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Mothers who are negative for the Kell 1 antigen develop antibodies after being exposed to red blood cells that are positive for Kell 1.Over half of the cases of hemolytic disease of the newborn owing the anti-Kell antibodies are caused by multiple blood transfusions, with the remainder due to a previous pregnancy with a Kell 1 positive baby.
Prophylactic antibiotic administration has been shown to prolong pregnancy and reduced neonatal morbidity with rupture of membranes at less than 34 weeks. [133] Because of concern about necrotizing enterocolitis , amoxicillin or erythromycin has been recommended but not amoxicillin + clavulanic acid ( co-amoxiclav ).
Nitrofurantoin is pregnancy category A in Australia. [3] It is one of the few drugs commonly used in pregnancy to treat UTIs. [38] There is a potential risk of hemolytic anemia in the newborn when used near time of delivery. [3] Newborns of women given this drug late in pregnancy had a higher risk of developing neonatal jaundice. [39]
[14] [12] However, all NSAIDs showed association with structural cardiac defects with usage during the early weeks of pregnancy. When ibuprofen and naproxen are used within the third trimester, there is a significant increase in the risk of premature closure of the ductus arteriosus with primary pulmonary hypertension in the newborn. [ 12 ]
Narrow-spectrum antibiotics have low propensity to induce bacterial resistance and are less likely to disrupt the microbiome (normal microflora). [3] On the other hand, indiscriminate use of broad-spectrum antibiotics may not only induce the development of bacterial resistance and promote the emergency of multidrug-resistant organisms, but also cause off-target effects due to dysbiosis.
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Antibiotics with less reliable but occasional (depending on isolate and subspecies) activity: occasionally penicillins including penicillin, ampicillin and ampicillin-sulbactam, amoxicillin and amoxicillin-clavulnate, and piperacillin-tazobactam (not all vancomycin-resistant Enterococcus isolates are resistant to penicillin and ampicillin)