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To address provider struggles to provide evidence‐based, rational drug therapy to pregnant women, this third Conference was convened to highlight the current progress and research in the field. Speakers from academic centers, industry, and governmental institutions spoke about: the Food and Drug Administration’s role in pregnancy pharmacology and the new labeling initiative; drug registries in pregnancy; the pharmacist’s role in medication use in pregnancy; therapeutic areas such as preterm labor, gestational diabetes, nausea and vomiting in pregnancy, and hypertension; breast‐feeding and medications; ethical challenges for consent in pregnancy drug studies; the potential for cord blood banks; and concerns about the fetus when studying drugs in pregnancy. The Conference highlighted several areas of collaboration within the current Obstetrics Pharmacology Research Units Network and hoped to educate providers, researchers, and agencies with the common goal to improve the ability to safely and effectively use individualized pharmacotherapy in pregnancy. Clin Trans Sci 2011; Volume 4: 204–209

It has been almost 50 years since the first child was born to a female transplant recipient. Since that time pregnancy has become common after transplantation, but physicians have been left to rely on case reports, small series and data from voluntary registries to guide the care of their patients. Many uncertainties exist including the risks that pregnancy presents to the graft, the patient herself, and the long-term risks to the fetus. It is also unclear how to best modify immunosuppressive agents or treat rejection during pregnancy, especially in light of newer agents available where pregnancy safety has not been established. To begin to address uncertainties and define clinical practice guidelines for the transplant physician and obstetrical caregivers, a consensus conference was held in Bethesda, Md. The conferees summarized both what is known and important gaps in our knowledge. They also identified key areas of agreement, and posed a number of critical questions, the resolution of which is necessary in order to establish evidence-based guidelines. The manuscript summarizes the deliberations and conclusions of the conference as well as specific recommendations based on current knowledge in the field.

Objectives: Our objectives were to describe the maternal and fetal hemodynamic impact of a 1 U acute blood loss during pregnancy and to compare the hemodynamic responses of pregnant women with those of nonpregnant controls. Study Design: With Doppler techniques cardiac output and total peripheral vascular resistance were determined in 16 pregnant women in the third trimester and in 16 nonpregnant volunteers before and during orthostatic stress, before and after donation of 450 ml of whole blood. In pregnant women the fetal umbilical artery systolic/diastolic ratio was also determined. Data were subjected to multiple logistic regression analysis. Results: In both groups orthostasis provoked significant decreases in cardiac output and increases in total peripheral vascular resistance. The hemodynamic effects of blood loss were less pronounced and did not significantly change the hemodynamic response to orthostasis in either group. Neither orthostasis nor blood loss caused significant changes in the umbilical systolic/diastolic ratio. Conclusion: These data support the hemodynamic safety of uncomplicated autologous blood donation during late pregnancy.