Drug use during pregnancy is not common.Drug-induced liver injury(DILI)is a potential complication that is rare but can adversely affect both the mother and the fetus.Although many drugs can directly cause hepatotoxic...Drug use during pregnancy is not common.Drug-induced liver injury(DILI)is a potential complication that is rare but can adversely affect both the mother and the fetus.Although many drugs can directly cause hepatotoxicity,idiosyncratic liver injury is common in pregnancy.Underreporting of adverse drug reactions,lack of adequate literature regarding drug safety in pregnancy,and the inherent difficulty in diagnosing DILI during pregnancy make the management of this condition challenging.This review attempts to describe the existing literature regarding DILI in pregnancy,which is mainly in the form of case reports;several studies have looked at the safety of antithyroid drugs,antiretroviral drugs,and paracetamol,which have an indication for use in pregnancy;the relevant data from these studies with regard to DILI has been presented.In addition,the review describes the diagnosis of DILI,grading the disease severity,assessment of causality linking the drug to the adverse event,regulatory guidelines for evaluating the potential of drugs to cause liver injury,efforts to ensure better participation of women in clinical trials and studies in pregnant women population in particular,and the challenges involved in generating adequate research evidence.The establishment of DILI registries in various countries is an encouraging development;however,there is a need for promoting active,spontaneous reporting of adverse events during pregnancy to ensure rapid generation of evidence regarding the safety of a drug in pregnant women.展开更多
Objective To explore the association of human leukocyte antigen (HLA) with pregnancy induced hypertension (PIH). Methods We oligotyped HLA DQA1, DQB1 locus of 30 Chinese PIH families and 14 control families ...Objective To explore the association of human leukocyte antigen (HLA) with pregnancy induced hypertension (PIH). Methods We oligotyped HLA DQA1, DQB1 locus of 30 Chinese PIH families and 14 control families in Shanghai area by polymerase chain reaction sequence specific oligonucleotide (PCR SSO) hybridization method (probes labeled by nonradioactive technique). Results Compared with the control group, the allelic frequency of HLA DQB 1*0502 was significantly higher in PIH couples, and the sharing of HLA DQA1 increased in PIH couples as well. No difference was found in HLA DQA1 allelic frequencies or HLA DQB1 sharing between the two groups. Analysis of neither HLA DQA1 nor HLA DQB1 allelic frequencies in PIH patients and PIH mother and fetuses showed positive result. Conclusion HLA DQB1*0502 may be a marker of susceptibility to PIH. DQB 1*0502 itself or some gene(s) located in HLA class Ⅱ region and in linkage disequilibrium with 0502 affect maternal T cell immunity during pregnancy. The increase of compatibility in HLA D region causes the production of blocking antibody to decrease.展开更多
亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)是妊娠期最常见的甲状腺疾病,SCH患者存在血管内皮功能损伤和自主神经功能障碍,可能会增加心血管疾病的发病风险。妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)...亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)是妊娠期最常见的甲状腺疾病,SCH患者存在血管内皮功能损伤和自主神经功能障碍,可能会增加心血管疾病的发病风险。妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)使妊娠复杂化,并导致孕产妇和胎儿不良妊娠结局发生率和死亡率升高。已有研究发现SCH与HDP发病率增加有关,但目前没有统一结论,且SCH孕妇应用左旋甲状腺素(levothyroxine,L-T4)治疗对HDP是否有益也尚存争议。综述妊娠期SCH对HDP的影响及L-T4的治疗效果,以规范临床妊娠管理方案,减少孕妇和胎儿围产期不良妊娠结局的发生。展开更多
文摘Drug use during pregnancy is not common.Drug-induced liver injury(DILI)is a potential complication that is rare but can adversely affect both the mother and the fetus.Although many drugs can directly cause hepatotoxicity,idiosyncratic liver injury is common in pregnancy.Underreporting of adverse drug reactions,lack of adequate literature regarding drug safety in pregnancy,and the inherent difficulty in diagnosing DILI during pregnancy make the management of this condition challenging.This review attempts to describe the existing literature regarding DILI in pregnancy,which is mainly in the form of case reports;several studies have looked at the safety of antithyroid drugs,antiretroviral drugs,and paracetamol,which have an indication for use in pregnancy;the relevant data from these studies with regard to DILI has been presented.In addition,the review describes the diagnosis of DILI,grading the disease severity,assessment of causality linking the drug to the adverse event,regulatory guidelines for evaluating the potential of drugs to cause liver injury,efforts to ensure better participation of women in clinical trials and studies in pregnant women population in particular,and the challenges involved in generating adequate research evidence.The establishment of DILI registries in various countries is an encouraging development;however,there is a need for promoting active,spontaneous reporting of adverse events during pregnancy to ensure rapid generation of evidence regarding the safety of a drug in pregnant women.
文摘Objective To explore the association of human leukocyte antigen (HLA) with pregnancy induced hypertension (PIH). Methods We oligotyped HLA DQA1, DQB1 locus of 30 Chinese PIH families and 14 control families in Shanghai area by polymerase chain reaction sequence specific oligonucleotide (PCR SSO) hybridization method (probes labeled by nonradioactive technique). Results Compared with the control group, the allelic frequency of HLA DQB 1*0502 was significantly higher in PIH couples, and the sharing of HLA DQA1 increased in PIH couples as well. No difference was found in HLA DQA1 allelic frequencies or HLA DQB1 sharing between the two groups. Analysis of neither HLA DQA1 nor HLA DQB1 allelic frequencies in PIH patients and PIH mother and fetuses showed positive result. Conclusion HLA DQB1*0502 may be a marker of susceptibility to PIH. DQB 1*0502 itself or some gene(s) located in HLA class Ⅱ region and in linkage disequilibrium with 0502 affect maternal T cell immunity during pregnancy. The increase of compatibility in HLA D region causes the production of blocking antibody to decrease.
文摘亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)是妊娠期最常见的甲状腺疾病,SCH患者存在血管内皮功能损伤和自主神经功能障碍,可能会增加心血管疾病的发病风险。妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)使妊娠复杂化,并导致孕产妇和胎儿不良妊娠结局发生率和死亡率升高。已有研究发现SCH与HDP发病率增加有关,但目前没有统一结论,且SCH孕妇应用左旋甲状腺素(levothyroxine,L-T4)治疗对HDP是否有益也尚存争议。综述妊娠期SCH对HDP的影响及L-T4的治疗效果,以规范临床妊娠管理方案,减少孕妇和胎儿围产期不良妊娠结局的发生。
