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Antibiotics in Pregnancy

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81. 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 (Full text)

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

2015 Journal of clinical microbiology Controlled trial quality: uncertain

82. Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity. (Full text)

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

2015 Cochrane database of systematic reviews (Online)

83. 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

84. Antibiotic regimens for management of intra-amniotic infection. (Full text)

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

2014 Cochrane

85. Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing cesarean delivery. (Full text)

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

2014 Cochrane

86. Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant. (Full text)

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

2014 Cochrane

87. 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

88. Antibiotic prophylaxis for operative vaginal delivery. (Full text)

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

2014 Cochrane

89. Antibiotics for prelabour rupture of membranes at or near term. (Full text)

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

2014 Cochrane

90. Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections. (Full text)

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

91. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. (Full text)

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

2014 Cochrane

92. 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

93. Safety Profile of Drug Use During Pregnancy at Peripheral Health Centres in Burkina Faso: A Prospective Observational Cohort Study (Full text)

by study participants and 36.6, 49.5 and 13.9% were, respectively, classified as 'probably safe', 'potentially risky' and 'unclassified'. Antimalarials and antibiotics were the most frequently used drugs. Around 39% of women used a least one medication classified as potentially risky. However, this proportion dropped to 26% with the modified classification. Living in urban areas and attending the first antenatal care within their first trimester of pregnancy (longer health surveillance) were associated (...) Safety Profile of Drug Use During Pregnancy at Peripheral Health Centres in Burkina Faso: A Prospective Observational Cohort Study Safety data of many drugs used during pregnancy remain scarce. This is especially true in developing countries characterised by the absence of a robust pharmacovigilance system, high prevalence of different tropical diseases affecting patients and potential for drug-drug interactions. This study aimed to assess the safety profile of drugs used in women at high risk

2018 Drugs - real world outcomes

94. Hypertension in pregnancy

Hypertension in pregnancy Hypertension in pregnancy - NICE CKS Share Hypertension in pregnancy: Summary Several different hypertensive disorders can complicate pregnancy. The National Institute for Health and Clinical Excellence (NICE) uses the following working definitions. Hypertension during pregnancy A diastolic blood pressure of 90 mmHg or greater on two occasions more than 4 hours apart, and/or A single diastolic blood pressure greater than 110 mmHg. Mild, moderate, and severe (...) the first and second trimesters and a woman with a high blood pressure before week 20 of pregnancy can therefore be assumed to have pre-existing hypertension. Gestational hypertension New hypertension presenting after 20 weeks' gestation without significant proteinuria. Pre-eclampsia New hypertension presenting after 20 weeks' gestation with significant proteinuria. Pre-eclampsia is a multi-system disorder which can affect the placenta, kidney, liver, brain, and other organs of the mother. HELLP

2019 NICE Clinical Knowledge Summaries

95. Polycystic ovary syndrome: metformin in women not planning pregnancy

Polycystic ovary syndrome: metformin in women not planning pregnancy P Poly olycystic o cystic ovary syndrome: metformin in women vary syndrome: metformin in women not planning pregnancy not planning pregnancy Evidence summary Published: 21 February 2013 nice.org.uk/guidance/esuom6 pathways K Ke ey points from the e y points from the evidence vidence The content of this evidence summary was up-to-date in February 2013. See summaries of product characteristics (SPCs), British national formulary (...) (BNF) or the MHRA or NICE websites for up-to-date information. Metformin is licensed in the UK for the control of blood glucose in people with type 2 diabetes. It has also been used to treat polycystic ovary syndrome (PCOS). Metformin is not licensed in the UK for this indication so its use in PCOS is off-label. This evidence summary relates to metformin for PCOS in women who are not planning pregnancy. The use of metformin for treating infertility in women with PCOS is not covered by this evidence

2013 National Institute for Health and Clinical Excellence - Advice

96. Reducing the Risk - Thrombosis and Embolism during Pregnancy and the Puerperium

risk assessment Any surgical procedure in pregnancy or puerperium except immediate repair of the perineum, e.g. appendicectomy, postpartum sterilisation Bone fracture Hyperemesis, dehydration Ovarian hyperstimulation syndrome (first trimester only) Assisted reproductive technology (ART), in vitro fertilisation (IVF) Admission or immobility (= 3 days’ bed rest) e.g. pelvic girdle pain restricting mobility Current systemic infection (requiring intravenous antibiotics or admission to hospital) e.g (...) Reducing the Risk - Thrombosis and Embolism during Pregnancy and the Puerperium Reducing the Risk of V enous Thromboembolism during Pregnancy and the Puerperium Green-top Guideline No. 37a April 2015RCOG Green-top Guideline No. 37a © Royal College of Obstetricians and Gynaecologists 2 of 40 Reducing the Risk of Venous Thromboembolism during Pregnancy and the Puerperium This is the third edition of this guideline, first published in 2004 under the title ‘Thromboprophylaxis during Pregnancy

2015 Royal College of Obstetricians and Gynaecologists

97. Prophylactic antibiotics for inhibiting preterm labour with intact membranes. (Full text)

benefit or causes harm, prior to membrane rupture.To assess the effects of prophylactic antibiotics administered to women in preterm labour with intact membranes, on maternal and neonatal outcomes.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2013).Randomised trials that compared antibiotic treatment with placebo or no treatment for women in preterm labour (between 20 and 36 weeks' gestation) with intact membranes.Two review authors independently assessed trial (...) Prophylactic antibiotics for inhibiting preterm labour with intact membranes. The aetiology of preterm birth is complex and there is evidence that subclinical genital tract infection influences preterm labour in some women but the role of prophylactic antibiotic treatment in the management of preterm labour is controversial. Since rupture of the membranes is an important factor in the progression of preterm labour, it is important to see if the routine administration of antibiotics confers any

2013 Cochrane

98. Antibiotics for mastitis in breastfeeding women. (Full text)

with mastitis with or without laboratory investigation.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2012), contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles.We selected randomised controlled trials (RCTs) and quasi-RCTs comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis.Two review (...) Antibiotics for mastitis in breastfeeding women. Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus aureus. The prevalence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment.This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women

2013 Cochrane

99. 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 IAP for maternal GBS colonization on neonatal: 1) all cause mortality and 2) morbidity from proven and probable EOGBSD, late onset GBS disease (LOD), maternal infectious outcomes and allergic reactions to antibiotics.We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 10 November 2012.Randomized trials assessing the impact of maternal IAP on neonatal GBS infections were included.We independently assessed eligibility and quality

2013 Cochrane

100. Management of pregnancy loss in the first trimester: a retrospective audit. (Full text)

Management of pregnancy loss in the first trimester: a retrospective audit. Early pregnancy loss occurs in 10% of all clinically recognised pregnancies. 80% of pregnancy losses occur in the first trimester. Offering choice and participation in the management decisions is essential to patient-centred care. The aim of this study was to assess the management of first trimester pregnancy loss at the Emirati Hospital in Rafah, Gaza Strip.In this retrospective audit, we compared the management (...) of first trimester pregnancy loss at Emirati Hospital using the American College of Obstetricians and Gynecologists guidelines (ACOG, No. 150, May 2015). Data were obtained from patients' medical records.50 cases were identified in November and December, 2015. 32 (64%) cases were missed miscarriages (an ultrasound finding of a non-viable pregnancy in an asymptomatic patient), 13 (26%) were incomplete miscarriages, and five (10%) were complete miscarriages. All cases were haemodynamically stable. Only

2018 Lancet

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