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Antibiotics in Pregnancy

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161. Differentiating Streptococcus pseudoporcinus from GBS: Could this have implications in pregnancy? (PubMed)

Differentiating Streptococcus pseudoporcinus from GBS: Could this have implications in pregnancy? Streptococcus agalactiae (GBS) is a common pathogen known to cause neonatal and maternal infectious morbidity. Streptococcus pseudoporcinus (S. pseudoporcinus) is a separate, recently identified beta-hemolytic gram positive coccus that can cause false positive results on standard GBS agglutination testing assays.To determine the prevalence and clinical implications of S. pseudoporcinus colonization (...) in pregnancy.This is a 2-year retrospective cohort study comparing pregnant women colonized with GBS to those colonized with S. pseudoporcinus. We used a proteomics method of identification, matrix assisted laser desorption ionization time of flight mass spectrometry, to distinguish between S. pseudoporcinus and GBS colonization. Antibiotic susceptibility testing was carried out on all specimens. Maternal and neonatal chart reviews were conducted to identify predictors of S. pseudoporcinus colonization

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2019 American Journal of Obstetrics and Gynecology

162. SMFM Consult Series #: Sepsis during pregnancy and the puerperium. (PubMed)

SMFM Consult Series #: Sepsis during pregnancy and the puerperium. Maternal sepsis is a significant cause of maternal morbidity and mortality and is a preventable cause of maternal death. The purpose of this guideline is to summarize what is known about sepsis and to provide guidance for the management of sepsis in pregnancy and the postpartum period. The following are SMFM recommendations: (1) we recommend that sepsis and septic shock be considered medical emergencies and that treatment (...) and resuscitation begin immediately (GRADE 1B); (2) we recommend that providers consider the diagnosis of sepsis in pregnant patients with otherwise unexplained end organ damage in the presence of an infectious process, regardless of the presence of fever (GRADE 1B); (3) we recommend that empiric broad-spectrum antibiotics be administered as soon as possible, ideally within 1 hour, in any pregnant woman in whom sepsis is suspected (GRADE 1B); (4) we recommend obtaining cultures (blood, urine, respiratory

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2019 American Journal of Obstetrics and Gynecology

163. Pregnancy Zone Protein is Associated with Airway Infection, Neutrophil Extracellular Trap Formation and Disease Severity in Bronchiectasis. (PubMed)

Pregnancy Zone Protein is Associated with Airway Infection, Neutrophil Extracellular Trap Formation and Disease Severity in Bronchiectasis. Pregnancy zone protein (PZP) is a broad-spectrum immunosuppressive protein believed to suppress T-cell function during pregnancy to prevent fetal rejection. It has not previously been reported in the airway.To characterise PZP in the bronchiectasis airway including its relationship with disease severity.Label free liquid chromatography/mass spectrometry (...) microscopy confirmed the presence of PZP in NETs, while fluorescence and electron microscopy localised PZP to the cytoplasm and nuclei of neutrophils. Effective antibiotic therapy reduced sputum PZP.PZP is released into NETs. We report a novel link between airway infection, NET formation and disease severity in bronchiectasis during chronic airway inflammation.

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2019 American Journal of Respiratory and Critical Care Medicine

164. Asymptomatic bacteriuria in pregnancy: systematic reviews of screening and treatment effectiveness and patient preferences. (PubMed)

. For treatment with antibiotics, we searched three databases for systematic reviews and obtained search results of the Cochrane Pregnancy and Childbirth Group's Trials Register to update a Cochrane review. Study selection, risk of bias assessment and evaluation of the quality for each outcome using Grading of Recommendations Assessment, Development and Evaluation was completed independently by two reviewers with consensus. Meta-analysis was conducted when appropriate as were analyses based on planned (...) opinions about antibiotic use during pregnancy. Fifteen trials compared antibiotic treatment with no treatment or placebo in women with confirmed bacteriuria. Low-quality evidence found that treatment lowered rates of pyelonephritis (12 trials, relative risk [RR] 0.24; 95% CI 0.13 to 0.42; absolute risk reduction [ARR] 17.6%; number needed to treat [NNT] 6, 95% CI 5 to 7) and low birth weight (seven trials, RR 0.63; 95% CI 0.45 to 0.90; ARR 4.4%; NNT 23, 95% CI 15 to 85).Antibiotic treatment for women

2019 BMJ open

165. The value of amniopatch in pregnancies associated with spontaneous preterm premature rupture of fetal membranes: a randomized controlled trial. (PubMed)

The value of amniopatch in pregnancies associated with spontaneous preterm premature rupture of fetal membranes: a randomized controlled trial. To evaluate the efficacy and safety of amniopatch in pregnancies associated with spontaneous preterm premature rupture of fetal membranes (PPROM).A randomized controlled trial that involved 100 women diagnosed with PPROM between 24 and 34 weeks of gestational age. Participants were randomized equally into two groups. Group I in which amniopatch was done (...) in addition to the routine management. Group II was treated with routine management including antibiotics and corticosteroids.Amniopatch was successful in complete sealing of the membrane defect in 6/50 (12%) of women while none the control group have undergone similar sealing (p = .0144, RR = 0.88). Women in the amniopatch group showed a significant increase of AFI compared to controls (12 versus 0, p = .0001, RR = 0.56).The amniopatch procedure is a successful technique that safely enhances sealing

2019 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Controlled trial quality: uncertain

166. Maternal smoking during pregnancy and offspring utilisation of health care services: A population-based cohort study. (PubMed)

Maternal smoking during pregnancy and offspring utilisation of health care services: A population-based cohort study. Maternal smoking during pregnancy (MSDP) has been associated with a wide range of adverse effects on offspring health, such as low birthweight, behavioural disorders, and asthma. The number of women that smoke during pregnancy in Denmark is still high, making it relevant to study the long-term health outcomes in offspring exposed to maternal smoking in utero.We investigated (...) whether exposure to MSDP is associated with more frequent use of health care services during the first 10 years of life.This population-based cohort study included participants enrolled in the Danish National Birth Cohort between 1996 and 2003. Data on MSDP were obtained from two telephone interviews during pregnancy and one interview after pregnancy. The primary outcome was contacts to the health care system. From Danish national registries, we obtained information on number and type of contacts

2019 Paediatric and perinatal epidemiology

167. First trimester termination of pregnancy. (PubMed)

First trimester termination of pregnancy. First trimester termination of pregnancy (TOP) is a safe and effective procedure. The complete abortion rates of surgical and medical abortion are approximately 97% and 95%, respectively. Vacuum aspiration (VA) either by electrical suction or manual aspiration is the method of choice for surgical TOP. Risk of significant bleeding is ≤ 5% in VA, while major complications occur in <1%. The risk of infection after VA can be reduced significantly by using (...) prophylactic antibiotics or by the screen-and-treat strategy. Pre-operative administration of misoprostol can also reduce the risk of complications. The combination of 200 mg mifepristone followed by 800 μg misoprostol 24-48 h later is recommended for first trimester medical TOP. If mifepristone is not available, misoprostol can also be used alone, but repeated doses may be required and the complete abortion rate may be lower. Due to the reduced efficacy in more advanced gestation, repeated doses

2019 Best practice & research. Clinical obstetrics & gynaecology

168. Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients. (PubMed)

antibiotics.This was a retrospective study of women aged 12-25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000-2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models.We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women (...) who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01-2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38-2.54), and infertility (aHR, 1.85; 95% CI, 1.27-2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status.We showed an association between CT-positive tests and 3 adverse

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2019 Clinical Infectious Diseases

169. 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 recurrent urinary tract infections 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 (8 June 2012) and reference lists of retrieved

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2012 Cochrane

170. How should Bacterial Vaginosis be Managed in Pregnancy?

. It is unclear whether BV recurrence is due to resistance, reinfection &/or recurrence. ? No studies or recommendations were located that specifically addressed treatment of BV recurrence or prophylaxis in pregnancy. ? Recurrence can be treated with the same antibiotic regimen used for the initial episode. 1,36 CAN OTHER PRODUCTS BE USED FOR BV? 1,46,47,48,49,50,51 ? Douching is a risk factor for BV & is not recommended, especially since it may also be an independent risk factor for preterm birth (...) . ? There is insufficient evidence to recommend the use of antiseptics (e.g. boric acid), disinfectants, acidifying agents, Lactobacillus probiotics alone or in combination with antibiotics for treatment of BV. TABLE: COMPARISON OF BV ANTIBIOTIC TREATMENT REGIMENS RECOMMENDED IN PREGNANCY BY CLINICAL GUIDELINES? 4,5,6,7,8,13,14,52,** Recommended treatment regimens & durations vary among the Guidelines (see below Table) due to the variation of treatment regimens & durations used in studies, as well as the different

2013 RxFiles

171. Bacterial Sepsis in Pregnancy

Bacterial Sepsis in Pregnancy Bacterial Sepsis in Pregnancy Green–top Guideline No. 64a April 2012RCOG Green-top Guideline No. 64a 2of 14 © Royal College of Obstetricians and Gynaecologists Bacterial Sepsis in Pregnancy This is the first edition of this guideline. 1. Purpose and scope The need for a guideline on the management of sepsis in pregnancy was identified by the 2007 Confidential Enquiry into Maternal Deaths. 1 The scope of this guideline covers the recognition and management (...) of serious bacterial illness in the antenatal and intrapartum periods, arising in the genital tract or elsewhere, and its management in secondary care. Sepsis arising due to viral, fungal or other infectious agents is outside the scope of this guideline. Bacterial sepsis following pregnancy in the puerperium is the subject of a separate Green-top Guideline. The population covered by this guideline includes pregnant women suspected of, or diagnosed with, serious bacterial sepsis in primary or secondary

2012 Royal College of Obstetricians and Gynaecologists

172. Bacterial Sepsis following Pregnancy

training for the identification and initial management of serious obstetric conditions or emerging potential emergencies, such as sepsis, which need to be distinguished from commonplace symptoms in pregnancy. 1 Any GAS identified during pregnancy should be treated aggressively. Several cases of women with known GAS infection have been reported where GAS was not treated, resulting in maternal death. 1 Any signs of infection or necessity to administer antibiotics noted during a woman’s hospital stay (...) caesarean section. Number of women with specific infections: MRSA, GAS, Clostridia sepsis. Percentage of women who had antibiotic therapy started within 1 hour of recognition of bacterial sepsis after pregnancy. Target: 100% within 1 hour. 116 of 21 RCOG Green-top Guideline No. 64b © Royal College of Obstetricians and Gynaecologists APPENDIX 1 Staphylococcal and streptococcal toxic shock syndrome: clinical disease definition. Staphylococcal toxic shock syndrome (TSS) 17 Streptococcal toxic shock

2012 Royal College of Obstetricians and Gynaecologists

173. Antibiotic use during pregnancy and/or early life and the risk of atopic dermatitis in children

Antibiotic use during pregnancy and/or early life and the risk of atopic dermatitis in children 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

2013 PROSPERO

174. Antibiotics for treating bacterial vaginosis in pregnancy. (PubMed)

Antibiotics for treating bacterial vaginosis in pregnancy. Bacterial vaginosis is an imbalance of the normal vaginal flora with an overgrowth of anaerobic bacteria and a lack of the normal lactobacillary flora. Women may have symptoms of a characteristic vaginal discharge but are often asymptomatic. Bacterial vaginosis during pregnancy has been associated with poor perinatal outcomes and, in particular, preterm birth (PTB). Identification and treatment may reduce the risk of PTB and its (...) consequences.To assess the effects of antibiotic treatment of bacterial vaginosis in pregnancy.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2012), searched cited references from retrieved articles and reviewed abstracts, letters to the editor and editorials.Randomised trials comparing antibiotic treatment with placebo or no treatment, or comparing two or more antibiotic regimens in pregnant women with bacterial vaginosis or intermediate vaginal flora whether symptomatic

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2013 Cochrane database of systematic reviews (Online)

175. Associations between antibiotic exposure during pregnancy, birth weight and aberrant methylation at imprinted genes among offspring. (PubMed)

Associations between antibiotic exposure during pregnancy, birth weight and aberrant methylation at imprinted genes among offspring. Low birth weight (LBW) has been associated with common adult-onset chronic diseases, including obesity, cardiovascular disease, type II diabetes and some cancers. The etiology of LBW is multi-factorial. However, recent evidence suggests exposure to antibiotics may also increase the risk of LBW. The mechanisms underlying this association are unknown, although (...) bisulfite pyrosequencing. Generalized linear models were used to examine associations among antibiotic use, birth weight and DMR methylation fractions.After adjusting for infant gender, race/ethnicity, maternal body mass index, delivery route, gestational weight gain, gestational age at delivery, folic acid intake, physical activity, maternal smoking and parity, antibiotic use during pregnancy was associated with 138 g lower birth weight compared with non-antibiotic use (β-coefficient=-132.99, s.e

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2013 International Journal of Obesity

176. To Compare the Strategies of Universal Antibiotic Prophylaxis Versus Screen-and-treat in Reducing Infective Complications and Re-infection in Women Who Undergo Termination of Pregnancy

To Compare the Strategies of Universal Antibiotic Prophylaxis Versus Screen-and-treat in Reducing Infective Complications and Re-infection in Women Who Undergo Termination of Pregnancy To Compare the Strategies of Universal Antibiotic Prophylaxis Versus Screen-and-treat in Reducing Infective Complications and Re-infection in Women Who Undergo Termination of Pregnancy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration (...) or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. To Compare the Strategies of Universal Antibiotic Prophylaxis Versus Screen-and-treat in Reducing Infective Complications and Re-infection in Women Who Undergo Termination of Pregnancy The safety and scientific validity of this study is the responsibility of the study sponsor

2013 Clinical Trials

177. Cardiac Disease and Pregnancy

Cardiac Disease and Pregnancy Good Practice No.13 June 2011 Cardiac Disease and Pregnancy2 of 18 Good Practice No. 13 Cardiac Disease and Pregnancy 1. Purpose Cardiac disease is a leading cause of maternal death in pregnancy in many developed countries, including the UK. However, there is a lack of evidence-based guidelines to assist in planning the management of affected pregnancies. The purpose of this Good Practice guidance is to provide a summary of current expert opinion as an interim (...) heart disease, and aortic dissection Pregnancy itself raises the risk of acute myocardial infarction by three- to four-fold, with the risk being 30 times higher for women over the age of 40 years compared with women aged less than 20 years. As reported by CEMACH, in the 2003–05 triennium 2 the rate of maternal death from ischaemic heart disease in the UK had risen to 1/132,000 pregnancies (up from 1/252,000 in 2000–2002). 4 Other risk factors include chronic hypertension, pre-eclampsia, diabetes

2011 Royal College of Obstetricians and Gynaecologists

178. Management of Sickle Cell Disease in Pregnancy

RCOG Green-top Guideline No. 61 © Royal College of Obstetricians and Gynaecologists 4.4 What is the importance of antibiotic prophylaxis and immunisation? Penicillin prophylaxis or the equivalent should be prescribed. Vaccination status should be determined and updated before pregnancy. Patients with SCD are hyposplenic and are at risk of infection, in particular from encapsulated bacteria such as Neisseria meningitides, Streptococcus pneumonia and Haemophilus influenzae. There is clear evidence (...) acid and prophylactic antibiotics (if not contraindicated). Drugs that are unsafe in pregnancy should be stopped immediately. Iron supplementation should be given only if there is laboratory evidence of iron deficiency. Women with SCD should be considered for low-dose aspirin 75 mg once daily from 12 weeks of gestation in an effort to reduce the risk of developing pre-eclampsia. Women with SCD should be advised to receive prophylactic low-molecular-weight heparin during antenatal hospital

2011 Royal College of Obstetricians and Gynaecologists

179. Maternal Collapse in Pregnancy and the Puerperium

Maternal Collapse in Pregnancy and the Puerperium Maternal Collapse in Pregnancy and the Puerperium Green–top Guideline No. 56 January 2011RCOG Green-top Guideline No. 56 2 of 24 © Royal College of Obstetricians and Gynaecologists Maternal Collapse in Pregnancy and the Puerperium This is the first edition of this guideline. 1. Purpose and scope Maternal collapse is a rare but life-threatening event with a wide-ranging aetiology. The outcome, primarily for the mother but also for the fetus (...) be covered. 2. Background and introduction Maternal collapse is defined as an acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent conscious level (and potentially death), at any stage in pregnancy and up to six weeks after delivery. While there is a robust and effective system for maternal mortality audit in the UK in the form of the Confidential Enquiry into Maternal and Child Health (CEMACH), now the Centre for Maternal and Child Enquiries (CMACE

2011 Royal College of Obstetricians and Gynaecologists

180. The relationship between body mass index in pregnancy and adverse maternal, perinatal, and neonatal outcomes in rural India and Pakistan (PubMed)

/eclampsia, cesarean/assisted delivery, and antibiotic use were higher among women with higher BMIs. Overweight women also had significantly higher risk of perinatal and early neonatal mortality compared with underweight/normal BMI women. Overweight women had a significantly higher perinatal mortality rate. High BMI in early pregnancy was associated with increased risk of adverse maternal, perinatal, and neonatal outcomes in rural India and Pakistan. These findings present an opportunity to inform (...) The relationship between body mass index in pregnancy and adverse maternal, perinatal, and neonatal outcomes in rural India and Pakistan  The objective of this study was to describe the relationship between early pregnancy body mass index (BMI) and maternal, perinatal, and neonatal outcomes in rural India and Pakistan. In a prospective, population-based pregnancy registry implemented in communities in Thatta, Pakistan and Nagpur and Belagavi, India, we obtained women's BMI prior to 12 weeks

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2018 American journal of perinatology

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