Patients may not benefit from first-trimester preeclampsia screening, according to an American College of Obstetricians and Gynecologists opinion paper in Obstetrics & Gynecology. Although tests including uterine artery Doppler velocimetry along with risk factors have been used to signal hypertensive prenatal disorders, there has been no evidence the early surveillance and more intensive care improves outcomes.
Given the current debate and growing public concerns on selective serotonin reuptake inhibitors (SSRIs) and birth defects generated by FDA warnings, the authors aim to quantify the association between first-trimester exposure to sertraline, a first-line treatment, and the risk of congenital malformations in a cohort of depressed women.
Bedside emergency department ultrasounds on first-trimester patients should be followed by expert sonographic imaging and interpretation in the radiology department, according to a study presented at an American College of Radiology meeting. The study found a 24% discrepancy between ED ultrasound and radiology ultrasounds conducted by ARDMS-certified sonographers with radiologist interpretation. Researcher Dr. Myrna Wallace-Severa noted that although point-of-care imaging is becoming more common, first-trimester imaging and interpretation pose special challenges that require additional expertise.
Glycosylated fibronectin rates higher than a threshold of 120 mg/L showed a 63% positive predictive value and accurately identified 57 of 90 pregnant women who developed gestational diabetes during their first trimester, according to a study in Obstetrics & Gynecology. Researchers said first-trimester glycosylated fibronectin may potentially serve as a biomarker to help identify women at risk of gestational diabetes.
Babies born to women who took the decongestant phenylephrine during their first trimester of pregnancy were eight times more likely to have endocardial cushion defect than unexposed peers, while first-trimester use of phenylpropanolamine was associated with an eightfold increased risk of ear and stomach defects. Researchers also found first-trimester use of pseudoephedrine was tied to a threefold higher risk of so-called limb reduction defects. The findings were published in the American Journal of Epidemiology.