Miconazole for the treatment of vulvovaginal candidiasis. , and clinical results. Review of the literature.

At concentrations achieved following systemic administration, the primary effect of imidazoles and triazoles on fungi is inhibition of 14-α-sterol demethylase, a microsomal cytochrome P450 (CYP) enzyme. Imidazoles and triazoles impair the biosynthesis of ergosterol for the cytoplasmic membrane and lead to the accumulation of 14-α-methyl sterols. The synthetic imidazole miconazole is additionally able to increase intracellular reactive oxygen species, at least in part through inhibition of fungal catalase and peroxidase.

Impact of point-of-care ultrasound and routine third trimester ultrasound on undiagnosed breech presentation and perinatal outcomes: An observational multicentre cohort study.

Background: Accurate knowledge of fetal presentation at term is vital for optimal antenatal and intrapartum care. The primary objective was to compare the impact of routine third trimester ultrasound or point-of-care ultrasound (POCUS) with standard antenatal care, on the incidence of overall and proportion of all term breech presentations that were undiagnosed at term, and on the related adverse perinatal outcomes.

Methods And Findings: This was a retrospective multicentre cohort study where we included data from St.

Developing future clinical leaders in patient safety: the Irish experience.

Introduction: It is 20 years since the Institute of Medicine advocated a national approach to improve care and patient safety. Patient safety infrastructure has greatly improved in certain countries. In Ireland, patient safety infrastructure is in ongoing development.

Pre-Vaccination Human Papillomavirus Genotypes and HPV16 Variants among Women Aged 25 Years or Less with Cervical Cancer.

Background: In 2007, Australia introduced a national human papillomavirus (HPV) vaccination program. In 2017, the onset of cervical screening changed from 18 to 25 years of age, utilising human papillomavirus (HPV) nucleic acid testing. The objective of the study is to describe the HPV genotypes and HPV16 variants in biopsies from women ≤ 25 years of age with cervical carcinoma (CC) (cases), compared with those aged >25 years (controls), in a pre-vaccination cohort.

Placenta-Derived Extracellular Vesicles in Pregnancy Complications and Prospects on a Liquid Biopsy for Hemoglobin Bart's Disease.

Extracellular vesicles (EVs) are nano-scaled vesicles released from all cell types into extracellular fluids and specifically contain signature molecules of the original cells and tissues, including the placenta. Placenta-derived EVs can be detected in maternal circulation at as early as six weeks of gestation, and their release can be triggered by the oxygen level and glucose concentration. Placental-associated complications such as preeclampsia, fetal growth restriction, and gestational diabetes have alterations in placenta-derived EVs in maternal plasma, and this can be used as a liquid biopsy for the diagnosis, prediction, and monitoring of such pregnancy complications.

Severity of maternal SARS-CoV-2 infection and perinatal outcomes of women admitted to hospital during the omicron variant dominant period using UK Obstetric Surveillance System data: prospective, national cohort study.

Objectives: To describe the severity of maternal infection when the omicron SARS-CoV-2 variant (B.1.1.

Severity of maternal infection and perinatal outcomes during periods of SARS-CoV-2 wildtype, alpha, and delta variant dominance in the UK: prospective cohort study.

Objective: To compare the severity of maternal infection and perinatal outcomes during periods in which wildtype, alpha variant, and delta variant of SARS-CoV-2 were dominant in the UK.

Design: Prospective cohort study.

Setting: 194 obstetric units across the UK, during the following periods: between 1 March and 30 November 2020 (wildtype dominance), between 1 December 2020 and 15 May 2021 (alpha variant dominance), and between 16 May and 31 October 2021 (delta variant dominance).

Design and management considerations for control groups in hybrid effectiveness-implementation trials: Narrative review & case studies.

Hybrid effectiveness-implementation studies allow researchers to combine study of a clinical intervention's effectiveness with study of its implementation with the aim of accelerating the translation of evidence into practice. However, there currently exists limited guidance on how to design and manage such hybrid studies. This is particularly true for studies that include a comparison/control arm that, by design, receives less implementation support than the intervention arm.

Clinical guidelines for the management of weight during pregnancy: a qualitative evidence synthesis of practice recommendations across NHS Trusts in England.

Background: Women who enter pregnancy with a Body Mass Index above 30 kg/m face an increased risk of complications during pregnancy and birth. National and local practice recommendations in the UK exist to guide healthcare professionals in supporting women to manage their weight. Despite this, women report inconsistent and confusing advice and healthcare professionals report a lack of confidence and skill in providing evidence-based guidance.

Prevalence and associated factors of recurrent pregnancy loss in Nigeria according to different national and international criteria (ASRM/ESHRE vs. WHO/RCOG).

Background: In low-and middle-income countries, no conclusive research explains the prevalence and associated factors of women with a history of recurrent pregnancy loss (RPL). Some authorities have recommended further scientific research on the effect of various definitions of RPL.

Objective: To assess prevalence and associated factors of RPL among pregnant women in Nigeria according to different national and international criteria: the American Society for Reproductive Medicine/ European Society for Human Reproduction and Embryology (ASRM/ESHRE; two losses) and the World Health Organization/ Royal College of Obstetricians and Gynecologists (WHO/RCOG; three consecutive losses) criteria.

The physical-mental health interface in the preconception period: analysis of 131 182 women planning pregnancy in the UK.

Objective: The physical and mental health of women prior to conception can have a significant impact on pregnancy and child outcomes. Given the rising burden of non-communicable diseases, the aim was to explore the relation between mental health, physical health and health behaviour in women planning a pregnancy.

Methods: Cross-sectional analysis of responses from 131 182 women to a preconception health digital education tool, providing data on physical and mental health and health behaviour.

Comparison of risk assessments for venous thromboembolism during the puerperium.

Objective: To compare the predictive value of different risk assessment methods for puerperium venous thromboembolism (VTE).

Methods: This study included 55 women with and 165 women without puerperal VTE. Using the cases, 11 assessment methods were compared.

Comparison of Four Intrapartum Cardiotocography Classifications for Predicting Neonatal Acidemia at Birth.

Objective: To compare diagnostic values of four intrapartum cardiotocography (CTG) classifications in predicting neonatal acidemia at birth.

Methods: Retrospective case-control study. Forty-three CTG traces with an umbilical artery pH < 7.

Maternity care provider acceptance of a future Group B Streptococcus vaccine - A qualitative study in three countries.

Introduction: There are vaccines in clinical trials that target the bacterium Group B Streptococcus (GBS). When approved, GBS vaccines will be intended for administration to pregnant women to prevent infection in their infants. The success of any vaccine will depend on its' uptake in the population.

Fibrin monomer complex as a potential thrombosis marker related to venous thromboembolism risk in pregnant women.

Background: Pregnancy is a risk factor for venous thromboembolism (VTE) due to increased coagulation factor activity and decreased protein S activity. However, thrombosis markers for predicting VTE in pregnancy remain controversial. This study aimed to investigate the relationship between VTE risk and thrombosis markers in pregnant women and to identify markers related to VTE risk.

Relationship between Diet Quality and Maternal Stool Microbiota in the MUMS Australian Pregnancy Cohort.

Dietary intake during pregnancy may influence the antenatal microbiome, which is proposed to impact maternal and infant health during the pregnancy and beyond. The aim of this sub-study was to examine associations between dietary intake and microbiota diversity during pregnancy using whole metagenomic sequencing and examine associations in low-risk versus high-risk pregnancies, as well as complicated versus uncomplicated pregnancies. Pregnancy data were analysed from women participating in the MUMS cohort study in Sydney, Australia (women followed from trimester 1 of pregnancy to 1-year postpartum), who had dietary intake data at either trimester 1 or 3, assessed using the Australian Eating Survey, and a matched stool sample ( = 86).

overlooked: Analysis of COVID-19 clinical guidance for maternal and newborn care from 101 countries shows breastfeeding widely undermined.

Background: In March 2020, the World Health Organization (WHO) published clinical guidance for the care of newborns of mothers with COVID-19. Weighing the available evidence on SARS-CoV-2 infection against the well-established harms of maternal-infant separation, the WHO recommended maternal-infant proximity and breastfeeding even in the presence of maternal infection. Since then, the WHO's approach has been validated by further research.

[Practical recommendations on physical exercise during pregnancy based on the main clinical practice guidelines].

The main guidelines for physical activity/exercise during pregnancy recommend that all pregnant women without medical or obstetric contraindications remain physically active during pregnancy, in order to achieve health benefits and, at the same time, reduce the possibility of complications during pregnancy. The objective of this article was to extract the practical recommendations on physical exercise during pregnancy, of interest to the primary care physician, from the clinical practice guidelines of three international societies of Obstetrics and Gynecology of recognized prestige and great international influence on this subject, two of them pioneers in the elaboration of this type of recommendations: the American College of Obstetrics and Gynecology and the Society of Obstetricians and Gynaecologists of Canada; and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, together with the one published by the Spanish Society of Gynecology and Obstetrics.

Implementation of Uterine Artery Doppler Scanning: Improving the Care of Women and Babies High Risk for Fetal Growth Restriction.

Introduction: While stillbirth rates have declined in many countries, these declines are less marked in the UK. Fetal growth restriction (FGR) affects about 3% to 7% of all pregnancies and is by far the single strongest risk factor for stillbirth. FGR implies a pathological restriction of the genetic growth potential and is not synonymous with small-for-gestational age (SGA).