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At least 19 recordsLinked to original sources
PubMed2000

Interventions for treating gonorrhoea in pregnancy.

BACKGROUND: Neisseria gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth and can cause gonococcal opthalmia neonatorum. OBJECTIVES: The objective of this review was to assess the effects of antibiotic regimens in the treatment of genital infection with gonorrhoea during pregnancy with respect to neonatal and maternal morbidity. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: October 1998. SELECTION CRITERIA: Randomised trials of one regimen of antibiotic versus another in pregnant women with culture confirmed genital gonococcal infection. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by one reviewer. MAIN RESULTS: Two trials involving 329 women were included. Amoxycillin with probenicid or spectinomycin or ceftriaxone have a similar effect on microbiological cure, defined by negative gonococcal culture. REVIEWER'S CONCLUSIONS: Any of the antibiotic regimens tested in these trials appear to be effective for the treatment of gonorrhoea in pregnancy in terms of their effect on microbiological cure. For women who are allergic to penicillin, this review provides reassurance that treatment with ceftriaxone or spectinomycin appears to be at least as equally effective in producing microbiological cure.

Anti-Bacterial Agents↗
PubMed2000

Interventions aimed at decreasing the risk of mother-to-child transmission of HIV infection.

BACKGROUND: At the end of 1998 over 33 million people were infected with the human immunodeficiency virus (HIV) and over one million children had been infected from their mothers. OBJECTIVES: The objective of this review was to assess what interventions may be effective in decreasing the risk of mother-to-child transmission of HIV infection as well as their effect on neonatal and maternal mortality and morbidity. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. SELECTION CRITERIA: Randomised trials comparing any intervention aimed at decreasing the risk of mother-to-child transmission of HIV infection compared with placebo or no treatment, or any two or more interventions aimed at decreasing the risk of mother-to-child transmission of HIV infection. DATA COLLECTION AND ANALYSIS: Trial quality assessments and data extraction were undertaken by the reviewer. MAIN RESULTS: Zidovudine Four trials comparing zidovudine with placebo involving 1585 participants were included. Compared with placebo, there was a significant reduction in the risk of mother-to-child transmission with any zidovudine (relative risk (RR) 0.54, 95% confidence interval (CI) 0.42-0.69). There is no evidence that 'long course therapy' is superior to 'short course therapy'. Nevirapine One trial compared intrapartum and postnatal nevirapine with intrapartum and postnatal zidovudine in 626 women, the majority of whom breast fed their infants. Compared with zidovudine, there was a significant reduction in the risk of mother-to-child transmission of HIV with nevirapine (RR 0.58, 95% CI 0.40-0.83). No trials are available comparing nevirapine with placebo. Caesarean section One trial comparing elective caesarean section with anticipation of vaginal delivery involving 436 participants was included. Compared with vaginal delivery, there was a significant reduction in the risk of mother-to-child transmission of HIV infection with caesarean section (RR 0.17, 95% CI 0.05-0.55). Immunoglobulin One trial comparing hyperimmune immunoglobulin plus zidovudine with non-specific immunoglobulin plus zidovudine involving 501 participants was included. The addition of hyperimmune immunoglobulin to zidovudine does not appear to have any additional effect on the risk of mother-to-child transmission (RR 0.67, 95% CI 0.29-1.55). REVIEWER'S CONCLUSIONS: Zidovudine, nevirapine and delivery by elective caesarean section appear to be very effective in decreasing the risk of mother-to-child transmission of HIV infection.

Anti-HIV Agents↗
PubMed2002

Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection.

BACKGROUND: At the end of 2000 it was estimated that over 36 million people were living with the human immunodeficiency virus (HIV). This includes 1.4 million children less than 15 years of age. This is one of several reviews assessing the available evidence for preventing mother-to-child transmission of HIV infection. The other reviews will address other interventions, including Caesarean section, breast feeding, vaginal lavage and vitamin A supplementation. OBJECTIVES: To assess which antiretroviral therapies may be effective in decreasing the risk of mother-to-child transmission of HIV infection as well as their effect on neonatal and maternal mortality and morbidity. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. We also searched conference abstracts from the International AIDS Conferences and Conference on Retroviruses and Opportunistic Infections. SELECTION CRITERIA: Randomised trials comparing any antiretroviral therapy aimed at decreasing the risk of mother-to-child transmission of HIV infection with placebo or no treatment, or any two or more antiretroviral therapies or regimens aimed at decreasing the risk of mother-to-child transmission of HIV infection. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. MAIN RESULTS: Zidovudine monotherapy Any zidovudine regimen versus placebo significantly reduces the risk of mother-to-child transmission (Peto odds ratio (OR) 0.46, 95% confidence interval (CI) 0.35 to 0.60). Zidovudine also appears to decrease the risk of infant death within the first year of birth (OR 0.57, 95% CI 0.38 to 0.85) and the risk of maternal death (OR 0.32, 95% CI 0.16 to 0.66). There is no evidence that zidovudine influences the incidence of premature delivery (OR 0.86, 95% CI 0.57 to 1.29) or low birth weight (OR 0.74, 95% CI 0.53 to 1.04). The risk of transmission using a 'short-short' course of zidovudine (from 35 weeks in pregnancy for the mother and for the baby until 3 days old) was higher than the risk using a 'long-long' course (from 28 weeks in pregnancy for the mother and for the baby until 6 weeks old), (OR 2.55, 95% CI 1.26 to 5.18). However, the effectiveness of the 'long-short' course (from 28 weeks in pregnancy for the mother and for the baby until 3 days old) and the 'short-long' course (from 35 weeks in pregnancy for the mother and for the baby until 6 weeks old) did not differ from that of the 'long-long' course. Nevirapine One large randomised controlled trial demonstrates that nevirapine given to mothers as a single dose at the onset of labour and to babies as a single dose within 72 hours of birth is more effective than an intrapartum and post-partum regimen of zidovudine (OR 0.51, 95% CI 0.33 to 0.79). When nevirapine is given to mothers already receiving standard antiretroviral therapy, however, there appears to be no additional advantage (OR 1.10, 95% CI 0.42 to 2.86). Combination Therapy Preliminary findings of the effect of combination therapy using zidovudine and lamivudine (3TC) suggest a decrease in the risk of transmission when the combination is given during the antenatal and intrapartum period or during the intrapartum and postpartum period compared with placebo. There is no evidence that intrapartum zidovudine and lamivudine alone are sufficient to decrease the risk of transmission compared with placebo. REVIEWER'S CONCLUSIONS: Implications for practice The randomised trials included in this review provide evidence that short course zidovudine and single-dose nevirapine are effective therapies for reducing mother-to-child transmission of HIV. The challenge for low and middle income countries will be to institute this therapy in practice. In industrialised countries practice has already moved on from the current evidence and combination antiretroviral therapy aimed primarily at preventing disease progression in the mother is the standard of care. Implications for research The potential value of nevirapine used for longer durations in breastfeeding populations should be considered as it may further reduce the risk of mother-to-child transmission, particularly if combined with early weaning. On-going evaluation of combination antiretroviral therapy is essential and will have an immediate benefit for countries with the resources to adopt such treatment. The search for effective, affordable, safe and acceptable alternatives to antiretroviral therapy for reducing mother-to-child transmission in resource poor countries should remain on the research agenda.

Anti-HIV Agents↗
PubMed1994

Maternal and pediatric AIDS in the United States: the current situation and future research directions.

The epidemic of HIV infection and disease in women, adolescents and children represents a complexly intertwined biological and social challenge to health care workers and researchers alike. When considering various issues in confronting this epidemic, women must be viewed as individuals important in their own right, as the primary caretaker of their family members (both infected and uninfected), and as the sexual partners of men who may or may not be infected. Of the myriad of compelling biological questions facing AIDS researchers today, two of the most interesting involve the timing and determinants of vertical transmission and the natural history of HIV infection and disease in women. Scientifically, confronting this epidemic involves research into pathogenesis, epidemiology, natural history, treatment, and prevention of HIV infection. Primary emphasis in the research arena in HIV/AIDS in the United States is focused on therapeutic and prophylactic research. Other research issues are very important, including studies of early diagnostic techniques, behavioral research concerning reproductive choices, the role of breastfeeding in HIV transmission, HIV-specific adolescent issues, and surrogate markers of disease progression.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Evaluation of pregnant women exposed to respiratory viruses.

Prenatal patients are often exposed to respiratory viruses at home and at work. Understandably, these patients may be concerned and want immediate answers and advice from their physicians. While most women who are exposed to chickenpox are immune, serologic testing can be performed and susceptible patients can be treated with varicella-zoster immune globulin. If the prenatal patient is infected with the varicella-zoster virus, the risk of fetal manifestations is less than 2 percent. Women who have been exposed to fifth disease can undergo serologic testing to determine the likelihood of infection. If the prenatal patient becomes infected with fifth disease during the first 20 weeks of gestation, the risk of fetal manifestations is about 9 percent and includes nonimmune hydrops and death. Cytomegalovirus, which is the most common congenital infection, is generally asymptomatic in the mother. Infected fetuses have a 25 percent chance of developing early or late neurologic manifestations. The evidence of harm from other common respiratory viruses is inconsistent.

Algorithms↗
PubMed1997

Treatment of viral infections during pregnancy and the neonatal period.

Over the past 15 years, successful antiviral therapy of herpes simplex virus (HSV) infection has emerged with safe therapeutics. Despite the major impact of acyclovir on the severity of HSV infection, morbidity and mortality from neonatal herpes exist. The development of therapeutics that impact on the natural history of HIV and AIDS just now are being realized, nearly a decade after the first beneficial effects of therapy were reported. Early investigations of antiviral agents in pregnant women and children must occur more promptly as the field of antiviral therapy advances. Improved therapeutics are likely to emerge over the next decade for both pregnant women and their offspring.

Antiviral Agents↗
PubMed2006

German-Austrian recommendations for HIV-therapy in pregnancy and in HIV-exposed newborn - update 2005.

In Germany during the last years about 200-250 HIV 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 HIV infection was known during pregnancy, since 1995 the rate of vertical transmission of HIV was reduced to 1-2%. - This low transmission rate has been achieved by the combination of anti-retroviral therapy of pregnant women, caesarean section scheduled before onset of labour, anti-retroviral post exposition prophylaxis in the newborn and refraining from breast-feeding by the HIV infected mother. To keep pace with new results in research, approval of new anti-retroviral drugs and changes in the general treatment recommendations for HIV infected adults, in 1998, 2001 and 2003 an interdisciplinary consensus meeting was held. Gynaecologists, infectious disease specialists, paediatricians, pharmacologists, virologists and members of the German AIDS Hilfe (NGO) were participating in this conference to update the prevention strategies. A third update became necessary in 2005. The updating process was started in January 2005 and was terminated in September 2005. The guidelines provide new recommendations on the indication and the starting point for therapy in pregnancies without complications, drugs and drug combinations to be used preferably in these pregnancies and updated information on adverse effects of anti-retroviral drugs. Also the procedures for different scenarios and risk constellations in pregnancy have been specified again. With these current guidelines in Germany and Austria the low rate of vertical HIV-transmission should be further maintained.

Female↗
PubMed1995

Factors contributing to delayed diagnosis of HIV-infected women and their children in south Texas.

Preliminary results from a previous study at a family human immunodeficiency virus (HIV) clinic in South Texas indicated that HIV-positive (HIV+) children from small communities were usually infected and often symptomatic at the time of referral. The current study evaluated rates of vertical transmission and factors that contributed to delayed diagnosis of HIV for 82 children born to HIV-infected women in South Texas. Children from smaller metropolitan statistical areas (MSAs) were infected more often (70.4% vs. 33.3%), identified later (average 9.7 vs. 3.2 months) and were less often known to be HIV+ at birth (51.4% vs. 64.4%), than those from the largest MSA. In addition, children whose mothers were infected sexually were infected more often (52.8% vs. 32.0%), tested later (average 7.6 vs. 1.6 months), and were less often known to be HIV+ at birth (46.8% vs. 85.2%), than those children whose mothers were injecting drug users (IDU). Children followed from birth were infected less often (34.3%) than those identified later (65.5%). In South Texas, children born to HIV+ mothers were at higher risk for missed or delayed diagnosis if they were from small MSAs and had mothers who were infected sexually. Early diagnosis of HIV+ women and children is increasingly important because of advances in treatment of HIV and prevention of vertical transmission of HIV.

Child↗
PubMed2004

Viremia and effect of fetal infection with porcine viruses with special reference to porcine circovirus 2 infection.

This publication reviews some pathogenetic features of the transplacental infection with porcine viruses in sows. Viremia either with virus freely circulating or associated to peripheral blood mononuclear cells (PBMC) is an essential part of such pathogenesis. Virus replication occurs either in fetal tissues only or both in fetal and maternal tissues and the outcome may be different. Since porcine circovirus 2 (PCV2) has been associated with reproductive failure in sows, the question was asked what type of viremia PCV2 causes and what the effect of PCV2 is on the pregnant uterus. Seronegative gilts were oronasally inoculated and plasma and PBMC were monitored for infectious virus and for quantity of viral DNA copies. Infectious virus was found in plasma only at 21 days post-inoculation (DPI). Virus associated to PBMC was detected between 14 and 49 DPI. Viral DNA was found in plasma between 14 and 49 DPI and associated to PBMC between 7 and 63 DPI (end of experiment). Direct intra-fetal inoculation at 57, 75 and 92 days of gestation and collection of fetuses 21 days later showed that the virus replicates highly in fetal tissues, particularly in the heart. Fetal death occurred in the 57 days sows while virus and antibodies were observed in the 75- and 92-day inoculated sows. Inoculation at 57 and 75 days of gestation and collection of the piglets at the end of pregnancy showed that intrauterine spread had occurred to fetuses adjacent to the inoculated ones and that fetal death occurred also in the presence of antibodies. The pregnancy was not interrupted.This study shows that PCV2 causes viremia which is largely cell-associated and that virus replication in fetuses causes fetal death with mummification. Whether such transplacental infection occurs in the immune sow population is questionable.

Abortion, Veterinary↗
PubMed2005

Risk factors for human immunodeficiency virus type-1 acquisition in women in Africa.

Over 65% of individuals infected with human immunodeficiency virus type 1 (HIV-1) reside in sub-Saharan Africa, and thus efforts to change the course of the HIV-1 pandemic should focus on this geographic region. Here, we discuss factors, including sexually transmitted diseases and hormonal contraceptive use, that impact susceptibility to HIV-1 in women in sub-Saharan Africa. This population is of special interest, given that women in this region are more likely to be infected than men. In addition, they are a potential source of transmission to their infants. A better understanding of the factors that influence HIV-1 susceptibility is key to developing interventions to control the epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed2001

[Importance of hepatitis C virus infection in gynecology and obstetrics].

OBJECTIVE: Diagnostic methods of hepatitis C-virus. SUBJECT: A review article. SETTING: 1st Internal Clinic, General Faculty Hospital in Prague, 1st Medical Faculty, Charles University. SUBJECT AND METHOD: Hepatitis C virus infection importance is increasing during the last few years, in concordance with this fact therapeutical options are being developed very rapidly, too. Majority of cases of HCV infection has a silent clinical course for a long time and patients are often diagnosed in the late stage of liver disease. This is the reason why the diagnosis should be established as early as possible. Gynecologist can be the first person who can observe the symptoms of the infection and therefore he may become the key person in the diagnostic process. CONCLUSION: The basic facts about the diagnostic methods and clinical course of the disease are mentioned in this review. The differences in clinical course of HCV infection in pregnancy and the vertical transmission is discussed in details.

Female↗
PubMed2000

[Action of the vaccination of sows against E. coli infections with a subsequent postpartum booster].

In an eastern european pig productions unit with high prevalence of suckling piglets diarrhoea during late lactation the following trial was conducted: The sows were assigned to an experimental and to a control group and were treated as follows: Group one (15 sows) were vaccinated with a single 2 ml dose of Porcovac Plus (Höchst Roussel Vet.) during their late pregnancy (gilts were vaccinated twice). Booster vaccination was performed between day 2-7 p.p. Group two (15 sows) were vaccinated during their late pregnancy the same was as the sows in the group one, but received no p.p. Booster. The following parameter were evaluated. A: Preweaning diarrhoea B: Preweaning mortality C: Three weeks weaning litter weights D: Postweaning mortality E: Average weight gain during the first 3 weeks postweaning The results revealed a marked difference between the groups (group 1: 16.1% vs. group 2: 23.3%) regarding preweaning diarrhoea (parameter A). A similar difference was to be seen regarding parameter B (preweaning mortality) between the groups (group 1: 7.5% vs. group 2: 10.7%). In spite of this there was a non significant difference as regards weaning litter weights (parameter C) between group 1: 59.2 +/- 2.4 kg and group 2: 57 +/- 2.2 kg. Postweaning parameters showed better results in the booster vaccinated group regarding both evaluated parameter as well. Regarding piglet mortality (parameter D) there was a marked difference between the group 1 (0.67%) and group 2 (2.1%) to be seen. Regarding average daily gain (parameter E) between group 1 (470 +/- 11 gr) and group 2 (380 +/- 9 gr) there was a significant difference (p < 0.05) to be discovered. It is the opinion of the authors that p.p. Booster vaccination of the sows is an economically important tool in large and small pig production units.

Animals↗