Botulinum toxin A during pregnancy: a survey of treating physicians

Morgan, John C.; Iyer, Sandhya; Moser, E T; Singer, Carlos; Sethi, Kapil D.

doi:10.1136/jnnp.2005.063792

Cited by 81 publications

(71 citation statements)

References 16 publications

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“…The large size of the molecule makes it unlikely to be able to cross the placental barrier [27]. The doses of Botulinum toxin used for aesthetic procedures is also much lower than the estimated hazardous dose (100 Units versus 600 Units) [27]. The arguments for the safety of Botulinum toxin in pregnancy are convincing, however, it is believed that there is still insufficient data to confirm absolute safety of Botulinum toxin in pregnancy.…”

Section: Botulinum Toxinmentioning

confidence: 94%

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A Review of the Safety of Common Aesthetic Procedures during Pregnancy

Jakharia-Shah

Chadha

Watson

2017

IPCB

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The prevalence of aesthetic procedures has increased exponentially over the last decade. Pregnancy causes many aesthetic changes in a woman, such as melasma, hirsutism and striae. Although these are temporary in most cases, they can be distressing to the mother. As such, the desire to undergo aesthetic procedures can increase during this period. A variety of procedures exist, however, their safety profiles have usually been determined by tests on non-pregnant volunteers. The changes that occur in pregnancy and the presence of a foetus, which is susceptible to a wider range of toxins, means this data cannot be directly transferred to dictate pregnancy safety profiles. In general, most aesthetic procedures and agents are deemed to be safe to use in pregnancy, however, the health of both mother and foetus should be paramount. Aesthetic procedures are non-urgent, therefore, best practice would be to centre consultations on patient counselling, encouraging patients to delay procedures until after pregnancy.

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Section: Botulinum Toxinmentioning

confidence: 94%

Section: Botulinum Toxinmentioning

confidence: 99%

A Review of the Safety of Common Aesthetic Procedures during Pregnancy

Jakharia-Shah

Chadha

Watson

2017

IPCB

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“…8 No deleterious effects to the mother or the fetus were reported if the local injection dosage was between 1.25 and 300 U. 10 The dosage that our patient received was not over this range, and repeated injections were not required. Botulinum toxin use should be strictly prohibited during the first trimester, as there are some references to miscarriages.…”

Section: Discussionmentioning

confidence: 99%

“…Botulinum toxin use should be strictly prohibited during the first trimester, as there are some references to miscarriages. 10 Theoretically, the administration of this neurotoxin shortly before birth may cause respiratory muscle paralysis in the newborn. The patient was advised that the neonatal resuscitation team would be available at the time of delivery.…”

Section: Discussionmentioning

confidence: 99%

Treatment of severe achalasia during pregnancy with esophagoscopic injection of botulinum toxin A: a case report

et al. 2009

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A pregnant Thai woman presented with progressive dysphagia starting from the gestational age of 18 weeks. Total parenteral nutrition was administered at 33 weeks of gestation due to severe malnutrition. The fetus was found to be growth restricted. Preliminary diagnosis was esophageal achalasia. Diagnostic and treatment options, including early delivery followed by surgical intervention, temporizing pneumatic dilation and intrasphincteric botulinum toxin injection, were discussed before endoscopic examination. The patient preferred temporizing treatments to prolong the pregnancy and to allow for an improvement of her nutritional status to facilitate postpartum recovery. Marked dilatation of the esophagus was found during esophagoscopy. Therefore, local injection of 80 U of botulinum toxin A was chosen over balloon dilation. The swallowing function improved soon after the treatment. The patient and the fetus started to gain weight. Subsequent sonographic examinations did not show any evidence of botulinum toxicity in the fetus. The baby was born at 36 weeks of gestation with an active respiration and preserved muscle tones. Breast-feeding was withheld. The patient remained asymptomatic for at least 6 weeks after delivery. There have been reports of an intentional use of botulinum toxin in selected cases of unremitting movement disorder during pregnancy. No deleterious effects to the mothers or the babies were found in local injection with limited dosage after the first trimester. The authors cannot encourage the routine administration of this neurotoxin for the treatment of achalasia during pregnancy. However, this report provides additional information of botulinum toxin use in pregnant women. Journal of Perinatology (2009) 29, 637-639; doi:10.1038/jp.2009 Keywords: achalasia; botulinum toxin; pregnancy Case report A 39-year-old Thai pregnant woman, G5P2-0-2-2, was referred to our hospital at 33 weeks of gestation due to progressive dysphagia. The symptom started from 18 weeks of gestation. Her first two children were delivered by low transverse Cesarean section. On admission, she had lost 9 kg, and severe malnutrition and dehydration were observed. Fetal weight estimation was 1400 g, which indicates fetal growth restriction (10th percentile).1 Her symptoms were suggestive of esophageal achalasia. Total parenteral nutrition was administered immediately. Diagnostic and treatment options were discussed before endoscopic examination. This included an early delivery of the growth-restricted fetus after steroids administration. The patient could have either definitive or palliative surgical treatments afterward. Temporizing interventions to improve the nutritional status of the fetus and herself were also discussed. The options were pneumatic dilation and intrasphincteric botulinum toxin injection. The temporizing options could prolong the pregnancy, so that the baby would be less likely to suffer from the complications of prematurity. As the route of delivery would be by Cesarean section, the improved nutritional sta...

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“…Bilinmeden gebeliğin erken döneminde toksin uygulaması yapılanlarda, gebeliğin sonlandırılmasına gerek olmadığı düşü-nülmektedir. 48,49 F Fi in na an ns sa al l K Ka ay yn na ak k Bu çalışma sırasında, yapılan araştırma konusu ile ilgili doğru-dan bağlantısı bulunan herhangi bir ilaç firmasından, tıbbi alet, gereç ve malzeme sağlayan ve/veya üreten bir firma veya herhangi bir ticari firmadan, çalışmanın değerlendirme sürecinde, çalışma ile ilgili verilecek kararı olumsuz etkileyebilecek maddi ve/veya manevi herhangi bir destek alınmamıştır.…”

Section: Göz çEvresi̇unclassified

The Uses and Application Methods of Botulinum Toxin in Ophthalmology

Aydemir¹,

Katircioğlu²,

Şingar³

et al. 2018

Turkiye Klinikleri J Ophthalmol

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otulinum toksini (BTX), gram-pozitif anaerobik bir bakteri olan Clostridium botulinum tarafından üretilmektedir ve insanlık tarihinde bilinen en potent toksinlerden biridir.1 Botulizm; klinik bir sendrom olup, kontamine besinlerin alınmasıyla veya cilt üzerindeki açık yaraya Turkiye Klinikleri J Ophthalmol 2018;27(1):51-7 51 Botulinum Toksininin Oftalmolojide Kullanım Alanları ve Uygulama Şekilleri Ö ÖZ ZE ET T Botulinum toksini (BTX), gram pozitif anaerobik bir bakteri olan Clostridium botulinum tarafından üretilmektedir ve insanlık tarihinde bilinen en potent toksinlerden biridir. Etkisini, kasların kasılmasında etkili nörotransmitter olan asetilkolinin kas-sinir aralığına geçişini engelleyerek göstermektedir. BTX, potansiyel etkilerine bağlı olarak farklı alanlarda kullanılmış ve Amerikan Gıda ve İlaç Dairesi tarafından adlandırılmıştır. Oftalmoloji dışında da tıpta birçok dalda kullanım alanları mevcuttur. BTX'in etkisi geçicidir ve tekrarlanan enjeksiyonlar ile etkinlik süresi uzatıl-maktadır. Başarılı uygulama, uygun enjeksiyon tekniğine ve uygulama bölgesindeki kas yapılarının anatomik pozisyonlarının ve özelliklerinin iyi bilinmesine bağlıdır. BTX'i, tedavi amaçlı kullanımına başlandığı 1980 yılından beri güvenle kullanılmaktadır. Komplikasyonları; enjeksiyonun hatalı böl-geye yapılması, önerilen doz dışında yapılması ve yanlış enjeksiyon tekniklerine bağlı olarak görül-mektedir. Bu çalışma, güncel bilimsel araştırmalar değerlendirilerek; BTX'in oftalmolojide kullanım alanları, yapılma şekli, doz uygulaması, endikasyonları ve kontrendikasyonları tartışılmış; yüz bölgesi uygulamaları, blefarospazm, şaşılık, entropion, üst kapak retraksiyonu ve timsah gözyaşı sendromu vb. göz hastalıklarındaki yerinin incelenmesi amaçlanmıştır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Botulinum toksinleri; blefarospazm; şaşılık; entropiyon A AB BS S T TR RA AC CT T Botulinum toxin (BTX) is produced by Clostridium botulinum, a gram-positive anaerobic bacterium, and one of the most potent toxins known in human history. Its effect is demonstrated by inhibiting the passage of acetylcholine, an effective neurotransmitter in muscle contraction, to the muscle-nerve range. BTX have been used in different areas due to their potential effects and are named by the U.S. Food and Drug Administration. Apart from ophthalmology, there are many areas for the usage of BTX. The effect of BTX is transient and the duration of activity is extended by repeated injections. Successful administration depends on the appropriate injection technique, well-known knowledge of the anatomical positions and properties of the muscle structures in the application site. Since its inception in 1980, BTX has been used safely. Complications are seen secondary to perform BTX at the wrong region, out of the recommended dose and wrong injection techniques. Current scientific studies have been evaluated the uses of the botulinum toxin in ophthalmology, how it is done, dosage, indications and contraindications. Applications of face region, in the ma...

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Botulinum toxin A during pregnancy: a survey of treating physicians

Cited by 81 publications

References 16 publications

A Review of the Safety of Common Aesthetic Procedures during Pregnancy

A Review of the Safety of Common Aesthetic Procedures during Pregnancy

Treatment of severe achalasia during pregnancy with esophagoscopic injection of botulinum toxin A: a case report

The Uses and Application Methods of Botulinum Toxin in Ophthalmology

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