Cross-sectional study of drug use in pregnancy Culig, Josip; Leppée, Marcel; Stimac, Danijela ...
Liječnički vjesnik,
2007 Aug-Sep, 20070801, Letnik:
129, Številka:
8-9
Journal Article
Recenzirano
The aim of the paper is to investigate the impact of drugs utilization during pregnancy in the City of Zagreb. This one-month cross-sectional study was conducted in all four Zagreb maternity ...hospitals using a questionnaire administered to 893 pregnant women. The women used a mean of 2.6 drugs. The vitamin-mineral complex was the leading medicament used by the women during the study period (62.9%) and during pregnancy period. The leading drugs taken between hospital admission and delivery were metoclopramide (10.1%) and diazepam (6.0%). Utilization of diazepam is high during the entire pregnancy. According to FDA risk classification during pregnancy, most drugs are in B class (88%), and in A class (77%). Percent of FDA C class is 16%. In the FDA classes with fetal risk, D class has 47.5%, and X class, with only one woman using drug from this class has a 0.1% of total utilization. In spite of some limitations of the study, the results pointed to the uneconomical, potentially harmful drug use during pregnancy and puerperium, obviously calling for therapy quality upgrading in this vulnerable period of life.
We studied the outcome of fetuses in whom cystic hygroma was diagnosed in the first and early second-trimester of pregnancy using transvaginal ultrasonography. The purpose of this study was to ...evaluate the association between fetal cystic hygroma and fetal cytogenetic abnormalities, and the long-term prognosis. Thirty-five consecutive fetuses between 9.1 and 13.4 weeks of gestation diagnosed as having a nuchal hygroma were evaluated ultrasonographically and karyotyped. Those with a normal chromosome complement were ultrasonographically monitored throughout the remainder of the pregnancy to document the resolution of the hygroma. Eighteen of thirty-five fetuses were found to have a normal karyotype and five of these were aborted electively. The hygromas resolved in ten of these karyotypically normal fetuses within four weeks of initial diagnosis and they were phenotypically normal at birth. Seventeen fetuses were karyotypically abnormal with trisomy twenty-one being the most common abnormality. Prenatal cytogenetic analysis should be offered to women with fetal cystic hygroma diagnosed in the first trimester. A normal outcome is likely in those without chromosome abnormalities.
Primary Fallopian tube carcinoma is rarely diagnosed preoperatively. We present the case of a 69-year-old woman with primary tubal carcinoma, which was diagnosed preoperatively on the basis of the ...cytological finding, characteristic features on transvaginal sonography, transvaginal color flow imaging and elevated CA-125. Transvaginal color Doppler imaging demonstrated the tumor revealed areas of neovascularization with characteristic low impedance (resistance index, 0.34 and pulsatility index, 0.62). Pathohistologic confirmation of the clearcell carcinoma has been done.
In 80 pregnancies with clinical and ultrasonic signs of cervical incompetency, the length of the cervix and the thickness of the anterior wall of a lower uterine segment have been evaluated ...ultrasonically. We have also measured the width of the endocervical canal and studied the prolapse of fetal membranes (with fetal parts) into the endocervical canal. We evaluated these same parameters in 80 healthy pregnancies. The length of the cervix, the thickness of the anterior wall of a lower uterine segment, and the width of the endocervical canal were followed longitudinally in the patients from the 10th to the 36th gestation week. No statistically significant differences between age groups were found. In four age groups at risk for cervical incompetency, cervical lengths and wall thickness were significantly different (p less than 0.001) from those in comparable controls. Forty-five percent of the patients in the at-risk group, with cervical cerclage, delivered at 37.3 (range: 32 to 41) weeks and 6.25% of pregnancies ended in abortion when the amniotic membrane herniated into the cervical canal, with or without some part of the fetus.
Transabdominal placental biopsy under ultrasound guidance was carried out in 260 cases in the second trimester and 50 cases in the third trimester of pregnancy. Placental tissue was aspirated using ...an 18 or 20 gauge needle. In a total of 310 placental biopsies in the second and third trimester, 100 were performed because of suspicious ultrasonographic findings. Placental biopsy is simple in the presence of severe oligohydramnios where fetal blood sampling is usually more difficult. Oligohydramnios and polyhydramnios were the ultrasonographic findings in 50% of cases and were found to be associated with 30% of abnormal chromosomal findings. There was one (0.3%) abortion within two weeks following placental biopsy. Placental biopsy did not affect the outcome of the pregnancy.
Prikazana je 41 godišnja trudnica kojoj je u 25. tjednu trudnoće otkrivena idiopatska autoimuna trombocitope-nija. Radi se o drugoj trudnoći u drugom braku. Trudnica nije imala znakove hemoragijske ...dijateze. Broj trombocita kod prijema bio je 4×109/L. Liječenje kortikosteroidima nije dalo rezultate, te je započeto liječenje imunoglobulinima na što broj trombocita kratkotrajno poraste na normalne vrijednosti. Nakon ponovljenog liječenja imunoglobulinima, u 34. tjednu, dovršena je trudnoća carskim rezom. Rođeno je živo, nedonošeno žensko dijete 1980 g/43 cm, bez kliničkih i laboratorij-skih znakova trombocitopenije. Babinjača je preseljena na Hematološki odjel. S obzirom na neodgovaranje na uobičajeno liječenje bolesnici je predložena splenektomija na koju ona ne pristaje. Dijete je otpušteno kući kao zdravo bez ikakovih znakova bolesti.
Sažetak. Cilj rada. Retrospektivna studija nakon primjene kombiniranog ultrazvučno-biokemijskog testa probira trisomija u prvom tromjesečju trudnoće. Metode. Od veljače 2006. do srpnja 2008. godine ...probir je učinjen u 1112 trudnica između 10. i 14. tjedna trudnoće. Individualni rizik trisomije 21, 18 i 13 izračunavali smo kombinacijom dobnog rizika trudnice, ultrazvučnih biljega u ploda (debljina nuhalnog nabora – NT, udaljenosti tjeme-trtica – CRL) te biokemijskih biljega u serumu trudnice (slobodni -hCG i PAPP-A), pomoću licenciranog računalnog programa (Typolog). Koncentracije biokemijskih biljega smo određivali imunometrijskom kemiluminiscentnom metodom (IMMULITE). Biokemijske biljege, kao i NT u odnosu na CRL, izrazili smo u obliku višekratnika MoM, u odnosu na dnevne regresijske medijane za odgovarajuću gestaciju u neugroženim trudnoćama. Rezultate smo obradili nakon dovršenih svih ispitanih trudnoća. Ukupno su 62 testirane trudnice imale povećani kombinirani rizik trisomije 21, od kojih je 10 trudnica imalo i povećani rizik trisomije 18/13. Četiri trisomije 21 i jedna trisomija 18 otkrivene su prenatalnom dijagnozom; stopa detekcije bila je 100% (5/5). U trudnica s povećanim rizikom u probiru učinjeno je 7 biopsija koriona i 38 ranih amniocenteza. Udio lažno-pozitivnih rezultata bio je 5.1%. Zaključak. Prvi rezultati provođenja kombiniranog probirnog testa u Hrvatskoj potvrdili su visoku osjetljivost i veću specifičnost, u poredbi s biokemijskim probirnim testom u drugom tromjesečju trudnoće.
