Latest & greatest articles for pregnancy

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Top results for pregnancy

181. HIV infection in pregnancy

HIV infection in pregnancy HIV infection in pregnancy - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  HIV infection in pregnancy Last reviewed: February 2019 Last updated: December 2018 Important updates 18 Dec 2018 Dolutegravir should not be used during the first trimester of pregnancy The US Department of Health and Human Services has updated its guidance on the management of pregnant women living with HIV (...) infection. The guideline has been revised to include interim recommendations regarding the use of dolutegravir in pregnancy and at the time of conception due to concerns about a possible increased risk of neural tube defects in the fetus. Recommendations Do not use dolutegravir during the first trimester of pregnancy, in non-pregnant women who want to become pregnant or who are trying to conceive, or in women who cannot consistently use effective contraception. Perform a pregnancy test before starting

2018 BMJ Best Practice

182. [Hydroxychloroquine to obtain pregnancy without adverse obstetrical events in primary antiphospholipid syndrome: French phase II multicenter randomized trial, HYDROSAPL]. (Abstract)

[Hydroxychloroquine to obtain pregnancy without adverse obstetrical events in primary antiphospholipid syndrome: French phase II multicenter randomized trial, HYDROSAPL]. Antiphospholipid syndrome is defined by the presence of thrombosis and/or obstetrical adverse events (≥3 recurrent early miscarriage or fetal death or a prematurity<34 weeks of gestation) associated with persistent antiphospholipid antibodies. The pregnancy outcome has been improved by the conventional treatment (aspirin 100mg (...) /day with low molecular weight heparin [LMWH] from 30 to 75% of uncomplicated pregnancies. In PROMISSE study, 19% of pregnancies had at least one obstetrical adverse event despite treatment (maternal, fetal or neonatal complications) in relation with APS. In the European registry of babies born from APS mothers, maternal and foetal adverse events were observed in 13% of cases, with prematurity in 14% despite treatment. The presence of lupus erythematosus, a history of thrombosis, presence of lupus

2018 Gynecologie, obstetrique, fertilite & senologie Controlled trial quality: uncertain

183. Prediction of Severe Maternal Outcome Among Pregnant and Puerperal Women in Obstetric ICU (Abstract)

Prediction of Severe Maternal Outcome Among Pregnant and Puerperal Women in Obstetric ICU World Health Organization recommends the use of maternal near miss as a tool to monitor and improve quality of obstetric care. Severe maternal outcome corresponds to the sum of maternal near miss and maternal death cases. This study was aimed at validating Acute Physiology and Chronic Health Evaluation II and IV, Simplified Acute Physiology Score III, and Sequential Organ Failure Assessment in pregnant

2018 EvidenceUpdates

184. Rubella in Pregnancy

and no proof of immunization against rubella (III-B). 2 Since the effects of rubella infection in pregnancy vary with the gestational age at the time of infection, accurate gestational dating should be established, as well as timing of rubella infection, as they are critical to counselling (II-3A). 3 In a pregnant woman exposed to rubella or who develops signs or symptoms of rubella or whose fetus presents ultrasound anomalies compatible with congenital rubella syndrome, serological testing for rubella (...) (i.e., systemic immunosuppression). Consider delaying vaccination if the woman received any immunoglobulin-containing preparations, including Rh immunoglobulin or intravenous immune globulin, or blood products during pregnancy or the peripartum period, as there is potential for reduced vaccine effectiveness (III-B). 6 Women who have been inadvertently vaccinated in early pregnancy or who become pregnant immediately following vaccination can be reassured that there have been no cases of congenital

2018 Society of Obstetricians and Gynaecologists of Canada

185. Management of Pregnancy Subsequent to Stillbirth Full Text available with Trip Pro

Management of Pregnancy Subsequent to Stillbirth No. 369-Management of Pregnancy Subsequent to Stillbirth - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 40, Issue 12, Pages 1669–1683 No. 369-Management of Pregnancy Subsequent to Stillbirth x Noor Niyar N. Ladhani , MD Toronto, ON x Megan E. Fockler , RN Toronto, ON x Louise Stephens , RM Manchester, UK x Jon F.R. Barrett , MD Toronto, ON x Alexander E.P. Heazell (...) , PhD Manchester, United Kingdom No. 369, December 2018 DOI: To view the full text, please login as a subscribed user or . Click to view the full text on ScienceDirect. Abstract Objective The primary objective of this consensus statement is to develop consensus statements to guide clinical practice and recommendations for antenatal care, intrapartum care, and the psychosocial considerations necessary in the care of pregnant women with a history of stillbirth. Intended users Clinicians involved

2018 Society of Obstetricians and Gynaecologists of Canada

186. Avoid pregnancy during treatment with valproic acid or its derivatives

and France: the recommendation to use valproic acid in girls and pregnant women or women of childbearing age only in the absence of a therapeutic alternative; improved information on the need for effective contraception; initial prescription restricted to paediatricians, neurologists and psychiatrists, with the obligation for both the prescriber and the patient to sign a care agreement informing on the risks in case of pregnancy. Some of these measures are the result of campaigning by APESAC (Association (...) of Parents of Children with Anticonvulsant Syndrome). In mid-2018, these measures were reinforced at the EU level. Valproic acid is now contraindicated in epilepsy in pregnant women, except in exceptional circumstances. It is also contraindicated in women of childbearing age, unless all the conditions of the "pregnancy prevention programme" are met: pregnancy tests before and during treatment, consultation with the prescriber to discuss treatment options when pregnancy is desired. In France, by the end

2018 Prescrire

187. Care of Women with Obesity in Pregnancy

What care should be provided in the primary care setting to women of childbearing age with obesity who wish to become pregnant? Primary care services should ensure that all women of childbearing age have the opportunity to optimise their weight before pregnancy. Advice on weight and lifestyle should be given during preconception counselling or contraceptive consultations. Weight and BMI should be measured to encourage women to optimise their weight before pregnancy. P Women of childbearing age (...) after caesarean (VBAC) section. B What nutritional supplements should be recommended to women with obesity who wish to become pregnant? Women with a BMI 30 kg/m 2 or greater wishing to become pregnant should be advised to take 5 mg folic acid supplementation daily, starting at least 1 month before conception and continuing during the ?rst trimester of pregnancy. D Obese women are at high risk of vitamin D de?ciency. However, although vitamin D supplementation may ensure that women are vitamin D

2018 Royal College of Obstetricians and Gynaecologists

188. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy Full Text available with Trip Pro

American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy Venous thromboembolism (VTE) complicates ∼1.2 of every 1000 deliveries. Despite these low absolute risks, pregnancy-associated VTE is a leading cause of maternal morbidity and mortality.These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and others in decisions about the prevention (...) and management of pregnancy-associated VTE.ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used

2018 Blood advances

189. Effects of dietary nitrate supplementation, from beetroot juice, on blood pressure in hypertensive pregnant women: A randomised, double-blind, placebo-controlled feasibility trial. Full Text available with Trip Pro

Effects of dietary nitrate supplementation, from beetroot juice, on blood pressure in hypertensive pregnant women: A randomised, double-blind, placebo-controlled feasibility trial. Chronic hypertension in pregnancy is associated with significant adverse pregnancy outcomes, increasing the risk of pre-eclampsia, fetal growth restriction and preterm birth. Dietary nitrate, abundant in green leafy vegetables and beetroot, is reduced in vivo to nitrite and subsequently nitric oxide, and has been (...) demonstrated to lower blood pressure, improve vascular compliance and enhance blood flow in non-pregnant humans and animals. The primary aims of this study were to determine the acceptability and efficacy of dietary nitrate supplementation, in the form of beetroot juice, to lower blood pressure in hypertensive pregnant women. In this double-blind, placebo-controlled feasibility trial, 40 pregnant women received either daily nitrate supplementation (70 mL beetroot juice, n = 20) or placebo (70 mL nitrate

2018 Nitric oxide : biology and chemistry Controlled trial quality: predicted high

190. Canadian Guideline for Physical Activity throughout Pregnancy

, and newborn macrosomia have risen dramatically, most likely as a consequence of rising rates of maternal obesity. 17,18 Physical activity has been proposed as a preventative or therapeutic measure to reduce pregnancy complications and optimize maternal- fetalhealth. 19,20 This evidence-based guideline apply to pregnant women and target users including obstetric care providers, policy- makers, and?tness professionals whoprovide guidanceon the impact of prenatal physical activity on maternal, fetal (...) as to identify pregnancy outcomes that were most important to them. During Con- sensus Meeting #1, the Guidelines Consensus Panel selected 37outcomesrelatedtomaternal,fetal,andneonatalhealth, 20 of which were rated as “critical” and 17 as “important” taking into consideration the feedback from pregnant women and the perspective of obstetric care providers based on their expert opinion (see Table 1 for outcomes). The Guidelines Consensus Panel also identi?ed 4 a priori sub- groups of women believed

2018 Society of Obstetricians and Gynaecologists of Canada

191. Diagnostic Biomarkers for Predicting Adverse Early Pregnancy Outcomes Full Text available with Trip Pro

Diagnostic Biomarkers for Predicting Adverse Early Pregnancy Outcomes Diagnostic Biomarkers for Predicting Adverse Early Pregnancy Outcomes - Memtsa - 2019 - BJOG: An International Journal of Obstetrics & Gynaecology - Wiley Online Library By continuing to browse this site, you agree to its use of cookies as described in our . Search within Search term Search term RCOG Scientific Impact Paper Free Access Diagnostic Biomarkers for Predicting Adverse Early Pregnancy Outcomes Scientific Impact (...) the Wiley Online Library Terms and Conditions of Use. Shareable Link Use the link below to share a full-text version of this article with your friends and colleagues. Copy URL Share a link In early pregnancy, the most commonly used biomarkers to predict outcome have been maternal serum human chorionic gonadotrophin (hCG) and progesterone. Transvaginal scanning (TVS) has revolutionised the diagnosis of early pregnancy complications and is now considered the diagnostic test of choice. However, ultrasound

2018 Royal College of Obstetricians and Gynaecologists

192. Early Pregnancy Loss

Early Pregnancy Loss INTERIM UPDATE ACOG PRACTICE BULLETIN Clinical Management Guidelines for Obstetrician–Gynecologists NUMBER 200 (Replaces Practice Bulletin Number 150, May 2015) CommitteeonPracticeBulletins—Gynecology.ThisPracticeBulletinwasdevelopedbytheACOGCommitteeonPractice Bulletins—GynecologyincollaborationwithSarahPrager,MD;VanessaK.Dalton,MD,MPH;andRebeccaH.Allen,MD,MPH. INTERIM UPDATE: This Practice Bulletin is updated as highlighted to reflect recent evidence regarding the use (...) of mife- pristone combined with misoprostol for medical management of early pregnancy loss. This Practice Bulletin also includes limited, focused updates to align with Practice Bulletin No. 181, Prevention of Rh D Alloimmunization. Early Pregnancy Loss Early pregnancy loss, or loss of an intrauterine pregnancy within the first trimester, is encountered commonly in clinical practice. Obstetricians and gynecologists should understand the use of various diagnostic tools to differentiate between viable

2018 American College of Obstetricians and Gynecologists

193. What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? (SRS diagnosis)

What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? (SRS diagnosis) What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? TAKE-HOME MESSAGE Both computed tomography (CT) pulmonary angiography and lung scintigraphy (ie, ventilation-perfusion scan) are appropriate imaging options for exclusion of pulmonary embolism during pregnancy. EBEM Commentators Latha Ganti, MD, MBA David Lebowitz, MD Department of Clinical Sciences University of Central Florida (...) College of Medicine Orlando, FL Jestin N. Carlson, MD, MS, and Alan Jones, MD, serve as editors of the SRS series. Editor’s Note: This is a clinical synopsis, a regular feature of the Annals’ Systematic Review Snapshot (SRS) series. The source for this systematic review snapshot is: van Mens TE, Scheres LJJ, de Jong PG, et al. Imaging for theexclusion of pulmonary embolism in pregnancy. Cochrane Database Syst Rev. 2017;1:CD011053. Results Summary of results for the diagnosis of pulmonary embolism

2018 Annals of Emergency Medicine Systematic Review Snapshots

194. Maternal-fetal transmission and adverse perinatal outcomes in pregnant women infected with Zika virus: prospective cohort study in French Guiana. Full Text available with Trip Pro

Maternal-fetal transmission and adverse perinatal outcomes in pregnant women infected with Zika virus: prospective cohort study in French Guiana. To estimate the rates of maternal-fetal transmission of Zika virus, adverse fetal/neonatal outcomes, and subsequent rates of asymptomatic/symptomatic congenital Zika virus infections up to the first week of life.Cohort study with prospective data collection and subsequent review of fetal/neonatal outcomes.Referral centre for prenatal diagnosis (...) of the French Guiana Western Hospital.Pregnant women at any stage of pregnancy with a laboratory confirmed symptomatic or asymptomatic Zika virus infection during the epidemic period in western French Guiana. The cohort enrolled 300 participants and prospectively followed their 305 fetuses/newborns.Rate of maternal-fetal transmission of Zika virus (amniotic fluid, fetal and neonatal blood, urine, cerebrospinal fluid, and placentas); clinical, biological, and radiological outcomes (blindly reviewed

2018 BMJ

195. Ectopic pregnancy

Ectopic pregnancy Ectopic pregnancy - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ectopic pregnancy Last reviewed: February 2019 Last updated: October 2018 Summary Typically presents 6-8 weeks after last normal menstrual period, but can present earlier or later. Risk increases with prior ectopic pregnancy, tubal surgery, history of sexually transmitted infections, smoking, in vitro fertilisation, or if pregnant (...) of referred pain from intraperitoneal blood. Definition A fertilised ovum implanting and maturing outside of the uterine endometrial cavity, with the most common site being the fallopian tube (97%), followed by the ovary (3.2%) and the abdomen (1.3%). Bouyer J, Coste J, Fernandez H, et al. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod. 2002 Dec;17(12):3224-30. http://humrep.oxfordjournals.org/content/17/12/3224.full http://www.ncbi.nlm.nih.gov/pubmed/12456628?tool

2018 BMJ Best Practice

196. Diagnosis of Pulmonary Embolism During Pregnancy: A Multicenter Prospective Management Outcome Study. (Abstract)

Diagnosis of Pulmonary Embolism During Pregnancy: A Multicenter Prospective Management Outcome Study. Data on the optimal diagnostic management of pregnant women with suspected pulmonary embolism (PE) are limited, and guidelines provide inconsistent recommendations on use of diagnostic tests.To prospectively validate a diagnostic strategy in pregnant women with suspected PE.Multicenter, multinational, prospective diagnostic management outcome study involving pretest clinical probability (...) assessment, high-sensitivity D-dimer testing, bilateral lower limb compression ultrasonography (CUS), and computed tomography pulmonary angiography (CTPA). (ClinicalTrials.gov: NCT00740454).11 centers in France and Switzerland between August 2008 and July 2016.Pregnant women with clinically suspected PE in emergency departments.Pulmonary embolism was excluded in patients with a low or intermediate pretest clinical probability and a negative D-dimer result. All others underwent lower limb CUS

2018 Annals of Internal Medicine

197. Determinants of disclosure and non-disclosure of HIV-positive status, by pregnant women in rural South Africa Full Text available with Trip Pro

Determinants of disclosure and non-disclosure of HIV-positive status, by pregnant women in rural South Africa Disclosure of HIV status remains one of the major challenges to the effectiveness of the prevention of mother to child transmission of HIV in rural areas in South Africa. This study aimed at assessing the determinants of HIV status disclosure among HIV infected pregnant women who have disclosed their HIV status to someone, as well as among those who have disclosed to their partners (...) . Cross-sectional data was collected from 673 HIV sero-positive pregnant women receiving antenatal care services at 12 Community Health Centers in Mpumalanga province. Results indicated that over two-thirds (72.1%) disclosed their status to someone, while just over half (58.4%) disclosed to their partners. Multivariate analysis showed that both disclosure of ones HIV status to someone and to their male partners was significantly associated with increase in antiretroviral therapy (ART) adherence

2018 SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance

198. β-Blocker Use in Pregnancy and the Risk for Congenital Malformations: An International Cohort Study. Full Text available with Trip Pro

β-Blocker Use in Pregnancy and the Risk for Congenital Malformations: An International Cohort Study. β-Blockers are a class of antihypertensive medications that are commonly used in pregnancy.To estimate the risks for major congenital malformations associated with first-trimester exposure to β-blockers.Cohort study.Health registries in the 5 Nordic countries and the U.S. Medicaid database.Pregnant women with a diagnosis of hypertension and their offspring.First-trimester exposure to β-blockers (...) was assessed. Outcomes were any major congenital malformation, cardiac malformations, cleft lip or palate, and central nervous system (CNS) malformations. Propensity score stratification was used to control for potential confounders.Of 3577 women with hypertensive pregnancies in the Nordic cohort and 14 900 in the U.S. cohort, 682 (19.1%) and 1668 (11.2%), respectively, were exposed to β-blockers in the first trimester. The pooled adjusted relative risk (RR) and risk difference per 1000 persons exposed

2018 Annals of Internal Medicine

199. Mapping the landscape of global programmes to evaluate health interventions in pregnancy: the need for harmonised approaches, standards and tools Full Text available with Trip Pro

Mapping the landscape of global programmes to evaluate health interventions in pregnancy: the need for harmonised approaches, standards and tools Pregnant women and their babies are among the populations most vulnerable to untoward health outcomes. Yet current standards for evaluating health interventions cannot be met during pregnancy because of lack of adequate evidence. The situation is even more concerning in low-income and middle-income countries, where the need for effective interventions (...) . Stronger coordination mechanisms and a roadmap to support harmonised monitoring of maternal interventions across programmes and partners, working on improving pregnancy and early childhood health events, will greatly enhance ability to generate evidence-based policies.

2018 BMJ global health

200. Early clindamycin for bacterial vaginosis in pregnancy (PREMEVA): a multicentre, double-blind, randomised controlled trial. (Abstract)

Early clindamycin for bacterial vaginosis in pregnancy (PREMEVA): a multicentre, double-blind, randomised controlled trial. Preterm delivery during pregnancy (<37 weeks' gestation) is a leading cause of perinatal mortality and morbidity. Treating bacterial vaginosis during pregnancy can reduce poor outcomes, such as preterm birth. We aimed to investigate whether treatment of bacterial vaginosis decreases late miscarriages or spontaneous very preterm birth.PREMEVA was a double-blind randomised (...) controlled trial done in 40 French centres. Women aged 18 years or older with bacterial vaginosis and low-risk pregnancy were eligible for inclusion and were randomly assigned (2:1) to three parallel groups: single-course or triple-course 300 mg clindamycin twice-daily for 4 days, or placebo. Women with high-risk pregnancy outcomes were eligible for inclusion in a high-risk subtrial and were randomly assigned (1:1) to either single-course or triple-course clindamycin. The primary outcome was a composite

2018 Lancet Controlled trial quality: predicted high