The birth defects caused by thalidomide led to the development of greater drug regulation and monitoring in many countries.It was approved in the United States in 1998 for use as a treatment for cancer. It is on the World Health Organizations List of Essential Medicines. It is available as a generic medication. Medical uses
Thalidomide is used as a first-line treatment in multiple myeloma in combination with dexamethasone or with melphalan and prednisone to treat acute episodes of erythema nodosum leprosum and for maintenance therapy.The bacterium that causes tuberculosis (TB) is related to leprosy. Thalidomide may be helpful in some cases where standard TB drugs and corticosteroids are not sufficient to resolve severe inflammation in the brain.It is used as a second-line treatment to manage graft versus host disease and aphthous stomatitis in children and has been prescribed for other conditions in children, including actinic prurigo and epidermolysis bullosa; the evidence for these uses is weak. It is recommended only as a third line treatment in graft-versus-host-disease in adults because of lack of efficacy and side effects observed in clinical trials. Contraindications
Thalidomide should not be used by men or women who are trying to father or conceive a child, or who cannot or will not follow the risk management program to prevent pregnancies, or by women who are breastfeeding or pregnant. The prescribing doctor is required to ensure that contraception is being used, and regular pregnancy tests are taken. Those allergic to thalidomide should not take it.
When mothers actively smoke during pregnancy, their child is at a higher risk of being born with a low birth weight. Smoking can also be a stress management tool used by expecting mothers. There is some support for lower socioeconomic status of the parents being a determinant of low birth weight, but there is conflicting evidence, as socioeconomic status is tied to many other factors. Neonatal care
Most babies admitted to the NICU are born before 37 weeks of pregnancy or have low birth weight which is less than 5.5 pounds (2.5 kg). They could also have a medical condition that requires special care. In the United States nearly half a million babies are born preterm. Because of this, many of these babies also have low birth weights. There are four levels of care in the neonatal care units. Intensive Care, High Dependency Care, Low Dependency, and Transitional Care are the four levels:
Intensive Care: For babies with serious problems. This includes babies born three months early and have extremely low birth weight. High Dependency Care: For babies with less serious problem, but who still may not to be looked after or babies that are recovering from a critical illness. Low Dependency Care: For babies that do not need a continuous supervision. Transitional Care: For babies that still need medical treatment, but are well enough to be called for at their mothers bedside.