamine did not cause birth defects or other problems during animal studies with pregnant rats, mice, rabbits, and dogs. When given in high doses to pregnant monkeys, ketamine did not cause problems in the fetus, but did cause slowed breathing in the newborn monkeys.
Ketamine is known to cross the placenta to the developing fetus. In humans, it has been reported to cause increased muscle tone and slowed breathing in newborns when given before delivery. It may also increase the frequency and intensity of contractions, and raise blood pressure and heart rate in the mother. These effects are dose-related, however, and less of a problem when lower amounts are used.
In addition, because ketamine is a short-acting anesthetic, it is unlikely to produce newborn side effects unless given immediately prior to delivery.
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