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Antibiotics in Pregnancy

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61. The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum

The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum Green-top Guideline No. 69 June 2016The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum This is the first edition of this guideline. Executive summary of recommendations Diagnosis of nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG) How is NVP diagnosed? NVP should only be diagnosed when onset (...) is in the first trimester of pregnancy and other causes of nausea and vomiting have been excluded. How is HG diagnosed? HG can be diagnosed when there is protracted NVP with the triad of more than 5% prepregnancy weight loss, dehydration and electrolyte imbalance. How can the severity of NVP be classified? An objective and validated index of nausea and vomiting such as the Pregnancy-Unique Quantification of Emesis (PUQE) score can be used to classify the severity of NVP . What initial clinical assessment

2016 Royal College of Obstetricians and Gynaecologists

62. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February (...) 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 Free Access article Share on Jump to Free Access article Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association , RN, MN, FAHA, Chair , MD, FRCP, Co-Chair , MD , MD , MD , MD, DPhil , MD, FAHA, FRCPC , MD , and MD, FRCPC MD, FAHAOn behalf of the American Heart Association Council

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2017 American Heart Association

63. Flowchart: Stable intrauterine non-viable pregnancy

Flowchart: Stable intrauterine non-viable pregnancy Queensland Health State of Queensland (Queensland Health) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Queensland Clinical Guidelines www.health.qld.gov.au/qcg Stable intrauterine non-viable pregnancy Expectant Indications • Woman’s preference • Incomplete miscarriage Contraindications • Haemodynamic instability • Suspected GTD • IUD (must be removed) • Risk (...) • Persistent excess bleeding • Evidence of infected POC • Suspected GTD Cautions • Risk of haemorrhage or effects of haemorrhage • Previous uterine perforation Care provision • Misoprostol for cervical priming • Routine antibiotics not required • USS at time of suction curettage (if indicated) Follow-up • GP if ongoing concerns • ß-hCG not routinely indicated • USS not routinely indicated Surgical Give written information about: • Management option chosen • Expected bleeding/symptoms • Resumption

2017 Queensland Health

64. Early pregnancy loss

suspected, recommend early surgical management with antibiotic cover • Recommend urinary pregnancy test at 3–6 weeks if 9 2 : o No POC histopathology o Failure to return to normal menstruation by 4–6 weeks o Ongoing abnormal bleeding Advice for women • Refer to Section 1.2 for information/advice requirements • Access to a telephone and 24 hour emergency hospital admission is required or a plan for access where there is geographical/social isolation 2,7 • Expect bleeding for up to two weeks (or longer (...) evacuation and minimise risk of Asherman’s syndrome o Administer antibiotics *Refer to the Australian pharmacopeia for complete drug information Refer to online version, destroy printed copies after use Page 21 of 39 Queensland Clinical Guideline: Early pregnancy loss 6 Second trimester pregnancy loss Second trimester pregnancy loss represents one to two percent of recognised pregnancies. 54 A cause and effect relationship is difficult to establish and there may be multiple contributing pathologies

2017 Queensland Health

65. Guidelines for the Use of Laparoscopy during Pregnancy

Guidelines for the Use of Laparoscopy during Pregnancy Guidelines for the Use of Laparoscopy during Pregnancy - A SAGES Publication Society of American Gastrointestinal and Endoscopic Surgeons Guidelines for the Use of Laparoscopy during Pregnancy This document was reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in May 2017. Authors Jonathan P Pearl, Raymond R Price, Allison E Tonkin, William S Richardson, Dimitrios (...) Stefanidis Preamble Surgical interventions during pregnancy should minimize fetal risk without compromising the safety of the mother. Favorable outcomes for the pregnant woman and fetus depend on accurate and timely diagnosis with prompt intervention. Surgeons must be aware of data regarding differences in techniques used for pregnant patients to optimize outcomes. This document provides specific recommendations and guidelines to assist physicians in the diagnostic work-up and treatment of surgical

2017 Society of American Gastrointestinal and Endoscopic Surgeons

66. Obesity in pregnancy

Obesity in pregnancy 37 Obesity in pregnancy – Sandbjerg 2017 DSOG (Danish Society of Obstetrics and Gynecology) Approved on January 21 st , 2017 by the participants at the yearly obstetric guideline meeting in DSOG Recommendations: The recommendations in this guideline are generally for women with BMI (Body Mass Index) = 35 kg/m 2 . However, for some recommendations the studies with the underlying evidence have shown effects already at BMI = 30 kg/m 2 , and therefore this cut-off is used (...) . In choosing the cut-offs, resources were taken into consideration, as the prevalence is high in the lower BMI-groups. For most complications, there is a linear association between BMI and risk, and the risk increases from BMI = 25 kg/m 2 . Every individual case must therefore be assessed by the healthcare professional, giving recommendations based on an overall assessment. BMI in a pregnant woman is calculated from the weight just before pregnancy, or the first measured weight in pregnancy, and BMI

2017 Nordic Federation of Societies of Obstetrics and Gynecology

67. Quality measures in high-risk pregnancies: Executive summary of a cooperative workshop of SMFM, NICHD, and ACOG

leading cause of maternal death in the United States; perioperative antibiotics decrease infectious morbidity. Yes Differences between prophylaxis pre- vs post- incision are clinically meaningful. Yes Use existing hospital infrastructure for surgical prophylaxis. Yes SMFM Publications Committee. Quality measures in high-risk pregnancies. Am J Obstet Gynecol 2017. (continued) SMFM Special Report smfm.org B8 OCTOBER 2017TABLE1 Principal workshop-proposed measures for participant consideration (...) , preeclampsia, or gestational hypertension who had combined documented care transition with a primary care provider and documented patient education on future cardiovascular and metabolic complications before hospital discharge No. of women who delivered with eclampsia, preeclampsia, or gestational hypertension Cesarean delivery rate b No. of cesarean deliveries for nulliparous, term, singleton, vertex pregnancies Total no. of deliveries for nulliparous, term, singleton, vertex pregnancies Antibiotic

2017 Society for Maternal-Fetal Medicine

68. Diarrhoea - antibiotic associated

Diarrhoea - antibiotic associated Diarrhoea - antibiotic associated - NICE CKS Share Diarrhoea - antibiotic associated: Summary Diarrhoea is a common consequence of treatment with antibiotics, occurring in 2–25% of people taking antibiotics, depending on the antibiotic prescribed. Around 20% to 30% of cases of antibiotic-associated diarrhoea are due to Clostridium difficile . Antibiotics frequently associated with C. difficile infection include clindamycin, cephalosporins (especially third (...) colitis, toxic megacolon, perforation of the colon, sepsis, and death. The severity of symptoms should be assessed and the need for hospital admission considered. If infection with C. difficile is suspected, a stool sample should be taken. If infection with C. difficile is not suspected or testing for C. difficile is negative: The antibiotic should be stopped, if this is appropriate. Fluid loss and symptoms should be managed as for acute gastroenteritis. If the C. difficile toxin test result

2019 NICE Clinical Knowledge Summaries

69. Group B streptococcal screening, intrapartum antibiotic prophylaxis, and neonatal early-onset infection rates in an Australian local health district: 2006-2016. (PubMed)

Group B streptococcal screening, intrapartum antibiotic prophylaxis, and neonatal early-onset infection rates in an Australian local health district: 2006-2016. Intrapartum antibiotic prophylaxis (IAP) to reduce the likelihood of neonatal early-onset group B streptococcal infection (EOGBS) has coincided with major reductions in incidence. While the decline has been largely ascribed to IAP following either universal screening or a risk-based approach to identify mothers whose babies may most (...) regression and covariates for potential effect modifiers.Our cohort included 62,281 women who had 92,055 pregnancies resulting in 93,584 live born babies. Screening occurred in 76% of pregnancies; 69% had a result recorded, 21.5% of those were positive for GBS. Prophylaxis was used by 79% of this group. Eighteen babies developed EOGBS, estimated incidence/1000 live births in 2006 and 2016 was 0.35 (95% CI, 0.07 to 0.63) and 0.1 (95% CI, 0 to 0.2) respectively. Seven of 10 term babies with EOGBS were born

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2019 PLoS ONE

70. Antibiotic regimens for postpartum endometritis. (PubMed)

Antibiotic regimens for postpartum endometritis. Postpartum endometritis occurs when vaginal organisms invade the endometrial cavity during the labor process and cause infection. This is more common following cesarean birth. The condition warrants antibiotic treatment.Systematically, to review treatment failure and other complications of different antibiotic regimens for postpartum endometritis.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2014 (...) ) and reference lists of retrieved studies.We included randomized trials of different antibiotic regimens after cesarean birth or vaginal birth; no quasi-randomized trials were included.Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy.The review includes a total of 42 trials, and 40 of these trials contributed data on 4240 participants.Regarding the primary outcomes, seven studies compared clindamycin plus an aminoglycoside versus

2015 Cochrane

71. Intrapartum antibiotics for known maternal Group B streptococcal colonization. (PubMed)

Intrapartum antibiotics for known maternal Group B streptococcal colonization. Maternal colonization with group B streptococcus (GBS) during pregnancy increases the risk of neonatal infection by vertical transmission. Administration of intrapartum antibiotic prophylaxis (IAP) during labor has been associated with a reduction in early onset GBS disease (EOGBSD). However, treating all colonized women during labor exposes a large number of women and infants to possible adverse effects without (...) benefit.To assess the effect of intrapartum antibiotics for maternal Group B haemolytic streptococci (GBS) colonization on mortality from any cause, from GBS infection and from organisms other than GBS.We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 11 March 2014.Randomized trials assessing the impact of maternal IAP on neonatal GBS infections were included.We independently assessed eligibility and quality of the studies.We did not identify any new trials from

2014 Cochrane

72. Antibiotic regimens for management of intra-amniotic infection. (PubMed)

in nearly 20% of term births and in 50% of preterm births. Women with chorioamnionitis have a two to three times higher risk for cesarean delivery and a three to four times greater risk for endomyometritis, wound infection, pelvic abscess, bacteremia, and postpartum hemorrhage.To assess the effects of administering antibiotic regimens for intra-amniotic infection on maternal and perinatal morbidity and mortality and on infection-related complications.We searched the Cochrane Pregnancy and Childbirth (...) Antibiotic regimens for management of intra-amniotic infection. Chorioamnionitis is a common infection that affects both mother and infant. Infant complications associated with chorioamnionitis include early neonatal sepsis, pneumonia, and meningitis. Chorioamnionitis can also result in maternal morbidity such as pelvic infection and septic shock.Clinical chorioamnionitis is estimated to occur in 1% to 2% of term births and in 5% to 10% of preterm births; histologic chorioamnionitis is found

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2014 Cochrane

73. Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections. (PubMed)

infections. Antibiotics may be an effective option to reduce such morbidity.The objective of this review is to assess the efficacy and side effects of prophylactic antibiotics for MSAF during labour in preventing maternal and neonatal infections.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2014). Randomised controlled trials (RCTs) comparing prophylactic antibiotics with placebo or no treatment during labour for women with MSAF.Two review authors independently (...) Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections. Chorioamnionitis is more likely to occur when meconium-stained amniotic fluid (MSAF) is present. Meconium may enhance the growth of bacteria in amniotic fluid by serving as a growth factor, inhibiting bacteriostatic properties of amniotic fluid. Many adverse neonatal outcomes related to MSAF result from meconium aspiration syndrome (MAS). MSAF is associated with both maternal and newborn

2014 Cochrane

74. Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant. (PubMed)

Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant. Amniotomy (the deliberate rupture of membranes) was described almost two centuries ago and since then has been used both for induction and augmentation of labour - which are common obstetric practices. Trends have shown a rise in the induction rates over the last decade and data suggest that the rate of labour inductions is increasing faster than the rate of pregnancy complications. Recent years have seen (...) infectious morbidity.The objective of this review was to evaluate the prophylactic use of antibiotics versus placebo or no treatment prior to amniotomy on maternal and neonatal infectious morbidity and mortality.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014), the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (12 September 2014).Randomised controlled trials or cluster-randomised trials comparing antibiotics prior to amniotomy

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2014 Cochrane

75. Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth. (PubMed)

infection. Prophylactic antibiotics might have a role in preventing this infection.To assess the effectiveness of antibiotic prophylaxis for reducing maternal morbidity and side effects in third- and fourth-degree perineal tear during vaginal birth.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014) and the reference lists of retrieved articles.Randomised controlled trials comparing outcomes of prophylactic antibiotics versus placebo or no antibiotics in third (...) Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth. One to eight per cent of women suffer third-degree perineal tear (anal sphincter injury) and fourth-degree perineal tear (rectal mucosa injury) during vaginal birth, and these tears are more common after forceps delivery (28%) and midline episiotomies. Third- and fourth-degree tears can become contaminated with bacteria from the rectum and this significantly increases in the chance of perineal wound

2014 Cochrane

76. Antibiotic prophylaxis for operative vaginal delivery. (PubMed)

infectious puerperal morbidities in women undergoing operative vaginal deliveries including vacuum or forceps deliveries, or both.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014).All randomised trials comparing any prophylactic antibiotic regimens with placebo or no treatment in women undergoing vacuum or forceps deliveries were eligible. Participants were all pregnant women without evidence of infections or other indications for antibiotics of any gestational (...) Antibiotic prophylaxis for operative vaginal delivery. Vacuum and forceps assisted vaginal deliveries are reported to increase the incidence of postpartum infections and maternal readmission to hospital compared to spontaneous vaginal delivery. Prophylactic antibiotics may be prescribed to prevent these infections. However, the benefit of antibiotic prophylaxis for operative vaginal deliveries is still unclear.To assess the effectiveness and safety of antibiotic prophylaxis in reducing

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2014 Cochrane

77. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. (PubMed)

not and to identify the appropriate regimen of antibiotic prophylaxis for this procedure.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2014).All randomized controlled trials comparing antibiotic prophylaxis and placebo or non antibiotic use to prevent endometritis after manual removal of placenta in vaginal birth.There are no included trials. In future updates, if we identify eligible trials, two review authors will independently assess trial quality and extract dataNo studies (...) Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. Retained placenta is a potentially life-threatening condition because of its association with postpartum hemorrhage. Manual removal of placenta increases the likelihood of bacterial contamination in the uterine cavity.To compare the effectiveness and side-effects of routine antibiotic use for manual removal of placenta in vaginal birth in women who received antibiotic prophylaxis and those who did

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2014 Cochrane

78. Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing cesarean delivery. (PubMed)

gynecologic surgery; however, administration of prophylactic antibiotics has traditionally been withheld until after neonatal umbilical cord clamping during cesarean delivery due to the concern for potential transfer of antibiotics to the neonate.To compare the effects of cesarean antibiotic prophylaxis administered preoperatively versus after neonatal cord clamp on postoperative infectious complications for both the mother and the neonate.We searched the Cochrane Pregnancy and Childbirth Group's Trials (...) Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing cesarean delivery. Given the continued rise in cesarean birth rate and the increased risk of surgical site infections after cesarean birth compared with vaginal birth, effective interventions must be established for prevention of surgical site infections. Prophylactic intravenous (IV) antibiotic administration 60 minutes prior to skin incision is recommended for abdominal

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2014 Cochrane

79. Antibiotics for prelabour rupture of membranes at or near term. (PubMed)

risks and benefits in order to ensure judicious use of antibiotics. This review was undertaken to assess the balance of risks and benefits to the mother and infant of antibiotic prophylaxis for PROM at or near term.To assess the effects of antibiotics administered prophylactically to women with PROM at 36 weeks' gestation or beyond, on maternal, fetal and neonatal outcomes.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2014).All randomised trials that compared (...) Antibiotics for prelabour rupture of membranes at or near term. Prelabour rupture of the membranes (PROM) at or near term (defined in this review as 36 weeks' gestation or beyond) increases the risk of infection for the woman and her baby. The routine use of antibiotics for women at the time of term PROM may reduce this risk. However, due to increasing problems with bacterial resistance and the risk of maternal anaphylaxis with antibiotic use, it is important to assess the evidence addressing

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2014 Cochrane

80. Neonatal infection: antibiotics for prevention and treatment

to prevent early- onset neonatal infection for women who have had: a previous baby with an invasive group B streptococcal infection group B streptococcal colonisation, bacteriuria or infection in the current pregnancy. Investigations before starting antibiotics in the baby Measure the C-reactive protein concentration at presentation when starting antibiotic treatment in babies with risk factors for infection or clinical indicators of possible infection. Antibiotics for suspected infection Use intravenous (...) , including 'red flags' able 1 Risk factors for early-onset neonatal infection, including 'red flags' Risk factor Risk factor Red flag Invasive group B streptococcal infection in a previous baby Maternal group B streptococcal colonisation, bacteriuria or infection in the current pregnancy Neonatal infection (early onset): antibiotics for prevention and treatment (CG149) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 15

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

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