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Pruritus in Pregnancy

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121. Liver Disease and Pregnancy (Treatment)

), intrahepatic cholestasis of pregnancy (ICP), and hemolysis and elevated liver enzymes and low platelets (HELLP) syndrome. [ ] Liver disease such as acute viral hepatitis can occur in pregnancy, and pregnancy may occur in a patient with underlying chronic liver disease, including patients with cirrhosis and portal hypertension, and patients who have undergone liver transplantation. In the initial evaluation of a pregnant patient with abnormal liver tests, the American College of Gastroenterology (ACG (...) and childhood hematologic malignancies but may be used judiciously with minimized radiation protocols (2-5 rads). Endoscopy is safe in pregnancy but should be deferred until the second trimester if possible. Meperidine and propofol can be used for endoscopic sedation. Next: Hyperemesis Gravidarum Approximately 50%-80% of pregnant women experience nausea, and an estimated 50% suffer from retching. [ , ] —in which persistent vomiting is associated with a 5% or more loss of prepregnancy body weight

2014 eMedicine.com

122. Liver Disease and Pregnancy (Overview)

), intrahepatic cholestasis of pregnancy (ICP), and hemolysis and elevated liver enzymes and low platelets (HELLP) syndrome. [ ] Liver disease such as acute viral hepatitis can occur in pregnancy, and pregnancy may occur in a patient with underlying chronic liver disease, including patients with cirrhosis and portal hypertension, and patients who have undergone liver transplantation. In the initial evaluation of a pregnant patient with abnormal liver tests, the American College of Gastroenterology (ACG (...) and childhood hematologic malignancies but may be used judiciously with minimized radiation protocols (2-5 rads). Endoscopy is safe in pregnancy but should be deferred until the second trimester if possible. Meperidine and propofol can be used for endoscopic sedation. Next: Hyperemesis Gravidarum Approximately 50%-80% of pregnant women experience nausea, and an estimated 50% suffer from retching. [ , ] —in which persistent vomiting is associated with a 5% or more loss of prepregnancy body weight

2014 eMedicine.com

123. Pruritic Urticarial Papules and Plaques of Pregnancy (Follow-up)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEyMzcyNS10cmVhdG1lbnQ= processing > Polymorphic Eruption of Pregnancy Treatment & Management Updated: May 14, 2018 Author: Joseph C Pierson, MD; Chief Editor: William D James, MD Share Email Print Feedback Close Sections Sections Polymorphic Eruption of Pregnancy Treatment Approach Considerations Treatment is directed at relieving the pruritus associated with polymorphic eruption of pregnancy (PEP). Topical corticosteroids are the mainstay of treatment. [ ] High-potency topical (class I or II), or even systemic (...) of pregnancy. JAMA . 1979 Apr 20. 241(16):1696-9. . Bourne G. Toxaemic rash of pregnancy. Proc R Soc Med . 1962 Jun. 55:462-4. . Ambros-Rudolph CM, Mullegger RR, Vaughan-Jones SA, Kerl H, Black MM. The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnant patients. J Am Acad Dermatol . 2006 Mar. 54(3):395-404. . Roth MM. Pregnancy dermatoses: diagnosis, management, and controversies. Am J Clin Dermatol . 2011 Feb 1. 12(1):25-41. . Rudolph

2014 eMedicine.com

124. Liver Disease and Pregnancy (Follow-up)

), intrahepatic cholestasis of pregnancy (ICP), and hemolysis and elevated liver enzymes and low platelets (HELLP) syndrome. [ ] Liver disease such as acute viral hepatitis can occur in pregnancy, and pregnancy may occur in a patient with underlying chronic liver disease, including patients with cirrhosis and portal hypertension, and patients who have undergone liver transplantation. In the initial evaluation of a pregnant patient with abnormal liver tests, the American College of Gastroenterology (ACG (...) and childhood hematologic malignancies but may be used judiciously with minimized radiation protocols (2-5 rads). Endoscopy is safe in pregnancy but should be deferred until the second trimester if possible. Meperidine and propofol can be used for endoscopic sedation. Next: Hyperemesis Gravidarum Approximately 50%-80% of pregnant women experience nausea, and an estimated 50% suffer from retching. [ , ] —in which persistent vomiting is associated with a 5% or more loss of prepregnancy body weight

2014 eMedicine.com

125. Common Pregnancy Complaints and Questions (Follow-up)

pregnancies, worsening cramping, or cramping associated with any vaginal bleeding may be a sign of , , or . Other physical effects that are normal during pregnancy, and not necessarily signs of disease, include nausea, vomiting, increase in abdominal girth, changes in bowel habits, increased urinary frequency, palpitations or more rapid heartbeat, upheaving of the chest (particularly with breathing), heart murmurs, swelling of the ankles, and shortness of breath. [ ] Why do pregnant women feel tired (...) . This is not accompanied by any functional osteoporosis, although pregnancy is a very high bone turnover state, approximately equivalent to double the bone loss rates of a menopausal female, reversibly losing about 2% of bone during the first 20 weeks of gestation. Spinal changes are usually not severe enough to affect the pregnancy or the lung's functional capacity. Also, the pregnancy rarely affects the degree of lateral curvature in these cases of scoliosis. If a pregnant patient has had correction with prior

2014 eMedicine.com

126. Common Pregnancy Complaints and Questions (Diagnosis)

pregnancies, worsening cramping, or cramping associated with any vaginal bleeding may be a sign of , , or . Other physical effects that are normal during pregnancy, and not necessarily signs of disease, include nausea, vomiting, increase in abdominal girth, changes in bowel habits, increased urinary frequency, palpitations or more rapid heartbeat, upheaving of the chest (particularly with breathing), heart murmurs, swelling of the ankles, and shortness of breath. [ ] Why do pregnant women feel tired (...) . This is not accompanied by any functional osteoporosis, although pregnancy is a very high bone turnover state, approximately equivalent to double the bone loss rates of a menopausal female, reversibly losing about 2% of bone during the first 20 weeks of gestation. Spinal changes are usually not severe enough to affect the pregnancy or the lung's functional capacity. Also, the pregnancy rarely affects the degree of lateral curvature in these cases of scoliosis. If a pregnant patient has had correction with prior

2014 eMedicine.com

127. Il-17 Levels in Intrahepatic Cholestasis of Pregnancy

: Zekai Tahir Burak Women's Health Research and Education Hospital Information provided by (Responsible Party): Ayse Kirbas, Zekai Tahir Burak Women's Health Research and Education Hospital Study Details Study Description Go to Brief Summary: The aim of this study is to investigate maternal and fetal serum IL-17 levels in pregnant women with intrahepatic cholestasis of pregnancy and to find out if Th-17 cells have a role in progress of intrahepatic cholestasis of pregnancy. Condition or disease (...) and the effects of UDCA therapy on it and find out if Th-17 cells have a role in progress of ICP. Study Design Go to Layout table for study information Study Type : Observational [Patient Registry] Estimated Enrollment : 30 participants Observational Model: Case Control Time Perspective: Prospective Target Follow-Up Duration: 12 Months Official Title: to Investigate the Maternal Serum IL-17 Levels in Pregnant Women With Intrahepatic Cholestasis of Pregnancy Study Start Date : July 2013 Estimated Primary

2013 Clinical Trials

128. The Use of Fish Oil Supplementation in Treatment of Intrahepatic Cholestasis of Pregnancy

anticholestatic effects, and is used to treat a variety of cholestatic liver diseases. Many studies have demonstrated superiority of UDCA over other agents, including dexamethasone and cholestyramine, for relief of maternal pruritus, improvement in transaminitis, reduction in serum bile acid concentrations, and improved pregnancy outcomes. As a result, UDCA is now widely used as first-line treatment for symptomatic relief in patients with ICP. Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are two (...) The Use of Fish Oil Supplementation in Treatment of Intrahepatic Cholestasis of Pregnancy The Use of Fish Oil Supplementation in Treatment of Intrahepatic Cholestasis 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

2013 Clinical Trials

129. Pregnancy-associated hyperkeratosis of the nipple: a report of 25 cases. Full Text available with Trip Pro

a clinicopathologic analysis of cases of pregnancy-associated nipple hyperkeratosis.Twenty-five cases of pregnancy-associated nipple hyperkeratosis identified during a 5-year period (January 1, 2007, through December 31, 2012) are reported. The lesions were bilateral and involved predominantly the top of the nipple. Lesions were symptomatic in 17 patients (68%), causing tenderness or discomfort, pruritus, sensitivity to touch, and/or discomfort with breastfeeding. Nine patients (36%) experienced symptomatic (...) Pregnancy-associated hyperkeratosis of the nipple: a report of 25 cases. Reported physiologic nipple changes in pregnancy do not include hyperkeratosis and are expected to resolve or improve post partum. Hyperkeratosis of the nipple and/or areola can develop in the context of inflammatory diseases (such as atopic dermatitis), in acanthosis nigricans, as an extension of epidermal nevus, after estrogen treatment, and/or in nevoid hyperkeratosis of the nipple and areola. We performed

2013 JAMA dermatology (Chicago, Ill.)

130. Ursodeoxycholic Acid in the Treatment of Intrahepatic Cholestasis of Pregnancy

): Titta Joutsiniemi, Turku University Hospital Study Details Study Description Go to Brief Summary: The purpose of this study is to examine the efficacy and safety of ursodeoxycholic acid (UDCA) in the treatment of patients with intrahepatic cholestasis of pregnancy (ICP). In the randomised (double-blind, placebo-controlled) study 20 pregnant women with ICP received (random allocation of) either 450 mg/day UDCA or placebo for 14 days during the third trimester of pregnancy. The severity of pruritus (...) Actual Study Completion Date : December 1998 Resource links provided by the National Library of Medicine related topics: available for: resources: Arms and Interventions Go to Arm Intervention/treatment Active Comparator: ursodeoxycholic acid 10 pregant women with intrahepatic cholestasis of pregnancy Drug: ursodeoxycholic acid 450 mg/day for 14 days Active Comparator: placebo 10 pregnant women with intrahepatic cholestasis of pregnancy Drug: Placebo placebo Outcome Measures Go to Primary Outcome

2012 Clinical Trials

131. Reference standard for serum bile acids in pregnancy. (Abstract)

Reference standard for serum bile acids in pregnancy. Obstetric cholestasis (OC) is a liver disorder characterised by pruritus and elevated serum bile acids (SBA) that affects one in 200 pregnant women. It is associated with adverse perinatal outcomes such as premature delivery and stillbirth. Mild OC is defined as SBA levels of 10-39 μmol/l, and severe OC is defined by levels >40 μmol/l. SBA levels in normal pregnancy have not been investigated. We aimed to establish reference values for SBA (...) in healthy pregnant women across different trimesters of pregnancy.Cross-sectional analysis of SBA levels.A large tertiary referral university teaching maternity hospital.Healthy pregnant women with a singleton pregnancy and a body mass index (BMI) < 40, excluding women with significant alcohol intake, history of liver disease, prior cholecystectomy and OC.Cross-sectional analysis of SBA levels at 12, 20, 28 and 36 weeks of gestation, and on days 1-3 postpartum.SBA levels in μmol/l.A total of 219 women

2012 BJOG

132. Editorial: Itching in pregnancy. Full Text available with Trip Pro

Editorial: Itching in pregnancy. 1172454 1975 12 11 2018 11 13 0007-1447 3 5984 1975 Sep 13 British medical journal Br Med J Editorial: Itching in pregnancy. 608 eng Journal Article England Br Med J 0372673 0007-1447 AIM IM Cholestasis complications etiology Female Humans Pregnancy Pregnancy Complications Pruritus etiology 1975 9 13 1975 9 13 0 1 1975 9 13 0 0 ppublish 1172454 PMC1674405 Steroids Lipids Res. 1972;3(1):30-48 4679049 Am J Med. 1973 May;54(5):600-4 4735674 Pathol Eur. 1970;5(2

1975 British medical journal

133. IV Acetaminophen vs IV Morphine for Pain Control in Pregnant Women

: The University of Texas Health Science Center, Houston Information provided by (Responsible Party): Jerrie Refuerzo, The University of Texas Health Science Center, Houston Study Details Study Description Go to Brief Summary: Purpose: To determine if IV acetaminophen can 1) decrease pain in pregnancy women, 2)reduce the amount of opioid use in pregnant women who encounter pain, 3) reduce maternal and fetal adverse effects compared to opioids. Design: This is a comparative effective trial that is a randomized (...) /treatment Phase Pain Management in Pregnant Women Drug: IV Acetaminophen Drug: IV Morphine Not Applicable Detailed Description: Rationale for this clinical trial The goal of analgesia in pregnancy is to reduce pain while minimizing both maternal and fetal adverse effects. Current opioids used in pregnancy provide minimal pain relief and are associated with adverse effects. IV acetaminophen has been shown to significantly improve pain control following cesarean section and in the first stage of labor

2014 Clinical Trials

134. Good maternal and fetal outcomes for pregnant women with primary biliary cirrhosis. (Abstract)

Good maternal and fetal outcomes for pregnant women with primary biliary cirrhosis. Up to 25% of patients diagnosed with primary biliary cirrhosis (PBC) are of childbearing age. However, little is known about disease course during pregnancy.We performed a retrospective analysis of women with PBC during pregnancy using a representative large cohort of patients attending the Liver Center at Toronto Western hospital from January 1979 through June 2009 (n = 306). Statistical analysis was performed (...) by using R statistical software.We identified 32 women (50 pregnancies) who either became pregnant after a diagnosis of PBC or in whom pregnancy led to diagnosis. Liver biochemistry remained stable in most patients (70%) throughout pregnancy. However, 23 of 32 patients (72%) had a flare in biochemical disease activity post partum, which was unrelated to biochemical disease activity before conception (P = .53), or during the gestational period (P = .14). No adverse maternal events were observed during

2014 Clinical Gastroenterology and Hepatology

135. Hepatic Disorders in Pregnancy

types of viral hepatitis (A, B, C, D), but may be more severe during pregnancy. Hepatitis B virus may be transmitted to the neonate immediately after delivery or, less often, to the fetus transplacentally; test all pregnant women for HBsAg to determine whether precautions against vertical transmission are needed. Intrahepatic cholestasis of pregnancy causes intense pruritus and increases risk of fetal prematurity, stillbirth, and respiratory distress syndrome. Fatty liver of pregnancy occurs near (...) hepatitis. All pregnant women are tested for HBsAg to determine whether precautions against vertical transmission are needed ( with immune globulin and vaccination for neonates exposed to hepatitis B virus). Chronic hepatitis , especially with cirrhosis, impairs fertility. When pregnancy occurs, risk of and is increased, but risk of maternal mortality is not. Despite standard immunoprophylaxis, many neonates of women with a high viral load are infected with hepatitis B virus. Data suggest that antiviral

2013 Merck Manual (19th Edition)

136. Pruritic Urticarial Papules and Plaques of Pregnancy

. Nonsedating oral antihistamines can also be used to relieve pruritus. Key Points Pruritic urticarial papules and plaques of pregnancy consist of intensely itchy lesions that usually develop during the last 2 to 3 wk of pregnancy and resolve within 15 days after delivery. Differentiating these lesions from others may be difficult. Treat with topical corticosteroids for mild symptoms and oral corticosteroids for more severe symptoms. Last full review/revision October 2017 by Antonette T. Dulay, MD NOTE (...) Pruritic Urticarial Papules and Plaques of Pregnancy Pruritic Urticarial Papules and Plaques of Pregnancy - Gynecology and Obstetrics - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC

2013 Merck Manual (19th Edition)

137. The Metabolic Profile in Intrahepatic Cholestasis of Pregnancy and Diabetes Mellitus

who have had intrahepatic cholestasis of pregnancy and/or gestational diabetes mellitus matched with parous women who have had uncomplicated pregnancies Criteria Inclusion criteria: Women with intrahepatic cholestasis of pregnancy, defined as pruritus in pregnancy in association with raised serum bile acids and in the absence of an alternative cause. Women with gestational diabetes mellitus (GDM) according to the diagnostic criteria used at the referring centre Non-pregnant parous females (...) tolerance in pregnancy. However the underlying mechanisms of these abnormalities is not known. Similarly the influence of cholestasis on fetal metabolism is not known, and nor is the role of the placenta. It is also not known whether women with ICP have a predisposition to abnormal lipid and glucose homeostasis when they are not pregnant. GDM is characterized by raised plasma glucose levels in pregnant women (in the absence of pre-pregnancy diabetes mellitus). This condition is associated with large

2011 Clinical Trials

138. Study on Combined Use of Letrozole, Mifepristone and Misoprostol in Termination of Pregnancy

liver and renal function Exclusion Criteria: a history or evidence of adrenal pathology, steroid-dependent cancer, porphyria, diastolic pressure over 95mm Hg, bronchial asthma, arterial hypotension a history or evidence of thrombo-embolism, severe or recurrent liver disease or pruritus of pregnancy the regular use of prescription drugs before admission to the study the presence of an IUCD in utero breast-feeding multiple pregnancies heavy smoker of more than 20 cigarettes per day any abnormal values (...) Study on Combined Use of Letrozole, Mifepristone and Misoprostol in Termination of Pregnancy Study on Combined Use of Letrozole, Mifepristone and Misoprostol in 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

2011 Clinical Trials

139. Induction of Labor in Intrahepatic Cholestasis of Pregnancy

by Karolinska Institutet: Intrahepatic Cholestasis of Pregnancy Induction of labor Pregnancy Caesarian section Pruritus IUFD Additional relevant MeSH terms: Layout table for MeSH terms Cholestasis Cholestasis, Intrahepatic Pregnancy Complications Bile Duct Diseases Biliary Tract Diseases Digestive System Diseases Liver Diseases (...) Induction of Labor in Intrahepatic Cholestasis of Pregnancy Induction of Labor in Intrahepatic Cholestasis 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. Induction of Labor in Intrahepatic

2011 Clinical Trials

140. Therapeutic guidelines for antiretroviral (ARV) treatment of adult HIV infection

therapy as soon as possible to reduce the risk of HIV transmission. THERAPEUTIC GUIDELINES FOR ANTIRETROVIRAL TREATMENT OF ADULT HIV INFECTION 7 VERSION: DEC 2019 RETURN TO TABLE OF CONTENTS Teratogenicity concerns and the potential for non-adherence due to morning sickness should be considered in selection and timing of antiretrovirals. Nausea and vomiting are common during pregnancy and ideally should be aggressively managed prior to initiating antiretrovirals (50-80% of pregnant individuals (...) of asymptomatic, HIV-1 infected controllers. PLoS Pathog. 2013; 9(10): e1003691. THERAPEUTIC GUIDELINES FOR ANTIRETROVIRAL TREATMENT OF ADULT HIV INFECTION 11 VERSION: DEC 2019 RETURN TO TABLE OF CONTENTS 19. British Columbia Guidelines for the care of HIV-positive pregnant individuals and interventions to reduce perinatal transmission and Dolutegravir prescribing guidelines for pregnancy and women of reproductive potential. Available at: http://www.bcwomens.ca/Professional-Resources- site/Documents/Oak

2020 CPG Infobase

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