Developing New Pharmaceutical Treatments for Obstetric Conditions

Question 1

Roughly what proportion of the global burden of disease is made up of maternal and perinatal disease?

Answer 1

7%

Question 2

Which cancers have increased likelihood in the children of women who took diethylstilboestrol for prevention of early miscarriage? (2 of them)

Answer 2

1. Clear cell adenocarcinoma of the vagina and cervix
2. Breast cancer

Question 3

What uses has Thalidomide been repurposed for?

Answer 3

Pain relief in leprosy and Kaposi sarcoma

Question 4

What is the mechanism and timing of teratogenicity due to isotretinoin?

Answer 4

Inhibition of migration of cranial neural crest cells if taking before 28 days’ gestation

Question 5

Why do immunoglobulins cross the human placenta but not that of other mammals?

Answer 5

The human placenta is monochorial.

(other mammals have multiple cell layers between maternal and fetal circulation)

Question 6

What is evaluated in phase 1 trials?

Answer 6

determining safety, safe dosage range and identifying side effects

Question 7

What is evaluated in phase 2 trials?

Answer 7

Evaluate safety and begin to determine efficacy

Question 8

What is evaluated in phase 4 trials?

Answer 8

Delineate additional information such as treatment risks, benefits and optimal use

Question 8

What is evaluated in phase 3 trials?

Answer 8

Comparison to existing treatments

Question 9

Why do the RCOG guidelines state that it is reasonable not to use tocolysis?

Answer 9

There are no trials demonstrating long term benefits of delaying delivery in preterm labour