Continuous low-dose antibiotics and cerclage for recurrent second-trimester pregnancy loss.

OBJECTIVE: To evaluate the role of continuous low-dose antibiotics in the prolongation of pregnancy in women at risk for recurrent second-trimester loss. METHODS: Only patients with a history of previous recurrent second-trimester losses associated with failed cervical cerclages were prospectively included in the study. Patients received low-dose antibiotics until delivery. Cerclage was performed at 14-24 weeks' gestation on the basis of transvaginal sonographic findings of cervical funneling. Outcome was evaluated by weeks of pregnancy gained in the current pregnancy as compared to the previous pregnancy. RESULTS: Ten patients were eligible for study after exclusions. All 10 achieved fetal viability. Pregnancy was prolonged by a mean of 13.4 +/- 4.2 weeks beyond the previous pregnancy. This was highly statistically significant (P < .001). CONCLUSION: Continuous low-dose antibiotics prolonged pregnancy in patients with recurrent second-trimester pregnancy losses and prior failed cerclage. Randomized clinical trials are needed to confirm the role of antibiotics in these high-risk pregnancies.

Effect of dietary protein on glomerular filtration rate in pregnancy.

High dietary protein intake is known to increase glomerular filtration rate in the nonpregnant state. The effects of dietary protein on renal function in human pregnancy are not well known. We studied 392 patients with singleton uncomplicated pregnancies at gestational ages of 7-40 weeks. Creatinine clearance was correlated with protein intake estimated from 24-hour dietary recall during the same period. Creatinine clearances were significantly higher when dietary protein was more than 50 g than when it was less than 50 g (P less than .005). The short- or long-term significance of this finding is unclear.