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Antibiotics in Pregnancy

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61. 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

62. 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

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2017 Society for Maternal-Fetal Medicine

63. Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection

Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Discover Portal Discover Portal Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Published on 23 May 2017 doi: Inducing labour may halve the risk of infection in the womb when waters break from 37 weeks. The procedure was started (...) ? Premature rupture of membranes (PROM) at full term (37 weeks or more) occurs in 8% of pregnancies. Spontaneous onset of labour within 24 hours occurs in approximately 95% of cases. Labour can be delayed for up to seven days if it does not start within 24 hours. The risk of maternal or neonatal infection and the need for caesarean section are increased by PROM. Untreated infections can lead to complications with reproductive organs, problems with fertility and general health. PROM at term is managed

2019 NIHR Dissemination Centre

64. 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

65. Antibiotics for gonorrhoea in pregnancy [Cochrane Protocol]

Antibiotics for gonorrhoea in pregnancy [Cochrane Protocol] Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect measures Timing

2015 PROSPERO

66. 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

67. 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

68. Antibiotics for amniotic-fluid colonization by Ureaplasma and/or Mycoplasma spp. to prevent preterm birth: A randomized trial. (PubMed)

Antibiotics for amniotic-fluid colonization by Ureaplasma and/or Mycoplasma spp. to prevent preterm birth: A randomized trial. To assess whether antibiotics used for treatment in asymptomatic second-trimester women positive for Mycoplasma or Ureaplasma spp. detected by amniotic-fluid PCR prevents preterm delivery.A randomized, double-blind, placebo-controlled trial.10 maternal fetal medicine centers in France.Women with a singleton pregnancy who underwent amniocentesis between 16 and 20 weeks (...) total, 1043 women underwent amniotic-fluid screening with specific PCR detection between July 2008 and July 2011: PCR detection failed in 27 (2.6%), and 20 (1.9%) underwent termination of pregnancy. Among the 1016 women with PCR results, 980 had available data for the primary outcome (delivery before 37 weeks) and 29 (3.0%) were positive for Ureaplasma and/or Mycoplasma spp. Because of the low rate of women with PCR-positive findings, the trial was stopped prematurely. In total, 19 women were

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2018 PLoS ONE Controlled trial quality: predicted high

69. A New, Potent, and Placenta-Permeable Macrolide Antibiotic, Solithromycin, for the Prevention and Treatment of Bacterial Infections in Pregnancy (PubMed)

A New, Potent, and Placenta-Permeable Macrolide Antibiotic, Solithromycin, for the Prevention and Treatment of Bacterial Infections in Pregnancy Intrauterine infection-inflammation is a major cause of early preterm birth and subsequent neonatal mortality and acute or long-term morbidity. Antibiotics can be administered in pregnancy to prevent preterm birth either prophylactically to women at high risk for preterm delivery, or to women with diagnosed intrauterine infection, prelabor rupture (...) of membranes, or in suspected preterm labor. The therapeutic goals of each of these scenarios are different, with different pharmacological considerations, although effective antimicrobial therapy is an essential requirement. An ideal antibiotic for these clinical indications would be (a) one that is easily administered and orally bioactive, (b) has a favorable adverse effect profile (devoid of reproductive toxicity or teratogenicity), (c) is effective against the wide range of microorganisms known

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2016 Frontiers in immunology

70. Appendicitis during pregnancy in a Greenlandic Inuit woman; antibiotic treatment as a bridge-to-surgery in a remote area (PubMed)

Appendicitis during pregnancy in a Greenlandic Inuit woman; antibiotic treatment as a bridge-to-surgery in a remote area Appendicitis during pregnancy causes severe diagnostic problems, and is associated with an increase in perforation rate and morbidity compared to that in the normal population. In addition, it may cause preterm birth and fetal loss. In remote areas, appendicitis during pregnancy, besides presenting diagnostic problems, also creates treatment difficulties. In Northern (...) Greenland, geographical distances are vast, and weather conditions can be extreme. We report a case of a Greenlandic Inuit woman who presented with appendicitis during pregnancy. The nearest hospital with surgical and anaesthetic care was located nearly 1200 km away, and, due to extreme weather conditions, she could not be transferred immediately. She was treated with intravenous antibiotic treatment, and after weather conditions had improved, she was transferred by aeroplane and underwent

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2016 BMJ case reports

71. Prophylactic Antibiotics in Twin Pregnancies Complicated by Previable Preterm Premature Rupture of Membranes (PubMed)

Prophylactic Antibiotics in Twin Pregnancies Complicated by Previable Preterm Premature Rupture of Membranes This study aims to determine if antibiotics given for latency to women with twins and previable preterm premature rupture of membranes (PPROM) affect the duration from membrane rupture to delivery.A retrospective cohort study of twin pregnancies at a single center from 2000 to 2015 with previable (14 (0/7)-22 (6/7) weeks) PPROM was conducted. Women who were not candidates for expectant (...) management or who elected for immediate delivery were excluded. Pregnancy complications, delivery data, and neonatal outcomes were compared between women who did and did not receive latency antibiotics. The primary outcome was latency.Of 52 eligible women, 30 (64%) elected expectant management; 17 women received antibiotics and 13 did not. No demographic differences existed between the groups. The median gestational age of rupture was 20 and 20.3 weeks in the antibiotic group and no antibiotic group

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2016 AJP Reports

72. Maternal Infections, Antibiotics and Paracetamol in Pregnancy and Offspring Celiac Disease: A Cohort Study. (PubMed)

Maternal Infections, Antibiotics and Paracetamol in Pregnancy and Offspring Celiac Disease: A Cohort Study. Infections in pregnancy are common, may affect fetal development, and have been linked to offspring autoimmunity. We aimed to determine whether maternal infections, the use of antibiotics, and use of paracetamol in pregnancy are associated with the risk of offspring celiac disease (CD).The nationwide Norwegian Mother and Child Cohort Study includes 84,274 children born in the period from (...) increased for categories 1 infection (1.01 [95% CI = 0.82-1.25]) and ≥2 infections (1.22 [95% CI = 1.00-1.49]) versus no infection. We found the same pattern for respiratory tract infections, but not for gastrointestinal infections. The aORs were broadly consistent across pregnancy periods of exposure. The use of antibiotics and paracetamol was, compared with no use, not associated with offspring CD (aOR = 1.16 [95% CI = 0.94-1.43] and aOR = 1.13 [95% CI = 0.96-1.33], respectively; P values for trend

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2016 Journal of Pediatric Gastroenterology and Nutrition

73. Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity. (PubMed)

Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity. Several studies have suggested that prophylactic antibiotics given during pregnancy improved maternal and perinatal outcomes, while others have shown no benefit and some have reported adverse effects.To determine the effect of prophylactic antibiotics on maternal and perinatal outcomes during the second and third trimester of pregnancy for all women or women at risk of preterm (...) delivery.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2014) and reference lists of retrieved articles.Randomised controlled trials comparing prophylactic antibiotic treatment with placebo or no treatment for women in the second or third trimester of pregnancy before labour.We assessed trial quality and extracted data.The review included seven randomised controlled trials. Approximately 2100 women were recruited to detect the effect of prophylactic antibiotic

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2015 Cochrane database of systematic reviews (Online)

74. Impact of Intermittent Preventive Treatment in Pregnancy with Azithromycin-Containing Regimens on Maternal Nasopharyngeal Carriage and Antibiotic Sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus: a Cross-Sectional (PubMed)

Impact of Intermittent Preventive Treatment in Pregnancy with Azithromycin-Containing Regimens on Maternal Nasopharyngeal Carriage and Antibiotic Sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus: a Cross-Sectional Sulfadoxine-pyrimethamine (SP) plus azithromycin (AZ) (SPAZ) has the potential for intermittent preventive treatment of malaria in pregnancy (IPTp), but its use could increase circulation of antibiotic-resistant bacteria associated with severe (...) pediatric infections. We evaluated the effect of monthly SPAZ-IPTp compared to a single course of SP plus chloroquine (SPCQ) on maternal nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus at delivery among 854 women participating in a randomized controlled trial in Papua New Guinea. Serotyping was performed, and antibiotic susceptibility was evaluated by disk diffusion and Etest. Potential risk factors for carriage were

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2015 Journal of clinical microbiology Controlled trial quality: uncertain

75. Antibiotic use during pregnancy and asthma in preschool children: the influence of confounding. (PubMed)

Antibiotic use during pregnancy and asthma in preschool children: the influence of confounding. A recent study suggested that early-life intestinal microbiota may play an important role in the development of childhood asthma, indicating that antibiotics taken during early life or in late pregnancy may be associated with childhood asthma.This study aims to assess the association between prenatal antibiotic use and asthma in preschool children using data from the prescription database IADB.nl (...) regression was used to estimate crude and adjusted odds ratios (aORs).In both the case-sibling and case-control analysis, the use of antibiotics in the third trimester of pregnancy was associated with an increased risk of asthma in preschool children (aOR 1.37; 95% CI 1.02-1.83 and aOR 1.40; 95% CI 1.15-1.47). Time-trend analyses showed that results were not influenced by a time trend in antibiotic exposure. A significant association between exposure to antibiotics in any trimester of pregnancy

2016 Clinical and Experimental Allergy

76. Antibiotic use during pregnancy: how bad is it? (PubMed)

Antibiotic use during pregnancy: how bad is it? Our microbial companions (the "microbiota") are extremely important for the preservation of human health. Although changes in bacterial communities (dysbiosis) are commonly associated with disease, such changes have also been described in healthy pregnancies, where the microbiome plays an essential role in maternal and child health outcomes, including normal immune and metabolic function in later life. Nevertheless, this new understanding (...) of the importance of the microbiome has not yet influenced contemporary clinical practice regarding antibiotic use during pregnancy.Antibiotic treatment during pregnancy is widespread in Western countries, and accounts for 80 % of prescribed medications in pregnancy. However, antibiotic treatment, while at times lifesaving, can also have detrimental consequences. A single course of antibiotics perturbs bacterial communities, with evidence that the microbial ecosystem does not return completely to baseline

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2016 BMC Medicine

77. Control Cross Sectional Study Evaluating an Antibiotic Prevention Strategy in 30 Pregnancies Under Clean Intermittent Self-Catheterization and Review of Literature. (PubMed)

Control Cross Sectional Study Evaluating an Antibiotic Prevention Strategy in 30 Pregnancies Under Clean Intermittent Self-Catheterization and Review of Literature. To assess the efficacy and safety of a weekly oral cycling antibiotic (WOCA) strategy to prevent UTI in women.We performed a monocentric, comparative, retrospective, cross-sectional study on pregnant women under clean intermittent self catheterization between January 2008 and December 2014. WOCA consisted the administration (...) of a single-dose antibiotic, alternating antibiotic A and B once every 2 weeks, according to previous urine cultures.Twenty-five women carried out 30 pregnancies. Thirteen pregnancies (43.3%) were in the WOCA group (WCG) strategy and 17 were in the non-WOCA group (NWCG) (56.7%). In the 19 (63.3%) pregnancies with urinary tract infection (UTI), 5 (38.4%) were in WCG, 14 (82.3%) were not (P = .023). There were more cystitis in NWCG (76.5% vs 23.1% P = .009) but more colonization in WCG (46.2% vs 5.8% P

2016 Urology

78. Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection

Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Discover Portal Discover Portal Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Published on 23 May 2017 doi: Inducing labour may halve the risk of infection in the womb when waters break from 37 weeks. The procedure was started (...) ? Premature rupture of membranes (PROM) at full term (37 weeks or more) occurs in 8% of pregnancies. Spontaneous onset of labour within 24 hours occurs in approximately 95% of cases. Labour can be delayed for up to seven days if it does not start within 24 hours. The risk of maternal or neonatal infection and the need for caesarean section are increased by PROM. Untreated infections can lead to complications with reproductive organs, problems with fertility and general health. PROM at term is managed

2018 NIHR Dissemination Centre

79. Duration of treatment for asymptomatic bacteriuria during pregnancy. (PubMed)

Duration of treatment for asymptomatic bacteriuria during pregnancy. A previous Cochrane systematic review has shown that antibiotic drug treatment of asymptomatic bacteriuria in pregnant women substantially decreases the risk of pyelonephritis and reduces the risk of preterm delivery. However, it is not clear whether single-dose therapy is as effective as longer conventional antibiotic treatment.To assess the effects of different durations of treatment for asymptomatic bacteriuria (...) in trials contributing data and for imprecise effect estimates (wide confidence intervals crossing the line of no effect, and in some cases, small studies with few events).A single-dose regimen of antibiotics may be less effective than a short-course (four- to seven-day) regimen, but more evidence is needed from large trials measuring important outcomes, such as cure rate. Women with asymptomatic bacteriuria in pregnancy should be treated by the standard regimen of antibiotics until more data become

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2015 Cochrane

80. Interventions for preventing recurrent urinary tract infection during pregnancy. (PubMed)

Interventions for preventing recurrent urinary tract infection during pregnancy. Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological (antibiotics) or non-pharmacological (cranberry products, acupuncture, probiotics and behavioural modifications). So (...) far little is known about the best way to prevent RUTI in pregnant women.To assess the effects of interventions for preventing RUTI in pregnant women.The primary maternal outcomes were RUTI before birth (variously defined) and preterm birth (before 37 weeks). The primary infant outcomes were small-for-gestational age and total mortality.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (20 May 2015) and reference lists of retrieved articles.Published, unpublished

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2015 Cochrane

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