Ghia et al, IJPSR, 2014; Vol. 5(11): 4948-4952.

E-ISSN: 0975-8232; P-ISSN: 2320-5148

IJPSR (2014), Vol. 5, Issue 11 (Research Article)

Received on 10 April, 2014; received in revised form, 05 June, 2014; accepted, 13 July, 2014; published 01 November, 2014

DRUG PRESCRIBING PATTERNS DURING ANTENATAL CARE IN A TERTIARY CARE

RURAL TEACHING HOSPITAL: A CROSS-SECTIONAL STUDY
C. J. Ghia *1, S. Gajbhiye 2, L. Khobragade 3, J. K. Ved 4 and G. S. Rambhad 5

MD., Medical Advisor, Pfizer India Limited. Past: Tutor, Department of Pharmacology 1, MD., Assistant
Professor, Department of Obstetrics and Gynaecology 2, MD., Assistant Professor, Department of
Pharmacology 3 Jawaharlal Nehru Medical College, Wardha 442004.
MD. PGDMM, Senior Medical Advisor 4, Pfizer India Limited. C-611; National Park View 2 (CHS);
Raheja Estate; Kulupwadi; Borivali East; Mumbai; 400066.
MD., Associate Director Medical Services 5, Wyeth Limited India (A subsidiary of Pfizer Inc.) A-102,
Raas, Vasant Utsav, Thakur Village, Kandivali East, Mumbai 400 101.

Keywords: ABSTRACT: Context: Drug treatment during pregnancy presents a special

concern. All drugs should not be avoided. A better knowledge of parameters that
Antenatal, Prescription pattern, determine teratogenicity may allow the physicians gain confidence. Aims: This
Drug utilization, Pregnancy study was conducted to understand the drug utilization practices during pregnancy in
women from rural areas and poor socioeconomic background; classify them
Correspondence to Author: according to US-FDA category for determining the teratogenic potential; to provide
Canna Jagdish Ghia feedback and recommendations to the health care providers. Settings and Design:
Medical Advisor, Pfizer India This was a retrospective cross-sectional study carried out at rural tertiary hospital.
Limited. 501, Krishna Kuni, 6th Road, Methods and Material: Case record forms of 300 patients admitted to the obstetrics
Santacruz East, Mumbai 400055, ward from September to November 2009 were analyzed for demographic details,
India. drug prescriptions and drug utilization patterns. The teratogenic potential of drugs
E-mail: [email protected] was analyzed according to US-FDA risk categories for drugs and medication.
Statistical analysis used: Statistical software SPSS was used for analysis. Results:
Maximum prescriptions happened in the second trimester of pregnancy. Vitamins,
mineral and nutritional supplements were prescribed in almost 100% cases. The
patients receiving more than 3 drugs had co-morbidity. Though 100% cases had
frequency of medications written, dose and duration was written in less than 50%.
Fixed Dose Combination commonly prescribed was iron & folic acid supplement.
Drugs from Category A-D were prescribed depending on the clinical condition of the
patients. Antibacterials and antacids were the most commonly prescribed (25%)
followed by antihistaminics (17%) and antiallergics (11%). Conclusions: Careful
prescription behaviour to the pregnant women under antenatal care visiting a tertiary
care rural hospital was noted.

INTRODUCTION: Drug treatment during The major reasons being, physiologic adjustments
pregnancy presents a special concern. in the mother and the threat of potential teratogenic
QUICK RESPONSE CODE effects of the drugs.1 However, the
DOI:
10.13040/IJPSR.0975-8232.5(11).4948-52 recommendation to avoid all drugs during early
pregnancy is unrealistic and may be dangerous. 2, 3
Prescribing drugs in pregnancy is an unusual risk-
Article can be accessed online on:
www.ijpsr.com benefit situation. Rational drug prescribing
practices, reducing medication errors, and
DOI link: http://dx.doi.org/10.13040/IJPSR.0975-8232.5(11).4948-52 improving patient safety are the important areas as

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Ghia et al, IJPSR, 2014; Vol. 5(11): 4948-4952. E-ISSN: 0975-8232; P-ISSN: 2320-5148
in addition to the mother, the health and life of her knowledge about deleterious consequences for the
unborn child is also equally important.4 It is felt fetus, prescription drug use by pregnant women
that a better knowledge of the parameters that should be viewed as a public health issue.8 Drug
determine teratogenicity may allow the physicians utilization studies can help in minimizing the
to feel more confident in assessing the risks and inherent risk of drug use in pregnancy, by
benefits associated with drug prescribing in establishing a profile of the safety and efficacy of
pregnancy.5 Experts in different countries have set drug consumption.9 With this background, the
up risk classification systems based on data from following study was conducted to understand the
human and animal studies to help physicians patterns of drug utilization during pregnancy in
interpret the risk associated with drugs women from rural areas and poor socioeconomic
administered during pregnancy. The most well background.
known classification was introduced by the US
Food and Drug Administration (FDA) in 1979, Objectives
using the letters A, B, C, D and X for five This study was conducted to understand the drug
categories.6 utilization practices (prescribing trends and
pharmacological class wise drug consumption) in
US-FDA Risk categories for drugs and
antenatal practice in the rural tertiary health care set
medications
Category A Adequate clinical studies have shown no risk up; to classify drugs prescribed during antenatal
to fetus in any trimester care according to the US-FDA category for
Category B Animal studies have not shown adverse effect determining the teratogenic potential; and to
on the fetus and there are inadequate clinical provide feedback and recommendations for the
studies health care providers with this information
Category C Animal studies have shown adverse effects,
no adequate clinical studies. May be useful in
pregnancy despite potential risks MATERIALS AND METHODS:
Category D There is evidence of risk to human fetus, but This was a retrospective cross-sectional study
potential benefits may be acceptable despite carried out at Acharya Vinoba Bhave Rural
potential risks (e.g. in a life-threatening Hospital, Wardha, Maharashtra. Case record forms
situation).
Category X Animal/human studies show foetal of 300 patients admitted to the obstetrics ward from
abnormalities. Risks involved clearly September 2009 to November 2009 were analyzed.
outweigh benefits. Contraindicated in women 100 patients each from the first, second and third
who are or may be pregnant trimester compromised this sample size of 300. The
study was approved by the Ethics Committee of the
In common practice, drugs do get prescribed during hospital.
pregnancy, more so if mother is suffering from has
a medical condition but there can be situations The data collected included the demographic
when the prescribing physician may not be sure of details of the patients (age, address, occupation);
the teratogenic potential of the medicine. socioeconomic status including the total monthly
family income; and detailed medical history. We
It is usually from the first trimester that a pregnant calculated monthly per capita income of the family
woman starts visiting the doctor and drug for individual patient, socio-economic class of the
prescriptions can happen. In a country like ours, patient using updated BG Prasad’s classification for
there can be a vast difference in the prescription socioeconomic status linked with the All India
patterns in cities and rural areas. e.g. doctors Consumer Price Index10 as shown in the following
practising in tertiary care rural set up have to cater data.
to hundreds of women visiting for antenatal check Monthly Per Capita Income
up, who could be semi-literate or illiterate and may Class
Original (1961) As per February 2010 ( )
not understand the significance of prescribed I 100 and above 3147 and above
medications. Poverty, disparities in access to II 50 to 99 1558 to 3146
health-care, and not so developed drug distribution III 30 to 49 923 to 1557
networks, may create additional issues for rural IV 15 to 29 478 to 922
communities.7 Since there exist numerous gaps in V Less than 15 477 and below

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Ghia et al, IJPSR, 2014; Vol. 5(11): 4948-4952. E-ISSN: 0975-8232; P-ISSN: 2320-5148
The drugs prescriptions (number, frequency, dose,
route, duration, whether generic or brand name)
were analyzed. Further the drugs were classified
according to the pharmacological class and their
teratogenic potential according to USFDA risk
categories for drugs and medication. 6 After
completing the basic data collection, the medical
records were analyzed for assessment of the drug
utilization. Statistical analysis was done by using
the statistical software SPSS.

The results are expressed as Mean + SD. Data is

presented descriptively.
FIGURE 1: SOCIO-ECONOMIC STATUS OF THE
RESULTS: PATIENTS MONTHLY PER CAPITA INCOME IN RS.
Total 300 case records of patients admitted to the
obstetrics ward were analyzed. The average age of The average number of drugs given to the patients
patients was 25.37 ± 5.75 years. Table 1 shows the is represented in Table 3.
distribution of patients in different age groups. As TABLE 3: AVERAGE NUMBER OF DRUGS
is evident 281/300 (93.66%) patients were in the PRESCRIBED
age group of 18 to 35 years. Trimester Average number of drugs
(n=100 in each group) (Mean + S.D.)
TABLE 1: DEMOGRAPHIC CHARACTERISTICS First 2.3 ± 1.6
No Age in Years No. of patients Percentage (%)
Second 3.3 ± 1.1
1 < 18 08 2.67 Third 2.9 ± 1.8
2 18-35 281 93.67 It was seen that maximum drug prescriptions
3 > 35 11 3.66 happened in the second trimester of pregnancy.
Vitamins, mineral and nutritional supplements were
prescribed in almost 100% cases. As these were
The socio-economic determinants of the study
antenatal cases they mandatorily received iron and
population are depicted in Table 2. Though the
folic acid, calcium supplement and protein
percentage of non-earning females is high (74%);
supplement in the form of powder. The patients
many females quit their jobs as a result of
receiving more than 3 drugs were having co-
pregnancy. Around 25% patients were working
morbid conditions. The analysis for completeness
women. Figure 1 shows the patient distribution as
of prescriptions is shown in Figure 2.
per the updated BG Prasad’s classification for
socioeconomic status. More than 60% patients had
their monthly per capita income in the range of
478 to 1557.
TABLE 2: SOCIO-ECONOMIC DETERMINANTS OF
THE STUDY POPULATION
Occupation No. on Percentage (%)
patients
Homemaker 222 74
Farmer 45 15
Service 18 6
Labourer 12 4
Student 03 1 FIGURE 2: FORMAT ADEQUACY OF
PRESCRIPTIONS

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Ghia et al, IJPSR, 2014; Vol. 5(11): 4948-4952. E-ISSN: 0975-8232; P-ISSN: 2320-5148
Though frequency of medications written was in ANTACIDS
100% prescriptions, it was noted that the other Ranitidine B
Pantaprazole B
details (dose as well as duration) was written in less ANTIHISTAMINICS
than 50% of the prescriptions. Further it was Cetrizine B
noticed that generic drug prescribing was very low Chlorpheneramine B
(2.3%) and constituted drugs like cabergoline, ANALGESICS
clomiphene citrate, tetanus toxoid and folic acid. Paracetamol B
Diclofenac B/D
Ibuprofen B/D
The most common Fixed Dose Combination ANTIEMETICS
prescribed was iron & folic acid supplement (Table Ondanseterone B
4). The essential combinations used were iron & Domperidone C
folic acid and magnesium & aluminium hydroxides Promethazine C
Prochlorperazine C
according to WHO and National list of Essential HORMONAL AGENTS
medicines. HCG D
TABLE 4: ANALYSIS OF FIXED DRUG Micronised Progesterone D
COMBINATIONS PRESCRIBED Didrogesterone D
No. Contents Frequency Essentiality CORTICOSTEROIDS
Dexamethasone C
1 Iron + Folic acid 92 Essential
Betamethasone C
Doxyllamine + Non-
2 06 ANTICONVULSANTS
Pyridoxine essential
Magnesium sulphate B
Magnesium hydroxide
Diazepam D
3 + Alluminium 02 Essential
ANTIASTHMATICS
hydroxide
B
Serratio peptidase + Non-
4 01 (Nebulisation only)
Diclofenac essential
Terbutaline
Pantoprazole + Non-
5 01 TOCOLYTICS
Domperidone essential
Isoxuprine C
Non-
6 Folic acid + Vit C 01 ANTIHYPERTENSIVES
essential
α- methyl dopa B
Dicyclomine + Non-
7 01 Nifedipine C
Mephenamic acid essential
Amlodipine C
ANTICHOLINERGICS
Table 5 lists all the drugs prescribed and their Scopolamine C
classification as per their ability to cause ANTIDIABETICS
teratogenicity. It can be seen that varied drugs Insulin B
ANTIPLATELET
(Category A to D) were prescribed depending on
Aspirin C/D
the clinical condition of the patients and most of DIURETICS
these were in the category B to C. Chlorthiazide C/D
ANTHELMENTHICS C
TABLE 5: DRUGS PRESCRIBED AS PER THE US- Mebendazole
FDA RISK CATEGORY ANTIFUNGAL
Fluconazole C
Pharmacological Class Drug category
THYROID
(US-FDA )
Levothyroxine A
VITAMINS
Propylthiouracil D
Vitamin C A/C
Vitamin B complex A/C
Folic Acid A/C The percentage of drugs prescribed in patients
ANTIBACTERIAL demonstrating physiological changes in pregnancy
Ciprofloxacin C according to pharmacological class is depicted in
Amoxycillin B Figure 3. It was seen that antibacterials and
Ampicillin+cloxacillin B
Metronidazole B
antacids were the most commonly prescribed
Cephalosporins B (25%) followed by antihistaminics (17%) and
Cotrimaxazole B antiallergics (11%
Clindamycin B

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FIGURE 3: PERCENTAGE OF DRUGS PRESCRIBED FIGURE 5: PERCENTAGE OF DRUGS PRESCRIBED

IN PATIENTS DEMONSTRATING PHYSIOLOGICAL IN PATIENTS WITH CO-MORBID CONDITIONS IN
CHANGES IN PREGNANCY PREGNANCY

The comparative analysis in the 3 trimesters The comparative analysis in the 3 trimesters
(Figure 4) showed that for antibacterials, antacids, (Figure 6) showed that for hormonal agents,
antihistaminics and analgesics. It was seen that corticosteroids and tocolytics. Maximum
maximum prescriptions happened in the 2nd nd
prescriptions happened in the 2 trimester of
trimester of pregnancy. pregnancy, whereas diuretics were equally
prescribed in 2nd and 3rd trimester of pregnancy

FIGURE 4: COMPARATIVE ANALYSIS OF

PRESCRIPTIONS IN FIRST, SECOND AND THIRD FIGURE 6: COMPARATIVE ANALYSIS OF
TRIMESTER IN PATIENTS DEMONSTRATING PRESCRIPTIONS IN FIRST, SECOND AND THIRD
PHYSIOLOGICAL CHANGES IN PREGNANCY TRIMESTER IN PATIENTS WITH CO-MORBID
CONDITIONS IN PREGNANCY
The percentage of drugs prescribed in patients with
co-morbid conditions in pregnancy according to DISCUSSION: Careful consideration of the
pharmacological class is illustrated in Figure 5. benefit to the mother and risk to the fetus has to be
The overall drug prescription was negligible with given when drugs are prescribed during
antihypertensives prescribed in only 2% patients pregnancy.11 The thalidomide tragedy in the 1960s
followed by anticholinergics in 1%. The rest of the and the teratogenicity with diethylstilboestrol in
drugs (antiasthmatics, antidiabetics, antiplatelets, 1971 had raised concerns, which led US-FDA to
etc) were prescribed in less than 1% of the patient establish strict regulations regarding the use of
population. medications in pregnancy, requiring

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Ghia et al, IJPSR, 2014; Vol. 5(11): 4948-4952. E-ISSN: 0975-8232; P-ISSN: 2320-5148
demonstrations on safety and efficacy of drugs multivitamins (27%) were the most frequently
before they became commercially available. 11 consumed drugs by pregnant women.17

Pregnancy requires a special care. The present A large proportion of women surveyed had anemia
study helped us understand the drug utilization in pregnancy. This was the main reason why iron
practices in antenatal practice in the rural tertiary and folic acid combination was prescribed to a
health care set up. It made us aware of the attitudes majority of patients. Anemia was also a reason for
and the factors influencing physician behavior admission in all the three trimesters. The poor
which can be used for developing rational drug socio-economic status may be responsible for the
policies in rural areas. Supplementary drug poor nutritional status of the pregnant females. This
treatment, that include iron, folic acid, calcium, population may not have a proper meal and also
vitamins and minerals, plays a pivotal role in the find it difficult to purchase nutritional supplements.
prevention of maternal and child mortality and Efforts should be taken to improve the nutrition of
morbidity.11 In our study, majority of drugs used women in child bearing age as a primordial
during pregnancy belonged to US-FDA category A, prevention. Detection of anaemia at an early stage
such as vitamins and mineral supplements. This can avoid the risks associated with blood
was followed by category B drugs antibacterials, transfusion during pregnancy.
antacids, antihistaminics and analgesics
(paracetamol). Category A drugs were used A noticeable fact was that maximum drug
throughout the pregnancy, while Category B drugs prescription (3.3 + 1.1) happened in the second
were used more in the last two trimesters for trimester of pregnancy. This was attributable to co-
pregnancy associated complications. Drugs from morbid conditions patients were suffering. On this
Category X were not prescribed in the samples basis we can say that drug prescription in our set up
analyzed. was rational. While the frequency of medications
written was noticeable in 100% of patients, an area
These results varied when compared to other of concern was that other details like dose and
studies. A study done by Sharma R et al in North duration of therapy was mentioned in <50% of
India reported that category-A drugs were patients. Considering the importance of
commonly used followed by category-B and documenting these facts as well as the lower
category-D12. In a study done by Andrade SE et al, literacy rates amongst the patients in our study, we
it was seen that 5.8% of women were prescribed feel, physicians should inculcate the habit of
teratogenic drugs (US-FDA category D or X writing correct prescriptions.
drugs)13, whereas Tisonova J et al reported that
drugs from Category C were prescribed the most in A large percentage of patients visiting our hospital
their practice.14 Similarly, a study conducted in came from poor socio-economic background. Their
Pakistan regarding the drug-prescribing patterns purchasing power for branded drugs was limited.
during pregnancy documented that <1% of women Hence, in practice, if generic drugs are prescribed,
were prescribed teratogenic drugs.15 the cost of the treatment can be reduced.

In our study, iron plus folic-acid (fixed dose Judicious use of drugs, adequate knowledge,
combinations) were the most commonly used drugs positive approach and awareness towards rational
in pregnancy, with a frequency of 92 (Table 4). drug use are mandatory prerequisites for good
The trend noticed was similar to that reported from maternal and child health.
different parts of the world. In a prospective survey Pharmacoepidemiological studies can help in
in Southwest Finland, iron and vitamin minimizing the inherent risk of drug use in
supplementation were the most frequently used pregnancy, by establishing a profile of drug
drugs, followed by analgesics, tocolytic agents and consumption, by evaluating the existing health
drugs for chronic conditions and common services and by investigating the interventional
pregnancy symptoms.16 In another study from measures.8 But few such studies on drug audits
Australia, folate (70%), iron (38%) and during pregnancy have been conducted in India.

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Ghia et al, IJPSR, 2014; Vol. 5(11): 4948-4952. E-ISSN: 0975-8232; P-ISSN: 2320-5148
So, it becomes important to examine the pattern of ACKNOWLEDGEMENT: Special thanks to Mr.
drug utilization in pregnancy, to check as to up to Disheet Shah, Research Fellow, University of
what extent there may be a room for improvement Nottingham, United Kingdom towards his
in the light of current knowledge.11 There is a need significant and valuable contribution towards this
to educate and counsel women of child-bearing age article in terms of help with the data management.
regarding advantages and disadvantages of drug
use during pregnancies.17 Even the doctors need to REFERENCES:
be trained to give rational treatment to the pregnant 1. Reddy BS, Patil NR, Hinchageri S, Swarna kamala S. Assessing the
women, by including community pharmacology pattern of drug use among pregnant women and evaluating the
impact of counselling on medication adherence among them.
studies in their academic curriculum International Research Journal of Pharmacy 2011; 2(8): 148-153.
2. Negasa M, Tigabu BM. Drug prescribing pattern among pregnant
mothers attending obstetrics and gynecology department in Hiwot
Our study had the following limitations. Since it Fana Specialized Teaching Hospital, Ethiopia. Archives of
Pharmacy 2014; 5(2): 78-83
was a cross sectional study, we were unable to 3. Sachdeva P, Patel BG, Patel BK. Drug use in pregnancy: A point to
determine the effects of drugs on pregnancy ponder. Indian J Pharm Sci. 2009; 71:1-7.
4. Benjamin DM. Reducing medication errors and increasing patient
outcomes. Further we were unable to study the safety: case studies in clinical pharmacology. J. Clin Pharmacol.
effect of factors like history of chronic diseases, 2003; 43: 768-783.
5. Buhimschi CS, Weiner CP. Medications in pregnancy and lactation:
bad obstetric history and parity on the pattern of the part 1. Teratology. Obstet Gynecol. 2009; 113(1): 166-88.
drug use. In India most pregnancies are unplanned 6. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and
lactation. 5th ed. Baltimore L Wilkins and Wilkin, 1998.
and chances are, pregnant women may be taking 7. Chomat AM, Solomons MW, Montenegro G, Burmudez OI.
drugs before they know are pregnant and also they Maternal health and health seeking behaviours among indigenous
Mam mothers from Quetzaltenango Guatemela. Rev \. Panam Salud
may be having little knowledge on the drugs Publica. 2014; 35(2): 113-20.
consumed18. Our study was done in rural tertiary 8. De Jong-van den Berg LT, Berg PB, Van den, Haaijer-Ruskamp
FM, Dukes MNm Wesseling H: Investigating drug use in
care set up; however, conditions could be worse in pregnancy. Methodical problems and perspectives. Pharm Weekbl
the remote corners of India. Such studies in diverse Sci. 1991; 13: 32-38.
9. Inamdar IF, Aswar NR, Sonkar VK, Doibale MK. Drug utilization
environmental, social, educational and cultural pattern during pregnancy. Indian Medical Gazette 2012; Aug: 305-
conditions should be carried out periodically. These 311.
10. Joseph C, Gfroerer BA, Larson SL, and Colliver JD. Drug use
will aid in providing directions to rational drug patterns and trends in rural communities. The Journal of Rural
usage in the community. Health. 2007; 23(s1): 10-15.
11. 11.Kureshee NI, Dhande PP. Awareness of Mothers and Doctors
about Drug Utilization Pattern for Illnesses Encountered during
CONCLUSION: Our study revealed a careful Pregnancy. J. Clin. Diagn. Res. 2013; 7(11): 2470-2474.
12. Sharma R, Kapoor B, Verma U. Drug utilization pattern during
prescribing behaviour by the physicians to the pregnancy in North India. Ind J Med Sci. 2006; 60: 277-87.
pregnant women under antenatal care visiting a 13. Andrade SE, Raebel MA, Morse AN, et all. Use of prescription
medications with a potential for fetal harm among pregnant women.
tertiary care rural hospital. We can conclude that it Pharmacoepidemiol Drug Saf. 2006, 15: 546-54.
is strongly recommended that the habit of 14. Tisonova J, Magulova L, Goboova M, Wawruch M, Lassanova M,
Bozekova L, et al. Consultation activity of two Slovak centres for
prescription of drugs by generic names should be pharmacotherapy during pregnancy and lactation. Cas Lek Cesk.
inculcated amongst the prescribers. Awareness of 2006; 145: 154-59.
15. Rohra D, Das N, Azam S, et al. Drug prescribing patterns during
low cost prescribing practices should be initiated pregnancy in the tertiary care hospitals in Pakistan: a cross sectional
among prescribers because a large percentage of study. BMC pregnancy and childbirth. 2008; 8: 24.
16. Heikkila AM, Erkkola RU, Nummi SE. Use of medication during
patients visiting this hospital are from poor socio- pregnancy- A prospective cohort study on use and policy of
economic background. A further cost analysis prescribing. Ann Chir Gynaecol Suppl. 1994; 208:80-3.
17. Maats FH, Crowther CA. Patterns of vitamin, mineral and herbal
study should be undertaken to determine if the cost supplement use prior to and during pregnancy. Aust N Z J Obstet
per day is affordable to patients. Gynaecol. 2002; 42:494-6.
18. Adhikari A, Biswas S, Gupta RK. Drug utilization pattern in
pregnant women in rural areas, India: cross-sectional observational
study. J Obstet Gynaecol Res. 2011; 37(12): 1813-7.

How to cite this article:

Ghia CJ, Gajbhiye S, Khobragade L, Ved JK and Rambhad GS: Drug Prescribing Patterns during Antenatal Care in a Tertiary Care Rural
Teaching Hospital: A Cross-Sectional Study. Int J Pharm Sci Res 2014; 5(11): 4948-52.doi: 10.13040/IJPSR.0975-8232.5 (11).4948-52.

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