Antidepressants in pregnancy: Challenges in decision‐making despite low risks

2021 ◽  
Vol 24 (1) ◽  
pp. 1-3
Author(s):  
Alison Knopf
Keyword(s):  
Decision Making ◽  
In Pregnancy

Approach to dyspnoea in pregnancy in the COVID-19 era

2020 ◽  
Vol 19 (4) ◽  
pp. 230-234
Author(s):  
Anita Banerjee ◽  
◽  
Lindsay A Arrandale ◽  
Srividhya Sankaran ◽  
Guy W Glover ◽  
...  
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Correct Diagnosis ◽  
Case Series ◽  
Differential Diagnoses ◽  
Shared Decision ◽  
First Case ◽  
Compromise Design ◽  
A Current ◽  
In Pregnancy

Importance: Dyspnoea and hypoxia in pregnant women during the COVID-19 pandemic may be due to causes other than SARS Co-V-2 infection which should not be ignored. Shared decision-making regarding early delivery is paramount. Objective: To highlight and discuss the differential diagnoses of dyspnoea and hypoxia in pregnant women and to discuss the risks versus benefit of delivery for maternal compromise. Design, setting and participants: Case series of two pregnant women who presented with dyspnoea and hypoxia during the COVID-19 pandemic. Results: Two pregnant women presented with dyspnoea and hypoxia. The first case had COVID-19 infection in the 3rd trimester. The second case had an exacerbation of asthma without concurrent COVID-19. Only the first case required intubation and delivery. Both recovered and were discharged home. Conclusion and relevance: Our two cases highlight the importance of making the correct diagnosis and timely decision-making to consider if delivery for maternal compromise is warranted. Whilst COVID-19 is a current healthcare concern other differential diagnoses must still be considered when pregnant women present with dyspnoea and hypoxia.

Factors that influence women's decision-making to use complementary medicine products in pregnancy and lactation

2019 ◽  
Vol 6 ◽  
pp. S98
Author(s):  
Larisa Barnes ◽  
Lesley Barclay ◽  
Kirsten McCaffery ◽  
Parisa Aslani
Keyword(s):  
Decision Making ◽  
Complementary Medicine ◽  
Pregnancy And Lactation ◽  
In Pregnancy

What Is the Impact of the Internet on Decision Making in Pregnancy? A Global Study

2012 ◽  
Vol 32 (4) ◽  
pp. 211-212
Author(s):  
B.M. Lagan ◽  
M. Sinclair ◽  
W.G. Kernohan
Keyword(s):  
Decision Making ◽  
The Internet ◽  
Global Study ◽  
The Impact ◽  
In Pregnancy

‘Doctor, what would you do in my position?’ Health professionals and the decision-making process in pregnancy monitoring

2013 ◽  
Vol 40 (5) ◽  
pp. 310-314 ◽  
Author(s):  
Solène Gouilhers Hertig ◽  
Samuele Cavalli ◽  
Claudine Burton-Jeangros ◽  
Bernice S Elger
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Decision Making Process ◽  
In Pregnancy

scholarly journals P563 Shared decision-making in pregnancy in inflammatory bowel disease: Design of a pregnancy in IBD decision aid (PIDA)

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S474-S475
Author(s):  
A J Williams ◽  
Y Leung ◽  
K O’Connor ◽  
V Huang
Keyword(s):  
Decision Making ◽  
Focus Groups ◽  
Disease Activity ◽  
Decision Aid ◽  
Negative Impact ◽  
Decision Aids ◽  
Mode Of Delivery ◽  
Surgical History ◽  
The Impact ◽  
In Pregnancy

Abstract Background A lack of IBD-specific reproductive knowledge has been associated with increased ‘voluntary childlessness’.Furthermore, a lack of patient and clinician knowledge may contribute to inappropriate medication changes during or after pregnancy that may lead to a flare of disease. Evidence exists for the benefit of decision aids to support decision-making in pregnancy in general, as well as in multiple other chronic disease; however, such a resource for pregnancy in IBD has not been identified. Methods Using International Patient Decision Aids Standards, we have commenced design of our Pregnancy in IBD Decision Aid (PIDA). A steering committee consisting of Canadian and Australian Healthcare professionals with an interest in IBD management in pregnancy, in addition to a patient representative was established. Initial patient and clinician focus groups were conducted. Themes prospectively chosen for discussion included inheritance, fertility, nutrition, medications, mode of delivery, breastfeeding, infant infections and vaccinations. We designed an electronic PIDA draft that incorporates individualised information (for example, type of IBD, pre-conception or pregnant, surgical history and current medications) in personalised decision-making. Further patient focus groups and interviews were conducted to obtain user opinion of the PIDA draft. Results In July 2017, patient and clinician focus groups were conducted at a Canadian site. Patient concerns regarding pregnancy included the impact of disease, previous surgical history on fertility, preterm delivery; the potential impact of current and past drug therapies on the fetus/ infant; and the negative impact of active disease on both maternal and fetal/infant health. Clinician concerns included the absence of pre-conception counselling and potential for lack of patient understanding about the impact of disease activity and IBD medication use in pregnancy. Patient feedback (n = 15) obtained through interviews at two Canadian and one Australian site regarding the current electronic PIDA draft was predominantly positive, with comments pertaining to the adequacy of content coverage, personalisation, readability and unbiased information presentation. Suggestions were made for inclusion of further content such as the impact of IBD on sexual function, expected laboratory changes and the timing of recommencement of medications post-partum. Conclusion The completion of pre and post-PIDA design focus groups and interviews affirmed the role for PIDA. Main decisions that were considered necessary to address included ideal timing of conception pending disease activity, management of medications and delivery methods. Ongoing user feedback is being obtained at Australian and Canadian sites currently.

scholarly journals Granulomatosis with polyangiitis and pregnancy: A case report and review of the literature

2019 ◽  
Vol 13 (2) ◽  
pp. 76-82
Author(s):  
A Daher ◽  
G Sauvetre ◽  
N Girszyn ◽  
E Verspyck ◽  
H Levesque ◽  
...  
Keyword(s):  
Decision Making ◽  
Granulomatosis With Polyangiitis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Intravenous Immunoglobulins ◽  
Review Of The Literature ◽  
Healthy Male ◽  
Sudden Loss ◽  
Loss Of Hearing ◽  
In Pregnancy

The association of granulomatosis with polyangiitis and pregnancy is rare and therapeutic options are limited by the risk of teratogenicity and fetotoxicity. There is a paucity of published literature to guide clinical decision-making in these cases. We report the case of a 26-year-old woman with no medical history who presented at 21 weeks of gestation with a bilateral sudden loss of hearing and erosive rhinitis. The diagnosis of granulomatosis with polyangiitis was confirmed radiologically and biologically. Corticosteroids were not enough to stabilize the disease and she received intravenous immunoglobulins with remission. A successful delivery of a healthy male newborn was done at 36 weeks. A review of all published literature on granulomatosis with polyangiitis in pregnancy between 1970 and 2017 is presented. Trial registration: Not applicable.

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