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
[目的]探讨PAPP—A、胱抑素-C（Cys—C）、D-二聚体（D-D）在妊娠高血压疾病（hypertensive disorders in pregnancy，PIH）孕妇中的表达及其意义。[方法]选择PIH患者94例，根据分类标准分为子痫前期轻度、子痫前期重度和子痫，同时选...[目的]探讨PAPP—A、胱抑素-C（Cys—C）、D-二聚体（D-D）在妊娠高血压疾病（hypertensive disorders in pregnancy，PIH）孕妇中的表达及其意义。[方法]选择PIH患者94例，根据分类标准分为子痫前期轻度、子痫前期重度和子痫，同时选择同期足月妊娠的正常孕妇41例。检测各组孕妇的妊娠相关蛋白A（PAPP—A）、Cys—C、D-D水平并比较。[结果]妊娠期高血压组孕妇血清PAPP—A、Cys—C、D-D水平均显著高于正常妊娠组孕妇；子痫前期轻度组、子痫前期重度组、子痫组孕妇血清PAPP—A、Cys—C、D-D水平依次升高，组间比较差异有统计学意义（P〈0．05）；Pearson相关性分析显示，血清PAPP—A、Cys—C、D-D水平与病情严重程度均呈正相关（r=0．604，P=0．013；r=0．618，P=0．007；r=0．583，P=0．013）。[结论]PAPP—A、Cys—C、D-D在PIH孕妇体内表达水平显著增高，且随着病情加重，其表达水平升高，在PIH的临床诊断具有较高的临床价值。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[目的]探讨PAPP—A、胱抑素-C（Cys—C）、D-二聚体（D-D）在妊娠高血压疾病（hypertensive disorders in pregnancy，PIH）孕妇中的表达及其意义。[方法]选择PIH患者94例，根据分类标准分为子痫前期轻度、子痫前期重度和子痫，同时选择同期足月妊娠的正常孕妇41例。检测各组孕妇的妊娠相关蛋白A（PAPP—A）、Cys—C、D-D水平并比较。[结果]妊娠期高血压组孕妇血清PAPP—A、Cys—C、D-D水平均显著高于正常妊娠组孕妇；子痫前期轻度组、子痫前期重度组、子痫组孕妇血清PAPP—A、Cys—C、D-D水平依次升高，组间比较差异有统计学意义（P〈0．05）；Pearson相关性分析显示，血清PAPP—A、Cys—C、D-D水平与病情严重程度均呈正相关（r=0．604，P=0．013；r=0．618，P=0．007；r=0．583，P=0．013）。[结论]PAPP—A、Cys—C、D-D在PIH孕妇体内表达水平显著增高，且随着病情加重，其表达水平升高，在PIH的临床诊断具有较高的临床价值。
