reference librarian comments, March 2000
| On Doctoring MEDLINE searches, with reference librarian comments, March 2000 |
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The question was
What are the recommendations for HEP C mothers to prevent transmission to the fetus during pregnancy?
1 exp *Hepatitis c/ results= 9017
2 exp *Pregnancy/ results= 14289
3 1 and 2 results= 11
4 from 3 keep 3-4,9-10 results= 4
5 *Maternal-Fetal Exchange/ results= 1467
6 1 and 5 results= 9
7 hepatitis c/ results= 9839
8 7 and (2 or 5) results= 13
9 limit 8 to english language results= 8
10 exp hepatitis c/ results= 10916
11 10 and (2 or 5) results= 13
12 limit 11 to english language results= 8
13 12 not 6 results= 2
Reference Librarian comments
I think you did a fine job. I happen to know of another potentially relevant MeSH term, which is "pregnancy complications." I did the search, in a slightly different way, incorporating that extra term, and got, I think, nothing much more than you did. Just in case these might be interesting, I copied the reference below.
Whenever I hear the word "guidelines" -- I consider searching the National Guideline Clearinghouse, at:
http://www.guideline.gov/index.asp
Thank you for participating in the assignment.
=== Here's what I did....1
exp *hepatitis c/
90172
exp pregnancy/ or exp pregnancy complications/ or exp maternal-fetal exchange/
1218553
1 and 2
2334
exp fetal development/ or exp fetal diseases/
339415
exp fetus/
183796
3 and (4 or 5)
107
limit 6 to (human and english language)
7
<1>
AN 99408589
AU Reilly M. Lawlor E.
IN Department of Statistics, University College Dublin, Ireland.
TI A likelihood-based method of identifying contaminated lots of blood product.
SO International Journal of Epidemiology. 28(4):787-92, 1999 Aug.
LM Dana. Incomplete holdings, check catalog.
AB BACKGROUND: In 1994 a small cluster of hepatitis-C cases in
Rhesus-negative women in Ireland prompted a nationwide screening programme
for hepatitis-C antibodies in all anti-D recipients. A total
of 55 386 women presented for screening and a history of exposure to anti-D
was sought from all those testing positive and a sample of those testing
negative. The resulting data comprised 620 antibody-positive and 1708
antibody-negative women with known exposure history, and interest was focused
on using these data to estimate the infectivity of anti-D in the period
1970-1993. METHODS: Any exposure to anti-D provides an opportunity for
infection, but the infection status at each exposure time is not observed.
Instead, the available data from antibody testing only indicate whether at
least one of the exposures resulted in infection. Using a simple Bernoulli
model to describe the risk of infection in each year, the absence of
information regarding which exposure(s) led to infection fits neatly into the
framework of 'incomplete data'. Hence the expectation-maximization (EM)
algorithm provides estimates of the infectiousness of anti-D in each of the
24 years studied. RESULTS: The analysis highlighted the 1977 anti-D as a
source of infection, a fact which was confirmed by laboratory investigation.
Other suspect batches were also identified, helping to direct the efforts of
laboratory investigators. CONCLUSIONS: We have presented a method to estimate
the risk of infection at each exposure time from multiple exposure data. The
method can also be used to estimate transmission rates and the risk
associated with different sources of infection in a range of infectious
disease applications.
<2>
AN 99357271
AU Locatelli A. Roncaglia N. Arreghini A. Bellini P. Vergani P. Ghidini A.
IN Department of Obstetrics and Gynecology, Istituto Scienze Biomediche San
Gerardo, Monza, Italy.
TI Hepatitis C virus infection is associated with a higher
incidence of cholestasis of pregnancy.
SO British Journal of Obstetrics & Gynaecology. 106(5):498-500, 1999 May.
LM Pre-1993 at Dana,1993-date at MFHSL.
AB To investigate a possible relationship between hepatitis C
virus infection and cholestasis of pregnancy, we identified
all cases of cholestasis of pregnancy (145/16,271) and
hepatitis C virus infection (63/16,271) between January 1992
and December 1997. Serologic screening was performed universally. The rate of
cholestasis of pregnancy was greater in women whose
hepatitis C virus antibodies were positive rather than
negative [15.9% (10/63) vs 0.8% (135/16,208), P < 0.001]. Among women with
cholestasis of pregnancy, mean (standard deviation)
gestational age at onset of symptoms and at delivery was significantly lower
among women whose hepatitis C virus antibodies were positive
compared with negative women: 28.9 (3.2) vs 34.3 (3.5) weeks, P < 0.001 and
36.3 (0.9) vs 37.0 (1.6) weeks, P = 0.03, respectively. These findings
suggest that early occurrence of cholestasis of pregnancy
may be an indication for serologic testing for hepatitis C
virus.
<3>
AN 98108631
AU Kumar RM. Frossad PM. Hughes PF.
IN Department of Obstetrics and Gynaecology, Faculty of Medicine and Health
Sciences, UAE University, Al-Ain, United Arab Emirates.
TI Seroprevalence and mother-to-infant transmission of
hepatitis C in asymptomatic Egyptian women.
SO European Journal of Obstetrics, Gynecology, & Reproductive Biology.
75(2):177-82, 1997 Dec.
LM Dana Biomedical Library (Dana).
AB OBJECTIVES: In this study, we sought to determine (1) the prevalence of
hepatitis C virus (HCV) RNA, or its antibodies, in a healthy
parturient Egyptian population and (2) the risk of mother-to-infant
transmission in this population. METHOD: The serum of 499 pregnant Egyptian
women was tested for anti-HCV with ELISA-3 and for HCV RNA by polymerase
chain reaction (PCR). Neonatal cord blood and infant blood were similarly
tested for anti-HCV and HCV RNA. RESULTS: Recombinant immunoblot assay (RIBA)
detected anti-HCV in 65/499 (13%) women; of these, 20/65 (31%) were
PCR-positive. The total number of babies born was 499. Of the original group,
97 mothers and infants (HCV-negative) were lost to follow up and were
excluded. Sixty-five anti-HCV-positive infants were born vaginally to the 65
anti-HCV-positive mothers, of which twenty (31%) corresponding mothers and
babies were also positive for HCV RNA. Of these twenty babies, three died of
hepatocellular disease by six months of age; sixteen developed chronic liver
disease; the remaining nine remained asymptomatic but were serologically and
PCR-positive. The mother-to-infant transmission rate was significantly
increased (5%; P < 0.0001). Of the seropositive children, 45/65 (69%; P <
0.0001) seroreverted by eighteen months of age. CONCLUSION: There is a high
prevalence of anti-HCV in healthy pregnant Egyptian women and vertical
transmission is a major risk for chronic HCV carriers.
<4>
AN 97092972
AU Aizaki H. Saito A. Kusakawa I. Ashiwara Y. Nagamori S. Toda G. Suzuki
T. Ishii K. Matsuura Y. Miyamura T.
IN Department of Virology II, National Institute of Health, Tokyo, Japan.
TI Mother-to-child transmission of a hepatitis C virus variant
with an insertional mutation in its hypervariable region.
SO Journal of Hepatology. 25(5):608-13, 1996 Nov.
LM Not at Dartmouth/DHMClibraries;request on interlibrary loan.
AB BACKGROUND/AIMS: We have analyzed the molecular basis of mother-to-child
transmission of hepatitis C virus. METHODS/RESULTS: Healthy
pregnant women were screened for anti-HCV antibody and babies born to
hepatitis C virus carrier mothers were prospectively
investigated. Among the 35 pairs studied, the hepatitis C
virus genome was detectable in only one baby, who did not show any
significant symptoms of hepatitis. The viral load in the
blood of the mother was one of the highest of the 35, and the population of
the hepatitis C virus genome was heterogeneous. Furthermore,
she was found to have a mixed infection with type 1a and type 1b
hepatitis C virus. However, the hepatitis C
virus genome obtained from the baby was only from type 1b, less heterogeneous
and composed of the clones which were detected in the blood of the mother.
The selected hepatitis C virus had a 12-nucleotide insertion
in the amino-terminus of the E2 hypervariable region of the genome.
CONCLUSIONS: The incidence of mother-to-child transmission of
hepatitis C virus from carrier mothers was shown by this
prospective study to be low. The presence of selection pressure during
transmission was suggested. The biological significance of the virus with
12-nucleotide insertion has to be determined.
<5>
AN 96081767
AU Silverman NS. Snyder M. Hodinka RL. McGillen P. Knee G.
IN Department of Obstetrics and Gynecology, Thomas Jefferson University
Hospital, Philadelphia, PA, USA.
TI Detection of hepatitis C virus antibodies and specific
hepatitis C virus ribonucleic acid sequences in cord bloods
from a heterogeneous prenatal population.
SO American Journal of Obstetrics & Gynecology. 173(5):1396-400, 1995 Nov.
LM Pre-1993 Dana; 1993-dateMFHSL;for Web access-check catalog
AB OBJECTIVE: Our aim was to quantify the prevalence of at-risk pregnancies for
maternal-fetal hepatitis C virus
transmission in a heterogeneous prenatal population by detection of both
hepatitis C virus-specific antibody and
hepatitis C virus ribonucleic acid sequences in cord bloods
from their deliveries. STUDY DESIGN: An anonymous serosurvey of 1432
consecutive umbilical cord blood samples were analyzed for
hepatitis C virus antibodies with a second-generation enzyme
immunoassay with all hepatitis C virus antibody-positive
samples batched and analyzed for both human immunodeficiency virus antibodies
and hepatitis C virus ribonucleic acid sequences by
polymerase chain reaction. RESULTS: Forty-seven of the samples (3.2%) were
positive for hepatitis C virus antibodies; seropositivity
rates differed significantly by socioeconomic status but not by race.
Significantly more of the antibody-positive women underwent cesarean section
for delivery (31.9% vs 21.9%, p = 0.03). Three (6.4%)
hepatitis C virus antibody-positive samples were also human
immunodeficiency virus-antibody positive, whereas nine (19.1%) were
hepatitis C virus ribonucleic acid positive. CONCLUSION: As
many as 19% of hepatitis C virus antibody-positive women in
this study also had hepatitis C virus ribonucleic acid
isolated from their delivery cord blood samples, which may indicate an
increased risk of vertical hepatitis C virus transmission in
those pregnancies. Hepatitis C virus-specific antibody and
ribonucleic acid detection may also be markers for other
pregnancy complications that result in
higher rates of cesarean section for these women.
<6>
AN 94212343
AU Uehara S. Abe Y. Saito T. Yoshida Y. Wagatsuma S. Okamura K. Yajima A.
Mandai M.
IN Department of Obstetrics and Gynecology, Tohoku University School of
Medicine, Sendai, Japan.
TI The incidence of vertical transmission of hepatitis C
virus.
SO Tohoku Journal of Experimental Medicine. 171(3):195-202, 1993 Nov.
LM Dana. Incomplete holdings, check catalog.
AB This study was undertaken to clarify the incidence of the vertical
transmission of hepatitis C virus (HCV). During the third
trimester, 2015 pregnant women were examined as to anti-HCV antibodies.
Anti-HCV antibody seropositive women were examined for HCV-RNA in peripheral
blood at labor and in breast milk. Their offspring were also examined for
HCV-RNA in umbilical cord blood and peripheral blood one week after birth and
during subsequent outpatient visits. The following results were obtained: (1)
Twelve of the 2015 pregnant women (0.6%) were seropositive for anti-HCV
antibodies; (2) Seven of the twelve women (58%) seropositive for anti-HCV
antibodies were also seropositive for HCV-RNA; (3) Three newborns of the
seven HCV-RNA seropositive women (43%) were found to have HCV-RNA in the cord
blood; (4) In the three newborns HCV-RNA had disappeared from the peripheral
blood within one month after birth; (5) Two of the seven HCV-RNA seropositive
women (29%) had HCV-RNA positive breast milk; (6) The possibility of
infection via breast milk was shown in one infant at ten months after birth.
Based on these results, it is indicated that HCV vertical transmission is
possible in more than half of the HCV-RNA seropositive mothers. However,
because of the disappearance of HCV from the infants' peripheral blood,
further following study is needed.
<7>
AN 94071491
AU Kurauchi O. Furui T. Itakura A. Ishiko H. Sugiyama M. Ohno Y. Ando H.
Tanamura A. Ishida T. Nawa A. et al.
IN Department of Obstetrics and Gynecology, Nagoya University School of
Medicine, Japan.
TI Studies on transmission of hepatitis C virus from
mother-to-child in the perinatal period.
SO Archives of Gynecology & Obstetrics. 253(3):121-6, 1993.
LM Dana. Incomplete holdings, check catalog.
AB To elucidate whether breast milk, vaginal discharge and contamination with
maternal blood at birth are possible routes of mother-to-child transmission
of hepatitis C virus (HCV), we examined HCV RNA in the cord
and peripheral blood of infants, and in the blood, vaginal discharge, and
breast milk of anti-HCV seropositive mothers. From July 1991 to July 1992, we
studied 20 healthy pregnant women, who were seropositive with the Ortho
anti-HCV EIA, and their infants. Using a sensitive nested polymerase chain
reaction (nested PCR), we investigated the presence or absence of
hepatitis C virus in the above-mentioned specimens. Moderate
elevation of aspartate aminotransferase (AST) and alanine aminotransferase
(ALT) was observed in only one woman in the first and third trimesters. The
nested PCR and subsequent Southern hybridization detected 0.5-5.5 copies of
HCV c-DNA. HCV RNA was detected in 17/20 blood samples (85%), 7/14 vaginal
discharge samples (50%) and 4/10 cord blood samples (40%). However, no HCV
RNA was identified in the peripheral blood of infants or breast milk. The
mother-to-child transmission of HCV at delivery or via breast milk does not
appear to contribute much to maintaining the global HCV reservoir.