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antibiotics in pregnancy

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https://www.readbyqxmd.com/read/29451847/appropriate-use-of-prophylactic-antibiotic-agents-in-gynecologic-surgeries-at-a-midwestern-teaching-hospital
#1
Locke Uppendahl, Caitlin Chiles, Stephanie Shields, Fanglong Dong, Elizabeth Kraft, Jennifer Duong, James Delmore
BACKGROUND: The purpose of this study was to establish compliance with guidelines published by the American College of Obstetricians and Gynecologists (ACOG) regarding prophylactic antibiotic use in gynecologic surgery at our institution, and define areas of improvement to promote antibiotic stewardship. PATIENTS AND METHODS: This was a retrospective cohort study at a single, large tertiary care and teaching hospital in Kansas. Patients who underwent inpatient or outpatient gynecologic surgery during 2013 were included...
February 16, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29447722/no-276-management-of-group-b-streptococcal-bacteriuria-in-pregnancy
#2
Victoria M Allen, Mark H Yudin
OBJECTIVE: To provide information regarding the management of group B streptococcal (GBS) bacteriuria to midwives, nurses, and physicians who are providing obstetrical care. OUTCOMES: The outcomes considered were neonatal GBS disease, preterm birth, pyelonephritis, chorioamnionitis, and recurrence of GBS colonization. EVIDENCE: Medline, PubMed, and the Cochrane database were searched for articles published in English to December 2010 on the topic of GBS bacteriuria in pregnancy...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29444799/salvage-from-cervical-dystocia-in-third-degree-uterovaginal-prolapse-duhrssen-s-incision
#3
Manju Lata Verma, Vartika Tripathi, Uma Singh, Zakia Rahman
We present a case of a 28-year-old woman second gravida with a full-term pregnancy who presented to us in active phase of labour with third degree uterovaginal prolapse complicated by entrapment of fetal head by dystocia of cervix and fetal distress. Patient was immediately shifted to the operation theatre and prompt delivery was conducted by giving Duhrssen's incision on the highly vascular, oedematous prolapsed cervix. The outcome was an alive and healthy male baby. Duhrssen's incision was stitched with minimal blood loss...
February 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29434061/immediate-neonatal-outcomes-of-preterm-infants-born-to-mothers-with-preterm-pre-labour-rupture-of-membranes
#4
Niveditha Dannapaneni, Tejopratap Oleti, Tarakeswari Surapaneni, Deepak Sharma, Srinivas Murki
Background & objectives: With the use of early and appropriate use of antibiotics, outcomes have improved in the mother-infant dyads exposed to preterm pre-labour rupture of membranes (PPROM). This study was undertaken to evaluate immediate neonatal outcomes in infants born before 33 completed weeks of gestation to mothers with PPROM versus without PPROM. Methods: During the study period from January 2013 to December 2013, a total of 182 mother-infant dyads were prospectively included in the study...
October 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29425317/human-cervical-mucus-plugs-exhibit-insufficiencies-in-antimicrobial-activity-towards-group-b-streptococcus
#5
Jay Vornhagen, Phoenicia Quach, Verónica Santana-Ufret, Varchita Alishetti, Alyssa Brokaw, Blair Armistead, Hai Qing Tang, James W MacDonald, Theodor K Bammler, Kristina M Adams Waldorf, Niels Uldbjerg, Lakshmi Rajagopal
Preterm birth is a leading cause of neonatal mortality and lacks an effective therapy. Ascending microbial infections from the lower genital tract lead to infection of the placenta, amniotic fluid and fetus causing preterm birth or stillbirth. Directly in the path of an ascending infection is the cervical mucus plug (CMP), a dense mucoid structure in the cervical canal with potential antimicrobial properties. In this study, we aimed to define the components of CMP responsible for antimicrobial activity against a common lower genital tract organism associated with preterm birth and stillbirths, namely Group B Streptococcus (GBS)...
February 7, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29416049/protective-effect-of-group-b-streptococcus-type-iii-polysaccharide-conjugates-against-maternal-colonization-ascending-infection-and-neonatal-transmission-in-rodent-models
#6
Emiliano Chiarot, Angela Spagnuolo, Silvia Maccari, Eleonora Naimo, Alessandra Acquaviva, Raffaella Cecchi, Bruno Galletti, Monica Fabbrini, Elena Mori, Paolo Ruggiero, Guido Grandi, Maria Rita Fontana, Giuliano Bensi, Immaculada Margarit
Group B Streptococcus (GBS) is a normal inhabitant of recto-vaginal mucosae in up to 30% of healthy women. Colonization is a major risk factor for perinatal infection which can lead to severe complications such as stillbirth and neonatal invasive disease. Intra-partum antibiotic prophylaxis in colonized women is a safe and cost-effective preventive measure against early-onset disease in the first days of life, but has no effect on late-onset manifestations or on early maternal infection. Maternal immunization with capsular polysaccharide-based vaccines shows promise for the prevention of both early-onset and late-onset neonatal infections, although ability to prevent maternal colonization and ascending infection has been less studied...
February 7, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29415232/maternal-antibiotic-exposure-during-pregnancy-and-hospitalization-with-infection-in-offspring-a-population-based-cohort-study
#7
Jessica Eden Miller, Chunsen Wu, Lars Henning Pedersen, Nicholas de Klerk, Jørn Olsen, David P Burgner
Background: The early life microbiome contributes to immune development. Antibiotics during pregnancy alter the microbiome and may influence disease risks in the offspring. We investigated the relationship between maternal antibiotic exposure before and during pregnancy, and risk of childhood hospitalization with infection. Methods: We used population-based Danish national databases for pregnancies between 1995 and 2009. Infants were followed from birth until their first infection-related hospitalization, death, 14th birthday, emigration or end-2009...
February 4, 2018: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29404418/intravaginal-administration-of-interleukin-12-during-genital-gonococcal-infection-in-mice-induces-immunity-to-heterologous-strains-of-neisseria-gonorrhoeae
#8
Yingru Liu, Julianny Perez, Laura A Hammer, Heather C Gallagher, Magdia De Jesus, Nejat K Egilmez, Michael W Russell
It has previously been shown that genital tract infection with Neisseria gonorrhoeae in mice does not induce a state of protective immunity against reinfection but instead suppresses the development of adaptive immune responses against N. gonorrhoeae dependent on transforming growth factor beta (TGF-β) and interleukin 10 (IL-10). Intravaginal administration during gonococcal infection of IL-12 encapsulated in biodegradable microspheres (IL-12/ms) reverses the immunosuppression and promotes the production of gamma interferon (IFN-γ) and of specific antibodies in serum and genital secretions and accelerates clearance of the infection...
January 2018: MSphere
https://www.readbyqxmd.com/read/29391293/a-case-of-non-treated-trichomonas-vaginalis-infection-and-severe-preterm-labour-with-positive-obstetrical-outcome
#9
E Salakos, D Korb, C Morin, O Sibony
Trichomonas vaginalis is a very common, sexually transmitted, infection that may sometimes be asymptomatic or cause vaginitis and urethritis. Recently, it has been associated with adverse obstetric outcomes such as preterm delivery, low birth weight and premature rupture of membranes. Trichomonas vaginalis can be vertically transmitted at birth. It has been found in pharynx and low respiratory tract of neonates with respiratory disease. It has also been involved in some cases of intellectual disability. The recommended treatment is a 2g metronidazole oral single dose, even for asymptomatic patients...
January 29, 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29370366/national-patterns-of-urine-testing-during-inpatient-admission
#10
Molly J Horstman, Andrew Spiegelman, Aanand D Naik, Barbara W Trautner
Background: Overuse of urine testing is a driver of inappropriate antimicrobial use. Limiting wasteful testing is important for patient safety. We examined the national prevalence and patterns of urine testing during adult inpatient admission in the United States. Methods: We performed a retrospective cohort study using a national dataset of inpatient admissions from 263 hospitals in the United States from 2009 to 2014. We included all adult inpatient admissions, excluding those related to pregnancy, urology procedures, and with lengths of stay >30 days...
October 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29365329/the-relationship-between-body-mass-index-in-pregnancy-and-adverse-maternal-perinatal-and-neonatal-outcomes-in-rural-india-and-pakistan
#11
Vanessa L Short, Stacie E Geller, Janet L Moore, Elizabeth M McClure, Shivaprasad S Goudar, Sangappa M Dhaded, Bhalachandra S Kodkany, Sarah Saleem, Farnaz Naqvi, Omrana Pasha, Robert L Goldenberg, Archana B Patel, Patricia L Hibberd, Ana L Garces, Marion Koso-Thomas, Menachem Miodovnik, Dennis D Wallace, Richard J Derman
OBJECTIVE:  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. STUDY DESIGN:  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' gestation (categorized as underweight, normal, overweight, and obese following World Health Organization criteria)...
January 24, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29361936/vaginal-dysbiosis-increases-risk-of-preterm-fetal-membrane-rupture-neonatal-sepsis-and-is-exacerbated-by-erythromycin
#12
Richard G Brown, Julian R Marchesi, Yun S Lee, Ann Smith, Benjamin Lehne, Lindsay M Kindinger, Vasso Terzidou, Elaine Holmes, Jeremy K Nicholson, Phillip R Bennett, David A MacIntyre
BACKGROUND: Preterm prelabour rupture of the fetal membranes (PPROM) precedes 30% of preterm births and is a risk factor for early onset neonatal sepsis. As PPROM is strongly associated with ascending vaginal infection, prophylactic antibiotics are widely used. The evolution of vaginal microbiota compositions associated with PPROM and the impact of antibiotics on bacterial compositions are unknown. METHODS: We prospectively assessed vaginal microbiota prior to and following PPROM using MiSeq-based sequencing of 16S rRNA gene amplicons and examined the impact of erythromycin prophylaxis on bacterial load and community structures...
January 24, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29355227/syphilis-screening-and-treatment-in-pregnant-women-in-kinshasa-democratic-republic-of-the-congo-and-in-lusaka-zambia-a-cross-sectional-study
#13
Mabel Berrueta, Maria Luisa Cafferata, Musaku Mwenechanya, Dalau Nkamba Mukadi, Fernando Althabe, Eduardo Bergel, Luz Gibbons, Alvaro Ciganda, Karen Klein, Abigail Mwapule Tembo, Friday Habulembe Mwanakalanga, Ernest Banda, Arlette Mavila Kilonga, Paul Lusamba Dikassa, Xu Xiong, Elwyn Chomba, Antoinette K Tshefu, Pierre Buekens
Background: Congenital syphilis is associated with perinatal deaths, preterm births and congenital malformations. Low rates of syphilis screening during pregnancy and treatment of those found seropositive have been reported in the Democratic Republic of the Congo (DRC) and Zambia. We report the rates on antenatal syphilis screening, the seroprevalence of syphilis infection, and the frequency of antibiotic treatment in pregnant women screened positive for syphilis during their attendance at antenatal care (ANC) clinics in Kinshasa, DRC and Lusaka, Zambia...
December 8, 2017: Gates Open Res
https://www.readbyqxmd.com/read/29344938/a-clinical-audit-on-the-efficacy-and-safety-of-uterine-artery-embolisation-for-symptomatic-adenomyosis-results-in-117-women
#14
Eisen Liang, Bevan Brown, Maxim Rachinsky
BACKGROUND: Uterine artery embolisation (UAE) is a possible uterine-sparing treatment option for women with unsuccessful conservative management for adenomyosis-related heavy menstrual bleeding (HMB) and dysmenorrhoea. AIM: To conduct a clinical audit on the efficacy and safety of UAE for symptomatic adenomyosis. MATERIALS AND METHODS: Retrospective review of 309 women who underwent UAE identified 117 women with magnetic resonance imaging features of adenomyosis (junctional zone thickness ≥ 12 mm)...
January 18, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#15
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29324599/risk-factors-incidence-and-morbidity-associated-with-obstetric-clostridium-difficile-infection
#16
Jacob Ruiter-Ligeti, Sophie Vincent, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
OBJECTIVE: To evaluate the risk factors, incidence, and morbidity associated with the diagnosis of obstetric Clostridium difficile infection. METHODS: We performed a retrospective cohort study on women admitted for delivery using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from the United States. The delivery admission records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic and clinical characteristics, we assessed risk factors for the diagnosis of C difficile infection using unconditional logistic regression...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29321166/fetal-and-early-life-antibiotics-exposure-and-very-early-onset-inflammatory-bowel-disease-a-population-based-study
#17
Anne K Örtqvist, Cecilia Lundholm, Jonas Halfvarson, Jonas F Ludvigsson, Catarina Almqvist
OBJECTIVE: Earlier studies on antibiotics exposure and development of IBD (Crohn's disease (CD) and ulcerative colitis (UC)) may have been biased by familial factors and gastroenteritis. We aimed to estimate the association between antibiotics during pregnancy or infantile age and very early onset (VEO) IBD. DESIGN: In this cohort study of 827 239 children born in Sweden between 2006 and 2013, we examined the link between exposure to systemic antibiotics and VEO-IBD (diagnosis <6 years of age), using Cox proportional hazard regression models...
January 10, 2018: Gut
https://www.readbyqxmd.com/read/29310411/evaluating-a-magnetic-resonance-imaging-of-the-third-trimester-abdominal-pregnancy-what-the-radiologist-needs-to-know
#18
Mei-Xiang Deng, Yu Zou
INTRODUCTION: A 33-week abdominal pregnancy is an extremely rare type of ectopic pregnancy that is potentially life-threatening for the mother and fetus. Reports of using magnetic resonance imaging (MRI) in the third-trimester abdominal pregnancy are very few. PATIENT CONCERNS: A 24-year-old woman (gravida 2, para 1, living 0) at 33 weeks' gestation presented to local hospital complaining of vaginal bleeding for 2 months and lower abdominal pain for 2 days. Then, the woman was transferred to our hospital for suspected abdominal pregnancy, which was confirmed at our hospital on ultrasonography and further evaluated in detail on MRI...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29305250/diagnosis-and-treatment-of-urinary-tract-infections-across-age-groups
#19
REVIEW
Christine M Chu, Jerry L Lowder
Urinary tract infections (UTI) are the most common outpatient infections, but predicting the probability of UTI through symptoms and test results can be complex. The most diagnostic symptoms of UTI include change in frequency, dysuria, urgency, and presence or absence of vaginal discharge, but UTIs may present differently in older women. Dipstick urinalysis is popular for its availability and usefulness, but results must be interpreted in context of the patient's pretest probability based on symptoms and characteristics...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29302186/risks-versus-benefits-of-medication-use-during-pregnancy-what-do-women-perceive
#20
Bianca Mulder, Maarten J Bijlsma, Catharina Cm Schuiling-Veninga, Leonard P Morssink, Eugene van Puijenbroek, Jan G Aarnoudse, Eelko Hak, Tjalling W de Vries
Background: Understanding perception of risks and benefits is essential for informed patient choices regarding medical care. The primary aim of this study was to evaluate the perception of risks and benefits of 9 drug classes during pregnancy and associations with women's characteristics. Methods: Questionnaires were distributed to pregnant women who attended a Dutch Obstetric Care facility (first- and second-line care). Mean perceived risk and benefit scores were computed for 9 different drug classes (paracetamol, antacids, antibiotics, antifungal medication, drugs against nausea and vomiting, histamine-2 receptor antagonists/proton pump inhibitors, antidepressants, nonsteroidal anti-inflammatory drugs, and sedatives/anxiolytics)...
2018: Patient Preference and Adherence
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