Fetal drug therapy

Maternal illness, infection, or disease may require medication during pregnancy, which presents the challenge of balancing the benefits and risks associated with fetal drug exposure. In cases of certain fetal disorders, however, the opposite situation arises: the need to weigh the benefits of fetal drug therapy against the risks of maternal side effects. Fetal arrhythmias, lung maturation, hematological or endocrine disorders, and other conditions may warrant drug delivery to the fetus. This chapter presents advantages and disadvantages of several strategies for fetal drug delivery, such as direct fetal injection. An overview of human placental transport functions is provided as it relates to fetal therapy following maternal drug administration. Potential applications of gene therapy, stem cell transplantation, and nanomedicine are highlighted and special considerations for fetal pharmacokinetics and ethics are discussed.