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Antibiotics in Pregnancy

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14341. The effects of internal electronic fetal heart rate monitoring on maternal and infant infections in high-risk pregnancies. (PubMed)

The effects of internal electronic fetal heart rate monitoring on maternal and infant infections in high-risk pregnancies. A controlled prospective study of the effects of fetal monitoring on mothers and infants was conducted at Denver General Hospital, Denver, Colorado. A total of 690 high-risk patients in labor were randomly assigned to one of three groups; auscultation alone, electronic fetal monitoring and electronic fetal monitoring with the option to obtain a scalp pH sample. Maternal (...) and neonatal infectious morbidity after vaginal or cesarean delivery was unchanged with internal fetal monitoring. Despite frequent antibiotic prophylaxis (95% cesarean section v. 11% vaginal), cesarean section was the most significant factor associated with increased maternal puerperal infectious morbidity (13.75% cesarean section v. 3.9% vaginal). Although hours of labor, hours of rupture of membranes, hours of internal catheter, number of exams and presence of meconium were not associated with increased

1982 Journal of Reproductive Medicine Controlled trial quality: uncertain

14342. Pyelonephritis in pregnancy. The role of in-hospital management and nitrofurantoin suppression. (PubMed)

Pyelonephritis in pregnancy. The role of in-hospital management and nitrofurantoin suppression. Acute pyelonephritis remains a frequent complication of pregnancy. Prevention of the potential complications of this disease requires aggressive in-hospital management. However, the high frequency of positive outpatient cultures following discharge has cast doubt on the adequacy of in-hospital care and, at the same time, has concentrated attention on follow-up care. In a randomized, prospective study (...) , we evaluated the effects of in-hospital management and outpatient nitrofurantoin on subsequent urine cultures. The overall frequency of positive cultures following discharge from the hospital was 38%. However, appropriate antibiotic selection, a negative follow-up in-hospital culture and nitrofurantoin suppression reduced the rate to 8% (P less than .01). Nitrofurantoin did not reduce the rate of positive cultures if antibiotic selection was inappropriate or if the in-hospital follow-up culture

1987 Journal of Reproductive Medicine Controlled trial quality: uncertain

14343. Transplacental passage of intravenous immunoglobulin in the last trimester of pregnancy. (PubMed)

Transplacental passage of intravenous immunoglobulin in the last trimester of pregnancy. Immunoglobulin G was given intravenously (IVIgG) to pregnant women (27 to 36 weeks gestation) with signs of chorioamnionitis who were at risk for preterm delivery. Twenty-four patients received antibiotics alone (control group). Twenty-seven patients received the same antibiotics in combination with IVIgG, either 12 gm in 12 hours (low IVIgG dosage) or 24 gm on each of 5 consecutive days (high IVIgG dosage

1986 The Journal of pediatrics Controlled trial quality: uncertain

14344. Treatment of urinary infections in pregnancy using single versus 10-day dosing. (PubMed)

Treatment of urinary infections in pregnancy using single versus 10-day dosing. Pregnant patients with symptomatic and asymptomatic urinary tract infections were treated with a long and a short antibiotic regimen. Two hundred two patients were randomized prospectively to a single oral dose of 3.5 g ampicillin plus 1 g probenecid (98 patients) versus 500 mg ampicillin orally four times a day for 10 days (104 patients). The multiple-dose cure rate was statistically significantly better than (...) that of the single-dose regimen (67.3% versus 57.1%, respectively). Interestingly, for resistant organisms, the cure rate for the long and short regimens was similar (48% versus 43%, respectively). In vitro susceptibility testing does not appear to be a good predictor of cure, at least for the single-dose group. Single-dose therapy with ampicillin and probenecid does not provide an optimal cure rate or prevent reinfection during pregnancy. Possible reasons for these findings are discussed.

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1992 Journal of the National Medical Association Controlled trial quality: uncertain

14345. Pharmacokinetics of ampicillin and sulbactam in pregnancy. (PubMed)

affected, although these changes failed to attain statistical significance.Because pregnancy is associated with more rapid elimination of beta-lactam drugs, physicians treating infections in pregnant or newly parturient women should consider using shorter intervals between antibiotic doses when a range of dosage intervals is under consideration. (...) Pharmacokinetics of ampicillin and sulbactam in pregnancy. This study evaluated the effects pregnancy had on pharmacokinetic parameters of ampicillin and sulbactam.Twenty-two women undergoing cesarean section for obstetric indications were randomly assigned to receive a single intraoperative dose of either 1 gm of ampicillin intravenously or 1 gm of ampicillin plus 0.5 gm of sulbactam intravenously after umbilical cord clamping. Blood was drawn from an indwelling intravenous catheter at 15, 30

1993 American journal of obstetrics and gynecology Controlled trial quality: uncertain

14346. Impact of intrapartum intravenous ampicillin on pregnancy outcome in women with preterm labor: a randomised, placebo-controlled study. (PubMed)

Impact of intrapartum intravenous ampicillin on pregnancy outcome in women with preterm labor: a randomised, placebo-controlled study. The purpose of this study was to elucidate whether the use of intravenous ampicillin (vs. placebo therapy) in women in early active-phase preterm labor reduces infectious complications postpartum in mothers and their newborns. A randomised, double-blind, placebo-controlled study was carried out on 102 women with gestational age < 37 completed weeks in the active (...) 2.0-19.4) and puerperal endometritis-myometritis (OR 3.7; 95% CI 1.3-10.3). It is concluded that women in the active phase of preterm labor and their newborns benefit from treatment with intravenous ampicillin. Antibiotic treatment reduces the incidence of neonatal infectious morbidity, of puerperal endometritis and of histological chorioamnionitis.

1996 Gynecologic and obstetric investigation Controlled trial quality: predicted high

14347. Pyelonephritis in pregnancy: once-a-day ceftriaxone versus multiple doses of cefazolin. A randomized, double-blind trial. (PubMed)

Pyelonephritis in pregnancy: once-a-day ceftriaxone versus multiple doses of cefazolin. A randomized, double-blind trial. The purpose of this study was to compare the efficacy of a single daily dose of intravenous ceftriaxone with that of multiple-dose cefazolin in the treatment of acute pyelonephritis in pregnancy.This was a double-blind, randomized, clinical trial. Patients admitted to the hospital with the diagnosis of acute pyelonephritis in pregnancy were enrolled and randomized according (...) to a computer-generated randomization schedule. The study group received a single daily 1 gm dose of ceftriaxone intravenously along with two additional doses of normal saline solution. The comparison group received three daily 2 gm doses of cefazolin intravenously. All infusions were given on an 8-hour schedule. Treatments were continued until the patient became afebrile. Each patient was discharged from the hospital on a regimen of appropriate oral antibiotics as directed by urine culture

1995 American journal of obstetrics and gynecology Controlled trial quality: uncertain

14348. Randomized prospective study comparing erythromycin, amoxicillin, and clindamycin for the treatment of chlamydia trachomatis in pregnancy. (PubMed)

Randomized prospective study comparing erythromycin, amoxicillin, and clindamycin for the treatment of chlamydia trachomatis in pregnancy. The purpose of this study was to compare the efficacy and side effects of erythromycin, amoxicillin, and clindamycin in eradicating Chlamydia trachomatis from the lower genital tract of pregnant women.A total of 174 women at <36 weeks gestation with positive cervical cultures for C. trachomatis were enrolled. Patients were assigned in a randomized (...) until treatment was complete.All 3 medications were effective agents for the treatment of antenatal C. trachomatis infection with treatment efficacies of 96%, 94%, and 98% for the erythromycin, amoxicillin, and clindamycin groups, respectively. When the antibiotic groups were compared, no statistically significant differences were noted in intolerance. However, the differences in the incidence of gastrointestinal symptoms between erythromycin and amoxicillin and/or clindamycin were significant (P

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1995 Infectious diseases in obstetrics and gynecology Controlled trial quality: uncertain

14349. Low-dose glucocorticoids after in vitro fertilization and embryo transfer have no significant effect on pregnancy rate. (PubMed)

% versus 40.8% and 12.8% versus 11.7% for stimulation cycles and 30.3% versus 25% and 9.9% versus 7.4% for cryopreservation cycles, respectively. None of these differences were statistically significant.Glucocorticoid plus antibiotic treatment at these doses for transfers of nonmicromanipulated embryos does not appear to have a significant effect on pregnancy or implantation rates. (...) Low-dose glucocorticoids after in vitro fertilization and embryo transfer have no significant effect on pregnancy rate. To determine the effect on pregnancy rate (PR) of low-dose glucocorticoid treatment in cycles without micromanipulation.Randomized, prospective, double-blinded, placebo-controlled trial.One university-based tertiary infertility center and two private infertility centers.All patients receiving standard stimulation IVF-ET or transfer of cryopreserved embryos at the participating

1995 Fertility and sterility Controlled trial quality: predicted high

14350. Outpatient treatment of pyelonephritis in pregnancy: a randomized controlled trial. (PubMed)

Outpatient treatment of pyelonephritis in pregnancy: a randomized controlled trial. To compare the safety and efficacy of outpatient and inpatient treatment of pyelonephritis in pregnancy.We performed a randomized controlled trial of pregnant women with pyelonephritis before 24 weeks' estimated gestational age, comparing inpatient and outpatient treatment. Sixty inpatients received cefazolin intravenously until afebrile for 48 hours, and 60 outpatients received two injections of ceftriaxone (...) cultures after therapy (relative risk 0.9, 95% confidence interval 0.4-1.9). Three patients in each group had recurrent pyelonephritis. We switched six inpatients to gentamicin because of a worsening clinical picture (two) or a prolonged febrile course (four); no outpatients required a change in antibiotic (Fisher exact test, P = .03). One preterm delivery occurred in an inpatient with recurrent pyelonephritis.Outpatient antibiotic therapy is effective and safe in selected pregnant women

1995 Obstetrics and Gynecology Controlled trial quality: uncertain

14351. [Conservative management of premature membrane rupture in pregnancy of 28-34 weeks. Aleatory clinical trial]. (PubMed)

[Conservative management of premature membrane rupture in pregnancy of 28-34 weeks. Aleatory clinical trial]. A random clinical trial to compare two managements: a conservative one (experimental group) and an interventionist one (control group) in patients with PROM in pregnancy between 28 and 34 weeks, was carried out. A group of women with complicate pregnancies with PROM, with amniotic fluid index of 5 cm in four quadrants, and a negative amniotic fluid culture, by amniocenthesis (...) ; no antibiotics, were studied at Perinatology Department, Centro Médico Nacional, IMSS, Torreón, Coah. México, from November 1, 1992 to October 31, 1993. The latency period was longer in the experimental group, than the control group (7.9 and 3 days, p < 0.001). There were no difference in chorioamnioitis or endometritis in both groups (p > 0.1). There were five cases of mid RDS in the experimental group, and seven cases in the control group, and nine of severe RDS, all of them died; there was a highly

1997 Ginecología y obstetricia de México Controlled trial quality: uncertain

14352. [Streptococcus group B and pregnancy: the therapeutic role of topical intravaginal clindamycin]. (PubMed)

) and 50 oral amoxicillin (2 g/day for 7 days).Patients were treated during pregnancy, none of them received intrapartum chemoprophylaxis. On the other hand, all the neonates, within 24 hours from delivery, were studied from the microbiological point of view, carrying out auricolar, nasal, oropharyngeal and umbilical cultures. RELIEFS: The eradication of the microorganism was evaluated by performing a vaginal culture after 6 weeks from the beginning of antibiotic therapy.The eradication rate (...) [Streptococcus group B and pregnancy: the therapeutic role of topical intravaginal clindamycin]. To evaluate the clinical and therapeutic efficacy of 2% clindamycin vaginal cream in pregnant women heavily colonized with group B streptococci (GBS).A prospective, clinical trial in which carriers of group B streptococci were randomized to receive topical intravaginal clindamycin or oral amoxicillin.We randomized 105 pregnant women: 55 received 2% clindamycin vaginal cream (100 mg/day for 7 days

1997 Minerva ginecologica Controlled trial quality: uncertain

14353. Outpatient treatment of acute pyelonephritis in pregnancy after 24 weeks. (PubMed)

Outpatient treatment of acute pyelonephritis in pregnancy after 24 weeks. To compare outpatient to inpatient management of acute pyelonephritis in pregnancy beyond 24 weeks' gestation.Ninety-two gravidas past 24 weeks' gestation, randomized to outpatient or inpatient therapy, received two 1-g doses of intramuscular ceftriaxone at 24-hour intervals while hospitalized, then were discharged and reevaluated within 48-72 hours or remained hospitalized until afebrile for 48 hours. Subjects received (...) oral cephalexin after initial treatment. Urine cultures were done on admission and 5-14 days after therapy. Surveillance continued until delivery. We anticipated that 15% of outpatients and 0.01% of inpatients would require changes in antibiotic therapy.Twenty-one percent of women evaluated were excluded. Thirteen of 46 (28%) outpatients' hospitalization exceeded 24 hours. Six outpatients (13.0%) and one inpatient did not respond to initial therapy and were treatment failures (relative risk [RR

1999 Obstetrics and Gynecology Controlled trial quality: uncertain

14354. The impact of regular vaginal pH screening on the diagnosis of bacterial vaginosis in pregnancy. (PubMed)

The impact of regular vaginal pH screening on the diagnosis of bacterial vaginosis in pregnancy. Bacterial vaginosis has recently been associated with preterm labor and delivery. The purpose of our study was to determine whether regular prenatal vaginal pH testing resulted in more frequent diagnoses of bacterial vaginosis and other vaginal infections, more frequent treatment with antibiotics, and fewer preterm deliveries. We also sought to determine the sensitivity and specificity of pH testing (...) % sensitivity.In our study, frequent vaginal pH testing during pregnancy resulted in more frequent diagnosis and treatment of bacterial vaginosis. Since vaginal symptoms and elevated pH levels appear to be useful in screening for bacterial vaginosis and trichomoniasis, frequent pH testing should be evaluated in larger studies.

2000 Journal of Family Practice Controlled trial quality: uncertain

14355. Effect of intravaginal clindamycin cream on pregnancy outcome and on abnormal vaginal microbial flora of pregnant women. (PubMed)

Effect of intravaginal clindamycin cream on pregnancy outcome and on abnormal vaginal microbial flora of pregnant women. To determine whether intravaginal clindamycin cream reduces the incidence of abnormal pregnancy outcome in women with abnormal vaginal microbial flora graded as intermediate or BV and to investigate the effect of the antibiotic on vaginal microbial flora.A prospective cohort study of pregnant women in an antenatal clinic of a district general hospital. The subjects were 268 (...) women who had abnormal vaginal microbial flora at first clinic visit by examination of a Gram-stained vaginal smear and 34 women with a normal vaginal flora. Two hundred and thirty-seven women were evaluable. Women with abnormal Gram-stained smears (graded as II or III) on clinic recall were randomised to receive treatment (intravaginal clindamycin cream) or placebo and followed to assess outcome of pregnancy, vaginal flora, and detection of Mycoplasma hominis and Ureaplasma urealyticum after

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2000 Infectious diseases in obstetrics and gynecology Controlled trial quality: uncertain

14356. A randomized controlled trial comparing two protocols for the use of misoprostol in midtrimester pregnancy termination. (PubMed)

A randomized controlled trial comparing two protocols for the use of misoprostol in midtrimester pregnancy termination. Our purpose was to compare the efficacy of oral misoprostol with that of vaginal misoprostol for midtrimester termination of pregnancy.Women seen for midtrimester pregnancy termination were randomly assigned to receive either misoprostol orally in a dose of 200 microg every hour for 3 hours followed by 400 microg every 4 hours or vaginally in a dose of 400 microg every 4 hours (...) . The two groups were comparable with respect to maternal age, parity, indication for pregnancy termination, gestational age, and maternal weight. The mean induction-to-delivery interval was significantly shorter for the vaginal group (19.6 +/- 17.5 hours vs 34.5 +/- 28.2 hours, P <.01). Length of stay was also shorter in the vaginal group (32.3 +/- 17.3 hours vs 50.9 +/- 27.9 hours, P <.01). Significantly more patients in the vaginal group were delivered within 24 hours (85.1% vs 39.5%, P <.01

2002 American journal of obstetrics and gynecology Controlled trial quality: predicted high

14357. Evaluation of reagent strips in detecting asymptomatic bacteriuria in early pregnancy: prospective case series. (PubMed)

Evaluation of reagent strips in detecting asymptomatic bacteriuria in early pregnancy: prospective case series. To evaluate the performance of reagent test strips in screening pregnant women for asymptomatic bacteriuria at their first visit to an antenatal clinic.Prospective case series.Antenatal clinic of a large inner city maternity hospital.All women attending for their first antenatal clinic. Patients taking antibiotics for any reason and those with urinary tract symptoms were excluded.A

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1998 BMJ : British Medical Journal

14358. Immune Thrombocytopenic Purpura During Pregnancy: Laparoscopic Treatment (PubMed)

, stress close steroids, and prophylactic antibiotics, she underwent a successful laparoscopic splenectomy. After a short hospital stay, the patient was discharged home.Immune thrombocytopenia purpura can be an indication for splenectomy. As demonstrated in appendectomy, cholecystectomy, and our case presentation, laparoscopic splenectomy can be safely performed during pregnancy. (...) Immune Thrombocytopenic Purpura During Pregnancy: Laparoscopic Treatment Laparoscopic surgical techniques in pregnancy have been accepted and pose minimal risks to the patient and fetus. We present the first reported case of a pregnant woman with immune thrombocytopenia purpura who underwent laparoscopic splenectomy during the second trimester.The anesthesia, hematology, and obstetrics services closely followed the patient's preoperative and intraoperative courses. After receiving immunization

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2001 JSLS : Journal of the Society of Laparoendoscopic Surgeons

14359. Prevalence of cervical gonorrhoea in women with unwanted pregnancies. (PubMed)

Prevalence of cervical gonorrhoea in women with unwanted pregnancies. Cervical specimens were collected from 1688 women attending a gynaecological clinic for induced abortion between February and December 1978. Thirteen (0.77%) women had positive culture results for Neisseria gonorrhoeae. Among those women who had a completed family or who came from outside Rotterdam or from outside the neighboring Rijnmond area, the isolation rate was very low. None of the women with positive culture results (...) developed salpingitis after abortion; all of them had been treated prophylactically with tetracycline. No reasons appear to exist for considering women who seek abortions to be in a high-risk group for cervical gonorrhoea. Whether or not antibiotic prophylaxis should be given for the prevention of salpingitis following abortion requires further study of potentially pathogenic micro-organisms inhabiting the vagina and cervix for women applying for abortion.

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1980 British Journal of Venereal Diseases

14360. Pregnancy attributable to interaction between tetracycline and oral contraceptives. (PubMed)

Pregnancy attributable to interaction between tetracycline and oral contraceptives. 7357347 1980 05 30 2018 11 13 0007-1447 280 6210 1980 Feb 02 British medical journal Br Med J Pregnancy attributable to interaction between tetracycline and oral contraceptives. 293 Bacon J F JF Shenfield G M GM eng Journal Article England Br Med J 0372673 0007-1447 0 Contraceptives, Oral F8VB5M810T Tetracycline AIM IM J Adult Contraceptives, Oral Drug Interactions Female Humans Pregnancy Tetracycline 800056 (...) 00073309 Various drugs, including antibiotics, may be responsible for contraceptive failure and breakthrough bleeding in oral contraceptive (OC) users. A case history is reported of a woman who took OCs for 4 years without a problem. On October 16, 1978 she had a normal withdrawal bleed, and on October 20 she started the next course of Microgynon and also a 5-day course of tetracyline 500 mg 6 hourly for 3 days and also 250 mg 6 hourly for 2 days for sinusitis. She completed the course on October 24

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1980 British medical journal

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