Latest & greatest articles for pregnancy

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Top results for pregnancy

1. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. (PubMed)

Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. Intrahepatic cholestasis of pregnancy is associated with adverse perinatal outcomes, but the association with the concentration of specific biochemical markers is unclear. We aimed to quantify the adverse perinatal effects of intrahepatic cholestasis of pregnancy in women with increased serum bile acid concentrations (...) and determine whether elevated bile acid concentrations were associated with the risk of stillbirth and preterm birth.We did a systematic review by searching PubMed, Web of Science, and Embase databases for studies published from database inception to June 1, 2018, reporting perinatal outcomes for women with intrahepatic cholestasis of pregnancy when serum bile acid concentrations were available. Inclusion criteria were studies defining intrahepatic cholestasis of pregnancy based upon pruritus and elevated

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2019 Lancet

2. Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. (PubMed)

Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. Congenital bleeding disorders can cause obstetric haemorrhage during pregnancy, labour and following delivery. Desmopressin acetate (DDAVP) is found to be an effective drug which can reduce the risk of haemorrhage and can also stop bleeding in certain congenital bleeding disorders. Its use in pregnancy has been controversial. Hence beneficial and adverse effects (...) of conferences proceedings. We also searched several clinical trial registries and grey literature (27 August 2017).Date of most recent search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coaguopathies Trials Register: 01 October 2018.Randomised and quasi-randomised controlled trials investigating the efficacy of DDAVP versus tranexamic acid or factor VIII or rFactor VII or fresh frozen plasma in preventing and treating congenital bleeding disorders during pregnancy were eligible.No trials

2019 Cochrane

3. Does Partial Meal Replacement During Pregnancy Reduce 12-Month Postpartum Weight Retention?

Does Partial Meal Replacement During Pregnancy Reduce 12-Month Postpartum Weight Retention? This randomized trial tested whether a behavioral intervention with meal replacements in pregnancy could increase the proportion of women who returned to prepregnancy weight and reduce postpartum weight retention by 12 months after delivery.Women (N = 264; 13.7 weeks' gestation) with overweight or obesity were randomly assigned to usual care or intervention. The intervention reduced excess gestational (...) in the intervention group. Independent of group, lower gestational weight gain was the strongest predictor of achieving prepregnancy weight at 12 months (P = 0.0008).A prenatal behavioral intervention with meal replacements that reduced pregnancy weight gain had no significant effect on 12-month postpartum weight retention.© 2018 The Obesity Society.

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2019 EvidenceUpdates

4. MRI during pregnancy: the pros and cons should be carefully assessed

MRI during pregnancy: the pros and cons should be carefully assessed Prescrire IN ENGLISH - Spotlight ''MRI during pregnancy: the pros and cons should be carefully assessed'', 1 February 2019 {1} {1} {1} | | > > > MRI during pregnancy: the pros and cons should be carefully assessed Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight MRI during (...) pregnancy: the pros and cons should be carefully assessed Before deciding to give a pregnant woman an MRI scan, with or without contrast agents, it is important to consider how the MRI results would change the clinical course. MRI, or magnetic resonance imaging, uses powerful electromagnetic fields that make tissues hot. In a study of 1500 children who had been exposed to MRI (without injection of a contrast agent) in the first trimester of pregnancy, vascular, digestive, musculoskeletal and auditory

2019 Prescrire

5. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period

Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period INTERIM UPDATE ACOGCOMMITTEEOPINION Number 767 (Replaces Committee Opinion Number 692, September 2017) Committee on Obstetric Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice in collaboration with committee members Yasser Y. El-Sayed, MD, and Ann E. Borders, MD, MSc, MPH. INTERIM UPDATE: This Committee Opinion (...) is updated as highlighted to align with the American College of Obstetricians and Gynecologists’ guidance on gestational hypertension, preeclampsia, and chronic hypertension in pregnancy. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period ABSTRACT: Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset

2019 American College of Obstetricians and Gynecologists

6. Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group

Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group - Gastroenterology Email/Username: Password: Remember me Search AGA Journals Search Terms Search within Search To read this article in full, please review your options for gaining (...) access at the bottom of the page. Article in Press Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group x Uma Mahadevan Affiliations University of California, San Francisco, San Francisco, California 1 , x Christopher Robinson Affiliations Bon Secours St Francis and Summerville Medical Center, Charleston, South Carolina 2 , x Nana Bernasko Affiliations Penn State Health, Milton S. Hershey Medical

2019 American Gastroenterological Association Institute

7. HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures

HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures The benefits of human immunodeficiency virus (HIV) testing in pregnancy, when combined with appropriate maternal antiretroviral therapy and intrapartum and postnatal prophylaxis, are well established. The vertical rate of transmission of HIV in North America is now well below 2%. Efforts must continue to ensure that these benefits are sustained. Women who have received little or no prenatal care and those who present (...) for delivery with unknown HIV status need immediate testing. As more infants are exposed to antiretroviral agents, strategies need to be implemented to ensure adequate follow-up of these infants. Issues relating to the identification of HIV-exposed infants are highlighted. Keywords: Human immunodeficiency virus; Infant; Intrapartum transmission; Pregnancy; Screening

2019 Canadian Paediatric Society

8. Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy

Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Discover Portal Discover Portal Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy Published on 31 October 2017 doi: Giving low dose aspirin to high-risk women reduced their risk of pre-eclampsia before 37 weeks of pregnancy. Preterm pre-eclampsia developed in 1.6% of women given 150mg aspirin daily compared with 4.3% who took (...) a placebo. Pre-eclampsia is a condition which can harm mother and baby. In the mother, it causes high blood pressure and protein in the urine, which can show in pregnancy after 20 weeks. Women with risk factors, such as previous pre-eclampsia, diabetes or high blood pressure, are often prescribed 75mg aspirin from 12 weeks onwards. This study aimed to test double this dose (still classified as a `low dose’) after using a new risk assessment with additional clinical tests to better identify those at high

2019 NIHR Dissemination Centre

9. Imaging is the only way to diagnose blood clots in pregnancy

Imaging is the only way to diagnose blood clots in pregnancy Imaging is the only way to diagnose blood clots in pregnancy Discover Portal Discover Portal Imaging is the only way to diagnose blood clots in pregnancy Published on 13 March 2018 doi: No blood test can accurately tell if a pregnant or recently pregnant woman has a blood clot. All pregnant women with a suspected clot should continue to have imaging investigations as per current UK guidelines. This NIHR-funded study recruited 328 (...) with and without a clot. Share your views on the research. Why was this study needed? Blood clots are the leading cause of death during pregnancy and after giving birth. Between 2012 and 2014 there were 20 maternal deaths due to blood clots in the UK. There are concerns about using CT scans to diagnose pulmonary embolism in pregnant women as only 5% of scans are positive. This could mean that women and their unborn baby are unnecessarily exposed to radiation. A blood test called D-dimer is used to rule out

2019 NIHR Dissemination Centre

10. Treating subclinical thyroid dysfunction in pregnancy probably has no benefit

Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Discover Portal Discover Portal Treating subclinical thyroid dysfunction in pregnancy probably has no benefit Published on 8 August 2017 doi: Testing for and then treating pregnant women with mild or “subclinical” underactive thyroid did not improve pregnancy outcomes, newborn baby outcomes, or the child’s IQ at three to five years (...) . A clearly underactive thyroid (clinical hypothyroidism) in pregnancy has been linked with various adverse outcomes for the mother and baby, including pre-eclampsia, preterm birth, congenital defects and neurodevelopmental delay. This needs treatment. However, there has been debate around the harms and benefits from treating only mildly abnormal blood test results in women who do not show signs of thyroid problems, subclinical hypothyroidism. These two linked trials randomised 1,203 women with borderline

2019 NIHR Dissemination Centre

11. No clear “best” treatment of mild or severe sickness in pregnancy

No clear “best” treatment of mild or severe sickness in pregnancy No clear “best” treatment of mild or severe sickness in pregnancy Discover Portal Discover Portal No clear “best” treatment of mild or severe sickness in pregnancy Published on 3 January 2017 doi: Pregnant women could benefit from simple, cheap, “self-help” remedies for mild nausea and vomiting. Ginger, vitamin B6 and possibly acupressure wrist-bands might relieve symptoms for some women, according to a recent overview (...) range from simple “morning sickness” to the more severe condition of hyperemesis gravidarum. The review gives some evidence on treating pregnant women, but it is limited, especially for more severe symptoms. The authors highlight the need for more robust research to compare treatments with costs and clarify the safety of some drugs. Share your views on the research. Why was this study needed? Up to 85% of women experience nausea and vomiting during pregnancy. Usually, symptoms resolve by about 20

2019 NIHR Dissemination Centre

12. General surgery is mostly safe during pregnancy

General surgery is mostly safe during pregnancy General surgery is mostly safe during pregnancy Discover Portal Discover Portal General surgery is mostly safe during pregnancy Published on 10 January 2017 doi: Routine data from English hospitals show that general surgery during pregnancy, such as removing the appendix or gallbladder, does not commonly harm mother or baby. This suggests that surgery in pregnant women is generally safe, but that mothers could be provided with more specific (...) estimates of the risks. This large observational study assessed the “real world” outcomes of nearly 6.5 million pregnancies at hospitals in England over a 10-year period. Women who had surgery during pregnancy for a condition unrelated to pregnancy were slightly more likely to experience miscarriage, preterm or caesarean delivery or a long stay in hospital. Babies were more also slightly more likely to be low birthweight or stillborn. However, the actual risks of negative outcomes were small

2019 NIHR Dissemination Centre

13. 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

14. Donor eggs may be linked to higher risk of pregnancy complications following IVF

Donor eggs may be linked to higher risk of pregnancy complications following IVF Donor eggs may be linked to higher risk of pregnancy complications following IVF Discover Portal Discover Portal Donor eggs may be linked to higher risk of pregnancy complications following IVF Published on 26 May 2016 doi: Women who use donor eggs in their IVF may have significantly higher rates of pregnancy complications than those who use their own eggs, a systematic review and meta-analysis has found. Use (...) of donor eggs was linked to up to four times the risk of developing high blood pressure in pregnancy. Other risks associated with donor eggs were low birth weight in the baby, caesarean section and premature delivery. It is always possible that other factors, such as the age of women who use donor eggs, may have influenced the study results. Advanced maternal age is itself associated with pregnancy complications, including high blood pressure. Nevertheless it seems likely from this research that donor

2019 NIHR Dissemination Centre

15. Links between antipsychotics in pregnancy and harmful outcomes for baby may be influenced by mother’s lifestyle

Links between antipsychotics in pregnancy and harmful outcomes for baby may be influenced by mother’s lifestyle Links between antipsychotics in pregnancy and harmful outcomes for baby may be influenced by mother’s lifestyle Discover Portal Discover Portal Links between antipsychotics in pregnancy and harmful outcomes for baby may be influenced by mother’s lifestyle Published on 6 June 2016 doi: This NIHR funded study found that antipsychotic use during pregnancy was not associated with worse (...) child outcomes after poorer health and riskier lifestyles were taken into account. For pregnant women these were things like other medications, obesity, smoking, alcohol and taking illicit drugs. The study also provides further evidence against the use of valproate during pregnancy for epilepsy, bipolar disorder or schizophrenia because of the increased risk of poor outcomes for the child. The risk was double that of taking the alternatives, lamotrigine or carbamazapine during pregnancy. Mental

2019 NIHR Dissemination Centre

16. One type of drug for depression during pregnancy may be linked to a small increase in pre-term births

One type of drug for depression during pregnancy may be linked to a small increase in pre-term births One type of drug for depression during pregnancy may be linked to a small increase in pre-term births Discover Portal Discover Portal One type of drug for depression during pregnancy may be linked to a small increase in pre-term births Published on 9 August 2016 doi: Women who are depressed during pregnancy and who take selective serotonin inhibitors (SSRIs) may be more likely to have a pre (...) -term birth than those who do not take SSRIs. Pre-term birth occurred in 6.8% of women with depression during pregnancy treated with SSRIs compared to 5.8% of depressed women who were treated with talking therapies alone. However, because this is a review of observational (cohort) studies rather than randomised controlled trials it is not possible to say that SSRIs cause pre-term birth. For example, it is possible that women who had worse depression were more likely to be prescribed SSRIs

2019 NIHR Dissemination Centre

17. No benefit from monitoring antiepileptic drug levels in pregnancy

No benefit from monitoring antiepileptic drug levels in pregnancy No benefit from monitoring antiepileptic drug levels in pregnancy Discover Portal Discover Portal No benefit from monitoring antiepileptic drug levels in pregnancy Published on 9 October 2018 doi: Regular monitoring of antiepileptic drug levels in pregnant women with epilepsy does not improve seizure control compared with clinical features-based monitoring. This NIHR-funded study was conducted across 50 UK hospitals (...) and is the largest randomised trial in pregnant women with epilepsy. Just over 260 pregnant women with unstable antiepileptic drug levels were assigned to ongoing monthly blood checks or clinical features monitoring. There were no differences in seizures or other pregnancy outcomes between the two strategies. But umbilical cord blood showed that babies whose mothers received blood checks were exposed to higher levels of antiepileptic drugs. The study provides important information about the utility of monitoring

2019 NIHR Dissemination Centre

18. Diet and exercise can reduce the risk of developing diabetes during pregnancy

Diet and exercise can reduce the risk of developing diabetes during pregnancy Diet and exercise can reduce the risk of developing diabetes during pregnancy Discover Portal Discover Portal Diet and exercise can reduce the risk of developing diabetes during pregnancy Published on 18 December 2018 doi: Diet and exercise are effective ways of preventing the development of diabetes during pregnancy, known as gestational diabetes. Gestational diabetes is becoming more common and is associated (...) suggest, comprehensive risk assessments that consider body mass index alongside other risk factors may help to identify women who could benefit most from structured lifestyle interventions during pregnancy. Share your views on the research. Why was this study needed? Gestational diabetes is associated with various adverse outcomes for mother and baby. Women with the condition are at higher risk of having their labour induced, having a caesarean section, developing pre-eclampsia, or developing type 2

2019 NIHR Dissemination Centre

19. Management of HIV in pregnancy and postpartum

Management of HIV in pregnancy and postpartum British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018 BHIVA guidelines on the management of HIV in pregnancy and postpartum 2 Guideline writing group Dr Yvonne Gilleece (Chair) Honorary Clinical Senior Lecturer and Consultant Physician in HIV and Genitourinary Medicine, Brighton and Sussex University Hospitals NHS Trust Dr Shema Tariq (Vice-chair) Postdoctoral Clinical Research Fellow, University College (...) NHS Trust Dr Luciana Rubinstein Consultant in Genitourinary Medicine, London North West Healthcare University NHS Trust, London Ms Sonali Sonecha Lead Directorate Pharmacist HIV/GUM, Chelsea and Westminster Healthcare NHS Foundation Trust, London Dr Lisa Thorley UK Community Advisory Board representative Dr Pat Tookey Honorary Senior Lecturer and Co-Investigator National Study of HIV in Pregnancy and Childhood, UCL Great Ormond Street Institute of Child Health, London Ms Jennifer Tosswill Clinical

2019 British HIV Association

20. Serial Third-Trimester Ultrasonography Compared With Routine Care in Uncomplicated Pregnancies: A Randomized Controlled Trial

Serial Third-Trimester Ultrasonography Compared With Routine Care in Uncomplicated Pregnancies: A Randomized Controlled Trial Among uncomplicated pregnancies, serial third-trimester ultrasound examinations identified significantly more cases with a composite of fetal growth or amniotic fluid abnormalities (27%) than did routine fundal height measurements (8%).Women without complications between 24 0/7 and 30 6/7 weeks of gestation were randomized (NCT0270299) to either routine care (control arm (...) %), cesarean delivery in labor (5% vs 6%), and prespecified composite maternal morbidity (9% in both groups) and composite neonatal morbidity (1% vs 4%).Among uncomplicated pregnancies between 24 0/7 and 30 6/7 weeks of gestation, serial third-trimester ultrasound examinations were significantly more likely to identify abnormalities of fetal growth or amniotic fluid than measurements of fundal height and indicated ultrasound examination. No differences in maternal and neonatal outcomes were noted, although

2019 EvidenceUpdates