Use of acyclovir for varicella pneumonia during pregnancy

Article Abstract:

Varicella infection in children usually causes mild disease (chickenpox), but it can cause severe disease in adults. In pregnant women, untreated varicella pneumonia has a death rate as high as 40 percent. The drug acyclovir, an antiviral agent, has been effective for treating various viral pulmonary infections afflicting pregnant women. Its effectiveness against varicella pneumonia has not yet been established. This study reviewed the cases of 16 pregnant women suffering from varicella pneumonia who were treated with acyclovir. The women received intravenous acyclovir for an average of seven days. The pneumonia occurred during the second trimester of pregnancy in 12 cases and during the third trimester in 9 cases. The only side effect of acyclovir treatment observed in the mothers was one case of seizure activity; no side effects were observed in the fetuses. Three mothers (14 percent) died from uncontrolled infection or complications of infection. These women had developed varicella pneumonia during the third trimester pregnancy. This was the only risk factor found for maternal death. Of the three deceased mothers, two infants died; one was stillborn at 34 weeks' gestation and one was born very prematurely at 26 weeks' gestation. None of the infants who were born showed signs of congenital varicella syndrome. These findings suggest that acyclovir is effective for treating maternal varicella pneumonia and safe for both the mother and the developing fetus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Complications and side effects, Drug therapy, Virus diseases, Pregnancy, Acyclovir, Chickenpox, Virus diseases in pregnancy, Viral pneumonia

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A pregnancy-prevention program in women of childbearing age receiving isotretinoin

Article Abstract:

Women appear to follow the warnings to avoid becoming pregnant while using isotretinoin for severe acne. Isotretinoin is a drug similar to vitamin A that may cause birth defects in children born to women during or soon after therapy. Researchers interviewed 177,216 women using isotretinoin between Jan 1989 and Dec 1993. Among 23,740 women completing the first telephone interviews, 99% responded that their doctors had warned them to avoid pregnancy. Ninety-six percent of the women responded that they were not sexually active or were using birth control while receiving isotretinoin therapy. Overall, 402 women reported pregnancies including 46 who were pregnant when therapy began and 356 who became pregnant during therapy. Of these women, 290 chose to terminate the pregnancy, 63 had spontaneous abortions, 32 had live births and 4 had an unknown outcome. Of the 32 live births, at least seven were known to have birth defects associated with isotretinoin therapy.

Evaluation, Causes of, Birth defects, Patient education, Health counseling, Isotretinoin

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