Sonja A Rasmussen, Colleen F Kelley, John P Horton, Denise J Jamieson
Coronavirus disease 2019 (COVID-19) vaccines have begun to be distributed across the United States and to be offered initially to priority groups including health care personnel and persons living in long-term care facilities. Guidance regarding whether pregnant persons should receive a COVID-19 vaccine is needed. Because pregnant persons were excluded from the initial phase 3 clinical trials of COVID-19 vaccines, limited data are available on their efficacy and safety during pregnancy. After developmental and reproductive toxicology studies are completed, some companies are expected to conduct clinical trials in pregnant persons...
February 4, 2021: Obstetrics and Gynecology
Chittaranjan Andrade
No abstract text is available yet for this article.
May 2012: Journal of Clinical Psychiatry
Michael Paulzen, Tamme W Goecke, Elmar Stickeler, Gerhard Gründer, Georgios Schoretsanitis
RATIONALE: This study is the first to measure and correlate sertraline concentrations in maternal blood, amniotic fluid and umbilical cord blood and account for distribution of the drug between these three compartments. METHODS: Concentrations of sertraline were measured in six mother infant pairs at the time of delivery. Data are provided as median values, first and third quartiles as well as ranges. To account for the penetration ratio into amniotic fluid and cord blood, the concentration of sertraline in both environments was divided by the concentration in maternal serum...
April 1, 2017: Journal of Affective Disorders
C D Chambers, K A Johnson, L M Dick, R J Felix, K L Jones
BACKGROUND: Although fluoxetine is the most frequently prescribed antidepressant drug in the United States, its safety in pregnant women has not been established. METHODS: From 1989 through 1995, we prospectively identified 228 pregnant women taking fluoxetine. We compared the outcomes of their pregnancies with those of 254 women identified in a similar manner who were not taking fluoxetine. RESULTS: The rate of spontaneous pregnancy loss did not differ significantly between the women treated with fluoxetine and the control women (10...
October 3, 1996: New England Journal of Medicine
Elke Leuridan
Pertussis vaccination in pregnancy has been introduced by several national advisory bodies, mostly in industrialized countries, as a means to protect young infants from disease by high titers of maternal antibodies. Most recommendations derive from epidemiological needs, but many knowledge gaps remained after implementation. This report aims to overview the solved and unsolved aspects of prenatal vaccination with a pertussis containing vaccine.
August 16, 2017: Vaccine
Nestor E Vain, Daniel G Batton
The designation meconium aspiration syndrome (MAS) reflects a spectrum of disorders in infants born with meconium-stained amniotic fluid, ranging from mild tachypnea to severe respiratory distress and significant mortality. The frequency of MAS is highest among infants with post-term gestation, thick meconium, and birth asphyxia. Pulmonary hypertension is an important component in severe cases. Prenatal hypopharyngeal suctioning and postnatal endotracheal intubation and suctioning of vigorous infants are not effective...
August 2017: Seminars in Fetal & Neonatal Medicine
Robert M Ehsanipoor, Gabriele Saccone, Neil S Seligman, Rebecca A M Pierce-Williams, Andrea Ciardulli, Vincenzo Berghella
INTRODUCTION: The National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine have emphasized the need to promote vaginal delivery and have offered recommendations to safely prevent primary cesarean delivery. However, there has been limited discussion regarding management of intravenous fluids and other aspects of labor management that may influence mode of delivery. Therefore the aim of our study was to determine whether an intravenous fluid rate of 250 vs...
July 2017: Acta Obstetricia et Gynecologica Scandinavica
Mohammad Ahmed Maher, Tarek Mohammad Sayyed, Nabih Elkhouly
OBJECTIVE: To compare sildenafil plus hydration with hydration alone in improving the amniotic fluid index and neonatal outcomes in pregnancies complicated by idiopathic oligohydramnios ( amniotic fluid index less than 5 cm without underlying maternal or fetal causes and with normal fetal growth). METHODS: This was an open-label randomized trial for women carrying singleton pregnancies at 30 weeks of gestation or more with idiopathic oligohydramnios detected during routine ultrasonogram...
April 2017: Obstetrics and Gynecology
Lee S Cohen, Ruta Nonacs
No abstract text is available yet for this article.
November 1, 2016: JAMA Psychiatry
Rosemary Townsend, Patrick O'Brien, Asma Khalil
Preeclampsia is a potentially serious complication of pregnancy with increasing significance worldwide. Preeclampsia is the cause of 9%-26% of global maternal mortality and a significant proportion of preterm delivery, and maternal and neonatal morbidity. Incidence is increasing in keeping with the increase in obesity, maternal age, and women with medical comorbidities entering pregnancy. Recent developments in the understanding of the pathophysiology of preeclampsia have opened new avenues for prevention, screening, and management of this condition...
2016: Integrated Blood Pressure Control
Marilyn N Bulloch, Dana G Carroll
One of the most difficult challenges health care providers encounter is drug selection for pregnant patients. Drug selection can be complex as efficacy and maternal side effects must be weighed against potential risk to the embryo or fetus. Verification of an individual drug's fetal safety is limited as most evidence is deduced from epidemiologic, prospective cohort, or case-control studies. Medication selection for the pregnant inpatient is a particularly complex task as the illnesses and conditions that require hospitalization mandate different medications, and the risk versus benefit ratio can vary significantly compared to the outpatient setting...
June 2012: Journal of Pharmacy Practice
Diarmaid D Houlihan, Michael C Dennedy, Nandini Ravikumar, John J Morrison
OBJECTIVE: To investigate and compare the direct effects of compounds used in the treatment of hypertensive disease in pregnancy on human umbilical artery resistance in vitro. METHODS: Isometric tension recordings were performed under physiological conditions on human umbilical arterial rings (n=30). The in vitro effects of labetolol, hydralazine, alpha-methyldopa, nifedepine and magnesium sulphate (at concentration ranges from 1 nanomolar to 1 millimolar), and their respective vehicle controls, were measured...
2004: Journal of Perinatal Medicine
Binny Thomas, P V Abdul Rouf, Wessam El Kassem, Moza Al Hail, Derek Stewart, Asma Tharannum, Afif Ahmed, Muna Al Saadi
CASE DESCRIPTION: Hyperkalemia can cause altered cardiac electrical conduction resulting in death. We describe a case of a 23-year old pregnant patient who presented with severe epigastric pain and vomiting. She was severely pre- eclamptic and received initial treatment with intravenous labetalol and decision was taken to deliver. She quickly became hyperkalaemic (serum potassium level 6.4 mmol/L) and labetalol was discontinued and intravenous hydralazine commenced. Post-surgery, her potassium levels were normal but due to rapidly rising blood pressure labetalol was recommenced, resulting in elevated potassium levels...
December 2014: International Journal of Clinical Pharmacy
Sebastiaan W A Nij Bijvank, Johannes J Duvekot
UNLABELLED: To evaluate the efficacy and safety of intravenous nicardipine for the treatment of severe hypertension in pregnancy. Articles were identified through electronic databases (Medline and Cochrane). No date or language restrictions were placed. Relevant citations were hand searched. The following search terms were used: pregnancy, severe hypertension and nicardipine. Patients included had chronic or gestational hypertension with or without marked proteinuria. Primary outcomes were reduction of systolic/diastolic and/or mean arterial pressure, time to target blood pressure, and severe maternal (hypotension, tachycardia) or severe fetal side effects (CTG abnormalities needing direct intervention)...
May 2010: Obstetrical & Gynecological Survey
Bei Xu, Francesca Charlton, Angela Makris, Annemarie Hennessy
OBJECTIVES: The interaction between trophoblasts and maternal endothelium is important for placental vascular modeling. Failure of uterine spiral artery transformation is linked to the etiopathology of preeclampsia. Antihypertensive medications used to control hypertension in early pregnancy can alter placental and circulating cytokines. This study investigated whether selected antihypertensive drugs can modulate the interaction between trophoblast and endothelial cells. METHODS: Human uterine myometrial microvascular endothelial cells were preincubated with (or without) low-dose tumor necrosis factor-α (TNF-α; 0...
May 2014: Journal of Hypertension
Fiona C Brownfoot, Stephen Tong, Natalie J Hannan, Natalie K Binder, Susan P Walker, Ping Cannon, Roxanne Hastie, Kenji Onda, Tu'uhevaha J Kaitu'u-Lino
UNLABELLED: Preeclampsia is a major pregnancy complication where excess placental release of soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin causes maternal endothelial and multisystem organ injury. Clinical trials have commenced examining whether pravastatin can be used to treat preeclampsia. However, the preclinical evidence supporting pravastatin as a treatment is limited to animal models, with almost no studies in human tissues. Therefore, we examined whether pravastatin reduced sFlt-1 and soluble endoglin secretion and decreased endothelial dysfunction in primary human tissues...
September 2015: Hypertension
Alberto Trapani, Luis Flavio Gonçalves, Thamyris Finger Trapani, Simone Vieira, Marilen Pires, Maria Marlene de Souza Pires
OBJECTIVE: To evaluate whether therapy with sildenafil citrate prolongs gestation in women with preeclampsia. METHODS: In a randomized double-blind, placebo-controlled trial, 100 singleton pregnancies with preeclampsia between 24 and 33 weeks of gestation were randomized to 50 mg oral sildenafil citrate every 8 hours or placebo. The primary outcome was prolongation of pregnancy from randomization to delivery. Secondary outcomes were changes in resistance indices of uterine, umbilical, and middle cerebral arteries by Doppler, fetal and maternal complications, and adverse neonatal outcomes...
August 2016: Obstetrics and Gynecology
Chittaranjan Andrade
No abstract text is available yet for this article.
February 2016: Journal of Clinical Psychiatry
Mieke L G Ten Eikelder, Katrien Oude Rengerink, Marta Jozwiak, Jan W de Leeuw, Irene M de Graaf, Mariëlle G van Pampus, Marloes Holswilder, Martijn A Oudijk, Gert-Jan van Baaren, Paula J M Pernet, Caroline Bax, Gijs A van Unnik, Gratia Martens, Martina Porath, Huib van Vliet, Robbert J P Rijnders, A Hanneke Feitsma, Frans J M E Roumen, Aren J van Loon, Hans Versendaal, Martin J N Weinans, Mallory Woiski, Erik van Beek, Brenda Hermsen, Ben Willem Mol, Kitty W M Bloemenkamp
BACKGROUND: Labour is induced in 20-30% of all pregnancies. In women with an unfavourable cervix, both oral misoprostol and Foley catheter are equally effective compared with dinoprostone in establishing vaginal birth, but each has a better safety profile. We did a trial to directly compare oral misoprostol with Foley catheter alone. METHODS: We did an open-label randomised non-inferiority trial in 29 hospitals in the Netherlands. Women with a term singleton pregnancy in cephalic presentation, an unfavourable cervix, intact membranes, and without a previous caesarean section who were scheduled for induction of labour were randomly allocated to cervical ripening with 50 μg oral misoprostol once every 4 h or to a 30 mL transcervical Foley catheter...
April 16, 2016: Lancet
Iris J Grooten, Ben W Mol, Joris A M van der Post, Carrie Ris-Stalpers, Marjolein Kok, Joke M J Bais, Caroline J Bax, Johannes J Duvekot, Henk A Bremer, Martina M Porath, Wieteke M Heidema, Kitty W M Bloemenkamp, Hubertina C J Scheepers, Maureen T M Franssen, Martijn A Oudijk, Tessa J Roseboom, Rebecca C Painter
BACKGROUND: Hyperemesis gravidarum (HG), or intractable vomiting during pregnancy, is the single most frequent cause of hospital admission in early pregnancy. HG has a major impact on maternal quality of life and has repeatedly been associated with poor pregnancy outcome such as low birth weight. Currently, women with HG are admitted to hospital for intravenous fluid replacement, without receiving specific nutritional attention. Nasogastric tube feeding is sometimes used as last resort treatment...
January 27, 2016: BMC Pregnancy and Childbirth
2016-02-07 00:10:11
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