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Acute Cystitis in Pregnancy

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1. Acute cystitis

urinary tract infections; history of infection with drug-resistant bacteria; or failed course of treatment for uncomplicated cystitis. Definition Acute cystitis is an infection of the urinary bladder most commonly affecting young, sexually active women. It can be classified as complicated or uncomplicated based on the presence of patient characteristics that would indicate a probable poor response to a short course of therapy. History and exam presence of risk factors dysuria urgency frequency (...) of trimethoprim/sulfamethoxazole or trimethoprim, or 5 days of nitrofurantoin. For complicated cases of cystitis, first line is empirical therapy with a fluoroquinolone antibiotic for 7 to 14 days; treatment should be adjusted based on the results of the urine culture. Complicating characteristics include pregnancy; recent instrumentation, including catheterisation or indwelling catheter; male patient; diabetes, immunosuppression; structurally or functionally abnormal urinary bladder; history of recurrent

2019 BMJ Best Practice

2. Acute cystitis

urinary tract infections; history of infection with drug-resistant bacteria; or failed course of treatment for uncomplicated cystitis. Definition Acute cystitis is an infection of the urinary bladder most commonly affecting young, sexually active women. It can be classified as complicated or uncomplicated based on the presence of patient characteristics that would indicate a probable poor response to a short course of therapy. History and exam presence of risk factors dysuria urgency frequency (...) of trimethoprim/sulfamethoxazole or trimethoprim, or 5 days of nitrofurantoin. For complicated cases of cystitis, first line is empirical therapy with a fluoroquinolone antibiotic for 7 to 14 days; treatment should be adjusted based on the results of the urine culture. Complicating characteristics include pregnancy; recent instrumentation, including catheterisation or indwelling catheter; male patient; diabetes, immunosuppression; structurally or functionally abnormal urinary bladder; history of recurrent

2018 BMJ Best Practice

3. Urinary Tract Infection (Cystitis) - acute, uncomplicated

of the following symptoms: Vaginal discharge or odor Pruritus Dyspareunia Urinary frequency and urgency usually absent Recommend OTC treatment for vaginitis or if risk of sexually transmitted infection (STI), refer Acute urethritis Inflammation of the urethra accompanied by dysuria; no urinary frequency or urgency Most common in sexually active women Causes include chlamydia, gonorrhea, trichomoniasis, candidiasis and herpes simplex virus History may indicate STI risk Interstitial cystitis (painful bladder (...) Urinary Tract Infection (Cystitis) - acute, uncomplicated Urinary Tract Infection (Cystitis) - acute, uncomplicated - medSask Home - College of Pharmacy and Nutrition - University of Saskatchewan Toggle Menu Search the U of S Search Urinary Tract Infection (Cystitis) - acute, uncomplicated An acute infection of the bladder (acute cystitis) Most commonly caused by Escherichia coli (80%), with the remaining 20 % caused by Staphylococcus species , proteus mirabilis, and enterococci Incidence

2018 medSask

4. CRACKCast E177 – Acute Complications of Pregnancy

of sexually transmitted diseases, in general, the tetracyclines and quinolones are contraindicated in pregnant patients. Treatment of genital tract infections may be important for preventing preterm labor and decreasing transmission to the infant. PID is very rare in pregnancy and does not occur after the first trimester. Given the risk of endometrial infection in pregnancy and the need to consider other diagnoses, pregnant patients who have suspected PID require hospitalization and IV antibiotics (...) , and occasional maternal infections. Approximately 80% of miscarriages occur during the first trimester; the rest occur before 20 weeks of gestation. Approximately 25% of clinically pregnant patients experience some bleeding. It is estimated that up to 50% of all women who have bleeding during early pregnancy miscarry, although the risk is probably higher in the emergency department (ED) population. Important to discuss with most women that usually fetuses are non-viable 1-2 weeks before the bleeding occurs

2018 CandiEM

5. Acute Cystitis in Pregnancy

Acute Cystitis in Pregnancy Aka: Acute Cystitis in Pregnancy , Asymptomatic Bacteriuria in Pregnancy , UTI in Pregnancy , Urinary Tract Infection in Pregnancy II. Epidemiology in 2 to 7% of pregnancies Significant cause of III. Etiology (most common) miribilis Pseudomonas aeruginosa saprophyticus IV. History Urinary Urgency Symptoms suggestive of Flank pain or Past Medical History s itis Predisposes to V. Signs of cystitis (Contrast with Pyelonephritis) Afebrile No Costovertebral angle (CVA (...) ) in late third trimester IX. Management: Urinary Tract Infection Prophylaxis 250 mg PO qhs 100 mg PO qhs (do not use after 38 weeks) ( ) 250 mg PO qhs 250 mg PO qhs X. References (2018) Presc Lett 25(3) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Acute Cystitis in Pregnancy." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Obstetrics

2018 FP Notebook

6. Pregnant women: urinary colonisation and cystitis

Pregnant women: urinary colonisation and cystitis Urinary colonisation in pregnant women Screening: • in women without a particular risk of urinary infection: urine test strip (UTS) every month starting from the 4 th month of pregnancy. If the UTS is positive (positive for leukocytes or nitrites), a cytobacteriological examination of the urine (CBEU) must be performed; • in women at risk of urinary infection (underlying organic or functional uropathy, diabetes, history of acute recurring (...) . Factsheet Pregnant women: urinary colonisation and cystitis November 2016 1 st line amoxicillin, 1 g x 3/day, for 7 days 2 nd line 3 rd line pivmecillinam, 400 mg x 2/day, for 7 days fosfomycin trometamol, 3 g in a single dose 4 th line trimethoprim, 300 mg/day for 7 days, to be avoided during the first 2 months of pregnancy 5 th line • nitrofurantoin, 100 mg x 3/day, for 7 days, repeat treatments contraindicated (contraindicated in cases of renal impairment with creatinine clearance 10 days

2016 HAS Guidelines

7. Pentosan polysulfate sodium (Elmiron) - Interstitial Cystitis

bladder. Up to 50% of patients with symptoms of interstitial cystitis will have spontaneous resolution in time. 2.1.3. Aetiology and pathogenesis There are many and different hypotheses about the causes of IC, including infection, inflammation, autoimmune mechanisms, hormonal troubles, defects in the urothelial glycosaminoglycan layer, hypoxia, and central neurologic mechanisms. Assessment report EMA/287422/2017 Page 10/115 The aetiology is unknown but some triggering factors such as certain acid (...) International Society for the Study of Bladder Pain Syndrome EU European Union FDA Food and Drug Administration FT-IR Fourrier Transform Infrared Spectroscopy GAG Glycosaminoglycan GPC Gel permeation chromatography GRA global response assessment GTI gastrointestinal HDPE High Density Polyethylene HPLC high performance liquid chromatography HSCIC Health and Social Care Information Centre IC Interstitial Cystitis ICH International Conference on Harmonisation of Technical Requirements for Registration of ICPI

2017 European Medicines Agency - EPARs

8. Pharmacokinetic Study of Oral Gepotidacin (GSK2140944) in Subjects With Uncomplicated Urinary Tract Infection (Acute Cystitis)

Pharmacokinetic Study of Oral Gepotidacin (GSK2140944) in Subjects With Uncomplicated Urinary Tract Infection (Acute Cystitis) Pharmacokinetic Study of Oral Gepotidacin (GSK2140944) in Subjects With Uncomplicated Urinary Tract Infection (Acute Cystitis) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached (...) the maximum number of saved studies (100). Please remove one or more studies before adding more. Pharmacokinetic Study of Oral Gepotidacin (GSK2140944) in Subjects With Uncomplicated Urinary Tract Infection (Acute Cystitis) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03568942 Recruitment Status

2018 Clinical Trials

9. Pregnancy and Renal Disease

to the survey, including 76 (49%) nephrologists, 36 (23%) obstetricians, 16 (10%) pharmacists, 12 (8%) midwives, 7 (4%) obstetric physicians, 5 (3%) physicians, 2 (1%) patients, 1 dietician and 1 person with role in guideline development. Of those completing the survey, 57 (37%) were part of a specialist multidisciplinary team managing women with CKD in pregnancy and 72 (46%) were routinely involved in either the renal or obstetric care of pregnant women with CKD. The strength of the recommendation (...) guidelines 19 6. Lay summary 74 7. Acknowledgements 75 Appendix 1. The experience of pregnancy and renal disease……………………………………………………………………………….76 Appendix 2. Summary of clinical responsibility for elements of the guideline 80 Appendix 3. Ovid Medline search terms (1946 to 2018) 81 Renal Association Clinical Practice Guideline Pregnancy and Renal Disease – September 2019 4 1. Introduction 1. Background Chronic kidney disease (CKD) is estimated to affect 3% of pregnant women in high-income countries

2019 Renal Association

10. Assessment of abdominal pain in pregnancy

or invasive diagnostic tests. Furthermore, there is a general reluctance to operate unnecessarily on a gravid patient. The acute abdomen in pregnancy remains a diagnostic dilemma. As pregnancy stretches the anterior abdominal wall, the resulting peritoneal signs are often different from what is expected in the non-pregnant patient owing to lack of contact with the underlying inflammation. In addition, the clinical picture may be distorted by the uterus obstructing the movement of the omentum to the area (...) of inflammation. Sivanesaratnam V. The acute abdomen and the obstetrician. Bailleres Best Pract Res Clin Obstet Gynaecol. 2000;14:89-102. http://www.ncbi.nlm.nih.gov/pubmed/10789262?tool=bestpractice.com Laboratory parameters can be non-specific and are often altered due to physiological changes in pregnancy. Despite advances in medical technology, pre-operative diagnosis of acute abdominal conditions can still be inaccurate, increasing the rate of exploratory laparotomy, caesarean section, premature delivery

2018 BMJ Best Practice

11. Urological diseases and pregnancy

be a sign of mild glomerulonefritis and should be examined 3 months after delivery 3 C Culture of the urine should be carried out in case of microscopic hematuri to rule out urinary tract infections B Macroscopic hematuria should always be evaluated B Imaging Recommendation Level of evidence Recommendation Evaluation of the pregnant woman imaging should be in cooperation with the radiological department to optimize the quality of the image and to minimize the risk to the fetus. D First line of imaging (...) of the pregnant woman is ultrasound, then MR and finally imaging with radiation such as CT. 3 C DSOG 2019 Urology and pregnancy Page 3 of 3 Danish version Below you find the entire Danish version of the guideline Urologiske nyresygdomme og graviditet Guidelinen er en revision af tidligere Nyresygdomme og graviditet fra 2011. Denne guideline er delt op i 2: medicinske nyresygdomme og graviditet samt urologiske sygdomme og graviditet Forfattere: Al-Saudi Noor Introlæge Slagelse Eskildsen Morten Reservelæge

2019 Nordic Federation of Societies of Obstetrics and Gynecology

12. CRACKCast E178 – Co-Morbird Medical Emergencies During Pregnancy

for use in patients with severe exacerbations Smooth muscle relaxation – MgSO4 – limited data supports its use Maintenance inhaled steroids and LRTA’s [2] What anti-hypertensives are not safe in pregnancy? How is a hypertensive emergency treated? The increase in blood volume due to pregnancy, along with the increases in preload, cardiac output, and oxygen consumption, can worsen or reveal cardiac disease in pregnant women. Because the signs and symptoms of acute coronary syndromes and heart failure (...) in an increased incidence of thromboembolic disease, with the incidence of deep vein thrombosis (DVT) reported as high as 8% in pregnant women with SCI. The incidence of urinary tract infection is also markedly increased as a result of neurogenic complications and the need for catheterization. Infections are even more likely during pregnancy and may progress to pyelonephritis, with the subsequent increased risk of fetal loss, prematurity, and maternal sepsis. [8] What is autonomic dysreflexia? How

2018 CandiEM

13. Early pregnancy loss

) • Immunologic factors (e.g. systemic lupus erythematosus) • Infection (e.g. cytomegalovirus) • Severe acute illness • Thrombophilia (e.g. factor V Leiden) • Uncontrolled chronic illness (e.g. diabetes, hypertension) 41 • Very high or low pre-pregnancy BMI 40 Other • Drug use/smoking • Teratogen exposure • Trauma (e.g. physical abuse) 41 Refer to online version, destroy printed copies after use Page 18 of 39 Queensland Clinical Guideline: Early pregnancy loss 5.2 Expectant management of non-viable (...) area, level of education and age ? compared with pregnant controls only Refer to online version, destroy printed copies after use Page 15 of 39 Queensland Clinical Guideline: Early pregnancy loss 4.2 Expectant management of ectopic pregnancy Expectant management is an option for selected women. Clear criteria for selection have not been well defined. 26 Table 10. Expectant management of ectopic pregnancy Aspect Consideration Context • Among selected cases (early gestation, with ß-hCG values below

2017 Queensland Health

14. Hypertension in pregnancy

- Options for local implementation No QIPP indicators were found during the review of this topic. NICE quality standards NICE quality standards Women of childbearing potential with treated hypertension are given information annually about safe antihypertensive treatment during pregnancy. Pregnant women at increased risk of pre-eclampsia at the booking appointment are offered a prescription of 75–150 mg of aspirin to take daily from 12 weeks until birth. Pregnant women taking antihypertensive medication (...) have a blood pressure target of 135/85 mmHg or less. Pregnant women with severe hypertension are admitted for a full assessment, carried out by a healthcare professional trained in managing hypertension in pregnancy. Women with pre-eclampsia who have severe hypertension or are at a high risk of adverse events, or if there are any clinical concerns are admitted to hospital and monitored. Women with pre-eclampsia have a senior obstetrician involved in any decisions about the timing of birth. Women

2019 NICE Clinical Knowledge Summaries

15. Acute Cystitis in Pregnancy

Acute Cystitis in Pregnancy Aka: Acute Cystitis in Pregnancy , Asymptomatic Bacteriuria in Pregnancy , UTI in Pregnancy , Urinary Tract Infection in Pregnancy II. Epidemiology in 2 to 7% of pregnancies Significant cause of III. Etiology (most common) miribilis Pseudomonas aeruginosa saprophyticus IV. History Urinary Urgency Symptoms suggestive of Flank pain or Past Medical History s itis Predisposes to V. Signs of cystitis (Contrast with Pyelonephritis) Afebrile No Costovertebral angle (CVA (...) ) in late third trimester IX. Management: Urinary Tract Infection Prophylaxis 250 mg PO qhs 100 mg PO qhs (do not use after 38 weeks) ( ) 250 mg PO qhs 250 mg PO qhs X. References (2018) Presc Lett 25(3) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Acute Cystitis in Pregnancy." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Obstetrics

2015 FP Notebook

16. Low Energy Shock Wave for the Treatment of Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS)

effects. LESW has been proved to have therapeutic effects in patients with nonbacterial prostatitis and chronic pelvic pain syndrome (CPPS). Investigator's previous study has demonstrated that LESW treatment inhibited nerve growth factor (NGF), interleukin-6 (IL-6), and cyclooxygenase-2 (COX-2) expression, and blocked the bladder pain, inflammation and overactivity in a cyclophosphamide induced cystitis model in rats. These findings suggest that a potential clinical benefit of LESW treatment (...) injection in recent 12 months Patients with severe cardiopulmonary disease and such as congestive heart failure, arrhythmia, poorly controlled hypertension, not able to receive regular follow-up Patients with bladder outlet obstruction on enrollment Patients with PVR >100 ml Patients with uncontrolled confirmed diagnosis of acute urinary tract infection Patients have laboratory abnormalities at screening including: alanine aminotransferase (ALT)> 3 x upper limit of normal range, and aspartate

2018 Clinical Trials

17. Guidelines for Antimicrobial Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women Full Text available with Trip Pro

for Academic Emergency Medicine. The focus of this work is treatment of women with acute uncomplicated cystitis and pyelonephritis, diagnoses limited in these guidelines to premenopausal, non-pregnant women with no known urological abnormalities or co-morbidities. The issues of in vitro resistance prevalence and the ecological adverse effects of antimicrobial therapy (collateral damage) were considered as important factors in making optimal treatment choices and thus are reflected in the rankings (...) or comorbidities. It should be noted that women who are postmenopausal or have well-controlled diabetes without urological sequelae may be considered by some experts to have uncomplicated urinary tract infection (UTI), but a discussion of specific management of these groups is outside the scope of this guideline. In addition, management of recurrent cystitis and of UTI in pregnant women, prevention of UTI, and diagnosis of UTI are all important issues that are not addressed in this guideline. The issues

2011 Infectious Diseases Society of America

18. Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome

ever had symptoms of a bladder infection (such as pain in your bladder and frequent urination) that lasted more than 3 months?" Those who gave a positive response were then asked, "When you had this condition, were you told that you had interstitial cystitis or painful bladder syndrome?" An affirmative answer to both questions was considered to define the presence of IC/BPS. The prevalence estimates obtained from these two studies were virtually identical. In the NHIS, the overall prevalence (...) Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome Intertitial Cystitis (IC/BPS) Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning

2014 American Urological Association

19. Fosfomycin: A First-Line Oral Therapy for Acute Uncomplicated Cystitis Full Text available with Trip Pro

Fosfomycin: A First-Line Oral Therapy for Acute Uncomplicated Cystitis Fosfomycin is a new agent to Canada approved for the treatment of acute uncomplicated cystitis (AUC) in adult women infected with susceptible isolates of E. coli and Enterococcus faecalis. We reviewed the literature regarding the use of oral fosfomycin for the treatment of AUC. All English-language references from 1975 to October 2015 were reviewed. In Canada, fosfomycin tromethamine is manufactured as Monurol® (...) concentration ~4000 µg/mL and remains at concentrations >100 µg/mL for 48 hours after a single 3-gram oral dose. No dosage adjustments are required in elderly patients, in pregnant patients, or in either renal or hepatic impairment. Fosfomycin demonstrates a favorable safety profile, and clinical trials have demonstrated efficacy in AUC that is comparable to ciprofloxacin, nitrofurantoin, and trimethoprim-sulfamethoxazole. Fosfomycin's in vitro activity against common uropathogens, including MDR isolates

2016 The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale

20. Polyhydramnios in singleton pregnancies

, but it is also a fetal and neonatal risk factor. Polyhydramnios is among other things associated with malformations, aneuploidy, immunization, diabetes, infections, placenta anomalies and multiple pregnancies. Idiopathic cases, which count for 43 to 67% of all cases, are by themselves a risk factor for obstetrical and neonatal complications. The diagnosis is a combination of clinical examination and an ultrasonic verification and graduation of the amnion volume. Various diagnostic approaches can be taken (...) to search for evidence of a pathological condition in the fetus or pregnant woman. A control program is then initiated to see if the amnion volume increases, if the fetus is affected or if the pregnant woman gets symptoms. To avoid pregnancy and birth related complications such as preterm birth, PPROM, placental abruption, fetal distress, cord prolapse, dystocia, and postpartum hemorrhage, it is important to have a plan to control the pregnant woman with polyhydramnios during pregnancy and delivery

2016 Nordic Federation of Societies of Obstetrics and Gynecology

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