Fetal uptake and neonatal disposition of procainamide and its acetylated metabolite: A case report

Few drugs are administered to pregnant women without fear of hazard to the fetus. Because there are few available data on the kinetics and effects of drugs given in pharmacological doses during pregnancy, many are either withheld or given with hesitation. The problem has many origins, not the least important of which are the ethical considerations in studying drug effects and disposition in the fetus and neonate. Measuring urinary drug excretion after birth is one relatively noninvasive method of examining fetal drug uptake and neonatal elimination. The authors have utilized this approach to examine the disposition of transplacentally acquired procainamide and its active metabolite, N-acetylated procainamide, in the neonate.