Latest & greatest articles for pregnancy

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Top results for pregnancy

61. 17alpha-Hydroxyprogesterone Caproate and the Risk of Glucose Intolerance in Pregnancy: A Systematic Review and Meta-analysis

17alpha-Hydroxyprogesterone Caproate and the Risk of Glucose Intolerance in Pregnancy: A Systematic Review and Meta-analysis To evaluate whether 17α-hydroxyprogesterone caproate use in preventing preterm birth increases the risk of gestational diabetes mellitus (GDM).Electronic databases (MEDLINE, Scopus, ClinicalTrials.gov, PROSPERO, EMBASE, Scielo and the Cochrane Central Register of Controlled Trials) were searched for studies published before October 2018. Keywords included "gestational (...) diabetes," "preterm birth," "pregnancy," and "17-hydroxyprogesterone caproate."Studies comparing 17α-hydroxyprogesterone caproate with unexposed control groups in women with singleton gestation and a history of a prior spontaneous preterm birth were included. The primary outcome was the development of GDM. Secondary outcomes included abnormal 1-hour, 50-g glucose screen results and mean venous blood glucose levels. Summary estimates were reported as mean differences and 95% CI for continuous variables

2019 EvidenceUpdates

62. Pessary Compared With Vaginal Progesterone for the Prevention of Preterm Birth in Women With Twin Pregnancies and Cervical Length Less Than 38 mm: A Randomized Controlled Trial

Pessary Compared With Vaginal Progesterone for the Prevention of Preterm Birth in Women With Twin Pregnancies and Cervical Length Less Than 38 mm: A Randomized Controlled Trial To compare the effectiveness of cervical pessary to vaginal progesterone for the prevention of preterm birth in women with twin pregnancies and short cervix.This randomized controlled trial was conducted at My Duc Hospital, Vietnam. Asymptomatic women with twin pregnancies and cervical length less than 38 mm were (...) outcomes (19% vs 27%; RR 0.70, 95% CI 0.43-0.93). In women with cervical length of 28 mm or less (25th percentile), pessary significantly reduced the preterm birth rate at less than 34 weeks of gestation from 46% (16/35) to 21% (10/47) (RR 0.47, 95% CI 0.24-0.90) and significantly improved the composite of poor perinatal outcomes.Cervical pessary and 400 mg vaginal progesterone resulted in similar rates of preterm birth at less than 34 weeks of gestation in women with twin pregnancies and cervical

2019 EvidenceUpdates

63. Associations between low- and high-dose oral fluconazole and pregnancy outcomes: 3 nested case-control studies

Associations between low- and high-dose oral fluconazole and pregnancy outcomes: 3 nested case-control studies While topical azoles are the first-line treatment for fungal infections, oral fluconazole is frequently used during pregnancy. We aimed to assess the effect of exposure to low and high doses of fluconazole during pregnancy on the occurrence of spontaneous abortions, major congenital malformations and stillbirths.Within the Quebec Pregnancy Cohort (1998-2015), we identified women (...) to analyze the 3 main outcomes separately.Within a cohort of 441 949 pregnancies, 320 868 pregnancies were included in the analyses of spontaneous abortions, 226 599 of major congenital malformations and 7832 of stillbirths. Most (69.5%) women exposed to fluconazole in pregnancy received the common single therapeutic dose of 150 mg (low dose); the remainder received a dose of > 150 mg (high dose). Use of oral fluconazole during early pregnancy was associated with an increased risk of spontaneous abortion

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2019 EvidenceUpdates

64. Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme

Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Valproate medicines and serious harms (...) in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme Ongoing patient survey data suggest that more effort is needed by clinicians to achieve full and timely compliance with the valproate Pregnancy Prevention Programme and meet the goal to rapidly reduce and eventually eliminate the harms of valproate in pregnancy in view of its serious teratogenicity. We have updated the Annual Risk Acknowledgement

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2019 MHRA Drug Safety Update

65. Elvitegravir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1

Elvitegravir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 Elvitegravir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Elvitegravir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1 Pharmacokinetic data (...) indicate exposure of elvitegravir boosted with cobicistat (Genvoya▼, Stribild) is lower during the second and third trimesters of pregnancy than postpartum. Low elvitegravir exposure may be associated with an increased risk of treatment failure and an increased risk of HIV-1 transmission to the unborn child, and therefore elvitegravir/cobicistat should not be used during pregnancy. Published 16 April 2019 From: Therapeutic area: , , Contents Advice for healthcare professionals: pharmacokinetic data

2019 MHRA Drug Safety Update

66. Ectopic pregnancy and miscarriage: diagnosis and initial management

Ectopic pregnancy and miscarriage: diagnosis and initial management Ectopic pregnancy and miscarriage: Ectopic pregnancy and miscarriage: diagnosis and initial management diagnosis and initial management NICE guideline Published: 17 April 2019 nice.org.uk/guidance/ng126 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view (...) in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Ectopic pregnancy and miscarriage: diagnosis and initial management (NG126) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

67. Medicines with teratogenic potential: what is effective contraception and how often is pregnancy testing needed?

Medicines with teratogenic potential: what is effective contraception and how often is pregnancy testing needed? Medicines with teratogenic potential: what is effective contraception and how often is pregnancy testing needed? - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Medicines with teratogenic potential: what is effective contraception and how often is pregnancy testing needed? New guidance on contraceptive methods and frequency of pregnancy testing to reduce inadvertent (...) exposures during pregnancy in a woman taking a medicine of teratogenic potential. Published 21 March 2019 From: Therapeutic area: , , Contents Background Some medicines are known or suspected to have the potential to increase the risk of birth defects and development disorders (teratogenic potential) when taken during pregnancy, especially during the first trimester (up to week 12 of pregnancy), when a woman may not know she is pregnant. The product information for these medicines advise that pregnancy

2019 MHRA Drug Safety Update

68. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. (PubMed)

Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. Intrahepatic cholestasis of pregnancy is associated with adverse perinatal outcomes, but the association with the concentration of specific biochemical markers is unclear. We aimed to quantify the adverse perinatal effects of intrahepatic cholestasis of pregnancy in women with increased serum bile acid concentrations (...) and determine whether elevated bile acid concentrations were associated with the risk of stillbirth and preterm birth.We did a systematic review by searching PubMed, Web of Science, and Embase databases for studies published from database inception to June 1, 2018, reporting perinatal outcomes for women with intrahepatic cholestasis of pregnancy when serum bile acid concentrations were available. Inclusion criteria were studies defining intrahepatic cholestasis of pregnancy based upon pruritus and elevated

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2019 Lancet

69. Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. (PubMed)

Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. Congenital bleeding disorders can cause obstetric haemorrhage during pregnancy, labour and following delivery. Desmopressin acetate (DDAVP) is found to be an effective drug which can reduce the risk of haemorrhage and can also stop bleeding in certain congenital bleeding disorders. Its use in pregnancy has been controversial. Hence beneficial and adverse effects (...) of conferences proceedings. We also searched several clinical trial registries and grey literature (27 August 2017).Date of most recent search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coaguopathies Trials Register: 01 October 2018.Randomised and quasi-randomised controlled trials investigating the efficacy of DDAVP versus tranexamic acid or factor VIII or rFactor VII or fresh frozen plasma in preventing and treating congenital bleeding disorders during pregnancy were eligible.No trials

2019 Cochrane

70. Does Partial Meal Replacement During Pregnancy Reduce 12-Month Postpartum Weight Retention?

Does Partial Meal Replacement During Pregnancy Reduce 12-Month Postpartum Weight Retention? This randomized trial tested whether a behavioral intervention with meal replacements in pregnancy could increase the proportion of women who returned to prepregnancy weight and reduce postpartum weight retention by 12 months after delivery.Women (N = 264; 13.7 weeks' gestation) with overweight or obesity were randomly assigned to usual care or intervention. The intervention reduced excess gestational (...) in the intervention group. Independent of group, lower gestational weight gain was the strongest predictor of achieving prepregnancy weight at 12 months (P = 0.0008).A prenatal behavioral intervention with meal replacements that reduced pregnancy weight gain had no significant effect on 12-month postpartum weight retention.© 2018 The Obesity Society.

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2019 EvidenceUpdates

71. MRI during pregnancy: the pros and cons should be carefully assessed

MRI during pregnancy: the pros and cons should be carefully assessed Prescrire IN ENGLISH - Spotlight ''MRI during pregnancy: the pros and cons should be carefully assessed'', 1 February 2019 {1} {1} {1} | | > > > MRI during pregnancy: the pros and cons should be carefully assessed Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight MRI during (...) pregnancy: the pros and cons should be carefully assessed Before deciding to give a pregnant woman an MRI scan, with or without contrast agents, it is important to consider how the MRI results would change the clinical course. MRI, or magnetic resonance imaging, uses powerful electromagnetic fields that make tissues hot. In a study of 1500 children who had been exposed to MRI (without injection of a contrast agent) in the first trimester of pregnancy, vascular, digestive, musculoskeletal and auditory

2019 Prescrire

72. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period

Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period INTERIM UPDATE ACOGCOMMITTEEOPINION Number 767 (Replaces Committee Opinion Number 692, September 2017) Committee on Obstetric Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice in collaboration with committee members Yasser Y. El-Sayed, MD, and Ann E. Borders, MD, MSc, MPH. INTERIM UPDATE: This Committee Opinion (...) is updated as highlighted to align with the American College of Obstetricians and Gynecologists’ guidance on gestational hypertension, preeclampsia, and chronic hypertension in pregnancy. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period ABSTRACT: Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset

2019 American College of Obstetricians and Gynecologists

73. Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group

Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group - Gastroenterology Email/Username: Password: Remember me Search AGA Journals Search Terms Search within Search To read this article in full, please review your options for gaining (...) access at the bottom of the page. Article in Press Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group x Uma Mahadevan Affiliations University of California, San Francisco, San Francisco, California 1 , x Christopher Robinson Affiliations Bon Secours St Francis and Summerville Medical Center, Charleston, South Carolina 2 , x Nana Bernasko Affiliations Penn State Health, Milton S. Hershey Medical

2019 American Gastroenterological Association Institute

74. HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures

HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures The benefits of human immunodeficiency virus (HIV) testing in pregnancy, when combined with appropriate maternal antiretroviral therapy and intrapartum and postnatal prophylaxis, are well established. The vertical rate of transmission of HIV in North America is now well below 2%. Efforts must continue to ensure that these benefits are sustained. Women who have received little or no prenatal care and those who present (...) for delivery with unknown HIV status need immediate testing. As more infants are exposed to antiretroviral agents, strategies need to be implemented to ensure adequate follow-up of these infants. Issues relating to the identification of HIV-exposed infants are highlighted. Keywords: Human immunodeficiency virus; Infant; Intrapartum transmission; Pregnancy; Screening

2019 Canadian Paediatric Society

75. Efficacy of Regular Exercise During Pregnancy on the Prevention of Postpartum Depression: The PAMELA Randomized Clinical Trial

Efficacy of Regular Exercise During Pregnancy on the Prevention of Postpartum Depression: The PAMELA Randomized Clinical Trial Interventions to reduce postpartum depression have mainly focused on enhancing screening to increase treatment rates among women. Preventive approaches are timely from a population health perspective, particularly in low- and middle-income countries where access to mental health services is limited.To assess the efficacy of regular exercise during pregnancy (...) the intervention group (4.8 [3.7]) and the control group (5.4 [4.1]) (mean difference, -0.6; 95% CI, -1.3 to 0.1). There was also no significant difference in rates of postpartum depression between the intervention group (12 of 192 [6.3%]) and the control group (36 of 387 [9.3%]) (odds ratio, 0.65; 95% CI, 0.33-1.28). Instrumental variable analysis indicated that noncompliance may have attenuated the effect estimates obtained in the primary analysis.Moderate-intensity exercise during pregnancy did not lead

2019 EvidenceUpdates

76. Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy

Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Discover Portal Discover Portal Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Published on 31 October 2017 doi: Giving low dose aspirin to high-risk women reduced their risk of pre-eclampsia before 37 weeks of pregnancy. Preterm pre-eclampsia developed in 1.6% of women given 150mg aspirin daily compared with 4.3% who took (...) a placebo. Pre-eclampsia is a condition which can harm mother and baby. In the mother, it causes high blood pressure and protein in the urine, which can show in pregnancy after 20 weeks. Women with risk factors, such as previous pre-eclampsia, diabetes or high blood pressure, are often prescribed 75mg aspirin from 12 weeks onwards. This study aimed to test double this dose (still classified as a `low dose’) after using a new risk assessment with additional clinical tests to better identify those at high

2019 NIHR Dissemination Centre

77. Imaging is the only way to diagnose blood clots in pregnancy

Imaging is the only way to diagnose blood clots in pregnancy Imaging is the only way to diagnose blood clots in pregnancy Discover Portal Discover Portal Imaging is the only way to diagnose blood clots in pregnancy Published on 13 March 2018 doi: No blood test can accurately tell if a pregnant or recently pregnant woman has a blood clot. All pregnant women with a suspected clot should continue to have imaging investigations as per current UK guidelines. This NIHR-funded study recruited 328 (...) with and without a clot. Share your views on the research. Why was this study needed? Blood clots are the leading cause of death during pregnancy and after giving birth. Between 2012 and 2014 there were 20 maternal deaths due to blood clots in the UK. There are concerns about using CT scans to diagnose pulmonary embolism in pregnant women as only 5% of scans are positive. This could mean that women and their unborn baby are unnecessarily exposed to radiation. A blood test called D-dimer is used to rule out

2019 NIHR Dissemination Centre

78. Treating subclinical thyroid dysfunction in pregnancy probably has no benefit

Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Discover Portal Discover Portal Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Published on 8 August 2017 doi: Testing for and then treating pregnant women with mild or “subclinical” underactive thyroid did not improve pregnancy outcomes, newborn baby outcomes, or the child’s IQ at three to five years (...) . A clearly underactive thyroid (clinical hypothyroidism) in pregnancy has been linked with various adverse outcomes for the mother and baby, including pre-eclampsia, preterm birth, congenital defects and neurodevelopmental delay. This needs treatment. However, there has been debate around the harms and benefits from treating only mildly abnormal blood test results in women who do not show signs of thyroid problems, subclinical hypothyroidism. These two linked trials randomised 1,203 women with borderline

2019 NIHR Dissemination Centre

79. No clear “best” treatment of mild or severe sickness in pregnancy

No clear “best” treatment of mild or severe sickness in pregnancy No clear “best” treatment of mild or severe sickness in pregnancy Discover Portal Discover Portal No clear “best” treatment of mild or severe sickness in pregnancy Published on 3 January 2017 doi: Pregnant women could benefit from simple, cheap, “self-help” remedies for mild nausea and vomiting. Ginger, vitamin B6 and possibly acupressure wrist-bands might relieve symptoms for some women, according to a recent overview (...) range from simple “morning sickness” to the more severe condition of hyperemesis gravidarum. The review gives some evidence on treating pregnant women, but it is limited, especially for more severe symptoms. The authors highlight the need for more robust research to compare treatments with costs and clarify the safety of some drugs. Share your views on the research. Why was this study needed? Up to 85% of women experience nausea and vomiting during pregnancy. Usually, symptoms resolve by about 20

2019 NIHR Dissemination Centre

80. General surgery is mostly safe during pregnancy

General surgery is mostly safe during pregnancy General surgery is mostly safe during pregnancy Discover Portal Discover Portal General surgery is mostly safe during pregnancy Published on 10 January 2017 doi: Routine data from English hospitals show that general surgery during pregnancy, such as removing the appendix or gallbladder, does not commonly harm mother or baby. This suggests that surgery in pregnant women is generally safe, but that mothers could be provided with more specific (...) estimates of the risks. This large observational study assessed the “real world” outcomes of nearly 6.5 million pregnancies at hospitals in England over a 10-year period. Women who had surgery during pregnancy for a condition unrelated to pregnancy were slightly more likely to experience miscarriage, preterm or caesarean delivery or a long stay in hospital. Babies were more also slightly more likely to be low birthweight or stillborn. However, the actual risks of negative outcomes were small

2019 NIHR Dissemination Centre