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.
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.
Routine antenatal anti-D prophylaxis in pregnant women who are Rhesus D-negative during week 28 to 30 of pregnancy could help prevent hemolytic disease in their babies, according to a study published in Acta Obstetricia et Gynecologica Scandinavica. The retrospective review involved a cohort of all RhD-immunized pregnant women in Stockholm between 1990 and 2008. Researchers also said that first-trimester fetal RHD gene screening allows for selective administration of RAADP to RhD-negative women with an RHD-positive fetus.