This article presents a comprehensive description of the causes, evaluation, and treatment of non-candidal vaginitis.

Depression is common in pregnant women. However, the rate of antidepressant treatment in pregnancy is significantly lower than in nonpregnant women. Although some antidepressants may cause potential risks to the fetus, not treating or withdrawing the treatment is associated with relapsing and adverse pregnancy outcomes such as preterm birth. Pregnancy-associated physiologic changes can alter pharmacokinetics (PK) and may impact dosing requirements during pregnancy. However, pregnant women are largely excluded from PK studies. Dose extrapolation from the nonpregnant population could lead to ineffective doses or increased risk of adverse events. To better understand PK changes during pregnancy and guide dosing decisions, we conducted a literature review to catalog PK studies of antidepressants in pregnancy, with a focus on maternal PK differences from the nonpregnant population and fetal exposure. We identified 40 studies on 15 drugs, with most data from patients taking selective serotonin reuptake inhibitors and venlafaxine. Most of the studies have relatively poor quality, with small sample sizes, reporting concentrations at delivery only, a large amount of missing data, and not including times and adequate dose information. Only four studies collected multiple samples following a dose and reported PK parameters. In general, there are limited data available regarding PK of antidepressants in pregnancy and deficiencies in data reporting. Future studies should provide accurate information on drug dosing and timing of dose, PK sample collection, and individual-level PK data.

between Pitocin, double lumen cervical ripening balloon (CRB) and prostaglandins (PGs). Since mechanical manipulation might affect the cervix, we aimed to investigate differences in cervical recuperation following different methods of induction and other cervical manipulations. STUDY DESIGN: The study was conducted between june 2016 to june 2018. Following informed consent, cervical length (CL) measurements were performed trans-vaginally following spontaneous and induced vaginal deliveries. All measurements were performed by a single observer (R.L) at 8, 24 and 48 hours postpartum. CL at the second trimester, demographic characteristics, obstetric history, parity, delivery outcomes, previous cervical manipulations and induction mode, were obtained from the patient's' medical records. RESULTS: Our cohort included 498 women. The average CL, 48 hours postpartum, following spontaneous term deliveries (254 women) was 35.2AE3.5 mm. 79 patients were induced with Dinoprostone, 77 with Pitocin and 88 by CRB. Significant abnormal cervical recovery was demonstrated in the CRB group compared to the Pitocin and the PGs groups (26.3AE1.9 mm vs. 35.9AE2.3 mm vs. 34.4AE3.1 mm, respectively (P¼0.012)) ( Fig 1a). One hundred twenty six patients had history of D&Cs, 49 had one D&C, 35 had two D&Cs and 43 patients had more than 2 D&Cs. Patients with more than 2 D&Cs demonstrated abnormal cervical recovery compared to patients that had 2 or 1 D&C (27.9AE2.3 mm vs. 32.6AE2.7 mm vs. 38.5AE1.8 mm, respectively (P¼0.028)) (Fig 1b). CONCLUSION: Cervical manipulations such as mechanical inductions and repeated D&Cs may cause damage to the cervix and increase its`recovery time. This has only been proven for the double lumen cervical ripening balloon and has not been evaluated for a Foley catheter. Although the clinical significance of delayed cervical recuperation postpartum has not been elucidated yet, these results might imply future cervical insufficiency and possible risk of preterm birth. Our results raise the question whether mechanical modes of induction have a negative and possibly long-term effect on the cervix. OBJECTIVE:The objective of this study was to determine if polydioxanone suture compared to polyglactin suture reduced the incidence of wound and fascial complications after cesarean deliveries.ajog.org

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