Observational Case Series Evaluation of the Granisetron Transdermal Patch System (Sancuso) for the Management of Nausea/Vomiting of Pregnancy.

Objective The objective of this study was to observe the efficacy of antiemetic therapy (no emesis/retching episodes and no rescue medication use) when granisetron is administered via a transdermal patch system (TDS) in women who are 6 to 14 weeks pregnant when compared with oral ondansetron by evaluating the frequency of the use of rescue medications for control of nausea/vomiting of pregnancy (NVP). Methods This was an observational case series study to observe the potential benefits of granisetron TDS compared with oral ondansetron for management of NVP in pregnant patients during the first trimester. Dates of data collection were September 1, 2014, through December 31, 2015. There was no direct contact with patient. The oral ondansetron and granisetron TDS patients were matched by age, 4:1. The proportion of patients who received rescue antiemetics was calculated from those patients who continued to experience NVP. Risk factors for NVP were identified and compared between groups. Descriptive statistics were used to describe study results. Results Patients were prescribed rescue antiemetics in 0/3 patients in the granisetron TDS group compared with 2/12 patients in the oral ondansetron group. Conclusion Prospective efficacy studies on the use of granisetron TDS for management of NVP are needed to confirm this clinical observation.

Comparison of bactericidal properties of alcohol-based chlorhexidine versus povidone-iodine prior to amniocentesis.

OBJECTIVE: To compare the bactericidal properties of povidone-iodine versus alcohol-based chlorhexidine solution for cleansing the gravid abdomen prior to amniocentesis. METHODS: Fifty study participants were recruited from the University of Texas Women's Clinic in Houston, Texas. Two baseline swabs of the patients' abdomens were obtained to assess bacterial flora prior to treatment. A 10% povidone-iodine solution and 2% chlorhexidine gluconate with 70% isopropyl alcohol solution in a 3-mL prefilled applicator (Chloraprep, Cardinal Health, Inc., Leawood, KS) were then applied on different sides of the abdomen. After 30 seconds, cultures were obtained and plated on Trypticase Soy (PML Microbiologicals, Durham, NC) with sheep's blood agar for aerobic flora. Plates were incubated at 37°C for 48 hours for aerobic flora. Colony-forming units were counted and recorded. RESULTS: No statistically significant difference was detected between baseline colony counts between the left and right side of each patient's abdomen (p = 0.33) prior to cleansing. Postcleansing colony counts were evaluated, and a statistically significant difference was identified, favoring chlorhexidine as a more efficacious abdominal cleanser (p <0.001). CONCLUSION: We demonstrated that 2% chlorhexidine with 70% isopropyl alcohol had excellent bactericidal efficacy and was superior to povidone-iodine for cleansing the maternal abdomen.

Vaginal myomectomy in pregnancy: a report of two cases.

Prolapsed fibroids presenting in pregnancy are rare. Two cases of bleeding prolapsed fibroids, one cervical and the other submucosal, are presented to demonstrate the clinical features and outcomes following surgical treatment during pregnancy. While vaginal myomectomy of a prolapsed cervical fibroid in pregnancy appears safe, prolapse of a submucosal fibroid in pregnancy necessitating excision may be associated with rupture of the membranes.