RESUMO
OBJECTIVE: To provide an update on rubella and pregnancy so that health professionals remain aware of the potentially devastating effects on the developing fetus. OUTCOMES: Rubella vaccination has been effective in virtually eliminating congenital rubella syndrome in Canada. EVIDENCE: Medline, PubMed, and Cochrane Database were searched for articles published between 1985 and 2007. VALUES: The quality of evidence was rated using the criteria described in the report of the Canadian Task Force on Preventive Health Care. SPONSOR: The Society of Obstetricians and Gynaecologists of Canada.
Assuntos
Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal/normas , Síndrome da Rubéola Congênita/prevenção & controle , Vacina contra Rubéola/uso terapêutico , Rubéola (Sarampo Alemão)/prevenção & controle , Canadá , Feminino , Ginecologia , Humanos , Recém-Nascido , Obstetrícia , Gravidez , Sociedades Médicas , VacinaçãoRESUMO
OBJECTIVE: Fetal safety has never been studied for any drug used in the treatment of hemorrhoids. Proctofoam-HC is a combination of a corticosteroid and a local anaesthetic that is proven effective for the treatment of hemorrhoids. The objective of this study was to assess prospectively the fetal safety of third trimester exposure to Proctofoam-HC. METHODS: In a multicentre study, 204 [corrected] women exposed to Proctofoam-HC in the third trimester and a similar number of control pregnant women were followed up postnatally. RESULTS: When compared to controls exposure to Proctofoam-HC was not associated with any adverse fetal effects on birth weight, gestational age, rates of prematurity, or pre- or postnatal complications. CONCLUSION: Proctofoam-HC is safe to use in the treatment of hemorrhoids in late pregnancy.
Assuntos
Anestésicos Locais/efeitos adversos , Anti-Inflamatórios/efeitos adversos , Desenvolvimento Fetal/efeitos dos fármacos , Hemorroidas/tratamento farmacológico , Hidrocortisona/efeitos adversos , Morfolinas/efeitos adversos , Complicações na Gravidez/tratamento farmacológico , Adulto , Peso ao Nascer , Combinação de Medicamentos , Feminino , Humanos , Gravidez , Terceiro Trimestre da GravidezRESUMO
OBJECTIVE: To provide an update on rubella and pregnancy so that health professionals remain aware of the potentially devastating effects on the developing fetus. OUTCOMES: Rubella vaccination has been effective in virtually eliminating congenital rubella syndrome in Canada. EVIDENCE: Medline, PubMed, and Cochrane Database were searched for articles published between 1985 and 2007. VALUES: The quality of evidence was rated using the criteria described in the report of the Canadian Task Force on Preventive Health Care. SPONSOR: The Society of Obstetricians and Gynaecologists of Canada.
Assuntos
Medicina Baseada em Evidências , Complicações Infecciosas na Gravidez , Síndrome da Rubéola Congênita/prevenção & controle , Rubéola (Sarampo Alemão)/diagnóstico , Rubéola (Sarampo Alemão)/tratamento farmacológico , Canadá , Feminino , Humanos , Gravidez , Vacina contra RubéolaRESUMO
OBJECTIVE: To compare the efficacy of oral misoprostol with that of intra-amniotic prostaglandin F2alpha (PGF2alpha) for second trimester pregnancy termination. METHODS: One hundred seventeen women with pregnancies of between 16 and 22 weeks' gestation were randomly assigned after insertion of laminaria to receive either oral misoprostol 400 microg every 4 hours (to a maximum of four doses) or intra-amniotic PGF2alpha 40 mg. The rate of complete abortion within 24 hours was the primary outcome for power analysis. Secondary outcome measures were the rate of dilatation and curettage (D&C) for retained placenta and the rates of fever and gastrointestinal complications. RESULTS: Patient characteristics were similar in both groups. The rate of complete abortion within 24 hours was similar in the misoprostol (63%) and PGF2alpha (66%) groups. The rate of retained placenta requiring D&C was significantly greater in the PGF2alpha group (22.4% vs. 3.4%, P = 0.002). There were no differences in other maternal morbidities. Parous patients treated with oral misoprostol had a significantly greater rate of complete abortion than nulliparous patients (84% vs. 57%, P = 0.04). CONCLUSIONS: Oral misoprostol is as effective as intra-amniotic PGF2alpha for second trimester pregnancy termination when laminaria is inserted before treatment. Parous patients have a higher success rate than nulliparous patients with use of oral misoprostol. Oral misoprostol is associated with a very low rate of placental retention.
