Cocaine use during pregnancy: implications for physicians

The growing use of cocaine among pregnant women and its effect on the fetus have become issues of great concern to physicians and society in general. In this paper, we review the available data about the incidence of cocaine use during pregnancy in the United States and in Wisconsin. The pharmacology of the drug is examined as well as its effect on pregnancy outcomes. Medical, neurobehavioral, and developmental effects on the fetus, newborn, and infant are discussed, as well as the relationship to the timing of drug use during pregnancy. Suggestions relevant to physicians for prevention and treatment are given.     

Reducing complications from alcohol use during pregnancy through screening

Prenatal providers are reluctant to discuss alcohol use in the clinical setting, even though heavy alcohol use is associated with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE), sometimes known as alcohol-related neurodevelopmental disorder. Fourteen percent to 20% of pregnant women report drinking some alcohol during pregnancy. Approximately 0.2% to 1% meet the criteria for heavy drinking. Reducing drinking during pregnancy has the potential to reduce the risk for FAS and FAE. Routine screening for alcohol use during pregnancy followed by referrals for those considered to be at risk is recommended. Women are often more receptive to intervention during pregnancy, as they focus on positive health behaviors. A number of brief screening tools designed for use on a routine basis are reviewed. Physicians who learn to comfortably discuss alcohol use during pregnancy can help substantially reduce the impact of these disorders.     

The use of progesterone during pregnancy to prevent preterm birth

One of the most significant problems facing maternal and children health worldwide is preterm birth (PTB). Although strategies to increase the survival of premature infants have significantly improved in the past few decades, they have yet to be successful. Nine years ago, the use of progesterone in pregnancy was approved by the United States Food and Drug Administration (FDA) for PTB prevention. This paper reviews the recent evidence supporting the use of progesterone in pregnancy for PTB prevention and provides guidelines for its use in daily clinical practice. The guidelines address multiple current controversial areas regarding the prevention of PTB to aid physicians with their clinical decision-making practice, including the use in multifetal gestation, different formulations, safety in pregnancy, dose and route of administration.     

Diazepam use during pregnancy: a review of the literature

Antianxiety medications such as benzodiazepines (BZDs) are frequently and appropriately used to ameliorate the anxiety symptoms of depression, dysthymic disorder, panic disorder, agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder, eating disorder, and many personality disorders. Pregnancy may be accompanied by anxiety necessitating therapeutic intervention by anxiolytic drugs like BZD. Keeping in view the potential risks of teratogenicity and direct neonatal toxicity, BZDs with established safety records should be used, while avoiding exposure in the first trimester, especially with multidrug regimens, and prescribing the lowest dose for the shortest duration. This literature review highlights information from various sources regarding safety data of exposure of pregnant and lactating mothers to long-acting BZDs, especially diazepam.     

输尿管镜术在妊娠期顽固性肾绞痛中的应用

目的：探讨输尿管镜术在妊娠期顽固性肾绞痛中的诊断治疗作用。方法：对8例妊娠期顽固性肾绞痛患者运用输尿管镜术,对因结石引起者行取石或气压弹道碎石。结果：所有病例术后的。肾绞痛都得到有效缓解,发现输尿管结石7例,经治疗后痊愈出院,所有孕妇均较顺利度过围产期并产健康婴儿。结论：对妊娠期顽固性肾绞痛患者采用输尿管镜术安全、有效。     

National guidelines on alcohol use during pregnancy: a dissenting opinion

New national guidelines recommend that women who choose to drink alcohol during pregnancy "should have less than seven standard drinks" in any week and "no more than two standard drinks" on any one day, and that they should never become intoxicated. Exposure to alcohol at these recommended levels has been shown to affect brain development and certain behaviours in animals. Some longitudinal studies in human children have detected detrimental affects from exposure to low levels of alcohol. Normal public health standards for exposure to environmental toxins should be applied for the unborn baby. We do not know what level of alcohol exposure is safe and pregnant women can only be advised to abstain.     

妊娠期低分子肝素使用的研究进展

妊娠增加女性血栓栓塞的风险.低分子肝素作为一种抗凝药,随着其安全性和有效性被不断地证实,被越来越多地应用于临床妊娠期女性.本文以依诺肝素作为低分子肝素的代表,就低分子肝素与肝素的区别、低分子肝素在妊娠期的用法用量、适用人群、监测指标及紧急逆转进行讨论,为临床妊娠期女性正确使用低分子肝素提供参考依据.