Latest & greatest articles for pregnancy

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Top results for pregnancy

121. Immune Modulating Therapies in Pregnancy and Lactation

to counsel women with autoimmune disease who are pregnant or contemplating pregnancy (2, ). Prepregnancy Considerations: Congenital Malformations and Pregnancy Complications Many commonly prescribed drugs can be used safely during pregnancy without risk of teratogenicity or pregnancy complications, whereas a few are strictly contraindicated. Still others have not been sufficiently studied during pregnancy. The decision to use any agent during pregnancy should be based on the clinical context, risks (...) after first trimester exposure to corticosteroids: a prospective controlled study. Reprod Toxicol 2004;18:93–101. Carmichael SL, Shaw GM, Ma C, Werler MM, Rasmussen SA, Lammer EJ. Maternal corticosteroid use and orofacial clefts. National Birth Defects Prevention Study. Am J Obstet Gynecol 2007;197:585.e1–7; discussion 683–4, e1–7. Viktil KK, Engeland A, Furu K. Outcomes after anti-rheumatic drug use before and during pregnancy: a cohort study among 150,000 pregnant women and expectant fathers

2019 American College of Obstetricians and Gynecologists

122. Use of metformin to treat pregnant women with polycystic ovary syndrome (PregMet2): a randomised, double-blind, placebo-controlled trial Full Text available with Trip Pro

Use of metformin to treat pregnant women with polycystic ovary syndrome (PregMet2): a randomised, double-blind, placebo-controlled trial Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy complications. Epi-analysis of two previous randomised controlled trials that compared metformin with placebo during pregnancy in women with PCOS showed a significant reduction in late miscarriages and preterm births in the metformin group. The aim of this third randomised trial (...) (PregMet2) was to test the hypothesis that metformin prevents late miscarriage and preterm birth in women with PCOS.PregMet2 was a randomised, placebo-controlled, double-blind, multicentre trial done at 14 hospitals in Norway, Sweden, and Iceland. Singleton pregnant women with PCOS aged 18-45 years were eligible for inclusion. After receiving information about the study at their first antenatal visit or from the internet, women signed up individually to participate in the study. Participants were

2019 EvidenceUpdates

123. 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 Full Text available with Trip Pro

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

124. Associations between low- and high-dose oral fluconazole and pregnancy outcomes: 3 nested case-control studies Full Text available with Trip Pro

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

2019 EvidenceUpdates

125. High-Dose Vitamin D Supplementation During Pregnancy and Asthma in Offspring at the Age of 6 Years. Full Text available with Trip Pro

High-Dose Vitamin D Supplementation During Pregnancy and Asthma in Offspring at the Age of 6 Years. 30860552 2019 03 25 2019 09 12 1538-3598 321 10 2019 03 12 JAMA JAMA High-Dose Vitamin D Supplementation During Pregnancy and Asthma in Offspring at the Age of 6 Years. 1003-1005 10.1001/jama.2019.0052 Brustad Nicklas N Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte University Hospital, Copenhagen, Denmark. Eliasen Anders U AU Copenhagen Prospective Studies on Asthma (...) Prospective Studies on Asthma in Childhood, Herlev and Gentofte University Hospital, Copenhagen, Denmark. eng Journal Article Randomized Controlled Trial United States JAMA 7501160 0098-7484 0 Vitamins 1406-16-2 Vitamin D AIM IM Asthma diagnosis epidemiology prevention & control Child Child, Preschool Dietary Supplements Dose-Response Relationship, Drug Female Follow-Up Studies Humans Male Pregnancy Prevalence Regression Analysis Respiratory Function Tests Respiratory Sounds Vitamin D administration

2019 JAMA Controlled trial quality: uncertain

126. Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism. Full Text available with Trip Pro

Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism. Pulmonary embolism is one of the leading causes of maternal death in the Western world. Because of the low specificity and sensitivity of the d-dimer test, all pregnant women with suspected pulmonary embolism undergo computed tomographic (CT) pulmonary angiography or ventilation-perfusion scanning, both of which involve radiation exposure to the mother and fetus. Whether a pregnancy-adapted algorithm could be used (...) to safely avoid diagnostic imaging in pregnant women with suspected pulmonary embolism is unknown.In a prospective study involving pregnant women with suspected pulmonary embolism, we assessed three criteria from the YEARS algorithm (clinical signs of deep-vein thrombosis, hemoptysis, and pulmonary embolism as the most likely diagnosis) and measured the d-dimer level. Pulmonary embolism was ruled out if none of the three criteria were met and the d-dimer level was less than 1000 ng per milliliter

2019 NEJM

127. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. Full Text available with Trip Pro

Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. To estimate the burden of miscarriage in the Norwegian population and to evaluate the associations with maternal age and pregnancy history.Prospective register based study.Medical Birth Register of Norway, the Norwegian Patient Register, and the induced abortion register.All Norwegian women that were pregnant between 2009-13.Risk of miscarriage according to the woman's age and pregnancy history (...) estimated by logistic regression.There were 421 201 pregnancies during the study period. The risk of miscarriage was lowest in women aged 25-29 (10%), and rose rapidly after age 30, reaching 53% in women aged 45 and over. There was a strong recurrence risk of miscarriage, with age adjusted odds ratios of 1.54 (95% confidence interval 1.48 to 1.60) after one miscarriage, 2.21 (2.03 to 2.41) after two, and 3.97 (3.29 to 4.78) after three consecutive miscarriages. The risk of miscarriage was modestly

2019 BMJ

128. Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. Full Text available with Trip Pro

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 DDAVP in these groups of pregnant women should be evaluated.This is an update of a Cochrane Review first published in 2013 and updated in 2015.To evaluate the efficacy and safety of DDAVP in preventing and treating acute bleeding in pregnant women with bleeding disorders.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coaguopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant and abstract books

2019 Cochrane

129. 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

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

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 (...) 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

2019 Prescrire

131. Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group Full Text available with Trip Pro

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

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

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 (...) preceding a stroke (10). A similar relationship between severe systolic hypertension and risk of hemorrhagic stroke has been observed in nonpregnant adults (11). Thus, systolic blood pressure (BP) of 160 mm Hg or greater should be included as part of the definition of severe hyper- tensioninpregnantwomenorwomeninthepostpar- tum period (12). Accurate measurement of blood pressure is neces- sary to optimally manage hypertension in pregnancy. Standardized protocols to measure BP in pregnant patients

2019 American College of Obstetricians and Gynecologists

133. Efficacy of Regular Exercise During Pregnancy on the Prevention of Postpartum Depression: The PAMELA Randomized Clinical Trial Full Text available with Trip Pro

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 (...) on the prevention of postpartum depression.This randomized clinical trial examines a prespecified secondary outcome of the Physical Activity for Mothers Enrolled in Longitudinal Analysis (PAMELA) Study, a parallel-group, randomized clinical trial. This trial was nested in the 2015 Pelotas (Brazil) Birth Cohort Study. Between August 27, 2014, and March 14, 2016, pregnant women between 16 and 20 weeks of gestation with no contraindications to exercise were randomized 1:2 to the intervention group or control group

2019 EvidenceUpdates

134. Does Partial Meal Replacement During Pregnancy Reduce 12-Month Postpartum Weight Retention? Full Text available with Trip Pro

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.

2019 EvidenceUpdates

135. The impact of universal home visits with pregnant women and their spouses on maternal outcomes: a cluster randomised controlled trial in Bauchi State, Nigeria. (Abstract)

The impact of universal home visits with pregnant women and their spouses on maternal outcomes: a cluster randomised controlled trial in Bauchi State, Nigeria. Maternal mortality in Nigeria is extremely high. Access to quality antenatal and obstetric care is limited. In Bauchi State, we found maternal morbidity was associated with domestic violence, heavy work in pregnancy, ignorance of danger signs, and lack of spousal communication. This cluster randomized controlled trial tested the impact (...) of universal home visits that discussed these upstream risk factors with pregnant women and their spouses, to precipitate household actions protecting pregnant women.We randomly allocated four wards in Toro Local Government Authority to immediate or delayed intervention. Female and male home visitors visited all pregnant women and their spouses in the two intervention wards every 2 months. We compared completed pregnancies between intervention and pre-intervention wards after 1 year. Primary outcomes were

2019 BMJ global health Controlled trial quality: predicted high

136. Effectiveness of intermittent screening and treatment for the control of malaria in pregnancy: a cluster randomised trial in India. Full Text available with Trip Pro

Effectiveness of intermittent screening and treatment for the control of malaria in pregnancy: a cluster randomised trial in India. The control of malaria in pregnancy (MiP) in India relies on testing women who present with symptoms or signs suggestive of malaria. We hypothesised that intermittent screening and treatment for malaria at each antenatal care visit (ISTp) would improve on this approach and reduce the adverse effects of MiP.A cluster randomised controlled trial comparing ISTp versus (...) passive case detection (PCD) was conducted in Jharkhand state. Pregnant women of all parities with a gestational age of 18-28 weeks were enrolled. Women in the ISTp group were screened with a rapid diagnostic test (RDT) for malaria at each antenatal clinic visit and those in the PCD group were screened only if they had symptoms or signs suggestive of malaria. All RDT positive women were treated with artesunate/sulfadoxine-pyrimethamine. The primary endpoint was placental malaria, determined

2019 BMJ global health Controlled trial quality: predicted high

137. [Influence of exercise on weight gain during pregnancy. Randomized clinical trial]. (Abstract)

[Influence of exercise on weight gain during pregnancy. Randomized clinical trial]. Introducción: el ejercicio físico es una buena forma de mantener un estilo de vida saludable y su práctica regular es recomendable durante el periodo gestacional, favoreciendo, entre otros, una adecuada ganancia ponderal durante la gestación y una mejor recuperación del peso pregestacional. Objetivo: analizar la evolución del peso, gestacional y posparto, en mujeres embarazadas que realizan un programa de (...) (p = 0,011). Conclusión: la metodología Study of Water Exercise Pregnancy (SWEP) durante el embarazo ayuda al control de la ganancia de peso gestacional y a la recuperación del peso pregestacional.

2019 Nutricion hospitalaria Controlled trial quality: uncertain

138. Chronic Hypertension in Pregnancy

Chronic Hypertension in Pregnancy Sign In (ACOG) Sign in to your ACOG account Email is required. Please enter valid Email. was not found in our system. Would you like to associated with your account? Forgot your email address? JSOG Member? © 2019 - American College of Obstetricians and Gynecologists

2019 American College of Obstetricians and Gynecologists

139. Syphilis in pregnancy

reduction · Early screening of all pregnant women, and identification of high risk pregnancies and babies can prevent adverse perinatal outcomes 15,16 Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies after use Page 9 of 31 1.4 Notifiable disease Table 3. Disease notification Aspect Consideration Context · Syphilis is a controlled notifiable disease in Queensland as per the Public Health Act (2005) 19 · Routine reporting is the cornerstone of syphilis (...) reactive POC testing by laboratory serology Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies after use Page 14 of 31 3.5 Risk groups and recommended screening for syphilis Table 10. Recommended screening by risk group Risk group Relevant to the following groups of pregnant women Recommended screening Universal risk · All pregnant women · Routinely at the first antenatal appointment and preferably before 10 weeks gestation 22 · Request ‘syphilis

2019 Queensland Health

140. Valproate medicines: are you in acting in compliance with the pregnancy prevention measures?

Valproate medicines: are you in acting in compliance with the pregnancy prevention measures? Valproate medicines: are you acting in compliance with the pregnancy prevention measures? - GOV.UK GOV.UK uses cookies to make the site simpler. Search Valproate medicines: are you acting in compliance with the pregnancy prevention measures? Although use of valproate medicines in female patients continues to slowly decline, there is wide variation in prescribing between Clinical Commissioning Groups (...) December 2018 From: Therapeutic area: , , , , , Contents New information Compliance by healthcare professionals with the new valproate measures for pregnancy prevention appears currently patchy Women are not always receiving Patient Information Leaflets with their medicines, as is required Some women using valproate for off-label indications are not being reviewed in line with the new pregnancy prevention measures is available for psychiatrists on the withdrawal of, and alternatives to, valproate

2019 MHRA Drug Safety Update