scholarly journals Umbilical Cord, Maternal Milk and Breastfed Infant Levetiracetam Concentrations Monitoring at Delivery and during Early Postpartum Period

Pharmaceutics ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 398
Author(s):  
Ivana Kacirova ◽  
Milan Grundmann ◽  
Hana Brozmanova
Keyword(s):  
Serum Concentration ◽  
Umbilical Cord ◽  
Concentration Ratio ◽  
Combined Treatment ◽  
Maternal Serum ◽  
Breastfed Infant ◽  
Serum Concentrations ◽  
Mature Milk ◽  
Cord Serum ◽  
The Mean

(1) To obtain objective information about levetiracetam transplacental passage and its transport into colostrum, mature milk, and breastfed infants, we analyzed data from women treated for epilepsy between October 2006 and January 2021; (2) in this cohort study, maternal, umbilical cord, milk, and infant serum concentrations were measured at delivery, 2–4 days postpartum (colostrum) and 7–31 days postpartum (mature milk). Paired umbilical cord serum, maternal serum, breastfed infant serum, and milk concentrations were used to assess the ratios of umbilical cord/maternal serum, milk/maternal serum, and infant/maternal serum concentrations. The influence of combined treatment with enzyme-inducing antiseizure medication carbamazepine was assessed; (3) the umbilical cord/maternal serum concentration ratio ranged between 0.75 and 1.78 (mean 1.10 ± 0.33), paired maternal and umbilical cord serum concentrations were not significantly different, and a highly significant correlation was found between both concentrations. The mean milk/maternal serum concentration ratio was 1.14 ± 0.27 (2–4 days postpartum) and 1.04 ± 0.24 (7–31 days postpartum) while the mean infant/maternal serum concentration ratio was markedly lower (0.19 ± 0.13 and 0.14 ± 0.05, respectively); (4) levetiracetam was found in the umbilical cord at a concentration similar to those in maternal serum. All of the breastfed infant serum concentrations were below the reference range used for the general epileptic population.

scholarly journals Valproic Acid Concentrations in Mothers, Colostrum and Breastfed Infants during the Early Postpartum Period: Comparison with Concentrations Determined during Delivery and in the Mature Milk Period

Pharmaceutics ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2074
Author(s):  
Ivana Kacirova ◽  
Milan Grundmann ◽  
Hana Brozmanova
Keyword(s):  
Valproic Acid ◽  
Serum Concentration ◽  
Lower Limit ◽  
Concentration Ratio ◽  
Maternal Serum ◽  
Serum Concentrations ◽  
Limit Of Quantification ◽  
Mature Milk ◽  
Breastfed Infants ◽  
Routine Monitoring

To obtain information on the transport of valproic acid from mothers to colostrum and breastfed infants, in this cohort study, valproic acid concentrations in maternal serum (90 subjects), colostrum and the serum of breastfed infants were analyzed in years 1993–2018, between the 2nd and 5th postnatal days. Valproic acid concentrations ranged from 4.3 to 66.5 mg/L (mean 31.2 ± 13.6 mg/L) in maternal serum, from 0.5 to 5.9 mg/L (mean 1.1 ± 1.2 mg/L) in milk, and from 0.5 to 42.9 mg/L (mean 15.4 ± 9.4 mg/L) in infant serum. The milk/maternal serum concentration ratio ranged from 0.01 to 0.22 (mean 0.04 ± 0.04), and the infant/maternal serum concentration ratio ranged from 0.01 to 1.61 (mean 0.51 ± 0.28). A significant correlation was found between serum concentrations of breastfed infants and milk concentrations, maternal serum concentrations, maternal daily dose, and dose related to maternal body weight. Valproic acid concentrations in milk and infant serum did not reach the lower limit of the reference range used for the general epileptic population, and three-quarters of the concentrations in milk were lower than the lower limit of quantification. Routine monitoring of serum concentrations of breastfed infants is not necessary. If signs of potential adverse reactions are noted, serum concentrations of the infants should be measured.

scholarly journals 1314. Neonatal Serum Gentamicin Concentrations following Maternal Once-daily Gentamicin Dosing

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Genene A Wilson ◽  
Allison Nelson ◽  
Palak Bhagat ◽  
Deborah Bondi ◽  
Pooja Shah ◽  
...  
Keyword(s):  
Serum Concentration ◽  
Compliance Rate ◽  
Retrospective Chart Review ◽  
Population Based ◽  
Serum Concentrations ◽  
Once Daily ◽  
The Mean ◽  
Group 2 ◽  
Clinically Significant ◽  
Group 1

Abstract Background Gentamicin is commonly used for peripartum infections. Given literature supporting efficacy of once-daily dosing (ODD) of 5 mg/kg for chorioamnionitis, University of Chicago Medicine made the change from three times daily dosing (TIDD) to ODD. As gentamicin readily cross the placenta, it would be expected that maternal ODD would result in higher gentamicin neonatal serum concentrations following birth. Methods This was a single-center, retrospective chart review of all neonates born to mothers receiving peripartum ODD gentamicin within 12 hours of delivery between October 2019 and March 2020. A STAT random gentamicin serum concentration was obtained upon admission in neonates when initiation of antibiotics was desired. Specific dosing recommendations (Table 1) were developed utilizing neonatal population-based pharmacokinetics. The primary outcome was initial neonatal gentamicin serum concentration at birth. Other outcomes were also evaluated. Results were evaluated in two groups based on neonatal serum concentrations of less than 2 mcg/mL (Group 1) versus 2 mcg/mL or greater (Group 2). Table 1: Neonatal gentamicin dosing algorithm Results Thirty-two mother-newborn dyads were included in this study. Baseline demographics are shown in Table 2. Newborns had a median gestational age of 39.4 weeks and median birth weight of 3.39 kilograms. The mean initial gentamicin concentration was supratherapeutic at 3.06 + 1.92 mcg/mL among all newborns (Table 3). The mean maternal dose in Group 1 (n=11) was 3.52 mg/kg (3.34, 4.77) based on actual body weight and 4.78 mg/kg (4.34, 5.18) in Group 2 (n=21) (p=0.025). The median time between maternal gentamicin administration and time of delivery varied between the groups at 0.5 hours versus 2.63 hours, respectively (p=0.005). All newborn gentamicin concentrations were less than 2 mcg/mL for maternal doses given less than 1 hour prior to delivery (n=8) (Figure 1). Overall protocol compliance rate was 81.3%. There were no significant differences in nephrotoxicity or ototoxicity between groups. Table 2. Baseline Demographics Table 3. Outcomes Figure 1. Comparison of maternal gentamicin time from administration to delivery and neonatal serum gentamicin concentrations Conclusion This study suggests peripartum ODD of gentamicin may lead to clinically significant serum concentrations in neonates if administered between 1 to 12 hours of birth. Further studies are warranted to evaluate the effects of maternal ODD of gentamicin on newborns. Disclosures All Authors: No reported disclosures

New prognostic protein markers for intrauterine infections in preterm birth

2020 ◽  
Vol 19 (5) ◽  
pp. 29-35
Author(s):  
L.V. Renge ◽  
◽  
E.Yu. Grigoryeva ◽  
V.N. Zorina ◽  
A.E. Vlasenko ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Amniotic Fluid ◽  
Umbilical Cord ◽  
Biological Fluids ◽  
Intrauterine Infection ◽  
Maternal Serum ◽  
Enzyme Linked Immunosorbent Assay ◽  
Protein Markers ◽  
Cord Serum ◽  
Intrauterine Infections

Objective. To identify prognostic markers of intrauterine infection (IUI) of the fetus and newborn in maternal serum, amniotic fluid, and umbilical cord serum in case of preterm birth. Patients and methods. We examined 93 pregnant women who had preterm birth (PB) from 24 to 33 weeks of gestation. Thirtyfive women delivered babies without any signs of IUI, while 30 women had newborns with mild IUI (conjunctivitis, lymphadenitis, pyoderma) and 28 women had newborns with severe IUI (early neonatal sepsis, advanced herpesvirus infection, chlamydiosis, candidiasis, pneumonia, and meningitis). We measured the levels of alpha 2-macroglobulin (α2-MG) in maternal serum (MS), umbilical cord serum (UCS) using rocket immunoelectrophoresis and in amniotic fluid (AF) using enzyme-linked immunosorbent assay (ELISA). The level of lactoferrin (LF) was assessed using ELISA. MS and UCS levels of albumin (ALB) were measured using biochemical methods, while AF level ALB was evaluated using rocket immunoelectrophoresis. Statistical analysis was performed using logistic regression. Results. We found no association between the concentration of LF in all biological fluids and the condition of newborns. Levels of ALB in MS and UCS also demonstrated no correlation with the condition of newborns. AF ALB in women who delivered babies with IUI (any grade of severity) was significantly higher than that in women who delivered babies without IUI. Women who delivered babies with severe IUI demonstrated the lowest concentration of α2-MG in their serum, whereas women who delivered babies with mild IUI had the highest α2-MG concentration. The AF α2-MG level was 10 to 20 times higher in women who had babies with IUI (any grade of severity) compared to those who had babies without IUI. Conclusion. Low α2-MG level in MS (<2.2 g/L) along with elevated α2-MG level in AF (≥6.0 mg/L) in 86–89% of PB cases indicated generalized fetal IUI and required urgent delivery without prolongation of pregnancy. Key words: albumin, alpha-2-macroglobulin, intrauterine infection, lactoferrin. premature birth

Measurement of Human Chorionic Gonadotropin (HCG) Concentrations in Paired Maternal and Cord Sera Using an Assay Specific for the Beta Subunit of HCG

PEDIATRICS ◽  
1976 ◽  
Vol 58 (1) ◽  
pp. 110-114
Author(s):  
Robert Penny ◽  
N. Olatunji Olambiwonnu ◽  
S. Douglas Frasier
Keyword(s):  
Serum Concentration ◽  
Cord Blood ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Male Infant ◽  
Maternal Serum ◽  
Assay System ◽  
Beta Subunit ◽  
Cord Serum ◽  
The Cross

Human chorionic gonadotropin (HCG) concentrations were determined in paired maternal and cord sera using an essay specific for the beta subunit of HCG. The sera of 46 mothers and 46 infants, 24 female and 22 male, were studied. Results were compared to those obtained using a radioimmunoassay for luteinizing-hormone (LH) which cross-reacted with HCG. With either assay system, mean maternal HCG concentrations were lower when the sex of the fetus was male than when the sex of the fetus was female. Mean cord HCG concentrations of male (0.09 ± 0.02 IU/ml) and female (0.09 ± 0.04 IU/ml) infants were not different as determined by the beta HCG assay. In contrast, the mean cord serum concentration of HCG was significantly greater (P &lt; .005) in male infants (0.29 ± 0.05 IU/ml) than in female infants (0.23 ± 0.09 IU/ml) as determined by the cross-reacting assay. HCG concentrations were lower in both maternal and cord sera when assayed in the specific HCG system than when assayed in the cross-reacting system. There was a significant correlation (r = &lt; .9; P.005) between the results obtained with the two assays in both maternal and cord blood. Regardless of the assay system employed, the cord serum concentration of HCG was markedly less than the corresponding maternal serum concentration. There was no correlation between maternal and cord serum HCG concentrations with either assay. These data are in agreement with the results of previous studies employing less specific methodology which indicated that maternal serum HCG concentrations were less when the fetus was male than when it was female. They are also consistent with a placental barrier effect with regard to HCG transfer to the fetus. The difference in results obtained in cord blood with the two assay systems suggests that the newborn male infant secretes more LH and/or alpha LH subunits than the newborn female infant.

Radioimmunoassay of Human Chorionic Somatomammotropin in Serum, Amniotic Fluid, and Urine

1973 ◽  
Vol 19 (6) ◽  
pp. 602-607 ◽  
Author(s):  
Russell J Moser ◽  
Dorothy R Hollingsworth
Keyword(s):  
Amniotic Fluid ◽  
Umbilical Cord ◽  
Maternal Serum ◽  
Antibody Technique ◽  
Cord Serum ◽  
Standard Curve ◽  
Double Antibody ◽  
Chorionic Somatomammotropin ◽  
The Cross

Abstract A method is described for measurement of human chorionic somatomammotropin (HCS) by use of a double-antibody technique, for concentrations ranging from 2 ng/ml to 20 µg/ml. The cross-reactive characteristics of rabbit anti-human HCS serum No. CT 3399 from NIAMD are explored. A dilution plan is presented utilizing a standard curve from 0.75 to 80 ng/ml. Concentrations (mean and ranges) for HCS in maternal serum (evaluated every four weeks during pregnancy), umbilical cord serum, serum from babies, amniotic fluid, and urine are given.

Triiodothyronine Concentration in Cord and Maternal Sera at Term

1973 ◽  
Vol 45 (2) ◽  
pp. 251-255 ◽  
Author(s):  
C. J. Eastman ◽  
J. M. Corcoran ◽  
A. Jequier ◽  
R. P. Ekins ◽  
E. S. Williams
Keyword(s):  
Maternal Blood ◽  
Maternal Serum ◽  
Blood Samples ◽  
Cord Serum ◽  
Serum T3 ◽  
The Mean ◽  
Triiodothyronine Concentration

1. Specific radioimmunoassays have been employed to measure triiodothyronine (T3), and thyroxine (T4) concentrations in the cord serum of fifty-five healthy babies and in a second series of fifteen paired cord and maternal blood samples. 2. The mean cord serum T3 was 332±136 (SD) pg/ml. In the paired series the mean cord serum T3 was 355±142 pg/ml whereas the mean maternal value was 1557±283 pg/ml. 3. Serum thyrotrophin (TSH) concentration was raised in cord serum compared with maternal serum.

SHBG in GDM maternal serum, placental tissues and umbilical cord serum expression changes and its significance

2013 ◽  
Vol 99 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Lei Sun ◽  
Zhen Jin ◽  
Weiping Teng ◽  
Xinshu Chi ◽  
Yanan Zhang ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Maternal Serum ◽  
Cord Serum
Sign in / Sign up

Export Citation Format

Share Document