Which agent is preferred for treating peptic ulcer disease during pregnancy?

• A. Misoprostol
• B. Sucralfate
• C. Metoclopramide
• D. Ranitidine

Answer: (B)

In pregnancy, safety for the fetus is a priority, so choosing a peptic ulcer treatment that minimizes fetal exposure is key. Misoprostol is avoided because it can stimulate uterine contractions and is an abortifacient, making it unsuitable during pregnancy.

Sucralfate works by forming a protective, viscous coating over the ulcer base. It acts locally in the gut and is not significantly absorbed into the bloodstream, so placental transfer to the fetus is minimal. This makes it a safer choice for treating peptic ulcers in pregnant patients compared with agents that have more systemic absorption or contraindications in pregnancy.

Metoclopramide is mainly a prokinetic/antiemetic and not a primary treatment for ulcers. Ranitidine, an H2 blocker, is also considered safe in pregnancy, but sucralfate’s local action and lack of systemic exposure often make it the preferred option when ulcer protection is needed.