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Latest & greatest articles for pregnancy
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on pregnancy or other clinical topics then use Trip today.
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be offered in-person as far as possible, with particular attention to those from BAME communities or those living with medical, social or psychological conditions that make them higher risk. • Appropriate screening for diabetes in pregnancy should be provided, following NICE guidance as far as possible, with awareness that changes in screening provision may be associated with a reduction in the detection of milder cases of gestational diabetes. • Open access for pregnant women to day assessment (...) ?’ 12 14.10.20 2.2 Recommendations added: • Women should be advised that vaccination against influenza is safe at all gestations of pregnancy and is recommended to protect both the woman and baby from the adverse effects of becoming seriously ill with flu during pregnancy. During the COVID-19 pandemic, it is particularly important that pregnant women take up the influenza vaccine to reduce their risk of contracting flu.4 • Appointments where physical examination is not required and where
. Target Population Pregnant women and women of child-bearing age and their families. Evidence Medline, EMBASE, and CENTRAL databases were searched for “alcohol use and pregnancy.” The results were filtered for a publication date between 2010 and September 2018. The search terms were developed using Medical Subject Headings terms and keywords, including pre-pregnancy, pregnant, breastfeeding, lactation, female, women, preconception care, prenatal care, fetal alcohol spectrum disorder, prenatal alcohol (...) and pregnancy outcomes. SUMMARY STATEMENTS (GRADE ratings in parentheses) 1 Alcohol is a known teratogen (high). 2 The current evidence cannot establish a safe threshold for alcohol consumption in pregnancy (high). 3 Abstaining from alcohol during pregnancy is the safest option (high). 4 Abstaining from alcohol while breastfeeding is the safest option (high). RECOMMENDATIONS (GRADE ratings in parentheses) 1 All pregnant women should be questioned about alcohol use by asking a single question
3, 2020 Akhtar, H., Patel, C., Abuelgasim, E., & Harky, A. (2020). COVID-19 (SARS- CoV-2) infection in pregnancy: A systematic review. Gynecologic and Obstetric Investigation. Epub ahead of print. Jul 30, 2020 (Search completed May 22, 2020) P: pregnant women and their fetuses/neonates E: COVID-19 infection C: no comparator O: maternal COVID-19 symptoms, pregnancy complications, neonatal COVID- 19 symptoms, neonatal health status, delivery timing and type, vertical transmission This review (...) includes 38 studies reporting on a total of 520 pregnant women in their third trimesters with COVID-19 infections. Most studies were from China, with other studies from Italy, Peru, India, USA, Portugal, South Korea. • 2 cohort studies • 11 cross- sectional studies • 4 case control studies • 11 case reports • 10 case series reports Birth outcomes were: • 433 newborns (366 cesarean deliveries) • Delivery outcomes for remaining pregnancies not reported In a meta-analysis of 3 studies, 60 pregnant women
Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO Clinical Practice Guidelines Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO Clinical Practice Guidelines† - Annals of Oncology Go search Powered By Mendeley Share on Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO Clinical Practice Guidelines † M. Lambertini Affiliations Department of Internal Medicine and Medical (...) of the ESMO Guidelines Committee ∗ Author Footnotes † Approved by the ESMO Guidelines Committee: June 2020. Published: September 22, 2020 DOI: Highlights: • This ESMO Clinical Practice Guideline provides recommendations for: • Fertility preservation strategies in post-pubertal cancer patients, including those with hereditary cancer syndromes • The management of post-treatment pregnancies in cancer survivors, including those with hereditary cancer syndromes • Management flowcharts for fertility
Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies. Preterm birth (PTB) remains the foremost global cause of perinatal morbidity and mortality. Thus, the prevention of spontaneous PTB still remains of critical importance. In an attempt to prevent PTB in singleton pregnancies, cervical cerclage, in combination with other treatments, has been advocated. This is because, cervical cerclage is an intervention (...) that is commonly recommended in women with a short cervix at high risk of preterm birth but, despite this, many women still deliver prematurely, as the biological mechanism is incompletely understood. Additionally, previous Cochrane Reviews have been published on the effectiveness of cervical cerclage in singleton and multiple pregnancies, however, none has evaluated the effectiveness of using cervical cerclage in combination with other treatments.To assess whether antibiotics administration, vaginal pessary
Valaciclovir to prevent vertical transmission of cytomegalovirus after maternal primary infection during pregnancy: a randomised, double-blind, placebo-controlled trial. Cytomegalovirus is a common congenital infection, with high morbidity after an early primary maternal infection. No effective means exist to prevent viral transmission to the fetus. We aimed to investigate whether valaciclovir can prevent vertical transmission of cytomegalovirus to the fetus in pregnant women with a primary (...) infection acquired early in pregnancy.This prospective, randomised, double-blind, placebo-controlled trial was done at the Infectious Feto-Maternal Clinic of Rabin Medical Center (Petach Tikvah, Israel). Pregnant women aged 18 years or older, with serological evidence of a primary cytomegalovirus infection acquired either periconceptionally or during the first trimester of pregnancy, were randomly assigned to oral valaciclovir (8 g per day, twice daily) or placebo from enrolment until amniocentesis
in medical care may reduce pregnancy risks and have made birth safer than ever before in terms of decreased maternal mortality. However, advances in medicine have also added to the high risk population (e.g. IVF) and the demand on resources, further increasing both clinical and operational risk. Stratification of pregnant women into normal, medium and high-risk categories is arbitrary and made difficult when there is a dearth of information, inappropriate analysis or incomparable processes and procedures (...) . It may be unclear whether the presence of a single risk factor is enough to necessitate a high- risk pregnancy carestream or if a multifactorial/combined risk factor algorithm is more appropriate. This is complicated by the fact that pregnancy covers up to 42 weeks of changes and a lifetime of predisposing factors, potentially contributing to risk. Despite the complexity of stratifying a pregnant woman based on risk, healthcare professionals need to give guidance, based on evidence
deterioration of pregnant patients 8 • Use standard administration forms for prophylactic and therapeutic medications (e.g. Heparin intravenous infusion order and administration form) 20,21 o For Dalteparin, write the brand name in addition to the generic name to reduce ambiguity 22 Queensland Clinical Guideline: VTE prophylaxis in pregnancy and the puerperium Refer to online version, destroy printed copies after use Page 10 of 25 2 Risk assessment Failure to recognise and/or treat personal or pregnancy (...) and the puerperium Refer to online version, destroy printed copies after use Page 12 of 25 2.3 Criteria for assessment of risk Consider the potential for additive effects of multiple risk factors. Refer to Appendix B Adjusted odds ratio (AOR) for risk of VTE. Table 5. Criteria for assessment of risk Risk assessment Antenatal criteria Postnatal criteria All risk • All pregnant women are at increased risk for VTE • All postnatal women are at increased risk for VTE Therapeutic anticoagulation • Pre-pregnancy
Termination of pregnancy Maternity and Neonatal C linical G uideline Queensland Health Termination of pregnancy Queensland Clinical Guideline: Termination of pregnancy Refer to online version, destroy printed copies after use Page 2 of 32 Document title: Termination of pregnancy Publication date: April 2013 Document number: MN13.21-V3-R19 Document supplement: The document supplement is integral to and should be read in conjunction with this guideline. Amendments: Full version history (...) : Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email firstname.lastname@example.org, phone (07) 3234 1479. Queensland Clinical Guideline: Termination of pregnancy Refer to online version, destroy printed copies after use Page 3 of 32 Flow Chart: Summary of termination of pregnancy Queensland Clinical Guidelines: Summary of termination of pregnancy Flowchart: F13.21-1-V3-R19 Legal requirements ToP Act 2018 Less than or equal to 22+0 weeks · A medical practitioner may perform
10.2.2 Late syphilis in pregnancy and syphilis of unknown duration (all three trimesters) . 14 10.2.3 Neurosyphilis (all trimesters) 14 10.3 Special considerations 15 10.3.1 Syphilis infection treated prior to pregnancy 15 10.3.2 Penicillin allergy 15 10.3.3 Syphilis diagnosis > 20 weeks of pregnancy 16 10.3.4 Jarisch-Herxheimer (JH) reaction 16 10.3.5 HIV positive pregnant woman with syphilis 17 10.3.6 Management of sexual contacts and other children 17 Syphilis in Pregnancy Sept 2020 V1 3 Table 2 (...) 17 10.3.7 Management of pregnant sexual contacts of infectious syphilis 17 10.3.8 Follow up 18 10.3.9 Labour and birth 19 10.3.10 Contact Precautions 19 10.3.11 Handling of placenta (whenua) 19 11. Care of the new-born (birth to 1 month) 20 11.1 Infant assessment and management summary (infants 2 years since acquisition with no symptoms) and tertiary syphilis (symptomatic late syphilis e.g. gummas, cardiovascular and neurological involvement). Syphilis in Pregnancy Sept 2020 V1 8 Primary syphilis
FSRH CEU Response to study: Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme inducing antibiotics and hormonal contraceptives 1 FSRH CEU Response to study: Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme inducing antibiotics and hormonal contraceptives 19 August 2020 The BMJ Evidence Based Medicine Journal has published a paper 1 suggesting that antibiotics may lessen the effectiveness of hormonal (...) contraception. The authors used the ‘Yellow Cards’ system where clinicians and patients can report adverse drug side-effects to the UK’s drug and medical devices regulator, the Medicines and Healthcare products Regulatory Agency (MHRA). Data between 1963 and July 2018 was analysed and researchers compared the number of unintended pregnancies reported in 74,623 Yellow Cards for antibiotics in general and in 32,872 for enzyme-inducing drugs with those reported in 65,578 other types of drugs in users of oral
Maternal Influenza A(H1N1) Immunization During Pregnancy and Risk for Autism Spectrum Disorder in Offspring : A Cohort Study. There are concerns that influenza vaccine exposure during pregnancy may be associated with increased risk for autism spectrum disorder (ASD).To examine the risk for ASD in offspring of mothers who were vaccinated against influenza A(H1N1)pdm09 ("swine flu") during pregnancy.Population-based cohort study using nationwide registers.Seven health care regions in Sweden.Live (...) in the first trimester of pregnancy did not influence risk estimates (aHR, 0.92 [CI, 0.74 to 1.16] for ASD and 0.91 [CI, 0.70 to 1.18] for AD).Data on H1N1 influenza infection are lacking.This large cohort study found no association between maternal H1N1 vaccination during pregnancy and risk for ASD in the offspring.Swedish Research Council.
Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. To determine the clinical manifestations, risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed coronavirus disease 2019 (covid-19).Living systematic review and meta-analysis.Medline, Embase, Cochrane database, WHO COVID-19 database, China National Knowledge Infrastructure (...) , with estimates pooled as odds ratios and proportions with 95% confidence intervals. All analyses will be updated regularly.77 studies were included. Overall, 10% (95% confidence interval 7% to14%; 28 studies, 11 432 women) of pregnant and recently pregnant women attending or admitted to hospital for any reason were diagnosed as having suspected or confirmed covid-19. The most common clinical manifestations of covid-19 in pregnancy were fever (40%) and cough (39%). Compared with non-pregnant women
included 4 RT-PCR positive neonates, 2 stillbirths, and 1 neonatal death. No evidence of vertical transmission. Limited data suggest that pregnant women have a clinical presentation and severity similar to non- pregnant adults, and adverse maternal and perinatal outcomes were rare. Low Not reported Yang Z, Wang M, Zhu Z, & Liu Y. (2020). Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review J Matern Fetal Neonatal Med. Epub ahead of print. Apr 20, 2020 (Search to Mar 26, 2020 (...) . No direct evidence of intrauterine vertical transmission. Moderate Low Version 1: May 15, 2020 7 The clinical characteristics of pregnant women with COVID-19 are similar to those of non-pregnant adults. Fetal and neonatal outcomes appear good in most cases. Limitation: Available data only include pregnant women infected in their third trimesters. Della Gatta AN, Rizzo R, Pilu G, & Simonazzi G. (2020). COVID19 during pregnancy: a systematic review of reported cases Am J Obstet Gynecol. Epub ahead