Abstract：
OBJECTIVE:Postpartum infections are polymicrobial and typically include Ureaplasma, an intracellular microbe that is treated by macrolides such as azithromycin. The aim of this study was to evaluate the perinatal pharmacokinetics of azithromycin after a single preincision dose before cesarean delivery. STUDY DESIGN:Thirty women who underwent scheduled cesarean delivery were assigned randomly to receive 500 mg of intravenous azithromycin that was initiated 15, 30, or 60 minutes before incision and infused over 1 hour. Serial maternal plasma samples were drawn from the end of infusion up to 8 hours after the infusion. Samples of amniotic fluid, umbilical cord blood, placenta, myometrium, and adipose tissue were collected intraoperatively. Breast milk samples were collected 12-48 hours after the infusion in 8 women who were breastfeeding. Azithromycin was quantified with high performance liquid chromatography separation coupled with tandem mass spectrometry detection. Plasma pharmacokinetic parameters were estimated with the use of noncompartmental analysis and compartmental modeling and simulations. RESULTS:The maximum maternal plasma concentration was reached within 1 hour and exceeded the in vitro minimum inhibitory concentration (MIC50) of 250 ng/mL of Ureaplasma spp in all 30 patients. The concentrations were sustained with a half-life of 6.7 hours. The median concentration of azithromycin in adipose tissue was 102 ng/g, which was below the MIC50. The median concentration in myometrium was 402 ng/g, which exceeded the MIC50. Azithromycin was detectable in both the umbilical cord plasma and amniotic fluid after the single preoperative dose. Azithromycin concentrations in breast milk were high and were sustained up to 48 hours after the single dose. Simulations demonstrated accumulation in breast milk after multiple doses. CONCLUSION:A single dose of azithromycin achieves effective plasma and tissue concentrations and is transported rapidly across the placenta. The tissue concentrations that are achieved in the myometrium exceed the MIC50 for Ureaplasma spp.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Sutton AL,Acosta EP,Larson KB,Kerstner-Wood CD,Tita AT,Biggio JRdoi
10.1016/j.ajog.2015.01.015subject
Has Abstractpub_date
2015-06-01 00:00:00pages
812.e1-6issue
6eissn
0002-9378issn
1097-6868pii
S0002-9378(15)00016-2journal_volume
212pub_type
杂志文章,随机对照试验abstract：OBJECTIVE:The objective was to evaluate whether the rate of neonatal group B streptococcal infection could be reduced by screening for group B streptococci during the third trimester of pregnancy. STUDY DESIGN:Two periods in which different screening and treatment protocols were applied were compared. In period A all ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(98)70063-8
更新日期：1998-09-01 00:00:00
abstract：OBJECTIVE:The objective of the study was the evaluation of a novel multiplex assay to detect fetal Rh blood group D-antigen gene (RHD) loci in maternal plasma from RhD-negative, pregnant women. STUDY DESIGN:An RHD genotyping assay was designed to detect exons 4, 5, 7, and 10 and RHDΨ (pseudogene) of the RHD gene along...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2010.09.028
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVES:This study details the incidence, by gestational age and birth weight, of specific neonatal morbidities in singleton neonates without major congenital anomalies. STUDY DESIGN:Data were prospectively collected on all deliveries at five tertiary centers in the United States during the years 1983 through 1986....
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(92)91551-k
更新日期：1992-06-01 00:00:00
abstract：:Domiciliary fetal monitoring via a telephone link has been in clinical use at the Royal Free Hospital for 2 years, during which time 858 traces of 134 patients who were moderately at risk have been transmitted to the hospital. All recognized abnormal heart rate patterns were detected during the study period. In seven ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)90411-y
更新日期：1990-02-01 00:00:00
abstract：:Management of idiopathic thrombocytopenic purpura (ITP) during pregnancy requires concern for both fetal and maternal morbidity and death. A review of 14 pregnancies revealed significant maternal morbidity but no maternal deaths. The perinatal mortally was21 per cent. Current recommendations for management include:...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(16)33490-1
更新日期：1975-05-01 00:00:00
abstract：BACKGROUND:The health and economic benefits of paid parental leave have been well-documented. In 2016, the American College of Obstetricians and Gynecologists released a policy statement about recommended parental leave for trainees; however, data on adoption of said guidelines are nonexistent, and published data on pa...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2018.04.017
更新日期：2018-08-01 00:00:00
abstract：OBJECTIVE:We sought to determine if uterine tachysystole, ≥ 6 contractions per 10 minutes, within the first 4 hours of labor induction, is associated with adverse infant outcomes. STUDY DESIGN:This was a prospective cohort study of 584 women ≥ 37 weeks' gestation undergoing induction of labor with 100 μg of oral misop...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2012.07.032
更新日期：2012-10-01 00:00:00
abstract：:Surgical experience with carcinomas of the uterus and rectum has provided new insights into the surgical anatomy of a lamina, which separates the paravesical space from the pararectal space. It has been proved that each of the lamina consists of the cardinal and lateral ligaments and pelvic splanchnic nerves, descendi...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(91)90614-w
更新日期：1991-01-01 00:00:00
abstract：:One hundred sixty-eight cases of puerperal laparoscopic sterilization are presented. The operative technique, complications, and morbidity are discussed. Intraoperative and postoperative complications occurred in six patients (3.6%). Operative time (21 minutes) and postoperative stay (2.4 days) compared favorably with...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(16)32831-9
更新日期：1980-08-15 00:00:00
abstract：OBJECTIVE:Recent developments permit the use of pulse oximetry to evaluate fetal oxygenation in labor. We tested the hypothesis that the addition of fetal pulse oximetry in the evaluation of abnormal fetal heart rate patterns in labor improves the accuracy of fetal assessment and allows safe reduction of cesarean deliv...
journal_title：American journal of obstetrics and gynecology
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1067/mob.2000.110632
更新日期：2000-11-01 00:00:00
abstract：OBJECTIVE:The objective of the study was to report experience with prenatal molecular diagnosis of tuberous sclerosis complex (TSC). STUDY DESIGN:Sequential deoxyribonucleic acid (DNA) studies were performed on amniotic fluid cells and chorionic villi from 50 pregnant women at risk for having a child with TSC. Mutatio...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2008.11.004
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:Venous thromboembolism events, including deep venous thrombosis and pulmonary embolism are the most common cause of preventable deaths in hospitalized patients in the United States. Although the risk of venous thromboembolism events in benign gynecologic surgery is generally low, the potential for venous thr...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2020.05.020
更新日期：2020-08-01 00:00:00
abstract：OBJECTIVE:Our purpose was to determine from published experience in humans whether metronidazole exposure during the first trimester of pregnancy is associated with an increased teratogenic risk. STUDY DESIGN:All published articles reporting on metronidazole use during pregnancy were screened by two independent review...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,meta分析
doi：10.1016/0002-9378(95)90567-7
更新日期：1995-02-01 00:00:00
abstract：OBJECTIVE:We sought to determine whether the transfer of enzyme-encoding genes in utero can be detected after birth. STUDY DESIGN:An adenoviral vector carrying the gene for beta-galactosidase was injected under ultrasonographic guidance into the livers of 4 rabbit fetuses per litter (3 litters total) at 27 days' gesta...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(99)70312-1
更新日期：1999-10-01 00:00:00
abstract：:Two patients who survived cardiorespiratory arrest occurring in association with amniotic fluid embolism syndrome were seen during the subsequent pregnancy. Both had uneventful pregnancies and delivered at term without complications. These are the only case reports of pregnancy after amniotic fluid embolism, and they ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(11)91442-2
更新日期：1992-08-01 00:00:00
abstract：OBJECTIVE:To analyze the effects of preconception maternal height and weight on the risk of preterm singleton and twin births resulting from in vitro fertilization (IVF). STUDY DESIGN:We performed a retrospective cohort analysis of the incidence of very early preterm birth (VEPTB), early preterm birth (EPTB), and pret...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2013.05.052
更新日期：2013-10-01 00:00:00
abstract：:Clear cell carcinoma originating in the abdominal wall is rare and usually develops within endometriotic implants in the scar. We describe 2 patients: a 42 year old with a 15 cm mass on the abdominal wall treated with neoadjuvant chemotherapy and excision and a 51 year old with a 6 cm abdominal mass treated with excis...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2012.05.029
更新日期：2012-08-01 00:00:00
abstract：:Fifty-seven prenatal patients with no known exposure to the element mercury, or any of its compounds, were observed for change in whole blood total mercury concentration from the initial prenatal clinic examination through delivery and postpartum hospitalization. On hospital admission for labor and delivery, whole blo...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(82)90087-4
更新日期：1982-06-15 00:00:00
abstract：:A rapid and accurate technique for assessment of spermatozoa motility has been developed. With the use of tricolor photography with sequential exposures in green, red, and blue light, spermatozoa were photographed in Makler chambers with a depth of 10 mu. Exposure in green light had a 1-second duration and was immedia...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(83)90497-0
更新日期：1983-01-15 00:00:00
abstract：BACKGROUND:Adverse maternal outcomes associated with chronic hypertension include accelerated hypertension and resultant target organ damage. One example is long-standing hypertension leading to maternal cardiac dysfunction. Our group has previously identified that features of such injury manifest as cardiac remodeling...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2018.02.015
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:Despite considerable public health burden, uterine fibroid population-based incidence estimates are few. Secular trends over time are even more limited. OBJECTIVE:We sought to evaluate the incidence, 10-year secular trends, and prevalence of uterine fibroid diagnoses and describe the proportion of symptomat...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2018.09.039
更新日期：2018-12-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to assess patient demographics, clinical presentation, response to previous treatment, and current evaluation of prepubertal girls referred for gynecologic care of labial agglutination. STUDY DESIGN:A retrospective chart review of all prepubertal female patients with labial aggl...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2002.126201
更新日期：2002-08-01 00:00:00
abstract：:There are two major approaches to the prophylaxis for adhesions: chemical methods (e.g., dextran) and barrier methods. Theoretically, dextran prevents the formation of adhesions by a surface-coating or hydroflotation effect, whereas the barrier methods either prevent the formation of or mask adhesions by covering and ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(82)90018-7
更新日期：1982-08-01 00:00:00
abstract：OBJECTIVE:This study was undertaken to assess the utility of the Advanced Life Support in Obstetrics Course for obstetrics/gynecology first-year residents by triangulating pretest and posttest scores on written test of knowledge by interns, with qualitative surveys by residents, and faculty. STUDY DESIGN:Obstetrics/gy...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2006.10.912
更新日期：2007-05-01 00:00:00
abstract：:Statistical procedures for hypothesis testing and interval estimation of the difference in a pair of Pearl rates are presented. The p value of the test statistic is evaluated exactly from the binomial distribution or approximately from the standard normal distribution. Interval estimation is provided by the test-based...
journal_title：American journal of obstetrics and gynecology
pub_type： 临床试验,杂志文章
doi：10.1016/0002-9378(85)90158-9
更新日期：1985-03-01 00:00:00
abstract：BACKGROUND:Subcuticular skin closure with suture after cesarean has been shown to result in lower rates of wound complications than with staple closure. However, the optimal choice of suture material for subcuticular skin closure is unclear. Vicryl (a braided multifilament synthetic suture; Ethicon, Somerville, NJ) and...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ajog.2016.05.012
更新日期：2016-10-01 00:00:00
abstract：:The changes in plasma lipids induced by the use of oral contraceptive pills have been shown in several studies to remain within normal physiologic limits. These changes are then probably without any clinical relevance because there is no evidence in the huge volume of oral contraceptive and cardiovascular literature t...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/0002-9378(90)90588-x
更新日期：1990-07-01 00:00:00
abstract：:Urinary tract infections are the most common outpatient infections, but predicting the probability of urinary tract infections through symptoms and test results can be complex. The most diagnostic symptoms of urinary tract infections include change in frequency, dysuria, urgency, and presence or absence of vaginal dis...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/j.ajog.2017.12.231
更新日期：2018-07-01 00:00:00
abstract：OBJECTIVE:The objective of the study was to identify the external funding status of the most frequently cited obstetrical publications (citation classics) and to assess trends in funded vs nonfunded manuscripts as well as each publication's type of external funding. STUDY DESIGN:For the first objective, the citation c...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2013.05.021
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVE:We studied the role of multidrug resistance proteins in regulating transplacental transmission of corticosteroids and protease inhibitors. STUDY DESIGN:We performed quantitative polymerase chain reaction and FACS analyses to study MDR1 (encodes P-glycoprotein) and MRP-1 expression in extravillous (HTR-8/SVne...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2007.02.019
更新日期：2007-05-01 00:00:00
