BACKGROUND: Fetal growth inhibition is a known sequelae of in utero glucocorticoid exposure and has long-term consequences for adult health. Sex-specific fetal growth patterns are observed in pregnancies with maternal asthma and may be due to differential sensitivity of the placenta to glucocorticoids. It is currently unknown whether expression of ...

General consensus exists about the need to avoid drug intake as much as possible during pregnancy due to the lack of thorough evidence about the safety of pharmacologic treatments during gestation for both mothers and fetuses. In this respect, the overall safety profile of selective serotonin reuptake inhibitors (SSRIs) in ...

A 20-year-old female in her third month of pregnancy, presented with generalised tonic clonic seizures, metabolic acidosis and coma following suicidal ingestion of antitubercular medication. We successfully managed the case with pyridoxine, sodium bicarbonate and mechanical ventilation.

Two pairs of omphalopagus twins were encountered at the Polish Mother's Health Institution in Lodz, Poland during the past 15 years. In the first set the prenatal diagnosis was not established and the delivery of the twins in a regional hospital was a complete surprise. Both babies died. In the ...

Asthma is an increasingly common problem during pregnancy. Mild and moderate asthma can be associated with excellent maternal and perinatal pregnancy outcomes, especially if patients are managed according to contemporary recommendations of National Asthma Education and Prevention Program. Severe and poorly controlled asthma may be associated with increased prematurity, need ...

The objectives of the study were to assess the prevalence of anxiolytic use in pregnancy, the rate of congenital malformations in neonates at in utero exposure to these agents, and the possible association of congenital malformations with the use of these drugs in pregnancy. The study was conducted as cross-sectional ...

Migrainous women note a significant improvement in their headaches during pregnancy. However, persistent or residual attacks need to be treated, keeping in mind that many drugs have potential dangerous effects on embryo and foetus. It is evident, therefore, that hygiene and behaviour measures capable of ensuring the best possible well-being ...

Asthma is a common, potentially serious, even life-threatening, chronic medical condition seen amongst nearly all groups of patients, regardless of ethnicity and socioeconomic circumstances. This article addresses the group of pregnant women with symptomatic asthma as well as those whose asthma is asymptomatic as a result of good control. The ...

Medication use during pregnancy is prevalent, but pharmacokinetic information of most drugs used during pregnancy is lacking in spite of known effects of pregnancy on drug disposition. Accurate pharmacokinetic information is essential for optimal drug therapy in mother and fetus. Thus, understanding how pregnancy influences drug disposition is important for ...

A patient who just found out that she is pregnant and suffers from migraine headaches informs me that she has been taking naratriptan. She indicates that she is planning on breastfeeding her baby and might need to continue treatment. How safe are the medications from this class of drugs during ...

There may be a causal relationship between n-6 PUFA intake and allergic disease and there are biologically plausible mechanisms, involving eicosanoid mediators of the n-6 PUFA arachidonic acid, that could explain this. There is some evidence that high linoleic acid intake is linked with increased risk of atopic sensitisation and ...

Epidemiological data indicate that pregnancies of epileptic women constitute about 1% of all pregnancies. Newborns of mothers exposed to anti-epileptic drugs (AEDs) are at increased risk for major congenital malformations, cognitive impairment and fetal death. Cord-blood lymphocytes of the newborns whose mothers received long-term AEDs therapy during pregnancy were used ...

The aim of this article is to critically review available data regarding the safety of immunomodulators and biological therapies during pregnancy and breast-feeding in women with inflammatory bowel disease. Methotrexate and thalidomide can cause congenital anomalies and are contraindicated during pregnancy (and breast-feeding). Although thiopurines have a Food and Drug ...

Disease modifying antirheumatic drugs are being increasingly utilized in the treatment of many autoimmune disorders. TNF-alpha antagonists have become the standard of care in treating many of these autoimmune diseases. Because these autoimmune disorders often affect women in their childbearing years, the safety of anti-TNF therapy in pregnancy becomes important. ...

Many of my pregnant and breastfeeding patients suffer from allergies and frequently ask me about the safety of antihistamines during pregnancy and breastfeeding. Should I advise them to use the older sedating medications? I have heard that they might be safer than the newer nonsedating class of drugs. Or have ...

PROBLEM: Pregnancy outcome in women with a previous history of drug allergy and the role of drug allergies in adverse pregnancy outcomes is unclear. METHOD OF STUDY: A retrospective cohort study comparing pregnancies of women with and without history of drug allergy was conducted. Data were collected from the computerized ...

Over the past 15 years, the number of studies investigating the potential teratogenic effects of antidepressants has drastically increased. Prescribing antidepressants during pregnancy is becoming a challenge for health care providers because of conflicting data on their teratogenic potential. A critical systematic review of studies describing the relationship between antidepressant ...

BACKGROUND: Observational studies have reported an association between maternal use of paracetamol in pregnancy and childhood asthma, which was not explained by measured confounding factors. However, it is possible that this relation might be confounded by unmeasured behavioural factors linked to paracetamol usage; if that were the case, effects of ...

A new Swedish study by Reis & Källén describes approximately 15,000 women (and their babies) that, between 1995 and 2007, reported the use of antidepressants, or were prescribed such drugs, during pregnancy. In this study, pregnancy and teratogenic outcomes after exposure to tricyclic antidepressants are, for most measures, equal or ...

OBJECTIVE: To report on 6 weeks of daptomycin treatment for tricuspid valve endocarditis caused by Staphylococcus aureus in a pregnant female in her second trimester. CASE SUMMARY: A 24-year-old, 14-week pregnant patient with no significant medical history, but with a history of intravenous drug abuse presented with tricuspid valve endocarditis ...

A case report of a minor, pregnant girl with epilepsy caused by a brain tumour is presented. There are several aspects which make the presented case complex from medical, but also from the bioethical point of view. The decision about keeping the pregnancy or not is the most important bioethical ...

Women who are pregnant and who have a history of psychosis are commonly managed with antipsychotic medications. The evidence regarding the use of antipsychotics in pregnancy has been insufficient to provide adequate support for this practice and is a concern for clinicians and women alike. This review presents literature surrounding ...

To examine whether factors related to the patient or her treatment influence asthma severity during pregnancy. Symptom and medication data were collected by in-person and telephone interviews. Women were recruited before 24 weeks of gestation through private obstetricians and hospital clinics. Eight hundred seventy-two women had physician-diagnosed asthma, 686 were ...

My patient is taking a medication for a chronic condition and has just found out that she is 6 weeks pregnant. The US Food and Drug Administration (FDA) has assigned this medication to pregnancy risk category D, and the Compendium of Pharmaceuticals and Specialties provides no additional data. How should ...

Epilepsy and pregnancy registries have been operational for more than 10 years, have accrued considerable experience, and collected an impressive amount of data. As findings have been published, it has become important to understand how observations from the different registries are comparable, especially since their methodologies differ somewhat. In September ...

BACKGROUND: According to the 2004 National Survey on Drug Use and Health, 4.6% of American women reported use of an illicit drug during pregnancy. Previous studies on illicit drug use during pregnancy and perinatal outcomes showed inconsistent results. METHODS: This population-based study included mothers who delivered live-born infants without birth ...

BACKGROUND: Clinicians practicing in Emergency Departments (EDs) using outdated pocket guides and other non-pregnancy-specific references when prescribing in pregnancy may place the pregnancy or fetus at risk. OBJECTIVE: To identify the references that emergency medicine (EM) clinicians use for prescribing in pregnant patients, the prescribing trends when clinicians are given ...

The goal of this study was to describe mapping and ablation of severe arrhythmias during pregnancy, with minimum or no X-ray exposure. Treatment of tachyarrhythmia in pregnancy is a clinical problem. Pharmacotherapy entails a risk of adverse effects and is unsuccessful in some patients. Radiofrequency ablation has been performed rarely, ...

OBJECTIVE: To evaluate the teratogenic effect of very large doses of nitrazepam in children born to pregnant women who attempted suicide and to check the feasibility of self-poisoning pregnant women model. DESIGN AND SETTING: Comparative analysis of exposed children and their unexposed sibs born to the same mothers who attempted ...

BACKGROUND: In patients with medically refractory seizures, vagal nerve stimulation is becoming an increasingly common adjunctive therapy. Although its safety and efficacy have been proven in the general population, little is known about its use during pregnancy. CASE: A 19-year-old primigravid woman presented during the first trimester for routine prenatal ...

To determine whether asthma-specific quality of life during pregnancy is related to asthma exacerbations and to perinatal outcomes. This was a secondary analysis of data from a randomized controlled trial of inhaled beclomethasone versus theophylline in the treatment of moderate asthma during pregnancy. The Juniper Asthma Quality of Life Questionnaire ...

We surveyed opinions and recommendations about perinatal anticonvulsant (AC) treatment among 166 neurologists (n = 88) and psychiatrists (n = 78) practicing in Massachusetts. They were similar in the recommendation of routinely informing patients of potential teratogenic risks of ACs and avoiding valproate during pregnancy. Neurologists were more likely to ...

Concerns have been expressed about possible adverse effects of the use of antidepressant medication during pregnancy, including risk for neonatal pathology and the presence of congenital malformations. Data from the Swedish Medical Birth Register (MBR) from 1 July 1995 up to 2007 were used to identify women who reported the ...

Information about the use of a medication in pregnancy is part of overall drug labelling as prepared by the pharmaceutical company and approved by the regulators. It is aimed at assisting clinicians in prescribing, however, very few drugs are labelled for specific indications in pregnancy, since there is rarely information ...

A Motherisk symposium on establishing benchmarks for the evaluation of medications during pregnancy, was held on May 10, 2006, under the auspices of the Canadian Society of Pharmacology and Therapeutics. From that symposium came a consensus on the need for collection and analysis of data on fetal safety and ongoing ...

BACKGROUND: Women with hyperthyroidism in pregnancy have increased risks of miscarriage, stillbirth, preterm birth, and intrauterine growth restriction; and they can develop severe pre-eclampsia or placental abruption. OBJECTIVES: To assess the effects of interventions for preventing or treating hyperthyroidism in pregnant women. SEARCH STRATEGY: We searched the Cochrane Pregnancy and ...

The formation of primordial follicles to establish a reservoir of resting follicles and the gradual depletion of that reservoir to provide a succession of growing follicles are key to female fertility, but little is known about the regulation of these early stages of follicular development. This review summarizes the efforts ...

Depression during pregnancy occurs frequently and selective serotonin reuptake inhibitors (SSRIs) are often the drug of choice when treating pregnant women. Most published studies found no increased risks of congenital malformations in association with SSRIs, but there are reports of various malformations for SSRIs as a group and for specific ...

Anti-TNFα medications have led to vast improvements in the treatment of inflammatory conditions, including rheumatoid arthritis and Crohn's disease. As these diseases often afflict women in their reproductive years, the safety of these drugs during pregnancy is an important issue. Prospectively collected data thus far appear to be reassuring; however ...

To determine the influence of epilepsy and its treatment on pregnancy and its outcome. Controlled, observational study. National Health Service maternity hospitals in Liverpool and Manchester regions. 277 women with epilepsy (WWE) and 315 control women. WWE were recruited from antenatal clinics. Controls were matched for age and parity but ...

The prevalence of autism, a neurodevelopmental condition resulting from genetic and environmental causes, has increased dramatically during the last decade. Among the potential environmental factors, hyperserotonemia during pregnancy and its effect on brain development could be playing a role in this prevalence raise. In the rodent model developed by Whitaker-Azmitia ...

During pregnancy, drug addiction represents one of the most dangerous situations. Each drug can badly affect the fetal development and, when the pregnancy is over, the negative influence continues in the newborn which is exposed to many risks, in particular the withdrawal syndrome. Since it is difficult to predict the ...

Montelukast (Singulair) is a selective leukotriene receptor antagonist (LTRA) indicated for the maintenance treatment of asthma. Currently, there are limited prospective, comparative studies in the literature examining the safety of montelukast use in pregnancy. The primary objective of this study was to determine whether exposure to montelukast during pregnancy increases ...

To address provider struggles to provide evidence-based, rational drug therapy to pregnant women, a second conference was convened to highlight the current research in the field. Speakers from academic centers and institutions spoke about: the unique physiology and pathology of pregnancy; pharmacokinetic changes in pregnancy; thyroid disorders in pregnancy; pharmacogenetics ...

While recreational drug use in UK women is prevalent, to date there is little prospective data on patterns of drug use in recreational drug-using women immediately before and during pregnancy. A total of 121 participants from a wide range of backgrounds were recruited to take part in the longitudinal Development ...

In Germany during the last years about 200-250 HIV1-infected pregnant women delivered a baby each year, a number that is currently increasing. To determine the HIV-status early in pregnancy voluntary HIV-testing of all pregnant women is recommended in Germany and Austria as part of prenatal care. In those cases, where ...

The introduction of tyrosine kinase inhibitors into clinical practice now offers most patients with chronic myelogenous leukemia lengthy remissions and the possibility of normal life expectancies. These improved survivals have resulted in the need to address issues relating to quality of life, including fertility and procreation. Treatment may require lifelong ...

Data on clinical teratogenicity are at best derived from carefully conducted observational studies, whereas randomized, controlled trials have no place in this research area. We can only expect level B recommendations and lower. New relevant information has become available during the last 5 years on pregnancy outcomes with 3 of ...

OBJECTIVE: Non-steroidal anti-inflammatory drug (NSAID) use on late pregnancy can be associated with severe adverse neonatal outcomes. Some NSAIDs, available over the counter, can be purchased easily by pregnant women. The present study evaluates pregnant womens' knowledge about NSAID use in pregnancy. STUDY DESIGN: The survey includes 250 pregnant women ...

BACKGROUND: Perception of risk may impact a woman's decision to take a needed drug during pregnancy. There is a paucity of research on this topic in the literature. OBJECTIVES: (1) To evaluate the perception of risk of 17 commonly used drugs and other substances by pregnant women. (2) To investigate ...