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Absalón-Medina VA, Sala RV, Bond R. Antimicrobial prophylaxis post-amniocentesis procedures in cattle: A randomized controlled equivalence study. Vet Anim Sci 2022; 15:100225. [PMID: 35005294 PMCID: PMC8717245 DOI: 10.1016/j.vas.2021.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Amniocentesis is a routine procedure utilized on several species including human, equine, and bovine patients. Early assessment and discovery of new genetic traits in the cattle industry are highly desirable in order to accelerate genetic gain by shortening generational intervals. One of the main concerns from this procedure is the introduction of pathogenic bacterial contamination into the amniotic cavity thereby increasing the risks of spontaneous pregnancy losses post procedure. In this randomized controlled equivalence study, we have tested the effect of antimicrobial prophylaxis on the incidence of spontaneous abortions and contrasted it to untreated individuals post amniocentesis. On the treated group (n = 67) all heifers remained pregnant whereas 1 of the untreated group (n = 65) resulted in a spontaneous abortion during the study period. The latter represents 1.54% of pregnancy losses attributed to the risk associated to the amniocentesis procedure. However, the probability of inducing spontaneous abortion from the technique itself is not different to that of the contemporaneous population (n = 694) not undergoing amniocentesis viz., 1.59%. Following a two-tailed distribution, statistical analyses showed no significant differences across treatments (Fisher's exact test P = 0.49). The current prospective study indicates that performing amniocenteses on cattle have resulted in similar spontaneous pregnancy losses comparable to those of pregnant heifers without undergoing amniocentesis and regardless of antimicrobial use. In conclusion, prophylactic antimicrobials may not be applicable within the cattle amniocentesis framework.
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Affiliation(s)
- V A Absalón-Medina
- STgenetics®, South Charleston 45368 OH, United States of America.,Department of Animal Sciences, The Ohio State University, Columbus OH, 43210 United States of America
| | - R V Sala
- STgenetics®, South Charleston 45368 OH, United States of America
| | - R Bond
- STgenetics®, South Charleston 45368 OH, United States of America
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Batra M, Sharma KA, Singh C, Devadasan S, Vikraman SK, Praveen TLN, Khurana A. SFM Clinical Practice Recommendations for Prenatal Invasive Diagnostic Procedures. JOURNAL OF FETAL MEDICINE 2021. [DOI: 10.1007/s40556-021-00311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Belleudi V, Fortinguerra F, Poggi FR, Perna S, Bortolus R, Donati S, Clavenna A, Locatelli A, Davoli M, Addis A, Trotta F. The Italian Network for Monitoring Medication Use During Pregnancy (MoM-Net): Experience and Perspectives. Front Pharmacol 2021; 12:699062. [PMID: 34248644 PMCID: PMC8262612 DOI: 10.3389/fphar.2021.699062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/04/2021] [Indexed: 11/25/2022] Open
Abstract
There is an acute need for research to acquire high-quality information on the use of medicines in pregnancy, both in terms of appropriateness and safety. For this purpose, the Italian Medicines Agency established a Network for Monitoring Medication use in pregnancy (MoM-Net) through the conduction of population-based studies using administrative data available at regional level. This paper aimed to describe the experiences and challenges within the network. MoM-Net currently involves eight regions and several experts from public and academic institutions. The first study conducted aimed to identify drug use before, during and after pregnancy investigating specific therapeutic categories, analysing regional variability and monitoring drug use in specific subpopulations (i.e. foreign women/multiple pregnancies). Aggregated demographic, clinical, and prescription data were analysed using a distributed network approach based on common data model. The study population included all women delivering during 2016–2018 in the participating regions (n = 449,012), and corresponding to 59% of deliveries in Italy. Seventy-three per cent of the cohort had at least one drug prescription during pregnancy, compared to 57% before and 59% after pregnancy. In general, a good adherence to guidelines for pregnant women was found although some drug categories at risk of inappropriateness, such as progestins and antibiotics, were prescribed. A strong variability in the use of drugs among regions and in specific subpopulations was observed. The MoM-Net represents a valuable surveillance system on the use of medicines in pregnancy, available to monitor drug categories at high risk of inappropriateness and to investigate health needs in specific regions or subpopulations.
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Affiliation(s)
- Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Francesca R Poggi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Renata Bortolus
- Directorate General for Preventive Health - Office 9, Ministry of Health, Rome, Italy
| | - Serena Donati
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Antonio Clavenna
- Laboratory for Mother and Child Health, Department of Public Health - Istituto di Ricerche Farmacologiche Mario Negri IRCSS, Milan, Italy
| | - Anna Locatelli
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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Lee JY, Kwon JY, Na S, Choe SA, Seol HJ, Kim M, Kim MA, Park CW, Kim K, Ryu HM, Hwang HS, Shim JY. Clinical Practice Guidelines for Prenatal Aneuploidy Screening and Diagnostic Testing from Korean Society of Maternal-Fetal Medicine: (2) Invasive Diagnostic Testing for Fetal Chromosomal Abnormalities. J Korean Med Sci 2021; 36:e26. [PMID: 33496085 PMCID: PMC7834898 DOI: 10.3346/jkms.2021.36.e26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/06/2020] [Indexed: 11/20/2022] Open
Abstract
The Korean Society of Maternal Fetal Medicine proposed the first Korean guideline on prenatal aneuploidy screening and diagnostic testing, in April 2019. The clinical practice guideline (CPG) was developed for Korean women using an adaptation process based on good-quality practice guidelines, previously developed in other countries, on prenatal screening and invasive diagnostic testing for fetal chromosome abnormalities. We reviewed current guidelines and developed a Korean CPG on invasive diagnostic testing for fetal chromosome abnormalities according to the adaptation process. Recommendations for selected 11 key questions are: 1) Considering the increased risk of fetal loss in invasive prenatal diagnostic testing for fetal genetic disorders, it is not recommended for all pregnant women aged over 35 years. 2) Because early amniocentesis performed before 14 weeks of pregnancy increases the risk of fetal loss and malformation, chorionic villus sampling (CVS) is recommended for pregnant women who will undergo invasive prenatal diagnostic testing for fetal genetic disorders in the first trimester of pregnancy. However, CVS before 9 weeks of pregnancy also increases the risk of fetal loss and deformity. Thus, CVS is recommended after 9 weeks of pregnancy. 3) Amniocentesis is recommended to distinguish true fetal mosaicism from confined placental mosaicism. 4) Anti-immunoglobulin should be administered within 72 hours after the invasive diagnostic testing. 5) Since there is a high risk of vertical transmission, an invasive prenatal diagnostic testing is recommended according to the clinician's discretion with consideration of the condition of the pregnant woman. 6) The use of antibiotics is not recommended before or after an invasive diagnostic testing. 7) The chromosomal microarray test as an alternative to the conventional cytogenetic test is not recommended for all pregnant women who will undergo an invasive diagnostic testing. 8) Amniocentesis before 14 weeks of gestation is not recommended because it increases the risk of fetal loss and malformation. 9) CVS before 9 weeks of gestation is not recommended because it increases the risk of fetal loss and malformation. 10) Although the risk of fetal loss associated with invasive prenatal diagnostic testing (amniocentesis and CVS) may vary based on the proficiency of the operator, the risk of fetal loss due to invasive prenatal diagnostic testing is higher in twin pregnancies than in singleton pregnancies. 11) When a monochorionic twin is identified in early pregnancy and the growth and structure of both fetuses are consistent, an invasive prenatal diagnostic testing can be performed on one fetus alone. However, an invasive prenatal diagnostic testing is recommended for each fetus in cases of pregnancy conceived via in vitro fertilization, or in cases in which the growth of both fetuses differs, or in those in which at least one fetus has a structural abnormality. The guidelines were established and approved by the Korean Academy of Medical Sciences. This guideline is revised and presented every 5 years.
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Affiliation(s)
- Ji Yeon Lee
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Ji Young Kwon
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sunghun Na
- Department of Obstetrics and Gynecology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seung Ah Choe
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hyun Joo Seol
- Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Minhyoung Kim
- Department of Obstetrics and Gynecology, MizMedi Hospital, Seoul, Korea
| | - Min A Kim
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Wook Park
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | | | - Hyun Mee Ryu
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Han Sung Hwang
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
| | - Jae Yoon Shim
- Mirae & Heemang Obstetrics and Gynecology Clinic, Seoul, Korea.
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Margolis CA, Schneider P, Huttner K, Kirby N, Houser TP, Wildman L, Grove GL, Schneider H, Casal ML. Prenatal Treatment of X-Linked Hypohidrotic Ectodermal Dysplasia using Recombinant Ectodysplasin in a Canine Model. J Pharmacol Exp Ther 2019; 370:806-813. [PMID: 31000577 DOI: 10.1124/jpet.118.256040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/08/2019] [Indexed: 11/22/2022] Open
Abstract
X-linked hypohidrotic ectodermal dysplasia (XLHED) is caused by defects in the EDA gene that inactivate the function of ectodysplasin A1 (EDA1). This leads to abnormal development of eccrine glands, hair follicles, and teeth, and to frequent respiratory infections. Previous studies in the naturally occurring dog model demonstrated partial prevention of the XLHED phenotype by postnatal administration of recombinant EDA1. The results suggested that a single or two temporally spaced injections of EDI200 prenatally might improve the clinical outcome in the dog model. Fetuses received ultrasound-guided EDI200 intra-amniotically at gestational days 32 and 45, or 45 or 55 alone (of a 65-day pregnancy). Growth rates, lacrimation, hair growth, meibomian glands, sweating, dentition, and mucociliary clearance were compared in treated and untreated XLHED-affected dogs, and in heterozygous and wild-type control dogs. Improved phenotypic outcomes were noted in the earlier and more frequently treated animals. All animals treated prenatally showed positive responses compared with untreated dogs with XLHED, most notably in the transfer of moisture through paw pads, suggesting improved onset of sweating ability and restored meibomian gland development. These results exemplify the feasibility of ultrasound-guided intra-amniotic injections for the treatment of developmental disorders, with improved formation of specific EDA1-dependent structures in dogs with XLHED.
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Affiliation(s)
- Carol A Margolis
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
| | - Pascal Schneider
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
| | - Kenneth Huttner
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
| | - Neil Kirby
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
| | - Timothy P Houser
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
| | - Lee Wildman
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
| | - Gary L Grove
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
| | - Holm Schneider
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
| | - Margret L Casal
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania (C.A.M., M.L.C.); Department of Biochemistry, University of Lausanne, Lausanne, Switzerland (P.S.); Edimer Pharmaceuticals, Cambridge, Massachusetts (K.H., N.K.); cyberDERM, Inc., Broomall, Pennsylvania (T.P.H., L.W., G.L.G.); and Universitätsklinikum Erlangen, Kinder- und Jugendklinik, Erlangen, Germany (H.S.)
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Ghi T, Sotiriadis A, Calda P, Da Silva Costa F, Raine-Fenning N, Alfirevic Z, McGillivray G. ISUOG Practice Guidelines: invasive procedures for prenatal diagnosis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2016; 48:256-268. [PMID: 27485589 DOI: 10.1002/uog.15945] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 04/15/2016] [Indexed: 06/06/2023]
Affiliation(s)
- T Ghi
- Department of Obstetrics and Gynecology, University of Parma, Parma, Italy
| | - A Sotiriadis
- Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P Calda
- Department of Obstetrics and Gynecology, Charles University in Prague, First Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic
| | - F Da Silva Costa
- Monash Ultrasound for Women and Perinatal Services, Monash Medical Centre, Melbourne, Victoria, Australia
| | - N Raine-Fenning
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK - Nurture Fertility, The Fertility Partnership
| | - Z Alfirevic
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - G McGillivray
- Victorian Clinical Genetics Services, Mercy Hospital for Women, Murdoch Children's Research Institute, Melbourne, Australia
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Cruz-Lemini M, Parra-Saavedra M, Borobio V, Bennasar M, Goncé A, Martínez JM, Borrell A. How to perform an amniocentesis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 44:727-731. [PMID: 25449117 DOI: 10.1002/uog.14680] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/24/2014] [Accepted: 07/28/2014] [Indexed: 06/04/2023]
Affiliation(s)
- M Cruz-Lemini
- Prenatal Diagnosis Unit, Institut Clínic de Ginecología, Obstetricia i Neonatología (ICGON), Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
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Giorlandino C, Cignini P, Cini M, Brizzi C, Carcioppolo O, Milite V, Coco C, Gentili P, Mangiafico L, Mesoraca A, Bizzoco D, Gabrielli I, Mobili L. Antibiotic prophylaxis before second-trimester genetic amniocentesis (APGA): a single-centre open randomised controlled trial. Prenat Diagn 2009; 29:606-12. [PMID: 19294678 DOI: 10.1002/pd.2256] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare procedure-related pregnancy loss after second-trimester genetic amniocentesis in women given an antibiotic prophylaxis and controls. METHODS Prospective, open randomised controlled single-centre study between January 1999 and December 2005 at Artemisia Fetal Maternal Medical Centre. A follow-up within 4 weeks after the procedure was done.Of 36,347 eligible women, 1424 refused to participate and 34,923 were enrolled and randomised with unequal chance of selection, 21,991 were assigned to treatment group and 12,932 were assigned to the control group, and did not receive any placebo. Oral azithromycin, 500 mg per day, was administered 3 days before amniocentesis. The primary endpoint was the procedure-related pregnancy loss. The secondary endpoint was the rate of preterm premature rupture of membranes. RESULTS The rate of abortion related to the amniocentesis was 7/21 219 women (0.03%, 95% CI 0.009-0.057) in the intervention group, and 36/12 529 (0.28%, 0.28-0.30) in controls (p = 0.0019). The rate of preterm premature rupture of membranes was 14/21 219 (0.06%, 0.031-0.101) in the intervention group, and 140/12 529 (1.12%, 0.94-1.30) in the control group (p = 0.001). CONCLUSIONS Antibiotic prophylaxis before second-trimester amniocentesis reduced the risk of abortion and of rupture of the membranes.
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Affiliation(s)
- Claudio Giorlandino
- Department of Prenatal Diagnosis, Artemisia Fetal-Maternal Medical Centre, Rome, Italy.
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Abstract
Down syndrome (DS) may be associated with various organ system disorders. Feeding problems are frequent in children with DS and may be caused by associated defects, including congenital heart defects, gastrointestinal defects, or endocrine disorders. In the absence of these associated conditions, feeding problems are often attributed to general hypotonia. However, an aberrant right subclavian artery (ARSA), a rare vascular anomaly and an unusual cause of problems with the passage of solid food through the esophagus, has recently been suggested to occur more frequently in patients with DS. This knowledge is of importance when evaluating feeding difficulties in patients with DS. Additional investigation for identifying an ARSA may be indicated in selected patients. Diagnostic techniques, such as transthoracic echocardiography, barium contrast esophagram, angiography, or computed tomography-angiography (CT) can be used in a diagnostic flow chart. The presence of ARSA is not synonymous to the cause of feeding problems in patients with DS and corrective surgery of this vascular anomaly should be restricted to selected cases.
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