WorldWideScience

Sample records for dystocia

  1. Shoulder dystocia.

    Science.gov (United States)

    Grobman, William

    2013-03-01

    The frequency of shoulder dystocia in different reports has varied, ranging 0.2-3% of all vaginal deliveries. Once a shoulder dystocia occurs, even if all actions are appropriately taken, there is an increased frequency of complications, including third- or fourth-degree perineal lacerations, postpartum hemorrhage, and neonatal brachial plexus palsies. Health care providers have a poor ability to predict shoulder dystocia for most patients and there remains no commonly accepted model to accurately predict this obstetric emergency. Consequently, optimal management of shoulder dystocia requires appropriate management at the time it occurs. Multiple investigators have attempted to enhance care of shoulder dystocia by utilizing protocols and simulation training.

  2. Complications of shoulder dystocia.

    Science.gov (United States)

    Dajani, Nafisa K; Magann, Everett F

    2014-06-01

    Complications of shoulder dystocia are divided into fetal and maternal. Fetal brachial plexus injury (BPI) is the most common fetal complication occurring in 4-40% of cases. BPI has also been reported in abdominal deliveries and in deliveries not complicated by shoulder dystocia. Fractures of the fetal humerus and clavicle occur in about 10.6% of cases of shoulder dystocia and usually heal with no sequel. Hypoxic ischemic brain injury is reported in 0.5-23% of cases of shoulder dystocia. The risk correlates with the duration of head-to-body delivery and is especially increased when the duration is >5 min. Fetal death is rare and is reported in 0.4% of cases. Maternal complications of shoulder dystocia include post-partum hemorrhage, vaginal lacerations, anal tears, and uterine rupture. The psychological stress impact of shoulder dystocia is under-recognized and deserves counseling prior to home discharge.

  3. Shoulder dystocia: prediction and management.

    Science.gov (United States)

    Hill, Meghan G; Cohen, Wayne R

    2016-01-01

    Shoulder dystocia is a complication of vaginal delivery and the primary factor associated with brachial plexus injury. In this review, we discuss the risk factors for shoulder dystocia and propose a framework for the prediction and prevention of the complication. A recommended approach to management when shoulder dystocia occurs is outlined, with review of the maneuvers used to relieve the obstruction with minimal risk of fetal and maternal injury.

  4. [Symphysiotomy to relieve shoulder dystocia

    NARCIS (Netherlands)

    Mourad, S.M.; Nieuwenhof, H.P. van de; Biert, J.; Heidema, W.M.; Bekker, M.N.

    2014-01-01

    Symphysiotomy to manage shoulder dystocia is seldom used in the western world. For this reason, in well-resourced countries knowledge of its recuperation rate and the management of physical discomfort in the post-partum period is scarce. We describe two cases of symphysiotomy for shoulder dystocia.

  5. Shoulder dystocia: definitions and incidence.

    Science.gov (United States)

    Hansen, Alexandra; Chauhan, Suneet P

    2014-06-01

    Though subjective in nature, both the American College of Obstetricians and Gynecologists practice bulletin and the Royal College of Obstetricians and Gynaecologists green guideline are in agreement on the descriptor of shoulder dystocia: requirement of additional obstetric maneuvers when gentle downward traction has failed to affect the delivery of the shoulders. The rate of shoulder dystocia is about 1.4% of all deliveries and 0.7% for vaginal births. Compared to non-diabetics (0.6%), among diabetics, the rate of impacted shoulders is 201% higher (1.9%); newborns delivered by vacuum or forceps have 254% higher likelihood of shoulder dystocia than those born spontaneously (2.0% vs. 0.6%, respectively). When the birthweight is categorized as 4500 g, the likelihood of shoulder dystocia in the US vs. other countries varies significantly. Future studies should focus on lowering the rate of shoulder dystocia and its associated morbidities, without concomitantly increasing the rate of cesarean delivery.

  6. Shoulder dystocia: management and documentation.

    Science.gov (United States)

    Stitely, Michael L; Gherman, Robert B

    2014-06-01

    Shoulder dystocia is an obstetric emergency that occurs when the fetal shoulders become impacted at the pelvic inlet. Management is based on performing maneuvers to alleviate this impaction. A number of protocols and training mnemonics have been developed to assist in managing shoulder dystocia when it occurs. This article reviews the evidence regarding the performance, timing, and sequence of these maneuvers; reviews the mechanism of fetal injury in relation to shoulder dystocia; and discusses issues concerning documentation of the care provided during this obstetric emergency.

  7. [Symphysiotomy to relieve shoulder dystocia].

    Science.gov (United States)

    Mourad, Selma M; van de Nieuwenhof, Hedwig P; Biert, Jan; Heidema, Wieteke M; Bekker, Mireille N

    2014-01-01

    Symphysiotomy to manage shoulder dystocia is seldom used in the western world. For this reason, in well-resourced countries knowledge of its recuperation rate and the management of physical discomfort in the post-partum period is scarce. We describe two cases of symphysiotomy for shoulder dystocia. Both babies did very well in the postpartum period. The short-term 6-week and 6-month follow-up of both mothers is described. Short-term maternal complications were minor and based on prolonged immobilization. In accordance with the international literature, the short-term and long-term follow-up after symphysiotomy for shoulder dystocia was good and there were no major maternal or neonatal complications. We therefore wish to advocate symphysiotomy as a good and safe option to deliver a baby in cases of severe shoulder dystocia, when all other manoeuvres fail.

  8. Contemporary management of shoulder dystocia.

    Science.gov (United States)

    Gittens-Williams, Lisa

    2010-11-01

    Shoulder dystocia is an uncommon but potentially catastrophic intrapartum event. Although risk factors such as maternal diabetes, obesity and macrosomia can be identified, shoulder dystocia most frequently occurs in patients who lack risk factors. Many maneuvers have been described to assist the operator in the safe release of the shoulder and subsequent delivery; however, no prospective trials have compared these maneuvers in such a way to suggest that one maneuver is superior to another. This article describes the identification of patients at risk for shoulder dystocia, clinical management of the shoulder dystocia, event documentation and the contemporary use of drills and simulation training to improve team preparedness for this unpredictable and usually unavoidable event.

  9. Management and Prevention of Dystocia.

    Science.gov (United States)

    Funnell, Bethany J; Hilton, W Mark

    2016-07-01

    Dystocia is an inevitable challenge in the livestock industries, particularly with primiparous female animals. Prevention and appropriate management will decrease cow and calf morbidity and mortality, which will improve the economic status of the beef or dairy operation. Early identification and proper intervention improves outcomes, and the use of selection tools to decrease the potential for dystocia will have positive returns. Assisted reproductive technologies present a unique set of challenges to the calving process that both the producer and practitioner should be prepared to address.

  10. Complications of labor and delivery: shoulder dystocia.

    Science.gov (United States)

    Anderson, Jane E

    2012-03-01

    This article reviews one of the less common but most dreaded complications of labor and delivery, shoulder dystocia, an infrequent but potentially devastating event that results from impaction of the fetal shoulders in the maternal pelvis. Shoulder dystocia occurs most commonly in patients without identified risk factors, and can result in both maternal and fetal morbidity. Because the vast majority of cases of shoulder dystocia are unpredictable, obstetric care providers must be prepared to recognize dystocia and respond appropriately in every delivery. Detailed documentation is essential after any delivery complicated by shoulder dystocia.

  11. Dystocia in the dog and cats

    OpenAIRE

    Anadol, Elvan

    2007-01-01

    Dystocia is the failureof completion of labor withoutexogenous intervention. The incidence of dystocia is highly variable among animal speciesand races. In domestic dogs and big and brachiocephalic races, this incidenceis particularly high. Early stimulation of labor causesuterine inertia and fetal developmental disorders whereas delayed labor   results in overgrowth of fetus thus increasing the rate of dystocia. Severalfactors both relatedto the mother and the fetus are responsible of dystoc...

  12. Observation of dystocia in wild elk

    Science.gov (United States)

    Chad P. Lehman; Lowell E. Schmitz; Mark A. Rumble; Jackie J. Kragel; Joshua J. Millspaugh

    2012-01-01

    On the basis of reports in the literature, incidence of dystocia in wild elk (Cervus elaphus) across the west is rare. In 2011, one of 34 (3%) pregnant cow elk in our study experienced dystocia during birth. Our visual observations indicated that it took approximately 4 days for a radio-collared cow elk to succumb to dystocia in our study. Little is known about...

  13. Dystocia in Blackbucks (Antilope cervicapra

    Directory of Open Access Journals (Sweden)

    Hasan Riaz, Nasim Ahmad* and Muhammad Aleem

    2012-05-01

    Full Text Available Four blackbucks, 4-6 years of age were handled for dystocia with a history of straining and without successful delivery. Clinical examination revealed normal vital parameters, partially opened cervix and dry birth canal. Water bags were ruptured in all cases. In three out of four cases (75%, the fetus was extracted out using standard obstetrical operations; however, one fetus (25% was taken out using fetotomy. All fetuses were dead after assisted delivery. Three out of four (75% dams were found active and behaved normally after delivery, however, one dam (25% died soon after obstetrical procedure. It was concluded that dystocia in blackbucks can be effectively handled on similar lines as in caprines and timely veterinary assistance is required in order to save the newborns.

  14. Shoulder dystocia: risk factors, predictability, and preventability.

    Science.gov (United States)

    Mehta, Shobha H; Sokol, Robert J

    2014-06-01

    Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery.

  15. Evolving understanding and treatment of labour dystocia.

    Science.gov (United States)

    Karaçam, Zekiye; Walsh, Denis; Bugg, George John

    2014-11-01

    The objective of the review is to critically review the diagnosis and management of dystocia in the first stage of labour. We conducted a narrative review of research since 1998. Eight studies were identified, four about the onset and duration of active phase of the first stage of labour, one on the diagnosis of dystocia, and three focused on the treatment of dystocia. The review demonstrates that current understandings of dystocia rest on outdated definitions of active first stage of labour, its progress and on treatments with an equivocal evidence base. These include the cervical dilatation threshold for active first stage, uncertainty over whether a reduced rate of dilatation and reduced strength of uterine contractions always represent pathology and the effectiveness of amniotomy/oxytocin for treating dystocia. Prospective studies should evaluate the impact of defining the active phase of the first stage of labour as commencing at 6 cm dilated and should test this definition in combination with Zhang's revised partogram.

  16. Labor Dystocia: Uses of Related Nomenclature.

    Science.gov (United States)

    Neal, Jeremy L; Ryan, Sharon L; Lowe, Nancy K; Schorn, Mavis N; Buxton, Margaret; Holley, Sharon L; Wilson-Liverman, Angela M

    2015-01-01

    Labor dystocia (slow or difficult labor or birth) is the most commonly diagnosed aberration of labor and the most frequently documented indication for primary cesarean birth. Yet, dystocia remains a poorly specified diagnostic category, with determinations often varying widely among clinicians. The primary aims of this review are to 1) summarize definitions of active labor and dystocia, as put forth by leading professional obstetric and midwifery organizations in world regions wherein English is the majority language and 2) describe the use of dystocia and related terms in contemporary research studies. Major national midwifery and obstetric organizations from qualifying United Nations-member sovereign nations and international organizations were searched to identify guidelines providing definitions of active labor and dystocia or related terms. Research studies (2000-2013) were systematically identified via PubMed, MEDLINE, and CINAHL searches to describe the use of dystocia and related terms in contemporary scientific publications. Only 6 organizational guidelines defined dystocia or related terms. Few research teams (n = 25 publications) defined dystocia-related terms with nonambiguous clinical parameters that can be applied prospectively. There is heterogeneity in the nomenclature used to describe dystocia, and when a similar term is shared between guidelines or research publications, the underlying definition of that term is sometimes inconsistent between documents. Failure to define dystocia in evidence-based, well-described, clinically meaningful terms that are widely acceptable to and reproducible among clinicians and researchers is concerning at both national and global levels. This failure is particularly problematic in light of the major contribution of this diagnosis to primary cesarean birth rates. © 2015 by the American College of Nurse-Midwives.

  17. [Prediction, prevention and management of shoulder dystocia].

    Science.gov (United States)

    Csorba, Roland

    2012-05-20

    Shoulder dystocia is one of the most tragic, fatal and unexpected obstetrical events, which is mostly unpredictable and unpreventable. This clinical picture is defined as a delivery that requires additional obstetric maneuvers to release the shoulders after gentle downward traction has failed. Shoulder dystocia occurs when the fetal shoulder impacts on the maternal symphysis or sacral promontory. The incidence of shoulder dystocia is 0.2-0.6%. High perinatal mortality and morbidity is associated with the condition, even when it is managed appropriately. Obstetricians should be aware of the existing risk factors, but should always be alert to the possibility of shoulder dystocia in all labors. Maternal morbidity is also increased, particularly postpartum hemorrhage, rupture of the uterus, injury of the bladder, urethra and the bowels and fourth-degree perineal tears. Complications of the newborn include asphyxia, perinatal mortality, fracture of the clavicula and the humerus. Brachial plexus injuries are one of the most important fetal complications of shoulder dystocia, complicating 4-16% of such deliveries. The purpose of this article is to review the current evidence regarding the possible prediction, prevention and management of shoulder dystocia.

  18. Obstetric risk indicators for labour dystocia in nulliparous women

    DEFF Research Database (Denmark)

    Kjaergaard, Hanne; Olsen, Jørn; Ottesen, Bent

    2008-01-01

    In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often...... do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria....

  19. Resuscitating the Baby after Shoulder Dystocia

    Directory of Open Access Journals (Sweden)

    Savas Menticoglou

    2016-01-01

    Full Text Available Background. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice. Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died. Conclusion. Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that (1 the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and (2 the neonatal resuscitators give volume much sooner.

  20. Labor Dystocia: A Common Approach to Diagnosis.

    Science.gov (United States)

    Neal, Jeremy L; Lowe, Nancy K; Schorn, Mavis N; Holley, Sharon L; Ryan, Sharon L; Buxton, Margaret; Wilson-Liverman, Angela M

    2015-01-01

    Contemporary labor and birth population norms should be the basis for evaluating labor progression and determining slow progress that may benefit from intervention. The aim of this article is to present guidelines for a common, evidence-based approach for determination of active labor onset and diagnosis of labor dystocia based on a synthesis of existing professional guidelines and relevant contemporary publications. A 3-point approach for diagnosing active labor onset and classifying labor dystocia-related labor aberrations into well-defined, mutually exclusive categories that can be used clinically and validated by researchers is proposed. The approach comprises identification of 1) an objective point that strictly defines active labor onset (point of active labor determination); 2) an objective point that identifies when labor progress becomes atypical, beyond which interventions aimed at correcting labor dystocia may be justified (point of protraction diagnosis); and 3) an objective point that identifies when interventions aimed at correcting labor dystocia, if used, can first be determined to be unsuccessful, beyond which assisted vaginal or cesarean birth may be justified (earliest point of arrest diagnosis). Widespread adoption of a common approach for diagnosing labor dystocia will facilitate consistent evaluation of labor progress, improve communications between clinicians and laboring women, indicate when intervention aimed at speeding labor progress or facilitating birth may be appropriate, and allow for more efficient translation of safe and effective management strategies into clinical practice. Correct application of the diagnosis of labor dystocia may lead to a decrease in the rate of cesarean birth, decreased health care costs, and improved health of childbearing women and neonates.

  1. [Twin dystocia: about one case of compaction].

    Science.gov (United States)

    Desseauve, D; Voluménie, J-L

    2008-09-01

    We report a case of twin dystocia during the evacuation of full-term fetus both in cephalic presentation. A low-outlet forceps for second-phase arrest was performed for the first twin but the head remained stuck to maternal perineum, mimicking a shoulder dystocia. Digital examination found a twin compaction, that is the presence of the second twin's fetal head at the level of the first twin's chest. The discrepancy between fetal weights and the use of forceps could favor this rare complication. Various maneuvers were described previously attempted to solve the problem. Forcing back the second head may help to achieve delivery of the first twin.

  2. Shoulder Dystocia: Quality, Safety, and Risk Management Considerations.

    Science.gov (United States)

    Moni, Saila; Lee, Colleen; Goffman, Dena

    2016-12-01

    Shoulder dystocia is a term that evokes terror and fear among many physicians, midwives, and health care providers as they recollect at least 1 episode of shoulder dystocia in their careers. Shoulder dystocia can result in significant maternal and neonatal complications. Because shoulder dystocia is an urgent, unanticipated, and uncommon event with potentially catastrophic consequences, all practitioners and health care teams must be well-trained to manage this obstetric emergency. Preparation for shoulder dystocia in a systematic way, through standardization of process, practicing team-training and communication, along with technical skills, through simulation education and ongoing quality improvement initiatives will result in improved outcomes.

  3. Dystocia in a giraffe Giraffa camelopardalis

    Directory of Open Access Journals (Sweden)

    V. de Vos

    1974-07-01

    Full Text Available Dystocia in a free-living giraffe Giraffa camelopardalis in the Willem Pretorius Nature Reserve is described. Posterior presentation and a unilateral engaged hock flexion posture caused a complete obstacle to parturition. Both parties, maternal and foetal, died as a result of the condition.

  4. Association of head circumference and shoulder dystocia in macrosomic neonates.

    Science.gov (United States)

    Larson, Austin; Mandelbaum, David E

    2013-04-01

    To determine whether asymmetric macrosomia (disproportionately large body size in comparison to head circumference) could be demonstrated in a population of infants suffering shoulder dystocia during delivery relative to those that did not suffer from shoulder dystocia. A case-control study was conducted as a retrospective chart review over 3 years at a large maternity hospital in an urban setting. Among infants over 4,000 g, those that suffered from shoulder dystocia during delivery had a smaller mean head circumference than infants of a similar size that did not suffer from shoulder dystocia. A statistically significant difference was also present when cases of documented gestational diabetes were excluded. Asymmetric macrosomia is more likely to be present in a population of infants who suffered shoulder dystocia during delivery. This knowledge could be used in designing tools to predict which pregnancies are at highest risk for shoulder dystocia during delivery.

  5. Odds ratio of dystocia in Holstein cows in Iraq

    OpenAIRE

    Al-Samarai Firas Rashad

    2011-01-01

    The objective of this research was to determine the effect of some factors on dystocia in Holstein cows. The analysis consist of 19090 records of parturitions belonged to 3181 cows from 1990 to 2004 in the Nasr Dairy Cattle Station in Iraq. A logistic regression model was used to predict dystocia. The model included effects of year of birth, season (winter or other seasons), parity (first or later), birth weight (kg), and sex of calf. Results revealed that odds of dystocia decreas...

  6. Anal sphincter injury in vaginal deliveries complicated by shoulder dystocia.

    Science.gov (United States)

    Hehir, Mark P; Rubeo, Zachary; Flood, Karen; Mardy, Anne H; O'Herlihy, Colm; Boylan, Peter C; D'Alton, Mary E

    2017-05-18

    Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury. We sought to identify risk factors for obstetric anal sphincter injury in women with shoulder dystocia. This retrospective analysis included all cases of shoulder dystocia from 2007 to 2011 at two large tertiary referral centers, in the USA and Ireland. Details of maternal demographics, intrapartum characteristics, and delivery outcomes in cases of shoulder dystocia were analyzed. Univariate and multivariate analyses were used to describe the association between shoulder dystocia and anal sphincter injury. There were 685 cases of shoulder dystocia, and the rate of shoulder dystocia was similar at both institutions. The incidence of anal sphincter injury was 8.8% (60 out of 685). The rate was 14% (45 out of 324) in nulliparas and 4.2% (15 out of 361) in multiparas. Women with sphincter injury were more likely to be nulliparous (75% [45 out of 60] vs 45% [279 out of 625]; p anal sphincter injury is 9%. Risk factors include nulliparity, operative vaginal delivery, and use of internal maneuvers, whereas episiotomy was found to have a protective effect against anal sphincter injury during cases of shoulder dystocia.

  7. Risk factors for dystocia in pigtailed macaques (Macaca nemestrina).

    Science.gov (United States)

    Stockinger, Diane E; Torrence, Anne E; Hukkanen, Renee R; Vogel, Keith W; Hotchkiss, Charlotte E; Ha, James C

    2011-04-01

    Dystocia (difficult labor) is an important component of the management of nonhuman primates and results in significant fetal and maternal morbidity and increased use of veterinary resources. Dystocias can arise from abnormalities of the maternal pelvis or fetus or uncoordinated uterine activity. Although risk factors for stillbirths have been established in nonhuman primates, risk factors for dystocias have not. The objective of this study was to determine maternal and fetal risk factors for dystocia in macaques. Retrospective data were collected from 83 pigtailed macaques (Macaca nemestrina) diagnosed with dystocia. The diagnosis of dystocia was made based on clinical or pathologic evidence. Maternal records of age, reproductive history, experimental history, clinical records, and fetal birth weight and any applicable fetal necropsy reports were reviewed. The gestational age of the fetus, the infant's birth weight, total previous births by the dam, and the proportions of both viable delivery (inverse effect) and surgical pregnancy interventions (direct effect) in the dam's history generated a model that maximized the experimental variance for predicting dystocia in the current pregnancy and explained 24% of the dystocia deliveries. The number of total previous births and proportion of previous cesarean sections accounted for the greatest effect. This model can identify individual dams within a colony that are at risk for dystocias and allow for changes in breeding colony management, more intense monitoring of dams at risk, or allocation of additional resources.

  8. Seasonal variation of dystocia in a large Danish cohort.

    Directory of Open Access Journals (Sweden)

    Christine Rohr Thomsen

    Full Text Available BACKGROUND: Dystocia is one of the most frequent causes of cesarean delivery in nulliparous women. Despite this, its causes are largely unknown. Vitamin D receptor (VDR has been found in the myometrium. Thus, it is possible that vitamin D affects the contractility of the myometrium and may be involved in the pathogenesis of dystocia. Seasonal variation of dystocia in areas with distinct seasonal variation in sunlight exposure, like Denmark, could imply that vitamin D may play a role. This study examined whether there was seasonal variation in the incidence of dystocia in a Danish population. METHOD: We used information from a cohort of 34,261 nulliparous women with singleton pregnancies, spontaneous onset of labor between 37 and 42 completed gestational weeks, and vertex fetal presentation. All women gave birth between 1992 and 2010 at the Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby. Logistic regression combined with cubic spline was used to estimate the seasonal variation for each outcome after adjusting for calendar time. RESULTS: No evidence for seasonal variation was found for any of the outcomes: acute cesarean delivery due to dystocia (p = 0.44; instrumental vaginal delivery due to dystocia (p = 0.69; oxytocin augmentation due to dystocia (p = 0.46; and overall dystocia (p = 0.91. CONCLUSION: No seasonal variation in the incidence of dystocia was observed in a large cohort of Danish women. This may reflect no association between vitamin D and dystocia, or alternatively that other factors with seasonal variation and influence on the occurrence of dystocia attenuate such an association.

  9. Association of fetal cranial shape with shoulder dystocia

    NARCIS (Netherlands)

    Belfort, M. A.; White, G. L.; Vermeulen, F. M.

    2012-01-01

    Objective To evaluate whether fetal cranial shape is related to shoulder dystocia. Methods We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched- pairs observational study. Subjects were matched for known maternal and fetal risk fac

  10. Perspectives of fetal dystocia in cattle and buffalo

    Directory of Open Access Journals (Sweden)

    Govind Narayan Purohit

    2012-04-01

    Full Text Available We review the causes of fetal dystocia in cows and buffalo. Two fetal causes are distinct fetal oversize and fetal abnormalities. Fetal oversize is common in heifers, cows of beef cattle breeds, prolonged gestations, increased calf birth weight, male calves and perinatal fetal death with resultant emphysema. Fetal abnormalities include monsters, fetal diseases and fetal maldispositions, and it is difficult to deliver such fetuses because of their altered shape. Although monsters are rare in cattle, a large number of monstrosities have been reported in river buffalo; yet also here, overall incidence is low. Diseases of the fetus resulting in dystocia include hydrocephalus, ascites, anasarca and hydrothorax. The most common cause of dystocia in cattle seems to be fetal maldispositions, of which limb flexion and head deviation appear to be the most frequent. We provide a brief description of the management of dystocia from different causes in cattle and buffalo. A case analysis of 192 and 112 dystocia in cattle and buffalo, respectively, at our referral center revealed that dystocia is significantly higher (P<0.05 in first and second parity cows and buffalo, and that dystocia of fetal origin is common in cows (65.62% but less frequent (40.17% in buffalo. In buffalo, the single biggest cause of dystocia was uterine torsion (53.57%. Fetal survival was significantly (P<0.05 higher both in cows and buffalo when delivery was completed within 12 h of second stage of labor.

  11. Association of fetal cranial shape with shoulder dystocia

    NARCIS (Netherlands)

    Belfort, M. A.; White, G. L.; Vermeulen, F. M.

    2012-01-01

    Objective To evaluate whether fetal cranial shape is related to shoulder dystocia. Methods We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched- pairs observational study. Subjects were matched for known maternal and fetal risk fac

  12. Labor Dystocia as First Presentation of Pelvic Malignancy

    Directory of Open Access Journals (Sweden)

    Dennis van Hamont

    2011-01-01

    Full Text Available The underlying causes of labor dystocia can be various. Lack of expulsive forces or fetal malpresentation are amongst the most common ones. However, pelvic masses are described as well. Here we describe two cases of labor dystocia as first presentation of pelvic malignancy.

  13. Labor Dystocia as First Presentation of Pelvic Malignancy

    OpenAIRE

    Dennis van Hamont; Zusterzeel, Petra L. M.

    2011-01-01

    The underlying causes of labor dystocia can be various. Lack of expulsive forces or fetal malpresentation are amongst the most common ones. However, pelvic masses are described as well. Here we describe two cases of labor dystocia as first presentation of pelvic malignancy.

  14. Dystocia in dromedary camels: Prevalence, forms, risks and hematobiochemical changes.

    Science.gov (United States)

    Ali, Ahmed; Derar, Derar; Tharwat, Mohamed; Zeitoun, Moustafa M; Alsobyil, Fahd A

    2016-07-01

    The objectives of this study were to investigate the prevalence of dystocia in camel herds, its forms in primi- and multipara, the risks to fetus and dam, and the associated hematobiochemical changes. A total of 1890 calvings were surveyed for the prevalence of dystocia. Cases with dystocia (n=107) were examined for causes and treated with traction, fetotomy or Cesarean section. Logistic regression was performed to identify risk factors. The dependent variables were the fetal and maternal mortality, while the independent variables were parity, duration of dystocia, causes of dystocia, and method of treatment. Blood samples were collected from all dystocia camels and six controls for hematology and concentrations of serum amyloid A (SAA), haptoglobin (Hp), estradiol-17β (E2), progesterone (P4), total protein, albumin, calcium, phosphorus, magnesium, blood urea nitrogen (BUN), creatinine and aspartate aminotransferase (AST). The overall prevalence of dystocia was 8.6%. Risk of dystocia was higher in camels managed in an intensive system than in those in a free system (Odds ratio=1.9, P=0.0003) and higher in primipara than in multipara (Odds ratio 1.7, P=0.005). Abnormal posture was the most important cause of dystocia (51.4%). Uterine torsion was the second most important cause (23.4%) and was mainly observed in multipara (P=0.0006). Dystocia was linked to high fetal mortality (87.9%). A significant relationship was found between fetal death and duration of dystocia (Odds ratio=8.04, P=0.005). The percentage of dam mortality was 17.8%. Significant associations were detected between dam mortality rate and the duration of dystocia (Odds ratio=4.74, P=0.03) and fetal viability (Odds ratio=5.82, P=0.02). Increasing duration of dystocia was associated with significant increases in SAA, Hp, BUN and AST, but with decreases in E2 (Pdystocia in dromedary camels, and fetal and maternal deaths were mainly associated with the duration of dystocia.

  15. Dystocia in Friesian cows and its effects on postpartum reproductive performance and milk production.

    Science.gov (United States)

    Gaafar, H M A; Shamiah, Sh M; El-Hamd, M A Abu; Shitta, A A; El-Din, M A Tag

    2011-01-01

    A total of 1,243 records for 585 dairy Friesian cows from 1997-2004 were used to study the factors affecting dystocia and its effects on reproductive performance and milk production. The overall incidence of dystocia was 6.9%. The percentage of dystocia decreased with increasing live body weight, age, and parity of cows (P dystocia was detected in winter season, but the least percentage was in summer season (P dystocia was significantly (P dystocia was significantly (P dystocia had adverse effects on reproductive performance and milk yield. The service interval, service period, days open, and calving interval were significantly (P dystocia compared to normal cows. The conception rate was lower (P dystocia compared to normal cows (60.5% vs. 73.0% and 3.4 vs. 2.7, respectively). Average daily milk yield was lower (P dystocia compared to normal cows.

  16. [Treatment for dystocia in ancient China].

    Science.gov (United States)

    Zhang, Lu

    2012-05-01

    Treatment for dystocia in ancient China includes delivery taboo, delivery promotion decoction and midwifery methods. Before the Sui and Tang dynasties, delivery was more like a rite. In the Sui and Tang dynasties, doctors began to understand dystocia from the physical condition, delivery environment and psychological factors, and the delivery taboo was rejected. After that period, the delivery taboo became a folk custom and was separated from the field of medicine. The herbs for delivery promotion decoctions usually used the principle of regulating the blood and removing stasis and were of slippery character during and before the Tang dynasty. In the Song dynasty promotion decoction was enlarged. In later ages some doctors put forward that emphasis should be on conformity to nature and nursing, not dependence on promotion drugs. Before and during the Tang dynasty, acupuncture and salt smearing had been key methods for abnormal fetal position and there were also case recordings. In the Northern Song dynasty, these two methods were no longer used and the midwife's skill was emphasized. With more and more focus on the midwife's skill, some male doctors depended on midwives and some criticism of midwives also increased. The book Dashengbian reflected maximum distrust of midwives.

  17. Shoulder dystocia: simulation and a team-centered protocol.

    Science.gov (United States)

    Grobman, William A

    2014-06-01

    Shoulder dystocia is an obstetric emergency that has been reported to occur in 0.2-3% of all vaginal deliveries. Several characteristics of shoulder dystocia make it a particular challenge to manage effectively. It is relatively infrequent, the diagnosis cannot be made according to a single objective criterion that can be recognized to exist by all members of the care team who are present, it is unpredictable, and there is the need for coordinated actions of all members of the health care team who have come together on the day of the delivery and may not have worked together before or specifically during a shoulder dystocia. In general, there is evidence from different medical disciplines that checklists/protocols and simulation may be used to enhance team performance. There is also some evidence, albeit limited, that such techniques may be used to improve shoulder dystocia outcomes.

  18. Outcomes associated with introduction of a shoulder dystocia protocol.

    Science.gov (United States)

    Grobman, William A; Miller, Deborah; Burke, Carol; Hornbogen, Abby; Tam, Karen; Costello, Robert

    2011-12-01

    The objective of this study was to assess outcomes that are associated with the implementation of a shoulder dystocia protocol that is focused on team response. We identified women who had a shoulder dystocia during 3 time periods: 6 months before (period A), 6 months during (period B), and 6 months after (period C) the institution of a shoulder dystocia protocol. Documentation and health outcomes were compared among the time periods. During the study period, 254 women (77, 100, and 77 in periods A, B, and C, respectively) had a shoulder dystocia. There were no differences among study periods in patient characteristics. However, complete and consistent documentation increased (14% to 50% to 92%; P < .001), and brachial plexus palsy that was diagnosed at delivery (10.1% to 4.0% to 2.6%; P = .03) and at neonatal discharge (7.6% to 3.0% to 1.3%; P = .04) declined.

  19. [Labor duration: from normality to dystocia].

    Science.gov (United States)

    Kayem, G

    2015-04-01

    "Normal" labor has been surprisingly little studied in the past 60 years even though it is a central axis in obstetrics. Standards were proposed 60 years ago by Emmanuel Friedman and adopted by many countries to become then, driven from Dublin school, the conditions allowing the management of labor: rupture of membranes and oxytocin with, in case of failure for dynamic dystocia, cesarean. Recent data have suggested that labor duration had changed since the 1960s. Changes in women's characteristics and in obstetric practice especially with the widespread use of oxytocin and realization of epidural may have an impact on labor duration. Current studies suggest that it may be possible to authorize longer labor duration without significant increase in maternal or neonatal morbidity. However, it is premature to change practices following the latest American recommendations without prior studies. Copyright © 2015. Published by Elsevier SAS.

  20. A survey of dystocia in the Boxer breed

    Directory of Open Access Journals (Sweden)

    Persson Gunilla

    2007-03-01

    Full Text Available Abstract Background Dystocia occurs more commonly in some breeds of dogs than others. The Boxer breed is one of the highrisk breeds for whelping problems. The aim of this study was to document some reproductive parameters and the frequency of dystocia in Boxers. Methods Two questionnaires were sent to the breeders of Boxers in Sweden during 1994 to 1997. Data from 253 whelpings and 1671 pups was received, which constitutes 56.5% of all Boxer litters registered with the Swedish Kennel Club during these years. Data was analysed using Chi-square test, and Fischer's exact test. Results Dystocia occurred in 32% of the individual bitches, and in 27.7% of all the whelpings. Caesarian section was performed in 22.8% of all the whelpings and in 80.1% of the cases of dystocia. Medical treatment was tried in 20 cases but was successful only in 5 (25%. The dystocia was of maternal origin in 68.6% and of fetal origin in 28.6% of cases. The most common reasons for dystocia were primary uterine inertia (60% and malpresentation of the fetus (26%. Dystocia increased with increasing age of the bitch from four years of age. Average litter size was 6.6 (± 2.2 pups born, and 5.0 (± 2.1 pups registered. Pup mortality was 24%. Stillbirths accounted for 6.1% of the pup deaths and 1% died in the neonatal period, while 15.6% of the pups were euthanised, the majority because they had disqualifying white coat colour. Cryptorchidism was observed in 9.8% of the male pups born and in 13.4% of the male pups that were registered. Conclusion The Boxer suffers a high frequency of dystocia, mainly due to uterine inertia, but also fetal malpresentation. Breeders should be adviced to include easy whelpings in their breeding program.

  1. Genetic evidence of multiple loci in dystocia - difficult labour

    Directory of Open Access Journals (Sweden)

    Westgren Magnus

    2010-06-01

    Full Text Available Abstract Background Dystocia, difficult labour, is a common but also complex problem during childbirth. It can be attributed to either weak contractions of the uterus, a large infant, reduced capacity of the pelvis or combinations of these. Previous studies have indicated that there is a genetic component in the susceptibility of experiencing dystocia. The purpose of this study was to identify susceptibility genes in dystocia. Methods A total of 104 women in 47 families were included where at least two sisters had undergone caesarean section at a gestational length of 286 days or more at their first delivery. Study of medical records and a telephone interview was performed to identify subjects with dystocia. Whole-genome scanning using Affymetrix genotyping-arrays and non-parametric linkage (NPL analysis was made in 39 women exhibiting the phenotype of dystocia from 19 families. In 68 women re-sequencing was performed of candidate genes showing suggestive linkage: oxytocin (OXT on chromosome 20 and oxytocin-receptor (OXTR on chromosome 3. Results We found a trend towards linkage with suggestive NPL-score (3.15 on chromosome 12p12. Suggestive linkage peaks were observed on chromosomes 3, 4, 6, 10, 20. Re-sequencing of OXT and OXTR did not reveal any causal variants. Conclusions Dystocia is likely to have a genetic component with variations in multiple genes affecting the patient outcome. We found 6 loci that could be re-evaluated in larger patient cohorts.

  2. Risk factors for stillbirth and dystocia in Japanese Black cattle.

    Science.gov (United States)

    Uematsu, Mizuho; Sasaki, Yosuke; Kitahara, Go; Sameshima, Hiroshi; Osawa, Takeshi

    2013-10-01

    Stillbirth and dystocia are major factors reducing the productivity of beef cattle. The objective of this study was to determine the effect of season, parity and gestation length on the rates of stillbirth and dystocia in Japanese Black cattle. Calving records were obtained from 905 farms in Miyazaki Prefecture, Japan. Data were collected from 41,116 calvings in 15,378 (14.42% primiparous). There were 1013 stillbirths (2.46%) and 3514 dystocias (8.55%). The stillbirth rate in winter (December to February) (3.18%) was higher (odds ratio (OR) [95% confidence interval]: 1.008 [1.004-1.012]) than that in summer (June to August). Similarly, the dystocia rates in winter (OR: 1.011 [1.004-1.019]) and spring (March to May) (OR: 1.020 [1.013-1.027]) were significantly higher than in summer. For primiparous cows, the rates of stillbirth (OR: 1.010 [1.004-1.015]) and dystocia (OR: 1.053 [1.042-1.064]) were higher than in cows with fifth parity (reference parity). Stillbirth rates were higher in cows at ≥ 301 days of pregnancy (OR: 1.049 [1.035-1.062]) and those at ≤ 270 days of pregnancy (OR: 2.072 [2.044-2.101]) than those at between 281 and 290 days of pregnancy. Likewise, dystocia rates were higher in cows at ≥ 301 days of pregnancy (OR: 1.033 [1.008-1.059]) and those at ≤ 270 days of pregnancy (OR: 1.124 [1.095-1.154]) than those at between 281 and 290 days of pregnancy. Winter, primiparity, and long and short gestation lengths were risk factors for stillbirth and dystocia in this cohort of Japanese Black cattle.

  3. Effects of dystocia on milk production and reproduction in subsequent lactation in a Turkish Holstein herd

    OpenAIRE

    İbrahim KAYA; UZMAY, Can; AYYILMAZ, Tarık

    2015-01-01

    The study investigated effects of dystocia on milk production, reproduction, calf loss, and cow culling in a Turkish Holstein herd at the Agricultural Faculty, Ege University, İzmir, Turkey. Data were from 653 single calvings between 2006 and 2010. Considering a greater dystocia incidence in primiparous cows, data was divided in two; 223 primiparous and 430 multiparous calvings scored on a 1-to-5 scale. Scores were categorized into no dystocia and dystocia. With few related observations, all ...

  4. Dystocia in the cat evaluated using an insurance database.

    Science.gov (United States)

    Holst, Bodil Ström; Axnér, Eva; Öhlund, Malin; Möller, Lotta; Egenvall, Agneta

    2017-01-01

    Objectives The aim of this study was to describe the incidence of feline dystocia with respect to breed. Methods The data used were reimbursed claims for veterinary care insurance and/or life insurance claims in cats registered in a Swedish insurance database from 1999-2006. Results The incidence rates for dystocia were about 22 cats per 10,000 cat-years at risk, 67 per 10,000 for purebred cats and seven per 10,000 for domestic shorthair cats. The median age was 2.5 years. A significant effect of breed was seen. An incidence rate ratio (IRR) that was significantly higher compared with other purebred cats was seen in the British Shorthair (IRR 2.5), the Oriental group (IRR 2.2), Birman (IRR 1.7), Ragdoll (IRR 1.5) and the Abyssinian group (IRR 1.5). A significantly lower IRR was seen in the Norwegian Forest Cat (IRR 0.38), the Maine Coon (IRR 0.48), the Persian/Exotic group (IRR 0.49) and the Cornish Rex (IRR 0.50). No common factor among the high-risk breeds explained their high risk for dystocia. There was no effect of location; that is, the incidence rate did not differ depending on whether the cat lived in an urban or rural area. Caesarean section was performed in 56% of the cats with dystocia, and the case fatality was 2%. Conclusions and relevance The incidence rate for dystocia was of a similar magnitude in purebred cats as in dogs. The IRR varied significantly among breeds, and the main cause for dystocia should be identified separately for each breed. A selection for easy parturitions in breeding programmes is suggested.

  5. Obstetric risk indicators for labour dystocia in nulliparous women: a multi-centre cohort study

    DEFF Research Database (Denmark)

    Kjaergaard, H.; Olsen, J.; Ottesen, Bent Smedegaard

    2008-01-01

    BACKGROUND: In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors...... for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria. METHODS: A multi-centre population based cohort study with prospectively collected data from 2810......: The following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI): dilatation of cervix

  6. Effects of twinning on gestation length, retained placenta, and dystocia.

    Science.gov (United States)

    Echternkamp, S E; Gregory, K E

    1999-01-01

    Constraints to maximal productivity from twinning in beef cattle include increased incidence of dystocia and retained placenta, longer postpartum interval, and lower conception rate. Incidence and cause(s) of the shorter gestation length and of the increased retained placenta and dystocia associated with twinning were evaluated for 3,370 single and 1,014 twin births produced in a population of cattle selected for natural twin births. Gestation length was shorter for twin than for single pregnancies (275.6 vs. 281.3 d, P.10) by parity with twin births. Because of the shorter gestation length and the increased incidence of retained placenta and(or) dystocia, achievement of increased productivity with twinning in cattle necessitates intensive management of twin-producing dams and their calves during the calving season. Management of the increased dystocia can be facilitated by preparturient diagnosis of twin pregnancies, enabling timely administration of obstetrical assistance to facilitate delivery of twin calves and to increase their neonatal survival.

  7. Identification of gene networks underlying dystocia in dairy cattle

    Science.gov (United States)

    Dystocia is a trait with a high impact in the dairy industry. Among its risk factors are calf weight, gestation length, breed and conformation. Biological networks have been proposed to capture the genetic architecture of complex traits, where GWAS show limitations. The objective of this study was t...

  8. Oxytocin in the treatment of dystocia in mice.

    Science.gov (United States)

    Narver, Heather L

    2012-01-01

    Physicians and veterinarians often prescribe oxytocin to treat dystocia. However, oxytocin administration to pregnant women or animals is not without risk. In the venue of laboratory animal medicine, the use of oxytocin may present confounding variables to research. Although oxytocin has been studied extensively, many of its physiologic effects and interactions with other hormones remain unclear. Investigator concerns about adverse and confounding effects of oxytocin in their research mice prompted the current review of oxytocin and its use to treat murine dystocia. Well-controlled studies of oxytocin in dystocic mice have not been conducted. However, in humans and other animals, inconsistent and adverse effects are well-documented. Limited knowledge of the complex physiologic and molecular mechanisms of action of oxytocin and scant support for the efficacy of oxytocin in dystocic mice fail to meet the standards of evidence-based veterinary medical practice. The administration of oxytocin is contraindicated in many cases of dystocia in research mice, and its use in dystocic mice may be unfounded. A brief review of oxytocin and the physiologic mechanisms of parturition are provided to support this conclusion. Alternative treatments for murine dystocia are discussed, and a holistic approach is advocated to better serve animal welfare and to safeguard the integrity of valuable research. Laboratory animal veterinarians overseeing the development of guidelines or standard operating procedures for technician or investigator treatment of dystocic mice should understand the effects of oxytocin administration in light of relevant research.

  9. Predictors of shoulder dystocia at the time of operative vaginal delivery.

    Science.gov (United States)

    Palatnik, Anna; Grobman, William A; Hellendag, Madeline G; Janetos, Timothy M; Gossett, Dana R; Miller, Emily S

    2016-11-01

    It remains uncertain whether clinical factors known prior to delivery can predict which women are more likely to experience shoulder dystocia in the setting of operative vaginal delivery. We sought to identify whether shoulder dystocia can be accurately predicted among women undergoing an operative vaginal delivery. This was a case-control study of women undergoing a low or outlet operative vaginal delivery from 2005 through 2014 in a single tertiary care center. Cases were defined as women who experienced a shoulder dystocia at the time of operative vaginal delivery. Controls consisted of women without a shoulder dystocia at the time of operative vaginal delivery. Variables previously identified to be associated with shoulder dystocia that could be known prior to delivery were abstracted from the medical records. Bivariable analyses and multivariable logistic regression were used to identify factors independently associated with shoulder dystocia. A receiver operating characteristic curve was created to evaluate the predictive value of the model for shoulder dystocia. Of the 4080 women who met inclusion criteria, shoulder dystocia occurred in 162 (4.0%) women. In bivariable analysis, maternal age, parity, body mass index, diabetes, chorioamnionitis, arrest disorder as an indication for an operative vaginal delivery, vacuum use, and estimated fetal weight >4 kg were significantly associated with shoulder dystocia. In multivariable analysis, parity, diabetes, chorioamnionitis, arrest disorder as an indication for operative vaginal delivery, vacuum use, and estimated fetal weight >4 kg remained independently associated with shoulder dystocia. The area under the curve for the generated receiver operating characteristic curve was 0.73 (95% confidence interval, 0.69-0.77), demonstrating only a modest ability to predict shoulder dystocia before performing an operative vaginal delivery. While risk factors for shoulder dystocia at the time of operative vaginal delivery

  10. Effects of stillbirth and dystocia on subsequent reproductive performance in Japanese Black cattle.

    Science.gov (United States)

    Sasaki, Yosuke; Uematsu, Mizuho; Kitahara, Go; Osawa, Takeshi; Sueyoshi, Masuo

    2014-06-01

    The objective of this study was to determine the effects of stillbirth and dystocia on subsequent reproductive performance in Japanese Black cattle. Data were collected for 34,763 calvings from 13,186 animals on 826 farms. Stillbirth was associated with a decreased first service conception rate compared to cows with a normal calving (44.4 versus 54.0%, respectively, P dystocia (P dystocia had inferior subsequent reproductive performance compared with those with a normal calving.

  11. Forgotten Vaginal Foreign Body Presenting as Cervical Dystocia.

    Science.gov (United States)

    Chawla, Sonia; Singla, Anshuja; Chandra, Charu; Falodia, Swati

    2016-02-01

    Generally encountered in paediatrics age group, vaginal foreign body is a rare presentation in gynaecological clinics. Inserted as a part of sexual abuse, gratification or psychiatric disorder, these foreign bodies can present with a varied symptomatology. We report a case of 22-year-old female, a victim of domestic violence, who had a foreign body inserted in the vagina which was forgotten. Later it was discovered when she presented at term with cervical dystocia.

  12. Risk Factors Profile of Shoulder Dystocia in Oman: A Case Control Study

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    Maha M. Al-Khaduri

    2014-09-01

    Full Text Available Objective: This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. Methods: A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factors, delivery, and obstetric complications were collected. Results: Dystocia was significantly associated with older maternal age, higher parity, larger BMI, diabetes, and previous record of dystocia. In addition, dystocia was associated more with vacuum and forceps deliveries. Routine traction (51% was the most used manoeuvre. Among dystocia cases, 13% were associated with fetal complications of which Erb’s Palsy was the most prevalent (79%. Conclusion: Our finding of significant associations with risk factors lays out the ground to develop a predictability index for shoulder dystocia, which would help in making it preventable. Further prospective studies are required to confirm the obtained results.

  13. Is it possible to reduce obstetrical brachial plexus palsy by optimal management of shoulder dystocia?

    Science.gov (United States)

    Doumouchtsis, Stergios K; Arulkumaran, Sabaratnam

    2010-09-01

    Obstetrical brachial plexus palsies (OBPP) have been historically attributed to the impaction of the fetal shoulder behind the symphysis pubis and to excessive lateral traction of the fetal head during maneuvers to deliver the fetal shoulders in shoulder dystocia. Shoulder dystocia is indeed a major risk factor as it increases the risk for OBPP 100-fold. The incidence of OBPP following shoulder dystocia varies widely from 4% to 40%. However, a significant proportion of OBPPs are secondary to in utero injury. The propulsive forces of labor, intrauterine maladaptation, and compression of the posterior shoulder against the sacral promontory as well as uterine anomalies are possible intrauterine causes of OBPP. Many risk factors for OBPP may be unpredictable. Early identification of risk factors for shoulder dystocia, as well as appropriate management when it occurs, may improve our ability to prevent the occurrence of OBPP in those cases that are caused by shoulder dystocia.

  14. [Macrosomia, shoulder dystocia and elongation of the brachial plexus: what is the role of caesarean section?

    Science.gov (United States)

    Kehila, Mehdi; Derouich, Sadok; Touhami, Omar; Belghith, Sirine; Abouda, Hassine Saber; Cheour, Mariem; Chanoufi, Mohamed Badis

    2016-01-01

    The delivery of a macrosomic infant is associated with a higher risk for maternofoetal complications. Shoulder dystocia is the most feared fetal complication, leading sometimes to a disproportionate use of caesarean section. This study aims to evaluate the interest of preventive caesarean section. We conducted a retrospective study of 400 macrosomic births between February 2010 and December 2012. We also identified cases of infants with shoulder dystocia occurred in 2012 as well as their respective birthweight. Macrosomic infants weighed between 4000g and 4500g in 86.25% of cases and between 4500 and 5000 in 12.25% of cases. Vaginal delivery was performed in 68% of cases. Out of 400 macrosomic births, 9 cases with shoulder dystocia were recorded (2.25%). All of these cases occurred during vaginal delivery. The risk for shoulder dystocia invaginal delivery has increased significantly with the increase in birth weight (p dystocia affectd macrosoic infants in 58% of cases. Shoulder dystocia is not a complication exclusively associated with macrosomia. Screening for risky deliveries and increasing training of obstetricians on maneuvers in shoulder dystocia seem to be the best way to avoid complications.

  15. Neonatal injury at cephalic vaginal delivery: a retrospective analysis of extent of association with shoulder dystocia.

    Directory of Open Access Journals (Sweden)

    Cantekin Iskender

    Full Text Available PURPOSE: To describe the risk factors and labor characteristics of Clavicular fracture (CF and brachial plexus injury (BPI; and compare antenatal and labor characteristics and prognosis of obstetrical BPI associated with shoulder dystocia with obstetrical BPI not associated with shoulder dystocia. METHODS: This retrospective study consisted of women who gave birth to an infant with a fractured clavicle or BPI between January 2009 and June 2013. Antenatal and neonatal data were compared between groups. The control group (1300 was composed of the four singleton vaginal deliveries that immediately followed each birth injury. A multivariable logistic regression model, with backward elimination, was constructed in order to find independent risk factors associated with BPI and CF. A subgroup analysis involved comparison of features of BPI cases with or without associated shoulder dystocia. RESULTS: During the study period, the total number of vaginal deliveries was 44092. The rates of CF, BPI and shoulder dystocia during the study period were 0,6%, 0,16% and 0,29%, respectively. In the logistic regression model, shoulder dystocia, GDM, multiparity, gestational age >42 weeks, protracted labor, short second stage of labor and fetal birth weight greater than 4250 grams increased the risk of CF independently. Shoulder dystocia and protracted labor were independently associated with BPI when controlled for other factors. Among neonates with BPI whose injury was not associated with shoulder dystocia, five (12.2% sustained permanent injury, whereas one neonate (4.5% with BPI following shoulder dystocia sustained permanent injury (p = 0.34. CONCLUSION: BPI not associated with shoulder dystocia might have a higher rate of concomitant CF and permanent sequelae.

  16. Dystocia Due to Relative Oversized Fetus and fetal maldisposition in a Buffalo

    Directory of Open Access Journals (Sweden)

    Navneet Vasishta

    Full Text Available A primiparous Murrah graded buffalo suffering with dystocia due to relative oversize fetus and fetal maldisposition and its successful management following laparohysterotomy has been described. [Vet. World 2011; 4(12.000: 569-570

  17. Fetal sonographic characteristics associated with shoulder dystocia in pregnancies of women with type 1 diabetes

    DEFF Research Database (Denmark)

    Secher, Anna L; Bytoft, Birgitte; Tabor, Ann

    2015-01-01

    INTRODUCTION: Shoulder dystocia is a rare but severe complication of vaginal delivery and diabetic women are at high risk. The aim of this study was to identify fetal sonographic and maternal glycemic characteristics associated with shoulder dystocia in pregnant women with type 1 diabetes. MATERIAL...... AND METHODS: Twelve cases (5%) of shoulder dystocia among 241 consecutive vaginal deliveries in women with type 1 diabetes followed at Rigshospitalet University Hospital in 2009-2013 were retrospectively identified in a local database. Fetal sonographic and clinical data were compared with 69 women with type...... 1 diabetes and uncomplicated vaginal deliveries. RESULTS: Women experiencing shoulder dystocia compared with women with uncomplicated deliveries had a higher glycated hemoglobin (HbA1c) in early pregnancy [median 7.0% (range 5.9-8.1) vs. 6.6% (range 5.4-10.0, P = 0.04)], whereas in late pregnancy...

  18. VAGINAL DELIVERY OF GIANT FETUS – SHOULDER DYSTOCIA

    Directory of Open Access Journals (Sweden)

    Jasmina Popović

    2009-04-01

    Full Text Available Shoulder dystocia (SD is defined as unpredictable and urgent obstetric complication that happens when the pelvis of a mother is spread sufficiently to deliver fetal head, but insufficiently to deliver fetal shoulders. It is associated with high percentage of maternal and fetal morbidity. Fetal lethality from hypoxia ranges from 2-16%.We observed the case of vaginal delivery in a multiparous woman in the 39th gestational week. Head delivery was performed by using vacuum extraction. Because of the shoulder dystocia, we applied McRoberts’ maneuver with Resnik’s suprapubic pressure and performed one more episiotomy. Since these maneuvers did not give the expected result, we did the aspiration of the upper respiratory paths of the fetus, after which we performed Hibbard’s cord with simultaneous Kristeler’s maneuver. It led to releasing the shoulders and fetal delivery. On delivery, male fetus was 6000 g/60 cm, estimated with Apgar 1. The urgent reanimation was undertaken. After few hours, the baby was transferred to Pediatric Surgical Clinic for further treatment of present pneumotorax and humerus fracture. After many days, the baby being in normal state, was referred to physical rehabilitation treatment. Today, the baby is without sequelae.SD is one of the most difficult, hardly predictable perilous obstetric complications with high percentage of maternal morbidity and fetal morbidity and mortality. It requires caution, training and skills of obstetric-neonatal team. Liberalization of the use of Caesarian section in managing SD decreases the appearance of injuries in both mother and child. However, regardless of very rapid development of perinatology and the use of modern diagnostic-therapeutic protocols, some questions from classical, practical obstetrics remain unanswered.

  19. Dystocia in Formosan sambar deer (Cervus unicolor swinhoei) in semi-domesticated herds.

    Science.gov (United States)

    Su, N-Y; Hsu, T-H; Tung, K-C; Tsai, H-Y; Chan, J P-W

    2010-06-19

    Over a nine-year period (2000 to 2008), 22 instances of dystocia and 50 normal fawnings in Formosan sambar deer (Cervus unicolor swinhoei) hinds from semi-domesticated herds were investigated. The majority of the hinds (17, 77.3 per cent) that suffered dystocia were categorised as having a body condition score (BCS) in the medium range (between 2.5 and 3.5 inclusive), indicating that there was no significant relationship between obesity (BCS >3.5) in hinds and the occurrence of dystocia. In addition, maternal body condition had no effect on the birthweight of the offspring. Among the 22 instances of dystocia, 16 of the fawns (72.7 per cent) did not survive; one of these deaths was anteparturient and the other 15 were parturient. Eighteen (81.8 per cent) of the cases of dystocia involved male fawns, and 15 (93.8 per cent) of the deaths were of male fawns (P=0.044). Nine (40.9 per cent) of the instances of dystocia resulted from maternal excitement, mainly attributable to disturbances caused by human beings. In 12 of the cases that resulted in the death of the fawn, the request for veterinary assistance had been delayed at least one day. There were six cases in which the fawns survived; these were the ones that had received assistance within six hours after the onset of parturition.

  20. Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study

    Directory of Open Access Journals (Sweden)

    Ottesen Bent

    2008-10-01

    Full Text Available Abstract Background In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria. Methods A multi-centre population based cohort study with prospectively collected data from 2810 nulliparous women in term spontaneous labour with a singleton infant in cephalic presentation. Data were collected by self-administered questionnaires and clinical data-records. Logistic regression analyses were used to estimate adjusted Odds Ratios (OR and 95% confidence intervals (CI are given. Results The following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI: dilatation of cervix Conclusion Vaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern.

  1. The obstetric nightmare of shoulder dystocia: a tale from two perspectives.

    Science.gov (United States)

    Beck, Cheryl Tatano

    2013-01-01

    Shoulder dystocia is one of the most terrifying of obstetric emergencies. In this secondary analysis of two qualitative studies, the experiences of shoulder dystocia are compared and contrasted from two perspectives: the mothers and the labor and delivery nurses. In the first study mothers' experiences of shoulder dystocia and caring for their children with obstetric brachial plexus injuries were explored. The second study explored secondary traumatic stress in labor and delivery nurses due to exposure to traumatic births. Krippendorff's content analysis technique of clustering was used to identify data that could be grouped together into themes. It was striking how similar the perspectives of mothers and their nurses were regarding a shoulder dystocia birth. Four themes emerged from the content analysis of these two data sets: (1) in the midst of the obstetric nightmare; (2) reeling from the trauma that just transpired; (3) enduring heartbreak: the heavy toll on mothers; and (4) haunted by memories: the heavy toll on nurses. Providing emotional support to the mother during shoulder dystocia births and afterward in the postpartum period has been acknowledged. What now needs to be added to best practices for shoulder dystocia are interventions for the nurses themselves. Support for labor and delivery nurses who are involved in this obstetric nightmare is critical.

  2. A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

    OpenAIRE

    Dykes Anna-Karin; Dejin-Karlsson Elisabeth; Finnbogadóttir Hafrún

    2011-01-01

    Abstract Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based ...

  3. Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset.

    Science.gov (United States)

    Kjaergaard, Hanne; Olsen, Jørn; Ottesen, Bent; Dykes, Anna-Karin

    2009-01-01

    To estimate the incidence of dystocia among nulliparous women without apparent co-morbidity and to examine maternal and fetal short-term outcomes after dystocia. A multi-center cohort study with prospectively collected data. Nine obstetric departments with annual birth rates between 850 and 5,400. Low-risk nulliparous women in term spontaneous labor with a singleton fetus in cephalic presentation. Follow-up of 2,810 nulliparas using self-administered questionnaires supplemented with clinical records. CRITERIA FOR DYSTOCIA: Cervical dilatation labor or no descent during two hours (three hours with epidural analgesia) in the descending phase of second stage or no progress for one hour during the expulsive phase of the second stage. Inclusion took place between May 2004 and July 2005. Incidences of dystocia, maternal, and fetal outcomes. The cumulative incidence of dystocia was 37% and of the diagnoses 61% were given in the second stage of labor. Women with dystocia treated by augmentation had more cesarean and ventouse deliveries, more often non-clear amniotic fluid, more post-partum hemorrhage and their children were more often given low one-minute neonatal Apgar scores as compared to women delivered without a diagnosis of dystocia. A dystocia incidence of 37% was found in healthy term nulliparas with no indication for induction or elective cesarean delivery. The adverse maternal and neonatal birth outcomes may be related to the cause of dystocia or to augmentation of labor and this question calls for further studies.

  4. Alteration of serum haptoglobin concentration in normal parturition and dystocia affected cows

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    D.M. Aziz

    2016-08-01

    Full Text Available This study was designed to investigate the alteration in serum haptoglobin (Hp concentration in dystocia affected cows in comparison to those having normal parturition. Thirty cows included in this study, seventeen with normal parturition and thirteen with difficult parturition (dystocia. Blood samples, from cows that having normal parturition, were collected every three days during the last two weeks of gestation, at calving, 3, 7, and 10 days postpartum. Blood samples from dystocia affected cows were collected at calving, 3, 7, and 10 days postpartum. Serum Hp concentration was determined using ELISA. The results gradual increase of Hp concentration prepartum from 190±70 mg/L at the 10th day before calving to 250±30 and 260±100 mg/L at 7th and 3rd day prepartum, respectively. At day of parturition, Hp concentration increased to 300±140 mg/L, to reach 330±150 mg/L at 3rd day postpartum. Hp concentration at 7th and 10th day postpartum declined to 230±90 and 220±160 mg/L, respectively. Serum Hp of dystocia affected cows was 360±240 mg/L at calving. At 3rd day postpartum, Hp increased to 660±220 mg/L. At 7th and 10th days postpartum, Hp concentration declined to 510±300 and 400±110 mg/L, respectively. No variation in Hp was observed between the cows giving twins and those giving single calve. There was no significant effect of dystocia causes on serum Hp at calving and at 3rd day postpartum. It be concluded that normal calving and dystocia elevated the serum Hp concentration, and insufficient dilatation of birth canal was the most effective cause of dystocia. Also comparison of serum Hp concentration at 3rd and 7th day postpartum can be used as an indicator for the development of complications.

  5. Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset

    DEFF Research Database (Denmark)

    Kjaergaard, Hanne; Olsen, Jørn; Ottesen, Bent

    2009-01-01

    OBJECTIVE: To estimate the incidence of dystocia among nulliparous women without apparent co-morbidity and to examine maternal and fetal short-term outcomes after dystocia. DESIGN: A multi-center cohort study with prospectively collected data. SETTING: Nine obstetric departments with annual birth...

  6. Cervical dilation at the time of cesarean section for dystocia - effect on subsequent trial of labor

    DEFF Research Database (Denmark)

    Abildgaard, Helle; Diness, Marie; Nickelsen, Carsten

    2012-01-01

    Objective. To investigate the effect of cervical dilation at the time of cesarean section due to dystocia and success in a subsequent pregnancy of attempted vaginal delivery. Design. Retrospective study. Setting. University hospital in Copenhagen capital area. Population. All women with a prior...... cesarean section due to dystocia who had undergone a subsequent pregnancy with a singleton delivery during 2006-2010. Methods. Medical records were reviewed for prior vaginal birth, cervical dilation reached before cesarean section and induction of labor, gestational age, use of oxytocin, epidural...... anesthesia and mode of birth was collected. Results. A total of 889 women were included; 373 had had a trial of labor. The success rate for vaginal birth among women with prior cesarean section for dystocia at 4-8 cm dilation was 39%, but 59% for women in whom prior cesarean section had been done at a fully...

  7. Fetal macrosomia and shoulder dystocia in women with gestational diabetes: risks amenable to treatment?

    Science.gov (United States)

    Young, Brett C; Ecker, Jeffrey L

    2013-02-01

    Fetal macrosomia and maternal diabetes are independent risk factors for shoulder dystocia, an obstetrical emergency that may cause permanent neonatal injury. Randomized trials of glycemic control in pregnancies complicated by gestational diabetes reveal decreased rates of macrosomia and shoulder dystocia among those treated. However, definitions of gestational diabetes vary and a specific glycemic threshold for clinically significant risk reduction remains to be delineated. This review discusses risks associated with gestational diabetes including macrosomia (birth weight above 4000-4500 g) and delivery-related morbidity, specifically, shoulder dystocia. Subsequently, we will review recent randomized trials assessing the impact of glycemic control on these delivery-related morbidities. Finally, we will examine a large observational study that found associations with delivery-related morbidity and hyperglycemia below current diabetic thresholds, observations which may suggest reexamination of current diagnosis guidelines for gestational diabetes.

  8. Use of birth weight threshold for macrosomia to identify fetuses at risk of shoulder dystocia among Chinese populations.

    Science.gov (United States)

    Cheng, Yvonne K-Y; Lao, Terence T; Sahota, Daljit S; Leung, Viola K-T; Leung, Tak Y

    2013-03-01

    To assess the incidence of macrosomia and the influence of birth weight on shoulder dystocia risk among a cohort of Chinese women. A retrospective analysis was conducted of 80953 singleton deliveries recorded at the Prince of Wales Hospital, Hong Kong, between 1995 and 2009. The incidences of macrosomia (birth weight ≥ 4000 g) and shoulder dystocia were assessed by birth weight; risk factors for shoulder dystocia were examined by multiple logistic regression analysis. The incidence of macrosomia was 3.4%. The overall incidence of shoulder dystocia was 0.3%; however, the incidence rose with increasing birth weight. The odds ratio (OR) for a birth weight of 4000-4199 g was 22.40, while the OR for a birth weight of 4200 g or above was 76.10. Other independent risk factors for shoulder dystocia included instrumental delivery (OR 12.11), short stature (OR 2.16), maternal diabetes mellitus (OR 1.78), and obesity (OR 1.58). Although the overall incidences of macrosomia and shoulder dystocia were low, the risk of shoulder dystocia was strongly linked to increasing birth weight. International guidelines for elective cesarean delivery in suspected cases of macrosomia may not, therefore, apply to Chinese women. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. An Investigation on Body Condition Score, Body Weight, Calf Weight and Hematological Profile in Crossbred Dairy Cows Suffering from Dystocia

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    Hamit Yıldız*, Nevzat Saat and Halil Şimşek1

    2011-04-01

    Full Text Available The knowledge of hematological values is useful in diagnosing various pathological and metabolic disorders, which can adversely affect reproductive performance of cows. The aim of this study was to investigate body condition score (BCS, body weight, calf weight, blood erythrocyte parameters and total and differential leukocyte count changes in dystocia-affected crossbred dairy cows. Values of mean corpuscular volume (MCV and neutrophil count were markedly increased (P<0.001 in the dystocia group compared to normal calving group. The levels of mean corpuscular haemoglobin concentration (MCHC and hematocrit in dystocia-affected cows were significantly lower (P<0.001 than normal control group. However, in cow suffering from dystocia, counts of the white blood cells (WBC, red blood cells (RBC, haemoglobin concentration, mean corpuscular haemoglobin (MCH, eosinophils, basophils, lymphocytes and monocytes were not different from the normal parturient group. In cows with dystocia, BCS, age and parity of dams did not show significant difference compared to normal parturition. However, body weight in cows with difficult calving was lower (P<0.05 than spontaneous calving cows. These results suggest that hematocrit, MCV, MCHC and neutrophil counts were significantly affected due to dystocia in cattle. BCS, age and parity of the cow had no affect on the occurrence of dystocia.

  10. A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

    Directory of Open Access Journals (Sweden)

    Dykes Anna-Karin

    2011-02-01

    Full Text Available Abstract Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1% met the protocol criteria for dystocia. Results Among the total cohort, 940 (35.4% women reported experience of violence, and among these, 66 (2.5% women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26 of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08, OR 0.90, 95% CI (0.54-1.50, respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96. Conclusions Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

  11. Risk factors for calving assistance and dystocia in pasture-based Holstein-Friesian heifers and cows in Ireland.

    Science.gov (United States)

    Mee, J F; Berry, D P; Cromie, A R

    2011-02-01

    The incidence of and risk factors associated with calving assistance and dystocia in pasture-based dairy herds were determined from analysis of 152,641 records of full-term calvings from Holstein-Friesian dams served by artificial insemination (AI) sires of seven breeds in herds of 20 calvings or more per year over 4 years. The overall incidence of calving assistance and dystocia was 31.1% and 6.8%, respectively. The incidence in primiparae and pluriparae was 40.0% and 28.2% for assistance, and 9.3% and 5.8% for dystocia, respectively. Association analyses were undertaken using generalised estimating equations using a logit link function. The likelihood of calving assistance or dystocia did not change over time but was greatest in autumn and in spring. The likelihood of calving assistance or dystocia was greater for males in primiparae and males sired by Charolais sires. The odds of calving assistance and dystocia were greater in twin calves (OR 2.0 and 2.4; Pdystocia at the previous calving (OR 1.65 and 2.9; Pdystocia increased linearly per unit increase in sire predicted transmitting ability for direct calving difficulty. The probability of assisted calving, but not dystocia, increased linearly in primiparae as animals calved at a younger age relative to the median age at first calving. Herd size and day of the week of calving were not associated with the odds of dystocia. Stakeholders must focus on identified modifiable risk factors to control the incidence of dystocia in dairy herds.

  12. Parturition, dystocia and foal survival: a retrospective study of 1047 births.

    Science.gov (United States)

    McCue, P M; Ferris, R A

    2012-02-01

    An understanding of the normal events of foaling, causes of dystocia and clinical outcomes is important for equine practitioners. The goals of the present study were to: 1) evaluate factors that influence gestation length; 2) report duration of Stage II labour; 3) determine the frequency of dystocia and premature placental separation; and 4) determine the relationship between problems at foaling and foal survival. Foaling records of 1047 mare births were evaluated. The average gestation length was 342.7 days [corrected] +/- 0.4 days, with no effect of mare age or breed observed. Mares carrying male fetuses had a longer gestation (P births and the incidence rate was higher in Thoroughbred mares than in Quarter Horse mares. The most common cause of dystocia was abnormalities of fetal posture. A delay in foal delivery beyond 40 min of Stage II of labour was associated with a significant increase in foal mortality. In addition, an increase in foal morbidity and mortality was noted when the interval from birth to standing or birth to nursing was prolonged. Early detection and rapid appropriate intervention are critical to foal survival in an equine dystocia. Equine veterinarians should counsel horse owners that early recognition of a foaling problem and rapid, appropriate intervention are critical to the survival of a foal.

  13. Dystocia in sheep and goats: outcome and fertility following surgical and non-surgical management

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    Zuhair Bani Ismail

    2017-03-01

    Full Text Available Cesarean section is a life-saving surgical procedure usually undertaken in sheep and goats that fail to deliver vaginally (dystocia. Unfortunately, there are no recent review articles in literature that summarize the results of published case reports and clinical trials concerning indications, surgical approaches and procedures and outcomes following cesarean section in sheep and goats. Therefore, the aim of this article was to compile available data related to dystocia and cesarean section in small ruminants. Fortunately, the incidence of dystocia in small ruminants is considered to be low. It can be caused by either maternal or fetal factors. Maternal-related dystocia is most commonly because of failure of cervical dilation, narrow birth canal and uterine inertia. Those related to fetal causes are usually associated with fetal malposition/presentation, feto-pelvic disproportion/fetal oversize, and fetal malformation. Manual extraction of the fetus may be attempted in most cases, however, early surgical intervention by performing cesarean section ensures satisfactory outcome. Cesarean section is usually performed in lateral recumbency through left paralumbar fossa or left paralumbar fossa oblique celiotomy under local analgesia. The success rates and post-operative complications in sheep and goats are underreported; however, early surgical intervention using aseptic technique usually results in a satisfactory outcome for both the dam and newborn with acceptable prognosis for future breeding soundness.

  14. Dystocia in dairy cattle breeding [:with special attention to sire evaluation for categorical traits

    NARCIS (Netherlands)

    Meijering, A.

    1986-01-01

    Field data recorded in the early seventies showed that dystocia (calving difficulty) in the main Dutch cattle breeds occurred at a rate of 15-17% in heifers and 5-6% in cows. Corresponding stillbirth rates were 9-12% and 2.5-3.5% respectively. In the sixties and seventies many research papers on

  15. The impact of dystocia on dairy calf health, welfare, performance and survival.

    Science.gov (United States)

    Barrier, A C; Haskell, M J; Birch, S; Bagnall, A; Bell, D J; Dickinson, J; Macrae, A I; Dwyer, C M

    2013-01-01

    Up to one-third of dairy calves are born after dystocia and this is a major cause of calf mortality. This study investigated the neonatal physiology, survival, health and subsequent growth of dairy calves following dystocia and is the first longitudinal study to analyse multiple effects and to look beyond the perinatal period. A total of 455 live born Holstein calves (N: No assistance, n=360; FN: Farmer assistance but normally presented calf, n=82; FM: Farmer assistance of malpresented calf, n=13) were followed from birth to first service (heifers) or until leaving the farm (bulls). Compared to N calves, FN and FM animals had higher salivary cortisol concentrations at day 1 (PDystocia had no biologically significant impact on rectal temperature throughout the first 4 days (P>0.05). During the first 60 days, FM calves had a higher proportion of days with non-routine health treatments (Pdystocia category (P>0.05). Calves which survive dystocia experience lower passive immunity transfer, higher mortality and higher indicators of physiological stress. Such calves have poorer welfare in the neonatal period and possibly beyond. Strategies need to be implemented to improve the subsequent health and welfare of such calves and to lower the incidence of dystocia.

  16. Dystocia in dairy cattle breeding. With special attention to sire evaluation for categorical traits.

    NARCIS (Netherlands)

    Meijering, A.

    1986-01-01

    Field data recorded in the early seventies showed that dystocia (calving difficulty) in the main Dutch cattle breeds occurred at a rate of 15-17% in heifers and 5-6% in cows. Corresponding stillbirth rates were 9-12% and 2.5-3.5% respectively. In the sixties and seventies many research papers on dys

  17. A new application of pelvis area data as culling tool to aid in the management of dystocia in heifers.

    Science.gov (United States)

    Holm, D E; Webb, E C; Thompson, P N

    2014-05-01

    Although fetomaternal disproportion is the major cause of dystocia in heifers, pelvis area (PA) is not recommended as a culling tool due to its relatively low importance and genetic correlation with calf birth weight (BWT), the most important factor associated with dystocia. The objective of this observational study of 484 limited bred yearling beef heifers was to compare the effects of different methods of adjustment of PA data for culling to select against dystocia. Multivariable analyses were used to determine predictors of PA, calf BWT, and dystocia. Hypothetical culling rates of 10 and 20% were then applied after ranking heifers by each of the following: unadjusted PA, PA adjusted to 365 d of age by subtracting 0.27 cm(2) per day of age difference between each heifer's age and 365 d (APA), PA:prebreeding BW ratio (PA:BW), PA adjusted to the median BW of the group using the regression coefficient of PA on BW within age group (BWPA), and PA similarly adjusted to the median lean BW (LBWPA). Dam parity, sire, prebreeding age, prebreeding BW, and prebreeding BCS were associated with PA whereas dam parity, sire, own BWT, PA, AI bull, and calf gender were associated with calf BWT (P dystocia (P dystocia. After hypothetical culling by PA, retained heifers were heavier and had a higher calving rate and calves tended to be heavier at birth compared to culled heifers, but dystocia rates were not different. Culling by APA resulted in similar effects, except that dystocia rate tended to be lower in retained heifers. Culling by PA:BW resulted in lower dystocia rate in retained than in culled heifers, but retained heifers had lower prebreeding BW than culls. Culling by BWPA and LBWPA resulted in lower proportions with dystocia and a tendency towards higher calving rates in the retained heifers, without affecting the prebreeding BW or calf BWT. It is concluded that pelvimetry is a useful culling tool to aid in the management of dystocia in yearling heifers and that adjustment

  18. Establishing Criteria for a Method to Automatically Detect the Onset of Parturition and Dystocia in Breeding Pigs

    OpenAIRE

    Gutierrez, Winson-Montanez; Kim, Dae-Geun; Kim, Dong-Hyeok; Kim, Suk; Le, Seung-Joo; Kim, Byeong-Woo; Hong, Jong-Tae; Yu, Byeong-Ki; Kim, Hyuck-Joo; Oh, Taek-Keun

    2011-01-01

    The aims of the present study were to characterize the farrowing process in gilts and multiparous sows in terms of duration of farrowing, birth intervals, birth weight, piglets born alive, stillbirth, mummified and dystocia by comparing means in terms of parities, and to establish criteria for a method to automatically detect the first birth and dystocia in breeding pigs for a selected farm in South Korea. One hundred nine Yorkshire x Landrace; YL, Landrace x Yorkshire; LY which were mainly r...

  19. Serum Progesterone and Estradiol-17β Profiles in Nili Ravi Buffaloes (Bubalus bubalis with and without Dystocia

    Directory of Open Access Journals (Sweden)

    Muhammad Amjad Ali, Laeeq Akbar Lodhi and Faiz-ul-Hassan1*

    2012-10-01

    Full Text Available The aim of this study was to compare serum hormone profiles (progesterone and estradiol-17β in buffaloes with dystocia and unassisted calving in three agro-ecological zones of Punjab, Pakistan. One hundred and seventy three buffaloes (n=173 with assisted (dystocia and unassisted calving (normal birth were sampled for study. The results showed that the buffaloes suffering with dystocia had significantly higher (P<0.05 mean serum progesterone level compared with those having normal calving. The comparison amongst the agro-ecological zones revealed that serum progesterone level of dystocia cases in buffaloes of northern irrigated zone was significantly lower (P<0.05 compared with those in the southern irrigated zone and the arid zone, whereas the latter two did not differ between each other. No difference was observed in serum progesterone levels in normal buffaloes when compared amongst three agro-ecological zones. The serum estradiol-17β profile showed a significant (P<0.05 lower level in buffaloes with dystocia as compared to those with normal calving. Mean serum estradiol-17β level in the buffaloes affected with dystocia in the northern irrigated zone was significantly lower (P<0.05 compared to those in the southern irrigated zone and the arid zone wherein the latter two did not differ between each other.

  20. Dystocia in a Rothschild Giraffe at the African Fund for Endangered Wildlife, Nairobi, Kenya

    Directory of Open Access Journals (Sweden)

    B Rono

    Full Text Available A 15-year old female Rothschild Giraffe (Giraffa camelopardalis rothschildi weighing approximately 800kg, at the African Fund for Endangered Wildlife (AFEW, Giraffe Center, Langata, Nairobi, Kenya was presented with dystocia in June 2010. This giraffe named Laura, had a protracted labor and was regularly monitored by sanctuary education staff. Dystocia was relieved on the 3rd day at this wildlife sanctuary. The giraffe was chemically immobilized by using 7mg of Etorphine Hcl (0.98% (M99® (Norvatis South Africa (Pty Limited and 50mg of Azaperone(10% (Kyron Laboratories (Pty Limited, South Africa in a Dan-Inject dart (Dan-inject APS, Sellerup Skowej, Denmark. On obstetrical examination of the giraffe, a fetal malposition type of dystocia had occurred. The fetus was positioned at posterior presentation extended posture with tail butting on the maternal pelvis, which is abnormal in giraffes. The fetus was manually extracted by using both alternate and simultaneous limb traction. The dam survived the procedure and later was reported to be in a good reproductive condition but the male fetus was a stillbirth. The fetus had died due to stress of prolonged labour. Relief of dystocia in giraffes is a difficult obstetrical procedure because obstetrical examination and relief requires chemical immobilization plus physical restrain with ropes by trained staff. Anesthesia or immobilization of giraffes remains a challenge because of the giraffe's unique anatomy and physiology. Giraffes are large animals which limits physical control and manipulation at critical times during induction and recovery of anesthesia. Giraffe's long neck if not pinned to the ground will act as a lever causing fatal injuries to self and support staff. Giraffes develop elevated systolic blood pressure; have a small respiratory tidal volume with a large dead space and relatively small cardiac output during anesthesia, which compromises safe levels of anesthesia. [Vet. World 2011; 4

  1. The Diagnostic Accuracy of Clinical and External Pelvimetry in Prediction of Dystocia in Nulliparous Women

    Directory of Open Access Journals (Sweden)

    R Alijahan

    2011-08-01

    Full Text Available Introduction: Clinical pelvimetry is very uncomfortable for the patient and is associated with subjective error, while external pelvimetry is a simple and acceptable method for patients. The objective of this study was to compare the diagnostic accuracy of clinical and external pelvimetry in prediction of dystocia in nulliparous women. Methods: In this study between December 2008 and January 2009, 447 nulliparous women with a single pregnancy in vertex presentation and gestational age 38-42 weeks referring to the Ommolbanin hospital of Mashhad were included. External pelvic dimensions were assessed at the time of admission and clinical pelvimetry was performed by another examiner. These measurements were not available to the clinician in charge of the delivery. Dystocia was defined as caesarean section and vacuum or forceps delivery for abnormal progress of labor ( active uterine contractions, arrest of cervical dilatation or cervical dilatation less than 1 cm /h in the active phase for 2 hours, prolongation of second stage beyond 2 hours or fetal head descent less than 1cm/h. Statistical tests included Fisher exact test and Chi- square test. Results: The highest sensitivity obtained from clinical pelvimetry was 33.3% and related to diagonal conjugate less than 11.5 cm. The sensitivity of external pelvic dimensions was higher than clinical pelvimetry that was highest for the Michaelis transverse diameter(60.72%. Conclusion: External pelvimetry in comparison to clinical pelvimetry is a better method for identifying dystocia in nulliparous women and can replace clinical pelvimetry in antenatal care programs.

  2. Management of fetal dystocia caused by carpal flexion in ewe: A case report

    Directory of Open Access Journals (Sweden)

    Faez Firdaus Jesse Abdullah

    2015-06-01

    Full Text Available Dystocia or difficulty in parturition in a ewe may need veterinary assistance for the successful parturition. An adult ewe weighing 30 kg was presented to the Hospital of Veterinary Medicine, Universiti Putra Malaysia with the history of difficulty in giving birth. Physical examination of the ewe revealed that the animal was weak and in recumbent position. Head of a dead fetus was observed as protruding out from the vulva region. Through physical evaluation of the ewe by per vaginal examination, the condition was diagnosed as fetal dystocia. Treatment and management plans given to the ewe were episiotomy and manipulative delivery of the dead fetus via mutation and traction method. Post-operative treatment was given with Flunixin meglumine (dosed at 2.2 mg/kg bwt for 3 days, and Norodine (dosed at 1 mL/16-kg bwt once intramuscularly. The case was completely cured after 2 weeks. The risk of losing the lamb as well as the ewe increases with delay in treatment of dystocia.

  3. Simulation for teaching normal delivery and shoulder dystocia to midwives in training.

    Science.gov (United States)

    Reynolds, A; Ayres-de-Campos, D; Pereira-Cavaleiro, A; Ferreira-Bastos, L

    2010-11-01

    The cognitive impact of using simulation sessions in midwifery training has not been the subject of previous research. The aim of this study was to compare the effect on students' knowledge of a simulation session versus an image-based lecture, for teaching routine management of normal delivery and resolution of shoulder dystocia to midwives in training. Sixty students were enrolled three weeks after a "labour and delivery" class, and randomly assigned to two groups. Ten were subsequently excluded as they were not able to attend the whole session and/or did not complete the tests. In the simulation group (n=26), students were divided into pairs and attended a 30-minute hands-on session in the simulation centre. In the lecture group (n=24), students participated in a 30-minute image-based interactive lecture. A ten-question multiple-choice test was taken before (pre-test) and after (post-test) both sessions, to evaluate students' knowledge of labour and delivery and shoulder dystocia. Learner satisfaction was evaluated by adding a six question Likert scale questionnaire to the post-test. Independent t-test, paired samples t-test, and Mann-Whitney test were used for statistical analysis, setting significance at plectures when teaching routine management of normal delivery and resolution of shoulder dystocia to midwives in training.

  4. Stillbirth in dairy calves is influenced independently by dystocia and body shape.

    Science.gov (United States)

    Barrier, A C; Mason, C; Dwyer, C M; Haskell, M J; Macrae, A I

    2013-08-01

    The objectives of this study were to determine (1) if stillborn calves born following dystocia present with specific injuries/pathological changes compared to stillborns delivered without difficulty, and (2) whether such stillborns differ in conformation from dystocic calves that survive. Post-mortem examinations were carried out on 20 stillborns that were either unassisted (N) or were 'farm-staff'-assisted/normally presented (FN) at birth. Evidence of greater trauma and bruising was observed in the FN calves and parameters such as body length, birth-weight and thyroid:body weight were similar. In a second part of the study birth-weight, body length and height, girth length, body mass (BMI), and ponderal (PI) indices were assessed in 490 calves. Regardless of the severity of dystocia, stillborns had greater body lengths and lower BMIs and PIs than calves born alive (Pdystocia. Half of the stillborns had breathed indicating they were alive and possibly had experienced pain/distress at time of delivery. Body conformation was related to stillbirth independently of dystocia, a finding likely reflecting inadequate prenatal development.

  5. Caregiver's satisfaction with a video tutorial for shoulder dystocia management algorithm.

    Science.gov (United States)

    Youssef, A; Salsi, G; Ragusa, A; Ghi, T; Pacella, G; Rizzo, N; Pilu, G

    2015-01-01

    In our questionnaire, a video tutorial illustrating the management of shoulder dystocia was considered by health personnel as a useful complementary training tool. We prepared a 5-min video tutorial on the management of shoulder dystocia, using a simulator that includes maternal pelvic and baby models. We performed a survey among obstetric personnel in order to assess their opinion on the tutorial by inviting them to watch the video tutorial and answer an online questionnaire. Five multiple-choice questions were set, focusing on the video's main objectives: clarity, simplicity and usefulness. Following the collection of answers, global and category-weighted analyses were conducted for each question. Out of 956 invitations sent, 482 (50.4%) answered the survey. More than 90% of all categories found the video tutorial to be clinically relevant and clear. For revising the management of shoulder dystocia most obstetric personnel would use the video tutorial together with traditional textbooks. In conclusion, our video tutorial was considered by health personnel as a useful complementary training tool.

  6. [Risk factors and clinical prediction of shoulder dystocia in non-macrosomia].

    Science.gov (United States)

    Li, Na; Li, Qiuling; Chang, Liang; Liu, Caixia

    2015-01-01

    To investigate the risk factors, clinical prediction and intrapartum management of shoulder dystocia in non-macrosomia. Totally 7 811 cases of vaginal delivery were retrospectively reviewed from Juanary 2009 to December 2013 in Shengjing Hospital. Shoulder dystocia was found in 11 cases (0.14% , 11/7 811), including 1 case of macrosomia and 10 cases of non-macrosomia (shoulder dystocia group). Each non-macrosomia shoulder dystocia case was matched with 10 cases of normal delivery in the same week, which were selected randomly as the control group. The tendency and risk factors of shoulder dystocia in macrosomia and non-macrosomia were analyzed, and the following data between the two groups were compared, including the height of uterus fundus, abdominal circumference of the pregnant woman, the increasing of body mass index (BMI), fetal biparietal diameter (BPD), fetal femur length (FL), duration of every stage of labor, birth weight of the newborn, head circumference and chest circumference of the newborn, Apgar score. (1) There were 213 macrosomias among the 7 811 vaginal deliveries, with the incidence of 2.73% (213/7 811). Only 1 shoulder dystocia was macrosomia (0.46%, 1/213); while the other 10 cases were non-macrosomia ( 0.13%, 10/7 598). (2) From 2009 to 2013, the macrosomia happened by 24 cases (2.32%, 24/1 034), 42 cases (3.61%, 42/1 164), 46 cases (2.60%, 46/1 772), 62 cases (3.01%, 62/2 060), 39 cases (2.19%, 39/1781), respectively. The incidence of macrosomia had no significant difference among these 5 years (P > 0.05). The shoulder dystosia occurrence without macrosia in these 5 years were 1 case ( 0.10% , 1/1 034), 3 cases (0.26%, 3/1 164), 2 cases ( 0.11%, 2/1 172), 2 cases (0.10%, 2/2 060), 2 cases ( 0.11%, 1/1 781), respectively. The incidence of shoulder dystocia without macrosomia had no significant difference among these 5 years (P > 0.05). (3) In the should dystocia group, 5 cases were complicated with premature rupture of membrane (5/10), 4

  7. Dystocia, stillbirth, gestation length, and birth weight in Holstein, Jersey, and reciprocal crosses from a planned experiment.

    Science.gov (United States)

    Olson, K M; Cassell, B G; McAllister, A J; Washburn, S P

    2009-12-01

    Holstein and Jersey cows were mated to 4 Holstein (H) bulls and 4 Jersey (J) bulls to create HH, HJ, JH, and JJ genetic groups (sire breed listed first) in a diallele crossbreeding scheme. Calvings (n = 756) occurred in research herds in Virginia, Kentucky, and North Carolina with 243, 166, 194, and 153 calvings in the HH, HJ, JH, and JJ groups, respectively. Birth weights (BW), dystocia scores (0 for unassisted and 1 for assisted), and stillbirth (0 for alive or 1 for dead within 48 h) were recorded at calving. Gestation lengths (GL) were determined from breeding dates. An animal model was used to analyze BW and GL, and an animal model with logistic regression was used for dystocia and stillbirth. Fixed effects considered for model inclusion were genetic group, herd-year-season, sex, parity (primiparous or multiparous), twin status, and gestation length. Genetic group and effects significant in the model building process were kept in the final model for each trait. Heifer calves had lower BW, shorter GL, and had a lower odds ratio (0.53) for dystocia than bull calves. Twins had lower BW, shorter GL, were 3.86 times more likely to experience dystocia, and 7.80 times more likely to be stillborn than single births. Primiparous cows had calves with lower BW, shorter GL, were 2.50 times more likely to require assistance at birth, and were 2.35 times more likely to produce stillborns than calves from multiparous cows. Genetic group did not affect GL. Least squares means (kg) for BW were 37.7 +/- 1.1, 29.1 +/- 1.1, 30.3 +/- 1.0, and 22.5 +/- 1.3 for HH, HJ, JH, and JJ, respectively. Animals in HH weighed more than animals of other genetic groups; the JJ group had the smallest BW, with no differences for BW between HJ and JH. Probability of dystocia in JJ and JH were 5.73% and 18.98% of HH. Calves in HJ and HH were not different for dystocia. Calves in HJ were 3.38 times more likely to be stillborn than calves in JH, but no other genetic group differences were significant

  8. Risk indicators for dystocia in low-risk nulliparous women: a study on lifestyle and anthropometrical factors

    DEFF Research Database (Denmark)

    Kjaergaard, H; Dykes, A K; Ottesen, B

    2010-01-01

    .45-0.89), contrary to a non-significant finding of intensive physical training (OR 1.57, CI 0.84-2.93). Caffeine intake of 200-299 mg/day was associated with dystocia (OR 1.37, CI 1.04-1.80); also high maternal age (OR 2.25, CI 1.58-3.22), small stature (OR 2.18, CI 1.51-3.15) and pre-pregnancy overweight (OR 1.......28, CI 1.02-1.61). No association was found between dystocia and alcohol intake, smoking, night sleep and options for resting during the day....

  9. Two-step delivery may avoid shoulder dystocia: head-to-body delivery interval is less important than we think.

    Science.gov (United States)

    Kotaska, Andrew; Campbell, Kim

    2014-08-01

    A belief that prolonged head-to-body delivery interval endangers the newborn underpins the common obstetrical practice of delivering the baby's trunk immediately after the head is born. Without intervention, however, birth typically occurs in two steps: once the fetal head is delivered there is usually a pause, and the rest of the infant is born with the next contraction. Allowing a two-step delivery does not increase the risk of fetal harm, and may lower the incidence of shoulder dystocia. A two-step approach to delivery should be considered physiologically normal. This has implications for the definition of shoulder dystocia.

  10. Dystocia due to schistosomus reflexus (cojoined twins in a Yankassa ewe

    Directory of Open Access Journals (Sweden)

    Ambali Hauwa Motunrayo

    2015-04-01

    Full Text Available A two years' old, white and brown Yankassa ewe, weighing 20 kg was presented with dystocia of about 48 h duration at Mabs Veterinary Centre Ltd, Lagos. On thorough physical and vaginal examination, there were evidences of feotal parts and foul smelling discharges per vagina. A systematic and calculated traction and retropulsion revealed schistosomus reflexus cojoined twins. There was a complete recovery of the ewe 3 days post operative management. Finally, this case reported a true schistosomus reflexus cojoined twins in Yankassa ewe which was successfully relieved through traction and retropulsion despite the supposedly small birth canal which precluded the procedure in ewes except for caesarian section or fetotomy

  11. [Dystocia risk score: a decision making tool to combat maternal mortality].

    Science.gov (United States)

    Ndiaye, Papa; Niang, Khadim; Diallo, Issakha

    2013-01-01

    As a way to prevent maternal mortality and stillbirth, the dystocia risk score includes three components: a left column provides a list of eight characteristics to check for in the woman; an upper horizontal section provides a checklist of possible outcomes of the pregnancy itself: and a rectangular grid indicates the prognosis in three zones: a large red (dangerous), a medium-sized grey (doubtful) and a small blue (hopeful). The DRS is positive if there is at least one cross in the dangerous zone and/or two crosses in the doubtful zone (it indicates that the woman should be referred to a center specialized in obstetric emergency care); elsewhere, the DRS is negative. The validation test gives good results (sensitivity=83.61%, specificity=90.05%, positive predictive value=72.34%, and negative predictive value=94.04%). Its large-scale use would accelerate the identification of pregnant women with a high risk of dystocia. Their timely referral to specialized emergency obstetrics centers would increase the efficacy of care and reduce the levels of maternal mortality and stillbirth.

  12. 103例头位难产临床研究%103 Cases of Head Dystocia Clinical Studies

    Institute of Scientific and Technical Information of China (English)

    李先银

    2014-01-01

    Objective:To investigate the clinical characteristics of head dystocia and treatment measures.Method:The clinical data of 103 patients with head dystocia were analyzed retrospectively.Result:Cesarean section in 65 cases(63.1%),vaginal delivery in 38 cases(36.9%);persistent occipitoposterior position,occiput transverse position was the main reason leading to head dystocia;dystocia causes uterine atony,postpartum hemorrhage.Conclusion:The incidence of head during childbirth is higher,large and complex reasons,the early recognition and to take effective measures to prevent and control.%目的:探讨头位难产的临床特点以及处理方法。方法:回顾性分析103例头位难产孕产妇的临床资料。结果:剖宫产65例(63.1%),阴道助产38例(36.9%);持续性枕后位、枕横位是导致头位难产的主要原因;头位难产会引发子宫收缩乏力、产后出血等。结论:头位难产的发病率较高,原因众多且复杂,需早期识别并采取有效的防治措施。

  13. 肩难产临床8例助产体会%Clinical experience of 8 cases of shoulder dystocia midwifery

    Institute of Scientific and Technical Information of China (English)

    徐素琴

    2013-01-01

    目的:本文通过对8例肩难产进行回顾性分析。方法总结分析8例肩难产的临床助产资料。结果8例肩难产通过有效的助产,胎儿均健康出院。结论对于肩难产的产妇,针对临床不同的情况,须立即采取合适的助产方法,结局满意。%Objective to based on 8 cases of shoulder dystocia were retrospectively analyzed. Methods summarize clinical midwifery data of 8 cases of shoulder dystocia. Results 8 cases of shoulder dystocia through effective midwifery, fetal health hospital. Conclusion for maternal shoulder dystocia, according to different clinical situation, must immediately take appropriate midwifery method, result satisfaction.

  14. A Case of Dystocia Induced by Misuse of Oxytocin in a Boerboel Bitch

    Directory of Open Access Journals (Sweden)

    Khalid Talha Biobaku

    2016-10-01

    Full Text Available A two year old boerboel bitch with dark greenish vaginal discharge and history of over 24 hours of difficult labor was presented to the Veterinary Teaching Hospital University of Ibadan for clinical examination and treatment. The owner had wrongfully given oxytocin after observation of signs of parturition. Following careful physical and clinical examinations of the bitch by Veterinary doctors, dystocia due to obstruction of maternal birth canal by a dead fetus was diagnosed. Treatment regimen was by digital manipulation which stimulated cervical dilatation and careful delivery of dead fetus via the vagina. Thereafter, oxytocin was administered to augment the bitch’s weak uterine contraction. Four weak puppies were delivered out of which three survived following adequate treatment.

  15. Hip Dislocation and Dystocia in Early Medieval Times: Possible Evidence of Labor Maneuver.

    Science.gov (United States)

    Malgosa, Assumpció; Carrascal, Susana; Piga, Giampaolo; Isidro, Albert

    2016-12-01

    In ancient times, maternal mortality would occur frequently, particularly during labor. Evidence of dystocia resulting in the death of a pregnant woman is very infrequent in paleopathologic literature, with only a few cases being demonstrated. In the early medieval site of Casserres, the skeleton of a young woman with a fetus in the pelvic region was found. Some abnormal findings of the maternal skeleton were evaluated, including a sacral anomaly, femoral head wound, the rare position of the lower left limb with the femoral head dislodged anteriorly and cephalad from the socket, and a fibular fracture. Examining the anomalies all together, a case of anterior hip dislocation related to a McRoberts-like maneuver performed during labor is a plausible explanation of the findings.

  16. Cyclopia with shoulder dystocia leading to an obstetric catastrophe: a case report

    Directory of Open Access Journals (Sweden)

    Metgud Mrityunjay C

    2010-05-01

    Full Text Available Abstract Introduction Cyclopia is a rare fetal malformation characterized by a single palpebral fissure and a proboscis associated with severe brain malformations. Approximately 1.05 in 100,000 births including stillbirths are identified as cyclopean. The prevalence is about one in 11,000 to 20,000 in live births and one in 250 during embryogenesis. Case presentation A 30-year-old Indian woman of Asian origin, sixth gravida, was referred to the labor room of our hospital. There were no ultrasound examinations performed during this pregnancy as our patient had not received regular antenatal care. We found out that the head of her baby was already outside the vulva but the remaining parts of the baby were not yet delivered. Further examination was carried out and a diagnosis of shoulder dystocia with intrauterine fetal demise was made. A stillborn baby boy of 3.5 kg was delivered using McRoberts' maneuver. The baby was suspected of having features of cyclopia and this was later confirmed by autopsy and anatomic correlation. The mother had a cervical tear which extended into the lower segment of her uterus, thus leading to the rupture of her uterus. There was a massive broad ligament hematoma on the left side of her uterus. A total abdominal hysterectomy was carried out. Conclusion Prenatal diagnosis by ultrasound examination might help in detecting cyclopia and preventing complications associated with this condition. However, in developing countries where women do not receive regular antenatal care and do not undergo prenatal diagnosis, such cases will go undetected. In our case report, the occurrence of shoulder dystocia could be coincidental, as no risk factors were previously noted.

  17. Uterine dysfunction in biglycan and decorin deficient mice leads to dystocia during parturition.

    Directory of Open Access Journals (Sweden)

    Zhiping Wu

    Full Text Available Cesarean birth rates are rising. Uterine dysfunction, the exact mechanism of which is unknown, is a common indication for Cesarean delivery. Biglycan and decorin are two small leucine-rich proteoglycans expressed in the extracellular matrix of reproductive tissues and muscle. Mice deficient in biglycan display a mild muscular dystrophy, and, along with mice deficient in decorin, are models of Ehlers-Danlos Syndrome, a connective tissue anomaly associated with uterine rupture. As a variant of Ehlers-Danlos Syndrome is caused by a genetic mutation resulting in abnormal biglycan and decorin secretion, we hypothesized that biglycan and decorin play a role in uterine function. Thus, we assessed wild-type, biglycan, decorin and double knockout pregnancies for timing of birth and uterine function. Uteri were harvested at embryonic days 12, 15 and 18. Nonpregnant uterine samples of the same genotypes were assessed for tissue failure rate and spontaneous and oxytocin-induced contractility. We discovered that biglycan/decorin mixed double-knockout dams displayed dystocia, were at increased risk of delayed labor onset, and showed increased tissue failure in a predominantly decorin-dependent manner. In vitro spontaneous uterine contractile amplitude and oxytocin-induced contractile force were decreased in all biglycan and decorin knockout genotypes compared to wild-type. Notably, we found no significant compensation between biglycan and decorin using quantitative real time PCR or immunohistochemistry. We conclude that the biglycan/decorin mixed double knockout mouse is a model of dystocia and delayed labor onset. Moreover, decorin is necessary for uterine function in a dose-dependent manner, while biglycan exhibits partial compensatory mechanisms in vivo. Thus, this model is poised for use as a model for testing novel targets for preventive or therapeutic manipulation of uterine dysfunction.

  18. Neonatal clinical evaluation, blood gas and radiographic assessment after normal birth, vaginal dystocia or caesarean section in dogs.

    Science.gov (United States)

    Silva, L C G; Lúcio, C F; Veiga, G A L; Rodrigues, J A; Vannucchi, C I

    2009-07-01

    This study aimed to standardize signs and diagnostic criteria of respiratory function in newborn puppies delivered normally or after dystocia and caesarean operation. A total of 48 neonates were allocated into groups: eutocia (n = 20), dystocia (n = 8), caesarean (c)-section (n = 20). Neonatal health was assessed using the Apgar score and body temperature was determined at 0, 5 and 60 min after delivery. Venous blood gases (pO(2) and SO(2)) was measured immediately and 60 min after delivery, and a thoracic radiograph was made between 0 and 5 min of life. The c-section group had significantly lower Apgar scores at birth and 5 min. Hypothermia was present at 5 min in the eutocia and c-section groups, and at 60 min in all groups. The eutocia group had an irregular respiratory pattern in 78% of puppies at birth, 27.7% at 5 min and 21% at 60 min compared with 87.5%, 62.5% and 12.5% of the pups in the dystocia group where there was irregular respiratory rhythm, moderate to intense respiratory sounds with agonic episodes. The c-section group had respiratory alterations in 70%, 45% and 16% of puppies at 0, 5 and 60 min, respectively. Radiographic abnormalities were present in 17% of the pups in the eutocia group, 25% of the pups in the dystocia group and 30% of the pups in the c-section group, respectively. The c-section group had significantly lower SO(2) values at 60 min than at birth. All puppies had hypoxaemia, but a significant decrease was observed in the c-section group. Newborn puppies had tissue hypoxia and irregular respiratory pattern at birth. Caesarean-section puppies had lower vitality; however, all developed satisfactory Apgar scores at 5 min of life, regardless of the obstetric condition.

  19. Mycoplasma infection in the uterus of early postpartum dairy cows and its relation to dystocia and endometritis.

    Science.gov (United States)

    Ghanem, Mohamed Elshabrawy; Higuchi, Hidetoshi; Tezuka, Erisa; Ito, Hideki; Devkota, Bhuminand; Izaike, Yoshiaki; Osawa, Takeshi

    2013-01-01

    This study investigated the incidence of mycoplasma infection in the uterus of postpartum Holstein dairy cows and its relationship to the occurrence of endometritis. The genital tracts of 209 cows from three dairy farms in the Iwate Prefecture, Japan, were examined at Weeks 5 and 7 postpartum. The condition of the cervicovaginal mucus was assessed using a Metricheck device and assigned a score from 0 (clear mucus) to 4 (purulent material with fetid odor). Intrauterine samples (N = 418) were collected at Weeks 5 and 7 postpartum using a cytobrush. After its withdrawal, swab samples were placed in mycoplasma culture broth at 37 °C for 72 hours. A novel and rapid polymerase chain reaction was used to detect seven mycoplasma species (Mycoplasma bovis, M. arginini, M. bovigenitalium, M. californicum, M. bovirhinis, M. alkalescens, and M. canadense). The cytobrush was also rolled gently along the length of a glass slide for subsequent polymorphonuclear neutrophil count. The diagnostic criteria for cytological endometritis were 6% or more and 4% or more polymorphonuclear neutrophils at Weeks 5 and 7, respectively. From a subset of cows, additional swabs were rolled against the cytobrush and then placed in transport medium. These samples were then plated on specific agar plates and cultured under aerobic and anaerobic conditions to identify other bacteria present. The incidence of dystocia at the last calving was compared in mycoplasma positive and negative cows. Of the seven mycoplasma species, only M. bovigenitalium was detected; it was detected in 31 of the 418 uterine swabs (7.4%). Twenty-four cows were positive for M. bovigenitalium (eight cows at Week 5, nine cows at Week 7, and seven cows at both Weeks 5 and 7). The incidence of dystocia was higher (P dystocia at last calving and subsequent uterine infection with other bacteria. In addition, the incidence of cytologic endometritis was higher (P dystocia and with cytologic endometritis in postpartum dairy cows.

  20. Dystocia in 3-year-old beef heifers; relationship to maternal nutrient intake during early- and mid-gestation, pelvic area and hormonal indicators of placental function.

    Science.gov (United States)

    Micke, G C; Sullivan, T M; Rolls, P J; Hasell, B; Greer, R M; Norman, S T; Perry, V E A

    2010-04-01

    The influence of nutrition during the first and second trimesters of gestation on the occurrence of dystocia was investigated in 3-year-old composite-breed beef heifers. Heifers were allocated according to stratification by weight and genotype to either a high (H/-=76 MJ metabolisable energy (ME) and 1.4 kg crude protein (CP)), or low (L/-=62 MJ ME and 0.4 kg CP daily) nutritional treatment on the day of artificial insemination (day 0) to the same Senepol bull. Half of each nutritional group changed to an opposite nutritional group on day 93 of gestation (-/H=82 MJ ME and 1.4 kg CP; -/L=63 MJ ME and 0.4 kg CP daily), resulting in four treatment groups: HH (n=16); HL (n=19); LH (n=17); LL (n=19). From 180 days until calving all heifers were fed the same diets. Pelvic area measures were taken at heifer selection (-72 days) and at 117 days. Maternal circulating concentrations of estrone sulphate (ES), bovine placental lactogen (bPL), bovine pregnancy associated glycoprotein and progesterone were monitored throughout gestation. Heifers were observed continuously over the calving period and delivery type classified as being either eutocic or dystocic. The occurrence of dystocia was 14.1%. Increased calf birth weight increased the odds of occurrence of dystocia (odds ratio (OR)=1.40; 95% confidence interval (95% CI) 1.12-1.76; Pdystocia (OR=0.97; 95% CI 0.93-1.01; P=0.09). Longer gestation length was associated with an increased risk of dystocia (P=0.03). ES (P=0.04) and bPL (P=0.09) at calving were positively associated with the risk of dystocia. In conclusion, the current study demonstrates (a) that pelvic area measurement at selection in 3-year-old Bos indicusxBos taurus heifers may be useful for identifying heifers at an increased risk of dystocia and (b) increased ES and bPL concentrations at calving are associated with increased risk of dystocia. Pelvic area measurements obtained prior to conception remain valid in their assessment of the relationship between

  1. Using an incomplete gamma function to quantify the effect of dystocia on the lactation performance of Holstein dairy cows in Iran.

    Science.gov (United States)

    Atashi, H; Abdolmohammadi, A R; Asaadi, A; Akhlaghi, A; Dadpasand, M; Ahangari, Y Jafari

    2012-05-01

    The aim of the present study was to estimate the effect of dystocia on lactation performance, using an incomplete gamma function. Data from March 2000 to April 2009 comprising 100,628 lactations of 65,421 cows in 204 dairy herds collected by the Animal Breeding Center of Iran were used. Of 100,628 births, 91.8% required no assistance, whereas 8.2% required assistance of some sort. Factors associated with the presence of dystocia were calving season, calving year, herd, calf sex, parity, and age of dam. Peak yield for primiparous cows with dystocia at calving occurred on d 87.2 [standard error (SE) 0.47], and for primiparous cows with easy calving, the peak of lactation was on d 83.3 (0.25). Peak yield was lowered by 0.39 (SE 0.07), 2.20 (SE 0.15), 2.22 (SE 0.21), and 2.54 (SE 0.32) kg for cows with incidence of dystocia compared with normal cows in parity 1 to 4, respectively. Dystocia was associated with decreased 305-d lactation performance in all parities, mostly in early lactation. Although more difficult births occurred in heifer calvings, loss in lactation performance was greater in second or later lactations following a difficult birth.

  2. Using cognitive task analysis to create a teaching protocol for bovine dystocia.

    Science.gov (United States)

    Read, Emma K; Baillie, Sarah

    2013-01-01

    When learning skilled techniques and procedures, students face many challenges. Learning is easier when detailed instructions are available, but experts often find it difficult to articulate all of the steps involved in a task or relate to the learner as a novice. This problem is further compounded when the technique is internal and unsighted (e.g., obstetrical procedures). Using expert bovine practitioners and a life-size model cow and calf, the steps and decision making involved in performing correction of two different dystocia presentations (anterior leg back and breech) were deconstructed using cognitive task analysis (CTA). Video cameras were positioned to capture movement inside and outside the cow model while the experts were asked to first perform the technique as they would in a real situation and then perform the procedure again as if articulating the steps to a novice learner. The audio segments were transcribed and, together with the video components, analyzed to create a list of steps for each expert. Consensus was achieved between experts during individual interviews followed by a group discussion. A "gold standard" list or teaching protocol was created for each malpresentation. CTA was useful in defining the technical and cognitive steps required to both perform and teach the tasks effectively. Differences between experts highlight the need for consensus before teaching the skill. In addition, the study identified several different, yet effective, techniques and provided information that could allow experts to consider other approaches they might use when their own technique fails.

  3. [Assessment of shoulder dystocia related knowledge among French obstetrics and gynecology residents].

    Science.gov (United States)

    Schmitt, A; Heckenroth, H; Cravello, L; Boubli, L; d'Ercole, C; Courbiere, B

    2016-09-01

    To study the related knowledge of French residents in obstetrics concerning maneuvers for shoulder dystocia (SD). Multicenter descriptive transversal study conducted from June to September 2014. Data collection was performed through questionnaires sent by email to French resident in obstetrics. Among the 1080 questionnaires sent, 366 responses were obtained with a response rate of 33.9%. One hundred and forty-three residents (39.1%) were in the first part of their training (≤5th semester) and 60.9% (n=223) were in the second part of their training. Theoretical training on the SD was provided to 88.2% of resident (n=323). In total, 38.8% (n=142) obtained their French degree in mechanical and technical obstetric and among them 77.5% (n=110) had the opportunity to train on simulators and dummies. Concerning their practical experiences, 31.5% (n=45) residents ≤5th semester reported having experienced SD during their residency vs 58.3% (n=130) amongst oldest residents (PObstetrics and Gynecology, which have to develop dependable measures to assess resident competencies to execute practical maneuvers for clinical emergencies in obstetrics. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Rumination time and reticuloruminal temperature as possible predictors of dystocia in dairy cows.

    Science.gov (United States)

    Kovács, L; Kézér, F L; Ruff, F; Szenci, O

    2017-02-01

    C and from 39.80 ± 0.06 to 38.81 ± 0.08°C in EUT and DYS cows, respectively, and reached baseline levels after 35.4 ± 3.4 and 37.8 ± 4.2 h after calving in EUT and DYS cows, respectively. Based on our results, continuous monitoring of changes in rumination time and reticuloruminal temperature seems to be promising in the early detection of cows with a higher risk of dystocia. Depressed rumination activity of DYS cows after calving highlights the importance of the postpartum monitoring of cows experiencing difficulties at calving. The effect of dystocia on postpartum reticuloruminal pH was not pronounced. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  5. Early Identification and Intervention of Head Position Dystocia%头位难产早期识别和干预

    Institute of Scientific and Technical Information of China (English)

    王稳玉

    2016-01-01

    目的:探讨头位难产早期识别和干预方法。方法:本研究选取笔者所在医院产科2013年4月-2015年4月进行分娩的165例头位难产产妇作为研究对象,对其采用头位难产干预处理,观察干预处理后的临床效果。结果:165例头位难产产妇中,剖宫产116例(70.3%),阴道分娩49例(29.7%)。产后出血5例(3.0%),阴道撕裂伤1例(0.6%),新生儿轻度窒息6例(3.6%),重度窒息2例(1.2%),无产妇及新生儿死亡。结论:早期准确识别头位难产,并进行及时干预处理对提高安全分娩具有重要意义。%Objective:To investigate the early identification and intervention of head position dystocia.Method:165 puerpera with head position dystocia were selected from April 2013 to April 2015 in our hospital,which were treated with intervention against head position dystocia.Observed the clinical efficacy of the intervention.Result:In the 165 cases of puerpera,116 cases(70.3%) were treated with cesarean section,49 cases(29.7%) were treated with vaginal delivery.5 cases(3.0%) occured postpartum hemorrhage,1 case(0.6%) occured vaginal laceration,6 cases(3.6%) occured mild neonatal asphyxia,2 cases(1.2%) occured severe neonatal asphyxia.No puerpera and neonatal dead.Conclusion:Identify the head position dystocia early and accurately,and intervening the puerpera timely is important to improve the safety of childbirth.

  6. 头位难产56例临床分析%Clinical analysis of 56 cases of head dystocia

    Institute of Scientific and Technical Information of China (English)

    罗明仙

    2015-01-01

    Objective:To discuss and analyze the causes and treatment methods of head position dystocia.Methods:56 patients with head dystocia were selected.We understood the causes of disease,and discussed treatment methods of head position dystocia. Results:There were 15 cases of fetal head position for persistent occipitotransverse position in 24 cases of vaginal delivery, persistent occipitoposterior position in 9 cases,vaginal delivery in 18 cases.There were 13 cases of fetal head position for persistent occipitotransverse position in 32 cases of cesarean section,persistent occipitoposterior position in 19 cases.The differences were statistically significant,P<0.05.Conclusion:The correct treatment of fetal head and pelvis position,select the appropriate mode of delivery are the main way to avoid head dystocia.%目的:对头位难产的发生原因和处理方式进行分析讨论。方法:收治头位难产患者56例,了解疾病的发生原因,同时对头位难产的治疗方式进行讨论。结果:阴道分娩24例中,胎头位置为持续性枕横位15例,持续性枕后位9例,阴道助产18例;剖宫产32例中,胎头位置为持续性枕横位13例,持续性枕后位19例;两组比较差异有统计学意义,P<0.05。结论:正确处理胎头和骨盆的位置、选择合适的分娩方式是避免头位难产的主要方式。

  7. Effect of dystocia and treatment with oxytocin on neonatal calf vitality and acid-base, electrolyte and haematological status.

    Science.gov (United States)

    Vannucchi, C I; Rodrigues, J A; Silva, L C G; Lúcio, C F; Veiga, G A L

    2015-02-01

    Under adverse obstetrical conditions, appropriate supervision and assistance during the immediate neonatal period are of the utmost importance, especially for weak calves. The aim of this study was to establish the effects of dystocia and oxytocin infusion on neonatal vitality, acid-base balance, and electrolyte and haematological homeostasis of dairy calves. Data were collected for 30 Holstein calves which were allocated to three groups: normal calving (n = 10); dystocia with mild to severe obstetric assistance (n = 10); and uterine inertia treated with oxytocin (n = 10). All 30 calves exhibited normothermia at birth, but had a significant decrease in body temperature after 60 min. Dystocic calves had lower Apgar scores than calves in the other two groups, and had respiratory and metabolic acidosis. Calves from normal calvings had normal blood pH, but base excess below the reference range. The mean partial pressure (Pa) of oxygen of calves whose dam had been treated with oxytocin was lower than that of calves from normal calvings. In all experimental groups, there was improvement in metabolic status in the first 60 min postpartum as PaCO2 values significantly decreased. All calves had normonatraemia, normokalaemia and normochloridaemia during the study period, but calves born to dams treated with oxytocin had a higher sodium concentration than those in the two other groups.

  8. Effect of oral mineral and energy supplementation on blood mineral concentrations, energetic and inflammatory profile, and milk yield in dairy cows affected with dystocia.

    Science.gov (United States)

    Benzaquen, M; Galvão, K N; Coleman, A E; Santos, J E P; Goff, J P; Risco, C A

    2015-05-01

    The objectives of this study were to determine the effect of mineral/energy supplementation of dairy cows with dystocia on blood mineral concentrations, energetic and inflammatory profiles, and milk yield. Multiparous Holstein cows with dystocia were randomly assigned into two groups, (1) treated with a mineral/energy supplement (DME, n= 18) and (2) not treated (DNT, n= 22). A group of cows with normal parturition were randomly selected and were left untreated (NNT, n= 25). Cows in DME received an oral drench of 110 g of calcium and 400 g of propionate as calcium propionate plus 110 g potassium chloride and 150 g of magnesium sulfate administered within 6 h of calving and again 3 days post-partum. Compared to cows with a normal parturition, dystocic cows had decreased plasma calcium concentrations, increased plasma haptoglobin, decreased milk yield at 1 day post-partum, and tended to have increased rectal temperatures from 1 to 12 days post-partum. Compared with cows in DNT, those in DME had decreased plasma calcium concentrations and increased plasma magnesium concentrations 2 and 3 days post-partum, and a tendency for an increase in rectal temperature from 1 to 12 days post-partum. Dystocia is detrimental to calcium homeostasis post-partum, but mineral/energy supplementation as undertaken in this study is not recommended for use in cows with dystocia.

  9. Incidence of uterine torsion during veterinary-assisted dystocia and singleton live births after vaginal delivery inHolstein-Friesian cows at pasture

    Institute of Scientific and Technical Information of China (English)

    Faria N; Simes J

    2015-01-01

    Objective:To determine the incidence of uterine torsion and their association with live births after vaginal delivery at pasture.Methods:A total of 119 veterinary-assisted dystocia, occurred in Holstein-Friesian cows, were accessed between September 2012 and February 2013 from Azores islands (Portugal). The general health status of dam, cause of dystocia, obstetric treatment choice, number and viability of fetus were evaluated.Results:The uterine torsion represented 24.4% (29/119) of total assisted dystocia. The general health status was normal or slowly affected, at delivery time, for 96.6% (28/29) of the cows with uterine torsion. Vaginal delivery after rolling cows, cesarean section or euthanasia were performed in 72.4% (21/29), 24.1% (7/29) and 3.5% (1/29) of dams with uterine torsion, respectively. Singletons were observed in 96.6% (28/29) and 86.7% (78/90) of cows with uterine torsion and remaining dystocia, respectively. After vaginal delivery, the occurrence of singleton live births was more probable to occur in cows with uterine torsion (17/21) than the remaining cows (37/70) of control group (odds ratio=3.79; 95% interval of confidence from 1.16 to 12.41;P<0.05).Conclusions:A high frequency of uterine torsion was observed in Holstein-Friesian cows with normal or slowly affected general health status at delivery time at pasture. The singleton live births prevailed and, in general, their occurrence by vaginal delivery after uterus reposition was most likely to occur in cows with uterine torsion than dams presenting other dystocia.

  10. Dystocia Ystocia Due to Due to Mummifiedummified Foetaloetal Monsteronster in ain a Yankasaankasa Ewewe: A Casease Reporteport

    Directory of Open Access Journals (Sweden)

    A.I. Kisani

    2012-06-01

    Full Text Available A 1 year old Yyankasa ewe weighing 24 kg was presented to the Large Animal Clinic unit of the Veterinary Teaching Hospital, University of Agriculture Makurdi, Nigeria. The owner with the complained t that she has been in labour for 24 h without delivery. Vital parameters were taken and found to be within the normal ranges. the The patient underwent general and obstetrical animal was examinationed. A diagnosis of dystocia was made with Tthe foetus was found to be in anterior presentation of the fetus, bilateral with the carpalus and shoulder flexioned and the neck deviated laterally.lateral deviation of the neck. Manual traction to deliver the foetus was not successful. Caesarean section was performed with the patient under sedation and epidural anaesthesiatherefore recommended. This was carried out and the dead foetus removed. Recovery post surgery was complete and the ewe was discharged five days post surgery.

  11. Peripartum Ultrasound-Guided Drainage of Cystic Fetal Sacrococcygeal Teratoma for the Prevention of the Labor Dystocia: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Vedran Stefanovic

    2011-12-01

    Full Text Available Fetal sacrococcygeal teratoma (SCT is the most common tumor in the neonatal period and is easily detected by modern ultrasound techniques, mostly during the second-trimester screening. It can cause significant fetal/neonatal morbidity and mortality due to its size, vascular loading, possible rupture, and labor dystocia. Mostly cystic teratomas have favorable prognosis, but if untreated in utero, they may rupture or cause labor obstruction. Cesarean delivery, especially with the vertical incision, increases significantly maternal morbidity due to the hemorrhage and the risk of the uterine rupture in the subsequent pregnancies. The authors report in details two SCT cases with uncomplicated vaginal delivery after peripartum ultrasound-guided drainage of the cystic teratoma. We conclude that the percutaneous emptying of the cystic SCT is an easy, encouraging, safe, and efficient procedure and enables normal vaginal delivery, thus avoiding labor dystocia and possible complications of the cesarean delivery and the risk of tumor rupture.

  12. Clinical utility of calf front hoof circumference and maternal intrapelvic area in predicting dystocia in 103 late gestation Holstein-Friesian heifers and cows.

    Science.gov (United States)

    Hiew, Mark W H; Megahed, Ameer A; Townsend, Jonathan R; Singleton, Wayne L; Constable, Peter D

    2016-02-01

    The objective of this study was to determine the clinical utility of measuring calf front hoof circumference, maternal intrapelvic area, and selected morphometric values in predicting dystocia in dairy cattle. An observational study using a convenience sample of 103 late-gestation Holstein-Friesian heifers and cows was performed. Intrapelvic height and width of the dam were measured using a pelvimeter, and the intrapelvic area was calculated. Calf front hoof circumference and birth weight were also measured. Data were analyzed using Spearman's correlation coefficient (rs), Mann-Whitney U test, and binary or ordered logistic regression; P dystocia (calving difficulty score = 4 or 5), with sensitivity = 0.50 and specificity = 0.93 at the optimal cutpoint for the ratio (>0.068 cm/cm(2)). Determining the ratio of calf front hoof circumference to maternal intrapelvic area has clinical utility in predicting the calving difficulty score in Holstein-Friesian cattle.

  13. Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.

    Science.gov (United States)

    Buerkle, Bernd; Pueth, Julia; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

    2012-10-01

    To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; Psecondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; Ptraining helps to achieve a significant improvement of shoulder dystocia management on a pelvic training model. www.ClinicalTrials.gov, NCT01618565. I.

  14. PDCA在HELPERR程序处理肩难产培训中的应用%Application of PDCA cycle in training HELPERR procedures for handling shoulder dystocia

    Institute of Scientific and Technical Information of China (English)

    徐名妨; 梁小勤; 谭美衡; 林晓华; 陆丽

    2011-01-01

    Objective To explore the effect of PDCA cycle used in training HELPERR procedures for dealing with shoulder dystocia.Methods PDCA cycle was applied in centralized training program for handling shoulder dystocia,including such theory training as definition, comprehensive assessment, prediction, preparation, identification, HELPERR procedures for handling shoulder dystocia,records, skills demonstration. And skills practice was focused. Problems found in training and tests were solved timely. Resuits Standardized treatment guideline was established. The test results of obstetric medical staff in theoretical knowledge and skills for using HELPERR procedures in handling shoulder dystocia showed significant differences before and after training (P<0.01 for both). Conclusion PDCA cycle used in specialty training can improve obstetric medical staff's knowledge and skills for using HELPERR procedures in handling shoulder dystocia.%目的 探讨采用PDCA循环法进行HELPERR程序处理肩难产培训的效果.方法 运用PDCA循环法进行集中专题培训,包括定义、综合评估、预测,准备,识别,HELPERR程序处理肩难产、记录及操作演习等理论培训,同时注意操作培训,并不断检验培训与考核中存在的问题,及时改进,进行下一循环.结果 讨论制定了规范的处理指引;产科医护人员培训前后HELPERR程序处理肩难产的理论知识和操作考核成绩比较,差异有统计学意义(均P<0.01).结论 采用PDCA循环法进行专题培训,可提高产科医护人员对应用HELPERR程序处理肩难产的相关理论知识和操作技能水平.

  15. [Dynamics of calving, dystocia and the organization and effectiveness of obstetrical care for cows on commercial farm complexes].

    Science.gov (United States)

    Bozhkov, I; Stoianov, A; Kolchev, G

    1986-01-01

    A study was carried out on the organization of the obstetrical aid with cows on the large cow complexes in order to raise its effectiveness. Determined was the dynamic of calvings, dystocia, retentio secundinarum, and puerperal endometritis as affected by the time of calving and the character of obstetrical aid as practised on the farms. It was found that most of the calvings (62.6 per cent) take place at night, and 37.4 per cent--in daytime, while within the working day as fixed by the Labour Code--24.8 per cent only. Directly proportional to these were the cases of laboured delivery--60.4 per cent at night and 39.6 per cent in daytime. It was also established that at night obstetrical aid is chiefly rendered by the attendants on duty and the watchmen, which meant that it was unqualified, with bad results: higher rate of postnatal deaths, higher morbidity rates resulting from puerperal endometritis, prolonged period from calving to the first physiologic estrus and prolonged service period, lower conception rates, and higher economic losses. The authors suggest that the organization of labour of vets should take into consideration the productional and biologic processes on the industrial cow complexes, with night duty or two-shift work. These problems should be settled financially and by means of additional personnel as provided by the Labour Code and the new economic approach and its mechanisms.

  16. 肩难产高危因素的回顾性分析与探讨%Retrospective analysis on risk factors of shoulder dystocia

    Institute of Scientific and Technical Information of China (English)

    侯丽萍; 岳慧萍; 侯红娟; 赵云鹤; 侯玉英

    2013-01-01

    目的 分析肩难产发生率、并发症及高危因素,降低母婴危害. 方法 收集2005-01~ 2011-12收治的2000例孕妇资料,采用1∶2的病例对照研究方法,探讨肩难产的高危因素及其对产妇和新生儿的损伤作用. 结果 共搜集肩难产产妇23例,发生率为1.15%.其中巨大儿11例,占47.83%,孕妇合并糖尿病4例,占17.39%,肥胖3例,占13.04%,骨盆狭窄2例,占8.70%,过期妊娠2例,占8.70%,第二产程延长1例,占4.35%.肩难产组与自然分娩组产妇的腹围、宫高、第一产程和第二产程差异有统计学意义(P<0.05).两组间新生儿的体重、身长、头围、胸围、1 min Apgar评分差异有统计学意义(P<0.05). 结论 巨大儿肩难产发生率比较高,但要根据高危的因素进行预测.%Objective To investigate the incidence,complications and high risk factors of shoulder dystocia for reducing the danger of mother-infant. Methods From January 2005 to December 2011,2 000 cases of pregnant women were collected, and the effect of shoulder dystocia on mother and newborn was analyzed by 1: 2 case control study. Results Twenty-three cases of shoulder dystocia were found with the incidence of 1. 15% ,including 11 cases (47.83% ) of huge newborns and 4 cases (17. 39% ) of pregnant women with diabetes,3 cases (13. 04%) of obesity, 2 cases (8. 70%) of pelvis, 2 cases (8. 70%) of prolonged pregnancy and 1 case (4. 35% ) of prolonged second stage. The fundal height,the abdominal girth,the first stage of labor and the second labor of pregnant women were significantly different between shoulder dystocia group and natural childbirth group (P<0.05). And the body weight,the body length, the crown-rump length, the head circumference, the chest circumference and 1 min Apar score of newborn were significantly different between shoulder dystocia group and natural childbirth group (P<0.05). Conclusion The incidence of shoulder dystocia is higher when huge newborn delivers, but

  17. A Bayesian threshold-linear model evaluation of perinatal mortality, dystocia, birth weight, and gestation length in a Holstein herd.

    Science.gov (United States)

    Johanson, J M; Berger, P J; Tsuruta, S; Misztal, I

    2011-01-01

    The objective of this research was to estimate genetic parameters for a multiple-trait evaluation of dystocia (DYS), perinatal mortality (PM), birth weight (BWT), and gestation length (GL) in Holsteins. The data included 5,712 calving records collected between 1968 and 2005 from the Iowa State University dairy breeding herd in Ankeny. The incidence of PM was 8.8% and that of DYS 28.8%; mean BWT was 40.5 kg, and GL was 279 d. A threshold-linear animal model included the effects of year, season, sex of calf, parity, sire group, direct genetic, maternal genetic, and maternal permanent environment. Direct heritabilities for DYS, PM, BWT, and GL were 0.11 (0.04), 0.13 (0.05), 0.26 (0.04), and 0.51 (0.05), respectively. Maternal heritabilities were 0.14 (0.04), 0.15 (0.03), 0.08 (0.01), and 0.08 (0.02), for DYS, PM, BWT, and GL, respectively. The heritabilities are the posterior means of the Gibbs samples with their standard deviations in parentheses. The direct genetic correlation between PM and DYS was estimated at 0.67 (0.19), whereas the maternal genetic correlation was 0.45 (0.16). Direct and maternal PM and DYS are partially controlled by the same genes. Selection on only calving ease is not sufficient to control PM. With moderate genetic correlations between all 4 traits, BWT and GL should be included with DYS and PM in an evaluation of calving performance.

  18. Effect of restricting silage feeding prepartum on time of calving, dystocia and stillbirth in Holstein-Friesian cows

    Science.gov (United States)

    2007-01-01

    A study was carried out to investigate the effect of restricting silage feeding on time of calving and calving performance in Holstein-Friesian cows. In the treatment group (n = 1,248 cows, 12 herds) silage feeding commenced in the evening (17:00 to 20:00 h), after a period of restricted access (2 to 10 h) while in the control group ad-libitum access to silage was provided over the 24 h period (n = 1,193 cows, 12 herds). Daytime and nighttime calvings were defined as calvings occurring between the hours of 06:30 and 00:29 and between 00:30 and 06:29, respectively. Restricting access to silage resulted in less calvings at night compared to cows with ad-libitum access to silage (18 vs 22%, P < 0.05). Cows with restricted access to silage had a higher percentage of difficult calvings (11 vs 7%, P < 0.001) and stillbirths (7 vs 5%, P < 0.05) compared to cows in the control group. The percentage of calvings at night was lower (13%) when access to silage was restricted for 10 h compared to 2, 4 or 6 h (22, 18, 25%, respectively) (P < 0.001). Calf sire breed, calf gender or cow parity did not influence time of calving. In conclusion, offering silage to pregnant Holstein-Friesian cows in the evening, after a period of restricted access, reduced the incidence of nighttime calvings, but increased the incidence of dystocia and stillbirth. PMID:21851689

  19. Early-identification and intervention of the head-position dystocia%头位难产早期诊断和处理

    Institute of Scientific and Technical Information of China (English)

    国海红; 陆春莲

    2011-01-01

    Head-position dystocia is a common disease in abnormal delivery, and it is difficult to.diagnose.Early-identification and early-intervention could improve its prognosis and are very important for it.The clinical manifestation of head-position dystocia are including premature rupture of membranes, abnormal labor, primarily and secondary uterine inertia, head of fetus is not abjoined or late to adjoin with pelvis, holding her breathing to make an effort earlier, cervix edema and clopedema and dysuresia and so on.When there is not obviously cephalopelvic disproportion, giving the chance for lying-in woman to delinery.%头位难产是异常分娩中常见的也是最难诊断的,早期诊断并及时处理可改善母儿预后.头位难产的临床表现有胎膜早破、产程异常、原发或继发宫缩乏力、胎头未衔接或延迟衔接,产妇过早屏气用力、阴道宫颈水肿及尿潴留等.无明显头盆不称时,应给予产妇充分试产的机会.

  20. 江西省县级医院助产士肩难产的知、信、行现状分析%KAP status analysis of midwife about shoulder dystocia in county hospital of Jiangxi

    Institute of Scientific and Technical Information of China (English)

    王芸

    2015-01-01

    目的:调查分析江西省县级医院助产士肩难产知、信、行现状。方法采用自制调查问卷,对在江西省县级医院的96名助产士进行问卷调查。结果此次参与调查的助产士均对肩难产有所了解,并知晓该状况为产科急症。且100%的助产士愿意利用业余时间参加肩难产应对培训。43.75%的助产士表示未接受过相应培训,或接受的培训形式单一,时间较短。结论应加强对县级医院助产士肩难产的培训,真正做到知、信、行合而为一。%Objective To investigate and analyze the KAP status of midwives about shoulder dystocia on county level hospital of Jiangxi province. Methods 96 midwives on country level hospital of Jiangxi province were surveyed by a self de-signed questionnaire. Results 100% of midwives knew shoulder dystocia and also knew and thought that shoulder dystocia was an obstetric emergency. 100% of midwives are willing to make use of spare time to participate in training. 43. 75% of mid-wives did not receive the training of shoulder dystocia,and most of the training form is monotonous,short time. Conclusion It needs to strengthen the training of shoulder dystocia on county hospital,then made knowlege-attitude-belief one line.

  1. 分娩镇痛对头位难产影响的观察%Observation of labor analgesia on cephalic presentation dystocia

    Institute of Scientific and Technical Information of China (English)

    刘莉

    2013-01-01

    Objective To observe analgesia clinical effect of cephalic presentation diystocia.Methods Our hospital between February 2010 to December 2010,78 patients with cephalic presentation dystocia were randomly divided into two groups,the control group received conventional delivery method,the observation group in the conventional intervention methods give the town childbirth pain were observed maternal childbirth.Results The observation group stage of labor,fetal asphyxia,fetal distress and pain VAS scores were significantly lower than those the control group,the difference was statistically significant (P < 0.05).Conclusions Cephalic presentation dystocia give labor analgesia can effectively shorten delivery time,reduce maternal pain and improve fetal outcomes,worthy of clinical application.%目的 观察头位难产实施分娩镇痛的临床效果.方法 将深圳市西乡人民医院2010年2月至2010年12月之间收治的78例头位难产产妇随机的分为两组,对照组给予常规的分娩方法,而观察组在常规干预方法给予镇分娩痛,观察两组产妇的分娩情况.结果 观察组产程时间、胎儿窒息率、胎儿窘迫率以及疼痛VAS评分均明显的低于对照组的情况,差异具有统计学意义(P<0.05).结论 对于头位难产产妇给予分娩镇痛能够有效的缩短分娩时间,降低产妇疼痛,并改善胎儿结局,值得临床中应用.

  2. The effect of dystocia on physiological and behavioral characteristics related to vitality and passive transfer of immunoglobulins in newborn Holstein calves.

    Science.gov (United States)

    Murray, Christine F; Veira, Doug M; Nadalin, Audrey L; Haines, Deborah M; Jackson, Marion L; Pearl, David L; Leslie, Ken E

    2015-04-01

    The objective of this study was to examine the effect of calving difficulty or dystocia on the vitality of newborn calves and its association with blood pH, the apparent efficiency of immunoglobulin G (IgG) absorption (AEA), and weight gain. A total of 45 calving events (N = 48 calves) were monitored from the first sight of fetal membranes. All calves were assessed at the time of first attaining sternal recumbency (SR), at 2 and 24 h, and at 7 and 14 d of age. Measurements included time to SR, rectal temperature, respiration and heart rate, analysis of blood gases and other blood measures, suckling response, time to standing, passive transfer of IgG, and weight gain. Calves were separated from their dam 2 h after birth and fed a commercial colostrum replacer containing 180 g of IgG by esophageal tube feeder. Calves born following dystocia had lower venous blood pH and took longer to attain SR and attempt to stand than those born unassisted. Duration of calving interacted with the number of people required to extract the calf by pulling as a significant predictor of pH at SR. No association was found between pH at SR and AEA. However, reduced AEA was found in calves that were female and in calves that did not achieve SR within 15 min of birth. A longer calving duration, being born in July or August rather than June, and a shorter time spent standing in the first 2 d of life were significantly associated with reduced weight gain to 14 d. It was concluded that factors at calving impact the physiology, vitality, and subsequent weight gain of newborn calves.

  3. Pregnancy Complications: Shoulder Dystocia

    Science.gov (United States)

    ... begun. If your baby is very large (called macrosomia) before birth, your provider may recommend that you ... begun. If your baby is very large (called macrosomia) before birth, your provider may recommend that you ...

  4. Composite prevention strategy for shoulder dystocia: meta-analysis%肩难产综合预防措施的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    王少为; 赵晓东; 褚德发; 李旻; 梁琳; 张俊荣

    2015-01-01

    目的 探讨肩难产的综合预防措施.方法 计算机检索2014年5月以前的PubMed数据库、美国EBSCO数据库、荷兰医学文摘数据库、Cochrane图书馆数据库,以“shoulder dystocia and prevention”为主题词检索英文文献.对检索到的文献进行质量评价,文献研究类型仅限于随机对照临床试验(RCT)研究;研究对象为经阴道分娩产妇,干预措施包括孕期管理、预防性引产、预防性剖宫产术,预防性肩难产处理.纳入的文献采用RevMan 5.1软件进行荟萃分析,以肩难产发生率作为终点指标.结果 共有16篇英文文献纳入荟萃分析,发表时间为1993-2009年.(1)对妊娠期糖尿病(GDM)孕妇的孕期干预:有2篇文献比较了GDM孕妇的孕期干预(干预组)与不干预(不干预组)对肩难产发生率的影响,结果显示,干预组肩难产发生率显著低于不干预组(OR=0.40,95% CI为0.21~0.75,P=0.004).(2)对GDM孕妇的孕期严格干预:5篇文献比较了GDM孕妇的孕期严格干预(饮食控制+胰岛素应用;严格干预组)与不严格干预(单纯饮食控制等;不严格干预组)对肩难产发生率的影响,结果显示,严格干预组肩难产发生率显著低于不严格干预组(OR=0.29,95%CI为0.11~ 0.73,P=0.009).(3)非糖尿病孕妇可疑巨大儿者引产:有4篇文献比较了非糖尿病孕妇可疑巨大儿者提前引产(提前引产组)对肩难产发生的影响,结果显示,提前引产组肩难产发生率与对照组比较,差异无统计学意义(OR=0.85,95%CI为0.41~ 1.75,P=0.660).(4)GDM孕妇引产:有2篇文献比较了GDM孕妇提前引产(孕38~ 39周;提前引产组)对肩难产发生的影响,结果显示,提前引产组肩难产发生率与对照组比较,差异有统计学意义(OR=0.18,95%CI为0.03~ 0.97,P=0.050);只与对照组中孕40周以后分娩者比较,提前引产组肩难产发生率显著低于对照组(OR=0.13,95% CI为0.02~ 0.75,P=0.020).(5)GDM孕妇可疑巨大

  5. 循证护理在头位难产中的应用及护理%Evidence-basedNursingintheApplicationandNursingofHeadPresentationDystocia

    Institute of Scientific and Technical Information of China (English)

    郭碧云; 胡春柳; 李凤珊; 钟慧梅

    2013-01-01

    Objective To explore the application of evidence-based nursing in head position dystocia and the effect of maternal method. Methods In 2011 were included in the control group, 92 cases, application of the routine nursing care;in 2012 were included in the study group, 96 cases, using evidence-based nursing;comparison of two groups of delivery outcome. Results The study group and natural birth rate was signiifcantly higher than the control group, the rate of cesarean section was signiifcantly lower than that of the control group, neonatal asphyxia and neonatal mortality rate was signiifcantly lower than the control group, the data by comparison with statistical signiifcance (P<0.05). Conclusion The evidence-based nursing for the promotion of head dystocia maternal natural labor, reduce cesarean section and neonatal complications have a positive effect, can improve the safety of mother and infant.%  目的探讨循证护理应用于头位难产产妇的方法及效果。方法2011年入院者列入对照组,92例,应用常规护理方法;2012年入院者列入研究组,96例,采用循证护理;比较两组分娩结局。结果研究组自然分娩率明显高于对照组,剖宫产率明显低于对照组,新生儿窒息和新生儿病死率明显低于对照组,数据经比较具有统计学意义(P<0.05)。结论循证护理对于促进头位难产产妇的自然分娩、减少剖宫产率和新生儿并发症具有积极作用,可提高母婴安全性。

  6. Treatment for dystocia in ancient China%试论中国古代中医对难产的治疗

    Institute of Scientific and Technical Information of China (English)

    张璐

    2012-01-01

    Treatment for dystocia in ancient China includes delivery taboo,delivery promotion decoction and midwifery methods.Before the Sui and Tang dynasties,delivery was more like a rite.In the Sui and Tang dynasties,doctors began to understand dystocia from the physical condition,delivery environment and psychological factors,and the delivery taboo was rejected.After that period,the delivery taboo became a folk custom and was separated from the field of medicine.The herbs for delivery promotion decoctions usually used the principle of regulating the blood and removing stasis and were of slippery character during and before the Tang dynasty.In the Song dynasty promotion decoction was enlarged.In later ages some doctors put forward that emphasis should be on conformity to nature and nursing,not dependence on promotion drugs.Before and during the Tang dynasty,acupuncture and salt smearing had been key methods for abnormal fetal position and there were also case recordings.In the Northern Song dynasty,these two methods were no longer used and the midwife' s skill was emphasized.With more and more focus on the midwife' s skill,some male doctors depended on midwives and some criticism of midwives also increased.The book Dashengbian reflected maximum distrust of midwives.%古代医家治疗难产主要涉及到生产禁忌、催生方药和助产手法3方面.在隋唐以前,产育之事具有很浓的仪式色彩.到了隋唐时期,医家开始从身体自身以及生产环境和心理因素来认识难产,并开始排斥禁忌之说.但在唐以后,禁忌之说开始民俗化,并逐渐脱离医学领域.唐及唐以前的催生方药多取调血祛瘀和性滑之义.在宋代,催生方药的功效开始扩大.而后世医家在承袭前人观点的同时,也在不断反思,并提出生产应顺应自然,重视自身调养,不宜过分依赖催生方药.在唐及唐以前,针刺及涂盐一直是治疗横生、逆生的主要方法,并有相应的医案记载.北宋时期,医

  7. Análise dos fatores relacionados a 60 casos de distocia em ovelhas no Agreste e Sertão de Pernambuco Analysis of factors related to 60 dystocia cases in ewes in the Agreste and semiarid region of Pernambuco, Northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Antônio Carlos Lopes Câmara

    2009-11-01

    Full Text Available O presente trabalho objetiva relatar os principais tipos de distocias em ovelhas, no Agreste e Sertão de Pernambuco, e avaliar alguns fatores relacionados com sua ocorrência, bem como determinar a eficiência dos tratamentos utilizados. A maior incidência de partos distócicos ocorreu na estação chuvosa, com 61,7% dos casos. Os resultados mostraram predominância de distocias de origem materna (71,6% sobre a fetal (29,4%, com maior incidência em ovelhas primíparas da raça Santa Inês, com gestações gemelares. A principal distocia materna foi a ausência ou dilatação cervical insuficiente, e fetal, a má disposição na apresentação anterior. A taxa de sobrevivência das mães correspondeu a 100 e 88,6%, enquanto das crias alcançou 41,2 e 46,7%, após manobra obstétrica e cesariana, respectivamente, com predominância de cordeiros inviáveis em ambos os procedimentos. As manobras obstétricas e a cesariana pelo flanco esquerdo permanecem opções seguras para o tratamento de distocias em ovelhas, sendo ainda importantes coadjuvantes, minimizando o impacto econômico causado por essa enfermidade em Pernambuco.The aim of the present study was to report the main dystocia causes in sheep in Agreste and semiarid region of Pernambuco and to evaluate some factors related to their occurrence, besides of determining the efficiency of the treatment choices. The higher incidence of dystocia occurred in rainy season corresponding to 61.7%. Results showed a major predominance of maternal dystocia (71.6% over fetal dystocia (29.4% with higher incidence in primiparous and gemelar pregnant Santa Inês ewes. The main maternal dystocia was ringwomb while fetal dystocia was maldisposition in anterior presentation. Maternal survival rate correspond to 100% and 88.6%, while lambs achieved 41.2% and 46.7% after obstetrical maneuver and caesarean section, respectively, with predominance of unviable lambs in both procedures. Obstetrical maneuver and left

  8. Discussion of the relationship between abnormal delivery and shoulder dystocia among primiparous women%初产妇分娩异常与肩难产的关系探讨

    Institute of Scientific and Technical Information of China (English)

    王海波; 高丽彩; 逯彩虹; 李萍; 李苓妙; 周艾琳; 孟宪涛

    2012-01-01

    Objective: To explore the relationship between abnormal delivery and shoulder dystocia among primiparous women. Methods: Twenty - nine primiparous women with shoulder dystocia of single pregnancy and head position from 2000 to 2008 were selected as study group, 108 primiparous women matched to the primiparous women in study group under the same circumstance were selected randomly as control group; the incidences of macrosomia, the proportions of spontaneous labor and vaginal assistant labor, the speeds of cervical dilation during active phase, the duration times of the first stage and the second stage of labor in the two groups were compared. Results: Compared with control group, the incidence of macrosomia and the proportion of uterine inertia in study group increased significantly ( P < 0. 05 ) , the duration time of deceleration period of the first stage of labor and the duration time of the second stage of labor prolonged significantly (P <0. 05) , the proportion of vaginal assistant labor increased significantly (P <0. 01) Conclusion; Macrosomia, the duration time of the second stage of labor more than two hours, and vaginal assistant labor are related to shoulder dystocia among primiparous women.%目的:探讨初产妇分娩异常与肩难产的关系.方法:选择2000~2008年以单胎、头位、初次分娩时发生肩难产的29例初产妇为研究组,随机选择同期条件与研究组相匹配的108例初产妇作为对照组,比较两组巨大儿的发生率、顺产及阴道助产比率、活跃期官颈扩张速率及第一、第二产程的持续时间.结果:与对照组相比,研究组巨大儿发生率、子宫收缩乏力明显增加(P<0.05),第一产程减速期及第二产程时限明显延长(P<0.05),阴道手术助产的比率增加(P<0.01).结论:初产妇分娩巨大胎儿、第二产程延长超过2h及阴道手术助产均与肩难产有关.

  9. Multicenter analysis of risk factors and clinical characteristics of shoulder dystocia%肩难产发生的危险因素和临床特征的多中心分析

    Institute of Scientific and Technical Information of China (English)

    王晓怡; 何玉甜; 钟梅; 王志坚; 樊尚荣; 刘增佑; 范舒舒; 陈敦金

    2015-01-01

    龄孕产妇(年龄>35岁)、孕前BMI>27 kg/m2、孕期体质量增重>20 kg、肩难产病史、分娩巨大儿、糖尿病合并妊娠、过期妊娠、最大加速期延长及第二产程延长是肩难产发生的危险因素及临床特征.%Objective To explore the risk factors and clinical characteristics of shoulder dystocia.Methods The data of 44 580 single pregnancy and full-term head delivery were colleceted in the Third Affiliated Hospital of Guangzhou Medical University,Nanfang Hospital,Shenzhen Nanshan Hospital,Peking University Shenzhen Hospital and Yue Bei People's Hospital from January 2008 to September 2013.Totally 116 cases of shoulder dystocia were defined as the shoulder dystocia group,and the others were in the control group.The clinical data of the two groups were analyzed retrospectively,including the maternal age,maternal height,pre-gestational body mass index,weight gain during pregnancy,gestational weeks,gravidity,parity,fundal height,fetal abdominal perimeter,shoulder dystocia medical history,macrosomia,gestational diabetes mellitus,pre-gestational diabetes mellitus,post-term pregnancy and the condition of labor stages.Results (1) The incidence of shoulder dystocia was 0.260% (116/44 580).The maternal age,pre-gestational body mass index and weight gain during pregnancy in the shoulder dystocia group were higher than those in the control group (all P<0.01).While the maternal height,gestational weeks,gravidity,parity,fundal height,abdominal circumference in the two groups had no significant difference (all P>0.05).(2) In the shoulder dystocia group,the incidence of shoulder dystocia medical history (11.21%,13/116),macrosomia (13.79%,16/116),pre-gestational diabetes mellitus (7.76%,9/116),post-term pregnancy (10.34%,12/116),prolongation of maximum acceleration phase (8.62%,10/116) and prolongation of second labor stage (7.76%,9/116) were different from those in the control group [1.43%(636/44 464),1.48%(658/44 464),0.57%(252/44 464

  10. A retrospective analysis of 52 cases with cephalic presentation dystocia of painless labor%无痛分娩发生头位难产病例的回顾性分析

    Institute of Scientific and Technical Information of China (English)

    顾丽芳; 黄鹰; 苏平平

    2011-01-01

    Objective To explore the incidence and causes of cephalic presentation dystocia of painless labor. Methods 506 cases of painless labor ( observation group ) in Pudong New Area Maternity & Child Health Hospital in 2009 were retrospectively analyzed, and contemporary 506 cases of vaginal deliver ( control group ) were randomly selected as the controls. The incidence of cephalic presentation dystocia, indication of cesarean section, neonatal birth weight and the influence on mother and infant were compared between two groups.Results The incidence of cephalic presentation dystocia in observation group ( 10.28%, 52/506 ) was lower than that in control group ( 22.13%, 112/506 ). Abnormal fetal position was the major cause of cesarean section in two groups. The difference in cesarean section because of protracted active phase and social factors between two groups was statistically significant (x2 was 6. 413 and 4. 772 respectively,P < 0. 05 ). There was no significant difference in neonatal birth weight, postpartum hemorrhage within 2 hours and Apgar score.Conclusion Painless labor can reduce the incidence of cesarean sections because of protracted active phase and social factors, and it does not increase the probability of cephalic presentation dystocia. In addition, it has no harmful effect on mother and infant. Painless labor is worth popularizing.%目的 分析无痛分娩发生头位难产的比率及原因.方法 回顾性分析2009年上海市浦东新区妇幼保健院506例无痛分娩病例,并随机抽取同期非无痛分娩阴道试产506例作为对照,分析两组头位难产的发生率、剖宫产指征、新生儿体重及对母儿的影响.结果 观察组发生头位难产占10.28%(52/506),低于对照组的22.13%(112/506);胎位异常是两组行剖宫产的主要指征,两组因活跃期停滞和社会因素导致的剖宫产比较差异有统计学意义(χ2值分别为6.413、4.772,均P0.05).结论 无痛分娩可减少因社会因素及活

  11. Manual Rotation Applied to the Midwifery Care for Head Position Dystocia%徒手旋转在头位难产产妇助产护理中的应用研究

    Institute of Scientific and Technical Information of China (English)

    蔡群英

    2015-01-01

    目的:探讨徒手旋转在头位难产产妇助产护理中的临床应用效果。方法对2013年4月-2014年4月该院收治的80例头位难产产妇资料进行分析,根据不同护理方法将产妇分为对照组和实验组,对照组采用自然分娩及助产护理,实验组实施徒手旋转抬头助产护理,比较两组护理效果。结果实验组24例自然分娩,占60%;12例阴道助产,占30%,显著高于对照组(30%自然分娩,20%阴道助产)(P<0.05);实验组剖宫产率为10%,显著低于对照组(剖宫产率为50%)(P<0.05);实验组第二产程时间为(24±3)min,显著短于对照组(38±7)min(P<0.05);实验组新生儿并发症发生率为7.5%,显著低于对照组(并发症发生率为17.5%)(P<0.05)。结论头位难产产妇分娩过程中采用徒手旋转抬头位置助产护理效果理想,能够促进第二产程加快,降低剖宫产率,值得推广使用。%Objective To investigate the clinical effect of manual rotation applied to the midwifery care for head position dystocia. Methods An analysis was conducted on the clinical data of 80 puerperants with head position dystocia admitted in our hospital from April 2013 to April 2014. The puerperants were divided into the control group and the experimental group in accordance with different methods of care given to them. The control group adopted natural childbirth and midwifery care, and the experimental group adopted the midwifery care of manual rotation for fetal malposition. And the nursing efficacy was compared between the two groups. Results In the experimental group, there were 24 cases with natural childbirth, accounting for 60%, 12 cases with vaginal midwifery, accounting for 30%. In the control group, 30% of the puerperants had natural childbirth, 20% of the puerperants had vaginal midwifery. The experimental group was much better than the control group in the above two aspects(P<0.05). The cesarean

  12. The Application Signiifcance of Head Dystocia Maternal Midwifery Care in the Rotation of the Hand%头位难产产妇助产护理中徒手旋转的应用意义研究

    Institute of Scientific and Technical Information of China (English)

    钱兰

    2016-01-01

    Objective To analyze the significance of application of head dystocia maternal midwifery care in the rotation of the hand. MethodsStudy object selected from July 2013 to June 2015 in our hospital in 86 cases of the ifrst birth mother, The patients were randomly divided into the experimental group and the control group, 43 cases in each group. The control group used conventional nursing and midwifery intervention;experimental group of patients with manual rotation of nursing and midwifery, the pregnancy outcomes of the two groups were observed and compared.Results The natural delivery rate of the experimental group was higher than that of the control group, the number of cases of cesarean section was lower than the control group, the difference was statistically signiifcant (P<0.05). The experimental group were shorter than the control during the second stage of labor, fetal distress and neonatal asphyxia rate was lower than the control group, the difference was statistically signiifcant (P<0.05).Conclusion The head dystocia midwifery care in maternal hand rotation can help the descending of fetal head, promote maternal and child safety, reduce the rate of cesarean section.%目的:分析头位难产产妇助产护理中徒手旋转的应用意义。方法研究对象选取本院2013年7月~2015年6月收治的86例头位难产产妇,随机将患者分为实验组与对照组,各43例。对照组常规应用助产干预和护理;实验组患者应用徒手旋转助产和护理,对两组产妇的妊娠结局进行观察对比。结果实验组产妇的自然分娩率高于对照组、剖宫产例数低于对照组,差异有统计学意义(P<0.05);实验组产妇第二产程短于对照,新生儿宫内窘迫及窒息率低于对照组,差异有统计学意义(P<0.05)。结论头位难产产妇助产护理中徒手旋转能够帮助胎头下降,促进母婴安全、减少剖宫产率。

  13. Clinical Effect of Manual Rotation Fetal Head With Lateral Decubitus Position in Head Presentation Dystocia%徒手旋转胎头辅以对侧卧位处理头位难产的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    刘海燕

    2015-01-01

    Objective To investigate the clinical effect of manual rotation fetal head with lateral decubitus treatment in head presentation dystocia. Methods 100 dystocia parturients in department of obstetrics and gynecology from January to December 2013 were randomly divided into the observation group and the control group,50 cases in each group. The control group patients were given fetal back for delivery on lateral position,and the observation group patients were given lateral position and manual rotation fetal head delivery method at same time. Compared the delivery success rate of two groups. Results The delivery success rate of the observation group was significantly higher than it of the control group. The differences between two groups were statistical significant(P<0.05). Conclusion The effect of manual rotation fetal head with lateral decubitus position is significant in head dystocia.%目的:探讨徒手旋转胎头辅以对侧卧位处理头位难产的临床效果。方法选取我院妇产科2013年1~12月收治的难产产妇100例,并将其随机分为观察组与对照组,每组50例。对照组患者取胎背对侧卧位法进行分娩;观察组患者取对侧卧位,同时以徒手旋转胎头法进行分娩。比较两组患者的分娩成功率。结果观察组患者的分娩成功率高于对照组,组间差异具有统计学意义(P<0.05)。结论徒手旋转胎头辅以对侧卧位处理头位难产效果显著。

  14. The Clinical Effect of Manual Rotation Fetal Head With Lateral Decubitus Position in Treatment of Head Presentation Dystocia%徒手旋转胎头辅以对侧卧位处理头位难产的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    刘艳

    2015-01-01

    Objective To investigate the clinical effect of manual rotation fetal head with lateral decubitus in treatment of head presentation dystocia. Methods Selected 100 examples of childbirth parturient woman in our hospital and then they were randomly divided into observation group and control group, 50 cases in each group. The control group patients received fetal back for delivery on lateral position, the observation group patients received lateral position, at the same time with manual rotation fetal head delivery method. Compared two groups of patients with the delivery success rate. Results The patients in the observation group the delivery success rate was significantly higher than the control group, the results had statistical significance(P<0.05). Conclusion Manual rotation fetal head with lateral decubitus in treatment of head dystocia is effective.%目的:探讨徒手旋转胎头辅以对侧卧位处理头位难产的临床效果。方法选取我院妇产科收治的难产产妇100例,并将其随机分为观察组与对照组,每组患者50例。对照组患者取胎背对侧卧位法进行分娩;观察组患者取对侧卧位,同时以徒手旋转胎头法进行分娩。比较两组患者的分娩成功率。结果观察组患者的分娩成功率高于对照组,组间差异具有统计意义(P<0.05)。结论徒手旋转胎头辅以对侧卧位处理头位难产效果显著。

  15. 改良 HEL PERR 程序预防肩难产致新生儿产伤及对产妇身心状况的影响%The modified HELPERR procedures to prevent the shoulder dystocia and neonatal birth and impact on the physical and mental status of pregnant women

    Institute of Scientific and Technical Information of China (English)

    李艳

    2015-01-01

    目的:探讨改良 HELPERR程序预防肩难产致新生儿产伤及对产妇身心状况的影响。方法选择2010年1月~2011年7月我科收治的175例肩难产产妇设为对照组,采取常规 HELPERR程序助产接生;选取2013年1月~2014年7月收治的184例肩难产产妇设为研究组,采取改良 HELPERR程序应用于阴道分娩全程。比较两组新生儿产伤、产后并发症发生率、产后抑郁症发生率及满意度。结果研究组窒息、骨骼损伤、臂丛神经损伤及胸锁乳突肌血肿发生率均低于对照组,有显著性差异(P<0.05)。产后出血、产道损伤、产褥感染及耻骨联合分离发生率低于对照组,有显著性差异(P<0.05)。研究组产褥期抑郁症发生率低于对照组,有显著性差异(P<0.05)。研究组满意度高于对照组,有显著性差异(P<0.05)。结论改良 HELPERR程序能降低肩难产致新生儿产伤及产妇并发症发生率,同时还能提高产妇心理舒适度,降低产后抑郁症发生率,取得较为满意的临床效果。%Objective To explore the modified HELPERR procedures to prevent the shoulder dystocia and neonatal birth and impact on the physical and mental status of pregnant women ,and for high risk parturient shoulder dystocia optimization scheme of evidence-based data accumulation .Methods A retrospective analysis of 175 cases of maternal shoulder dystocia in our hospital in 2010 January ~2011 year in July obstetrics were set as control group ,take ,conventional HELPERR pro‐gram development of midwifery delivery ;184 cases of shoulder selects my courtyard in 2013 January ~2014 year in July ob‐stetrics from dystocia maternal ,set as study group ,to adopt a modified HELPERR procedure applied to the whole process of vaginal delivery .Recorded the incidence of two groups of neonatal and maternal complications ,and two groups were com‐pared with the incidence of postpartum depression

  16. 体位改变配合徒手矫正胎方位用于头位难产的临床价值%Clinical Value of Postural Change Combined with Manual Correction of Fe-tal Position Applied to Head Dystocia

    Institute of Scientific and Technical Information of China (English)

    朱月英

    2015-01-01

    目的:分析体位改变配合徒手矫正胎方位在头位难产中的临床应用价值。方法选择该院在2013年12月-2014年12月收治的110例头位难产产妇作为分析对象,将110例分为观察组与对照组,每组55例,采用两种不同的方法帮助头位难产产妇实现顺利分娩,观察组为体位改变配合徒手矫正,对照组为单纯性徒手矫正。结果观察组的自然分娩率及产钳助产率均高于对照组,两组在自然分娩率上差异有统计学意义(P<0.05),观察组的剖宫产率明显低于对照组差异有统计学意义(P<0.05)。结论在头位难产中应用体位改变配合徒手矫正的方法可以改善妊娠结局,应推广使用。%Objective To analyze the clinical value of postural change combined with manual correction of fetal position applied to head dystocia. Methods 110 puerperants with head dystocia admitted in our hospital from December 2013 to December 2014 were selected as the subjects and divided into the observation group and the control group with 55 cases in each. In order to help the puerperants deliver successfully, postural change combined with manual correction of fetal position was given to the observation group, and manual correction of fetal position was given to the control group. Results Compared with the control group, the obser-vation group had obviously higher natural childbirth rate(P<0.05), higher forceps delivery rate and significantly lower cesarean sec-tion rate (P<0.05). Conclusion Postural change combined with manual correction of fetal position can improve the prognosis of pregnancy, so it is recommended to be implemented widely.

  17. 徒手旋转胎头辅以对侧卧位处理头位难产的临床疗效分析%The analysis of clinical curative effect on head dystocia by manual rotation fetal head with the lateral position

    Institute of Scientific and Technical Information of China (English)

    许淑兰

    2014-01-01

    目的:探讨分析徒手旋转胎头辅以对侧卧位处理头位难产的临床疗效。方法回顾性分析2011年6月至2013年12月间在我院进行治疗的148例头位难产产妇的临床记录资料。结果治疗后,观察组的剖宫产率明显低于对照组,具有显著性差异(P0.05)。观察组的并发症发生率明显低于对照组,具有显著性差异(P0.05). The occurance rate of complications in observation group were signiifcantly lower than that in the control group, with signiifcant difference (P <0.05).Conclusionthere was a remarkable clinical curative effect on manual rotation fetal head with lateral decubitus treatment for dystocia, which is worthy of spreading in clinical practice.

  18. 顺应宫缩连续娩肩法与传统娩肩法预防肩难产新生儿产伤的效果比较%With Continuous Contraction Mian Shoulder Method and the Traditional Method of Preventing Mian Shoulder Dystocia Effect of Neonatal Injury

    Institute of Scientific and Technical Information of China (English)

    江文; 古丹婷; 古丽端; 曾露剑

    2016-01-01

    目的:探讨顺应宫缩连续娩肩法与传统娩肩法预防肩难产新生儿产伤的效果比较。方法选取2012年9月至2015年9月五华县中医医院产科收治的60例自然分娩肩难产产妇作为研究对象,根据助产接生方式的不同将其分为对照组和观察组,各30例。对照组产妇选择传统娩肩方法进行分娩,观察组产妇采用顺应宫缩连续娩肩法,比较两组新生儿产伤发生情况与产妇产后并发症及产褥期抑郁症发生情况。结果观察组新生儿的轻度窒息、肱骨骨折、臂丛神经损伤、胸锁乳肌血肿发生率均明显低于对照组,差异均有统计学意义(均P<0.05);观察组产妇产道损伤、产后出血、产褥感染、产褥期抑郁症发生率均明显低于对照组,差异均有统计学意义(均P<0.05)。结论顺应宫缩连续娩肩法可有效改善新生儿及产妇分娩结局,效果较传统娩肩法更胜一筹。%Objective To conform to the continuous contraction Mian shoulder method and the traditional methodof preventing Mian shoulder shoulder dystocia effect of neonatal injury.Methods Select September 2012 to 2015 years 9 month Wuhua County Hospital of traditional Chinese medicine in obstetric department of 60 cases of spontaneous delivery of shoulder dystocia maternal as the research object,according to different midwifery delivery wil be divided into the observation group and the control group,with 30 cases in each.Control group mothers choose traditional Mian shoulder method of delivery,the observation group of mothers using adaptation uterine continuous Mian shoulder method,were compared between the two groups of neonatal birth trauma occurred and postpartum complications and puerperal depression.Results Observation of neonatal group of mild asphyxia,humerus fracture, brachial plexus injury,chest lock breast muscle hematoma incidence was significantly lower than that in control group,diferences were

  19. Late gestation not dystocia%晚孕≠难产

    Institute of Scientific and Technical Information of China (English)

    高琳; 翟建军(指导专家)

    2006-01-01

    经历生活和工作双重压力的你,是否已错过最佳生育年龄?晚孕,就会难产吗?体形不易恢复,宝宝不够健康……这些是否都会成为你的顾虑?其实,你完全可以打消顾虑,因为,晚孕不等于难产。

  20. 头位难产的临床分析%Clinical analysis of head position dystocia

    Institute of Scientific and Technical Information of China (English)

    肖琼坤

    2012-01-01

    目的 探讨头位难产的原因及分娩方式.方法 回顾性分析251 例头位难产的临床资料,对其结果和产生原因进行分析探讨.结果251 例头位难产中65 例为持续性枕后位,108 例为持续性枕横位,共占头位难产的68.9%,23 例为产道异常,8 例为巨大儿,7 例为精神心理因素.结论 密切观察产程进展和胎头下降,是早期发现头位难产的重要手段,选择良好分娩方式,能降低母婴危险因素.

  1. Systemic mycoplasmosis with dystocia and abortion in North American bison (Bison bison) herd

    Science.gov (United States)

    Mycoplasma bovis has recently emerged as a significant health threat in bison and is an increasing concern and source of economic loss for producers. Clinical manifestations of infection documented in bison include pneumonia, respiratory distress and polyarthritis. The current study describes the ...

  2. Effect of sexed-semen use on Holstein conception rate, calf sex, dystocia, and stillbirth in the United States

    Science.gov (United States)

    Most artificial-insemination organizations in the United States now market sex-sorted semen. For 10.8 million US Holstein breedings with conventional semen since January 2006 and 122,705 sexed-semen breedings, data were available from all breedings for conception rate, 12 and 9% of breedings for cal...

  3. Does teaching of documentation of shoulder dystocia delivery through simulation result in improved documentation in real life?

    Science.gov (United States)

    Comeau, Robyn; Craig, Catherine

    2014-03-01

    Objectif : La documentation des accouchements compliqués par une dystocie de l’épaule constitue une compétence communicationnelle précieuse que les résidents doivent chercher à maîtriser au cours de leur formation. Nous avions pour objectif de déterminer si l’enseignement de la documentation de la dystocie de l’épaule dans le cadre d’une simulation se traduisait en une amélioration de la documentation d’un tel événement dans le cadre d’une situation clinique réelle. Méthodes : Nous avons mené, entre novembre 2010 et décembre 2012, une étude de cohorte portant sur des résidents en obstétrique-gynécologie qui en étaient rendus à la 2e, 3e, 4e ou 5e année de leur formation. Chacun de ces résidents a participé à une séance de simulation de la dystocie de l’épaule; à cette occasion, nous leur avons demandé de rédiger une note sur l’accouchement immédiatement à la suite de la séance de simulation. Des commentaires leur ont été offerts quant à leur rendement au cours de l’accouchement et à leur documentation des événements. Par la suite, les dossiers dictés liés aux accouchements compliqués par une dystocie de l’épaule ayant eu lieu immédiatement avant et après la séance de simulation ont été récupérés dans le système Meditech. Une liste de vérification détaillée a été utilisée pour évaluer la qualité de la documentation dictée par les résidents avant et après la séance de simulation. Résultats : Tous les résidents admissibles (18) se sont inscrits à l’étude et 17 d’entre eux ont répondu aux critères d’inclusion. Dix résidents (59 %) avaient procédé à la documentation d’un accouchement compliqué par une dystocie de l’épaule avant et après la séance de simulation, cinq résidents (29 %) n’avaient procédé à une telle documentation qu’avant la séance et deux résidents (18 %) ne l’avaient fait qu’après la séance. Lorsque l’évaluation a porté sur les résidents en tant que groupe, aucune différence n’a été constatée pour ce qui est de la proportion des résidents consignant des articles tirés de la liste de vérification avant et après la séance de simulation (P > 0,05 pour tous). De façon semblable, l’analyse du rendement des 10 résidents qui avaient dicté une documentation tant avant qu’après la séance n’a révélé aucune différence pour ce qui est du nombre d’éléments consignés dans cette documentation avant et après la simulation (P > 0,05 pour tous). Conclusion : L’enseignement de la documentation de la dystocie de l’épaule au moyen de la simulation ne s’est pas traduit en une amélioration mesurable de la qualité de la documentation de la dystocie de l’épaule dans des situations cliniques réelles.

  4. Effect of restricting silage feeding prepartum on time of calving, dystocia and stillbirth in Holstein-Friesian cows

    Directory of Open Access Journals (Sweden)

    Gleeson David E

    2007-11-01

    Full Text Available Abstract A study was carried out to investigate the effect of restricting silage feeding on time of calving and calving performance in Holstein-Friesian cows. In the treatment group (n = 1,248 cows, 12 herds silage feeding commenced in the evening (17:00 to 20:00 h, after a period of restricted access (2 to 10 h while in the control group ad-libitum access to silage was provided over the 24 h period (n = 1,193 cows, 12 herds. Daytime and nighttime calvings were defined as calvings occurring between the hours of 06:30 and 00:29 and between 00:30 and 06:29, respectively. Restricting access to silage resulted in less calvings at night compared to cows with ad-libitum access to silage (18 vs 22%, P

  5. 21 CFR 510.410 - Corticosteroids for oral, injectable, and ophthalmic use in animals; warnings and labeling...

    Science.gov (United States)

    2010-04-01

    ... parturition may be followed by dystocia, fetal death, retained placenta, and metritis. Additionally... last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal...

  6. 21 CFR 522.775 - Doxapram.

    Science.gov (United States)

    2010-04-01

    ... reflexes after anesthesia. Administer to neonate dogs and cats to initiate respiration following dystocia or caesarean section; or to stimulate respiration following dystocia or caesarean section....

  7. Experience of treatment dystocia in female dogs by caesarean birth%剖腹产手术治疗母犬难产的体会

    Institute of Scientific and Technical Information of China (English)

    徐海忠

    2004-01-01

    随着畜牧业的发展,人民生活水平的不断提高,宠物爱好者的增加,犬的饲养数量越来越大,母犬在产仔过程中遇到难产的现象,也就明显增加,笔者在日常门诊中曾多次遇到过此病例,对其中有的病例使用剖腹产术治疗难产,取得较好的疗效,现将治疗体会总结报告如下:

  8. Effect of HELPERR mnemonic in shoulder dystocia on pregnancy outcome%HELPERR法处理肩难产对母婴结局的影响

    Institute of Scientific and Technical Information of China (English)

    于燕; 任利容; 黄小红; 张锐; 李桂青

    2011-01-01

    目的:探讨HELPERR法处理肩难产对母婴结局的影响.方法:采用回顾性研究方法,将采用HELPERR法处理的肩难产病例21例设为研究组,将用传统方法处理的肩难产17例设为对照组,比较两组新生儿窒息、臂丛神经损伤、锁骨骨折、颅内出血及新生儿缺血缺氧性脑病的发生率,产妇会阴伤口延裂、会阴Ⅲ度裂伤的发生率及产后出血等情况,并进行统计对比分析.结果:研究组新生儿轻度窒息发生率14.28%(3/21);对照组新生儿轻度窒息发生率47.0%(8/17),两组比较,差异有统计学意义(P0.05),但研究组母婴并发症明显低于对照组.结论:HELPERR法处理肩难产显著降低母婴并发症的发生,值得临床推广,每位产科医生及助产士必需熟练掌握HELPERR法.

  9. Use of sexed semen and its effect on conception rate, calf sex, dystocia, and stillbirth of Holsteins in the United States

    Science.gov (United States)

    Sexed-semen use for breeding Holstein heifers and cows in Dairy Herd Improvement herds was documented by frequency and percentage for parity and service number as well as for herd region, size, and milk yield. Year of breeding accounted for the most variation in the amount of use of sexed semen for ...

  10. Incidence of shoulder dystocia and its relation to brachial plexus palsy: a 10 year retrospective review at King Abdulaziz University Hospital

    Directory of Open Access Journals (Sweden)

    Ayman A. Bukhari

    2016-12-01

    Conclusions: Most of clinically diagnosed SD cases did not give the consequence of BPP. However, this complication in addition to other complications of SD mandates extra caution in cases with risk factors. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4415-4418

  11. Early identification and intervention for head-position dystocia%头位难产早期识别和干预

    Institute of Scientific and Technical Information of China (English)

    范玲

    2010-01-01

    头位难产是异常分娩中常见的也是最难诊断的,早期识别并干预非常重要,可改善母儿预后.头位难产的临床表现有胎膜早破、产程异常、原发或继发宫缩乏力、胎头未衔接或延迟衔接、产妇过早屏气、宫颈阴道水肿及排尿困难等.无明显头盆不称时,应给予产妇充分试产的机会.

  12. Abnormal Position and Presentation of the Fetus

    Science.gov (United States)

    ... Membranes (PROM) Preterm Labor Prolapsed Umbilical Cord Shoulder Dystocia Uterine Rupture Augmentation or Slowing of Labor Cesarean ... Membranes (PROM) Preterm Labor Prolapsed Umbilical Cord Shoulder Dystocia Uterine Rupture Augmentation or Slowing of Labor Cesarean ...

  13. What Are Some Common Complications During Labor and Delivery?

    Science.gov (United States)

    ... delivery, or just after birth. 3 , 4 Shoulder dystocia. In this situation, the infant’s head has come ... Obstetricians and Gynecologists. (2003). ACOG Practice Bulletin: Shoulder dystocia. International Journal of Gynecology & Obstetrics, 80, 87–92. [ ...

  14. 21 CFR 520.540b - Dexamethasone tablets and boluses.

    Science.gov (United States)

    2010-04-01

    ... dystocia, fetal death, retained placenta, and metritis. (vi) Federal law restricts this drug to use by or... parturition followed by dystocia, fetal death, retained placenta, and metritis. (b) Do not use in...

  15. The Influence of Parity on the Outcomes of Pregnancy

    Science.gov (United States)

    1990-06-01

    malpresentations, uterine rupture, dystocia , etc. Results G.M. is at higher risk for malpresentation, CPD and uterine rupture due to pendulous...functional dystocia . 98 Date, Researchers, Site: 1968 Duckman, S., Chen, W., Gungon, T., & Bonura, F. New York Type of Study Retrospective Descriptive To...analysis of dystocia and use of cesareans January 1985 to June 1985 Sample Characteristics Subjects come from three practices in Texas 2,324 total births

  16. 21 CFR 520.1408 - Methylprednisolone tablets.

    Science.gov (United States)

    2010-04-01

    ... during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia... presence of active tuberculosis, diabetes, osteoporosis, chronic psychotic reactions, predisposition...

  17. 21 CFR 520.1409 - Methylprednisolone, aspirin tablets.

    Science.gov (United States)

    2010-04-01

    ... of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained..., osteoporosis, predisposition to thrombophlebitis, hypertension, congestive heart failure, or...

  18. 21 CFR 522.540 - Dexamethasone injection.

    Science.gov (United States)

    2010-04-01

    ... precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis. (iv... premature parturition followed by dystocia, fetal death, retained placenta, and metritis. (iv) Not for use... during the last trimester of pregnancy and may precipitate premature parturition followed by...

  19. Oral Prenatal and Postnatal Development Study of WR238605 Succinate in Rats. Volume 2 of 2

    Science.gov (United States)

    1996-09-18

    litter loss. Females that fail to deliver will be euthanized and necropsied on presumed gestation day 25. Females which demonstrate dystocia (i.e...day 25 (i.e., 25 days after evidence of mating was detected). Females which demonstrate dystocia (i.e., incomplete delivery) will be euthanized and

  20. Women in the Military; Pregnancy, Command Climate, Organizational Behavior, and Outcome. Part 1

    Science.gov (United States)

    1996-05-01

    problem 42-43 (up to 3) 02) shoulder dystocia 44-45 03) intolerance to contractions 04) knot in cord 05) terminal mec. 160 06) fetal distress 07) RO...hypoplasig 24) bilateral fetal renal cysts 18. COMPLICATIONS: List of text for baby 40-41 BABY 01) nuchal chord problem 42-43 (up to 3) 02) shoulder dystocia

  1. International Meeting on Simulation in Healthcare 2007

    Science.gov (United States)

    2007-03-01

    100% of staff. A reduction in low Apgar score, Hypoxic­  ischaemic encephalopathy (HIE) and brachial plexus injuries  associated with shoulder  dystocia ...Healthcare  Research Abstract : 62  Effect Of Cardinal Movements On Fetal Mechanical Response During Simulated Shoulder  Dystocia   Deliveries.  Robert Allen...Obstetrics, Johns Hopkins University,  Baltimore, Maryland OBJECTIVE: In simulated shoulder dystocia deliveries, we sought to compare neck extension

  2. Pregnancy and Obesity: Know the Risks

    Science.gov (United States)

    ... index, maternal weight change and offspring birthweight. Acta Obstetricia et Gynecologica Scandinavica. 2012;91:243. Quinlivan JA, ... Heart. 2012;98:474. Fetal dystocia. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/print/ ...

  3. 21 CFR 522.542 - Dexamethasone-21-isonicotinate suspension.

    Science.gov (United States)

    2010-04-01

    ... during the last trimester of pregnancy and may precipitate premature parturition following by dystocia, fetal death, retained placenta, and metritis. (4) Not for use in horses intended for food. (5)...

  4. 21 CFR 520.540a - Dexamethasone powder.

    Science.gov (United States)

    2010-04-01

    ... administered during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis. (4) Federal law restricts this drug to use by or...

  5. 21 CFR 520.540c - Dexamethasone chewable tablets.

    Science.gov (United States)

    2010-04-01

    ... parturition when administered during the last trimester of pregnancy; and they may precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis. (iii) Do not use in...

  6. Practice Bulletin No. 173: Fetal Macrosomia

    National Research Council Canada - National Science Library

    2016-01-01

    Suspected fetal macrosomia is encountered commonly in obstetric practice. As birth weight increases, the likelihood of labor abnormalities, shoulder dystocia, birth trauma, and permanent injury to the neonate increases...

  7. Clinical impact of mild carbohydrate intolerance in pregnancy

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Damm, P; Sørensen, B

    2001-01-01

    . Information on oral glucose tolerance test results and clinical outcomes was collected from laboratory charts and medical records. RESULTS: The following outcomes increased significantly with increasing glucose values during the oral glucose tolerance test: shoulder dystocia, macrosomia, emergency cesarean...

  8. Practice Bulletin No. 173 Summary: Fetal Macrosomia

    National Research Council Canada - National Science Library

    2016-01-01

    Suspected fetal macrosomia is encountered commonly in obstetric practice. As birth weight increases, the likelihood of labor abnormalities, shoulder dystocia, birth trauma, and permanent injury to the neonate increases...

  9. 77 FR 38844 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

    Science.gov (United States)

    2012-06-29

    .... Potential complications during pregnancy and delivery include preeclampsia (high blood pressure and excess protein in the urine), caesarean delivery, macrosomia (large birth weight), shoulder dystocia (when a baby's shoulders become lodged during delivery), and birth injuries. For the neonate, complications...

  10. Identification of a myometrial molecular profile for dystocic labor.

    LENUS (Irish Health Repository)

    Brennan, Donal J

    2011-01-01

    The most common indication for cesarean section (CS) in nulliparous women is dystocia secondary to ineffective myometrial contractility. The aim of this study was to identify a molecular profile in myometrium associated with dystocic labor.

  11. Neonatal brachial plexus injury: comparison of incidence and antecedents between 2 decades.

    LENUS (Irish Health Repository)

    Walsh, Jennifer M

    2011-04-01

    We sought to compare the incidence and antecedents of neonatal brachial plexus injury (BPI) in 2 different 5-year epochs a decade apart following the introduction of specific staff training in the management of shoulder dystocia.

  12. Análise dos fatores relacionados a 60 casos de distocia em ovelhas no Agreste e Sertão de Pernambuco Analysis of factors related to 60 dystocia cases in ewes in the Agreste and semiarid region of Pernambuco, Northeastern Brazil

    OpenAIRE

    Antônio Carlos Lopes Câmara; José Augusto Bastos Afonso; Alexandre Cruz Dantas; Janaina Azevedo Guimarães; Nivaldo de Azevêdo Costa; Maria Isabel de Souza; Carla Lopes de Mendonça

    2009-01-01

    O presente trabalho objetiva relatar os principais tipos de distocias em ovelhas, no Agreste e Sertão de Pernambuco, e avaliar alguns fatores relacionados com sua ocorrência, bem como determinar a eficiência dos tratamentos utilizados. A maior incidência de partos distócicos ocorreu na estação chuvosa, com 61,7% dos casos. Os resultados mostraram predominância de distocias de origem materna (71,6%) sobre a fetal (29,4%), com maior incidência em ovelhas primíparas da raça Santa Inês, com gesta...

  13. The clinical value of the modified scoring method for head-position delivery in the diagnosis of head-position dystocia%改良头位分娩评分法识别头位难产临床应用价值的研究

    Institute of Scientific and Technical Information of China (English)

    颜建英; 崔小妹; 刘青闽; 陈文祯

    2005-01-01

    目的:探讨改良头位分娩评分法用于识别头位难产的可行性及临床应用价值.方法:应用改良头位分娩评分法对625例足月分娩的初孕产妇适时评分,采取相应措施,选择正确分娩方式.结果:改良头位分娩评分法与头位分娩评分法比较,其识别头位难产的敏感性和特异性较高,误诊和漏诊较少.影响头位分娩的诸因素中先露下降、宫口扩张、胎位、宫缩强度、活跃期长短与难产相关性较大;改良法临产评分≤50分者,69.5%需行剖宫产术,>50分者,94.82%经阴道分娩,与头位分娩评分法比较,改良法与分娩结局更吻合;不同分娩方式处理后,改良法评分均有不同程度地提高,提高越明显,自然分娩几率越高.结论:改良头位分娩评分法将影响分娩的诸因素进行量化评分,能更及时、准确地判断头位顺产或难产,正确选择分娩方式,减少了产科并发症.

  14. Changing Labor and Delivery Practice: Focus on Achieving Practice and Documentation Standardization with the Goal of Improving Neonatal Outcomes.

    Science.gov (United States)

    Burstein, Paul D; Zalenski, David M; Edwards, John L; Rafi, Ishrat Z; Darden, Jennifer F; Firneno, Cassandra; Santos, Palmira

    2016-12-01

    To establish multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. Primary data collection was conducted over 3 years. Implementation of the protocol spanned 13 months. Data collection occurred at five sites, which were chosen for their diversity in both patient mix and geographical location. Case study evaluation methodology was used to examine clinician engagement and protocol adoption. The training completion for all practice engagement team activities was collected by the site project manager and entered into a flat file. Data from the labor and delivery notes, medical records, and interviews with labor and delivery teams were gathered and analyzed by the senior investigator. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements and in subsequent years, 98 percent completed the follow-up training. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol. System and site management teams implemented a standardized shoulder dystocia protocol that fostered effective teamwork and obstetric team readiness for managing shoulder dystocia emergencies. © Health Research and Educational Trust.

  15. Vaginal leiomyoma in pregnancy presenting as a prolapsed vaginal mass.

    Science.gov (United States)

    Dane, Cem; Rustemoglu, Yaprak; Kiray, Murat; Ozkuvanci, Unsal; Tatar, Zeynep; Dane, Banu

    2012-12-01

    Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour.

  16. Reproductive Performance of Saanen Goats under Rural or Intensive Management Systems in Elazığ Region, Turkey

    Directory of Open Access Journals (Sweden)

    Yaşar Akar

    2013-01-01

    Full Text Available This study was carried out to compare the reproductive performance of Saanen goats under rural (n:75 and intensive (n:206 management systems in Elazığ region. Single and multiple births, stillbirth, dystocia, abortion and kids survival rates were determined in both the goat flocks between February 1 and April 30 2011. Percentages of single and multiple births, stillbirth, dystocia and abortion were not statistically different between the flocks. However, the kids survival rates of intensive management system (74.05% were lower than rural management system (88.88%, (P<0.003. Overall percentage of single and multiple births, stillbirth, dystocia, abortion and kids survival in all goats were 45.08, 54.92, 17.62, 12.29, 13.16 and 78.40%, respectively. Our results show that rural and intensive management systems do not have an important effect on reproductive performance of Saanen goats.

  17. Fear of childbirth and risk for birth complications in nulliparous women in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Laursen, M; Johansen, C; Hedegaard, M

    2009-01-01

    OBJECTIVES: To examine the associations between fear of childbirth and emergency caesarean section and between fear of childbirth and dystocia or protracted labour and fetal distress. DESIGN: Prospective cohort study. SETTING: Danish National Birth Cohort. POPULATION: A total of 25 297 healthy...... for emergency caesarean section of women who feared childbirth; risk for dystocia/protracted labour or fetal distress of women who feared childbirth. RESULTS: Fear of childbirth in early (16 weeks, 6 +/- 29 days) and late (31 weeks, 4 +/- 21 days) pregnancy was associated with emergency caesarean section: OR, 1.......23 (1.05-1.47) and 1.32 (1.13-1.55), respectively. When fear of childbirth was expressed at both interviews, the OR was 1.43 (1.13-1.80). Women who feared childbirth had an increased risk for dystocia or protracted labour (OR, 1.33; 1.15-1.54), but not for fetal distress (OR, 0.94; 0...

  18. Physiologic partograph to improve birth safety and outcomes among low-risk, nulliparous women with spontaneous labor onset.

    Science.gov (United States)

    Neal, Jeremy L; Lowe, Nancy K

    2012-02-01

    Oxytocin augmentation and cesarean rates among low-risk, term, nulliparous women with a spontaneous onset of labor in the United States approximate 50% and 26.5%, respectively. This indicates that the quality of obstetrical care is less than optimal in this nation. Exorbitant oxytocin use, the intervention most commonly associated with preventable adverse perinatal outcomes, jeopardizes birth safety while the high cesarean rate in this high-volume group compromises population health and increases health care costs. Dystocia, characterized by the slow, abnormal progression of labor, is the most commonly reported indication for primary cesareans, accounting directly for approximately 50% of all nulliparous cesareans and indirectly for most repeat cesareans. Diagnoses of dystocia are most often based on ambiguously defined delays in cervical dilation beyond which labor augmentation is deemed justified. Dystocia is known to be over-diagnosed which undoubtedly contributes to contemporary oxytocin augmentation and primary cesarean rates. Labor attendants would benefit from an evidence-based framework for homogenous labor assessment. To this end, we present a physiologically-based partograph for 'in-hospital' use in assessing the labors of low-risk, term, nulliparous women with spontaneous labor onset. This tool incorporates several evidence-based labor principles that combine to give needed clinical meaning to 'dystocia' as a diagnosis. It is hypothesized that our partograph will safely limit diagnoses of dystocia to only the slowest 10% of low-risk, nulliparous women. This should, in turn, safe-guard against unnecessary, injudicious, and potentially harmful use of oxytocin when labor is already adequately progressing while also indicating when its use may be justified. We further hypothesize that cesareans performed for dystocia in this population will decrease by ≥ 50%. No significant influence on other labor process or labor outcome variables is expected with

  19. Fetal and maternal complications in macrosomic pregnancies

    Directory of Open Access Journals (Sweden)

    Cheng YK

    2014-03-01

    Full Text Available Yvonne Kwun-Yue Cheng, Terence T LaoDepartment of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong KongAbstract: The prediction and management of fetal macrosomia remains an obstetric challenge. Significant maternal and neonatal complications can result from the birth of a macrosomic infant, and include prolonged labor, operative delivery, postpartum hemorrhage, perineal trauma, shoulder dystocia, birth trauma, chorioamnionitis, meconium aspiration, perinatal asphyxia, low Apgar scores, neonatal hypoglycemia, and perinatal mortality. This review article discusses these maternal and perinatal risks and the management of suspected macrosomia.Keywords: macrosomia, large for gestational age, shoulder dystocia, birth trauma, perineal tear

  20. Problems of the pelvic passageway

    Energy Technology Data Exchange (ETDEWEB)

    Langnickel, D.

    1987-01-01

    In this book, measurements by clinical, X-ray, ultrasound, CT and MRI pelvimetry are presented. Fetopelvic scores for vertex and breech presentations can facilitate delivery planning. Management of labor, dystocia and relative fetopelvic disproportion are outlined, as well as features distinguishing primigravid from multigravid labor. The book also deals with trial of labor, forceps and vacuum extraction, and their effects on fetal and maternal outcome. Many other aspects, such as shoulder dystocia, hypoxia, symphysiotomy, premature rupture of membranes, episiotomies, cervical scores and the use of cervical dilators, are discussed in detail.

  1. Studies on Influence of Seasonality on Clinical Conditions of Small ...

    African Journals Online (AJOL)

    SH

    Non-infectious conditions such as dystocia (13.92%) and fractures (9.71%) were ... as well as prophylactic treatment (7.77%) were reported most in early dry season respectively. ... Materials and Methods ... Percentage. Abscesses. 4. 0. 4. 1.94. Amputation. 1. 0. 1. 0.49. Anaemia. 1. 0. 1 ..... and horse, Ninth Edition, Bailliere.

  2. multiple congenital skeletal malformations in a associated with ...

    African Journals Online (AJOL)

    There were multiple skeletal malformations which included brachygnathia, arthrogryposis and ... Dystocia was believed to be a result of fetal monstrosity resulting in abnormal posture. The cause ... subsequent pregnancies are envisaged. ... veterinarian to deliver a dead lamb that ... difficult to understand why only one of the.

  3. Four decades of conjoined twins at Red Cross Children's Hospital ...

    African Journals Online (AJOL)

    Fetal Medicine Unit, Groote Schuur Hospital and University of Cape Town. L S Matthews, MB ChB .... echocardiography, ultrasonography, computed tomography. (CT) and magnetic ... anomalous pulmonary veins, atrioventricular septal defects,. September 2006 .... maturity, because of the high rate of stillbirths and dystocia.

  4. Practice Bulletin No. 173: Fetal Macrosomia.

    Science.gov (United States)

    2016-11-01

    Suspected fetal macrosomia is encountered commonly in obstetric practice. As birth weight increases, the likelihood of labor abnormalities, shoulder dystocia, birth trauma, and permanent injury to the neonate increases. The purpose of this document is to quantify those risks, address the accuracy and limitations of methods for estimating fetal weight, and suggest clinical management for a pregnancy with suspected fetal macrosomia.

  5. 78 FR 11210 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

    Science.gov (United States)

    2013-02-15

    ... and delivery include preeclampsia (high blood pressure and excess protein in the urine), cesarean delivery, macrosomia (large birth weight), shoulder dystocia (when a baby's shoulders become lodged during delivery), and birth injuries. For the neonate, complications include difficulty breathing at birth...

  6. Estimating internal pelvic sizes using external body measurements in the double-muscled Belgian Bleu beef breed

    NARCIS (Netherlands)

    Coopman, F.; Smet, S.; Gengler, N.; Haegeman, A.; Jacobs, K.; Poucke, van M.; Laevens, H.; Zeveren, van A.; Groen, A.F.

    2003-01-01

    In the double-muscled (DM) Belgian Blue beef (BBB) breed, caesarean section (CS) is being applied systematically as a management tool to prevent dystocia. As a matter of fact, CS is the only possible way of calving in the breed. High birth weight and a relatively small pelvic area are the main cause

  7. Derivation of economic values for veal, beef and milk production traits using profit equations.

    NARCIS (Netherlands)

    Bekman, H.; Arendonk, van J.A.M.

    1993-01-01

    In this study profit equations for milk, veal and beef bull production were developed to obtain economic values for different traits. Veal and beef production were described in terms of fat and protein daily gain. For categorical traits, dystocia and carcass quality traits, economic values were deri

  8. A cow-level association of ruminal pH on body condition score, serum beta-hydroxybutyrate and postpartum disorders in Thai dairy cattle

    NARCIS (Netherlands)

    Inchaisri, C.; Chanpongsang, S.; Noordhuizen, J.; Hogeveen, H.

    2014-01-01

    Subacute ruminal acidosis in dairy cows occurs when ruminal pH is below about 5.5. However, the exact threshold level of ruminal pH affecting cow health is still in debate. This investigation was carried out in 505 cows within 31 farms. The postpartum disorders, including dystocia, retained placenta

  9. The hunt for a functional mutation affecting conformation and calving traits on chromosome 18 in Holstein cattle

    Science.gov (United States)

    Sequence data from 11 US Holstein bulls were analyzed to identify putative causal mutations associated with calving and conformation traits. The SNP ARS-BFGL-NGS-109285 at 57,589,121 bp (UMD 3.1 assembly) on BTA18 has large effects on 4 measures of body shape and size, 2 measures of dystocia, longev...

  10. Comparison of external morphological traits of newborns to inner morpholical traits of the dam in the double-muscled Belgian Blue Beef breed.

    NARCIS (Netherlands)

    Coopman, F.; Gengler, N.; Groen, A.F.; Smet, de S.; Zeveren, van A.

    2004-01-01

    In the double-muscled (DM) Belgian Blue Beef (BBB) breed, caesarean section (CS) is used as a routine management tool to prevent dystocia. This practice is criticized on animal welfare grounds. With unassisted (natural) births, difficulties arise because of disproportion between the sizes of the new

  11. Relative virulence in bison and cattle of bison-associated genotypes of Mycoplasma bovis

    Science.gov (United States)

    Background. Mycoplasma bovis is a cause of respiratory disease in cattle and the bacterium most frequently isolated from bovine respiratory disease complex. It has recently emerged as a major health problem in bison, causing pharyngitis, pneumonia, arthritis, dystocia and abortion. In cattle, M. b...

  12. Caesarean of Lion (Panthera leo at Dulahajra Safari Park, Bangladesh

    Directory of Open Access Journals (Sweden)

    Z.M.M. Rahman

    2011-01-01

    Full Text Available A six years eight months pregnant lioness at the Dulahajara Safari Park, Chakoria, Cox’s Bazar, Bangladesh, was presented with dystocia. This paper described the pre-, intra- and postoperative procedures including anesthetic protocol carried out and performing a caesarean section to remove dead fetuses and the successful recovery of the lioness without complications.

  13. Genetic and Environmental Factors That Impact Gestation Length in Dairy Cattle

    Science.gov (United States)

    Genetic and environmental factors that might affect gestation length (GL) were investigated. Data from over 9 million parturitions from 1999 through 2006 for 7 dairy breeds were assembled from lactation, reproduction, and dystocia records from across the United States. Effects examined were year of ...

  14. Evaluation of Columbia, USMARC-Composite, Suffolk, and Texel rams as terminal sires in an extensive rangeland production system: I. Ewe productivity and crossbred lamb survival and preweaning growth

    Science.gov (United States)

    A 3-yr study was conducted to comprehensively evaluate Columbia, Suffolk, USMARC-Composite (Composite), and Texel breeds as terminal sires in an extensive rangeland production system. The objective was to estimate breed-of-ram effects on ewe fertility, prolificacy, and dystocia, and sire breed effe...

  15. 21 CFR 522.1885 - Prednisolone tertiary butylacetate suspension.

    Science.gov (United States)

    2010-04-01

    ...-inflammatory agent in horses, dogs, and cats.1 (2) It is administered to horses intramuscularly at a dosage... administered intramuscularly to dogs and cats at a dosage level of 1 milligram per 5 pounds of body weight and... pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained...

  16. Prenatal sonographic diagnosis of fetal death and hydranencephaly in two Chihuahua fetuses.

    Science.gov (United States)

    Cruz, Robert De J; Alvarado, Manuel S; Sandoval, Jorge E; Vilchez, Eloina

    2003-01-01

    Hydranencephaly and fetal death was diagnosed in two of three fetuses during the abdominal sonographic examination of a 2.5-year-old, intact female Chihuahua that had clinical signs of dystocia 63 days after mating. A cesarean section was performed and one live normal puppy was present. Two dead puppies, each with a markedly enlarged and fluid filled skull were removed.

  17. The implementation and evaluation of a mandatory multi-professional obstetric skills training program

    DEFF Research Database (Denmark)

    Sørensen, Jette Led; Løkkegaard, Ellen; Johansen, Marianne

    2009-01-01

    OBJECTIVE. To implement and evaluate a simulation-based training program. DESIGN. Descriptive. Study period: June 2003-June 2006. SETTING. Obstetric Department, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. POPULATION. Two training sessions were provided for all health......, shoulder dystocia, basic neonatal resuscitation, and severe preeclampsia. MAIN OUTCOME MEASURES. Before, just after and 9-15 months following the training, data were collected on the confidence and stress levels relating to the carrying out of certain procedures. In addition, a written objective test...... of all respondents had a positive attitude toward the training program. They considered management of shoulder dystocia, preeclampsia, and neonatal resuscitation less stresful and less unpleasant to perform after training. Confidence scores for all the trained skills improved significantly. A significant...

  18. Management of Labor Complicated with Extensive Uterine Prolapse

    Directory of Open Access Journals (Sweden)

    Emre Pabuccu

    2014-02-01

    Full Text Available Management of severe uterine prolapsus during active labor is challenging. Detrimental complications are inevitable unless preventive measures have been taken. Active labor may result with uneventful vaginal delivery, nevertheless impeded cervical dilation, cervical dystocia and obstructive labor are all potential outcomes. Enlarged and edematous cervix accompanying prolapse in such cases may obstruct course of labor and may result with dystocia. In this instance, C-section stands as feasible and safe option for both mother and the fetus. Also, it is more likely to provide normal anatomic texture during C-section with effective prolapse reduction. Moreover, spontaneous resolution of the uterine prolapse is possible following C-section and considering suspension procedures till complete recovery of the pelvic anatomy seems reasonable. In this case report, succesful management of an active labor complicated with extensive uterus prolapse have been described along with current literature findings.

  19. Identification of a Myometrial Molecular Profile for Dystocic Labor

    LENUS (Irish Health Repository)

    Brennan, Donal J

    2011-10-16

    Abstract Background The most common indication for cesarean section (CS) in nulliparous women is dystocia secondary to ineffective myometrial contractility. The aim of this study was to identify a molecular profile in myometrium associated with dystocic labor. Methods Myometrial biopsies were obtained from the upper incisional margins of nulliparous women undergoing lower segment CS for dystocia (n = 4) and control women undergoing CS in the second stage who had demonstrated efficient uterine action during the first stage of labor (n = 4). All patients were in spontaneous (non-induced) labor and had received intrapartum oxytocin to accelerate labor. RNA was extracted from biopsies and hybridized to Affymetrix HuGene U133A Plus 2 microarrays. Internal validation was performed using quantitative SYBR Green Real-Time PCR. Results Seventy genes were differentially expressed between the two groups. 58 genes were down-regulated in the dystocia group. Gene ontology analysis revealed 12 of the 58 down-regulated genes were involved in the immune response. These included (ERAP2, (8.67 fold change (FC)) HLA-DQB1 (7.88 FC) CD28 (2.60 FC), LILRA3 (2.87 FC) and TGFBR3 (2.1 FC)) Hierarchical clustering demonstrated a difference in global gene expression patterns between the samples from dystocic and non-dystocic labours. RT-PCR validation was performed on 4 genes ERAP2, CD28, LILRA3 and TGFBR3 Conclusion These findings suggest an underlying molecular basis for dystocia in nulliparous women in spontaneous labor. Differentially expressed genes suggest an important role for the immune response in dystocic labor and may provide important indicators for new diagnostic assays and potential intrapartum therapeutic targets.

  20. UNTERSUCHUNGEN ZUM EINFLUSS EINER VARIIERTEN VORBEREITUNGSDAUER AUF DAS AUFTRETEN VON SCHWERGEBURTEN UND DER PERINATALEN MORTALITÄT BEI KÄLBERN PRIMIPARER RINDER

    OpenAIRE

    Sorge, Ulrike

    2010-01-01

    In the recent years the incidence of perinatal mortality of calves in calvings of primiparous cows has increased. Dystocia is the main cause for the death of the perinatal calf. The most important factor influencing calving performance is the birth weight of the calf. This study was designed to examine the influence of the duration of the close up period on the growth of the primiparous heifer, its hormonal birth preparation and calving performance. Additionally, this study was to show the in...

  1. Woman abuse and pregnancy outcome among women in Khoram Abad, Islamic Republic of Iran.

    Science.gov (United States)

    Khodakarami, N; Naji, H; Dashti, M G; Yazdjerdi, M

    2009-01-01

    We carried out a descriptive analysis on the pregnancy outcome in 313 pregnant women abused, 160 non-abused). Abuse was statistically significantly correlated with mean weight gain during pregnancy, mean frequency of the prenatal care, prolonged labour (dystocia), premature rupture of membrane, low mean birth weight and mean gestational age at birth. Given the high likelihood that a woman will access health care services during her pregnancy, physicians providing prenatal care are in a strategic position to screen for partner abuse.

  2. Defining an abnormal first stage of labor based on maternal and neonatal outcomes.

    Science.gov (United States)

    Harper, Lorie M; Caughey, Aaron B; Roehl, Kimberly A; Odibo, Anthony O; Cahill, Alison G

    2014-06-01

    The objective of the study was to determine the threshold for defining abnormal labor that is associated with adverse maternal and neonatal outcomes. This study consisted of a retrospective cohort of all consecutive women admitted at a gestation of 37.0 weeks or longer from 2004 to 2008 who reached the second stage of labor. The 90th, 95th, and 97th percentiles for progress in the first stage of labor were determined specific for parity and labor onset. Women with a first stage above and below each centile were compared. Maternal outcomes were cesarean delivery in the second stage, operative delivery, prolonged second stage, postpartum hemorrhage, and maternal fever. Neonatal outcomes were a composite of the following: admission to level 2 or 3 nursery, 5 minute Apgar less than 3, shoulder dystocia, arterial cord pH of less than 7.0, and a cord base excess of -12 or less. Of the 5030 women, 4534 experienced first stage of less than the 90th percentile, 251 between the 90th and 94th percentiles, 102 between the 95th and 96th percentiles, and 143 at the 97th percentile or greater. Longer labors were associated with an increased risk of a prolonged second stage, maternal fever, the composite neonatal outcome, shoulder dystocia, and admission to a level 2 or 3 nursery (P labor dystocia may ultimately deliver vaginally, a longer first stage of labor is associated with adverse maternal and neonatal outcomes, in particular shoulder dystocia. This risk must be balanced against the risks of cesarean delivery for labor arrest. Copyright © 2014 Mosby, Inc. All rights reserved.

  3. Birth Injuries and Related Risk Factors in Neonates Born in Emam Sajjad Hospital in Yasuj in 2005 to 2006

    Directory of Open Access Journals (Sweden)

    M Rezaie

    2009-04-01

    Risk factors were included NVD (difficult vaginal delivery, high gestation age, and low Apgar score at first minute of life, shoulder dystocia, vacuum and birth at night. Conclusion: The present study revealed that the incidence of birth injuries in this area is high. Considering the serious complications of birth injuries and hypoxic-ischemic encephalopathy with no treatment for some cases, it seems that using the preventing methods to reduce the prevalence of birth injuries is nessesary

  4. Identification of a myometrial molecular profile for dystocic labor

    Directory of Open Access Journals (Sweden)

    O'Connor Darran P

    2011-10-01

    Full Text Available Abstract Background The most common indication for cesarean section (CS in nulliparous women is dystocia secondary to ineffective myometrial contractility. The aim of this study was to identify a molecular profile in myometrium associated with dystocic labor. Methods Myometrial biopsies were obtained from the upper incisional margins of nulliparous women undergoing lower segment CS for dystocia (n = 4 and control women undergoing CS in the second stage who had demonstrated efficient uterine action during the first stage of labor (n = 4. All patients were in spontaneous (non-induced labor and had received intrapartum oxytocin to accelerate labor. RNA was extracted from biopsies and hybridized to Affymetrix HuGene U133A Plus 2 microarrays. Internal validation was performed using quantitative SYBR Green Real-Time PCR. Results Seventy genes were differentially expressed between the two groups. 58 genes were down-regulated in the dystocia group. Gene ontology analysis revealed 12 of the 58 down-regulated genes were involved in the immune response. These included (ERAP2, (8.67 fold change (FC HLA-DQB1 (7.88 FC CD28 (2.60 FC, LILRA3 (2.87 FC and TGFBR3 (2.1 FC Hierarchical clustering demonstrated a difference in global gene expression patterns between the samples from dystocic and non-dystocic labours. RT-PCR validation was performed on 4 genes ERAP2, CD28, LILRA3 and TGFBR3 Conclusion These findings suggest an underlying molecular basis for dystocia in nulliparous women in spontaneous labor. Differentially expressed genes suggest an important role for the immune response in dystocic labor and may provide important indicators for new diagnostic assays and potential intrapartum therapeutic targets.

  5. Freestanding midwifery unit versus obstetric unit: a matched cohort study of outcomes in low-risk women

    DEFF Research Database (Denmark)

    Overgaard, Charlotte; Møller, Anna Margrethe; Fenger-Grøn, Morten

    2011-01-01

    women were significantly less likely to experience an abnormal fetal heart rate (RR: 0.3, 95% CI 0.2 to 0.5), fetal–pelvic complications (0.2, 0.05 to 0.6), shoulder dystocia (0.3, 0.1 to 0.9), occipital–posterior presentation (0.5, 0.3 to 0.9) and postpartum haemorrhage >500 ml (0.4, 0.3 to 0...

  6. The molecular effects of a polymorphism in the 5'UTR of solute carrier family 44, member 5 that is associated with birth weight in Holsteins.

    Directory of Open Access Journals (Sweden)

    Mayumi Sugimoto

    Full Text Available Dystocia is a major problem for the dairy cattle industry, and the observed high rates of this condition stem from genetic selection to increase subsequent milk production of the calving female. Because smaller birth size does not adversely affect subsequent milk production, selecting for cows with a smaller birth size would reduce dystocia rates and be beneficial for both the cattle and the farmers. To identify genes that regulate birth weight, we conducted a genome-wide association study using 1151 microsatellite markers and identified a single nucleotide polymorphism (SNP associated with birth weight: A-326G in the 5' untranslated region (UTR of solute carrier family 44, member 5 (SLC44A5. Cows with higher birth weights carried the A polymorphism in the SLC44A5 5' UTR, and the presence of the A polymorphism correlated with a high rate of dystocia. Luciferase assays and quantitative polymerase chain reaction (QPCR assays revealed that SLC44A5 transcripts with the A polymorphism are expressed at lower levels than those carrying the G polymorphism. SLC44A5 encodes a choline transporter-like protein, and choline is a component of the major phospholipids of cell membranes. Uptake studies in HeLa cells demonstrated that SLC44A5 knockdown reduces choline efflux, whereas SLC44A5 overexpression resulted in the opposite effect. Furthermore, cell viability assays indicated that SLC44A5 knockdown increased cell proliferation, whereas SLC44A5 overexpression repressed proliferation. Taken together, our results suggest that calves with reduced SLC44A5 expression are larger due to enhanced cell proliferation. This study provides novel insights into the molecular mechanisms that control birth weight in Holsteins and suggests that SLC44A5 may serve as a potential target for preventing dystocia.

  7. Pilot Study of Physiologic Partograph Use Among Low-Risk, Nulliparous Women With Spontaneous Labor Onset.

    Science.gov (United States)

    Neal, Jeremy L; Lowe, Nancy K; Nacht, Amy S; Koschoreck, Kate; Anderson, Jessica

    2016-01-01

    Neal and Lowe developed a physiologic partograph to give clinicians an evidence-based, uniform approach to assessing active labor progress and diagnosing dystocia in high-resource settings. The aim of this pilot study was to examine the feasibility of implementing the Neal and Lowe partograph for in-hospital labor assessment. A descriptive study of low-risk, nulliparous women with spontaneous labor onset was performed at an academic medical center. Eight certified nurse-midwives from a single practice used the Neal and Lowe partograph for the assessment of labor progress. Descriptive statistics were used to summarize characteristics, interventions, and outcomes for women with partograph-assessed labors. Labors assessed by nurse-midwives (n = 83) or obstetricians (n = 75) using their usual assessment strategies were also described for the year prior to partograph introduction to contextualize partograph-assessed labor findings. Inferential statistical tests were not performed. Thirty-one of 34 (91.2%) partographs were used correctly. Seventy-one percent (n = 22) of these women progressed to complete dilatation within expected physiologic time frames while the remaining women (n = 9) experienced labor dystocia. Similar proportions of women in the partograph and usual labor assessment groups received oxytocin during labor. The cesarean rate was lower in the partograph group than in the usual care groups. No cesareans were performed for dystocia in active labor for women whose labors were assessed via partograph. Implementation of the Neal and Lowe partograph for in-hospital labor assessment is feasible. Incorrect plotting and/or interpretation of the partograph may be further minimized by providing clinicians opportunities for ongoing partograph training after implementation or through partograph software development. The Neal and Lowe partograph may assist clinicians in safely and significantly decreasing primary cesarean births performed for active labor dystocia in

  8. Cardiac asystole at birth: Is hypovolemic shock the cause?

    Science.gov (United States)

    Mercer, J; Erickson-Owens, D; Skovgaard, R

    2009-04-01

    A birth involving shoulder dystocia can rapidly deteriorate-from a fetus with a reassuring tracing in the minutes before birth, to a neonate needing aggressive resuscitation. Infants experiencing a traumatic birth involving shoulder dystocia may be severely compromised, even when the preceding labor was uncomplicated. This paper presents two cases in which infants had normal heart beats recorded 5-10min before birth and were born with cardiac asystole following shoulder dystocia. Often, in cases of shoulder dystocia, infants shift blood to the placenta due to the tight compressive squeeze of the body in the birth canal (along with cord compression) and thereby may be born hypovolemic. Our hypothesis is that the occurrence of sudden cardiac asystole at birth is due to extreme hypovolemic shock secondary to the loss of blood. At birth, the sudden release of pressure on the infant's body results in hypoperfusion resulting in low central circulation and blood pressure. Severe hypovolemic shock from these effects leads to sudden cardiac arrest. Immediate cord clamping maintains the hypovolemic state by preventing the physiologic and readily available placental blood from returning to the infant. Loss of this blood initiates an inflammatory response leading to seizures, hypoxic-ischemic encephalopathy, and brain damage or death. Animal studies have shown that human umbilical stem cells injected into a rat's abdomen after induced brain damage, can protect the rat's brain from developing permanent injury. To prevent damage to newborns, the infant must receive the blood volume and stem cells lost at the time of descent and immediate cord clamping. Recommended countermeasures for research include: (1) resuscitation at the perineum with intact cord; or (2) milking the cord before clamping; or (3) autologous transfusion of placenta blood after the birth; or (4) rapid transfusion of O negative blood after birth and before seizures begin.

  9. Association between birth conditions and glucose and cortisol profiles of periparturient dairy cows and neonatal calves.

    Science.gov (United States)

    Vannucchi, C I; Rodrigues, J A; Silva, L C G; Lúcio, C F; Veiga, G A L; Furtado, P V; Oliveira, C A; Nichi, M

    2015-04-04

    Parturition in cattle is a stressful event for both the dam and the offspring. Stress and pain can alter the energy profile of calves and calving cows, producing a metabolic imbalance at birth. This study aimed to assess the effects of dystocia and oxytocin and calcium infusion on metabolic homeostasis in dairy cows and calves. Thirty Holstein cows and their calves were divided into three groups: an eutocia group (n=10), in which no calving assistance was needed; a dystocia group, which required mild-to-severe obstetric assistance (n=10); and a uterine inertia group, which was treated with oxytocin and calcium (n=10). To assess serum cortisol and blood glucose levels, blood samples were collected during the peripartum period from cows and during the first hour since birth from calves. All groups were hyperglycaemic following parturition. Infusion of oxytocin and calcium resulted in lower maternal glucose concentrations and lower levels of stress than in cows in the dystocia group. Birth condition was significantly associated with blood glucose and cortisol concentrations in calves. Glucose concentration was lower in calves born with oxytocin and calcium infusion than those born with fetal extraction. In conclusion, assisted calving with fetal extraction causes important metabolic changes for the dam and calf. Conversely, the practice of oxytocin and calcium infusion for hypotonic cows has no harmful effects on metabolic balance and can be safely employed as a medical treatment.

  10. Risk factors and impact of retained fetal membranes on performance of dairy bovines reared under subtropical conditions.

    Science.gov (United States)

    Kumari, Susavi; Prasad, Shiv; Kumaresan, Arumugam; Manimaran, Ayyasamy; Patbandha, Tapas Kumar; Pathak, Rupal; Boro, Prasanta; Mohanty, Tushar Kumar; Ravi, Sanjay Kumar

    2015-02-01

    The risk factors and impact of retained fetal membranes (RFM) on productive and reproductive performance of crossbred cattle, Zebu cattle, and Murrah buffalos were evaluated using data spread over 12 years. Multivariable logistic regression model was used to identify risk factors and to quantify their odds ratio (OR). Overall incidence of RFM in crossbred cattle, Zebu cattle, and Murrah buffalos were 26, 16, and 13 %, respectively; and significant risk factors for RFM in crossbred cattle were abortion (OR = 3.9), dead calf (OR = 4.1), dystocia (OR = 4.3), pluriparity (OR = 1.5), and shorter gestation length (OR = 4.3). In Zebu cattle, abortion (OR = 4.0), dead calf (OR = 3.7), dystocia (OR = 3.9), lower birth weight of calf (OR = 1.6), and shorter gestation length (OR = 6.4) were significant risk factors for RFM. In Murrah buffalos, abortion (OR = 19.2), dead calf (OR = 4.4), dystocia (OR = 4.7), pluriparity (OR = 1.7), shorter gestation length (OR = 12.7), and calving during summer season (OR = 1.8) were the risk factors for RFM. Although the occurrence of RFM did not affect fertility parameters, a significant (P gestation length were the main risk factors for RFM in dairy bovine.

  11. Risk factors of recurrent anal sphincter ruptures

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen

    2012-01-01

    augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...... analysis were: birthweight (adjusted OR, aOR, 2.94 per increasing kg, 95% CI 2.31-3.75); vacuum extraction (aOR 2.96, 95% CI 2.03-4.31); shoulder dystocia (aOR 1.98, 95% CI 1.11-3.54); delivery interval (aOR 1.08 by year, 95% CI 1.02-1.15); year of second delivery (aOR 1.06, 95% CI 1.03-1.09); and prior...... fourth-degree ASR (aOR 1.72, 95% CI 1.28-2.29). Head circumference was a protective factor (aOR 0.91 per increasing cm, 95% CI 0.85-0.98). Conclusions  The incidence of recurrent ASR was 7.1%. Risk factors of recurrent ASR were excessive birthweight, vacuum extraction, shoulder dystocia, delivery...

  12. Effect of calving process on the outcomes of delivery and postpartum health of dairy cows with unassisted and assisted calvings.

    Science.gov (United States)

    Kovács, L; Kézér, F L; Szenci, O

    2016-09-01

    Welfare aspects of obstetrical assistance were studied in multiparous Holstein-Friesian cows (n=176) with (1) unassisted calving in an individual pen (UCIP; n=42), (2) unassisted calving in a group pen (UCG; n=48), (3) assisted calving with appropriately timed obstetrical assistance (ACAP; n=50), and (4) assisted calving with inappropriately timed (premature) obstetrical assistance (ACIN; n=36). Duration of the stages of calving, the prevalence and the degree of dystocia, stillbirth ratio, newborn calf vitality, and the occurrence of postpartum health problems (i.e., retained placenta and vulvovaginal laceration) were recorded. The time from amniotic sac and hooves appearance to birth and the total duration of calving (from the onset of calving restlessness to delivery) were shorter for UCG cows than for any other groups. The overall incidence of dystocia was 31.3% in the calvings studied. The prevalence of dystocia was below 10% in cases of unassisted calvings. The proportion of severe dystocia was higher in ACIN cows than in ACAP cows (47.2 vs. 12.0%, respectively). The prevalence of stillbirths was the highest in ACIN calvings (22.2%), followed by ACAP, UCI, and UCG cows (8.0, 4.8, and 0.0%, respectively). The ACIN calves had lower vitality scores than calves born from ACAP, UCG, and UCIP dams immediately after delivery and 24h after birth. Although ACAP calves had lower vitality scores than UCG and UCIP calves at birth, a delayed recovery of vitality was mirrored by satisfactory vitality scores 24h after birth. Retained placenta and vulvovaginal laceration occurred more often with assisted dams (i.e., ACAP and ACIN animals) compared with UCIP cows with the highest prevalence in ACIN cows. In UCG cows, no injuries occurred in the vulva or vagina, and we noted only 4 cases of retained placenta (8.3%), proportions lower than in cows with unassisted calving in the maternity pen. Our results suggest that calving in a group might have benefits over calving in an

  13. Perdas reprodutivas e reconcepção em bovinos de corte segundo a idade ao acasalamento Reproductive disorders and reconception of beef cows according to of mating age

    Directory of Open Access Journals (Sweden)

    C. Gottschall

    2008-04-01

    Full Text Available Avaliou-se o desempenho reprodutivo de novilhas de corte acasaladas aos 14 meses (14M, aos 24 meses (24 M e de vacas multíparas (V, totalizando 4.012 animais. As perdas reprodutivas (PR foram de 19,3%, 11,6% e 7,6% para 14M, 24M e V, respectivamente, sendo que 14M diferiu de V (PReproductive performances of beef heifers mated at 14 months of age (14M, at 24 months of age (24M and pluriparous cows (C, based on data from 4.012 animals were evaluated. The reproductive disorders were 19.3%, 11.6% and 7.6%, respectively, at 14M, 24M and for C; 14M was different from C (P<0.01. The occurrence of dystocia was 20.7%, 5.1% and 0.8% for the 14M, 24M and C, respectively. The 14M group was different from C (P<0.01. The mortality caused by dystocia was higher for 14M group 7.4% than for the C group 0.4% (P<0.01, respectively. The reconception rate was higher for the 14M (85.3% and V (81.1% than for the 24M group (70.7% (P<0.01. The category which concentrated the parturition in the first period (until 09/19 (52.3% was the 24M. Animals mated earlier tended to show high reproductive disorders and incidence of dystocia.

  14. Some medical and other risk factors for current cesarean section in a Jakarta hospital

    Directory of Open Access Journals (Sweden)

    Endang Poedjiningsih

    2001-12-01

    Full Text Available For the last year the prevalence of cesarean section (CS increased in several countries as well as in Indonesia. In Indonesia there was no comprehensive study on risk factors related to CS. This case-control study was conducted at Fatmawati Hospital in Jakarta from 1 July 200 until 31 January 2001. Data was extracted from available medical records. Ceserean section was defined as a delivery through laparotomy. The control group consisted of subjects having vaginal deliveries. For each cases were selected randomly a control based on the date before or after 18 October 2000. Subject who had fetal distress had 544-folds increased risk to be CS relative to those who did not have fetal distress [adjusted odds ratio (OR = 544.86; 95% confidence intervals (CI = 71.85- 4131.78]. Furthermore, relative those who did not have dystocia, those who had dystocia had 143 times increased risk to be CS (adjusted OR = 52.86; 95% CI = 52.86 - 391.17. In term of previous CS, subjects who ever had previous CS had 30 times increased risk to be CS compared with the subjects who never had CS (adjusted OR = 30.23; 95% CI = 12.06 - 75.57. In contrast, compared with those who non cash payment, those who paid in cash had a lowered risk of 80% (adjusted OR = 0.20; 95% CI = 0.11-0.34. In conclusion, previous CS, dystocia, pre eclampsia, other medical indications, fetal distress, and non cash hospitalization expences increased risk of CS. (Med J Indones 2001; 10: 230-4Keywords: cesarean section, risk factors

  15. Maternal near-miss in a rural hospital in Sudan

    Directory of Open Access Journals (Sweden)

    Adam Gamal K

    2011-06-01

    Full Text Available Abstract Background Investigation of maternal near-miss is a useful complement to the investigation of maternal mortality with the aim of meeting the United Nations' fifth Millennium Development Goal. The present study was conducted to investigate the frequency of near-miss events, to calculate the mortality index for each event and to compare the socio-demographic and obstetrical data (age, parity, gestational age, education and antenatal care of the near-miss cases with maternal deaths. Methods Near-miss cases and events (hemorrhage, infection, hypertensive disorders, anemia and dystocia, maternal deaths and their causes were retrospectively reviewed and the mortality index for each event was calculated in Kassala Hospital, eastern Sudan over a 2-year period, from January 2008 to December 2010. Disease-specific criteria were applied for these events. Results There were 9578 deliveries, 205 near-miss cases, 228 near-miss events and 40 maternal deaths. Maternal near-miss and maternal mortality ratio were 22.1/1000 live births and 432/100 000 live births, respectively. Hemorrhage accounted for the most common event (40.8%, followed by infection (21.5%, hypertensive disorders (18.0%, anemia (11.8% and dystocia (7.9%. The mortality index were 22.2%, 10.0%, 10.0%, 8.8% and 2.4% for infection, dystocia, anemia, hemorrhage and hypertensive disorders, respectively. Conclusion There is a high frequency of maternal morbidity and mortality at the level of this facility. Therefore maternal health policy needs to be concerned not only with averting the loss of life, but also with preventing or ameliorating maternal-near miss events (hemorrhage, infections, hypertension and anemia at all care levels including primary level.

  16. Schistosomus reflexus in a red sokoto doe

    Directory of Open Access Journals (Sweden)

    A. Bello

    2012-12-01

    Full Text Available Dystocia was observed in a primiparous One year old Red Sokoto Doe and was relieved manually, the fetus was observed to be monstrous and gross pathological examination showed; cleft sternum, scoliosis, abdominal and thoracic evisceration, absence of diaphragm, pulmonary hypoplasia, malpositioned kidney and heart, spinal inversion and limb ankylosis. The digestive, respiratory, cardiovascular, urogenital and skeletal system anomalies were observed in this report. Many of the malformations and malpositioning have been previously reported. The above clinical findings suggest Schistosomus Reflexus. 

  17. Endocardial fibrosarcoma in a reticulated python (Python reticularis).

    Science.gov (United States)

    Gumber, Sanjeev; Nevarez, Javier G; Cho, Doo-Youn

    2010-11-01

    A female, reticulated python (Python reticularis) of unknown age was presented with a history of lethargy, weakness, and distended coelom. Physical examination revealed severe dystocia and stomatitis. The reticulated python was euthanized due to a poor clinical prognosis. Postmortem examination revealed marked distention of the reproductive tract with 26 eggs (10-12 cm in diameter), pericardial effusion, and a slightly firm, pale tan mass (3-4 cm in diameter) adhered to the endocardium at the base of aorta. Based on histopathologic and transmission electron microscopic findings, the diagnosis of endocardial fibrosarcoma was made.

  18. Developing protocols for obstetric emergencies.

    Science.gov (United States)

    Roth, Cheryl K; Parfitt, Sheryl E; Hering, Sandra L; Dent, Sarah A

    2014-01-01

    There is potential for important steps to be missed in emergency situations, even in the presence of many health care team members. Developing a clear plan of response for common emergencies can ensure that no tasks are redundant or omitted, and can create a more controlled environment that promotes positive health outcomes. A multidisciplinary team was assembled in a large community hospital to create protocols that would help ensure optimum care and continuity of practice in cases of postpartum hemorrhage, shoulder dystocia, emergency cesarean surgical birth, eclamptic seizure and maternal code. Assignment of team roles and responsibilities led to the evolution of standardized protocols for each emergency situation.

  19. Time to subsequent live birth according to mode of delivery in the first birth.

    Science.gov (United States)

    O'Neill, S M; Khashan, A S; Kenny, L C; Kearney, P M; Mortensen, P B; Greene, R A; Agerbo, E; Uldbjerg, N; Henriksen, T B

    2015-08-01

    To estimate the rate and time to next live birth by mode of delivery. Hospital-based cohort. Aarhus University Hospital (AUH), Denmark. All pregnant women attending AUH were invited to enroll in the Aarhus Birth Cohort (ABC) study between 1989 and 2010 (n = 91,625). Women were followed from their first live birth until the subsequent live birth or until censoring due to study end using Cox regression models. Rate and time to subsequent live birth according to mode of delivery. 46,162 index live births were identified, of which 22,462 (49%) had a subsequent live birth. Women with any type of caesarean had a 6% reduction in the rate of subsequent live birth (HR 0.94, 95% CI 0.89, 0.98), which remained unchanged in the analysis by type (emergency, HR 0.95, 95% CI 0.89, 1.02; elective, HR 0.91, 95% CI 0.85, 0.98) compared with women who had a spontaneous vaginal delivery (SVD). Operative vaginal delivery was associated with an 8% reduction in subsequent live birth rates (HR 0.92, 95% CI 0.86, 0.98) and vaginal delivery complicated by shoulder dystocia with a 19% reduction compared with SVD. Median time to next birth in days was shortest in women with a first caesarean (994 days, 95% CI 973, 1026) and longest in women with a vaginal delivery complicated by shoulder dystocia (1065 days, 95% CI 994, 1191). In women with planned pregnancies, the shortest median time to second birth was in women with breech vaginal deliveries (859 days, 95% CI 737, 1089) and the longest in women with vaginal deliveries complicated by shoulder dystocia (1193 days, 95% CI 1028, 1430). The impact of mode of delivery on subsequent rate and time to next birth was minimal in this study. The greatest reduction was among women with assisted vaginal delivery complicated by shoulder dystocia. This study is strengthened by data on pregnancy planning as well as information on complications of pregnancy, delivery and neonatal morbidities, all of which may influence a woman's decision on subsequent birth

  20. Partogram: clinical study to assess the role of Partogram in primigravidae in labor

    Directory of Open Access Journals (Sweden)

    Manjulatha VR

    2016-04-01

    Conclusions: This study shows that using the Partogram improves the quality of delivery care, since it permits to identify dystocia and make logical and effective interventions. It reduces unnecessary strain on mothers by reducing total duration of labour, without any increased foetal morbidity and mortality. If accepted as routine procedure, it will be suitable in all situations where the labour room remains busy and congested day and night for better and more efficient management of labour. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1014-1025

  1. 北京密云地区264例新生儿窒息的产科因素分析%Obstetric factors of 264 cases of neonatal asphyxia in Miyun County of Beijing

    Institute of Scientific and Technical Information of China (English)

    杨淑君

    2013-01-01

    Objective To investigate the obstetric factors of neonatal asphyxia in past 10 years and their changes in Miyun District ,so as to provide basis for reducing the incidence of neonatal asphyxia and improving the obstetric quality .Methods Retrospective analysis was conducted on the data of 264 cases of neonatal asphyxia from January 2003 to December 2012 in Miyun County .The trend of neonatal asphyxia incidence in these 10 years was explored as well as the obstetric factors of neonatal asphyxia and changes .Results During these 10 years, neonatal asphyxia rate decreased significantly (χ2 =102.46, P<0.001).The major obstetric factors of neonatal asphyxia were amniotic fluid contamination , labor abnormalities , gestational hypertension and shoulder dystocia .The constitute of neonatal asphyxia caused by shoulder dystocia increased (P =0.026).Conclusion Amniotic fluid contamination, labor abnormalities, gestational hypertension and shoulder dystocia are major factors leading neonatal asphyxia .The neonatal asphyxia caused by shoulder dystocia should obtain more attention.%目的探讨近10年密云地区新生儿窒息的产科因素及变化,为降低新生儿窒息发生率、提高产科质量提供依据。方法回顾性分析2003年1月至2012年12月在北京市密云县妇幼保健院分娩的264例新生儿窒息的病例资料,探讨10年间新生儿窒息发生率的变化趋势,以及造成新生儿窒息的产科因素及变化。结果10年间新生儿窒息率明显下降(χ2=102.46,P<0.001);新生儿窒息的主要产科因素分别为羊水污染、产程异常、妊娠期高血压疾病和肩难产,肩难产导致新生儿窒息的构成比上升(确切概率法P=0.026)。结论羊水污染、产程异常、妊娠期高血压疾病和肩难产是导致新生儿窒息的主要因素,肩难产导致新生儿窒息应引起产科重视。

  2. 单胎头位初产妇产程图分析%Partogram Analysis of Single Fetal Head Position Primipara

    Institute of Scientific and Technical Information of China (English)

    张书芬; 龚姗; 陈晓冬; 李云飞; 郝天羽

    2011-01-01

    目的:探讨存在难产因素初产妇产程图的临床意义.方法:对2009年6月至2010年6月在济南军区总医院住院分娩的326例单胎头位初产妇的产程图进行回顾性分析.结果:产程图异常组中难产因素的构成比和剖宫产率均高于产程图正常组;存在难产因素的组别(胎方位异常组、宫缩乏力组、巨大儿组)产程中各阶段时限均较正常产妇组长,宫颈扩张速度均较正常组慢,胎头位置均高于正常组,以上差异均有统计学意义(P<o.05).结论:在产程中对产程图中各阶段时限、宫颈扩张速度及胎头位置等指标进行监测,来预测和及时发现头位难产因素的存在,及时给予处理,改善母儿预后.%Objective: To explore the clinical significance of-primipara partogram with dystocia factors. Methods: Retrospectively analyze the partogram of 326 cases of single fetal head position primipara deliveried in Jinan Military General Hospital from June 2009 to June 2010. Results: The composition of dystocia factors and cesarean section rate in abnormal partogram group were higher than normal partogram group; Groups with dystocia factors (fetal position abnormal group, uterine inertia group, fetal macrosomia group) each stage time of labor were longer, cervical dilatation slower, fetal head position higher than normal group, the above differences are statistically significant (P<0.05). Conclusion: Monitoring the indicators such as each stage time, cervical dilatation, fetal head position in the partogram can predict and discover dystocia factors in time and improve the outcome.

  3. Morbidity-mortality and performance evaluation of Brahman calves from in vitro embryo production.

    Science.gov (United States)

    Pimenta-Oliveira, Andreza; Oliveira-Filho, José P; Dias, Adriano; Gonçalves, Roberto C

    2011-12-04

    The use of bovine in vitro embryo production (IVP) increases the reproductive potential of genetically superior cows, enabling a larger scale of embryo production when compared with other biotechnologies. However, deleterious effects such as abnormal fetal growth, longer gestation period, increased birth weight, abortion, preterm birth and higher rates of neonatal mortality have been attributed to IVP. The aim of this study was to compare the influence of in vitro embryo production and artificial insemination (AI) on gestation length, complications with birth, birth weight, method of feeding colostrum, passive transfer of immunity, morbidity-mortality, and performance in Brahman calves. Whilst gestation length and birth weight were significantly increased in IVP-derived calves, no difference in weaning weight was observed between groups. The passive transfer of immunity (PT), was assessed in IVP (n = 80) and AI (n = 20) groups 24 hours after birth by determination of gamma-glutamyl transferase (GGT) and gammaglobulin activity as well as by quantification of the concentration of total protein in serum. No differences in passive transfer or incidences of dystocia and diseases at weaning were observed between groups. Birth weight, method of feeding colostrum and dystocia were not correlated with PT in either group. In this study, in vitro embryo production did not affect the health status, development, or passive transfer of immunity in Brahman calves. © 2011 Pimenta-Oliveira et al; licensee BioMed Central Ltd.

  4. Should the visceral peritoneum at the bladder flap closed at cesarean sections? A post-partum sonographic and clinical assessment.

    Science.gov (United States)

    Malvasi, Antonio; Tinelli, Andrea; Guido, Marcello; Zizza, Antonella; Farine, Dan; Stark, Michael

    2010-07-01

    To compare cesarean section (CS) using open or closed visceral peritoneum of the bladder flap (BF) in relation to fluid collection in vesico-uterine space (VUS) by ultrasound (US) and clinical outcome. A prospective cohort of repeat CS in 474 in advanced first and second stage of labor was studied. All women underwent a Misgav Ladach CS, in local combined anesthesia. These were divided into two groups by surgical management of the BF at the time of CS: Group I (n = 262), with visceral peritoneum left open and Group II (n = 212), with visceral peritoneum closed. An US check for the fluid collections in the VUS was done in the third post-operative day. The two groups were also clinically compared for: intra-operative estimated blood loss, the need for post-CS pain killers, febrile morbidity and duration of hospital stay. Visceral peritoneum (VP) closure resulted in a significant increase blood collections in the VUS (p post-operative fever, need for post-operative analgesia, require antibiotic administration and prolonged hospitalisation (p < 0.05). VP suturing of women requiring CS for dystocia is associated to increased rate of blood collection in the VUS, which could possibly explain the higher rate of puerperal complications in these patients. These data clearly indicate that suturing the VP of the BF in women undergoing CS for dystocia is contraindicated. This data could be probably extrapolated to all cesarean deliveries.

  5. Morbidity-mortality and performance evaluation of Brahman calves from in vitro embryo production

    Directory of Open Access Journals (Sweden)

    Pimenta-Oliveira Andreza

    2011-12-01

    Full Text Available Background The use of bovine in vitro embryo production (IVP increases the reproductive potential of genetically superior cows, enabling a larger scale of embryo production when compared with other biotechnologies. However, deleterious effects such as abnormal fetal growth, longer gestation period, increased birth weight, abortion, preterm birth and higher rates of neonatal mortality have been attributed to IVP. The aim of this study was to compare the influence of in vitro embryo production and artificial insemination (AI on gestation length, complications with birth, birth weight, method of feeding colostrum, passive transfer of immunity, morbidity-mortality, and performance in Brahman calves. Results Whilst gestation length and birth weight were significantly increased in IVP-derived calves, no difference in weaning weight was observed between groups. The passive transfer of immunity (PT, was assessed in IVP (n = 80 and AI (n = 20 groups 24 hours after birth by determination of gamma-glutamyl transferase (GGT and gammaglobulin activity as well as by quantification of the concentration of total protein in serum. No differences in passive transfer or incidences of dystocia and diseases at weaning were observed between groups. Birth weight, method of feeding colostrum and dystocia were not correlated with PT in either group. Conclusions In this study, in vitro embryo production did not affect the health status, development, or passive transfer of immunity in Brahman calves.

  6. Counseling for fetal macrosomia: an estimated fetal weight of 4,000 g is excessively low.

    Science.gov (United States)

    Peleg, David; Warsof, Steven; Wolf, Maya Frank; Perlitz, Yuri; Shachar, Inbar Ben

    2015-01-01

    Because of the known complications of fetal macrosomia, our hospital's policy has been to discuss the risks of shoulder dystocia and cesarean section (CS) in mothers with a sonographic estimated fetal weight (SEFW) ≥ 4,000 g at term. The present study was performed to determine the effect of this policy on CS rates and pregnancy outcome. We examined the pregnancy outcomes of the macrosomic (≥ 4,000 g) neonates in two cohorts of nondiabetic low risk women at term without preexisting indications for cesarean: (1) SEFW ≥ 4,000 g (correctly suspected macrosomia) and (2) SEFW macrosomia). There were 238 neonates in the correctly suspected group and 205 neonates in the unsuspected macrosomia group, respectively. Vaginal delivery was accomplished in 52.1% of the suspected group and 90.7% of the unsuspected group, respectively, p macrosomia was correctly suspected. The policy of discussing the risk of macrosomia with SEFW ≥ 4,000 g to women is not justified. A higher SEFW to trigger counseling for shoulder dystocia and CS, more consistent with American College of Obstetrics and Gynecology (ACOG) guidelines, should be considered. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Antenatal macrosomia prediction using sonographic fetal abdominal circumference in South Tunisia.

    Science.gov (United States)

    Chaabane, Kais; Trigui, Khaled; Louati, Doulira; Kebaili, Sahbi; Gassara, Hichem; Dammak, Abdallah; Amouri, Habib; Guermazi, Mohamed

    2013-01-01

    Identifying newborns who weight 4000 g or more is important because birth of macrosomic fetuses is associated with adverse peripartum outcomes. Ultrasound is widely used for this purpose Our objective was to evaluate the diagnostic value of sonographic measurement of fetal abdominal circumference (AC) over 350 mm for the prediction of fetal macrosomia and shoulder dystocia, to specify factors that could generate errors in its measure. A retrospective clinical trial was conducted at the Department of Obstetrics and Gynecology, Hédi Chaker Hospital, Sfax, Tunisia. The study consisted of comparing two groups of singleton newborns: the first group (n=465) includes macrosomic babies and the second group (n=465) includes the non macrosomic ones. All women underwent sonographic measurements of the fetal abdominal circumference (AC) within 72 hours before delivery. The AC values were correlated to actual fetal birth weight. The cut-off value of AC for predicting of fetal macrosomia was analyzed. A cut-off value of abdominal circumference ≥ 350 mm, in predicting of fetal macrosomia., had a sensitivity, specificity, accuracy, positive predictive value, and negative predictive value: 78.7%, 76.8%, 77%, 92.6%, and 49.2%, respectively. In macrosomic group obesity was significantly more frequent when AC ≥ 350 mm. The fetal AC measurement was useful in predicting of fetal macrosomia. An AC measurement AC ≥ 350 mm could help to suspect shoulder dystocia.

  8. [Analysis of risk factors for perinatal brachial plexus palsy].

    Science.gov (United States)

    Gosk, Jerzy; Rutowski, Roman

    2005-04-01

    Risk factors of obstetrical brachial plexus palsy include: (1) large birth weight, (2) shoulder dystocia and prolonged second stage of labour, (3) instrumental vaginal delivery (forceps delivery, vacuum extraction), (4) diabetes mellitus and mother's obesity, (5) breech presentation, (6) delivery and infant with obstetrical brachial plexus palsy in antecedent delivery. The purpose was analysis of the classical risk factors for brachial plexus palsy based on our own clinical material. Clinical material consists of 83 children with obstetrical brachial plexus palsy treated at the Department of Trauma and Hand Surgery (surgically--54, conservatively--29). Control group consists of 56 healthy newborns. Data recorded included: birth weight, body length, head and chest circumference, Apgar test at 1 min., type of brachial palsy and side affected, type of birth, presentation, duration of delivery (II stage), age of mother, mother's diseases, parity. The infants treated surgically have had a significantly higher birth weight, body height, head and chest circumference, in compression with control group and group treated conservatively. The differences were statistically important. Shoulder dystocia occurred in 32.9% of all vaginal delivery. Instrumental vaginal delivery was observed in 11.3% and breech presentation in 4.9% cases. There were no incidences of obstetrical brachial plexus palsy recurrence. Diabetes mellitus and mother's obesity was found in 3 cases. (1) Fetal macrosomia is the important risk factor of the obstetrical brachial plexus palsy. (2) Obstetrical brachial plexus palsy may occur also in the absence of the classical risk factors.

  9. Reproductive Parameters of the Dogo Argentino Bitch

    Directory of Open Access Journals (Sweden)

    Marina Caffaratti

    2013-01-01

    Full Text Available The Dogo Argentino (DA is the first and only breed from Argentina recognized worldwide. Although its morphologic features have been well established, its normal reproductive parameters are not clearly known. The aim of this study was to determine the main DA bitch reproductive parameters. One hundred and forty-nine surveys were obtained from breeders from Córdoba province, Argentina: one for each intact DA bitch from 1 to 14 years old. The DA bitch reached puberty at an average of 8.93 months. The mean duration of vulval bleeding found in this study was 11.11 days. The clinical signs characteristic for proestrous-estrous were vulval edema (89.93%, bleeding during the time of mating (32.21%, holding the tail to the side (95.30%, and docility during mating (85.91%. DA bitches had a whelping rate of 84%. Out of 299 pregnancies, 89.30% exhibited a normal parturition, 6.69% presented dystocia, 2.68% needed Cesarean section, and 1.34% aborted. In conclusion, the reproductive parameters of the DA bitch are similar to those identified for other large breeds. DA often showed a prolonged vulval bleeding longer than proestrus. Its high whelping rate, its low incidence of dystocia, and its good maternal ability define the DA as a good reproductive breed with normal reproductive functions.

  10. Contemporary Cesarean Delivery Practice in the United States

    Science.gov (United States)

    ZHANG, Jun; TROENDLE, James; REDDY, Uma M.; LAUGHON, S. Katherine; BRANCH, D. Ware; BURKMAN, Ronald; LANDY, Helain J.; HIBBARD, Judith U.; HABERMAN, Shoshana; RAMIREZ, Mildred M.; BAILIT, Jennifer L.; HOFFMAN, Matthew K.; GREGORY, Kimberly D.; GONZALEZ-QUINTERO, Victor H.; KOMINIAREK, Michelle; LEARMAN, Lee A.; HATJIS, Christos G.; VAN VELDHUISEN, Paul

    2010-01-01

    Objective To describe contemporary cesarean delivery practice in the U.S. Study Design Consortium on Safe Labor collected detailed labor and delivery information from 228,668 electronic medical records from 19 hospitals across the U.S., 2002 – 2008. Results The overall cesarean delivery rate was 30.5%. 31.2% of nulliparas were delivered by cesarean section. Prelabor repeat cesarean delivery due to a previous uterine scar contributed 30.9% of all cesarean sections. 28.8% of women with a uterine scar had a trial of labor and the success rate was 57.1%. 43.8% women attempting vaginal delivery had induction. Half of cesarean for dystocia in induced labor were performed before 6 cm of cervical dilation. Conclusion To decrease cesarean delivery rate in the U.S., reducing primary cesarean delivery is the key. Increasing VBAC rate is urgently needed. Cesarean section for dystocia should be avoided before the active phase is established, particularly in nulliparas and in induced labor. PMID:20708166

  11. [Active management of labor].

    Science.gov (United States)

    Ruiz Ortiz, E; Villalobos Román, M; Flores Murrieta, G; Sotomayor Alvarado, L

    1991-01-01

    Eighty three primigravidae patients at the end of latency labor, erased cervix, 3 cm dilation, vertex presentation and adequate pelvis, were studied. Two groups were formed: 53 patients in the study group, who received active management of labor, and 30 patients in the control group, treated in the traditional way. In all the patients a graphic recording of labor, was carried out; it included all the events, and as labor advanced, a signoidal curve of cervical dilatation, was registered, as well as the hyperbolic one for presentation descent. The study group received the method in a systematized manner, as follows: 1. Peridular block. 2. Amniotomy. 3. IV oxytocin one hour after amniotomy. 4. FCR monitoring. 5. Detection of dystocia origin. Materno-fetal morbidity was registered in both groups, as well as cesarean section rate, instrumental delivery and its indications, labor duration, and time of stay in labor room. Diminution of above intems and opportune detection of dystocia, were determined. It was concluded that a constructive action plan, starting at hospital admission in most healthy women, allows a normal delivery of brief duration.

  12. Pelvimetry revisited: Analyzing cephalopelvic disproportion

    Energy Technology Data Exchange (ETDEWEB)

    Lenhard, Miriam S. [Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, 81377 Munich (Germany); Johnson, Thorsten R.C., E-mail: thorsten.johnson@med.uni-muenchen.d [Department of Radiology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377 Munich (Germany); Weckbach, Sabine; Nikolaou, Konstantin [Department of Radiology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377 Munich (Germany); Friese, Klaus; Hasbargen, Uwe [Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, 81377 Munich (Germany)

    2010-06-15

    The objective of this study was to assess the clinical value of pelvimetry to predict dystocia due to cephalopelvic disproportion. 63 patients who had received an abdominal CT scan postpartum were included. Pelvimetry was performed retrospectively with these datasets on a 3D workstation; there were no CT examinations performed solely for pelvimetry, and there was no radiation exposure for study purposes. Patients were divided into three groups by the course of birth, i.e. normal vaginal delivery (A), dystocia due to cephalopelvic disproportion (B) and other patients (C). Previously described methods were evaluated for their accuracy in diagnosing cephalopelvic disproportion. The pelvimetric parameters did not show significant differences between groups A (n = 20) and B (n = 20) except for the sagittal mid-pelvic diameter (q) with 12.7 {+-} 0.6 cm vs. 11.9 {+-} 0.6 cm (p = 0.0001). The ROC analysis of the previously described methods showed areas under the curve between 0.50 and 0.67. The ROC curves for q had an area of 0.88, providing 85% sensitivity with 85% specificity. In conclusion, the sagittal mid-pelvic diameter shows potential to detect cephalopelvic disproportion with acceptable accuracy. With the information gained on the CT data, a prospective trial based on MR imaging can be set up to validate the diagnostic accuracy.

  13. Unintended clinical consequences of the implementation of a checklist-based, low-dose oxytocin protocol.

    Science.gov (United States)

    Rohn, Amanda E; Bastek, Jamie A; Sammel, Mary D; Wang, Eileen; Srinivas, Sindhu K

    2015-03-01

    Standardized oxytocin protocols have been used to improve the safety and quality of obstetric care. We examined rates of chorioamnionitis and labor dystocia requiring cesarean delivery as unintended consequences of the implementation of a low-dose, checklist-based oxytocin protocol. We performed a retrospective cohort study of live singleton deliveries that underwent a trial of labor in two 15-month periods, comparing outcomes in those who delivered before to after protocol implementation. Patients and outcomes were identified using a combination of electronic medical records and International Classification of Diseases, 9th Revision, Clinical Modification codes. Time trend analysis was performed to evaluate for secular trends. A total of 8,717 women were included; 5,077 received oxytocin. Despite an unchanged rate of cesarean deliveries from before to after initiation of the protocol (15.15 vs. 14.75%, p = 0.60), deliveries after protocol implementation were generally characterized by higher rates of chorioamnionitis (7.48 vs. 5.97%, p labor dystocia (50.62 vs. 40.92%, p oxytocin protocols are intended to increase safety, but they may have unintended consequences related to prolonged labor, and should be studied before widespread use. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Piglet mortality: the impact of induction of farrowing using prostaglandins and oxytocin.

    Science.gov (United States)

    Kirkden, R D; Broom, D M; Andersen, I L

    2013-04-01

    Induction is usually carried out by administering prostaglandins (prostaglandin F2α or a synthetic analogue). Other hormones, most commonly oxytocin, may also be given. The primary objective is to increase the synchrony of farrowing. This facilitates farrowing supervision, early fostering and 'all in, all out' management of the farrowing house, all of which have the potential to decrease piglet mortality. However, there are also risks, including decreased piglet viability when farrowing is induced too early and an increased probability of dystocia associated with oxytocin use. What are the effects of induction procedures on mortality in pigs? With respect to prostaglandins, studies show that the date of induction and the level of supervision provided are important factors affecting piglet mortality. We recommend administering prostaglandins no earlier than 2d before the expected farrowing date for the herd. Some studies have reported that prostaglandin induction decreases stillbirth and live-born mortality and this is probably due to increased farrowing supervision. The incidence of postpartum dysgalactia syndrome is also decreased in herds with a high prevalence of this condition. Inconsistent effects on the progress of farrowing are reported following the routine administration of oxytocin 20-24h after prostaglandin. Although there is generally no effect on stillbirth rate, dystocia may increase. Earlier administration of low doses may decrease stillbirths, but this requires further research. Carbetocin, a long-acting analogue of oxytocin, is a possible alternative. We recommend that prostaglandin induction be used in conjunction with skilled farrowing supervision to decrease piglet mortality.

  15. A comparative study on the efficacy of drotaverine and valethamate on cervical dilatation during labour

    Directory of Open Access Journals (Sweden)

    Hema Sinhasane

    2017-01-01

    Full Text Available Background: The most common cause of prolonged first stage of labour is cervical spasm leading to cervical dystocia. Many times it is observed that inspite of good uterine contractions; cervix fails to dilate or dilates very slowly. This is functional cervical dystocia. Methods: On admission detailed history was taken, complete general physical examination was made. Careful obstetric examination confirmed the lie, presentation, position of the foetus and FHP. Vaginal examination was made and the state of cervix (Dilatation, consistency and effacement station of the vertex and type and adequacy of the pelvis was noted. Results: A slight increase in the cervical tear is noted in the multrigravida in Group II. The incidence of PPH was double that of Group III. This was observed specifically when the drug was given after 5cms of dilatation of cervix. Conclusions: The maternal adverse effects were more with valethamate. Though there was transient fetal tachycardia with valethamate, the fetal outcome remained the same in all the groups.

  16. Abortions in sheep associated with Arcobacter skirrowii infection

    Directory of Open Access Journals (Sweden)

    Gareth F. Bath

    2013-02-01

    Full Text Available The history, circumstances, clinical signs, post mortem lesions, morbidity, mortality and laboratory findings are described in an abortion storm in sheep that occurred in Mpumalanga, South Africa, associated with infection with Arcobacter skirrowii. Altogether, about 200 Suffolk Down ewes lost 60 lambs in late pregnancy or at term. Although only three foetuses were submitted for investigation, two had signs consistent with a diagnosis of A. skirrowii infection and the organism was isolated from the placentas of both specimens. No abortions had occurred in previous years, or have subsequently. There were no animal introductions prior to the outbreak that could have indicated a source of infection. One stillborn lamb submitted subsequently had lesions consistent with dystocia, and the history and circumstantial evidence indicated that dystocia had been a factor in several more losses. No ewes or rams had shown signs of diarrhoea or other diseases associated with A. skirrowii infection. Twenty-two faecal, preputial and vaginal swab specimens taken from six rams and 13 ewes after the abortion event were all negative for A. skirrowii. This is the first report of abortions in sheep associated with A. skirrowiiin South Africa. Because the genus Arcobacter is similar to Campylobacter, it is possible that infection has gone unrecognised in the past. Veterinarians and laboratories should take note and include this genus in the list of potential abortifacient organisms. The possible role of Arcobacter species in other diseases like enteritis and mastitis, as well as the potential role as a zoonosis, must be borne in mind.

  17. Newborn calf vitality: risk factors, characteristics, assessment, resulting outcomes and strategies for improvement.

    Science.gov (United States)

    Murray, Christine F; Leslie, Ken E

    2013-11-01

    Dystocia is a stressful and traumatic event for both the cow and calf. As the prevalence of dystocia has increased over time, attention has been focused on maintaining the health and longevity of the cow. Lack of vitality in the newborn calf may go unnoticed and result in short or long-term implications for calf health and performance. A prolonged or assisted delivery may increase birth stress in calves causing a variety of effects including injury, inflammation, hypoxia, acidosis, pain and an inability to maintain homeostasis. Each of these effects can further contribute to a reduced state of vitality in the newborn calf. Newborn vitality is essential to the health, survival and welfare of the calf. If the calf is not vital at birth, it may be unwilling or unable to get up and suckle colostrum in a timely manner. Early colostrum intake improves passive transfer of immunoglobulins, energy uptake and thermoregulation. Intervention may be required to assist these calves such as respiratory and thermal support, manual feeding of colostrum or the administration of non-steroidal anti-inflammatory drugs to aid health and long-term survival. However, more research is needed to determine ways in which newborn calf vitality can be assessed and improved in order to reduce the increased risk of morbidity and mortality and long-term effects on performance.

  18. [Uterine torsion in cattle - frequency, clinical symptoms and theories about the pathogenesis].

    Science.gov (United States)

    Erteld, E; Wehrend, A; Goericke-Pesch, S

    2012-01-01

    Aim of the present study was to summarize the available literature about the incidence, frequency, clinical symptoms and ideas as to the pathogenesis of uterine torsion in the cow. Analysis of the literature using electronic libraries (Pub Med, Medline), German veterinary medicine journals and obstetrical textbooks. Uterine torsion is a very important maternal reason for dystocia as most cases occur during parturition. The post-cervical torsion (combined uterine and vaginal torsion, Torsio uteri and vaginae) is more commonly diagnosed than an intra-cervical or pre-cervical torsion. Torsions to the left occur more frequently than to the right. Clinical symptoms clearly vary depending on the degree of torsion. The frequency in relation to all parturitions is described as between 0.5 and 1%, whereas the percentage of uterine torsions presented to the veterinarian as a reason for dystocia varies between 2.7 and 65%. The pathogenesis of uterine torsion remains unclear; however, general agreement exists that the cow is predisposed to uterine torsion due to its anatomy. It appears that the Brown Swiss is more often affected than other cattle breeds.

  19. [In case of fetal macrosomia, the best strategy is the induction of labor at 38 weeks of gestation].

    Science.gov (United States)

    Rozenberg, P

    2016-11-01

    Macrosomic fetuses are at increased risk of obstetric complications, and notably shoulder dystocia, responsible for a severe neonatal morbidity. In case of fetal macrosomia, three options are: (i) the elective cesarean delivery, but this is recommended only when the estimated fetal weight is≥4500g for diabetic women and 5000g for non-diabetic women; (ii) the expectative management, but children with birth weight≥4500 had significantly increased risk of perinatal mortality, neonatal asphyxia, trauma, and cesarean delivery; (iii) the induction of labor which, reducing the possibility of fetal growth, reduce the risk of cesarean delivery for cephalopelvic disproportion and shoulder dystocia. As 2 former trials did not show maternal or neonatal benefit with induction of labor for fetal macrosomia, it was therefore not recommended. However, these 2 studies had small sample size (273 and 40 women) and a methodology limiting their ability to show a difference, justifying to achieve a large multicentre randomized controlled trial. This trial was performed by Boulvain et al. and the results published in 2015 in the Lancet. Inclusion criteria were: a singleton pregnancy in cephalic presentation and a suspected fetal macrosomia defined by an ultrasound estimated weight>95th percentile between 36 and 38 weeks. Women were randomly assigned to receive induction of labor within 3 days between 37(+0) and 38(+6) weeks of gestation, or expectant management. Expectant management continued until either spontaneous labour or diagnosis of a condition necessitating induction. The primary outcome was a composite of clinically significant shoulder dystocia, fracture of the clavicle, brachial plexus injury, intracranial haemorrhage, or death. Baseline characteristics were similar between groups. The mean birth weight (±SD) was 3831 (±324) g in the induction group 4118 (±392) g in the expectant group. Induction of labor significantly reduced the risk of shoulder dystocia or

  20. Risk factors associated with detailed reproductive phenotypes in dairy and beef cows.

    Science.gov (United States)

    Carthy, T R; Berry, D P; Fitzgerald, A; McParland, S; Williams, E J; Butler, S T; Cromie, A R; Ryan, D

    2014-05-01

    The objective of this study was to identify detailed fertility traits in dairy and beef cattle from transrectal ultrasonography records and quantify the associated risk factors. Data were available on 148 947 ultrasound observations of the reproductive tract from 75 949 cows in 843 Irish dairy and beef herds between March 2008 and October 2012. Traits generated included (1) cycling at time of examination, (2) cystic structures, (3) early ovulation, (4) embryo death and (5) uterine score; the latter was measured on a scale of 1 (good) to 4 (poor) characterising the tone of the uterine wall and fluid present in the uterus. After editing, 72,773 records from 44,415 dairy and beef cows in 643 herds remained. Factors associated with the logit of the probability of a positive outcome for each of the binary fertility traits were determined using generalised estimating equations; linear mixed model analysis was used for the analysis of uterine score. The prevalence of cycling, cystic structures, early ovulation and embryo death was 84.75%, 3.87%, 7.47% and 3.84%, respectively. The occurrence of the uterine heath score of 1, 2, 3 and 4 was 70.63%, 19.75%, 8.36% and 1.26%, respectively. Cows in beef herds had a 0.51 odds (95% CI=0.41 to 0.63, Pbeef herds. The likelihood of cycling at the time of examination increased with parity and stage of lactation, but was reduced in cows that had experienced dystocia in the previous calving. The presence of cystic structures on the ovaries increased with parity and stage of lactation. The likelihood of embryo/foetal death increased with parity and stage of lactation. Dystocia was not associated with the presence of cystic structures or embryo death. Uterine score improved with parity and stage of lactation, while cows that experienced dystocia in the previous calving had an inferior uterine score. Heterosis was the only factor associated with increased likelihood of early ovulation. The fertility traits identified, and the associated

  1. Estudo comparativo das indicações de cesariana entre um hospital público-universitário e um hospital privado Comparative study of cesarean section indications between a public university hospital and a private hospital

    Directory of Open Access Journals (Sweden)

    Renato Humberto Fabri

    2002-04-01

    Full Text Available OBJETIVOS: analisar a incidência e as indicações de cesariana realizadas no Hospital Escola da Falculdade de Medicina do Triângulo Mineiro e um hospital privado, ambos localizados em Uberaba, Minas Gerais, Brasil. MÉTODOS: trata-se de estudo transversal desenvolvido a partir da coleta nos prontuários dos hospitais, consistindo da idade, procedência, situação conjugal, escolaridade, paridade e indicações de cesariana. RESULTADOS: a incidência de cesariana foi de 24,3% no Hospital Escola contra 89,2% no hospital privado. As indicações mais freqüentes de cesariana no Hospital Escola foram a cesárea iterativa (26,7%, distócia (22,4% e o sofrimento fetal agudo (18,2%, e no hospital privado foram cesárea iterativa (36% e distócia (36%. As pacientes do hospital privado tinham maior escolaridade. CONCLUSÕES: os dados sugerem que o aumento de cesarianas no hospital privado foi decorrente de iteratividade, distócia e a escolaridade mais elevada das pacientes.OBJECTIVES: to analyse the incidence and the indications of cesarean section performed in the University Hospital of the "Triângulo Mineiro Faculty of Medicine " and a private hospital in Uberaba, Minas Gerais, Brazil. METHODS: a cross sectional study was carried out by using the data source of the medical files from both hospitals consisting of patient age, place of origin, marital status, education level, parity and cesarean sections indications. RESULTS: the cesarean sections rate was 24,3 % (325 of 1.441 births at the university hospital against 89,2% (100 of 112 births of the private hospital. The most frequent indications in the University Hospital were previous cesarean sections (26,7%, dystocia (22,4% and acute fetal distress (18,2%. In the private hospital, indications were previous cesarean section (36% and dystocia (36%. The private hospital's patients had higher education levels. CONCLUSIONS: the higher rate of cesarean sections observed in the private hospital

  2. Postpartum hemorrhage in a Jehovah's Witness patient controlled with Tisseel, tranexamic acid, and recombinant factor VIIa.

    Science.gov (United States)

    Arab, Tarek Samir; Al-Wazzan, Ahmad Bakr; Maslow, Ken

    2010-10-01

    The management of a patient refusing blood transfusion who subsequently experiences a severe postpartum hemorrhage is a particular clinical challenge. A 30-year-old nulliparous patient (who was a Jehovah's Witness) had labour induced for post-dates at 41+4 weeks' gestational age after an uncomplicated pregnancy. She delivered by Caesarean section for dystocia and suspected chorioamnionitis, and subsequently developed postpartum hemorrhage that required management with oxytocin, ergometrine, carboprost, uterine artery ligation, and Hayman compression sutures. The patient ultimately required two additional visits to the operating room, culminating in hysterectomy. Use of tranexamic acid, recombinant factor VIIa, and Tisseel was instrumental in halting the ongoing hemorrhage. Optimal management of a patient refusing administration of blood products requires a multidisciplinary approach as well as a combination of traditional and novel therapies.

  3. Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant Danish women

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Damm, Peter; Sørensen, Bente

    2003-01-01

    OBJECTIVE: This study was undertaken to investigate the relationship between pregnancy outcome and prepregnancy overweight or obesity in women with a normal glucose tolerance test. STUDY DESIGN: A historical cohort study of 2459 pregnant women systematically examined for gestational diabetes...... overweight and obesity is associated with adverse pregnancy outcome in glucose-tolerant women........0-29.9 kg/m(2)) and obese women (BMI >or= 30.0 kg/m(2)) compared with women who were of normal weight (BMI 18.5-24.9 kg/m(2)). The frequencies of shoulder dystocia, preterm delivery, and infant morbidity other than macrosomia were not significantly associated with maternal BMI. CONCLUSION: Prepregnancy...

  4. Vitamin D and gestational diabetes

    DEFF Research Database (Denmark)

    Joergensen, Jan S; Lamont, Ronald F; Torloni, Maria R

    2014-01-01

    PURPOSE OF REVIEW: Vitamin D status (which is involved in glucose homeostasis) is related to gestational diabetes mellitus (GDM). GDM is characterized by increased resistance to and impaired secretion of insulin and results in higher risk of adverse pregnancy outcomes including operative delivery......, macrosomia, shoulder dystocia and neonatal hypoglycemia. Women with GDM and their babies are at increased risk for developing type II diabetes. RECENT FINDINGS: International definitions of vitamin D deficiency and normality are inconsistent. Vitamin D deficiency is common in pregnant women particularly...... those with poor diets and who have dark skins living in temperate climes with lack of exposure to sunlight. SUMMARY: Few interventional studies indicate that supplementation optimizes maternal vitamin D status or improves maternal glucose metabolism. Observational studies about maternal vitamin D status...

  5. Clinical skills training in obstetrics - a descriptive survey of current practice in Denmark

    DEFF Research Database (Denmark)

    Nielsen, Mathilde Maagaard; Johansen, Marianne; Lottrup, Pernille

    2012-01-01

    The Danish National Board of Health has recommended that labor wards establish regular obstetric emergency skills training programs. The aim of this study was to describe current practice in Denmark. A questionnaire was sent to all obstetric departments in Denmark in 2008. All responded. Simulation......-based training was conducted in 26/28 obstetrical departments. Settings for the training programs were mainly local. Training was provided for shoulder dystocia, postpartum bleeding and basic neonatal resuscitation in almost all the departments, but was not organized in a uniform way. Neither the program itself...... nor the participants' performance was evaluated in a structured or validated way. Obstetric emergency skills training is being actively conducted in the majority of the Danish labor wards. However, it still remains a challenge to ensure the uniform organization and evaluation of the current training...

  6. Approaches to the management of antenatally diagnosed congenital tumours

    Energy Technology Data Exchange (ETDEWEB)

    Mahony, Rhona; McParland, Peter [National Maternity Hospital, Department of Fetal and Maternal Medicine, Dublin (Ireland)

    2009-11-15

    Congenital fetal tumours are rare, but current imaging modalities including US and MRI facilitate antenatal diagnosis and investigation, allowing a presumptive diagnosis and management strategy. Although the prevalence of fetal tumours is difficult to ascertain, an incidence of 7.2 per 100,000 live births has previously been reported, with the incidence of neonatal malignancy estimated at 36.5 per million births. Teratomas and neuroblastomas are the most common solid tumours described. Tumours may be very large or associated with severe hydrops leading to significant dystocia with the potential for difficult vaginal or caesarean delivery. Once the diagnosis of a fetal tumour is made, optimal management incorporates a multidisciplinary approach including obstetrician, neonatologist, paediatric surgeon and paediatric oncologist so that counselling is appropriate and a clear management plan is in place for parents. (orig.)

  7. The association between low 50 g glucose challenge test result and fetal growth restriction.

    Science.gov (United States)

    Melamed, Nir; Hiersch, Liran; Peled, Yoav; Hod, Moshe; Wiznitzer, Arnon; Yogev, Yariv

    2013-07-01

    To determine whether a low-GCT result is predictive of low birthweight and to identify the lower GCT threshold for prediction of fetal growth restriction. A retrospective cohort study of 12,899 women who underwent a GCT (24-28 weeks). Women with a low-GCT result (result (70-140 mg/dL). ROC analysis was used to determine the optimal lower GCT threshold for the prediction of growth restriction. Women in the low GCT had significant lower rates of cesarean delivery (18.7% versus 22.5%), shoulder dystocia (0.0% versus 0.3%), mean birthweight (3096 ± 576 versus 3163 ± 545) and birthweight percentile (49.1 ± 27.0 versus 53.1 ± 26.7) and significant higher rates of birthweight result is independently associated with low birthweight and can be used in combination with additional factors for the prediction of fetal growth restriction.

  8. Intrapartum considerations in prenatal care.

    Science.gov (United States)

    Ehrenberg, Hugh M

    2011-12-01

    The epidemic of obesity continues to grow undaunted, promising to affect the lives of more women of childbearing age. The challenges facing those charged with obstetrical care of the obese may require variation in care from forethought and planning, to consultation or referral for care at specialized centers. The routine management of late pregnancy must take into account the increase in risk for late fetal loss, failed induction and trial of labor after cesarean delivery, and postcesarean complications, such as wound-related morbidity and venous thromboembolism. Awareness of prolonged labor curves and the risk of shoulder dystocia must also be part of the management of labor. The data regarding many interventions attempted on behalf of these at risk gravidas are rudimentary but may allow for modifications in care that will positively impact outcomes for mother and child.

  9. [Obesity as an obstetric risk factor].

    Science.gov (United States)

    Kanadys, W M; Oleszczuk, J

    1999-06-01

    Obesity-related metabolic and functional disorders may disturb adaptation process taking place in pregnant women body. Insufficient adaptation may lead to development of several medical complications during pregnancy, labor, delivery, and puerperium. Maternal obesity is associated with increased frequencies of hypertension, preeclampsia, gestational diabetes mellitus, fetal macrosomia, congenital malformations, labor abnormalities (including prolonged second stage of labor, meconium-stained amniotic fluid, FHR abnormalities and shoulder dystocia), postdatism, and cesarean delivery. Operative complications among obese women undergoing cesarean delivery include increased blood loss, prolonged operative time, and increased rates of postoperative infection, thrombophlebitis. Treatment of these complications increases hospital stays and costs. Obese women should be carefully examined by dietetician before conception and cared for dietetically and medically during gestation.

  10. Maternal obesity and pregnancy.

    Science.gov (United States)

    Johnson, S R; Kolberg, B H; Varner, M W; Railsback, L D

    1987-05-01

    We examined the risk of maternal obesity in 588 pregnant women weighing at least 113.6 kilograms (250 pounds) during pregnancy. Compared with a control group matched for age and parity, we found a significantly increased risk in the obese patient for gestational diabetes, hypertension, therapeutic induction, prolonged second stage of labor, oxytocin stimulation of labor, shoulder dystocia, infants weighing more than 4,000 grams and delivery after 42 weeks gestation. Certain operative complications were also more common in obese women undergoing cesarean section including estimated blood loss of more than 1,000 milliliters, operating time of more than two hours and wound infection postoperatively. These differences remained significant after controlling for appropriate confounding variables. We conclude that maternal obesity should be considered a high risk factor.

  11. Using simulation to teach nursing students and licensed clinicians obstetric emergencies.

    Science.gov (United States)

    Alderman, Jennifer Taylor

    2012-01-01

    Improving patient safety in healthcare has reached critical mass both in the United States and worldwide. Effective communication between nurses and other members of the healthcare team is an essential component of patient safety. In obstetrics, poor communication and teamwork were causative factors in many of reviewed sentinel event cases. Simulation is a recommended teaching strategy used to improve communication and teamwork skills, and therefore patient safety, among interprofessional team members. This article offers a strategy in the form of a shoulder dystocia simulation that can be implemented in either academic or clinical settings. Simulations such as this one can be used to enhance teamwork and communication skills of healthcare professionals, both in educational institutions and in clinical practice settings, with a goal of improving patient safety.

  12. [The cultural and medical significance of Xin an mingzuzhi(History of Famous Family in Xin'an)].

    Science.gov (United States)

    Hu, A H; Wan, S M

    2016-01-28

    History of Famous Family in Xin'an includes abundant information and important value of the medical cultural history, including the medical family, medical ethics and the number of the famous doctors and its distribution, the medical books and its outline the medical ethics, the diseases. As for the 115 famous doctors recorded in this book, Shexian county owns the most while Jixi county owns the least, and of the average number of famous doctors among the 10, 000 local people, Yixian county owns the most while Xiuning county owns the least. History of Famous Family in Xin'an includes 26 medical books, ranging from medical literature study, gynecological treatment, external medical treatment, diagnosis and treatment of pediatric diseases, ancient medical case records, medical education, acu-moxibustion and summary of other medical experiences. The book also demonstrates the noble morality of doctors, development of doctor' family, and records of paralytic stroke, epistaxis, tuberculous consumptive diseases, furunculosis, dystocia and some infectious diseases.

  13. Indications for episiotomy performance - a cross-sectional survey and review of the literature.

    Science.gov (United States)

    Sagi-Dain, L; Sagi, S

    2016-01-01

    Our objective was to assess the reported reasons for episiotomy performance in Israel and to review the relevant professional literature. Using anonymous questionnaires, a survey was conducted among obstetricians and midwives in four northern Israel hospitals, and the accoucheurs were asked to score their agreement with 13 proposed indications for episiotomy. Overall, 84 doctors and 32 midwives completed the questionnaires. 86.1% of the responders reported performing episiotomy in all or most cases of shoulder dystocia, and more than half reported performing it in most cases of vacuum deliveries, fetal macrosomia and advanced perineal tear in previous delivery. Subjective assessment of perineal characteristics constituted a justified reason for episiotomy for 15.8-43.9% of the accoucheurs. In conclusion, there is a wide variation in reported reasons for episiotomy between the obstetricians, and many of these indications are not congruent with international practice guidelines. Uniform protocols and educational programmes are needed to guide episiotomy practice.

  14. Obesity and pregnancy

    DEFF Research Database (Denmark)

    Andreasen, Kirsten Riis; Andersen, Malene Lundgren; Schantz, Anne Louise

    2004-01-01

    BACKGROUND: As obesity is an increasing problem among fertile women, it is crucial that specialists involved in the treatment of these women be aware of the risks of complications and know how to deal with them. Complications associated with obesity in pregnancy are gestational diabetes mellitus......, hypertensive disorders, and thromboembolic complications. Complications associated with obesity in labor are augmentation, early amniotomy, cephalopelvic disproportion, cesarean section, and perioperative morbidity. Complications associated with obesity in children are macrosomia, shoulder dystocia, small...... for gestational age, late fetal death, and congenital malformations, especially neural tube defects. OBJECTIVE: The aim was to review the potential complications associated with obesity and pregnancy. RESULTS: Obesity is associated with a higher risk of all reviewed complications except small for gestational age....

  15. Maternal obesity: implications for pregnancy outcome and long-term risks-a link to maternal nutrition.

    Science.gov (United States)

    Aviram, Amir; Hod, Moshe; Yogev, Yariv

    2011-11-01

    As obesity becomes a worldwide epidemic, its prevalence during reproductive age is also increased. Alarming reports state that two-thirds of adults in the USA are overweight or obese, with half of them in the latter category, and the rate of obese pregnant women is estimated at 18-38%. These women are of major concern to women's health providers because they encounter numerous pregnancy-related complications. Obesity-related reproductive health complications range from infertility to a wide spectrum of diseases such as hypertensive disorders, coagulopathies, gestational diabetes mellitus, respiratory complications, and fetal complications such as large-for-gestational-age infants, congenital malformations, stillbirth, and shoulder dystocia. Recent reports suggest that obesity during pregnancy can be a risk factor for developing obesity, diabetes, and cardiovascular diseases in the newborn later in life. This review will address the implication of obesity on pregnancy and child health, and explore recent literature on obesity during pregnancy.

  16. Erb's palsy after delivery by Cesarean section. (A medico-legal key to a vexing problem.).

    Science.gov (United States)

    Iffy, Leslie; Pantages, Pamela

    2005-12-01

    Despite impressive progress in perinatology, fetal injuries from arrest of the shoulders at birth have not decreased in recent decades. Based upon sporadic reports of Erb's palsy in neonates born by Cesarean section, some obstetricians embraced the theory recently that brachial plexus lesions often derive from spontaneous forces acting in utero. Having reviewed three hundred malpractice claims involving fetal injuries attributed to shoulder dystocia at birth, the authors found only two cases connected with abdominal deliveries. One followed manual replacement of the already delivered fetal head into the pelvis after sequential vacuum and forceps procedures and failed manual extraction of the body. The other was an elective repeat Cesarean section where extensive adhesions limited the available space for the lower segment transverse uterine incision. Coincidental fracture of the clavicle and absence of contractures or deformities indicated that the brachial plexus injury was acute, having resulted from forceful traction at delivery.

  17. Retrospective analysis of reproductive disease conditions among domestic ruminants in Sokoto, Nigeria

    Directory of Open Access Journals (Sweden)

    M.A. Umaru

    2013-03-01

    Full Text Available A fifteen-year (1991 — 2005 study of reproductive cases in animals presented to the Usmanu Danfodiyo University Veterinary Teaching Hospital, Sokoto, were analyzed based on species, disease condition and sex using clinical case Files of Sheep, goat and cattle. Within the study period a total of 88 reproductive cases were handled out of which 53 (57.95 % occurred in sheep, 32(36.36 % goat and 5(5.68 % cattle. Dystocia 23(26.13 %, Pregnancy toxaemia 11(12.50 %, mastitis 9(10.23 %, castration 5(5.68 % and orchitis 3(3.41 % were the diseases recorded. Reproductive cases were higher in females 77(87.5 % than in mates 11(12.5 %. From the study, reproductive cases were most prevalent in sheep than in goats and cattle.

  18. Eficiência produtiva e reprodutiva em vacas leiteiras Productive and reproductive efficiency in dairy cows

    Directory of Open Access Journals (Sweden)

    Tisa Echevarria Leite

    2001-06-01

    Full Text Available O presente trabalho teve por objetivo avaliar efeitos de transtornos puerperais sobre a eficiência reprodutiva e produtiva de vacas da raça Holandês de uma estação experimental, durante 24 anos. Foram coletados dados produtivos e reprodutivos de 350 vacas. Todos os dados foram submetidos à análise descritiva. As variáveis dependentes: intervalo entre partos (IEP, intervalo parto concepção (IPC, intervalo parto primeiro cio (IPPC, número de crias (NC e produção de leite (PL foram submetidas a análise de variância para determinação dos efeitos da ocorrência de transtornos puerperais (aborto, natimorto, distocia e retenção de placenta e de mastite. A idade ao primeiro cio (IdPC foi de 29,4 meses, a idade ao primeiro parto (IdPP de 37,1 meses e a longevidade (L de 69,7 meses. O IEP apresentou média de 14,6 meses, o IPPC de 97,0 dias e o IPC de 150,7 dias. O intervalo entre cios (IEC apresentou média de 48,2 dias, sugerindo falhas na detecção de cios. Foi observado efeito significativo (PThe present study was conducted to evaluate the effects of post partum disorders on productive and reproductive performance of Holstein cows, from a dairy experimental station, during 24 years. Productive and reproductive data were collected from 350 cows. Analyses of variance was conducted to evaluate the effects of occurrence of post partum disorders (abortion, stillbirth, dystocia, retained placenta and mastitis on calving interval (IEP, calving to conception interval (IPC, calving to first estrus interval (IPPC, number of estrus before conception (NC and milk production (PL. The mean age at first estrus was 29.4 months and the mean age at first calving was 37.1 months. Mean IEP was 14.6 months, mean IPPC was 97.04 days and median IPC was 150.71 days. Median interestrus interval was 24 days, suggesting problems in a estrus detection. A significant effect of occurrence of abortion (P<0.05 was observed on IEP. Calving intervals were 258 days

  19. Obesity and pregnancy

    DEFF Research Database (Denmark)

    Andreasen, Kirsten Riis; Andersen, Malene Lundgren; Schantz, Anne Louise

    2004-01-01

    BACKGROUND: As obesity is an increasing problem among fertile women, it is crucial that specialists involved in the treatment of these women be aware of the risks of complications and know how to deal with them. Complications associated with obesity in pregnancy are gestational diabetes mellitus......, hypertensive disorders, and thromboembolic complications. Complications associated with obesity in labor are augmentation, early amniotomy, cephalopelvic disproportion, cesarean section, and perioperative morbidity. Complications associated with obesity in children are macrosomia, shoulder dystocia, small...... for gestational age, late fetal death, and congenital malformations, especially neural tube defects. OBJECTIVE: The aim was to review the potential complications associated with obesity and pregnancy. RESULTS: Obesity is associated with a higher risk of all reviewed complications except small for gestational age....

  20. [Advanced uterine prolapse during pregnancy: pre- and postnatal management].

    Science.gov (United States)

    Pizzoferrato, A-C; Bui, C; Fauconnier, A; Bader, G

    2013-01-01

    Pelvic organ prolapse is a common pelvic floor disorder in postmenopausal women. The literature is quite poor concerning the management of prolapse during pregnancy in young women. We report the case of a 39-year-old multiparous woman referred for the treatment of an exteriorized uterine prolapse at 13 weeks of gestation. The management of cervical prolapse depends on its stage, its evolution and on gestational age. It combines local antiseptics, rest and manual reintegration or reduction of the prolapsus using a pessary to prevent ulceration of the cervix. In case of stage IV (POP-Q) uterine prolapse, vaginal delivery may be compromised. No recommendation is actually available about route of delivery in case of exteriorized uterine prolapse. It should be clearly discussed regarding the potential risk of cesarean section for dystocia. Surgical repair of the prolapse will be discussed after childbirth according to functional impairment and women's desire for pregnancy. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Uterine prolapse in a 19 year old pregnant woman: a case report

    Science.gov (United States)

    Toy, Harun; Camuzcuoğlu, Hakan; Aydın, Halef

    2009-01-01

    It is well-known that multiparity and advanced age are major risk factors for pelvic organ prolapse which can rarely complicate pregnancy. We present the youngest case of uterine prolapse during pregnancy. She admitted with ruptured membranes at the 36th week of gestation and irreducible prolapse. As the edematous and thick, trapped and ulcerated cervix was not reducible, labor was obstructed due to cervical dystocia and a cesarean delivery was decided. A live male infant weighing 3100 gram was delivered. The prolapsed uterus recovered spontaneously following the cesarean operation. Uterine prolapse during pregnancy should be managed conservatively. It seems to be essential to perform elective cesarean section because of the risk of possible obstructed labor. We observed a rapid recovery of the anatomy, probably due to the young age. PMID:24591867

  2. Mode of Delivery according to Leisure Time Physical Activity before and during Pregnancy

    DEFF Research Database (Denmark)

    Nielsen, Emilie Nor; Andersen, Per Kragh; Hegaard, Hanne Kristine

    2017-01-01

    Objectives: To examine the association between maternal leisure time physical activity and mode of delivery. Study Design: Population-based multicentre cohort. From the Danish Dystocia Study, we included 2,435 nulliparous women, who delivered a singleton infant in cephalic presentation at term...... after spontaneous onset of labor in 2004-2005. We analysed mode of delivery according to self-reported physical activity at four stages, that is, the year before pregnancy and during first, second, and third trimester, in logistic regression models. Further, we combined physical activity measures at all...... with statistically significant trends at all four time stages except the third trimester. This tendency was confirmed in the proportional odds model showing 28% higher odds of a more complicated mode of delivery among women with a low activity level compared to moderately active women. Conclusions: We found...

  3. Maternal and neonatal outcomes in pregnancies complicated by gestational diabetes

    DEFF Research Database (Denmark)

    Ovesen, Per Glud; Jensen, Dorte Møller; Damm, Peter

    2015-01-01

    and delivery and fetal complications were classified according to the International Classification of Diseases 10th Revision. RESULTS: The final study population consisted of 398 623 women. Of these, 9014 (2.3%) had GDM. Data were adjusted for maternal age, parity, smoking, gestational age, birth weight, BMI......OBJECTIVE: To estimate the association between gestational diabetes mellitus (GDM) and adverse pregnancy and neonatal outcomes in Denmark. METHODS: A population-based cohort study including all singleton pregnancies in Denmark from 2004 to 2010 (n = 403 092). Maternal complications during pregnancy......, gender of the fetus and calendar year. The risk of preeclampsia, caesarean section (both planned and emergency) and shoulder dystocia was increased in women with GDM. In the unadjusted analysis, the risk of thrombosis was increased by a factor 2 in the GDM patients, but in the adjusted analysis...

  4. Increased calf production in cattle selected for twin ovulations.

    Science.gov (United States)

    Echternkamp, S E; Thallman, R M; Cushman, R A; Allan, M F; Gregory, K E

    2007-12-01

    The effects of increasing fetal numbers and their distribution between the left and right uterine horns on calf survival, calf BW at birth and weaning, gestation length, dystocia, and calf sex ratio were evaluated for single (n = 1,587), twin (n = 2,440), and triplet calves (n = 147) born to primiparous and multiparous females in the Twinner population at the US Meat Animal Research Center between 1994 and 2004. Cattle were distributed equally between the spring and fall breeding seasons. Fetal number and distribution in utero were determined by real-time ultrasonography at 40 to 70 d postbreeding. For cows and heifers combined, number of calves per parturition increased from 1.34 in 1994 to 1.56 in 2004. Gestation length was 6.8 d shorter (P gestation length, and less (P gestation length vs. 0.38 kg/d for individual twins. Calf BW at birth increased (P < 0.01) with age of dam from 2 to 4 yr. Twin and triplet births had a greater (P < 0.01) incidence of dystocia than single births. The ratio of male:female calves (0.52:0.48) at birth was not affected by type of birth. Postnatal calf survival was similar for all 3 types of birth. Total progeny BW at weaning for single, twin, and triplet births was 217.7 +/- 2.5, 328.3 +/- 3.2, and 378.4 +/- 15.0 kg, respectively (P < 0.01). Although most bovine females have the uterine capacity to gestate twin calves, decreased survival and BW of unilateral twins and of all triplets indicate that their growth and development may have been compromised by uterine crowding.

  5. Physiological increases in lactate inhibit intracellular calcium transients, acidify myocytes and decrease force in term pregnant rat myometrium.

    Science.gov (United States)

    Hanley, Jacqui-Ann; Weeks, Andrew; Wray, Susan

    2015-10-15

    Lactate is increased in myometrial capillary blood from women in slow or non-progressive labour (dystocia), suggesting that it is detrimental to uterine contractions. There are, however, no studies of the effect of lactate on the myometrium. We therefore investigated its effects and mechanism of action on myometrial strips from term pregnant rats. The effects on spontaneous and oxytocin-induced contractility in response to sodium lactate and other weak acids (1-20 mM) were studied. In some experiments, simultaneous force and intracellular Ca(2+) or pH (pH(i)) were measured with Indo-1 or Carboxy-SNARF, respectively. Statistical differences were tested using non-parametric tests. Lactate significantly decreased spontaneous contractility with an EC50 of 3.9 mM. Propionate, butyrate and pyruvate also reduced contractions with similar potency. The effects of lactate were reduced in the presence of oxytocin but remained significant. Lactate decreased pH(i) and nulling the decrease in pH(i) abolished its effects. We also show that lactate inhibited Ca(2+) transients, with these changes mirroring those produced on force. If Ca(2+) entry was enhanced by depolarization (high KCl) or applying the Ca(2+) channel agonist, Bay K 4644, the effects of lactate were abolished. Taken together, these data show that lactate in the physiological range potently decreases myometrial contractility as a result of its inhibition of Ca(2+) transients, which can be attributed to the induced acidification. The present study suggests that the accumulation of extracellular lactate will reduce myometrial contractions and could therefore contribute to labour dystocia.

  6. Reproductive disorders in dairy cattle under semi-intensive system of rearing in North-Eastern India

    Science.gov (United States)

    Khan, M. H.; Manoj, K.; Pramod, S.

    2016-01-01

    Aim: This study was conducted to determine the incidence of major reproductive problems of dairy cattle reared under a semi-intensive system by small and marginal farmers in Meghalaya province of North-Eastern India. Materials and Methods: In a 3 years study, a total of 576 crossbred dairy cattle (212 Holstein Friesian cross and 364 Jersey cross) from all districts (n=11) of Meghalaya were assessed with the survey, clinical examination, and personal observations. Results: Out of the total animal assessed, 33.85% (n=195) were found to be affected with one or more of the clinical reproductive problems. Repeat breeding (RB), anestrus, retention of fetal membrane, and abortion were found to be the major clinical reproductive problems. Out of the total animal affected with reproductive disorders, the incidence of anestrus, RB, retention of fetal membrane, and abortion was found to be 31.79% (n=62), 24.61% (n=48), 14.35% (n=28), and 11.25% (n=22), respectively. In addition, dystocia (5.12%), prolapse (1.53%), endometritis (4.61%), and pyometra (6.66%) were minor clinical reproductive problems. There was a significant difference in the incidence of reproductive disorders with respect to breed, age, and parity. Conclusion: It was revealed from this study that RB, anestrus, retention of fetal membrane, and dystocia are the major clinical reproductive problems in Meghalaya. Results indicated unsatisfactory feeding, housing, and health management practices are the main cause of low fertility of dairy cows. Lack of scientific knowledge, low access to breeding, and health services further contributed to low productivity and fertility. PMID:27284229

  7. Factors associated with the number of calves born to Norwegian beef suckler cows.

    Science.gov (United States)

    Holmøy, Ingrid H; Nelson, Sindre T; Martin, Adam D; Nødtvedt, Ane

    2017-05-01

    A retrospective cohort study was performed to evaluate factors associated with the number of calves born to Norwegian beef suckler cows. Production data from 20,541 cows in 2210 herds slaughtered over a three-year period (1st of January 2010 to 23rd of January 2013) were extracted from the national beef cattle registry. This study's inclusion criteria were met for 16,917 cows (from 1858 herds) which gave birth to 50,578 calves. The median number of calves born per cow was 2 (min 1, max 18). Two multilevel Poisson regression models with herd random effects showed that early maturing breeds (Hereford and Aberdeen Angus) gave birth to more calves than late maturing breeds (Charolais and Limousin) in four out of five areas of Norway. The significant breed-region interaction indicated that the coastal South East region of Norway, which has a relatively long growing season and gentle topography, yielded the highest number of calves born for all but one breed (Simmental). Cows that needed assistance or experienced dystocia at their first calving produced fewer calves than those that did not: incidence rate ratio 0.87 (95% confidence interval (CI) 0.84-0.91) for assistance and 0.70 (95% CI: 0.66-0.75) for dystocia, respectively. Cows in larger herds (>30 cows) produced 11% more calves in their lifetime compared to cows in smaller herds (≤30 cows) (Pborn. The large inter-herd variation indicate systematic differences in herd level factors influencing the number of calves born to each cow. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Reproductive disorders in dairy cattle under semi-intensive system of rearing in North-Eastern India

    Directory of Open Access Journals (Sweden)

    M. H. Khan

    2016-05-01

    Full Text Available Aim: This study was conducted to determine the incidence of major reproductive problems of dairy cattle reared under a semi-intensive system by small and marginal farmers in Meghalaya province of North-Eastern India. Materials and Methods: In a 3 years study, a total of 576 crossbred dairy cattle (212 Holstein Friesian cross and 364 Jersey cross from all districts (n=11 of Meghalaya were assessed with the survey, clinical examination, and personal observations. Results: Out of the total animal assessed, 33.85% (n=195 were found to be affected with one or more of the clinical reproductive problems. Repeat breeding (RB, anestrus, retention of fetal membrane, and abortion were found to be the major clinical reproductive problems. Out of the total animal affected with reproductive disorders, the incidence of anestrus, RB, retention of fetal membrane, and abortion was found to be 31.79% (n=62, 24.61% (n=48, 14.35% (n=28, and 11.25% (n=22, respectively. In addition, dystocia (5.12%, prolapse (1.53%, endometritis (4.61%, and pyometra (6.66% were minor clinical reproductive problems. There was a significant difference in the incidence of reproductive disorders with respect to breed, age, and parity. Conclusion: It was revealed from this study that RB, anestrus, retention of fetal membrane, and dystocia are the major clinical reproductive problems in Meghalaya. Results indicated unsatisfactory feeding, housing, and health management practices are the main cause of low fertility of dairy cows. Lack of scientific knowledge, low access to breeding, and health services further contributed to low productivity and fertility.

  9. Lactate in Amniotic Fluid: Predictor of Labor Outcome in Oxytocin-Augmented Primiparas’ Deliveries

    Science.gov (United States)

    Pembe, Andrea B.; Järnbert-Pettersson, Hans; Norman, Margareta; Wihlbäck, Anna-Carin; Hoesli, Irene; Todesco Bernasconi, Monya; Azria, Elie; Åkerud, Helena; Darj, Elisabet

    2016-01-01

    Background One of the major complications related to delivery is labor dystocia, or an arrested labor progress. Many dystocic deliveries end vaginally after administration of oxytocin, but a large numbers of women with labor dystocia will undergo a long and unsafe parturition. As a result of the exertion required in labor, the uterus produces lactate. The uterine production of lactate is mirrored by the level of lactate in amniotic fluid (AFL). Objectives To evaluate whether the level of AFL, analysed in a sample of amniotic fluid collected vaginally at arrested labor when oxytocin was needed, could predict labor outcome in nulliparous deliveries. Methods A prospective multicentre study including 3000 healthy primiparous women all with a singleton pregnancy, gestational age 37 to 42 weeks and no maternal /fetal chronic and/or pregnancy-related conditions. A spontaneous onset of labor, regular contractions and cervical dilation ≥ 3 cm were required before the women were invited to take part in the study. Results AFL, analysed within 30 minutes before augmentation, provides information about delivery outcome. Sensitivity for an acute cesarean section according to high (≥10.1mmol/l) or low (12h (p = 0.04), post-partum fever (>38°C, p = 0.01) and post-partum haemorrhage >1.5L (p = 0.04). Conclusion The AFL is a good predictor of delivery outcome in arrested nulliparous deliveries. Low levels of AFL may support the decision to continue a prolonged vaginal labor by augmentation with oxytocin. A high level of AFL correlates with operative interventions and post-partum complications. PMID:27783611

  10. Lactate in Amniotic Fluid: Predictor of Labor Outcome in Oxytocin-Augmented Primiparas' Deliveries.

    Science.gov (United States)

    Wiberg-Itzel, Eva; Pembe, Andrea B; Järnbert-Pettersson, Hans; Norman, Margareta; Wihlbäck, Anna-Carin; Hoesli, Irene; Todesco Bernasconi, Monya; Azria, Elie; Åkerud, Helena; Darj, Elisabet

    2016-01-01

    One of the major complications related to delivery is labor dystocia, or an arrested labor progress. Many dystocic deliveries end vaginally after administration of oxytocin, but a large numbers of women with labor dystocia will undergo a long and unsafe parturition. As a result of the exertion required in labor, the uterus produces lactate. The uterine production of lactate is mirrored by the level of lactate in amniotic fluid (AFL). To evaluate whether the level of AFL, analysed in a sample of amniotic fluid collected vaginally at arrested labor when oxytocin was needed, could predict labor outcome in nulliparous deliveries. A prospective multicentre study including 3000 healthy primiparous women all with a singleton pregnancy, gestational age 37 to 42 weeks and no maternal /fetal chronic and/or pregnancy-related conditions. A spontaneous onset of labor, regular contractions and cervical dilation ≥ 3 cm were required before the women were invited to take part in the study. AFL, analysed within 30 minutes before augmentation, provides information about delivery outcome. Sensitivity for an acute cesarean section according to high (≥10.1mmol/l) or low (12h (p = 0.04), post-partum fever (>38°C, p = 0.01) and post-partum haemorrhage >1.5L (p = 0.04). The AFL is a good predictor of delivery outcome in arrested nulliparous deliveries. Low levels of AFL may support the decision to continue a prolonged vaginal labor by augmentation with oxytocin. A high level of AFL correlates with operative interventions and post-partum complications.

  11. Effect of obstetric team training on team performance and medical technical skills: a randomised controlled trial.

    Science.gov (United States)

    Fransen, A F; van de Ven, J; Merién, A E R; de Wit-Zuurendonk, L D; Houterman, S; Mol, B W; Oei, S G

    2012-10-01

    To determine whether obstetric team training in a medical simulation centre improves the team performance and utilisation of appropriate medical technical skills of healthcare professionals. Cluster randomised controlled trial. The Netherlands. The obstetric departments of 24 Dutch hospitals. The obstetric departments were randomly assigned to a 1-day session of multiprofessional team training in a medical simulation centre or to no such training. Team training was given with high-fidelity mannequins by an obstetrician and a communication expert. More than 6 months following training, two unannounced simulated scenarios were carried out in the delivery rooms of all 24 obstetric departments. The scenarios, comprising a case of shoulder dystocia and a case of amniotic fluid embolism, were videotaped. The team performance and utilisation of appropriate medical skills were evaluated by two independent experts. Team performance evaluated with the validated Clinical Teamwork Scale (CTS) and the employment of two specific obstetric procedures for the two clinical scenarios in the simulation (delivery of the baby with shoulder dystocia in the maternal all-fours position and conducting a perimortem caesarean section within 5 minutes for the scenario of amniotic fluid embolism). Seventy-four obstetric teams from 12 hospitals in the intervention group underwent teamwork training between November 2009 and July 2010. The teamwork performance in the training group was significantly better in comparison to the nontraining group (median CTS score: 7.5 versus 6.0, respectively; P = 0.014). The use of the predefined obstetric procedures for the two clinical scenarios was also significantly more frequent in the training group compared with the nontraining group (83 versus 46%, respectively; P = 0.009). Team performance and medical technical skills may be significantly improved after multiprofessional obstetric team training in a medical simulation centre. © 2012 The Authors BJOG An

  12. 手法处理头位难产在少数民族偏远地区的意义

    Institute of Scientific and Technical Information of China (English)

    罗彩红; 李虹; 姑再努尔·阿不来提; 章素娟

    2012-01-01

    目的 探讨经阴道徒手旋转胎头处理头位难产的临床应用价值.方法 回顾性分析经阴道徒手旋转胎头处理头位难产的病例,分析其异常头先露、先露高低、宫口扩张及胎儿体重与徒手旋转胎头处理后分娩情况.结果 头位难产1356例,占分娩总数的20.56%.对其中1030例孕妇进行了经阴道徒手旋转纠正头先露异常,顺产842例,成功率81.75%;剖宫产141例(13.69%),阴道助产47例(4.56%),失败188例,失败率18.52%.持续性枕后位与枕横位徒手旋转胎头成功率明显高于前不均倾位及高直位(P<0.01);先露S+1以下徒手旋转胎头成功率明显高于S+1以上者(P<0.01);宫口开大4cm以上徒手旋转胎头成功率明显高于宫口开大4cm以下者(P<0.01);胎儿体重3750g以下时,徒手旋转胎头成功率明显高于胎儿体重3750g以上者(P<0.01).结论 重视头盆评分及产程观察,适时经阴道徒手旋转异常头先露,能有效提高头位难产的阴道分娩率,降低剖宫产率,对少数民族偏远地区有重要意义.%Objective To explore the clinical application value of transvaginal manual rotation of fetal head in dealing with cephalic dystocia presentation in Sinkiang county hospital. Methods A retrospective analysis was used for analyzing the abnormal cephalic presentation, presentation engagement, dilatation of cervix, fetal weight and the other pregnant outcomes of the patients with cephalic dystocia presentation who accepted the transvaginal manual rotation in Jiashi district Sinkiang province. Results After searching the medical records, we found a total of 1356 patients with cephalic dystocia presentation, it counted for 20.56% of all the pregnancies. Of the 1356 patients, 1030 were accepted transvaginal manual rotation of fetal head for regulating the abnormal presentation and 842(81.75%) were natural delivery, 141(13.69%) caesarean section, 47 (4.56%) vaginal aid delivery and 188(18.52%) failed to delivery. The success

  13. Different insulin types and regimens for pregnant women with pre-existing diabetes.

    Science.gov (United States)

    O'Neill, Sinéad M; Kenny, Louise C; Khashan, Ali S; West, Helen M; Smyth, Rebecca Md; Kearney, Patricia M

    2017-02-03

    trial (N = 33 women) compared Lispro insulin with regular insulin and provided very low-quality evidence for the outcomes. There were seven episodes of pre-eclampsia in the Lispro group and nine in the regular insulin group, with no clear difference between the two groups (risk ratio (RR) 0.68, 95% CI 0.35 to 1.30). There were five caesarean sections in the Lispro group and nine in the regular insulin group, with no clear difference between the two groups (RR 0.59, 95% CI 0.25 to 1.39). There were no cases of fetal anomaly in the Lispro group and one in the regular insulin group, with no clear difference between the groups (RR 0.35, 95% CI 0.02 to 8.08). Macrosomia, perinatal deaths, episodes of birth trauma including shoulder dystocia, nerve palsy, and fracture, and the composite outcome measure of neonatal morbidity were not reported.2. One trial (N = 42 women) compared human insulin to animal insulin, and provided very low-quality evidence for the outcomes. There were no cases of macrosomia in the human insulin group and two in the animal insulin group, with no clear difference between the groups (RR 0.22, 95% CI 0.01 to 4.30). Perinatal death, pre-eclampsia, caesarean section, fetal anomaly, birth trauma including shoulder dystocia, nerve palsy and fracture and the composite outcome measure of neonatal morbidity were not reported.3. One trial (N = 93 women) compared pre-mixed insulin (70 NPH/30 REG) to self-mixed, split-dose insulin and provided very low-quality evidence to support the outcomes. Two cases of macrosomia were reported in the pre-mixed insulin group and four in the self-mixed insulin group, with no clear difference between the two groups (RR 0.49, 95% CI 0.09 to 2.54). There were seven cases of caesarean section (for cephalo-pelvic disproportion) in the pre-mixed insulin group and 12 in the self-mixed insulin group, with no clear difference between groups (RR 0.57, 95% CI 0.25 to 1.32). Perinatal death, pre-eclampsia, fetal anomaly, birth trauma

  14. The effects of building design on hazard of first service in Norwegian dairy cows.

    Science.gov (United States)

    Martin, A D; Kielland, C; Nelson, S T; Østerås, O

    2015-12-01

    Reproductive inefficiency is one of the major production and economic constraints on modern dairy farms. The environment affects onset of ovarian activity in a cow postcalving and influences estrus behavior, which in turn affects a stockperson's ability to inseminate her at the correct time. This study used survival analysis to investigate effects of building design and animal factors on the postpartum hazard of first service (HFS) in freestall-housed Norwegian Red cows. The study was performed on 232 Norwegian dairy farms between 2004 and 2007. Data were obtained through on farm measurements and by accessing the Norwegian Dairy Herd Recording System. The final data set contained data on 38,436 calvings and 27,127 services. Univariate Cox proportional hazard analyses showed that herd size and milk yield were positively associated with HFS. Total free accessible area and free accessible area available per cow year were positively associated with the HFS, as was the number of freestalls available per cow. Cows housed on slatted floors had a lower HFS than those housed on solid floors. Conversely, cows housed on rubber floors had a higher HFS than cows on concrete floors. Dead-ending alleyways reduced the hazard of AI after calving. A multivariable Cox proportional hazards model, accounting for herd management by including a frailty term for herd, showed relationships between hazard of postpartum service and explanatory variables. Animals in herds with more than 50 cows had a higher HFS [hazard ratio (HR)=3.0] compared with those in smaller herds. The HFS was also higher (HR=4.3) if more than 8.8 m(2) of space was available per cow year compared with herds in which animals had less space. The HFS after calving increased with parity (parity 2 HR=0.5, parity ≥3 HR=1.7), and was reduced if a lactation began with dystocia (HR=0.82) or was a breed other than Norwegian Red (HR=0.2). The frailty term, herd, was large and highly significant indicating a significant

  15. Study on Occipitoposterior position corrected at 36 gestational weeks%妊娠36周始纠正枕后位研究

    Institute of Scientific and Technical Information of China (English)

    陈东东; 王丽娟; 卢晓强

    2011-01-01

    目的:预防枕后位,减少头位难产.方法:选择2004年10月~2007年10月在产前检查、妊娠36周始至动产、经彩超及产科检查确诊为枕后位、年龄21-35岁的初产妇200名随机分为两组,观察组采取侧俯卧位与胸膝卧位结合纠正枕后位,对照组采取自由体位.结果:至动产时观察组89例转为枕前位,5例转为枕横位,6例枕后位,枕后位发生率6%;对照组29例转为枕前位,25例枕横位,46例枕后位,枕后位发生率46%,差异有统计学意义(P<0.01).结论:妊娠36周始纠正枕后位,可减少枕后位,预防头位难产.%Objective: To prevent occipitoposterior position and reduce cephalic presentation dystocia. Methods: 200 primiparous women aged 21 ~35 years old at 36 gnstational weeks who received prenatal examination and were diagnosed as occipitoposterior position by color Doppler ultrasound and obstetric check in the hospital from October 2004 to October 2007 were selected and divided into two groups randomly: the primiparous women in observation group were treated with contralateral prone position combined with chest - knee position to correct occipitoposterior position, the primiparous women in control group adopted free postures. Results: In observation group, 89 primiparous women converted into occipitoanterior position, 5 primiparous women converted into occipitotransverse position, 6 primiparous women continued occipitoposterior position, the incidence of occipitoposterior position was 6%; in control group, 29 primiparous women converted into occipitoanterior position, 25 primiparous women converted into occipitotransverse position, 46 primiparous women continued occipitoposterior position, the incidence of occipitoposterior position was 46%, there was significant difference ( P < 0. 01 ) . Conclusion: Correcting occipitoposterior position at 36 gostational weeks can reduce occipitoposterior position and prevent cephalic presentation dystocia.

  16. Effects of folic acid and vitamin B12 supplementation on culling rate, diseases, and reproduction in commercial dairy herds.

    Science.gov (United States)

    Duplessis, M; Girard, C L; Santschi, D E; Laforest, J-P; Durocher, J; Pellerin, D

    2014-01-01

    This study was undertaken to determine the effect of a combined folic acid and vitamin B12 supplement given in early lactation on culling rate, metabolic disorders and other diseases, and reproduction in commercial dairy herds. A total of 805 cows (271 primiparous and 534 multiparous cows) in 15 commercial dairy herds were involved. Every 2mo from February to December 2010 and within each herd, cows were assigned according to parity, previous 305-d milk production, and calving interval to 5mL of either (1) saline 0.9% NaCl (control group) or (2) 320mg of folic acid + 10mg of vitamin B12 (vitamin group). Treatments were administered weekly by intramuscular injections starting 3wk before the expected calving date until 8wk after parturition. A total of 221 cows were culled before the next dry period. Culling rate was not affected by treatment and was 27.5%; culling rate was greater for multiparous (32.2%) than for primiparous cows (18.8%). Within the first 60d in milk (DIM), 47 cows were culled, representing 21.3% of total culling, and no treatment effect was noted. Ketosis incidence based on a threshold ≥100µmol/L of β-hydroxybutyrate in milk was 38.3±2.9% for the vitamin group and 41.8±3.0% for the control group and was not affected by treatment. The combined supplement of folic acid and vitamin B12 did not decrease incidence of retained placenta, displaced abomasum, milk fever, metritis, or mastitis. However, the incidence of dystocia decreased by 50% in multiparous cows receiving the vitamin supplement, although no effect was observed in primiparous cows. The first breeding postpartum for multiparous cows occurred 3.8d earlier with the vitamin supplement compared with controls, whereas no treatment effect was seen for primiparous cows. Days open, first- and second-breeding conception rates, number of breedings per conception, and percentage of cows pregnant at 150 DIM were not affected by treatment. The reduced percentage of dystocia combined with the

  17. 产房风险管理对产妇分娩质量的影响%The Impact of Risk Management of Delivery Room on Delivery Quality

    Institute of Scientific and Technical Information of China (English)

    汪士辉

    2014-01-01

    目的:研究观察产房风险管理对产妇分娩质量的影响。方法选取2012年8-10月与实施产房风险管理后2013年8-10月该院收治的共521例产妇,分别设为对照组261例与观察组260例。比较两组分娩时间、难产率并且调查孕产妇对医疗服务满意度。结果观察组分娩时间和难产率均较对照组低满意率高两组比较均差异有统计学意义(P﹤0.05)。结论产房风险管理有利于提高产妇分娩质量,值得临床推广应用。%Objective To investigate the effect of risk management of delivery room on delivery quality. Methods A total of 521 cases of puerperants including the puerperants admitted in our hospital from August, 2012 to October, 2012 and the puerperants admitted in our hospital from August, 2013 to October, 2013 after the implementation of risk management of delivery room were divided into the control group of 261 cases and observation group of 260 cases. The delivery time, maternal dystocia rate of both groups were compared, and the maternal satisfaction with medical service of the groups was investigated. Results The delivery time and rate of dystocia of the observation group were less than those of the control group, but the maternal satisfaction with medical service was higher than that of the control group with statistically significance (P<0.05). Conclusion Risk management of delivery room helps improve the delivery quality, which is worthy of clinical promotion and application.

  18. Effects of perinatal exposure to nonylphenol on delivery outcomes of pregnant rats and inflammatory hepatic injury in newborn rats

    Directory of Open Access Journals (Sweden)

    J. Yu

    Full Text Available The current study aimed to investigate the effects of perinatal exposure to nonylphenol (NP on delivery outcome of pregnant rats and subsequent inflammatory hepatic injury in newborn rats. The pregnant rats were divided into 2 groups: control group (corn oil and NP exposure group. Thirty-four pregnant rats were administered NP or corn oil by gavage from the sixth day of pregnancy to 21 days postpartum, with blood samples collected at 12 and 21 days of pregnancy and 60 days after delivery. The NP concentration was measured by HPLC, with chemiluminescence used for detection of estrogen and progesterone levels. Maternal delivery parameters were also observed. Liver and blood of the newborn rats were collected and subjected to automatic biochemical detection of liver function and blood lipid analyzer (immunoturbidimetry, and ultrastructural observation of the hepatic microstructure, with the TNF-α and IL-1β hepatic tissue levels evaluated by immunohistochemistry. Compared with the control group, the pregnant and postpartum serum NP and estradiol levels of the mother rats in the NP group were significantly increased, together with lowered progesterone level, increased number of threatened abortion and dystocia, and fewer newborn rats and lower litter weight. Serum and hepatic NP levels of the newborn rats measured 60 days after birth were significantly higher than those of the control group, as well as lower testosterone levels and increased estradiol levels. When observed under electron microscope, the hepatocyte nuclei of the control group were large and round, with evenly distributed chromatin. The chromatin of hepatocytes in the NP group presented deep staining of the nuclei, significant lipid decrease in the cytoplasm, and the majority of cells bonded with lysate. The results of immunohistochemistry showed that there was almost no TNF-α or IL-1β expression in the hepatocytes of the control group, while the number of TNF-α-, PCNA-, and IL-1

  19. Clinical Analysis of Hand-Knee Type Prone Position Childbirth%手-膝式俯卧位分娩在临床上应用的分析

    Institute of Scientific and Technical Information of China (English)

    李洪梅

    2014-01-01

    目的比较手-膝式俯卧位分娩与传统平卧位分娩在改善分娩结局的临床分析。方法将121例分娩孕妇随机分为对照组60例(应用平卧位分娩)、观察组61例(在第二产程应用手-膝俯卧位分娩),观察两组第二产程进展、产后出血量、胎儿窘迫、肩难产发生情况。结果观察组产妇出血量未增加,胎儿宫内窘迫发生率观察组低于对照组,肩难产的发生观察组低于对照组,第二产程时间观察组少于对照组。结论采取手-膝式俯卧位分娩方式对提高顺产分娩质量,促进分娩顺利进行具有积极意义。%Objective Compare hand-knee type prone position with the traditional hypothesis childbirth labor in improving the labor outcomes of clinical analysis.Methods 121 pregnant women were randomly divided into control group of 60 patients (using the hypothesis of delivery), the observation group, 61 cases of prone position (in the second hand labor application -knee childbirth), observe two groups of the second progress in labor, postpartum blood loss, fetal distress, shoulder dystocia is happening.Results Observation group the bleeding is not increased maternal and fetal intrauterine distress group is lower than the control group,the incidence of shoulder dystocia in observation group is lower than the control group,the second labor time observation group is less than the control group.Conclusion Hand-knee type prone position delivery ways to improve the quality of natural childbirth, promote positive significance for the smooth delivery.

  20. Double Muscling in Cattle: Genes, Husbandry, Carcasses and Meat

    Science.gov (United States)

    Fiems, Leo O.

    2012-01-01

    Simple Summary Selection for an increased meatiness in beef cattle has resulted in double-muscled (DM) animals, owing to the inactivation of the myostatin gene. These animals are characterized by an excellent conformation and an extremely high carcass yield, coinciding with a reduced organ mass. As a consequence, voluntary feed intake is reduced, but feed efficiency is considerably improved, although maintenance requirements are not clearly reduced. DM animals are more susceptible to respiratory disease, stress and dystocia, requiring extra attention for accommodation and welfare. Carcasses of DM animals are very lean, and intramuscular fat content is low. The fatty acid profile is different when compared with non-DM animals, containing less saturated fatty acids. Collagen content of the meat is lower, so that meat from double-muscled animals is mostly more tender. However, meat tenderness, color and juiciness are not always improved. A different metabolism as a consequence of faster glycolytic myofibers can be partly responsible for this phenomenon. DM animals are interesting for the producer and butcher, and beneficial for the consumer, if an appropriate nutrition and accommodation, and adequate slaughter conditions are taken into account. Abstract Molecular biology has enabled the identification of the mechanisms whereby inactive myostatin increases skeletal muscle growth in double-muscled (DM) animals. Myostatin is a secreted growth differentiation factor belonging to the transforming growth factor-β superfamily. Mutations make the myostatin gene inactive, resulting in muscle hypertrophy. The relationship between the different characteristics of DM cattle are defined with possible consequences for livestock husbandry. The extremely high carcass yield of DM animals coincides with a reduction in the size of most vital organs. As a consequence, DM animals may be more susceptible to respiratory disease, urolithiasis, lameness, nutritional stress, heat stress and

  1. Association Between Type of Screening for Gestational Diabetes Mellitus and Cesarean Delivery.

    Science.gov (United States)

    Palatnik, Anna; Swanson, Kate; Churchill, Tessa; Bilski, Ania; Grobman, William A; Miller, Emily S

    2017-09-01

    To compare maternal and neonatal outcomes using two different testing strategies for gestational diabetes mellitus (GDM) diagnosis: the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) and Carpenter-Coustan approaches. Specifically, we wanted to compare the rates of cesarean delivery between the two epochs. This was a retrospective cohort study of women with a singleton pregnancy delivering at 37 0/7 weeks of gestation or greater, between 2010 and 2015, in a single tertiary care center. The IADPSG testing was used for GDM diagnosis from December 2010 until July 2013 when institutional guidelines changed to Carpenter-Coustan testing. Maternal and neonatal outcomes were compared between these two different epochs using bivariable and multivariable analyses. The primary outcome was the frequency of cesarean delivery. The analysis included a total of 23,509 women: 14,074 (60%) from the IADPSG epoch and 9,435 (40%) from the Carpenter-Coustan epoch. The incidence of GDM diagnosis was higher using the IADPSG compared with Carpenter-Coustan criteria (8.3% compared with 7.5%, P=.042). The total (27.0% compared with 25.5% P=.022) as well as primary cesarean delivery rates (19.1% compared with 18.0%, P=.041) were higher during the IADPSG epoch. The rates of total (39.1% compared with 37.5%, P=.594) and primary (27.3% compared with 27.0%, P=.903) cesarean delivery among women with GDM did not differ between the two epochs. Secondary outcomes of shoulder dystocia (2.5% compared with 2.1%, P=.043) and neonatal intensive care unit admission (3.2% compared with 2.0%, P<.001) also were significantly higher in women screened during the IADPSG epoch, whereas hypertensive disease of pregnancy (6.9% compared with 7.7%, P=.018) was less frequent during the IADPSG epoch. These findings persisted after adjusting for potential confounding factors. Compared with testing using the Carpenter-Coustan criteria, the IADPSG criteria for diagnosis of GDM were

  2. Factors influencing the chance of cows being pregnant 30 days after the herd voluntary waiting period.

    Science.gov (United States)

    Löf, E; Gustafsson, H; Emanuelson, U

    2014-01-01

    The objective of this study was to study factors affecting a reproductive performance indicator at the cow level adjusted for herd management strategy. Associations between the outcome variable, pregnant or not at the herd voluntary waiting period (VWP) plus 30d (pregnant at VWP+30), and the predictor variables were analyzed using a multivariable, generalized estimation equations model that adjusted for clustering of the data at the herd level. The statistical analysis was stratified on parity. In total, 132,721 cows were retained for analyses, of which 29,113 (22%) were pregnant at VWP+30d. Of the nonpregnant cows, 81,483 cows had records of artificial inseminations (AI) and 22,125 cows had no records of AI. The chance of pregnancy was higher for cows of the Swedish Red and for other/crossbreeds compared with Swedish Holstein, for cows from herds with high heat detection efficiency compared with cows from herds with medium and low heat detection efficiency, for cows from herds with long VWP (i.e., >51d) compared with cows from herds with short VWP (cows in freestalls compared with cows in tiestalls. The chance for pregnancy was lower for cows with severe problems at claw trimming compared with cows with no problems at trimming (only for second- and higher-parity cows), for cows that had a record of reproduction-related disease, for cows that had a record of any other disease compared with cows without record, for second- and higher-parity cows with records of dystocia compared with cows with no record of dystocia, for first-parity cows in the group with the highest milk yield compared with first-parity cows in the group with the lowest milk yield, for cows of third and higher parity in the group with the lowest milk yield compared with cows in higher yielding groups, for cows bred in summer compared with those bred in winter-spring (not significant for first-parity cows), and for cows with a twin birth had compared with cows with a single birth. We observed

  3. Early versus Late Admission to Labor Affects Labor Progression and Risk of Cesarean Section in Nulliparous Women.

    Science.gov (United States)

    Mikolajczyk, Rafael T; Zhang, Jun; Grewal, Jagteshwar; Chan, Linda C; Petersen, Antje; Gross, Mechthild M

    2016-01-01

    Rates of cesarean section increase worldwide, and the components of this increase are partially unknown. A strong role is prescribed to dystocia, and at the same time, the diagnosis of dystocia is highly subjective. Previous studies indicated that risk of cesarean is higher when women are admitted to the hospital early in the labor. We examined data on 1,202 nulliparous women with singleton, vertex pregnancies and spontaneous labor onset. We selected three groups based on cervical dilatation at admission: early (0.5-1.5 cm, N = 178), intermediate (2.5-3.5 cm, N = 320), and late (4.5-5.5 cm, N = 175). The Kaplan-Meier estimator was used to analyze the risk of delivery by cesarean section at a given dilatation, and thin-plate spline regression with a binary outcome (R library gam) to assess the form of the associations between the cesarean section in either the first or second stage versus vaginal delivery and dilatation at admission. Women who were admitted to labor early had a higher risk of delivery by cesarean section (18 versus 4% in the late admission group), while the risk of instrumental delivery did not differ (24 versus 24%). Before 4 cm dilatation, the earlier a woman was admitted to labor, the higher was her risk of delivery by cesarean section. After 4 cm dilatation, however, the relationship disappeared. These patterns were true for both first and second stage cesarean deliveries. Oxytocin use was associated with a higher risk of cesarean section only in the middle group (2.5-3.5 cm dilatation at admission). Early admission to labor was associated with a significantly higher risk of delivery by cesarean section during the first and second stages. Differential effects of oxytocin augmentation depending on dilation at admission may suggest that admission at the early stage of labor is an indicator rather than a risk factor itself, but admission at the intermediate stage (2.5-3.5 cm) becomes a risk factor itself. Further research is

  4. Analysis on the psychological states and nursing efficacy of pregnant women during delivery%分娩期产妇的心理状况及心理护理效果分析

    Institute of Scientific and Technical Information of China (English)

    王丽峰; 张景美

    2013-01-01

    Objective To analyze the psychological state characteristics and applied psychological nursing efficacy of pregnant women during delivery. Methods Sixty pregnant women during delivery in our hospital were selected as the research data, and their psychological state characteristics were analyzed. Aiming at the characteristics, the psychological nursing was performed, and its clinical effects was observed. Results After analysis, it was found that the psychological states of pregnant women during delivery were unsatisfactory, mainly resulting from the bad emotions like afraid of abnormal fetal development, labor pain, bleeding, operative delivery, no-one cares and dystocia. It was indicated that both pain threshold and capability of controlling emotions in pregnant women receiving psychological nursing improved, and the bad emotions such as nervousness, fear and anxiety were effectively removed. Conclusion Analyzing the psychological characteristics of pregnant women during delivery and adopting specific psychological nursing can make the pregnant women keep a good psychological state, which plays very important roles in ensuring maternal -neonatal safety and smooth stages of labor in order to reduce the dystocia caused by psychological factors to the greatest extent.%目的 分析分娩期产妇的心理状况特点及应用心理护理的效果.方法 本研究选择60例分娩期产妇作为研究资料,分析其心理状况特点,并针对其特点进行心理护理,观察心理护理的临床疗效.结果 经过分析发现分娩期产妇心理状况并不理想,不良情绪以怕胎儿发育异常、怕分娩疼痛、怕出血、怕手术分娩、怕无人关心以及怕难产为主.本组产妇经过心理护理发现产妇的疼痛阈值及情绪控制能力均有所提高,有效地消除了紧张、恐惧、焦虑等不良情绪.结论 分析分娩期产妇的心理特点并采取针对性的心理护理,可以使产妇保持良好的心理状态,对于确

  5. Effects of perinatal exposure to nonylphenol on delivery outcomes of pregnant rats and inflammatory hepatic injury in newborn rats

    Science.gov (United States)

    Yu, J.; Luo, Y.; Yang, X.F.; Yang, M.X.; Yang, J.; Yang, X.S.; Zhou, J.; Gao, F.; He, L.T.; Xu, J.

    2016-01-01

    The current study aimed to investigate the effects of perinatal exposure to nonylphenol (NP) on delivery outcome of pregnant rats and subsequent inflammatory hepatic injury in newborn rats. The pregnant rats were divided into 2 groups: control group (corn oil) and NP exposure group. Thirty-four pregnant rats were administered NP or corn oil by gavage from the sixth day of pregnancy to 21 days postpartum, with blood samples collected at 12 and 21 days of pregnancy and 60 days after delivery. The NP concentration was measured by HPLC, with chemiluminescence used for detection of estrogen and progesterone levels. Maternal delivery parameters were also observed. Liver and blood of the newborn rats were collected and subjected to automatic biochemical detection of liver function and blood lipid analyzer (immunoturbidimetry), and ultrastructural observation of the hepatic microstructure, with the TNF-α and IL-1β hepatic tissue levels evaluated by immunohistochemistry. Compared with the control group, the pregnant and postpartum serum NP and estradiol levels of the mother rats in the NP group were significantly increased, together with lowered progesterone level, increased number of threatened abortion and dystocia, and fewer newborn rats and lower litter weight. Serum and hepatic NP levels of the newborn rats measured 60 days after birth were significantly higher than those of the control group, as well as lower testosterone levels and increased estradiol levels. When observed under electron microscope, the hepatocyte nuclei of the control group were large and round, with evenly distributed chromatin. The chromatin of hepatocytes in the NP group presented deep staining of the nuclei, significant lipid decrease in the cytoplasm, and the majority of cells bonded with lysate. The results of immunohistochemistry showed that there was almost no TNF-α or IL-1β expression in the hepatocytes of the control group, while the number of TNF-α-, PCNA-, and IL-1β-positive cells

  6. Gambaran Kejadian Persalinan Disfungsional pada Pasien Anemia dalam Kehamilan di RSUP Dr. M. Djamil Periode 2010–2012

    Directory of Open Access Journals (Sweden)

    Mega Redha Putri

    2015-05-01

    Full Text Available AbstrakPersalinan disfungsional (distosia akibat kelainan tenaga merupakan masalah persalinan dunia dan merupakan salah satu indikasi dilakukannya intervensi selama persalinan dengan tingkat kekerapan kejadian sebesar 4-40%. Persalinan disfungsional dapat disebabkan oleh anemia dalam kehamilan. Kekuatan kontraksi uterus atau his ibu hamil dengan anemia kurang dari normal, lemah dan dalam durasi yang pendek sehingga tidak cukup kuat untuk melahirkan janin dan ibu hamil akan cepat lelah, akibatnya persalinan dapat mengalami perlambatan atau terhenti. Semakin berat anemia, semakin berat manifestasi klinis yang muncul. Tujuan penelitian ini adalah untuk mengetahui gambaran kejadian persalinan disfungsional pada pasien anemia dalam kehamilan berdasarkan derajat anemia di RSUP Dr. M. Djamil Padang. Ini merupakan penelitian deskriptif menggunakan data retrospektif bagian rekam medik RSUP. Dr. M. Djamil Padang periode 2010-2012. Data yang digunakan sebanyak 61 sampel. Hasil penelitian menunjukkan distribusi kejadian persalinan disfungsional paling tinggi pada anemia derajat ringan yaitu sebanyak 4 orang (8,7%, anemia derajat sedang sebanyak 1 orang (8,3% dan anemia derajat berat 0%. Hasil penelitian menunjukkan bahwa derajat anemia dalam kehamilan tidak mempengaruhi angka kejadian persalinan disfungsional.Kata kunci: anemia dalam kehamilan, persalinan disfungsional, distosia, ibu hamil AbstractDysfunctional labor (dystocia due to abnormal labor is a worldwide labor problem and one of the indications for intervention during labor with prevalence rate 4-40%. Dysfunctional labor can be caused by anemia in pregnancy. The strength of uterine contractions or his in pregnant women with anemia is less than normal, weak and short in duration so it is not strong enough to bear the fetus and the pregnant women will get tired, causing a slow or stopped. The more severe anemia, the more severe clinical manifestations appear. The objective of this study was to know

  7. Analysis on Indications and Causes of Cesarean Section on Pemba Island of Zanzibar in Africa

    Institute of Scientific and Technical Information of China (English)

    Zhou Liping; Zubeir TS; Hamida SA

    2013-01-01

    Objective: To explore and analyze the indications and causes of cesarean section on Pemba island of Zanzibar in Africa to improve the quality of obstetrics. Methods: 564 patients performed cesarean section in Abdulla Mzee Hospital of Pemba from January, 2008 to December, 2011 were selected, and statistics was conducted by the method of retrospective analysis. Results: The rate of cesarean section in Abdulla Mzee Hospital of Pemba was 10.01%. The primary causes of cesarean section included cephalopelvic disproportion (27.13%), scar uterus (23.40%), preeclampsia and eclampsia (13.30%), fetal distress in uterus (9.40%), fetal factors (9.75%) and complication of pregnancy (6.91%). Conclusion: Cesarean section plays a great role in the treatment of dystocia, some complications of pregnancy and reducing the mortality of pregnant women and perinatal infants, but in the area with relatively undeveloped medical conditions in Africa, cesarean section still takes great risks. Unnecessary cesarean section cannot reduce the incidence of postpartum hemorrhage and neonatal morbidity. The local medical staff should improve the midwifery technique, establish and perfect the formal antenatal examination system to improve the quality of maternity.

  8. [Active management of labor with cesarean index 6.4% and very good materno-fetal outcome].

    Science.gov (United States)

    Crespo Ruiz, Eliodoro; Rodríguez Fernández, Jesús Javier

    2002-11-01

    The objective of this study is to reduce the incidence of cesarean section and to evaluate the impact on fetal-maternal morbidity and mortality by strictly following the guidelines of the National Health Office (Secretaria de Salud) at the Hospital of Gynecology and Obstetrics of Garza Garcia in Nuevo Leon, Mexico. A prospective and observational study was made. All the patients who culminated their pregnancy on Saturdays and Sundays between 7:00 and 19:00 hrs, in the period June 2000 to June 2001, were included in this study. The incidence of Cesarean sections and its impact on maternal-fetal morbidity and mortality were observed. A total of 798 patients were included in the study. The total number of newborns was 801. The age average was of 23.4 years (14 years-40 years). Of the 798 patients, 280 (35.1%) presented dystocia at vaginal delivery, 467 patients (58.5%) had an eutocic vaginal delivery and 51 patients (6.4%) went through a Caesarean section. The Apgar scores were: 8 at the first minute and 9 at the fifth minute for 681 neonates (85.01%); and 7/9 for 53 (6.6%). According to the results obtained in the present study we can conclude that the incidence of Cesarean section can be reduced by strictly following the guidelines of the National Health Office without affecting the maternal-fetal morbidity and mortality.

  9. Analysis of Caesarean-Section rates according to Robson's ten group classification system and evaluating the indications within the groups

    Directory of Open Access Journals (Sweden)

    Amita Ray

    2017-01-01

    Full Text Available Background: With Caesarean sections on the rise WHO proposes that health care facilities use the Robson's 10 group classification system to audit their C-sections rates. This classification would help understand the internal structure of the CS rates at individual health facilities identify key population groups, indications in each group and formulate strategies to reduce these rates. Methods: This was a cross sectional study for a period of 24 months at a tertiary care hospital in a tribal area of Kerala South India. Women who delivered during this period were included and classified into 10 Robson's classes and percentages were calculated for the overall rate, the representation of groups, contribution of groups and Caesarean percentage in each group. Results: Highest contribution was by Group 5 and Group 2. Together these two groups contributed to 38% of the total Caesareans. Followed by Group 8 and 10. All four added contributed to 63% of the section rate The least contribution was by Group 3. Groups 6, 7 and 9 by themselves did not contribute much but within their groups had a 100% C-Section rate. Conclusions: The contribution of the various Robson's Group to the absolute C-Section rates needs to be looked into. Reducing primary section rates, adequate counselling and encouraging for VBAC, changing the norms for dystocia and non-reassuring fetal status, training and encouraging obstetricians to perform versions when not contraindicated could reduce the contribution of Robson's groups towards the absolute C-Section rates.

  10. Perimortality in a Captive Reared Agouti (Dasyprocta leporina

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    Gary Wayne Garcia

    2015-12-01

    Full Text Available erinatal mortality has been reported in cattle, swine, goats, sheep and rabbits; however, there have been no documented reports on this phenomenon in agouti (Dasyprocta leporina. The agouti is a Neotropical polytocous rodent, hunted for its meat. This study reports on an incident of perinatal mortalities in a captive reared agouti from the wildlife unit of the Faculty of Food and Agriculture. The pluriparous female agouti was reared in captivity from birth and had delivered three (3 previous litters successfully. These ranged from 2-3 young, with a 100% survival rate. This case presented a difficult labor, with delivery of three (3 healthy female precocious offspring (434g, 378g and 402g, and three (3 perinatal mortalities (285g, 368g and 300g. The female agouti died during delivery and postmortem results indicated that Dystocia resulting in Secondary Uterine Inertia as the cause of death. This abnormally large litter may have been as a result of captive conditions, where an abundance of food and a lack of predators may have dulled the animal’s survival instinct. The agouti’s ability and the time taken to deliver all six (6 young may also have contributed to the animals delivery stress.

  11. Septicaemia secondary to infection by Corynebacterium macginleyi in an Indian python (Python molurus).

    Science.gov (United States)

    Martínez, Jorge; Segura, Pablo; García, David; Aduriz, Gorka; Ibabe, José C; Peris, Bernardo; Corpa, Juan M

    2006-09-01

    A seven-year-old female Indian python (Python molurus) weighing about 35kg was euthanased after several clinical episodes of stomatitis, pneumonia, ophthalmitis and dystocia over a period of four years. The animal had been maintained in a terrarium in a circus truck at an adequate temperature. During shows, however, the snake was considered to be exposed to stressful conditions for several hours at a time at low temperatures and with noise and bright lights. A post-mortem examination indicated ulcerative stomatitis, osteomyelitis, severe pneumonia and numerous granulomata and multifocal necrosis in stomach and spleen. Corynebacterium macginleyi was isolated in pure culture from the ulcerative stomatitis, and mixed with Stenotrophomonas maltophilia from the lungs and spleen. The findings indicated that the snake had died from a septicaemic process caused by C. macginleyi, probably originating from the stomatitis. The role of S. maltophilia as a secondary agent is discussed. The stress of the circus show and poor husbandry may have predisposed the animal to infection and septicaemia. This is the first report of C. macginleyi causing disease in a snake.

  12. Sense and sensibility: Swedish midwives' ambiguity to the use of synthetic oxytocin for labour augmentation.

    Science.gov (United States)

    Ekelin, Maria; Svensson, Judith; Evehammar, Susanne; Kvist, Linda J

    2015-03-01

    The use of intravenous artificial oxytocin for augmentation of labour is very common in midwifery care in Sweden. Studies have shown that oxytocin is often administered to women in labour who have no signs of labour dystocia. It was the aim of this study to examine Swedish midwives' views on and experiences of labour augmentation in the context of normal labour. Individual interviews were carried out with 15 midwives from southern Sweden. The material was analysed using qualitative content analysis, which resulted in one theme: sense and sensibility and four main categories: permissible situations, motivating the decision, intervening in the birth process and iatrogenic awareness. The results showed that midwives expressed ambiguity about augmentation of labour. They were of the opinion that oxytocin was used very often and sometimes unnecessarily. There is awareness that interventions to augment labour can result in undesirable effects on the birth process. Despite this, deeper discussion of this problem was avoided in the interviews. Further research should focus on the process involved when midwives weigh pros and cons when deciding to augment labour. More knowledge is also needed about the barriers for optimal care in labour that are inherent in health-care systems.

  13. Bacterial infections in Myd88-deficient mice.

    Science.gov (United States)

    Villano, Jason S; Rong, Fang; Cooper, Timothy K

    2014-04-01

    Three breeding colonies of Myd88(-/-) mice had a history of significant morbidity and mortality. Although strain-specific poor reproductive performance might explain neonatal death and dystocia, mice were found dead or required euthanasia because of moribundity, distended abdomen, head tilt, and seizures. Histopathology results included bacteremia, placentitis, metritis, peritonitis with abscess formation, and suppurative meningoencephalitis. Intralesional gram-negative coccobacilli were present, often in extremely high number. Cultures of samples of the cardiac blood of a mouse and from water-bottle sipper tubes provided to some affected mice grew Pseudomonas aeruginosa. In addition, affected tissues from 2 mice and feces from a third tested PCR-positive for P. aeruginosa. Although the mice had received autoclaved reverse-osmosis-purified drinking water, we suspect that the mice were inoculated with P. aeruginosa through contaminated sipper tubes. Because of the deficiency in most of the Toll-like receptor signaling pathways, these Myd88(-/-) mice were unlikely to have developed competitive innate and adaptive immune responses, resulting in bacterial infections. These clinical cases underscore the importance of understanding how genotype, phenotype and environment affect animal health. Sound husbandry and experimental practices are needed to prevent the exposure of immuno-deficient mice to pathogens.

  14. Decisions to Perform Emergency Caesarean Sections at a University Hospital; Do obstetricians agree?

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    Gowri Vaidyanathan

    2016-02-01

    Full Text Available Objectives: This study was undertaken to assess the degree of agreement amongst obstetricians regarding decisions to perform emergency Caesarean section (CS procedures at a university hospital. Methods: This retrospective clinical audit was carried out on 50 consecutive emergency CS procedures performed between November 2012 and March 2013 on women with singleton pregnancies at the Sultan Qaboos University Hospital in Muscat, Oman. Data on each procedure were collected from electronic patient records and independently reviewed by six senior obstetricians to determine agreement with the decision. Results: Of the 50 women who underwent CS procedures, the mean age was 28.9 ± 5.1 years and 48% were primigravidae. A total of 65% of the CS procedures were category I. The most common indications for a CS was a non-reassuring fetal heart trace (40% and dystocia (32%. There was complete agreement on the decision to perform 62% of the CS procedures. Five and four obstetricians agreed on 80% and 95% of the procedures, respectively. The range of disagreement was 4–20%. Disagreement occurred primarily with category II and III procedures compared to category I. Additionally, disagreement occurred in cases where the fetal heart trace pattern was interpreted as an indication for a category II CS. Conclusion: The majority of obstetricians agreed on the decisions to perform 94% of the emergency CS procedures. Obstetric decision-making could be improved with the implementation of fetal scalp pH testing facilities, fetal heart trace interpretation training and cardiotocography review meetings.

  15. 孕妇体重对分娩方式的影响

    Institute of Scientific and Technical Information of China (English)

    杜鹃; 李洁

    2012-01-01

    孕前体重过重或孕期体重增加过多均会导致剖宫产率增加、产程延长、引产率及器械助产率增加.孕妇体重增加其巨大儿发生率、肩难产发生率、产伤的发生率增高.肥胖导致内分泌异常、引产失败率增高、产程进展异常等均是影响分娩方式重要因素.%Both pre-pregnant overweight women and women with excess weight gain during pregnancy induce increasing of the rate of cesarean delivery, prolonging the length of labor, increasing of the rate of induction of labor and instrumental delivery. Women with the more weight gain during pregnancy, the higher probability of macrosomia, birth injuries and shoulder dystocia. Endocrine disorder of obesity, increasing of the rate of failed of induction of labor and the disorder of the length of labor are the influencing factor of the mode of delivery.

  16. PERICARDITIS CONSTRICTIVA EN UNA MUJER DE 36 AÑOS / Constrictive Pericarditis in a 36 year-old woman

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    Tessa Negrín Valdés

    2012-07-01

    Full Text Available ResumenPaciente femenina, de 36 años de edad, con antecedentes de dos gestaciones, dos partos y ningún aborto, que en el año 2003 tras su segundo parto, distócico por cesárea, desarrolla una pericarditis de causa no precisada que produjo un derrame pericárdico grave con signos de taponamiento cardíaco, y requirió ingreso hospitalario y pericardiocentesis. Siete años después se identifican, en la consulta de Cardiología, síntomas clínicos de una pericarditis constrictiva, corroborada por ecocardiograma y cateterismo derecho; actualmente ingresa para pericardiectomía, evaluada como alto riesgo quirúrgico. / Abstract36 year-old female patient, with a history of two pregnancies, two births and no abortion, who in 2003 after her second delivery (cesarean for dystocia she developed pericarditis of undetermined cause that produced a severe pericardial effusion with signs of cardiac tamponade and required hospital admission and pericardiocentesis. Seven years later, in the Cardiology service, clinical symptoms of constrictive pericarditis are identified and confirmed by echocardiography and right heart catheterization. This patient has been recently admitted for pericardiectomy, and evaluated as high surgical risk.

  17. Effects of replacing grass silage with either maize silage or concentrates during late pregnancy on the performance of breeding ewes fed isonitrogenous diets.

    Science.gov (United States)

    Annett, R W; Carson, A F; Gordon, A W

    2013-06-01

    A study was undertaken to investigate the performance of breeding ewes fed a range of forage and concentrate-based diets in late pregnancy, balanced for supply of metabolizable protein (MP). For the final 6 weeks before lambing, 104 twin-bearing multiparous ewes were offered one of four diets: ad libitum precision-chop grass silage + 0.55 kg/day concentrates (GS); ad libitum maize silage + 0.55 kg/day concentrates (MS); a 1 : 1 mixture (on a dry matter (DM) basis) of grass silage and maize silage fed ad libitum + 0.55 kg/day (GSMS); or 1.55 kg/day concentrates + 50 g/day chopped barley straw (C). The CP content of the concentrates was varied between treatments (157 to 296 g/kg DM) with the aim of achieving a daily intake of 130 g/day MP across all treatments. Compared with ewes fed GS, forage DM intake was higher (P silage-based diets (7.5% v. 37.4% ewes), and was higher (P maize silage and all-concentrate diets can replace grass silage in pregnant ewe rations without impacting on performance, provided the supply of MP is non-limiting. The higher incidence of dystocia in ewes fed maize silage as the sole forage is a concern.

  18. Double Muscling in Cattle: Genes, Husbandry, Carcasses and Meat.

    Science.gov (United States)

    Fiems, Leo O

    2012-09-20

    Molecular biology has enabled the identification of the mechanisms whereby inactive myostatin increases skeletal muscle growth in double-muscled (DM) animals. Myostatin is a secreted growth differentiation factor belonging to the transforming growth factor-β superfamily. Mutations make the myostatin gene inactive, resulting in muscle hypertrophy. The relationship between the different characteristics of DM cattle are defined with possible consequences for livestock husbandry. The extremely high carcass yield of DM animals coincides with a reduction in the size of most vital organs. As a consequence, DM animals may be more susceptible to respiratory disease, urolithiasis, lameness, nutritional stress, heat stress and dystocia, resulting in a lower robustness. Their feed intake capacity is reduced, necessitating a diet with a greater nutrient density. The modified myofiber type is responsible for a lower capillary density, and it induces a more glycolytic metabolism. There are associated changes for the living animal and post-mortem metabolism alterations, requiring appropriate slaughter conditions to maintain a high meat quality. Intramuscular fat content is low, and it is characterized by more unsaturated fatty acids, providing healthier meat for the consumer. It may not always be easy to find a balance between the different disciplines underlying the livestock husbandry of DM animals to realize a good performance and health and meat quality.

  19. Double Muscling in Cattle: Genes, Husbandry, Carcasses and Meat

    Directory of Open Access Journals (Sweden)

    Leo O. Fiems

    2012-09-01

    Full Text Available Molecular biology has enabled the identification of the mechanisms whereby inactive myostatin increases skeletal muscle growth in double-muscled (DM animals. Myostatin is a secreted growth differentiation factor belonging to the transforming growth factor-β superfamily. Mutations make the myostatin gene inactive, resulting in muscle hypertrophy. The relationship between the different characteristics of DM cattle are defined with possible consequences for livestock husbandry. The extremely high carcass yield of DM animals coincides with a reduction in the size of most vital organs. As a consequence, DM animals may be more susceptible to respiratory disease, urolithiasis, lameness, nutritional stress, heat stress and dystocia, resulting in a lower robustness. Their feed intake capacity is reduced, necessitating a diet with a greater nutrient density. The modified myofiber type is responsible for a lower capillary density, and it induces a more glycolytic metabolism. There are associated changes for the living animal and post-mortem metabolism alterations, requiring appropriate slaughter conditions to maintain a high meat quality. Intramuscular fat content is low, and it is characterized by more unsaturated fatty acids, providing healthier meat for the consumer. It may not always be easy to find a balance between the different disciplines underlying the livestock husbandry of DM animals to realize a good performance and health and meat quality.

  20. [Time and obstetric anesthesia: from chaotic cosmology to chronobiology].

    Science.gov (United States)

    Vale, Nilton Bezerra do; Vale, Lúcio Flávio Bezerra do; Cruz, José Rômulo

    2009-01-01

    Temporal cycles (dark/light; birth/death; etc.), along with environmental conditions (synchronizers), influence labor physiology because of the presence of endogenous clocks (oscillators) that interact with social diuturnal clues. In this review, the most important cyclic anesthetic-obstetric parameters in parturient care are listed. Chronobiological analysis of the main events in the obstetric pathophysiology of Mulier sapiens: I) Embryogenesis - risk of teratogenesis; II) From prematurity to post-didacticism: from eutocic labor to cervical cerclage; III) Night and labor: higher incidence of nocturnal labor (physiological facilitation) and daylight cesarean section (choice of the obstetrician); IV) The moon and labor - non-conclusive results; V) The night shift in obstetric anesthesia: riskier professional contingency; VI) Phases of cesarean section: removal of the fetus: UD stage (uterotomy - delivery) as brief as possible; effective correction of hypotension and valorize pre-anesthetic fasting; VII) circadian variation of dystocia: pain; uterine contraction; blood loss; hypertension (HTN); risk of allergy and asthma. In the nocturnal phase, the intensity of contraction and risk of hemorrhage, allergy, and asthma are greater. On the other hand, HTN in eclampsia does not show circadian variation; VIII) Obstetric chronopharmacology: local anesthetics, analgesics, hypnotics, general anesthetics, and neuromuscular blockers. Chronoenergy explains the matinal peak of opioid analgesia, vespertine of local anesthetic, and nocturnal of inhalational anesthetics. The chronobiological approach of labor anesthesia emphasizes the obstetric importance of circadian rhythmicity in labor humanization and safety.

  1. A STUDY ON THE RISK FACTORS FOR OBSTETRICAL BRACHIAL PLEXUS PALSY

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    Farah ASHRAFZADEH

    2011-02-01

    Full Text Available ObjectiveConsiderable medical and legal debates have surrounded the prognosis and outcome of obstetrical brachial plexus injuries and obstetricians are oftenconsidered responsible for the injury. In this study, we assessed the factors related to the outcome of brachial plexus palsy.Material & MethodsDuring 24 months, 21 neonates with obstetrical brachial plexus injuries were enrolled.Electrophysiology studies were done at the age of three weeks. They received physiotherapy and occupational therapy. They were examined every 3 monthsfor one year and limbs function was assessed according to Mallet scores; also, maternal and neonatal factors were collected by a questionnaire.Results There were 10 boys and 11 girls.Of all, 76.2% had Erb's palsy, 19% had total brachial palsy and 4.8% hadklumpke paralysis.Risk factors including primiparity, high birth weight, shoulder dystocia, andprolonged second stage of labor were assessed.Electrophysiology studies showed neuropraxia in 52.4% and axonal injuries in42.9% of the patients.At the end of the first year, 81% of the patients had functioned recovery aroundgrade III or IV of Mallet scores.There were only significant relationships between functional improvement andneurophysiologic findings.ConclusionOutcome of obstetrical brachial injuries has a close relationship toneurophysiologic study results than other risk factors.Keyword: Obstetrical brachial injuries, Neonate, Neurophysiologic study

  2. A STUDY ON THE RISK FACTORS FOR OBSTETRICAL BRACHIAL PLEXUS PALSY

    Directory of Open Access Journals (Sweden)

    Farah Ashrafzadeh MD

    2010-10-01

    Full Text Available ObjectiveConsiderable medical and legal debates have surrounded the prognosis and outcome of obstetrical brachial plexus injuries and obstetricians are oftenconsidered responsible for the injury. In this study, we assessed the factors related to the outcome of brachial plexus palsy.Material & MethodsDuring 24 months, 21 neonates with obstetrical brachial plexus injuries were enrolled.Electrophysiology studies were done at the age of three weeks. They received physiotherapy and occupational therapy. They were examined every 3 monthsfor one year and limbs function was assessed according to Mallet scores; also, maternal and neonatal factors were collected by a questionnaire.Results There were 10 boys and 11 girls.Of all, 76.2% had Erb's palsy, 19% had total brachial palsy and 4.8% hadklumpke paralysis.Risk factors including primiparity, high birth weight, shoulder dystocia, andprolonged second stage of labor were assessed.Electrophysiology studies showed neuropraxia in 52.4% and axonal injuries in42.9% of the patients.At the end of the first year, 81% of the patients had functioned recovery aroundgrade III or IV of Mallet scores.There were only significant relationships between functional improvement andneurophysiologic findings.ConclusionOutcome of obstetrical brachial injuries has a close relationship toneurophysiologic study results than other risk factors.

  3. The prevalence and practice of female genital mutilation in Nnewi, Nigeria: the impact of female education.

    Science.gov (United States)

    Igwegbe, A O; Egbuonu, I

    2000-09-01

    Three hundred and twenty-five consecutive live female deliveries at Nnamdi Azikiwe University Teaching Hospital, Nnewi were followed up for 9 months for evidence of any genital mutilation. Their mothers were examined for genital mutilation and a questionnaire based on face-to-face interview of the mothers was also administered. There was no genital mutilation observed among the 200 female babies whose mothers completed the 9 months follow up, The prevalence of genital mutilation among the mothers was 48%. The prevalence of female genital mutilation among the mothers increased with age. The circumcision index C.I. was zero and 3.0 at 16-20 years and 31-35 years age groups, respectively. Also the prevalence decreased with increasing level of education. The circumcision index was 1.0 for mothers at primary level education and least 0.33 at tertiary level of education. There was no relationship with parity. None of the mothers was willing to allow genital mutilation to be performed on her baby but 36% applied local treatment to the clitoris especially powder (28%). Dystocia was the commonest complication in the mothers and the knowledge about female genital mutilation was acquired informally from fellow women. Female education is paramount in the campaign and advocacy against female genital mutilation.

  4. Relationships of efficiency to reproductive disorders in Danish milk production: a stochastic frontier analysis.

    Science.gov (United States)

    Lawson, L G; Bruun, J; Coelli, T; Agger, J F; Lund, M

    2004-01-01

    Relationships of various reproductive disorders and milk production performance of Danish dairy farms were investigated. A stochastic frontier production function was estimated using data collected in 1998 from 514 Danish dairy farms. Measures of farm-level milk production efficiency relative to this production frontier were obtained, and relationships between milk production efficiency and the incidence risk of reproductive disorders were examined. There were moderate positive relationships between milk production efficiency and retained placenta, induction of estrus, uterine infections, ovarian cysts, and induction of birth. Inclusion of reproductive management variables showed that these moderate relationships disappeared, but directions of coefficients for almost all those variables remained the same. Dystocia showed a weak negative correlation with milk production efficiency. Farms that were mainly managed by young farmers had the highest average efficiency scores. The estimated milk losses due to inefficiency averaged 1142, 488, and 256 kg of energy-corrected milk per cow, respectively, for low-, medium-, and high-efficiency herds. It is concluded that the availability of younger cows, which enabled farmers to replace cows with reproductive disorders, contributed to high cow productivity in efficient farms. Thus, a high replacement rate more than compensates for the possible negative effect of reproductive disorders. The use of frontier production and efficiency/inefficiency functions to analyze herd data may enable dairy advisors to identify inefficient herds and to simulate the effect of alternative management procedures on the individual herd's efficiency.

  5. Diagnosis and Shunt Treatment of Hydrocephalus in Infants%婴儿脑积水的诊断及分流术治疗

    Institute of Scientific and Technical Information of China (English)

    薛崇德

    1986-01-01

    @@ 脑积水并非婴儿期的罕见病,但由于未能及早诊断,给予有效的治疗,长期以来预后欠佳.电子计算机轴层扫描(CT)为早期诊断提供了技术帮助,硅胶管脑积水分流装置为有效治疗创造了条件.现将我院1984年一年内收治的12例脑积水患儿的临床资料作一小结.%Presented in this paper are the data of 12 cases of infantile hydrocephalus treated in 1984.High risk babies are those born with dystocia,asphyxia,infection and intractanial hemorrhage during perinatal period and they should be routinely followed up and examined by ultrasonography and CT,for early diagnosis and timely operations of either ventriculoatrial or ventriculo-peritoneal shunt.Even in severe cases showing psychomotor delay,provided in the abscence of other disorders of nervous system,shunt operation will obviously improve the retarded intelligence.

  6. [Closed claims in obstetrics: A study based on French Sham insurance data].

    Science.gov (United States)

    Theissen, A; Fuz, F; Carbonne, B; Bonnet, L; Rouquette-Vincenti, I; Niccolai, P; Raucoules-Aime, M

    2016-01-01

    The aim of this study was to analyze the medicolegal claims related to obstetrics in French hospitals. We did retrospective study on insurance claims provided by Sham insurances and which has been settled by a court over a 3-year period (2004-2006). We analyzed 66 closed claims that occurred between 1983 and 2005 in French hospitals (54 general hospitals and 12 academic). The average time between the declaration of the claim and the court conviction was 6 years. The average amount of compensation per claim was 500,000 €. The damage occurred during vaginal delivery (n=44), planned (n=5) or unplanned (n=4) cesarean. The more often claims are fetal asphyxia (n=24) or shoulder dystocia (n=8). The consequences are very important: cerebral palsy (16), death of the newborn (12), death of the mother (2) or brachial plexus injuries (6). The causes identified by the expert are always multifactorial with generally a misdiagnosis (n=27), a decision making error (n=36), a care error by the midwife (n=21) and/or a delay in medical care (n=13). These data should help strengthen the quality approach in obstetrics. Copyright © 2015. Published by Elsevier Masson SAS.

  7. The effect of pre-pregnancy body mass and gestational weight gain on pregnancy outcome%孕前体重和孕期增重对妊娠结局的影响观察

    Institute of Scientific and Technical Information of China (English)

    刘三连

    2015-01-01

    gestational diabetes mellitus (GDM),pregnancy induced hypertension (PIH),dystocia,caesarean section in obesity group were 6.47%,7.43%,51.56%,47.48% respectively,the rates of PIH,dystocia,caesarean section in obesity group were significantly higher than those in low body weight group and normal control group (P<0.05),the rate of GDM in obesity group was significantly higher than that in normal control group (P<0.05).The rates of neonatal asphyxia,fetal distress,macrosomia in obesity group were 6.47%,5.52%,11.27% respectively,significantly higher than those in normal control group (P<0.05).(2)The rates of GDM,PIH,dystocia,caesarean section in high weight gain group were 5.57%,9.79%,56.43%,49.32% respectively,the rates of PIH,dystocia,caesarean section in high weight gain group were significantly higher than those in low weight gain group and normal weight gain group (P<0.05),the rate of GDM in high weight gain group was significantly higher than that in normal weight gain group (P<0.05).The rates of neonatal asphyxia,macrosomia in high weight gain group were 6.53%,14.97% respectively,significantly higher than those in low weight gain group and normal weight gain group (P<0.05).Conclusion 18.5-24 kg/m2 pre-pregnancy BMI and 10-15 kg gestational weight gain will lead to satisfactory pregnancy outcome.

  8. Fetal and Maternal Outcomes in Pregnancies Complicated with Fetal Macrosomia

    Science.gov (United States)

    Alsammani, Mohamed Alkahatim; Ahmed, Salah Roshdy

    2012-01-01

    Background: Fetal macrosomia remains a considerable challenge in current obstetrics due to the fetal and maternal complications associated with this condition. Aim: This study was designed to determine the prevalence of fetal macrosomia and associated fetal and maternal morbidity and mortality in the Al Qassim Region of Saudi Arabia. Materials and Methods: This register-based study was conducted from January 1, 2011 through December 30, 2011 at the Maternity and Child Hospital, Qassim, Saudi Arabia. Macrosomia was defined as birth weight of 4 kg or greater. Malformed babies and those born dead were excluded. Results: The total number of babies delivered was 9241; of these, 418 were macrosomic. Thus, the prevalence of fetal macrosomia was 4.5%. The most common maternal complications were postpartum hemorrhage (5 cases, 1.2%), perineal tear (7 cases, 1.7%), cervical lacerations (3 cases, 0.7%), and shoulder dystocia (40 cases, 9.6%) that resulted in 4 cases of Erb's palsy (0.96%), and 6 cases of bone fractures (1.4%). The rate of cesarean section among women delivering macrosomic babies was 47.6% (199), while 52.4% (219) delivered vaginally. Conclusion: Despite extensive efforts to reduce fetal and maternal complications associated with macrosomia, considerable fetal and maternal morbidity remain associated with this condition. PMID:22754881

  9. Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Nalinee Poolsup

    Full Text Available OBJECTIVE: To assess the efficacy and safety of treating pregnant women with gestational diabetes mellitus in comparison to usual antenatal care. METHODS: A systematic review and meta-analysis was conducted by including randomized controlled trials comparing any form of therapeutic intervention in comparison to usual antenatal care. A literature search was conducted using electronic databases together with a hand search of relevant journals and conference proceedings. RESULTS: Ten studies involving 3,881 patients contributed to meta-analysis. Our results indicated that gestational diabetes mellitus treatment significantly reduced the risk for macrosomia (RR, 0.47; 95% CI, 0.38-0.57, large for gestational age births (RR, 0.55; 95% CI, 0.45-0.67, shoulder dystocia (RR, 0.42; 95% CI, 0.23-0.77 and gestational hypertension (RR, 0.68; 95% CI, 0.53-0.87 without causing any significant increase in the risk for small for gestational age babies. However, no significant difference was observed between the two groups regarding perinatal/neonatal mortality, neonatal hypoglycemia, birth trauma, preterm births, pre-eclampsia, caesarean section and labor induction. CONCLUSION: Treating GDM reduces risk for many important adverse pregnancy outcomes and its association with any harm seems unlikely.

  10. Gestational diabetes mellitus and macrosomia: a literature review.

    Science.gov (United States)

    Kc, Kamana; Shakya, Sumisti; Zhang, Hua

    2015-01-01

    Fetal macrosomia, defined as a birth weight ≥ 4,000 g, may affect 12% of newborns of normal women and 15-45% of newborns of women with gestational diabetes mellitus (GDM). The increased risk of macrosomia in GDM is mainly due to the increased insulin resistance of the mother. In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called 'large for gestational age'. This paper reviews studies that explored the impact of GDM and fetal macrosomia as well as macrosomia-related complications on birth outcomes and offers an evaluation of maternal and fetal health. Fetal macrosomia is a common adverse infant outcome of GDM if unrecognized and untreated in time. For the infant, macrosomia increases the risk of shoulder dystocia, clavicle fractures and brachial plexus injury and increases the rate of admissions to the neonatal intensive care unit. For the mother, the risks associated with macrosomia are cesarean delivery, postpartum hemorrhage and vaginal lacerations. Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age (during adolescence) and are more likely to develop type II diabetes later in life. Besides, the findings of several studies that epigenetic alterations of different genes of the fetus of a GDM mother in utero could result in the transgenerational transmission of GDM and type II diabetes are of concern.

  11. Prevention, management, and outcomes of macrosomia: a systematic review of literature and meta-analysis.

    Science.gov (United States)

    Rossi, A Cristina; Mullin, Patrick; Prefumo, Federico

    2013-10-01

    Macrosomia represents an obstetric challenge, and when suspected, there is no general consensus as to whether expectant management, induction of labor, or elective cesarean delivery are the best option. This review article was aimed to discuss literature published in the last decade about the identification, management, and outcomes of macrosomia. The identification of macrosomia remains uncertain, mainly because of the high heterogeneity across studies because of different definitions of macrosomia, gestational age at time of assessment, and fetal weight formulas. With regard to management and outcomes of macrosomia, 12,212 macrosomic neonates can be pooled from 17 articles. Compared with neonates with normal birth weight, the odds ratio of emergency cesarean delivery increases from 1.92 (1.53-2.42) to 2.24 (1.42-3.56) and 5.20 (3.47-7.79) for macrosomia 4000 g or greater, 4500 g or greater, and 5000 g or greater, respectively. The odds ratios of shoulder dystocia are 7.18 (2.06-25.00), 7.33 (5.13-10.48), and 16.16 (7.62-34.26) for macrosomia 4000 g or greater, 4500 g or greater, and 5000 g or greater, respectively. Three birth traumas were reported after cesarean delivery. Perinatal mortality is similar between macrosomic and neonates with normal birth weight at each cutoff of macrosomia. Nonetheless, limitations of current literature, which are also discussed in this review, do not allow to drive definitive conclusion about the management of macrosomia.

  12. Ocean View Nursing Home, Knockglassmore, Camp, Tralee, Kerry.

    LENUS (Irish Health Repository)

    Owens, Lisa A

    2010-03-01

    OBJECTIVE A prospective study of the impact of obesity on pregnancy outcome in glucose-tolerant women. RESEARCH DESIGN AND METHODS The Irish Atlantic Diabetes in Pregnancy network advocates universal screening for gestational diabetes. Women with normoglycemia and a recorded booking BMI were included. Maternal and infant outcomes correlated with booking BMI are reported. RESULTS A total of 2,329 women fulfilled the criteria. Caesarean deliveries increased in overweight (OW) (odds ratio 1.57 [95% CI 1.24-1.98]) and obese (OB) (2.65 [2.03-3.46]) women. Hypertensive disorders increased in OW (2.30 [1.55-3.40]) and OB (3.29 [2.14-5.05]) women. Reported miscarriages increased in OB (1.4 [1.11-1.77]) women. Mean birth weight was 3.46 kg in normal BMI (NBMI), 3.54 kg in OW, and 3.62 kg in OB (P < 0.01) mothers. Macrosomia occurred in 15.5, 21.4, and 27.8% of babies of NBMI, OW, and OB mothers, respectively (P < 0.01). Shoulder dystocia occur in 4% (>4 kg) compared with 0.2% (<4 kg) babies (P < 0.01). Congenital malformation risk increased for OB (2.47 [1.09-5.60]) women. CONCLUSIONS OW and OB glucose-tolerant women have greater adverse pregnancy outcomes.

  13. Mode of Delivery according to Leisure Time Physical Activity before and during Pregnancy: A Multicenter Cohort Study of Low-Risk Women.

    Science.gov (United States)

    Nielsen, Emilie Nor; Andersen, Per Kragh; Hegaard, Hanne Kristine; Juhl, Mette

    2017-01-01

    Objectives. To examine the association between maternal leisure time physical activity and mode of delivery. Study Design. Population-based multicentre cohort. From the Danish Dystocia Study, we included 2,435 nulliparous women, who delivered a singleton infant in cephalic presentation at term after spontaneous onset of labor in 2004-2005. We analysed mode of delivery according to self-reported physical activity at four stages, that is, the year before pregnancy and during first, second, and third trimester, in logistic regression models. Further, we combined physical activity measures at all four stages in one variable for a proportional odds model for cumulative logits. Main Outcome Measures. Mode of delivery (emergency caesarean section; vacuum extractor; spontaneous vaginal delivery). Results. The odds of emergency caesarean section decreased with increasing levels of physical activity with statistically significant trends at all four time stages except the third trimester. This tendency was confirmed in the proportional odds model showing 28% higher odds of a more complicated mode of delivery among women with a low activity level compared to moderately active women. Conclusions. We found increasing leisure time physical activity before and during pregnancy associated with a less complicated delivery among low-risk, nulliparous women.

  14. Predictive risk factors for moderate to severe hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Gláucia Macedo de Lima

    2007-12-01

    Full Text Available Objective: to describe predictive factors for severity of neonataljaundice in newborn infants treated at the University Neonatal Clinic,highlighting maternal, obstetric and neonatal factors. Methods: Acohort retrospective study by means of review of medical charts todefine risk factors associated with moderate and severe jaundice.The cohort consisted of newborns diagnosed with indirect neonatalhyperbilirubinemia and submitted to phototherapy. Risk was classifiedas maternal, prenatal, obstetric and neonatal factors; risk estimationwas based on the odds ratio (95% confidence interval; a bi-variantmultivariate regression logistic analysis was applied to variables forp < 0.1. Results: Of 818 babies born during the studied period, 94(11% had jaundice prior to hospital discharge. Phototherapy was usedon 69 (73% patients. Predictive factors for severity were multiparity;prolonged rupture of membranes, dystocia, cephalohematoma, a lowApgar score, prematurity and small-for-date babies. Following birth,breastfeeding, sepsis, Rh incompatibility, and jaundice presentingbefore the third day of life were associated with an increased risk ofhyperbilirubinemia and the need for therapy. Conclusion: Other thanthose characteristics that are singly associated with phototherapy,we concluded that multiparity, presumed neonatal asphyxia, low birthweight and infection are the main predictive factors leading to moderateand severe jaundice in newborn infants in our neonatal unit.

  15. Antepartum findings and obstetric aspects in pregnancies followed by neonatal persistent hyperinsulinemic hypoglycemia.

    Science.gov (United States)

    Parviainen, Anna-Maria; Puolakka, Jukka; Kirkinen, Pertti

    2002-04-01

    In this study we report antepartum and obstetric findings in cases of persistent hyperinsulinemic hypoglycemia of infancy (PHHI). The study is retrospective and covers the years 1983 to 1994, when there were 9 infants treated for PHHI in the region of the University Hospital of Kuopio. One of the mothers had gestational diabetes mellitus and one had insulin-dependent diabetes mellitus (IDDM). There were signs of fetal distress in cardiotocography (CTG) in 3 of 9 cases prenatally and in 3 of 9 cases intrapartum (33%). There were 5 premature deliveries (56%) and 5 cesarean sections (56%) in this series. Five neonates (56%) were macrosomic and one delivery was complicated by shoulder dystocia. Three neonates (33%) had a 1-minute Apgar score of <6, but there were no cases at 5 minutes. In cases of fetal macrosomia without a maternal diabetic problem amniocentesis may be carried out after 34 weeks of gestation to assay amniotic fluid insulin, C-peptide and erythropoietin to reveal rare cases of PHHI where there may be problems of fetal hypoxemia similar to those in diabetic pregnancies.

  16. Treatment of one case of cerebral palsy combined with posterior visual pathway injury using autologous bone marrow mesenchymal stem cells.

    Science.gov (United States)

    Li, Min; Yu, Aixue; Zhang, Fangfang; Dai, Guanghui; Cheng, Hongbin; Wang, Xiaodong; An, Yihua

    2012-05-18

    Cerebral palsy is currently one of the major diseases that cause severe paralysis of the nervous system in children; approximately 9-30% of cerebral palsy patients are also visually impaired, for which no effective treatment is available. Bone marrow mesenchymal stem cells (BMSCs) have very strong self-renewal, proliferation, and pluripotent differentiation potentials. Therefore, autologous BMSC transplantation has become a novel method for treating cerebral palsy. An 11-year-old boy had a clear history of dystocia and asphyxia after birth; at the age of 6 months, the family members observed that his gaze roamed and noted that he displayed a lack of attention. A brain MRI examination at the age of 7 years showed that the child had cerebral palsy with visual impairment (i.e., posterior visual pathway injury). The patient was hospitalized for 20 days and was given four infusions of intravenous autologous BMSCs. Before transplantation and 1, 6, and 12 months after transplantation, a visual evoked potential test, an electrocardiogram, routine blood tests, and liver and kidney function tests were performed. The patient did not have any adverse reactions during hospitalization or postoperative follow-up. After discharge, the patient could walk more smoothly than he could before transplantation; furthermore, his vision significantly improved 6 months after transplantation, which was also supported by the electrophysiological examinations. The clinical application of BMSCs is effective for improving vision in a patient with cerebral palsy combined with visual impairment.

  17. 晚清《申报》对产妇报道及其影响%Reports on Pregnant Women's Fertility in Shen Paper

    Institute of Scientific and Technical Information of China (English)

    曾繁花; 刘正刚

    2011-01-01

    The Western Medicine resolved the dystocia with its excellent skill which Chinese Medicine were quite unable to do. People payed more attention t0 the birth treatments. Shen Paper's reporting on the diagnosis and treatment of women's reproductive respectively by midwives, Traditional Chinese and Western Medicine in Late Qing Dynasty has called the attention of the society to the fertility. People came to realize that the advantages and disadvantages of the three treatments.At the same time, they accepted the scientific Western delivery method. Traditional Chinese Medicine also adjusted itself timely with the challenge oF Western medicine.%晚清时期,西医用其高超技艺解决了中国传统接生法束手无策的难产问题,引起了社会对接生法的极大关注.晚清对稳婆、中医、西医诊治产妇进行了报道,人们通过报道认识了三者在诊治难产中的医术优劣,对西医科学的接生法产生了认同.中医面对西医的挑战,被迫进行了自我调整.

  18. Neonatal Brachial Plexus Palsy and Causation

    LENUS (Irish Health Repository)

    Turner, M J

    2016-07-01

    A vaginal childbirth is the result of the internal (endogenous) expulsive forces of uterine contractions, usually supplemented by active maternal pushing1. Depending on the clinical circumstances, additional external (exogenous) traction forces may be required from the birth attendant. This blend of internal and external forces varies from birth to birth. Women who have had a previous vaginal delivery, for example, may deliver successfully with uterine contractions alone and the role of the birth attendant may be simply to control and slow the delivery so that trauma to the maternal perineum from stretching by the fetal head is minimised. In contrast, additional traction may be required by an obstetrician at the time of an operative vaginal delivery for fetal distress or dystocia. The strength of the traction required may be increased by clinical factors, for example, fetal macrosomia or malposition. The traction should be axial in the direction of the birth canal, which is a vector combining horizontal and vertical traction at 25-45 degrees below the horizontal when the woman is in the lithotomy position.

  19. Morphological characteristics of pelves of estonian holstein and estonian native breed cows from the perspective of calving.

    Science.gov (United States)

    Nahkur, E; Ernits, E; Jalakas, M; Järv, E

    2011-10-01

    Dystocia is more common in Holstein-Friesian (HF) breed cows than in other dairy breeds. This is often caused by a disproportion between the birth canal of a female animal and the fetus. It is thought that the main determiners of unsuitability are the birth mass of the calf and the shape of the female pelvis. From the perspective of calving the cranial and caudal pelvic apertures are of great significance. This study focuses on pluriparous pelves of the Estonian Native Breed (EN) and the Estonian Holstein Breed (EHF). The longest measurement of the cranial pelvic aperture of an EHF cow is the conjugate diameter. The cranial pelvic aperture narrows slightly ventrally, being shaped like a trapezium with rounded angles. The longest measurement of the caudal aperture is its caudal transverse measurement. The aperture is flattened dorsoventrally. The cranial pelvic aperture of an EN cow is dorsally angular, but more oval ventrally, and is on the whole narrower and higher. By comparison with the EHF cow, the pelvic cavity of the EN cow widens caudally, and the height of the pelvic apertures contributes to ease of calving. It appears that the configuration of the pelvis of an EN cow is similar to the pelvis of the elk (Alces alces). The pelvis of the EHF cow has become unsuitable for easy calving, especially with regard to the caudal aperture.

  20. Pregnancy outcome after induction of labor in women with previous cesarean section.

    Science.gov (United States)

    Ashwal, Eran; Hiersch, Liran; Melamed, Nir; Ben-Zion, Maya; Brezovsky, Alex; Wiznitzer, Arnon; Yogev, Yariv

    2015-03-01

    As conflicting data exist concerning the safety of induction of labor (IoL) in women with previous single lower segment cesarean section (CS), we aimed to assess pregnancy outcome following IoL in such patient population. All singleton pregnancies with previous single CS which underwent IoL during 2008-2012 were included (study group). Their pregnancy outcome was compared to those pregnancies with previous single CS that admitted with spontaneous onset of labor (control group). Overall, 1898 pregnancies were eligible, of them, 259 underwent IoL, and 1639 were admitted with spontaneous onset of labor. Parity, gestational age at delivery and birthweight were similar. Women in the study group were more likely to undergo CS mainly due to labor dystocia (8.1 versus 3.7%, p < 0.01). The rate of CS due to non-reassuring fetal heart rate was similar. No difference was found in the rate of uterine rupture/dehiscence. Short-term neonatal outcome was similar between the groups. On multivariable logistic regression analysis, IoL was not independently associated with uterine rupture (OR 1.33, 95% C.I 0.46-3.84, p = 0.59). Our data suggest that IoL in women with one previous low segment CS neither increases the risk of uterine rupture nor adversely affects immediate neonatal outcome.

  1. IS IT TIME TO RETHINK CORD MANAGEMENT WHEN RESUSCITATION IS NEEDED?

    Science.gov (United States)

    Mercer, Judith S.; Erickson-Owens, Debra A.

    2015-01-01

    An infant who receives a placental transfusion at birth, either from cord milking or delayed cord clamping, obtains about 30% more blood volume than the infant whose cord is cut immediately. Receiving an adequate blood volume from placental transfusion at birth may be protective for the distressed neonate as it prevents hypovolemia and can support optimal perfusion to all organs. New research shows that ventilating before clamping the umbilical cord can reduce large swings in cardiovascular function and help to stabilize the infant. Hypovolemia, often associated with nuchal cord or shoulder dystocia, may lead to an inflammatory cascade and subsequent ischemic injury. A sudden unexpected neonatal asystole at birth may occur from severe hypovolemia. The restoration of blood volume is an important action to protect the hearts and brains of these neonates. Current protocols for resuscitation imply immediate cord clamping and the care of the infant away from the mother's bedside. We suggest that an obstetrical provider can achieve placental transfusion for the distressed neonate by milking the cord several times or resuscitating the infant at the perineum with an intact cord. Milking the cord can be done quickly within the current Neonatal Resuscitation Program guidelines. Cord blood gases can be collected with delayed cord clamping. “Bringing the resuscitation” to the mother's bedside is a novel concept and supports an intact cord. Adopting a policy for resuscitation with an intact cord in a hospital setting will take concentrated effort and team work by obstetrics, pediatrics, midwifery, and nursing. PMID:25297530

  2. Double-balloon catheter for induction of labour in women with a previous cesarean section, could it be the best choice?

    Science.gov (United States)

    De Bonrostro Torralba, Carlos; Tejero Cabrejas, Eva Lucía; Marti Gamboa, Sabina; Lapresta Moros, María; Campillos Maza, Jose Manuel; Castán Mateo, Sergio

    2017-05-01

    We analysed the efficacy and safety of double-balloon catheter for cervical ripening in women with a previous cesarean section and which were the most important variables associated with an increased risk of repeated cesarean delivery. We designed an observational retrospective study of 418 women with unfavourable cervices (Bishop Score cesarean delivery, and induction of labour with a double-balloon catheter. Baseline maternal data and perinatal outcomes were recorded for a descriptive, bivariate, and multivariate analysis. A p value cesarean section were dystocia in the previous pregnancy (OR 1.744; CI 95% 1.066-2.846), the absence of previous vaginal delivery (OR 2.590; CI 95% 1.066-6.290), suspected fetal macrosomia (OR 2.410; CI 95% 0.959-6.054), and duration of oxytocin induction period (OR 1.005; CI 95% 1.004-1.006). The area under the curve was 0.789 (p cesarean delivery and unfavourable cervix. In our study, most women could have a vaginal delivery in spite of their risk factors for cesarean delivery. A multivariate model based on some clinical variables has moderate predictive value for intrapartum cesarean section.

  3. Labor induction and cesarean delivery: A prospective cohort study of first births in Pennsylvania, USA.

    Science.gov (United States)

    Kjerulff, Kristen H; Attanasio, Laura B; Edmonds, Joyce K; Kozhimannil, Katy B; Repke, John T

    2017-09-01

    Mode of delivery at first childbirth largely determines mode of delivery at subsequent births, so it is particularly important to understand risk factors for cesarean delivery at first childbirth. In this study, we investigated risk factors for cesarean delivery among nulliparous women, with focus on the association between labor induction and cesarean delivery. A prospective cohort study of 2851 nulliparous women with singleton pregnancies who attempted vaginal delivery at hospitals in Pennsylvania, 2009-2011, was conducted. We used nested logistic regression models and multiple mediational analyses to investigate the role of three groups of variables in explaining the association between labor induction and unplanned cesarean delivery-the confounders of maternal characteristics and indications for induction, and the mediating (intrapartum) factors-including cervical dilatation, labor augmentation, epidural analgesia, dysfunctional labor, dystocia, fetal intolerance of labor, and maternal request of cesarean during labor. More than a third of the women were induced (34.3%) and 24.8% underwent cesarean delivery. Induced women were more likely to deliver by cesarean (35.9%) than women in spontaneous labor (18.9%), unadjusted OR 2.35 (95% CI 1.97-2.79). The intrapartum factors significantly mediated the association between labor induction and cesarean delivery (explaining 76.7% of this association), particularly cervical dilatation cesarean delivery after labor induction among nulliparous women is attributable mainly to lower cervical dilatation at hospital admission and higher rates of labor complications. © 2017 Wiley Periodicals, Inc.

  4. Impact of clinical audits on cesarean section rate.

    Science.gov (United States)

    Peng, Fu-Shiang; Lin, Hsien-Ming; Lin, Ho-Hsiung; Tu, Fung-Chao; Hsiao, Chin-Fen; Hsiao, Sheng-Mou

    2016-08-01

    Many countries have noted a substantial increase in the cesarean section rate (CSR). Several methods for lowering the CSR have been described. Understanding the impact of clinical audits on the CSR may aid in lowering CSR. Thus, our aim is to elucidate the effect of clinical audits on the CSR. We retrospectively analyzed 3781 pregnant women who gave birth in a medical center between January 2008 and January 2011. Pregnant women who delivered between January 2008 and July 2009 were enrolled as the pre-audit group (n = 1592). After August 2009, all cesarean section cases that were audited were enrolled in the audit group (n = 2189). The CSR was compared between groups. The overall CSR (34.5% vs. 31.1%, adjusted odds ratio [OR] = 0.83, p = 0.008) and the cesarean section rate due to dystocia (9.6% vs. 6.2%, p cesarean section was achieved in 16 (8.2%) of 195 audit cases in the monthly audit conference. In nulliparous pregnant women (n = 2148), multivariate analysis revealed that clinical audit (OR = 0.78), maternal age (OR = 1.10), gestational age at delivery (OR = 0.80), and fetal body weight at birth (OR = 1.0005) were independent predictors of cesarean section (all p cesarean section to reduce the CSR. Copyright © 2016. Published by Elsevier B.V.

  5. The changing indications and rates of cesarean section in one academic center over a 16-year period (1997-2012).

    Science.gov (United States)

    Lurie, Samuel; Shalev, Amir; Sadan, Oscar; Golan, Abraham

    2016-08-01

    To compare trends and rates of cesarean section delivery by indication in one academic center. A retrospective analysis of the indications of all cesarean sections performed in Edith Wolfson Medical Center, Holon, Israel, a tertiary healthcare university facility, during 1997-2012 was done. Each delivery was assigned to the primary indication noted for that pregnancy, regardless of other indications reported. Whenever more than one indication was present, the principle indication chosen by the attending obstetrician was chosen for the analysis. The cesarean section rate gradually rose from 15.29% in 1997 to 21.10% in 2012, with an overall cesarean section rate of 20.66%. The cesarean section rate between 1997 and 2000 was 17.52%, between 2001 and 2004 was 18.5%, between 2005 and 2009 was 22.86%, and between 2009 and 2012 was 22.07% (p cesarean section (26.0%), non-reassuring fetal heart rate pattern (18.1%), malpresentation (16.9%), labor dystocia (8.8%), and suspected macrosomia (7.2%). Previous cesarean section persistently increased and was the leading indication throughout the years. Any attempt to reverse this trend must be based on reduction of the primary cesarean section rate. Copyright © 2016. Published by Elsevier B.V.

  6. Simplified cesarean section: a strategic surgical approach to minimize postoperative infectious morbidity.

    Science.gov (United States)

    Pelosi

    1998-07-01

    Objective: A simplified method of cesarean delivery aimed at minimizing postoperative morbidity is illustrated.Methods: Two hundred consecutive cesarean deliveries were performed by the authors' simplified cesarean technique. Mean patient age was 27 years (range 17-46), and mean weight was 169 pounds (range 112-414). Indications for cesarean delivery included dystocia or failure to progress in labor (38%), repeat cesarean (32%), malpresentation (11.5%), fetal distress (9.5%), and other (9%).Results: Simplified cesarean delivery was successfully completed in all cases. Mean operating time was 16 minutes (range 9-33), mean blood loss was 460 mL (range 100-1150), and mean postsurgical hospitalization time was 72 hours (range 36-120). No bowel, bladder, or vascular injuries occurred. Postoperative febrile morbidity occurred in one patient (0.5%), ileus occurred in one patient (0.5%), and blood transfusion was administered to one patient (0.5%). No cases of wound infection, wound dehiscence, hematoma, or incisional hernia occurred. All patients were ambulatory on the first postoperative day. All but one patient (99.5%) tolerated a regular diet on the first postoperative day.Conclusions: The authors' technique of cesarean section appears to be a safe and efficient method for cesarean delivery associated with minimal postoperative infectious morbidity and rapid resumption of bowel and ambulatory function.

  7. Factors affecting sexual function in menopause: A review article

    Directory of Open Access Journals (Sweden)

    Soheila Nazarpour

    2016-08-01

    Full Text Available This study aimed to systematically review the articles on factors affecting sexual function during menopause. Searching articles indexed in Pubmed, Science Direct, Iranmedex, EMBASE, Scopus, and Scientific Information Database databases, a total number of 42 studies published between 2003 and 2013 were selected. Age, estrogen deficiency, type of menopause, chronic medical problems, partner's sex problems, severity of menopause symptoms, dystocia history, and health status were the physical factors influencing sexual function of menopausal women. There were conflicting results regarding the amount of androgens, hormonal therapy, exercise/physical activity, and obstetric history. In the mental–emotional area, all studies confirmed the impact of depression and anxiety. Social factors, including smoking, alcohol consumption, the quality of relationship with husband, partner's loyalty, sexual knowledge, access to health care, a history of divorce or the death of a husband, living apart from a spouse, and a negative understanding of women's health were found to affect sexual function; however, there were conflicting results regarding the effects of education, occupation, socioeconomic status, marital duration, and frequency of sexual intercourse.

  8. Research on the Effect of Different Operation Type of Pet Canine Caesarean%犬剖腹产不同术式的效果研究

    Institute of Scientific and Technical Information of China (English)

    张苗苗; 黎瑞

    2012-01-01

    为探讨宠物犬剖腹产的最佳术式,提高临床治疗效果,将68例宠物犬难产病例分为3组,第1组27例,用脐后腹正中线切口治疗;第2组29例,用腹侧壁切口治疗;第3组12例,用腹白线旁切口治疗。结果表明:第1组治愈率88.9%;第2组治愈率89.7%;第3组治愈率83.3%。试验结果表明,腹侧壁切口效果最好。%In order to investigate the best caesarean section methods of pet canines and to improve clinical therapeutic efficacy, 86 dystocia cases of pet canines were divided into 3 groups randomly in the experiment. The first group 27 cases were taken caesarean section through the mid-incision afer the navel. The second 29 eases were used caesarean section through the cut of flank. Caesarean section through near-mid-incision cut taken in the third group 12 cases. The cure rate in the three groups were 88.9% ,89.7% ,83.3% respectively. The results showed that the effect of ventral incision treatment was the best.

  9. Assisted reproduction in female rhinoceros and elephants--current status and future perspective.

    Science.gov (United States)

    Hermes, R; Göritz, F; Streich, Wj; Hildebrandt, Tb

    2007-09-01

    Over the last few decades, rhinoceroses and elephants became important icons in the saga of wildlife conservation. Recent surveys estimate the wild Asian (Elephas maximus) and African (Loxodonta africana) elephant populations to be, at most, 50 250 and 637 600 respectively. For the five rhinoceros species, black (Diceros bicornis), white (Ceratotherium simum), Indian (Rhinoceros unicornis), Javan (Rhinoceros sondaicus) and Sumatran rhinoceros (Dicerorhinus Sumatrensis), the population estimates of 3610, 11 330, 2400, 60 and 300, respectively, are of even greater concern. Protected against habitat loss, poaching and left undisturbed, rhinoceros and elephants reproduce well in the wild. But small and decreasing populations make successful captive management of these taxa increasingly important. In captivity, however, most populations face possible 'extinction' because of historically poor reproductive performance. From the first descriptions of the reproductive anatomy and the oestrous cycle (Laws 1969; Kassam and Lasley 1981; Balke et al. 1988a,b; Plotka et al. 1988; Godfrey et al. 1991) to the present use of advanced assisted reproduction technologies, researchers have strive to understand the function and dysfunction of the reproductive biology of these charismatic species. This paper reviewed the current knowledge on rhinoceros and elephant reproduction biology, reproductive cycle, gestation, dystocia, reproductive pathology, oestrous induction and artificial insemination, sperm sexing, IVF and contraception, and how this knowledge is or might be used to aid species conservation for maximal reproductive efficiency and enhancement of genetic management.

  10. Pathologic Findings and Trends in Mortality in the Beluga (Delphinapterus leucas) Population of the St Lawrence Estuary, Quebec, Canada, From 1983 to 2012.

    Science.gov (United States)

    Lair, S; Measures, L N; Martineau, D

    2016-01-01

    An isolated population of beluga (Delphinapterus leucas) inhabits the St Lawrence Estuary, Quebec, Canada. This population has failed to recover despite the prohibition of hunting >30 years ago, suggesting the presence of other limiting factors. The authors summarize the reported causes of death and propose risk factors to explain the lack of recovery of this population. From 1983 to 2012, a total of 472 beluga were found stranded. Complete necropsies were carried out on 222 beluga, including 178 adults, 25 juveniles, and 19 newborn calves. Infectious diseases, the most prevalent cause of mortality in this population, accounted for the death of one-third of all beluga (32%). Verminous pneumonia was the cause of mortality of 13 juvenile beluga (52% of juvenile beluga). A total of 39 malignant neoplasms, diagnosed in 35 beluga, caused the death of 31 beluga (20% of beluga >19 years old). Median age at diagnosis of cancer was 48 years (range, 30-61 years). Dystocia and postpartum complications were the cause of death in 18 beluga, accounting for 19% of the females >19 years old examined. The occurrence of parturition-associated complications, as well as mortality of calves <1 year old, have increased recently in this population and may be the probable cause of the recent decrease in the size of this population. One of the hypotheses proposed to explain the unusually high occurrence of some of the pathologic conditions observed in this population is chronic exposure to environmental contaminants.

  11. Use and abuse of oxytocin for augmentation of labor.

    Science.gov (United States)

    Selin, Lotta; Almström, Elisabeth; Wallin, Gunnar; Berg, Marie

    2009-01-01

    To investigate the use of oxytocin for augmentation of labor and its relation to labor progress and delivery outcome. A retrospective observational study undertaken in a Swedish hospital during 2000-2001. Singleton pregnancies at > or = 37 weeks of gestation with cephalic presentation and spontaneous onset of labor. Data were collected from 1,263 clinical records. The partogram was used to diagnose labor dystocia (LD). Prevalence of oxytocin administration, LD and operative delivery. Oxytocin was administered to 55% of the women (75% of primiparas and 38.1% of multiparas); a majority did not meet LD criteria. LD frequency was 19.8% (32.7% in primiparas and 7.4% in multiparas). Oxytocin was started both 'too early' and 'too late' in relation to the diagnosis of LD. Cesarean section (CS) was performed on 17.1% of primiparous and 2.4% of multiparous oxytocin recipients with LD, compared to 2.3 and 1.5%, respectively, of oxytocin recipients without diagnosed LD. Oxytocin augmentation was undertaken in an unstructured manner; some women were inadequately treated and others were treated unnecessarily. Oxytocin recipients with LD underwent operative delivery to a higher extent than oxytocin recipients without LD, suggesting that the main reason for CS was the underlying problem of LD rather than the oxytocin augmentation itself.

  12. [Use of oxytocin augmentation after spontaneous onset of labor].

    Science.gov (United States)

    Blix, Ellen; Pettersen, Siv-Heidi; Eriksen, Hilde; Røyset, Bodil; Pedersen, Eva Håheim; Øian, Pål

    2002-05-30

    Use of oxytocin augmentation during labour is not systematically registered in Norway. We wanted to describe the use of oxytocin augmentation in Hammerfest Hospital from 1996 to 2000. The patient files of all women who delivered in the study period (n = 2,725) were examined retrospectively. After exclusion because of induction of labour, planned Caesarean section, breech delivery, twin delivery and intrauterine fetal death, 2,122 women were included in the study. 490 of 969 nulliparas (51%) and 233 of 1,153 multiparas (20%) were augmented with oxytocin. 203 of the 239 nulliparas (85%) who had epidural anaesthesia and 287 of the 730 nulliparas (39%) without epidural anaesthesia were augmented, compared to 64 of the 96 multiparas (67%) and 169 of the 1,057 multiparas (16%). In the present study, half of the primiparas and one fifth of the multiparas had their labour augmented with oxytocin. It is not known whether this is representative nationwide. There is a need for more research about dystocia, when intervention is appropriate and which women will benefit from oxytocin augmentation.

  13. Clinical pathology of milking calves digestion disorder

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    Fatur Bogo

    2003-01-01

    Full Text Available The period from calving until normal dry food feeding is very sensitive for preruminat animals. Normal weaning can be successful at 6 to 8 weeks post partum. Young milking calves are very susceptible to bacterial or viral infection if immunity is not reached through colostrum on time. On the other hand indigestions are very frequent and account for one-third of the most frequent disorders in young calves. Parturition losses (dystocia and respiratory diseases are more frequent. The final result of negative environmental and management influences can be the onset of acute or chronic diarrhea associated with long, expensive and often unsuccessful treatment. Acute dehydration and death are not so rare. Etiological reasons are known, it is possible define them: inadequate feeding of pregnant cows and heifers in late stages of pregnancy; hygiene problems and bad management of neonate calves. Contaminated milk, starters and milk substitutes are the main source of scours. These problems are evident on farms where owners or workers do not have the elementary knowledge about physiology, anatomic differences and management principles for preruminant animals. At weaning time calves can develop serious problems when dry feeding does not begin on time. For does that reason normal micro flora and fauna are not able to accept normal function for ruminal digestion.

  14. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

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    Rijn, Rick R. van [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam Zuid-Oost (Netherlands); Bilo, Rob A.C. [Netherlands Forensic Institute, Department of Forensic Pathology, Amsterdam (Netherlands); Robben, Simon G.F. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands)

    2009-01-15

    Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature. We present three neonates with both posterior rib fractures and ipsilateral clavicular fractures resulting from birth trauma. A review of the literature is also presented. The common denominator and a possible mechanical aetiology are discussed. In total, 13 cases of definitive birth-related posterior rib fractures were identified. Nearly all (9/10) posterior rib fractures were (as far as reported in the original publications) in the midline. In 12 of the 13 children, birth weight was high and in 7 children birth was complicated by shoulder dystocia. An interesting finding was that in cases where a clavicular fracture was present, this was on the ipsilateral side. Radiologists, when presented with a neonate with posterior rib fractures, should be aware of this rare differential diagnosis. (orig.)

  15. Systematic review: nutritional therapy in gestational diabetes mellitus

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    Helaine Thomaz de Lima

    2013-12-01

    Full Text Available Introduction: Several methods of dietetic counseling can be used in the nutritional therapy in gestational diabetes mellitus (GDM. The main methods are the traditional method (TM and the carbohydrate counting (CCM. Objective: Presenting a systematic review of the literature on the impact of nutritional therapy in GDM, through TM and CCM, evaluating the results for maternal and child health. Methods: We searched databases PubMed, Scopus, Web of Science, Lilacs and CAPES Digital Bank of Thesis. The methodological quality of all the studies included was made using the Jadad score. Results and conclusion: We have found five studies that evaluated the effects of nutritional therapy, through the TM, on the maternal and child health. None study evaluating the CCM was detected in pregnant women with GDM Nutritional therapy given during antenatal care was effective in reducing pregnancy complications (preeclampsia, excessive gestational weight gain, necessity for cesarean delivery, for insulin therapy and for shoulder dystocia, perinatal complications (macrosomia, neonatal hypoglycemia, and birth weight and also in better glycemic control. The use of nutritional therapy should be highlighted within the antenatal care for pregnant women with GDM, giving the satisfactory results on metabolic control and on pregnancy outcomes. Studies examining the CCM to GDM patients should be conducted to show its effects on maternal and child health.

  16. Congenital Malformations in River Buffalo (Bubalus bubalis

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    Sara Albarella

    2017-02-01

    Full Text Available The world buffalo population is about 168 million, and it is still growing, in India, China, Brazil, and Italy. In these countries, buffalo genetic breeding programs have been performed for many decades. The occurrence of congenital malformations has caused a slowing of the genetic progress and economic loss for the breeders, due to the death of animals, or damage to their reproductive ability or failing of milk production. Moreover, they cause animal welfare reduction because they can imply foetal dystocia and because the affected animals have a reduced fitness with little chances of survival. This review depicts, in the river buffalo (Bubalus bubalis world population, the present status of the congenital malformations, due to genetic causes, to identify their frequency and distribution in order to develop genetic breeding plans able to improve the productive and reproductive performance, and avoid the spreading of detrimental gene variants. Congenital malformations most frequently reported in literature or signaled by breeders to the Department of Veterinary Medicine and Animal Production of the University Federico II (Naples, Italy in river buffalo are: musculoskeletal defects (transverse hemimelia, arthrogryposis, umbilical hernia and disorders of sexual development. In conclusion this review put in evidence that river buffalo have a great variety of malformations due to genetic causes, and TH and omphalocele are the most frequent and that several cases are still not reported, leading to an underestimation of the real weight of genetic diseases in this species.

  17. Midwife-led Care Model for Reducing Caesarean Rate: A Novel Concept for Worldwide Birth units where Standard Obstetric Care Still Dominates

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    Hong Zhou

    2012-01-01

    Full Text Available Caesarean rate has been increasing year by year in China and other countries in the world. In fact, caesarean section is associated with increased risk of maternal mortality and serious foetal pulmonary morbidity. To reduce caesarean rate, obstetricians in physician-based birth units get used to take early intervention for any delay in labour progress that could cause dystocia. However, standard obstetric care enhanced by obstetric power has not consistently been shown to reduce rate of caesarean delivery. Other than physician-based model, midwife-led model of care is aiming to promote normal birth by use of midwives’ skills as well as continuous support rather than augmentation of labour through excessive medical treatment. Midwife-led care model is novel to worldwide birth units where standard obstetric care still dominates. It has made some headway in efforts to reduce caesarean rate. The fact that standard obstetric care of childbirth have not consistently reduced rate of caesarean delivery encourages us for creating the hypotheses that midwife-led care model satisfying puerpera with care and support could minimise unnecessary obstetric intervention and facilitate vaginal birth, and finally reduces caesarean rate. This hypothesis, if confirmed, might have the potential to be disseminated elsewhere in the world, where most women still take standard obstetric care. Moreover, it has political implications for the national health-care policymaking.

  18. Use of oxytocin during Caesarean section at Princess Marina Hospital, Botswana: An audit of clinical practice

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    Billy M. Tsima

    2013-01-01

    Full Text Available Background: Oxytocin is widely used for the prevention of postpartum haemorrhage. In the setting of Caesarean section (CS, the dosage and mode of administrating oxytocin differs according to different guidelines. Inappropriate oxytocin doses have been identified as contributory to some cases of maternal deaths. The main aim of this study was to audit the current standard of clinical practice with regard to the use of oxytocin during CS at a referral hospital in Botswana.Methods: A clinical audit of pregnant women having CS and given oxytocin at the time of the operation was conducted over a period of three months. Data included indications for CS, oxytocin dose regimen, prescribing clinician’s designation, type of anaesthesia for the CS and estimated blood loss.Results: A total of 139 case records were included. The commonest dose was 20 IU infusion (31.7%. The potentially dangerous regimen of 10 IU intravenous bolus of oxytocin was used in 12.9% of CS. Further doses were utilized in 57 patients (41%. The top three indications for CS were fetal distress (36 patients, 24.5%, dystocia (32 patients, 21.8% and a previous CS (25 patients, 17.0%. Estimated blood loss ranged from 50 mL – 2000 mL.Conclusion: The use of oxytocin during CS in the local setting does not follow recommended practice. This has potentially harmful consequences. Education and guidance through evidence based national guidelines could help alleviate the problem.

  19. Availability and quality of emergency obstetric care in Gambia's main referral hospital: women-users' testimonies

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    Sundby Johanne

    2009-04-01

    Full Text Available Abstract Background Reduction of maternal mortality ratio by two-thirds by 2015 is an international development goal with unrestricted access to high quality emergency obstetric care services promoted towards the attainment of that goal. The objective of this qualitative study was to assess the availability and quality of emergency obstetric care services in Gambia's main referral hospital. Methods From weekend admissions a group of 30 women treated for different acute obstetric conditions including five main diagnostic groups: hemorrhage, hypertensive disorders, dystocia, sepsis and anemia were purposively selected. In-depth interviews with the women were carried out at their homes within two weeks of discharge. Results Substantial difficulties in obtaining emergency obstetric care were uncovered. Health system inadequacies including lack of blood for transfusion, shortage of essential medicines especially antihypertensive drugs considerably hindered timely and adequate treatment for obstetric emergencies. Such inadequacies also inflated the treatment costs to between 5 and 18 times more than standard fees. Blood transfusion and hypertensive treatment were associated with the largest costs. Conclusion The deficiencies in the availability of life-saving interventions identified are manifestations of inadequate funding for maternal health services. Substantial increase in funding for maternal health services is therefore warranted towards effective implementation of emergency obstetric care package in The Gambia.

  20. Uterine Artery Pseudoaneurysm in the Setting of Delayed Postpartum Hemorrhage: Successful Treatment with Emergency Arterial Embolization

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    Ankur M. Sharma

    2011-01-01

    Full Text Available Postpartum hemorrhage is a major cause of maternal mortality. Though uncommon, uterine artery pseudoaneurysm can follow uterine dilatation and curettage (D + C and needs to be considered in the differential diagnosis. This 30-year-old G1P1 woman presented with right upper quadrant pain and vaginal bleeding. She was afebrile but her white blood count was significantly increased (22.2×109 /L. One week prior, she had undergone a Cesarean delivery which was complicated by hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP, fetal dystocia, and chorioamnionitis. Uterine dilatation and curettage (D & C and placement of a Bakri intrauterine balloon, performed for suspected retained products of conception, failed to control her postpartum bleeding. The patient wished to have a hysterectomy only as a last resort in order to preserve fertility. Emergency uterine artery angiography revealed a left uterine artery pseudoaneurysm and contrast extravasation. The patient was successfully treated with selective embolization. Computed tomography (CT later revealed dehiscence of her uterine Cesarean section incision with an intra-abdominal fluid collection. This collection was drained. She also developed disseminated intravascular coagulopathy (DIC syndrome as well as multiple pulmonary emboli which were both successfully treated. We discuss this unique case of uterine artery pseudoaneurysm with associated uterine dehiscence.

  1. Analysis of Pregnancy Outcomes Using the New IADPSG Recommendation Compared with the Carpenter and Coustan Criteria in an Area with a Low Prevalence of Gestational Diabetes

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    Katrien Benhalima

    2013-01-01

    Full Text Available Aims. This paper aims to evaluate characteristics and pregnancy outcomes in women prior classified normal by Carpenter and Coustan criteria (old criteria and now gestational diabetes (GDM by the IADPSG criteria. Methods. Retrospective analysis of 6727 pregnancies is used. Using the old criteria, 222 had GDM (old GDM. Using the IADPSG criteria, 382 had GDM of which 160 had a normal glucose tolerance with the old criteria (new GDM. We compared the new GDM group with the old GDM group and women with normal glucose tolerance with both criteria (NGT group, 6345. Results. New GDM women were younger (31.6 ± 4.7 versus 33.3 ± 7.2 years, than old GDM women. Caesarean section was performed in 30.5% of new GDM, in 32.4% of old GDM (, and in 23.3% of NGT women (. Large for gestational age occurred in 10.8% of new GDM, in 13.8% of old GDM (, and in 9.0% of NGT women (. Shoulder dystocia occurred in 3.9% of new GDM, in 3.2% of old GDM (, and in 1.4% of NGT women (. Conclusion. Using the IADPSG criteria, more women are identified as having GDM, and these women carry an increased risk for adverse gestational outcome compared to women without GDM.

  2. Why Do So Many Calves Die on Modern Dairy Farms and What Can We Do about Calf Welfare in the Future?

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    John F. Mee

    2013-11-01

    Full Text Available Poor bovine neonatal survival rates are an international animal welfare issue. The key modifiable risk factors associated with such loss are age at first calving in primiparae, calf breed, gender and gestation length and calving management. The primary causes of mortality in the perinatal period are calving problems, in particular dystocia, defined as both difficult and abnormal calvings. Calf loss rates are rising on modern dairy farms in many countries internationally. High calf loss rates are often not recognised at national or at farm-level; recording needs to be improved. Improving bovine neonatal survival requires re-prioritization of this issue. Stakeholders need to be made cognisant of this prioritization. Actions to effect change need to occur at both national and farm-levels. National-level actions need firstly to address raising awareness of the issue. Farm-level actions need to focus on identifiable problem farms through targeted surveillance. Application of existing knowledge to alter modifiable risk factors is the key to improving calf welfare in the future. Research also has a role to play in filling knowledge gaps in particular about the ‘unexplained stillbirth’.

  3. Fetal and maternal outcomes in pregnancies complicated with fetal macrosomia

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    Mohamed Alkhatim Alsammani

    2012-01-01

    Full Text Available Background: Fetal macrosomia remains a considerable challenge in current obstetrics due to the fetal and maternal complications associated with this condition. Aim: This study was designed to determine the prevalence of fetal macrosomia and associated fetal and maternal morbidity and mortality in the Al Qassim Region of Saudi Arabia. Materials and Methods: This register-based study was conducted from January 1, 2011 through December 30, 2011 at the Maternity and Child Hospital, Qassim, Saudi Arabia. Macrosomia was defined as birth weight of 4 kg or greater. Malformed babies and those born dead were excluded. Results: The total number of babies delivered was 9241; of these, 418 were macrosomic. Thus, the prevalence of fetal macrosomia was 4.5%. The most common maternal complications were postpartum hemorrhage (5 cases, 1.2%, perineal tear (7 cases, 1.7%, cervical lacerations (3 cases, 0.7%, and shoulder dystocia (40 cases, 9.6% that resulted in 4 cases of Erb′s palsy (0.96%, and 6 cases of bone fractures (1.4%. The rate of cesarean section among women delivering macrosomic babies was 47.6% (199, while 52.4% (219 delivered vaginally. Conclusion: Despite extensive efforts to reduce fetal and maternal complications associated with macrosomia, considerable fetal and maternal morbidity remain associated with this condition.

  4. Admission clinicopathological data, length of stay, cost and mortality in an equine neonatal intensive care unit

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    M.N. Saulez

    2007-06-01

    Full Text Available Veterinary internists need to prognosticate patients quickly and accurately in a neonatal intensive care unit (NICU. This may depend on laboratory data collected on admission, the cost of hospitalisation, length of stay (LOS and mortality rate experienced in the NICU. Therefore, we conducted a retrospective study of 62 equine neonates admitted to a NICU of a private equine referral hospital to determine the prognostic value of venous clinicopathological data collected on admission before therapy, the cost of hospitalisation, LOS and mortality rate. The WBC count, total CO2 (TCO2 and alkaline phosphatase (ALP were significantly higher (P < 0.05 and anion gap lower in survivors compared with nonsurvivors. A logistic regression model that included WBC count, hematocrit, albumin / globulin ratio, ALP, TCO2, potassium, sodium and lactate, was able to correctly predict mortality in 84 % of cases. Only anion gap proved to be an independent predictor of neonatal mortality in this study. In the study population, the overall mortality rate was 34 % with greatest mortality rates reported in the first 48 hours and again on day 6 of hospitalisation. Amongst the various clinical diagnoses, mortality was highest in foals after forced extraction during correction of dystocia. Median cost per day was higher for nonsurvivors while total cost was higher in survivors.

  5. Analysis on Indications and Causes of Cesarean Section on Pemba Island of Zanzibar in Africa

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    Liping Zhou

    2013-03-01

    Full Text Available Objective: To explore and analyze the indications and causes of cesarean section on Pemba island of Zanzibar in Africa to improve the quality of obstetrics. Methods: 564 patients performed cesarean section in Abdulla Mzee Hospital of Pemba from January, 2008 to December, 2011 were selected, and statistics was conducted by the method of retrospective analysis. Results: The rate of cesarean section in Abdulla Mzee Hospital of Pemba was 10.01%. The primary causes of cesarean section included cephalopelvic disproportion (27.13%, scar uterus (23.40%, preeclampsia and eclampsia (13.30%, fetal distress in uterus (9.40%, fetal factors (9.75% and complication of pregnancy (6.91%. Conclusion: Cesarean section plays a great role in the treatment of dystocia, some complications of pregnancy and reducing the mortality of pregnant women and perinatal infants, but in the area with relatively undeveloped medical conditions in Africa, cesarean section still takes great risks. Unnecessary cesarean section cannot reduce the incidence of postpartum hemorrhage and neonatal morbidity. The local medical staff should improve the midwifery technique, establish and perfect the formal antenatal examination system to improve the quality of maternity.

  6. Participatory surveillance of livestock and poultry diseases in Agidi development area of Nasarawa state Nigeria

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    Victor Haruna

    2012-08-01

    Full Text Available A participatory surveillance of livestock and poultry diseases was carried out in Agidi Development Area of Nasarawa State among 123 farmers, 29 of the respondent were female, while 94 were male. Open-ended interviews were utilized where necessary to clarify information that needed clarifications by the respondents; physical examination of the some affected animals and it surroundings were carried out during the surveillance. The following diseases were established in the study area: Peste des peptits ruminants, Foot rot, helminthosis, mite/lice/flea infestation, tick infestation, bloat, Orf (Contagious ecthyma, poison, mange, Newcastle disease, fowl pox, coccidiosis, infectious bursal disease (Gumboro, chronic respiratory disease, African Swine Fever (ASF, abortion, Dystocia, sudden death, foot and mouth disease, Fascioliasis, trypanosomosis, black quarter disease, babesiosis, and wounds. Some of these diseases have specific period (season of outbreak, while some occurs at all season. Analysis of data indicated that Newcastle disease was the most important disease of poultry, Peste des peptits ruminants was the disease that lead to high mortality in small ruminants, while African Swine Fever (ASF is the most devastating disease of pigs, and Lice/flea infestation is the most common disease to poultry, small ruminants and pigs, in the study area.

  7. Prevalence of Various Reproductive Disorders and Economic Losses Caused by Genital Prolapse in Buffaloes

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    Rasheed A. Rabbani, I. Ahmad*, L. A. Lodhi, N. Ahmad and G. Muhammad1

    2010-01-01

    Full Text Available The present study was conducted to investigate the prevalence of various reproductive disorders and to estimate the economic losses due to genital prolapse in buffaloes in Sir Shamir area of District Faisalabad, Pakistan. The survey was conducted in 8 villages during the 12 months period from June 2005 to May 2006 and the data from 400 farmers (50 farmers from each village were collected. The total buffalo population of this area was 7,785, out of which 2,135 (27.42% animals were included in the study. The overall prevalence of reproductive disorders in buffaloes was recorded as 46.18%. Among all the reproductive disorders, repeat breeding showed the highest prevalence (15.69%, followed by anestrous (9.74%, genital prolapse (7.73%, abortion (5.99%, retained placenta (2.58%, uterine torsion (2.39% and dystocia (2.06%. The total economic losses due to genital prolapse in buffaloes in eight villages during the period of study were estimated to be Rs. 4,59,500/- Among these, the highest losses were due to mortality of dam (39.17%, followed by milk losses (25.14%, service charges (21.33% and medicine cost (14.36%. Thus, repeat breeding, anoestrus and genital prolapse seem to be the major reproductive problems in buffaloes in the study area.

  8. Real-time PCR genotyping and frequency of the myostatin F94L mutation in beef cattle breeds.

    Science.gov (United States)

    Vankan, D M; Waine, D R; Fortes, M R S

    2010-04-01

    This research developed two real-time PCR assays, employing high-resolution melt and allele-specific analysis to accurately genotype the F94L mutation in cattle. This mutation (g.433C > A) in the growth differentiation factor 8 or myostatin gene has recently been shown to be functionally associated with increased muscle mass and carcass yield in cattle. The F94L mutation is not, like other myostatin mutations, associated with reduced fertility and dystocia. It is therefore a candidate for introgression into other breeds to improve retail beef yield and the development of a simple and accurate test to genotype this specific mutation is warranted. Variations in the efficiency of enzyme cleavage compromised the accuracy of genotyping by published methods, potentially resulting in an overestimation of the frequency of the mutant allele. The frequency of the F94L mutation was determined by real-time PCR in 1140 animals from 15 breeds of cattle in Australia. The mutation was present in Simmental (0.8%), Piedmontese (2%), Droughtmaster (4%) and Limousin (94.2%) but not found in Salers, Angus, Poll Hereford, Hereford, Gelbvieh, Charolais, Jersey, Brahman, Holstein, Shorthorn or Maine Anjou. The low prevalence of F94L in all beef breeds except Limousin indicates the significant potential for this mutation to improve retail yield in Australian beef cattle.

  9. Species differences in developmental toxicity of epoxiconazole and its relevance to humans.

    Science.gov (United States)

    Schneider, Steffen; Hofmann, Thomas; Stinchcombe, Stefan; Moreno, Maria Cecilia Rey; Fegert, Ivana; Strauss, Volker; Gröters, Sibylle; Fabian, Eric; Thiaener, Jutta; Fussell, Karma C; van Ravenzwaay, Bennard

    2013-06-01

    Epoxiconazole, a triazole-based fungicide, was tested in toxicokinetic, prenatal and pre-postnatal toxicity studies in guinea pigs, following oral (gavage) administration at several dose levels (high dose: 90 mg/kg body weight per day). Maternal toxicity was evidenced by slightly increased abortion rates and by histopathological changes in adrenal glands, suggesting maternal stress. No compound-related increase in the incidence of malformations or variations was observed in the prenatal study. In the pre-postnatal study, epoxiconazole did not adversely affect gestation length, parturition, or postnatal growth and development. Administration of epoxiconazole did not alter circulating estradiol levels. Histopathological examination of the placentas did not reveal compound-related effects. The results in guinea pigs are strikingly different to those observed in pregnant rats, in which maternal estrogen depletion, pathological alteration of placentas, increased gestation length, late fetal death, and dystocia were observed after administration of epoxiconazole. In the studies reported here, analysis of maternal plasma concentrations and metabolism after administration of radiolabeled epoxiconazole demonstrated that the different results in rats and guinea pigs were not due to different exposures of the animals. A comprehensive comparison of hormonal regulation of pregnancy and birth in murid rodents and primates indicates that the effects on pregnancy and parturition observed in rats are not applicable to humans. In contrast, the pregnant guinea pig shares many similarities to pregnant humans regarding hormonal regulation and is therefore considered to be a suitable species for extrapolation of related effects to humans.

  10. Oxytocin augmentation during labor: how to implement medical guidelines into clinical practice.

    Science.gov (United States)

    Holmgren, Stina; Silfver, Kristina Gren; Lind, Cecilia; Nordström, Lennart

    2011-11-01

    To describe an extensive process to implement guidelines for oxytocin use during labor and to report its effects on compliance to clinical practice guidelines after 1 year. A multifaceted strategy was developed to involve all obstetric staff and identify possible local barriers to change in advance. The process lasted for more than 1 year. To describe the implementation of oxytocin use according to the new guidelines, and to compare management in clinical practice with guideline recommendations from audits performed before and after the project. Identification of possible barriers to change, academic detailing, audits with feedback, and local opinion leaders were important factors for a successful process. Documentation of the indication for oxytocin use increased from 54% before, to 86% after the completion of the project (Poxytocin augmentation was started before the diagnosis of labor dystocia was reduced from 40% to 11% (Poxytocin use according to clinical guidelines. Established rules for documentation were used as a check list to monitor oxytocin use. However, audits with feedback need to continue for medical safety, and have been planned to take place every 6 months. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Uterine prolapse in pregnancy: risk factors, complications and management.

    Science.gov (United States)

    Tsikouras, Panagiotis; Dafopoulos, Alexandros; Vrachnis, Nikolaos; Iliodromiti, Zoe; Bouchlariotou, Sofia; Pinidis, Petros; Tsagias, Nikolaos; Liberis, Vasileios; Galazios, Georgios; Von Tempelhoff, Georg Friedrich

    2014-02-01

    Presentation of uterine prolapse is a rare event in a pregnant woman, which can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of the uterus in pregnancy vary from minor cervical infection to spontaneous abortion, and include preterm labor and maternal and fetal mortality as well as acute urinary retention and urinary tract infection. Moreover, affected women may be at particular risk of dystocia during labor that could necessitate emergency intervention for delivery. Recommendations regarding the management of this infrequent but potentially harmful condition are scarce and outdated. This review will examine the causative factors of uterine prolapse and the antepartum, intrapartum and puerperal complications that may arise from this condition as well as therapeutic options available to the obstetrician. While early recognition and appropriate prenatal management of uterine prolapse during pregnancy is imperative, implementation of conservative treatment modalities throughout pregnancy, these applied in accordance with the severity of the uterus prolapse and the patient's preference, may be sufficient to achieve uneventful pregnancy and normal, spontaneous delivery.

  12. Titrated oral misoprostol for augmenting labour to improve maternal and neonatal outcomes.

    Science.gov (United States)

    Vogel, Joshua P; West, Helen M; Dowswell, Therese

    2013-09-23

    Labour dystocia is associated with a number of adverse maternal and neonatal outcomes. Augmentation of labour is a commonly used intervention in cases of labour dystocia. Misoprostol is an inexpensive and stable prostaglandin E1 analogue that can be administered orally, vaginally, sublingually or rectally. Misoprostol has proven to be effective at stimulating uterine contractions although it can have serious, and even life-threatening side-effects. Titration refers to the process of adjusting the dose, frequency, or both, of a medication on the basis of frequent review to achieve optimal outcomes. Studies have reported on a range of misoprostol titration regimens used for labour induction and titrated misoprostol may potentially be effective and safe for augmentation of labour. To examine the effects and safety of titrated oral misoprostol compared with placebo, oxytocin, other interventions, or no active treatment, in women with labour dystocia. The Trials Search Co-ordinator of the Cochrane Pregnancy and Childbirth Group searched the Cochrane Pregnancy and Childbirth Group's Trials Register; date of search: 29 May 2013. We also searched the reference lists of retrieved studies Randomised trials (including quasi-randomised and cluster-randomised trials) comparing titrated oral misoprostol with placebo, other interventions (e.g. oxytocin, other prostaglandins), or no treatment in women requiring augmentation of labour were eligible for inclusion. Two review authors independently assessed eligibility for inclusion, carried out data extraction and assessed risk of bias in included studies. Data were entered by one author and checked for accuracy. We included two randomised trials with a total of 581 women each comparing different regimens of titrated oral misoprostol with intravenous oxytocin. One study compared 20 mcg doses of misoprostol dissolved in water (repeated every hour up to four hours, after which the dose was increased to 40 mcg per hour up to a maximum

  13. Preliminary survey on the impact of Schmallenberg virus on sheep flocks in South of Belgium.

    Science.gov (United States)

    Saegerman, C; Martinelle, L; Dal Pozzo, F; Kirschvink, N

    2014-10-01

    Between late February and May 2012, a preliminary anonym survey was conducted among sheep farmers in south of Belgium in order to contribute to future estimations of the economic losses caused by Schmallenberg virus (SBV). Based on clinical signs consistent with SBV infection, this survey involved 13 meat sheep flocks considered as positive flocks with subsequent SBV detection by RT-qPCR [SBV-positive flocks (PF); total of 961 animals], and 13 meat sheep flocks considered as negative flocks (NF; total of 331 animals). These preliminary results indicated several significant characteristics that were more present in PF than in NF. These include an increased rate of abortions (6.7% in PF versus 3.2% in NF), of lambs born at term but presenting malformations (10.1% in PF versus 2.0% in NF) and of dystocia (10.1% in PF versus 3.4% in NF). Lamb mortality during the first week of life was reported more frequently in PF (8 of 13 PF, 61.5%) than in NF (1 of 13 NF, 7.7%). In PF, the observed prolificacy rate was 2-fold lower (93%) than expected (186%). The implementation of a survey at larger scale, including a high number of breeders, is necessary to allow a more detailed analysis of the SBV impact in the sheep sector.

  14. Effects of main reproductive and health problems on the performance of dairy cows: a review

    Directory of Open Access Journals (Sweden)

    N. Ghavi Hossein-Zadeh

    2013-01-01

    Full Text Available This review focuses on the potential effects of twinning, dystocia, stillbirth, abortion, retained placenta and metritis on the productive and reproductive performances in dairy cattle. These are diverse disorders that are similar in that they all can result in impaired performance of dairy cows. Reproductive problems occur frequently in lactating dairy cows and can dramatically affect reproductive efficiency in a dairy herd. Poor reproductive performance is a major cause of involuntary culling and therefore reduces the opportunity for voluntary culling and has a negative influence on the subsequent productivity of a dairy herd. Reproductive performance is influenced by the interactive effect of environment, management, health, and genetic factors. In addition, diseases mainly affect dairy cow productivity by decreasing reproductive efficiency, shortening the expected length of productive life and by lowering milk production. Deciding whether to breed, treat, or cull dairy cows showing one or more of these problems is a challenge for both veterinarians and dairy producers. In addition, there is considerable debate among dairy scientists and bovine practitioners regarding the economic impact of these problems in a dairy operation and the most effective management or therapeutic intervention for treating them. Because of this controversy, dairy managers should focus on prevention and control of risk factors associated with each problem rather than on prescriptive therapeutic interventions.

  15. Cow attributes, herd management, and reproductive history events associated with abortion in cow-calf herds from Western Canada.

    Science.gov (United States)

    Waldner, C L

    2014-04-01

    The primary objective of this study was to identify herd management and cow characteristics that are associated with abortion in cow-calf herds in Western Canada. Reproductive events were closely monitored in 29,713 cows in 203 herds from the beginning of the breeding season in 2001 through the calving season in 2002. Herd management and cow-level risk factors such as age, body condition score, and previous reproductive history were measured through a series of herd visits by project personnel and detailed individual animal records maintained by the herd owner. Pregnancy status was assessed in fall of 2001 by the herd veterinarian. Cows most likely to abort were replacement heifers, cows that were more than 10 years of age, cows with a body condition score of less than or equal to or 5 of 9 at pregnancy testing, or with twin pregnancies. Cows vaccinated for bovine viral diarrhea virus and infectious bovine rhinotracheitis and bred on community pastures were less likely to abort than cows from community pastures that were not vaccinated. Cows bred on community pastures that were not vaccinated were also more likely to abort than cows that were not on community pastures regardless of vaccination status. Adverse calving-associated events such as severe dystocia, problems such as uterine prolapse or retained placentas, abortion or calf death within 1 hour of birth were also associated with an increased risk of abortion the subsequent calving season after accounting for all other factors.

  16. A multistate population-based analysis of linked maternal and neonatal discharge records to identify risk factors for neonatal brachial plexus injury.

    Science.gov (United States)

    Freeman, Michael D; Goodyear, Shaun M; Leith, Wendy M

    2017-03-01

    To evaluate the interaction and contribution of maternal and fetal risk factors associated with neonatal brachial plexus injury (BPI). In a case-control study, matched maternal and neonatal discharge records were accessed from US State Inpatient Databases for New Jersey (2010-2012), Michigan (2010-2011), and Hawaii (2010-2011). Univariate and multivariate logistic regressions were used to evaluate associations between risk factors and BPI. Area under the receiver operating characteristic curve was used to build predictive models, including two stratified models evaluating deliveries among obese and diabetic cohorts. Among 376 325 deliveries, BPI was diagnosed in 274 (0.1%). Significant BPI risk factors included maternal obesity (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.7-4.4), maternal diabetes (OR 4.6, 95% CI 3.0-7.0), use of forceps (OR 4.6, 95% CI 2.3-9.0), and vacuum assistance (OR 2.3, 95% CI 1.7-3.3). After adjusting for shoulder dystocia and other predictive factors, cesarean reduced the risk of BPI by 88% (OR 0.1, 95% CI 0.07-0.2). When stratified by obesity and diabetes, the ORs for BPI increased significantly for macrosomia, forceps, and vacuum assistance. The analysis confirms and quantifies more precisely the impact of risk factors for neonatal BPI, and provides a reliable basis for evidence-based clinical decision-making models. © 2016 International Federation of Gynecology and Obstetrics.

  17. Teratology Public Affairs Committee position paper: maternal obesity and pregnancy.

    Science.gov (United States)

    Scialli, Anthony R

    2006-02-01

    Compared to normal-weight women, obese women have an increased risk of infertility and pregnancy complications. The most consistently described pregnancy complications are hypertensive disorders, gestational diabetes mellitus, thromboembolic events, and cesarean section. Fetal and neonatal complications may include congenital malformations, macrosomia, and shoulder dystocia. The literature suggests that women with a body mass index (BMI) >or=30 have approximately double the risk of having a child with a neural tube defect (NTD) compared to normal-weight women, and the increased risk associated with higher maternal body weight does not appear to be modified by folic acid supplementation. The Public Affairs Committee of the Teratology Society supports the public health initiatives identified by the U.S. Food and Drug Administration in 2004 and the research initiatives identified by the National Institutes of Health in 2004. The Public Affairs Committee recommends that clinicians counsel women about appropriate caloric intake and exercise and that health-care providers educate parents about appropriate childhood nutrition. Breast-feeding should be encouraged based on evidence of a protective effect against childhood obesity, as well as other health advantages.

  18. ATLANTIC DIP: the impact of obesity on pregnancy outcome in glucose-tolerant women.

    LENUS (Irish Health Repository)

    Owens, Lisa A

    2010-03-01

    OBJECTIVE A prospective study of the impact of obesity on pregnancy outcome in glucose-tolerant women. RESEARCH DESIGN AND METHODS The Irish Atlantic Diabetes in Pregnancy network advocates universal screening for gestational diabetes. Women with normoglycemia and a recorded booking BMI were included. Maternal and infant outcomes correlated with booking BMI are reported. RESULTS A total of 2,329 women fulfilled the criteria. Caesarean deliveries increased in overweight (OW) (odds ratio 1.57 [95% CI 1.24-1.98]) and obese (OB) (2.65 [2.03-3.46]) women. Hypertensive disorders increased in OW (2.30 [1.55-3.40]) and OB (3.29 [2.14-5.05]) women. Reported miscarriages increased in OB (1.4 [1.11-1.77]) women. Mean birth weight was 3.46 kg in normal BMI (NBMI), 3.54 kg in OW, and 3.62 kg in OB (P < 0.01) mothers. Macrosomia occurred in 15.5, 21.4, and 27.8% of babies of NBMI, OW, and OB mothers, respectively (P < 0.01). Shoulder dystocia occur in 4% (>4 kg) compared with 0.2% (<4 kg) babies (P < 0.01). Congenital malformation risk increased for OB (2.47 [1.09-5.60]) women. CONCLUSIONS OW and OB glucose-tolerant women have greater adverse pregnancy outcomes.

  19. [Kaiseijutsu and obstetrics in Osaka during the Yedo era: focusing mainly on the development of surgical operations in obstetrics].

    Science.gov (United States)

    Uchino, Hanna

    2009-03-01

    In the Yedo era, the Kamigata area was the place of dispatch of new cultures and was the seat of the economy. However, because natural disasters happened frequently, the economic differential between the central area and the provinces grew wider. The families who suffered poverty sold their daughters to the licensed quarters. Moreover, among the general public, there were a lot of foundlings and women who had abortions. Indeed, we can find these phenomena throughout the Yedo era. Early in the era, such cases were regarded as very common; for example, in IHARA Saikaku works, which describes scenes in Osaka early in the Yedo era, there are a lot of descriptions of foundlings and women who had abortions as common social phenomena. However, in the middle of the era, these phenomena came to be considered sins, as they were in Saikaku's works. This transition period of conceptions about foundlings or abortions coincided with changes in technology in obstetrics. Early in the era when dystocia occurred, both mothers and babies could only be expected to die, and in the middle, after the invention of Kaiseijutsu, which was designed by KAGAWA Gen'etsu, obstetricians could help a lot of women in childbirth. However, when abortions came to be regarded as a sin, people accepted Kaiseijutsu because of the concept of life and because it could help women in childbed and babies as medicine, before everything else.

  20. Perinatal characterization of multiple pregnancy in Cienfuegos city from 2001 to 2002

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    Mariam Zam

    2004-08-01

    Full Text Available Background: Multiple pregnancy is the gestation of more than one fetus in the uterine cavity, in this case two of them. This kind of pregnancy is considered a high obstetric risk due to its high rate in perinatal morbimortality. Objectives: to assess the morbimortality rate behavior in multiple pregnancy of two fetuses in Cienfuegos city. Methods: A descriptive retrospective study about multiple pregnancy of two fetuses was carried out in the University Hospital ¨Dr: Gustavo Aldereguía Lima¨; in Cienfuegos city from 2001 to 2002. This kind of pregnancy with more than 28 weeks of gestation as well as the deliveries taken place in the above mentioned hospital constituted the sample of this investigation. The influence of this kind of pregnancy in the main perinatal morbimortality indicators was analyzed. Results: out of the total of 9 556 birth, 95 of them were of twins for a 0, 9 per cent of incidence. The increment of the maternal weight was over 12 kg. and was associated with the higher weight of the newborn baby. 61 % of the mothers presented obstetric diseases. The most frequent were preterm labor, hypertension, and premature rupture of the membrane. Cesarean delivery had the 51 % for both deliveries and its main causes were; malposition of one or both fetuses, soft parts dystocia and hypertension in the pregnancy process. The most frequent illnesses in the perinatal morbimortality were low weight at birth, fetal late antepartal death and the umbilical cord procidentia.

  1. The natural history of anencephaly.

    LENUS (Irish Health Repository)

    Obeidi, Nidaa

    2012-01-31

    OBJECTIVE: Early elective termination of pregnancy is the most common outcome of a diagnosis of anencephaly in developed countries. Experience and expertise with management of ongoing pregnancies is limited. We aimed to investigate the natural history of these pregnancies from diagnosis to delivery and to determine timing of death. METHOD: A retrospective review of cases of anencephaly diagnosed between 2003 and 2009 in tertiary-referral university teaching hospitals in Cork. RESULTS: The majority of cases (25\\/26; 96%) were diagnosed prenatally at a median gestation of 21(+2) weeks (range 13(+4)-32(+4)). The median maternal age was 30 years (range 17-41) and 50% were primigravidae. Seven pregnancies were complicated by polyhydramnios and four deliveries were complicated by shoulder dystocia. The median gestation at delivery was 35 weeks (range 22(+5)-42(+6)); 69% of labours were induced at a median gestation of 34 weeks. Six women (6\\/26; 23%) had a pre-labour intrauterine fetal death and nine women (9\\/26; 35%) had an intrapartum fetal death. Median neonatal survival time was 55 min (range 10 min to 8 days). Six parents donated neonatal organs for transplantation. CONCLUSION: This study provides useful information for health professionals caring for patients with a diagnosis of anencephaly. The majority of these infants die prior to delivery but short-term survival is possible.

  2. Analysis on the related factors of female orgasmic dysfunction%女性性高潮障碍相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张鹤鹏; 潘连军; 张爱霞; 雷雨; 阚延静

    2012-01-01

    目的:探讨女性性高潮障碍的相关危险因素,为女性性高潮障碍的防治提供依据.方法:采用回顾性调查方法,对2009年3月~12月在南京医科大学附属南京市妇幼保健院进行健康体检的20岁以上女性及其女性陪护人进行问卷调查,应用女性性功能指数(FSFI)问卷评估性功能,性高潮评分<4.0分为性高潮障碍的诊断标准,采用多因素Logistic回归进行多因素分析.结果:共发放问卷2 658份,有1 856例女性完成问卷,问卷回收率69.8%.剔除性唤起障碍者602例,其余性唤起正常的855例中性高潮障碍者298例,占34.9% (298/855).Logistic多因素分析表明,年龄(≥40岁)、难产、对居所不满意、绝经、性交疼痛、配偶性功能障碍等是女性性高潮障碍的独立危险因素(P<0.05).结论:女性性高潮障碍的发生与年龄(≥40岁)、难产、对居所满意度、绝经、性交疼痛、配偶性功能障碍多种因素相关.%Objective: To explore the related risk factors of female orgasmic dysfunction, provide a basis for prevention and treatment of female orgasmic dysfunction. Methods: A retrospective investigation method was used to survey the women more than 20 years who received physical examination in the hospital from March to December in 2009 and the women who accompanied them by a questionnaire, female sexual function index (FSFI) questionnaire was applied to assess their sexual function, orgasm score 40 years) , dystocia, being unsatisfied with residence, menopause, dyspareunia, and sexual dysfunction of partners were the independent risk factors of female orgasmic dysfunction (P <0. 05) . Conclusion: The occurrence of female orgasmic dysfunction is related to age ( ^40 years) , dystocia, being unsatisfied with residence, menopause, dyspareunia, and sexual dysfunction of partners.

  3. 初产妇足月胎膜早破406例分娩方式及新生儿结局的分析%Analysis of delivery way and neonatal outcome of 406 cases of primipara term premature rupture of membranes

    Institute of Scientific and Technical Information of China (English)

    费翠芹; 范桂金

    2014-01-01

    目的:探讨初产妇足月胎膜早破的分娩时机、方式对母婴结局的影响及其合理的处理措施。方法:2012年1月-2013年12月收治足月胎膜早破初产妇406例,分为12 h内临产、24 h内临产和24 h后引产组,进行初产妇分娩方式、产妇及新生儿并发症统计学比较。结果:与12 h内临产组相比,24 h内临产组自然分娩率下降,难产及剖宫产率升高但无统计学意义,其胎儿宫内窘迫、新生儿窒息及产后出血亦无统计学意义(P>0.05);而引产组自然分娩率明显下降,难产及剖宫产率明显升高,差异有统计学意义,其胎儿宫内窘迫、新生儿窒息与临产组比较有统计学意义(P<0.05),但产后出血无统计学意义(P>0.05)。结论:24 h后行引产的足月胎膜早破初产妇剖宫产率明显增加,且可增加围生儿并发症。%Objective:To explore the influence of delivery time and way of primipara term premature rupture of membranes on maternal and child outcome and reasonable treatment measures.Methods:406 primiparas with term premature rupture of membranes were selected from January 2012 to December 2013.They were divided into labor within 12 hours group,labor within 24 hours group and labor induction after 24 hours group.The primipara delivery way,the complications of maternal and neonatal were statistical compared.Results:Compared with labor within 12 hours group,the natural delivery rate of labor induction after 24 hours group was reduced;the dystocia and cesarean section rate were increased,but there were no statistical significance;the fetal distress,neonatal asphyxia and postpartum hemorrhage had no statistical significance(P>0.05).The natural delivery rate of induced labor group was reduced;the dystocia and cesarean section rate were increased;there were statistical significance;the fetal distress and neonatal asphyxia had statistical significance compared with labor group(P0.05).Conclusion

  4. Aspectos fisiopatológicos da retenção de ovos em Jabutipiranga (Geochelone carbonaria Spix, 1824 Fisiopathological aspects of egg retention in South American Red-footed Tortoise (Geochelone carbonaria Spix, 1824

    Directory of Open Access Journals (Sweden)

    Carlos Alexandre Rey Matias

    2006-10-01

    Full Text Available Das enfermidades que acometem o sistema genital de répteis, a retenção de ovos tem grande prevalência em quelônios. Neste trabalho, são analisados quatorze casos de retenção de ovos na espécie jabutipiranga (Geochelone carbonaria Spix, 1824, mantidos como animais de companhia, os quais foram atendidos na Policlínica Veterinária da Universidade Federal Fluminense (UFF entre os anos de 1999 e 2003. Dos fatores que provocam ou favorecem a ocorrência dessa distocia, foram avaliados: em relação aos ovos retidos, a presença de ovos com alterações de formato e de tamanho aumentado e hipercalcificação das cascas; em relação aos fatores predisponentes, foram analisados fatores ambientais, sinais nos pacientes relacionados à ocorrência de doença osteometabólica, presença de corpo estranho ou fezes ressecadas no trato gastrintestinal, bem como a associação da retenção de ovos com prolapso de oviduto. A utilização de técnicas radiográficas no diagnóstico definitivo da retenção de ovos e no direcionamento da sua resolução mostrou-se indispensável nos casos estudados. Quanto ao tratamento, duas condutas foram consideradas: a utilização de ocitócinos e a intervenção cirúrgica. Da análise dos fatores que favorecem a ocorrência da distocia, conclui-se que a manutenção dos animais em ambientes com substrato rígido foi decisiva.Egg retention is a disorder that affects the genital system of reptiles, with a great prevalence in chelonians. These work analyses fourteen cases of egg retention in South American Red-footed Tortoise (Geochelone carbonaria Spix, 1824 maintained as pets that had been attended in the Veterinary Clinic of Universidade Federal Fluminense (UFF between 1999 and 2003. Among the factors that contribute to the occurrence of this dystocia are aspects of the retained eggs such as shape abnormalities, size enlargement and thickened shells were analyzed, as well as poor environmental condition

  5. Clinical experience in midwifery manual rotation fetal head cases%徒手旋转在头位难产产妇助产护理中的应用

    Institute of Scientific and Technical Information of China (English)

    周广菊

    2014-01-01

    目的:探讨徒手旋转在头位难产产妇助产护理中的临床应用效果。方法:选取2013年6月~2014年5月头位难产产妇108例为研究对象,随机等分为观察组和对照组,对照组产妇按照常规产程行自然分娩及助产护理,观察组给予徒手旋转胎头助产护理。结果:两组产妇自然分娩、阴道助产、剖宫产例数比较差异有统计学意义,观察组产妇第二产程平均时间显著短于对照组,两组比较差异有统计学意义,两组宫内窘迫和新生儿窒息发生率比较差异具有统计学意义(均P<0.05)。结论:徒手旋转异常胎头位置助产护理有利于改变胎头俯屈下降困难,促进第二产程进程加快,提高母婴安全,降低剖宫产率。%Objective:To report the effect of implementation experience and manual rotation of head dystocia abnormal position of fetal head delivery meth-od. Methods:From June 2013 to May 2014 108 cases of dystocia were studied, which were randomly divided into study group 54 cases and control group with 54 cases. Control group mothers according to the conventional process for natural childbirth,midwifery,the research group were treated by manual rotation fe-tal head,the first rotating failed on the same method for second times,if not yet successful, to delivery or according to the indications for cesarean section. Results:The natural childbirth,vaginal delivery,cesarean section rates were with statistical significance between the two groups. The average time of women during the second stage of labor in study group was shorter than the control group. Study group of fetal distress and neonatal asphyxia were lower than that of the control group,with statistical significance between the two groups (P<0. 05). Conclusion:Manual rotation fetal head to help change the fetal head low-ering down the difficult problem,to promote the second birth process to speed up the process,improve maternal and child safety

  6. 难产性产后出血的高危因素分析及紧急子宫切除术的临床观察

    Institute of Scientific and Technical Information of China (English)

    董明珍

    2014-01-01

    目的:研究难产性产后出血高危因素及紧急子宫切除术的疗效。方法:48例难产性产后出血产妇为实验组,同期48例非产后出血产妇为对照组,对其相关因素进行单因素及多因素分析。实验组分别采取宫腔纱布填塞或子宫切除疗法,对比疗效。结果:实验组产妇的年龄、宫缩乏力、软产道损伤、胎盘因素、产程、凝血功能障碍、新生儿畸形及妊娠合并症与对照组差异明显,具有统计学意义(P<0.05)。多因素分析显示难产性产后出血的危险因素与宫缩乏力、胎盘因素、凝血功能障碍、新生儿畸形及妊娠合并症密切相关。子宫切除疗法效率显著高于宫腔纱布填塞疗法(P<0.05)。结论:难产性产后出血的高危因素为宫缩乏力、胎盘因素、凝血功能障碍、新生儿畸形及妊娠合并症。紧急子宫切除疗法可提高抢救成功率,减少输血量,对预后有积极意义。%Objective:to study the risk factors for postpartum hemorrhage in childbirth and emergency hysterectomy effect. Methods:48 cases of postpartum hemorrhage in childbirth as women in the experimental group, compared with 48 cases of non-maternal postpartum hemorrhage control group, univariate and multivariate analysis of its related factors. Experimental group were taken uterine gauze packing or hysterectomy therapy, contrast effect. Results:The maternal age, uterine inertia, soft birth canal injury, placental factors, labor, coagulation disorders, birth defects and pregnancy complications and significant differences between the control group, a statistically significant (P<0.05). Multivariate analysis showed that risk factors for postpartum hemorrhage and dystocia uterine inertia, placental factors, coagulation disorders, birth defects and pregnancy complications are closely related. Hysterectomy therapy was significantly higher than gauze packing intrauterine therapy (P<0.05). Conclusion

  7. Twinning in Iranian Holstein Dairy Cattle: A Study of Risk Factors and Production and Reproduction Consequences

    Directory of Open Access Journals (Sweden)

    abolfazl mahnani

    2016-08-01

    Full Text Available Introduction Cattle are a monotocous species meaning that, under most circumstances, a successful pregnancy results in the birth of one calf. Twinning rate has been reported in dairy cows from 3 to 5 percent, which can be influenced by maternal age.The birth of twins is detrimental to the majority of beef and dairy cattle producer. Financial loss arising from any of twinning has been reported in Europe between 109 to 201 dollars in recent years. Because it is associated with undesirable consequences such as reduced survival, calf, cow increased removal rate and poor performance. This also reduces pregnancy rates and profitability herds. One of the effects of twinning severe is reduction of the number of calves for replacement fertility in dairy cows. This is a loss arising from an increase in infant mortality and a gender bias in bull calves homo zygote.Twinning rate increases significantly the incidence of reproductive abnormalities, including the retained placenta, dystocia, stillbirth and abortion. Many studies have been done on the effect of multiple pregnancies in cattle production and reproduction. Higher milk production for cows twin issue is controversial as some studies have shown that there is a positive correlation between the rate of twinning in dairy cattle and milk production. But in the next lactation, production for cows that have been the twin of the infected cow metabolic disease in the previous period was lower. In a study reported that cows spend fewer days in the twin peak production. The results of the study on the effect of twinning on reproductive traits of Holstein cows-Farzin showed that only half of the twin cows are prone to reproduce in the next period. It is also reported a greater number of insemination per conception in twin compared to single cows. In addition, it has been reported that the twin was more than 15 days from calving to first services. Average twin cows experiencing 1.7 times more death and removal

  8. 196例胎膜早破患者的临床分析

    Institute of Scientific and Technical Information of China (English)

    薛芬; 陶学强

    2014-01-01

    目的:探讨胎膜早破的危险因素及其对母婴并发症的影响,为临床工作提供指导。方法回顾性分析我院妇产科2011---2013年收治的196例胎膜早破患者的临床资料,并选取同期住院分娩的无胎膜早破及其他并发症的正常产妇196例作为对照组,比较两组胎儿分娩方式及母婴并发症发生率,并分析胎膜早破发生的危险因素。结果胎膜早破组难产、剖宫产发生率高于对照组,差异有统计学意义( P<0.05);产妇感染率和新生儿感染率明显增高,差异有统计学意义(P<0.05)。结论胎膜早破患者难产发生率及母儿并发症发生率均较正常产妇明显升高,及时就诊,早期处理,减少母婴并发症,改善分娩结局。%Objective To investigate the risk factors of premature rupture of membranes and its influence on maternal and infant complications ,and provide guid-ance for clinical work.Methods retrospective analysis of 196 cases of 2011-2013 in our hospital of Obstetrics and gynecology were premature rupture in patients with clinical data,and selected the normal period of delivery in hospital without premature rupture of membranes and other maternal complications in 196 cases as control group,compared two groups of mode of delivery and maternal fetal complication rate,and the risk analysis of premature rupture of membranes factors of.Results prema-ture rupture of membrane group,the incidence of dystocia cesarean section was higher than that in the control group,the difference was statistically significant(P<0.05);maternal infection rate was significantly higher infection rate and newborn,the difference was statistically significant(P<0.05).Conclusion the pa-tients with the incidence of dystocia and mother infant complications were higher than normal pregnant women were elevated ,premature rupture of membranes,timely treatment,early treatment,reduce maternal complications,improve birth outcomes.

  9. Interspecies embryo transfer in camelids: the birth of the first Bactrian camel calves (Camelus bactrianus) from dromedary camels (Camelus dromedarius).

    Science.gov (United States)

    Niasari-Naslaji, A; Nikjou, D; Skidmore, J A; Moghiseh, A; Mostafaey, M; Razavi, K; Moosavi-Movahedi, A A

    2009-01-01

    Interspecies embryo transfer is a possible approach that can be used to conserve endangered species. It could provide a useful technique to preserve the Iranian and wild Bactrian camels, both of which are threatened with extinction. In the present study, one Bactrian camel was superovulated using decreasing doses of FSH (60, 40, 30, 30, 20, 20 mg, b.i.d.; Folltropin-V; Bioniche, London, ON, Canada) for 6 days, followed by a single injection of FSH (20 mg, i.m.) on Day 7. Daily ovarian ultrasonography was performed until most of the growing follicles had reached a mature size of 13-17 mm, at which time the camel was mated twice, 24 h apart, with a fertile male Bactrian camel. At the time of first mating, female camels were given 20 microg, i.v., buserelin (Receptal; Intervet, Boxmeer, The Netherlands). One day after the donor camel had been mated, the dromedary recipients (n = 8) were injected with 25 mg, i.v., porcine LH (Lutropin-V; Bioniche) to induce ovulation. Embryos were recovered on Day 8.5 after the first mating and transferred non-surgically into recipients on Day 7.5 after LH injection. Pregnancy was diagnosed 25 days after embryo transfer. Healthy Bactrian camel calves (n = 4) were born without any particular complications at the time of parturition (e.g. dystocia and neonatal diseases). The present study is the first report of the birth of Bactrian camel calves from dromedary camels, as well as the first report of interspecies embryo transfer in old world camelids.

  10. An international delphi study of the causes of death and the criteria used to assign cause of death in bovine perinatal mortality.

    Science.gov (United States)

    Mee, J F; Sanchez-Miguel, C; Doherty, M

    2013-08-01

    The objective of the present study was to elicit opinion from two groups of veterinarians [subject matter experts and non-subject matter experts] about the causes of bovine perinatal mortality and the criteria used to assign such causes. The subject matter experts were selected on the basis of their scientific publications or experience of working in a veterinary diagnostic or research laboratory in the area of bovine perinatal mortality. The non-subject matter experts were self-selected as cattle veterinarians without particular expertise in bovine perinatology. A total of 74 veterinarians (46 subject matter experts and 28 non-subject matter experts) from 23 countries responded. The study was conducted using Delphi methodology over seven rounds. Respondents were asked to agree the causes of bovine perinatal mortality and for each cause to agree the supporting diagnostic criteria. There was a close agreement between groups on 16 causes of death apart from intra-uterine growth retardation (IUGR) and micronutrient imbalances which were accepted by fewer subject matter experts. There was inter-group consensus on the criteria to diagnose accidents, congenital defects, dystocia, hyperthermia, infections, premature placental separation, prematurity and prolonged calving. There was inter-group consensus on the criteria to diagnose anoxia, apart from gingival cyanosis; on haemorrhage, apart from haemorrhagic anaemia; on IUGR, apart from organ weights; and on iodine imbalance, apart from goitre and thyroid iodine content. The results from this study highlighted the current lack of standardization of the criteria used to define the cause of death for bovine perinatal mortality and the need for such standardization.

  11. A mixed-methods study of secondary traumatic stress in certified nurse-midwives: shaken belief in the birth process.

    Science.gov (United States)

    Beck, Cheryl Tatano; LoGiudice, Jenna; Gable, Robert K

    2015-01-01

    Secondary traumatic stress (STS) is an occupational hazard for clinicians who can experience symptoms of posttraumatic stress disorder (PTSD) from exposure to their traumatized patients. The purpose of this mixed-methods study was to determine the prevalence and severity of STS in certified nurse-midwives (CNMs) and to explore their experiences attending traumatic births. A convergent, parallel mixed-methods design was used. The American Midwifery Certification Board sent out e-mails to all their CNM members with a link to the SurveyMonkey study. The STS Scale was used to collect data for the quantitative strand. For the qualitative strand, participants were asked to describe their experiences of attending one or more traumatic births. IBM SPSS 21.0 (Version 21.0, Armonk, NY) was used to analyze the quantitative data, and Krippendorff content analysis was the method used to analyze the qualitative data. The sample consisted of 473 CNMs who completed the quantitative portion and 246 (52%) who completed the qualitative portion. In this sample, 29% of the CNMs reported high to severe STS, and 36% screened positive for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for PTSD due to attending traumatic births. The top 3 types of traumatic births described by the CNMs were fetal demise/neonatal death, shoulder dystocia, and infant resuscitation. Content analysis revealed 6 themes: 1) protecting my patients: agonizing sense of powerlessness and helplessness; 2) wreaking havoc: trio of posttraumatic stress symptoms; 3) circling the wagons: it takes a team to provide support … or not; 4) litigation: nowhere to go to unburden our souls; (5) shaken belief in the birth process: impacting midwifery practice; and 6 moving on: where do I go from here? The midwifery profession should acknowledge STS as a professional risk. © 2015 by the American College of Nurse-Midwives.

  12. Pituitary stalk interruption syndrome in Chinese people: clinical characteristic analysis of 55 cases.

    Directory of Open Access Journals (Sweden)

    Qinghua Guo

    Full Text Available OBJECTIVE: Pituitary stalk interruption syndrome (PSIS is characterized by the absence of pituitary stalk, pituitary hypoplasia, and ectopic posterior pituitary. Due to the rarity of PSIS, clinical data are limited, especially in Chinese people. Herein, we analyzed the clinical characteristics of patients diagnosed with PSIS from our center over 10 years. PATIENTS AND METHODS: We retrospectively analyzed the clinical manifestations and laboratory and MRI findings in 55 patients with PSIS. RESULTS: Of the 55 patients with PSIS, 48 (87.3% were male. The average age was 19.7±6.7 years and there was no familial case. A history of breech delivery was documented in 40 of 45 patients (88.9% and 19 of 55 patients (34.5% had a history of dystocia. Short stature was found in 47 of 55 patients (85.5% and bone age delayed 7.26±5.37 years. Secondary sex characteristics were poor or undeveloped in most patients. The prevalence of deficiencies in growth hormone, gonadotropins, corticotropin, and thyrotropin were 100%, 95.8%, 81.8%, 76.3%, respectively. Hyperprolactinemia was found in 36.4% of patients. Three or more pituitary hormone deficiencies were found in 92.7% of the patients. All patients had normal posterior pituitary function and absent pituitary stalk on imaging. The average height of anterior pituitary was 28 mm, documented anterior pituitary hypoplasia. Midline abnormalities were presented in 9.1% of patients. CONCLUSIONS: The clinical features of our Chinese PSIS patients seem to be different from other reported patients in regarding to the higher degree of hypopituitarism and lower prevalence of midline defects. In addition, our patients were older at the time of case detection and the bone age was markedly delayed. We also had no cases of familial PSIS.

  13. Factors associated with the differential in actual gestational age and gestational age predicted from transrectal ultrasonography in pregnant dairy cows.

    Science.gov (United States)

    Fitzgerald, A M; Ryan, D P; Berry, D P

    2015-08-01

    The objective of the study was to determine (1) how gestational age predicted using transrectal ultrasonography related to actual gestational age derived as the number of days from the most recent artificial insemination date, (2) what factors, if any, were associated with the differential between the two measures, and (3) the association between this differential in gestational age and the likelihood of subsequent pregnancy loss, stillbirth, or calving dystocia. The data set contained 7340 ultrasound records from 6805 Holstein Friesian dairy cows in 175 herds. Ultrasonography assessment underestimated gestational age relative to days since last service by 0.51 days (standard error [SE]: 0.040), although the differential was less during embryonic development phase (i.e., ≤42 days of gestation; mean overestimation of 0.31 days) versus fetal development phase (i.e., >42 days of gestation; mean underestimation of 0.81 days). Predicted calving date calculated from ultrasonography was 1.41 days (SE: 0.040) later than the actual subsequent calving date and was, on average, 0.52 days later than predicted calving date, assuming a gestation length of 282 days. Parity of the dam (P gestation length. Gestation length was 1.27 days longer (SE: 0.01) for bull calves compared to heifer calves. Calves from beef sires had a longer gestation length than calves from dairy sires, and older parity cows had a longer gestation length than younger cows. The results highlight factors associated with differences in gestational age obtained from ultrasonography and insemination data and illustrate the value of ultrasonography for the prediction of calving date and pregnancy loss.

  14. Costs of near-miss obstetric complications for women and their families in Benin and Ghana.

    Science.gov (United States)

    Borghi, J; Hanson, K; Acquah, C Adjei; Ekanmian, G; Filippi, V; Ronsmans, C; Brugha, R; Browne, E; Alihonou, Eusebe

    2003-12-01

    This paper estimates the total cost to women and their families associated with a spontaneous vaginal delivery and five types of 'near-miss' obstetric complication in Benin and Ghana, and assesses affordability in relation to household cash expenditure. A retrospective evaluation of costs was carried out among 121 mothers in three hospitals in Ghana. A prospective evaluation of costs was undertaken among 420 pregnant women in two hospitals in Benin. Information was collected on the cost of travel to the facilities and of direct medical and non-medical costs incurred during their stay in hospital. In Benin, costs ranged from an average of 15 US dollars for a spontaneous delivery to 256 US dollars for a near-miss complication caused by dystocia. In Ghana, average costs ranged from 18 US dollars for a spontaneous vaginal delivery to 115 US dollars for a near-miss complication caused by haemorrhage. Medical costs accounted for the largest share of total costs, mainly drugs and medical supplies in Ghana and costs of the delivery and any surgical intervention in Benin. Payments associated with a spontaneous vaginal delivery amounted to at least 2% of annual household cash expenditure in both countries. In the case of severe obstetric complications, costs incurred reached a high of 34% of annual household cash expenditure in Benin. The economic burden of hospital-based delivery care in Ghana and Benin is likely to deter or delay women's use of health services. Should a woman develop severe obstetric complications while in labour, the relatively high costs of hospital care could have a potentially catastrophic impact on the household budget.

  15. Clinical Observation of Epidural Analgesia for Labor Pain%硬膜外阻滞麻醉用于无痛分娩的临床观察

    Institute of Scientific and Technical Information of China (English)

    李仁兰; 周玮

    2012-01-01

      目的探讨分娩镇痛的效果及对产程、母婴的影响.方法采用PECA泵硬膜外腔给药用于分娩镇痛,观察产程时间、分娩方式、产后出血、胎儿宫内窘迫及新生儿窒息情况.结果观察组和对照组产程比较、两组分娩方式比较有显著性差异(P0.05).结论 PECA泵用于持续硬膜外腔给药镇痛,疼痛阻滞完善,加速了产程的进展,降低了剖宫产率阴道难产率,对母婴均无不良影响.%  Objective To study the pain relief effectiveness and its influence on the labor course, and both the mothers and the newborns. Methods The pump of PECA (patient controlled epidural analgesia) was used during labor in the study group. The labor course, the methods of delivery, the incidence of post partum hemorrhage, fetal distress and neonatal asphyxia were observed respectively in the groups. Results There were significant differences between both groups in the stage of labor and delivery modes. There were no significant differences in the incidences of post partum hemorrhage, fetal distress and neonatal asphyxia(P>0.05).Conclusion The pump of PECA during labor is safe and effective, which accelerates course of labor and reduce the rates of cesarean and dystocia.

  16. Management practices associated with pain in cattle on western Canadian cow-calf operations: A mixed methods study.

    Science.gov (United States)

    Moggy, M A; Pajor, E A; Thurston, W E; Parker, S; Greter, A M; Schwartzkopf-Genswein, K S; Campbell, J R; Windeyer, M C

    2017-02-01

    The implementation of on-farm pain mitigation strategies is dependent on feasibility and importance to producers. Currently, there is a lack of information regarding adoption of management practices associated with pain in cattle within the Canadian beef industry. The objective of this mixed methods study was to describe pain-associated practices implemented on farm and producer perceptions toward pain mitigation strategies. A questionnaire about calving management and calf processing was delivered to 109 cow-calf producers in western Canada. In addition, 15 respondents were purposively selected based on questionnaire responses to participate in individual semistructured, on-farm interviews. The prevalence of pain mitigation strategies used for dystocia and cesarean section by respondents were 46 and 100%, respectively. The majority of operations reported castrating and dehorning calves before 3 mo of age (95 and 89%, respectively). The majority of operations did not use pain mitigation strategies for castration and dehorning (90 and 85%, respectively). Branding was practiced by 57% of respondents, 4% of which used pain mitigation. Thematic content analysis revealed that producers' perception of pain were influenced by what they referred to as "common sense," relatability to cattle, visual evidence of pain, and age of the animal. Factors that influenced participant rationale for the implementation of pain mitigation practices included access to information and resources, age of the animal, benefit to the operation, cost and logistics, market demands, and personal conscience. Overall, management practices were generally in compliance with published Canadian guidelines. Results of this study may provide direction for future policy making, research, and extension efforts to encourage the adoption of pain mitigation strategies.

  17. Reproductive tract tumours: the scourge of woman reproduction ails Indian rhinoceroses.

    Science.gov (United States)

    Hermes, Robert; Göritz, Frank; Saragusty, Joseph; Stoops, Monica A; Hildebrandt, Thomas B

    2014-01-01

    In Indian rhinoceros, extensive leiomyoma, a benign smooth muscle tumour, was sporadically diagnosed post mortem and commonly thought of as contributing factor for reduced fecundity of this species in captivity. However, to date, the prevalence of reproductive tract tumours and their relevance for fecundity are unknown. Our analysis of the international studbook now reveals that females cease reproducing at the age of 18.1±1.2 years; equivalent to a reproductive lifespan of just 9.5±1.3 years. This short reproductive life is in sharp contrast to their longevity in captivity of over 40 years. Here we show, after examining 42% of the captive female population, that age-related genital tract tumours are highly prevalent in this endangered species. Growth and development of these tumours was found to be age-related, starting from the age of 10 years. All females older than 12 years had developed genital tumours, just 7-9 years past maturity. Tumour sizes ranged from 1.5-10 cm. With age, tumours became more numerous, sometimes merging into one large diffuse tumour mass. These tumours, primarily vaginal and cervical, presumably cause widespread young-age infertility by the age of 18 years. In few cases, tumour necrosis suggested possible malignancy of tumours. Possible consequences of such genital tract tumour infestation are hindered intromission, pain during mating, hampered sperm passage, risk of ascending infection during pregnancy, dystocia, or chronic vaginal bleeding. In humans, leiomyoma affect up to 80% of pre-menopause women. While a leading cause for infertility, pregnancy is known to reduce the risk of tumour development. However, different from human, surgical intervention is not a viable treatment option in rhinoceroses. Thus, in analogy to humans, we suggest early onset and seamless consecutive pregnancies to help reduce prevalence of this disease, better maintain a self-sustained captive population and improve animal welfare.

  18. The association between labour variables and primiparous women's experience of childbirth; a prospective cohort study.

    Science.gov (United States)

    Ulfsdottir, Hanna; Nissen, Eva; Ryding, Elsa-Lena; Lund-Egloff, Doris; Wiberg-Itzel, Eva

    2014-06-18

    Studies have suggested several risk factors for a negative birth experience among primiparas. Factors that are mentioned frequently include labour dystocia, operative intervention such as acute caesarean section or vacuum extraction, or the infant being transferred to neonatal care. Another important factor mentioned is lack of support from the midwife. A study was made of the deliveries of 446 healthy primiparas in a prospective cohort study performed at Soder Hospital, Stockholm, Sweden. Samples of amniotic fluid were collected at delivery and the levels of amniotic fluid lactate (AFL) were measured to give an indication of the metabolism of the uterine tissue. Obstetrical data were collected from birth records.Postpartum, all the women included in the study were asked to complete the Wijma Delivery Experience Questionnaire (W-DEQ B) that measures the experience of a woman's delivery. The main objective of the project was to study well-known as well as new factors associated with negative experience of childbirth among a group of healthy primiparas. Risk factors for reporting a higher level of negative childbirth experience were shown to be a high level of AFL (AOR 3.1, 95%, CI; 1.1-8.9), a longer latent phase (AOR 1.8, 95%, CI; 1.03-3.1), and a low Apgar score (labour (p = 0.003). A high AFL level, as a marker of uterine metabolic status, and a longer latent phase are strongly associated with a negative experience of childbirth. A low 1 minute Apgar score of the newborn seems to have the strongest negative influence on the woman's experience of childbirth, even when the infant recovers immediately.

  19. [Effects on the newborn infant of thiopental and propofol used in anesthetic induction in cesarean section].

    Science.gov (United States)

    Zamora, E; Redondo, J A; Catalán, P A; Carrillo, F

    1994-01-01

    To compare the effects of an anesthetic induction dose of thiopental to that of propofol on the vitality of the neonate, as measured by Apgar score and the interval between extraction of the newborn and unassisted respiration. One hundred ASA I-II women undergoing cesarean section were randomly assigned to two groups of 50. Anesthesia was induced with thiopental 4 mg/kg in one group; in the other group, propofol 2 mg/kg was used. Time intervals recorded were induction-to-extraction, uterine incision-to-extraction and extraction-to-unassisted respiration. An Apgar score was recorded 1, 5 and 10 min after birth. For statistical analysis, each group was divided into three subgroups, in accordance with the reason for performing the cesarean section: subgroup 1, elective cesarean; subgroup 2, emergency cesarean due to dystocia or failure; subgroup 3, emergency cesarean section due to acute fetal distress. Means of intervals for induction-extraction and uterine incision-extraction showed no significant differences. All induction-extraction intervals were under 10 min (4.94 +/- 1.55 min) and all uterine incision-extraction intervals were under 180 sec, with most staying under 90 sec (43.13 +/- 25.76 sec). No statistically significant differences were found for vitality between the two groups of neonates. If the induction-extraction interval is 10 min or less, both thiopental (4 mg/kg) and propofol (2 mg/kg) given in a single dose for induction of general anesthesia in all types of cesarean section are equally safe for the newborn infant.

  20. Successful external cephalic version is an independent factor for caesarean section during trial of labor - a matched controlled study.

    Science.gov (United States)

    Boujenah, J; Fleury, C; Bonneau, C; Pharisien, I; Tigaizin, A; Carbillon, L

    2017-09-22

    To assess the mode of delivery and Caesarean Section (CS) rate after successful External Cephalic Version (ECV). A matched case-control study. Data were gathered from a tertiary care university hospital register from 1996-2015. All pregnant women who delivered after successful External Cephalic Version (ECV). Among 643 women who attempted ECV, we identified 198 with successful ECVs and compared them with the next two women who presented for labor management with spontaneous cephalic presentation, matching for delivery date, maternal age, parity, body mass index, and delivery history using univariate and stepwise logistic regression. The main outcome measure was the risk of caesarean. The caesarean section rate was higher after successful ECV (respectively 20.7% versus 7.07%, Pface) was higher after successful ECV (28.6% versus 0%). After adjustment for matching and confounding variables (variation of the caesarean section rate over the study period, gestational maternal complications, antepartum fetal complications, term of delivery, induction of labor, oxytocin use for dystocia, neonatal cephalic perimeter), a successful ECV increased the risk of caesarean section (adjusted OR 3.17, 95% CI 1.86-5.46). By stratifying on week, a trend for increased risk for caesarean section was observed at the week after ECV and at post term (28.6% before 37+6, 14.8% at 38+0-38+6, 13.8% at 39+0-39+6, 14.2% at 40+0-40+6 and 33.3% beyond 41+0 weeks' gestation, P=0.06). Women who have a successful ECV are at increased risk of caesarean section compared with women who experience spontaneous cephalic version. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Riesgo preconcepcional y producto de la concepción

    Directory of Open Access Journals (Sweden)

    Lex Cervera Estrada

    1997-12-01

    Full Text Available Se realizó un estudio de casos y controles para determinar la influencia del riesgo preconcepcional en las características del parto y del recién nacido y determinar la evolución del desarrollo psicomotor, dentario, óseo y pondoestatural en los infantes menores de 1 año, en 35 consultorios del médico de la familia pertenecientes al Policlínico Comunitario Docente "Tula Aguilera" del Municipio de Camagüey. Los resultados más relevantes fueron que casi la cuarta parte del grupo de estudio (26,47 % presentó distocias en el parto, además fueron más frecuentes las alteraciones del desarrollo óseo y la evaluación nutricional deficiente a la captación. Un 64,70 % de los niños con evolución desfavorable al año de vida fue determinado por la desnutrición materna III-IV.A case-control study was conducted to determine the influence of the preconceptional risk on the characteristics of delivery and of the newborn, and to find out the evolution of the psychomotor, dental, bone, and pondostatural development of infants under one at 35 family physicians offices of the "Tula Aguilera" Teaching Community Polyclinc, in the municipality of Camagüey. The most important result was that one fourth of the case-base study (26.47 % presented dystocia, whereas the alterations of bone development and the deficient nutritional evaluation at the time of catchment were the most common findings. 64.70 % of children aged 1 had an unfavorable evolution due to maternal malnutririon III-IV.

  2. [Characteristics of induced labors at Marqués de Valdecilla University Hospital].

    Science.gov (United States)

    González-Maestro, Marta; Laurrieta-Saiz, Izaskun; García-González, Casandra; López-Mirones, Marta; Terán-Muñoz, Oihane; Alonso-Salcines, Alicia

    2017-01-03

    Induction of labor (IOL) is a common obstetric practice which has increased in recent decades. The main objective of this study is to describe the characteristics of induced labor at Marqués de Valdecilla University Hospital. A descriptive, retrospective study was performed between January 1st and April 30t(h) of 2014, by reviewing medical histories. A standardised registration has been used to collect data. There were a total of 376 IOL, the incidence was 35.1%. The most frequent indications were premature rupture of membranes (33.9%) and gestational age of 41 completed weeks or more (16.7%). Oxytocin was used to start 66.8% of the IOL. Of all births, 61.4% were spontaneous vaginal births and 25.3% caesarean sections. An increase in the rate of caesarean sections was observed in the group of gestational age of 41 completed weeks or more (27.3%) and hypertensive disorders of pregnancy (29.8%). The main cause of dystocia was suspected fetal compromise (36.4%). Adaptation to extrauterine life was within the parameters of normality in 94% of the newborn infants. Comparing the IOL with spontaneous labor, a decrease in spontaneous vaginal births and an increase in caesarean sections and operative vaginal births was observed in the inductions. This study provides relevant information to the professionals in the fields of gynaecology and obstetrics, and opens the way for future research to obtain results transferable to the clinical practice. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  3. Concept of defensive medicine and litigation among Sudanese doctors working in obstetrics and gynecology.

    Science.gov (United States)

    Ali, AbdelAziem A; Hummeida, Moawia E; Elhassan, Yasir A M; Nabag, Wisal O M; Ahmed, Mohammed Ahmed A; Adam, Gamal K

    2016-02-09

    Obstetrics and gynaecology always has reputation for being a highly litigious. The field of obstetrics and gynaecology is surrounded by different circumstances that stimulate the doctors to practice defensive medicine. This study was directed to assess the extent and the possible effect of defensive medicine phenomenon (in term of knowledge and prevalence) on medical decision making among different grades of obstetric and gynaecologic Sudanese doctors, and to determine any experience of medical litigations with respect to sources and factors associated with it (in term of area of work, characteristics of the area at which the doctors worked, professionalism, hospitals systems…ect). A total of 117 doctors were approached, their distribution according to job description was as follow: consultants (42.7%, 50\\117) registrars (34.2%, 40\\117) and specialists (23.1%, 27\\117). The majority 89.7% had the impression that litigation against doctors are increasing and 27.6% had a direct experience of litigation. In this study less than one half (42.7%) of the surveyed doctors knew the concept of defensive medicine and 71.8% reported practicing one or another form of defensive medicine. The different sources of the litigations reported by the doctors included: maternal death (n = 15), perinatal death (n = 5), other {misdiagnosis, intra-uterine fetal death, uterine perforation, rupture uterus} (n = 4), fetal distress (n = 3), injury to viscera (n = 3) and shoulder dystocia (n = 2). In this study the experience of medical litigation was significantly observed among those who worked in area of blame culture (90.6% Vs 56.5%, P = 0.000). In logistic regression model, there was no significant difference between those who knew the concept of defence medicine and those who didn't. There should be strategic plan to reduce the practice of defensive medicine and medical litigation against doctors.

  4. [Fetal macrosomia in Lubumbashi: risk factors and maternal and perinatal prognosis].

    Science.gov (United States)

    Luhete, Prosper Kakudji; Mukuku, Olivier; Kiopin, Patrick Mubinda; Tambwe, Albert Mwembo; Kayamba, Prosper Kalenga Muenze

    2016-01-01

    Fetal macrosomia is usually defined when the estimated fetal weight is greater than or equal to 4000 grams. The aim of this study was to determine the incidence of macrosomia, to identify its etiological factors and to evaluate maternal and perinatal prognosis. This is a case-control study conducted in maternity units of 10 general referral hospitals in the city of Lubumbashi in Democratic Republic of Congo between 1 December 2013 and 31 March 2014. The post-partum women were divided into two groups according to their fetal birth weight: group I (≥4000 grams or more) and groups II (from 2500 to 3500 grams). Maternal characteristics, obstetrical environment as well as maternal and perinatal prognosis were studied and compared in the two groups. Data were analyzed using Epi Info 7.1 software. Differences were considered significant if p macrosomia was 5,7%. Compared to mothers from the control group, we found that mothers of macrosomic infants were older, multiparous, multigravidae, obese, diabetic and had previously delivered a macrosomic fetus. The rates of cesarean delivery and pathological delivery were significantly higher in mothers of macrosomic infants than in those of the control group. Male sex was significantly more prevalent among macrosomic infants than among the control group. Shoulder dystocia was recorded only in the macrosomic group. The prevalence of delivery of a macrosomic infant in Lubumbashi is 5,7%. Macrosomia is often the cause of maternal and perinatal complications. Reduction of maternal and perinatal complications passes through a better understanding of risk factors and an early detection.

  5. Determinants and outcome of fetal macrosomia in a Nigerian tertiary hospital.

    Science.gov (United States)

    Olokor, Oghenefegor Edwin; Onakewhor, Joseph Ubini; Aderoba, Adeniyi Kolade

    2015-01-01

    To determine the incidence and risk factors of fetal macrosomia and maternal and perinatal outcome. This was a 1-year prospective case-control study of singleton pregnancies in a Nigerian tertiary hospital. Only women who gave consent were recruited for the study. The maternal and perinatal outcomes in women who delivered macrosomic infants (birth weight ≥ 4000 g) were compared with the next consecutive delivery of normal birth weight (2500-3999 g) infants. The total deliveries for the study period were 2437, of which 135 were macrosomic babies. The incidence of fetal macrosomia was 5.5%. The mean birth weights of macrosomic and nonmacrosomic babies were 4.26 ± 0.29 kg and 3.20 ± 0.38 kg, respectively, P = 0.000. Mothers with macrosomic babies were more likely to be older (P = 0.047), of higher parity (0.001), taller (P = 0.007), and weighed more at delivery (P = 0.000). Previous history of fetal macrosomia (P = 0.000) and maternal diabetes (P = 0.007) were factors strongly associated with the delivery of macrosomic infants. Pregnancies associated with fetal macrosomia had increased duration of labor (P = 0.007), interventional deliveries (P = 0.000), shoulder dystocia, and genital laceration (P = 0.000). There was no significant difference in the incidence of primary postpartum hemorrhage (P = 0.790), birth asphyxia, and perinatal mortality (P = 0.197). Fetal macrosomia is associated with maternal and fetal morbidities. The presence of the observed risk factors should elicit the suspicion of a macrosomic fetus and the need for appropriate management to reduce maternal and fetal morbidities.

  6. Risk factors and outcomes of fetal macrosomia in a tertiary centre in Tanzania: a case-control study.

    Science.gov (United States)

    Said, Aisha Salim; Manji, Karim Premji

    2016-08-24

    Fetal macrosomia is defined as birth weight ≥4000 g. Several risk factors have been shown to be associated with fetal macrosomia. There has been an increased incidence of macrosomic babies delivered and the antecedent complications. This study assessed the risk factors, maternal and neonatal complications of fetal macrosomia in comparison with normal birth weight neonates. A case-control study was conducted at the Muhimbili National Hospital (MNH) maternity and neonatal wards. Cases comprised of neonates with birth weight ≥4000 g; controls were matched for sex and included neonates weighing 2500-3999 g. Detailed clinical and demographic information and laboratory investigations which included blood glucose, hematocrit and plasma calcium were collected. The child was followed up to discharge/death. The prevalence of macrosomic babies was 2.3 % (103 out of 4528 deliveries). Mean birth weight of macrosomic babies was 4.2 ± 0.31 kg whereas in the controls it was 3.2 ± 0.35 kg. Maternal weight ≥80 kg, maternal age ranging between 30 and 39 years, multiparity, presence of diabetes mellitus, and gestational age ≥40 years, previous history of fetal macrosomia and delivery weight ≥80 kg were significantly associated with fetal macrosomia. Macrosomic infants were more likely to have birth asphyxia, shoulder dystocia, hypoglycemia, respiratory distress and perinatal trauma and increased risk of death compared to controls. Maternal complications such as postpartum hemorrhage, second degree perineal tears and prolonged labor occurred more frequently in the macrosomia group compared to controls (p-value macrosomia was an important cause of maternal and neonatal morbidity at Muhimbili National Hospital. Presence of risk factors should alert the obstetrician to closely monitor these pregnancies and plan on appropriate mode of delivery. Macrosomic neonates should be routinely screened and appropriately managed for hypoglycemia.

  7. Extreme macrosomia--obstetric outcomes and complications in birthweights >5000 g.

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    Hehir, Mark P; Mchugh, Ann F; Maguire, Patrick J; Mahony, Rhona

    2015-02-01

    Management of extremely large birthweight infants presents challenges during the period of labour and delivery. We sought to examine outcomes in infants with extreme macrosomia (birthweight > 5000 g), at an institution where the management of labour is standardised. This is a retrospective analysis of prospectively gathered data on all infants with a birthweight >5000 g delivered at a tertiary level institution from 2008 to 2012. Details of labour characteristics and outcomes were examined; these were compared according to parity. During the study period, there were 46 128 deliveries at the hospital and 182 infants with a birthweight >5000 g, giving an incidence of 0.4%. The majority of women (133/182) were multiparous. Among nulliparas, 47% (23/49) had a vaginal delivery, while 53% (26/49) had a caesarean delivery. 86% (97/113) of multiparas had a vaginal delivery, and 14% (16/113) had a caesarean delivery. 43% (69/162) required induction of labour. This was more common in nulliparous compared with multiparous women (58% [29/49] vs 30% [40/133], P = 0.005, OR = 3.4, 95% CI = 1.7-6.6). A total of 30% (49/162) of women had their labour accelerated with oxytocin. There were higher rates of oxytocin use in nulliparas than in multiparas (55% [27/49] vs 16.5% [22/133], P macrosomia affects 0.4% of pregnancies in contemporary practice. Multiparas have a low rate of caesarean section. Infants delivered vaginally are at increased risk of shoulder dystocia and associated complications. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  8. Determinants and outcome of fetal macrosomia in a Nigerian tertiary hospital

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    Oghenefegor Edwin Olokor

    2015-01-01

    Full Text Available Background: To determine the incidence and risk factors of fetal macrosomia and maternal and perinatal outcome. Patients and Methods: This was a 1-year prospective case–control study of singleton pregnancies in a Nigerian tertiary hospital. Only women who gave consent were recruited for the study. The maternal and perinatal outcomes in women who delivered macrosomic infants (birth weight ≥ 4000 g were compared with the next consecutive delivery of normal birth weight (2500–3999 g infants. Results: The total deliveries for the study period were 2437, of which 135 were macrosomic babies. The incidence of fetal macrosomia was 5.5%. The mean birth weights of macrosomic and nonmacrosomic babies were 4.26 ± 0.29 kg and 3.20 ± 0.38 kg, respectively, P = 0.000. Mothers with macrosomic babies were more likely to be older (P = 0.047, of higher parity (0.001, taller (P = 0.007, and weighed more at delivery (P = 0.000. Previous history of fetal macrosomia (P = 0.000 and maternal diabetes (P = 0.007 were factors strongly associated with the delivery of macrosomic infants. Pregnancies associated with fetal macrosomia had increased duration of labor (P = 0.007, interventional deliveries (P = 0.000, shoulder dystocia, and genital laceration (P = 0.000. There was no significant difference in the incidence of primary postpartum hemorrhage (P = 0.790, birth asphyxia, and perinatal mortality (P = 0.197. Conclusion: Fetal macrosomia is associated with maternal and fetal morbidities. The presence of the observed risk factors should elicit the suspicion of a macrosomic fetus and the need for appropriate management to reduce maternal and fetal morbidities.

  9. Dairy calving management: description and assessment of a training program for dairy personnel.

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    Schuenemann, G M; Bas, S; Gordon, E; Workman, J D

    2013-04-01

    The objective of this study was to assess the effectiveness of a comprehensive calving management program designed to enhance the flow of applied, research-based, calving information to dairy personnel. Calving personnel (n=70), serving an estimated 18,100 cows from 18 Ohio dairies, attended the calving management program (∼1h of training and ∼2h of demonstration). Description of the birth canal, behavioral signs of normal parturition (stages I to III), dystocia (presentations, positions, and postures), hygiene practices during the assistance procedure, strategies for intervention (when and how to intervene), record-keeping, communication (when to call for help), and newborn care were discussed. Posttraining follow-ups (2/yr) were available for participating personnel. Educational materials were delivered through lectures followed by group discussions and hands-on demonstrations. Attendees were assessed using pre- and posttests of knowledge to determine the level of knowledge gained during the training program. Participants evaluated the program and provided feedback at the conclusion of the program. Dairy personnel reported that the overall program, presentations, and discussions were useful. The presented materials and demonstrations substantially increased the knowledge level of the attendees by 20.9 percentage points from pre- to posttest scores. Importance of open communication within the farm team, recognizing the landmarks for parturition, signs of calving progress, reference times for intervention, hygiene practices at calving, and strategies to correct abnormal presentation, position, or posture were listed as learned concepts with immediate field application. The follow-up assessment with participant personnel revealed that they were able to implement and apply their learned skills, communicate calving records with the farm team, and follow written calving protocols. Results indicated that the workshop was relevant and effective, offering information

  10. Obstetric and neonatal characteristics of pregnancy and delivery for infant birthweight ≥5.0 kg.

    Science.gov (United States)

    Crosby, David A; Ahmed, Sahar; Razley, Aminah; Morrison, John J

    2017-12-01

    Infant birthweight ≥5.0 kg represents a significant risk factor for mother and neonate. The objective of this study was to examine the obstetric and neonatal outcome measures in a large cohort of such deliveries. The data used for this study were prospectively entered into an obstetric computerized database during the period 1989-2013. All pregnancies where the delivery resulted in an infant weighing ≥5.0 kg were identified. The results were retrospectively analyzed separately for parity, and a separate analysis was performed comparing the outcome measures observed in the earlier years of the study with those of the later years. There were 73,796 deliveries in the time period of which there were n = 201 (0.3%) infants with birth weight ≥5.0 kg. The mean maternal body mass index (BMI) was in the obese category range (30.9 kg/m(2)) and the median gestation at delivery was 40.8 weeks. The cesarean delivery rate for nulliparous women was 56.3% and for parous women 30.8%. The overall rate of third degree perineal tears was 3.8%, the rate of shoulder dystocia was 4.6% and the rate of Erb's Palsy was 1.5%. There was a significant increase in cesarean delivery in the latter of the study (26.7% versus 43.0%, p = 0.02), due to an increase in the planned pre-labor cesarean deliveries (30.0 versus 12.9%, p = 0.005). There was no difference in adverse outcomes in both groups. These findings describe the features of pregnancy associated with infant birthweight ≥5.0 kg, and outline reliable maternal and neonatal morbidity data for these pregnancies. In this cohort, there was no apparent benefit from increased planned pre-labor cesarean delivery rates.

  11. The use of Doppler evaluation of the canine umbilical artery in prediction of delivery time and fetal distress.

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    Giannico, Amália Turner; Gil, Elaine Mayumi Ueno; Garcia, Daniela Aparecida Ayres; Froes, Tilde Rodrigues

    2015-03-01

    The aim of this study was to describe changes in umbilical artery blood flow in the later stages of canine pregnancy. Seventeen pregnant bitches were examined sonographically to evaluate umbilical artery blood flow at the following antepartum times: 120-96, 96-72, 72-48, 48-24, 24-12, 12-6 and 6-1h. The peak systolic velocity and end diastolic velocity were measured to calculate the resistive index (RI). Bitches were classified into two groups according to delivery method: normal delivery (Group 1, n=11) and Cesarean section, due to fetal distress, (Group 2, n=6). During the study, the RI of the umbilical artery in bitches in Group 1 significantly declined in the time periods 72-48, 24-12, 12-6 and 6-1h before delivery when compared to the reference RI (120-96h antepartum period), with values ​​below 0.7 in the 12-6 and 6-1h periods. In Group 2, the RI decreased significantly in the antepartum periods 96-72, 72-48, 48-24h with respect to the period 120-96h, and increased in the periods from 24-12, 12-6 and 6-1h (being significantly higher in this last period) until the time of Cesarean section. Therefore monitoring of changes in umbilical artery RI in the pre-partum period may provide information about time of delivery in bitches and also assist in the diagnosis of possible dystocia and fetal distress. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Design of a Serious Game for Handling Obstetrical Emergencies.

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    Jean Dit Gautier, Estelle; Bot-Robin, Virginie; Libessart, Aurélien; Doucède, Guillaume; Cosson, Michel; Rubod, Chrystèle

    2016-12-21

    The emergence of new technologies in the obstetrical field should lead to the development of learning applications, specifically for obstetrical emergencies. Many childbirth simulations have been recently developed. However, to date none of them have been integrated into a serious game. Our objective was to design a new type of immersive serious game, using virtual glasses to facilitate the learning of pregnancy and childbirth pathologies. We have elaborated a new game engine, placing the student in some maternity emergency situations and delivery room simulations. A gynecologist initially wrote a scenario based on a real clinical situation. He also designed, along with an educational engineer, a tree diagram, which served as a guide for dialogues and actions. A game engine, especially developed for this case, enabled us to connect actions to the graphic universe (fully 3D modeled and based on photographic references). We used the Oculus Rift in order to immerse the player in virtual reality. Each action in the game was linked to a certain number of score points, which could either be positive or negative. Different pathological pregnancy situations have been targeted and are as follows: care of spontaneous miscarriage, threat of preterm birth, forceps operative delivery for fetal abnormal heart rate, and reduction of a shoulder dystocia. The first phase immerses the learner into an action scene, as a doctor. The second phase ask the student to make a diagnosis. Once the diagnosis is made, different treatments are suggested. Our serious game offers a new perspective for obstetrical emergency management trainings and provides students with active learning by immersing them into an environment, which recreates all or part of the real obstetrical world of emergency. It is consistent with the latest recommendations, which clarify the importance of simulation in teaching and in ongoing professional development.

  13. Vitamin D Deficiency Increases the Risk of Adverse Neonatal Outcomes in Gestational Diabetes

    Science.gov (United States)

    Weinert, Letícia Schwerz; Reichelt, Angela Jacob; Schmitt, Leonardo Rauber; Boff, Roberta; Oppermann, Maria Lucia Rocha; Camargo, Joiza Lins; Silveiro, Sandra Pinho

    2016-01-01

    Background Gestational diabetes mellitus (GDM) and vitamin D deficiency have been associated with increased risk of adverse perinatal outcomes but the consequences of both conditions simultaneously present in pregnancy have not yet been evaluated. Our objective was to study the influence of vitamin D deficiency in neonatal outcomes of pregnancies with GDM. Methods 184 pregnant women with GDM referred to specialized prenatal monitoring were included in this cohort and had blood sampled for 25-hydroxyvitamin D measurement. Vitamin D was measured by chemiluminescence and deficiency was defined as < 20 ng/mL. Participants were followed until puerperium and adverse neonatal outcomes were evaluated. Results Newborns of women with vitamin D deficiency had higher incidences of hospitalization in intensive care units (ICU) (32 vs 19%, P = 0.048), of hypoglycemia (any, 17.3 vs 7.1%, P = 0.039requiring ICU, 15.3 vs 3.6%, P = 0.008), and were more frequently small for gestational age (SGA) (17.3 vs 5.9%, P = 0.017). After adjustment, relative risk (RR) for hypoglycemia requiring ICU was 3.63 (95%CI 1.09–12.11) and for SGA was 4.32 (95%CI 1.75–10.66). The incidence of prematurity, jaundice and shoulder dystocia was no statistically different between groups. Conclusions In this cohort of pregnant women with GDM, vitamin D deficiency was associated with a major increase in the incidence of adverse neonatal outcomes such as SGA newborns and neonatal hypoglycemia. PMID:27764194

  14. What is the slowest-yet-normal cervical dilation rate among nulliparous women with spontaneous labor onset?

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    Neal, Jeremy L.; Lowe, Nancy K.; Patrick, Thelma E.; Cabbage, Lori A.; Corwin, Elizabeth J.

    2010-01-01

    Objective To integrate research literature that has provided insights into the cervical dilation rate that may best describe the slowest-yet-normal dilation rate among nulliparous women when beginning with criteria commonly associated with active labor onset. Data Sources A literature search from 1950 through 2008 was conducted using the Medline electronic database, reference lists from identified articles, and other key references. Study Selection Research reports written in English with a focus on the cervical dilation and/or labor duration of low-risk, nulliparous women with spontaneous labor onset. Data Extraction Classic and contemporary research literature was reviewed and organized under the following subheadings: Friedman Studies; Partograph Studies; Active Management of Labor Studies; Additional Studies. Data Synthesis An integrative review of the literature approximated the slowest-yet-normal cervical dilation rate for nulliparous women when beginning with criteria commonly associated with active labor. Conclusions The slowest-yet-normal linear dilation rate approximates 0.5 cm/hr for low-risk, nulliparous women with spontaneous labor onset when starting at dilatations traditionally associated with active labor onset. However, this linear rate must be evaluated judiciously in light of the physiological acceleration of dilation that occurs during typical labor. Given this, cervical dilation for this population is likely slower than 0.5 cm/hr in earlier active labor and faster in more advanced active labor. Faster dilation expectations (e.g., 1 cm/hr) likely contribute to an overdiagnosis of dystocia (“slow, abnormal progression of labor”) in contemporary practice and, subsequently, to an overuse of interventions aimed at accelerating labor progress. PMID:20629924

  15. Karakteristik dan Faktor Risiko Obstetrical Brachial Plexus Palsy pada Bayi Baru Lahir

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    Andreas Vincent Handoyo

    2010-06-01

    Full Text Available Obstetrical brachial plexus palsy (OBPP is an injury of entire or part of brachial plexus correlated with delivery process. Incidence in developing countries is around 0.15%. Risk factors include intrapartum and intrauterine. Three types of OBPP are Duchenne Erb, Klumpke, and whole arm palsy. This was a retrospective study of characteristic and risk factors of OBPP in Hasan Sadikin Hospital, Bandung, period January 2002-April 2007. Data were collected from perinatology ward medical records, and analyzed using binary logistic regression. OBPP incidence was 0.141%. All were Erb palsy and single pregnancy, 68.75% were head-occiput posterior presentation, 50% were spontaneous birth, 18.75% had meconeal staining, 62.5% had birth weight ≥3,500 g, 56.25% were male, 68.75% asphyxia, 12.5% shoulder dystocia, and 6.25% clavicle fracture. Risk factors significantly correlated were foot presentation (OR 9.357; 95%CI, transverse fetal position (OR 5.136; 95%CI, vacuum, forceps, breech/foot extraction (OR 5.240;95%CI, 4.320; 95%CI, 14.411; 95%CI, respectively, birth weight 3,500-3,999 g (OR 4.571;95%CI, birth weight ≥4,500 g (OR 57.759; 95%CI, asphyxia (ORs 5.992; 95%CI, and severe asphyxia (OR 6.094; 95%CI. Sectio cesarea tend to have protective effect {OR 0.244; 95%CI; p=0.062 (>0.05}. The important risk factors of OBPP are foot presentation, breech/foot extraction, and birth weight >4,500 g.

  16. Cesarean section indications and anthropometric parameters in Rwandan nulliparae: preliminary results from a longitudinal survey.

    Science.gov (United States)

    Kakoma, Jean-Baptiste

    2016-01-01

    Maternal anthropometric parameters as risk factors for cesarean section have always been a matter of interest and concern for obstetricians. Some of these parameters have been shown to be predictors of dystocia. This study aims at showing the relationship between cesarean section indications and anthropometric parameters sizes in Rwandan nulliparae for the purpose of comparison and appropriate recommendations. A cross-sectional and analytical study was made on data collected from 32 operated patients among 152 nulliparae with singleton pregnancy at term and vertex presentation. Concerned anthropometric parameters were height, weight and six pelvic distances. Fisher exact and Student's tests were used to compare observed proportions and mean values, respectively. Findings were as follows: 1) the overall cesarean section rate was 21.05%; 2) acute fetal distress (31.3 %), generally contracted pelvis (28.1 %), and engagement failure (25%) were the most frequent indications of cesarean section; 3) all patients ≤ 145 cm tall were operated on for general pelvis contraction whose proportion was significantly higher in them than in the others (p < 0.01); 4) more than half of pelvis contraction cases were observed in patients weighing ≤ 50 kg, but the difference with other weight categories was not significant; 5) considered external pelvic diameters but the Biiliac Diameter displayed average measurements smaller in clinically contracted pelvis than in other CS indications. External pelvimetry associated with specific other anthropometric parameters could be helpful in the screening of generally contracted pelves, and consequently pregnancies at high risk of cephalopelvic disproportion in nulliparous women, particularly in developing countries with limited resources. Further investigations are requested to deal with this topic in depth.

  17. COMPARISON OF METFORMIN WITH GLYBURIDE IN GESTATIONAL DIABETES: A DOUBLE BLIND RANDOMISED CLINICAL TRIAL

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    Miriam George

    2015-04-01

    Full Text Available AIMS : To compare the effects of metformin and glyburide on gestational d i abetes with regard to 1 . G lycaemic control in antenatal period . 2 . N eonatal outcomes . STUDY DESIGN : This is a prospective double blind randomized clinical trial . Patients were diagnosed to have Gestational diabetes mellitus with the 2 step test . Those cases not responding to diet therapy were randomized to two arms of treatment . Patients in Arm A were given starte d on glyburide ( n=24 : started at 2 . 5mg BID , next step 5mg and 2 . 5mg , then maximum dose of 5mg BID . If not controlled , Insulin was added . Those patients randomized to Arm B were given metformin : started at 500mg BID dosage , next step 850mg morning – 500mg with dinner , then maximum dose of 850mg BID . If not controlled , Insulin was added . The outcomes analyzed were maternal HbA1c in third trimester , patients who needed additional insulin for glycaemic control , patients with hypoglycaemic symptoms , maternal we ight gain in pregnancy , mode of delivery . Perinatal outcomes analyzed were birth weight , cord blood C peptide levels , neonatal complications - jaundice , hypoglycaemia , shoulder dystocia . ANALYSIS : Excluding the 1 case from each arm lost to follow up , we ha d 46 patients ( n=23 in each arm . Using SPSS software , characteristics were analyzed and using chi square test , the proportions in the two groups were compared . RESULTS : The two arms were comparable with regard to maternal and neonatal outcomes for gestational diabetes . No significant differences were found in treatment failure needing Insulin , rate of participants with glyc osyl ated haemoglobin above 6 . 5 , rate of large - for - gestational - age newborns , and there were no newborns with hypoglycaemia in bo th the arms . CONCLUSION : Metformin and glyburide showed equal safety and efficacy when used in treatment of gestational diabetes mellitus .

  18. What do midwives fear?

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    Dahlen, Hannah Grace; Caplice, Shea

    2014-12-01

    There is evidence that a significant number of women are fearful about birth but less is known about the fears of maternity health providers and how their fear may impact on the women they care for. The aim of this study was to determine the top fears midwives in Australia and New Zealand hold when it comes to caring for childbearing women. From 2009 to 2011, 17 workshops were held in Australia and New Zealand supporting over 700 midwives develop skills to keep birth normal. During the workshop midwives were asked to write their top fear on a piece of paper and return it to the presenters. Similar concepts were grouped together to form 8 major categories. In total 739 fears were reported and these were death of a baby (n=177), missing something that causes harm (n=176), obstetric emergencies (n=114), maternal death (n=83), being watched (n=68), being the cause of a negative birth experience (n=52), dealing with the unknown (n=36) and losing passion and confidence around normal birth (n=32). Student midwives were more concerned about knowing what to do, while homebirth midwives were mostly concerned with being blamed if something went wrong. There was consistency between the 17 groups of midwives regarding top fears held. Supporting midwives with workshops such as dealing with grief and loss and managing fear could help reduce their anxiety. Obstetric emergency skills workshops may help midwives feel more confident, especially those dealing with shoulder dystocia and PPH as they were most commonly recorded. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  19. A brief study on status and reason of caesarean section and its effect%浅谈剖宫产率增高的原因及对策

    Institute of Scientific and Technical Information of China (English)

    吴少平; 陈婉; 黄芳

    2010-01-01

    Objective To study the status and reason of caesarean section and its effect to obstetrics and gynecology department. Methods Caesarean section was the effective method to solve dystocia and some high risk pregnancy before 1980s. With the improving of anesthesia,caesarean section and newborn rescue technology, the cesarean rate was increased year after year. Results There were many reasons, the main one was the social factors, secondly, the diagnostic technique was improved and the reducing application of the vagina deliver technique, etc. ,There were man y complications after caesarean section, and the maternal mortality was higher than that of vaginal spontaneous labour. Conclusion Doctors are expected to correctly master the operative indication for caesare an section, increase vagina deliver technique, reduce cesarean section rate and improve obstetric quality.%20世纪80年代之前剖宫产是解决难产及解决某些高危妊娠的有效方法.随着麻醉,削宫产及新生儿抢救技术的提高,剖宫产率逐年增高.原因很多,主要原因有社会因素,其次是诊疗技术的提高以及阴道助产技术的减少等,削官产术后的并发症较多,产妇死亡率较阴道分娩高,希望临床产科医生正确掌握削宫产的手术指征,提高阴道助产技术,降低剖宫产率,提高产科质量.

  20. A prospective cohort study of the morbidity associated with operative vaginal deliveries performed by day and at night

    Science.gov (United States)

    Butler, Katherine; Ramphul, Meenakshi; Dunney, Clare; Farren, Maria; McSweeney, Aoife; McNamara, Karen; Murphy, Deirdre J

    2014-01-01

    Objective To evaluate maternal and neonatal outcomes associated with operative vaginal deliveries (OVDs) performed by day and at night. Design Prospective cohort study. Setting Urban maternity unit in Ireland with off-site consultant staff at night. Population All nulliparous women requiring an OVD with a term singleton fetus in a cephalic presentation from February to November 2013. Methods Delivery outcomes were compared for women who delivered by day (08:00–19:59) or at night (20:00–07:59). Main outcome measures The main outcomes included postpartum haemorrhage (PPH), anal sphincter tear and neonatal unit admission. Procedural factors included operator grade, sequential use of instruments and caesarean section. Results Of the 597 women who required an OVD, 296 (50%) delivered at night. Choice of instrument, place of delivery, sequential use of instruments and caesarean section did not differ significantly in relation to time of birth. Mid-grade operators performed less OVDs by day than at night, OR 0.60 (95% CI 0.43 to 0.83), and a consultant supervisor was more frequently present by day, OR 2.26 (95% CI 1.05 to 4.83). Shoulder dystocia occurred more commonly by day, OR 2.57 (95% CI 1.05 to 6.28). The incidence of PPH, anal sphincter tears, neonatal unit admission, fetal acidosis and neonatal trauma was similar by day and at night. The mean decision to delivery intervals were 12.0 and 12.6 min, respectively. Conclusions There was no evidence of an association between time of OVD and adverse perinatal outcomes despite off-site consultant obstetric support at night. PMID:25354825

  1. Antioxidative and Antitumor Effects of Isoflavones Isolated from the Leaves of Maackia fauriei .

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    Ki Hoon Yoon

    2016-01-01

    Full Text Available The flowers of Maackia fauriei have traditionally been used to treat hypertension, apoplexy, hemostasis, vaginal bleeding, and dystocia; moreover, the bark of this plant has been used as a natural dye. In the present study, activity-guided isolation of the leaves of M. fauriei yielded five isoflavones [genistein (1, pratensein (2, genistin (3, 2'-hydroxygenistein-7-O-β-D-glucopyranoside (4, and 2,3-dehydrokievitone (5]; three pterocarpans [medicarpin (6, maackiain (7, and 4-hydroxy maackiain (8]; and one flavonol [isoquercitrin (9]. To evaluate the anti-oxidative effects of these compounds, their 1,1-diphenyl-2-picryl-hydrazyl (DPPH radical scavenging assays and nitrotetrazolium blue chloride (NBT superoxide scavenging assays were measured. And the anti-tumor activity against human cancer cell lines in genital system, LNCaP, PC-3,HeLa and OVCAR-3 cells were evaluated by MTT method. Furthermore, the apoptosis of the PC-3 and HeLa cells were determined by by annexin V-FITC and PI their fluorescence was analyzed by flow cytometry. The flavonol (9, isoquercitrin and pterocarpan (8, 4-hydroxymaackiain showed strong anti-oxidative activities. Besides, the isoflavones (1-5 did not showed anti-oxidative activity and the isoflavones (1-5 and pterocarpans (6-8 generally showed the potent cytotoxic activity against all of four human genital cancer cells. Especially, 2,3-dehydrokievitone (5 which had a prenyl group at C-8 position of the A-ring exhibited strong cytotoxic activity and induced apoptosis efficiently in cancer cells.

  2. Screening of selected indicators of dairy cattle welfare in Macedonia

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    Miroslav Radeski

    2015-03-01

    Full Text Available The welfare state of cattle in dairy farms in Macedonia has never been assessed previously. The objective of this study was to perform screening analysis of dairy cows welfare and to test the practical implementation of the Welfare Quality® Assessment protocol for cattle in dairy farms in Macedonia. In ten small scale and large scale tie stall farms 23 measures were recorded related to 9 welfare criteria of 4 welfare principles (WP described in the Welfare Quality® Assessment protocol for dairy cows. The mean percentage of very lean cows was 40.5±9.1%. All assessed farms were not providing access to pasture and an outdoor loafing area. Regarding cleanliness, the presence of dirty udder, upper leg/flank and lower leg was 65.2±9.0%, 85.5±8.0% and 86.5±5.8%, respectively. The overall prevalence of lameness was 5.6±5.0%, and for mild and severe alterations it was 30.8±5.8% and 54.1±4.6%, respectively. The ocular and vulvar discharge, diarrhea, dystocia, percentage of downer cows and mortality rate exceeded the warning and alarm threshold. The avoidance – distance test classified 70.4±6.8% as animals that can be touched or approached closer than 50cm, with overall score of 42.9±3.5. This screening reveals that the most welfare concerns are found in the WP Good Feeding and Good Housing. The on-farm welfare assessment using the full protocol on a representative sample of farms in the country is highly recommended for emphasizing the key points for improving the animal welfare in Macedonian dairy farms.

  3. Reproductive tract tumours: the scourge of woman reproduction ails Indian rhinoceroses.

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    Robert Hermes

    Full Text Available In Indian rhinoceros, extensive leiomyoma, a benign smooth muscle tumour, was sporadically diagnosed post mortem and commonly thought of as contributing factor for reduced fecundity of this species in captivity. However, to date, the prevalence of reproductive tract tumours and their relevance for fecundity are unknown. Our analysis of the international studbook now reveals that females cease reproducing at the age of 18.1±1.2 years; equivalent to a reproductive lifespan of just 9.5±1.3 years. This short reproductive life is in sharp contrast to their longevity in captivity of over 40 years. Here we show, after examining 42% of the captive female population, that age-related genital tract tumours are highly prevalent in this endangered species. Growth and development of these tumours was found to be age-related, starting from the age of 10 years. All females older than 12 years had developed genital tumours, just 7-9 years past maturity. Tumour sizes ranged from 1.5-10 cm. With age, tumours became more numerous, sometimes merging into one large diffuse tumour mass. These tumours, primarily vaginal and cervical, presumably cause widespread young-age infertility by the age of 18 years. In few cases, tumour necrosis suggested possible malignancy of tumours. Possible consequences of such genital tract tumour infestation are hindered intromission, pain during mating, hampered sperm passage, risk of ascending infection during pregnancy, dystocia, or chronic vaginal bleeding. In humans, leiomyoma affect up to 80% of pre-menopause women. While a leading cause for infertility, pregnancy is known to reduce the risk of tumour development. However, different from human, surgical intervention is not a viable treatment option in rhinoceroses. Thus, in analogy to humans, we suggest early onset and seamless consecutive pregnancies to help reduce prevalence of this disease, better maintain a self-sustained captive population and improve animal welfare.

  4. Design of a Serious Game for Handling Obstetrical Emergencies

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    Bot-Robin, Virginie; Libessart, Aurélien; Doucède, Guillaume; Cosson, Michel; Rubod, Chrystèle

    2016-01-01

    Background The emergence of new technologies in the obstetrical field should lead to the development of learning applications, specifically for obstetrical emergencies. Many childbirth simulations have been recently developed. However, to date none of them have been integrated into a serious game. Objective Our objective was to design a new type of immersive serious game, using virtual glasses to facilitate the learning of pregnancy and childbirth pathologies. We have elaborated a new game engine, placing the student in some maternity emergency situations and delivery room simulations. Methods A gynecologist initially wrote a scenario based on a real clinical situation. He also designed, along with an educational engineer, a tree diagram, which served as a guide for dialogues and actions. A game engine, especially developed for this case, enabled us to connect actions to the graphic universe (fully 3D modeled and based on photographic references). We used the Oculus Rift in order to immerse the player in virtual reality. Each action in the game was linked to a certain number of score points, which could either be positive or negative. Results Different pathological pregnancy situations have been targeted and are as follows: care of spontaneous miscarriage, threat of preterm birth, forceps operative delivery for fetal abnormal heart rate, and reduction of a shoulder dystocia. The first phase immerses the learner into an action scene, as a doctor. The second phase ask the student to make a diagnosis. Once the diagnosis is made, different treatments are suggested. Conclusions Our serious game offers a new perspective for obstetrical emergency management trainings and provides students with active learning by immersing them into an environment, which recreates all or part of the real obstetrical world of emergency. It is consistent with the latest recommendations, which clarify the importance of simulation in teaching and in ongoing professional development. PMID

  5. Midwives’ Clinical Reasons for Performing Episiotomies in the Kurdistan Region; Are they evidence-based?

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    Hamdia M. Ahmed

    2014-08-01

    Full Text Available Objectives: An episiotomy is one of the most common obstetric surgical procedures and is performed mainly by midwives. The decision to perform an episiotomy depends on related clinical factors. This study aimed to find out midwives’ reasons for performing episiotomies and to identify the relationship between these reasons and the demographic characteristics of the midwives. Methods: This cross-sectional study was conducted between 1st July and 30th September 2013 in three governmental maternity teaching hospitals in the three main cities of the Kurdistan Region of Iraq. All of the midwives who had worked in the delivery rooms of these hospitals for at least one year were invited to participate in the study (n = 53. Data were collected through interviews with midwives as well as via a questionnaire constructed for the purpose of the study. The questionnaire sought to determine: midwives’ demographic characteristics; type of episiotomy performed; authority of the decision to perform the procedure, and reasons for performing episiotomies. Results: The main clinical reasons reported by midwives for performing an episiotomy were: macrosomia/large fetus (38, 71.7%, breech delivery (31, 58.5%, shoulder dystocia (29, 54.7%, anticipated perineal tear (27, 50.9% and fetal distress (27, 50.9%. There was a significant association between the frequency of these reasons and midwives’ total experience in delivery rooms as well as their levels of education. Conclusion: Most of the reasons given by the midwives for performing episiotomies were not evidencebased. Age, years of experience, specialties and level of education also had an effect on midwives’ reasons for performing episiotomies.

  6. Resultados da assistência ao parto no Centro de Parto Normal Dr. David Capistrano da Costa Filho em Belo Horizonte, Minas Gerais, Brasil Results of childbirth care at a birthing center in Belo Horizonte, Minas Gerais, Brazil

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    Sibylle Emilie Vogt Campos

    2007-06-01

    Full Text Available A qualidade da assistência prestada em Centro de Parto Normal (CPN por enfermeira obstetra é amplamente questionada. Foi realizado um estudo descritivo e retrospectivo de 2.117 partos ocorridos entre janeiro de 2002 e julho 2003, no CPN Dr. David Capistrano da Costa Filho, em Belo Horizonte. Entre os principais resultados da assistência, destacam-se a taxa de transferência materna com 11,4%; a taxa de cesárea com 2,2%; a taxa de admissão em Centro de Tratamento Intensivo (CTI neonatal de 1,2%; e a taxa de Apgar This was a descriptive and retrospective study of 2,117 deliveries from January 2002 to July 2003 at the Dr. David Capistrano da Costa Filho Birthing Center in Belo Horizonte, Minas Gerais, Brazil. Widespread questions have been raised concerning the quality of services provided at birthing centers by obstetric nurses. The results of the current study were: 11.4% maternal transfer rate; 2.2% cesarean sections; 1.2% neonatal ICU admissions; and 1% 5-minute Apgar scores below 7. Delivery dystocia and the request for epidural anesthesia were the main reasons for maternal transfer, and respiratory distress was the main cause of neonatal ICU admission. Corrected neonatal mortality was 2 per 1,000 live births. The results at this birthing center did not differ significantly from those in a review of the international literature. The most striking finding was the low cesarean rate. Comparative studies and more comprehensive national data on low-risk gestations are needed.

  7. Effects of epidural lidocaine analgesia on labor and delivery: A randomized, prospective, controlled trial

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    Nafisi Shahram

    2006-12-01

    Full Text Available Abstract Background Whether epidural analgesia for labor prolongs the active-first and second labor stages and increases the risk of vacuum-assisted delivery is a controversial topic. Our study was conducted to answer the question: does lumbar epidural analgesia with lidocaine affect the progress of labor in our obstetric population? Method 395 healthy, nulliparous women, at term, presented in spontaneous labor with a singleton vertex presentation. These patients were randomized to receive analgesia either, epidural with bolus doses of 1% lidocaine or intravenous, with meperidine 25 to 50 mg when their cervix was dilated to 4 centimeters. The duration of the active-first and second stages of labor and the neonatal apgar scores were recorded, in each patient. The total number of vacuum-assisted and cesarean deliveries were also measured. Results 197 women were randomized to the epidural group. 198 women were randomized to the single-dose intravenous meperidine group. There was no statistical difference in rates of vacuum-assisted delivery rate. Cesarean deliveries, as a consequence of fetal bradycardia or dystocia, did not differ significantly between the groups. Differences in the duration of the active-first and the second stages of labor were not statistically significant. The number of newborns with 1-min and 5-min Apgar scores less than 7, did not differ significantly between both analgesia groups. Conclusion Epidural analgesia with 1% lidocaine does not prolong the active-first and second stages of labor and does not increase vacuum-assisted or cesarean delivery rate.

  8. The effect of early oxytocin augmentation in labor: a meta-analysis.

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    Wei, Shu-Qin; Luo, Zhong-Cheng; Xu, Hairong; Fraser, William D

    2009-09-01

    To estimate the effects of early augmentation with oxytocin for slow progress of labor on the delivery method and on indicators of maternal and neonatal morbidity. We conducted electronic database searches of PubMed, MEDLINE, EMBASE, and the Cochrane Library for articles published through February 2009 using the keywords "oxytocin," "augmentation," "active management of labor," "cesarean section," and "labor." Primary authors were contacted directly if the data sought were unavailable. We included randomized controlled trials comparing early oxytocin augmentation with a more conservative approach to care in labor. We included only those studies in which membrane management was similar in the two groups. Early oxytocin augmentation was defined as immediate oxytocin administration when dystocia was identified. Data were extracted by two authors independently and evaluated for potential sources of bias. Relative risk (RR) and 95% confidence interval (CI) were calculated using fixed and random effects models. Nine trials with 1,983 women met the inclusion criteria. Early oxytocin was associated with an increase in the probability of spontaneous vaginal delivery (RR 1.09, 95% CI 1.03-1.17). For every 20 patients treated with early oxytocin augmentation, one additional spontaneous vaginal delivery is expected. Although the point estimate for the effect on cesarean delivery (RR 0.87, 95% CI 0.71-1.06) and on operative vaginal delivery (RR 0.84, 95% CI 0.70-1.00) showed modest protective effects, the CIs for both estimates included the null effect. A decrease in antibiotic use (RR 0.45, 95% CI 0.21-0.99) was observed with early intervention. Early oxytocin was associated with an increased risk of hyperstimulation (RR 2.90, 95% CI 1.21-6.94) without evidence of adverse neonatal effects. Women in the early oxytocin group reported higher levels of pain and discomfort in labor. Early oxytocin for augmentation in labor is associated with an increase in spontaneous vaginal

  9. Discontinuation of oxytocin in the active phase of labor.

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    Girard, Bénédicte; Vardon, Delphine; Creveuil, Christian; Herlicoviez, Michel; Dreyfus, Michel

    2009-01-01

    To show that early discontinuation of oxytocin will not increase the mean duration of the active labor phase in a clinically significant way. Controlled non-inferiority study. Department of Obstetrics and Gynecology, University of Caen, Clemenceau Hospital, France. A total of 138 women with singleton pregnancy and a vertex presentation of over 34 gestational weeks, presenting a medical indication of induction of labor or a dystocia at onset of labor, from May 2005 to June 2006. Two parallel groups were compared: continuation of oxytocin until delivery versus discontinuation of oxytocin at the onset of the active phase. The clinically acceptable increase in mean duration of the active phase of labor (non-inferiority margin) was set at 60 minutes. Primary outcome measure was duration of the active labor phase. Secondary outcome measures included total duration of labor, parameters concerning oxytocin use, rates of uterine hyperstimulation and fetal heart rate (FHR) abnormalities, and mode of delivery. Some neonatal outcomes were also analyzed. Equivalence of the two strategies (continuation vs. discontinuation of oxytocin) was not demonstrated (p=0.97 testing for non-inferiority), the active phase even being significantly longer by a mean of 113 minutes (p=0.0001 testing for superiority). The rates of cesarean sections, alterations of FHR and delivery hemorrhage were higher when oxytocin was continued, but not significantly. There were significantly more infants hospitalized in neonatology when oxytocin was continued (p=0.028). Discontinuation of oxytocin at the onset of the active phase prolongs labor. We found no argument for discontinuing the infusion of oxytocin at the onset of the active phase.

  10. Preliminary validation of assays to measure parameters of calcium metabolism in captive Asian and African elephants in western Europe.

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    van Sonsbeek, Gerda R; van der Kolk, Johannes H; van Leeuwen, Johannes P T M; Schaftenaar, Willem

    2011-05-01

    Hypocalcemia is a well known cause of dystocia in animals, including elephants in captivity. In order to study calcium metabolism in elephants, it is of utmost importance to use properly validated assays, as these might be prone to specific matrix effects in elephant blood. The aim of the current study was to conduct preliminary work for validation of various parameters involved in calcium metabolism in both blood and urine of captive elephants. Basal values of these parameters were compared between Asian elephants (Elephas maximus) and African elephants (Loxodonta africana). Preliminary testing of total calcium, inorganic phosphorus, and creatinine appeared valid for use in plasma and creatinine in urine in both species. Furthermore, measurements of bone alkaline phosphatase and N-terminal telopeptide of type I collagen appeared valid for use in Asian elephants. Mean heparinized plasma ionized calcium concentration and pH were not significantly affected by 3 cycles of freezing and thawing. Storage at 4 °C, room temperature, and 37 °C for 6, 12, and 24 hr did not alter the heparinized plasma ionized calcium concentration in Asian elephants. The following linear regression equation using pH (range: 6.858-7.887) and ionized calcium concentration in heparinized plasma was utilized: iCa(7.4) (mmol/l) = -2.1075 + 0.3130·pH(actual) + 0.8296·iCa(actual) (mmol/l). Mean basal values for pH and plasma in Asian elephant whole blood were 7.40 ± 0.048 and 7.49 ± 0.077, respectively. The urinary specific gravity and creatinine concentrations in both Asian and African elephants were significantly correlated and both were significantly lower in Asian elephants.

  11. Invited review: piglet mortality: management solutions.

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    Kirkden, R D; Broom, D M; Andersen, I L

    2013-07-01

    Preweaning mortality varies greatly among herds and this is partly attributed to differences in farrowing house management. In this review, we describe the various management strategies than can be adopted to decrease mortality and critically examine the evidence that exists to support their use. First, we consider which management procedures are effective against specific causes of death: intrapartum stillbirth, hypothermia, starvation, disease, crushing, and savaging. The most effective techniques include intervention to assist dystocic sows, measures to prevent and treat sow hypogalactia, good farrowing house hygiene, providing newborn piglets with a warm microenvironment, early fostering of supernumerary piglets, methods that assist small and weak piglets to breathe and obtain colostrum, and intervention to prevent deaths from crushing and savaging. The provision of nest-building material and modifications to the pen to assist the sow when lying down may also be beneficial, but the evidence is less clear. Because most deaths occur around the time of farrowing and during the first few days of life, the periparturient period is a particularly important time for management interventions intended to reduce piglet mortality. A number of procedures require a stockperson to be present during and immediately after farrowing. Second, we consider the benefits of farrowing supervision for preweaning mortality in general, focusing particularly on methods for the treatment of dystocia and programs of piglet care that combine multiple procedures. Third, we discuss the need for good stockmanship if farrowing supervision is to be effective. Stockmanship refers not only to technical skills but also to the manner in which sows are handled because this influences their fearfulness of humans. We conclude that piglet survival can be improved by a range of management procedures, many of which occur in the perinatal period and require the supervision of farrowing by trained staff

  12. Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials.

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    Magro-Malosso, E R; Saccone, G; Chen, M; Navathe, R; Di Tommaso, M; Berghella, V

    2017-02-01

    Several randomized controlled trials (RCTs) compared induction of labour with expectant management in non-diabetic women with suspected fetal macrosomia. To evaluate the effects of labour induction for suspected fetal macrosomia. Literature search in electronic databases. We included all RCTs of suspected fetal macrosomia comparing labour induction with expectant management in term pregnancy. The primary outcome was the incidence of caesarean delivery. Four RCTs, including 1190 non-diabetic women with suspected fetal macrosomia at term, were analysed. Pooled data did not show a significant difference in incidence of caesarean delivery [relative risk (RR) 0.91, 95% confidence interval (CI) 0.76-1.09], operative and spontaneous vaginal delivery, shoulder dystocia, intracranial haemorrhage, brachial plexus palsy, Apgar score <7 at 5 min, cord blood pH <7, and mean birth weight comparing women who received induction of labour with those who were managed expectantly. The induction group had a significantly lower time to delivery (mean difference -7.55 days, 95% CI -8.20 to -6.89), lower rate of birth weight ≥4000 g (RR 0.50, 95% CI 0.42-0.59) and ≥4500 g (RR 0.21, 95% CI 0.11-0.39), and lower incidence of fetal fractures (RR 0.17, 95% CI 0.03-0.79) compared with expectant management group. Induction of labour ≥38 weeks for suspected fetal macrosomia is associated with a significant decrease in fetal fractures, and therefore can be considered as a reasonable option. TWEETABLE ABSTRACT: #Induction of labour for #macrosomia improves neonatal outcome. © 2016 Royal College of Obstetricians and Gynaecologists.

  13. 一例犬子宫蓄脓的实验室诊断与治疗%Diagnosis in Lab and Treatment of One Case of Canine Pyometra

    Institute of Scientific and Technical Information of China (English)

    李基棕; 文明; 马喆; 杨通灵; 王开功; 周碧君

    2011-01-01

    Canine pyometra is a disease which caused by pus product in uterine cavity and abnormal endometrium secondary infection by pathogens.Genital dirty, breeding, postnatal infection or stillbirth, dystocia midwifery infection can cause disease.One case of dog, therapia in animal hospital of Guizhou University, confirmed the disease of pyometra with clinical examination and laboratory examination, surgery was taken and successful; isolation and identification of pathogen and drug sensitivity tests.The results showed that the pathogen was Escherichia, and the highest sensitive drug were Cephalothin, Cephalothin,Kanamycin, Gentamycin.These investigations provided an important reference data for diagnosis, prevention and early drug choices for this disease.%犬子宫蓄脓是异常的子宫内膜继发病原微生物感染引起的子宫腔内积有脓液的疾病.外阴部不洁、配种、产后感染或死胎、难产助产感染等均可引起该病.笔者通过对贵州大学动物医院收治的一例病犬进行临床检查和实验室检查,确诊为子宫蓄脓后采取手术疗法治疗并取得成功;对子宫内容物进行病原菌分离鉴定、药敏试验,病原学分析显示,此犬子宫内病原菌为大肠杆菌,且该菌株对先锋霉素、头孢噻吩、卡那霉素和庆大霉素等药物敏感.本试验为犬子宫蓄脓诊治,预防及前期的药物选择提供临床指导.

  14. Thyroid dysfunction during pregnancy and evaluation of its results

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    Fatih Taşkesen

    2011-06-01

    Full Text Available In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women.Materials and methos: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH, free tri-iyodotironin (T3, free thyroxine (T4 levels for all patients were studied. Antithyroidal peroxidase (anti-TPO and Anti-thyroglobulin (anti-Tg parameters were measured if they were necessary. The relationship between thyroid functions and complications such as eclampsia, preeclampsia, maternal anemia, postpartum hemorrhage, fetal anomalies, shoulder dystocia, neonatal hypoglycemia was examined.Results: Hypothyroidism was found 18 of cases and hyperthyroidism was found 4 of them. The mean age of patients in the study was 26.42 (± 8.42. The mean values were 1.86 ± 0.19 μIU/mL for TSH, 1.15 ± 0.29 ng/mL for free T4 and 2.90 ± 0.31 pg/mL for free T3 respectively. Hashimoto’s thyroiditis (9 cases, 50 % was the most frequent etiology for patients with hypothyroidism. Other etiologic factors for hypothyroidism were found to be for 4 cases as (22.2%, iatrogenic (previously undergone thyroidectomy and 5 cases as (37.8% a lack of iodine. Maternal anemia was observed in 5 (27.78% cases with hypothyroidism. Preeclampsia was observed 16.67% in patients with hypothyroidism.Conclusion: Observed thyroid dysfunction in pregnant women may cause serious maternal and fetal complications. For disorders of thyroid function during pregnancy, to provide the necessary treatment at the appropriate time is important to prevent complications of mother and fetus. J Clin Exp Invest 2011;2(2:196-201

  15. Dairy farmer attitudes and empathy toward animals are associated with animal welfare indicators.

    Science.gov (United States)

    Kielland, C; Skjerve, E; Osterås, O; Zanella, A J

    2010-07-01

    Attitudes and empathy of farmers influence human-animal interaction, thereby affecting their behavior toward animals. The goal was to investigate how measures of attitude and empathy toward animals were associated with animal welfare indicators such as milk yield, mastitis incidence, fertility index, and the prevalence of skin lesions on cows. To assess empathy toward animals, a photo-based pain assessment instrument was developed depicting various conditions that could be associated with some degree of pain in cattle and included questions aimed at assessing attitudes toward animals. Photos of painful conditions are useful in eliciting measurable empathic responses to pain in humans. A total of 221 farmers were sampled via e-mail and 154 responses were obtained. In the first analysis, farmers were categorized into 2 groups according to their agreement or disagreement with the attitude statement "animals experience physical pain as humans do." In the second analysis, farmers were assigned a median pain assessment score obtained from their estimates on the visual analog scale of 21 conditions assumed painful for cattle. In the third analysis, farmers were clustered in 3 groups according to their visual analog scale responses. Three conditions were ranked as the most painful: fracture of tuber coxae, dystocia, and serious mastitis. Farmers with positive attitudes toward animals scored 2 points higher on their empathy score compared with farmers with negative attitudes. Personal experience with each additional condition resulted in a 0.09 higher score. Cluster analysis revealed 3 groups. Farmers in group 3 had the highest median pain assessment score (6.7+/-0.2), indicating a high level of empathy and a positive attitude toward animals. They had the lowest prevalence of skin lesions over the carpus (24+/-6%) and the lowest milk production (6,705+/-202 kg). The complex associations between indicators of empathy and attitudes with relevant welfare outcomes suggest that

  16. Induction of labour at or near term for suspected fetal macrosomia.

    Science.gov (United States)

    Boulvain, Michel; Irion, Olivier; Dowswell, Therese; Thornton, Jim G

    2016-05-22

    Women with a suspected large-for-dates fetus or a fetus with suspected macrosomia (birthweight greater than 4000 g) are at risk of operative birth or caesarean section. The baby is also at increased risk of shoulder dystocia and trauma, in particular fractures and brachial plexus injury. Induction of labour may reduce these risks by decreasing the birthweight, but may also lead to longer labours and an increased risk of caesarean section. To assess the effects of a policy of labour induction at or shortly before term (37 to 40 weeks) for suspected fetal macrosomia on the way of giving birth and maternal or perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2016), contacted trial authors and searched reference lists of retrieved studies. Randomised trials of induction of labour for suspected fetal macrosomia. Review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We contacted study authors for additional information. For key outcomes the quality of the evidence was assessed using the GRADE approach. We included four trials, involving 1190 women. It was not possible to blind women and staff to the intervention, but for other 'Risk of bias' domains these studies were assessed as being at low or unclear risk of bias.Compared to expectant management, there was no clear effect of induction of labour for suspected macrosomia on the risk of caesarean section (risk ratio (RR) 0.91, 95% confidence interval (CI) 0.76 to 1.09; 1190 women; four trials, moderate-quality evidence) or instrumental delivery (RR 0.86, 95% CI 0.65 to 1.13; 1190 women; four trials, low-quality evidence). Shoulder dystocia (RR 0.60, 95% CI 0.37 to 0.98; 1190 women; four trials, moderate-quality evidence), and fracture (any) (RR 0.20, 95% CI 0.05 to 0.79; 1190 women; four studies, high-quality evidence) were reduced in the induction of labour group. There were no clear differences

  17. Subclinical hypocalcemia, plasma biochemical parameters, lipid metabolism, postpartum disease, and fertility in postparturient dairy cows.

    Science.gov (United States)

    Chamberlin, W G; Middleton, J R; Spain, J N; Johnson, G C; Ellersieck, M R; Pithua, P

    2013-01-01

    occurrence of clinical mastitis, ketosis, displaced abomasum, dystocia, retained placenta, metritis, or fertility measures (percentage cycling at 50-60 d postpartum, services per conception, or days open). These data suggest that early lactation fatty acid metabolism differs between cows with subclinical hypocalcemia and their normocalcemic counterparts.

  18. Description and factors of variation of the overall health score in French dairy cattle herds using the Welfare Quality(®) assessment protocol.

    Science.gov (United States)

    Coignard, M; Guatteo, R; Veissier, I; de Boyer des Roches, A; Mounier, L; Lehébel, A; Bareille, N

    2013-11-01

    Extensive information is available in the literature on the specific risk factors of the main health disorders afflicting dairy cattle herds. However, it remains difficult to manage a herd's overall health because measures to control one risk factor can exacerbate the risk of another disease. To achieve and maintain good overall herd health, livestock systems and management practices need to simultaneously take into account all of the main health disorders. We aimed to identify the characteristics of systems and practices conducive to good herd health using the Welfare Quality(®) assessment protocol for cattle. This protocol allows an assessment of the level of health and welfare at the herd level according to the opinion of a selected group of 13 experts from animal sciences. Our objectives were to (i) describe the distribution of dairy herds' health scores in a representative sample of French dairy cattle herds, and (ii) to investigate systems (housing system, milking system, herd size, breed, farm location) and management practices associated with variations of the overall health score of dairy herds. This protocol was carried out on 130 farms between December 2010 and March 2011. A multivariable analysis of variance (ANOVA) was performed to investigate the factors of variation of the overall health score at the herd level. The overall health scores of the farms in the sample were classified as moderate for the vast majority of farms (95.4%) (mainly due to subclinical mastitis, dystocia and pain induced by disbudding/dehorning) and varied little between farms. Some livestock systems were associated with a higher overall health score: straw yards and milking parlors (P<0.0001), highland vs. lowland locations (P=0.013), Montbeliarde rather than Holstein breeds (P=0.006). Some management practices also were associated with a higher level of health: medium herd average parity (P=0.03), low proportion of dirty cows (P=0.002) and low proportion of cows with abnormal

  19. 剖宫产对新生儿近远期的影响%Recent and long-term effection of cesarean section on newborn infants

    Institute of Scientific and Technical Information of China (English)

    吴立志; 周晓玉

    2015-01-01

    Although the cesarean section has become an effective means to solve dystocia,high - risk pregnan-cy and other critical obstetrical disease,but the morbidity rate and hospitalization rate of newborn did not decreased obviously because of the continuous increasing of cesarean section rate. Contrary,in recent years,many domestic and foreign researches have found that,compared with normal vaginal delivery babies,cesarean section newborn infants have higher related disease incidence rate after birth,especially respiratory distress sydrome,transient tachypnea of newborn infants,persistent pulmonary hypertension and infection,and more attention should be paid to the fact that cesarean section children are more prone to allergic and immune system diseases as well as neuropsychiatric related diseases. Therefore,this article aims at integrating the researches and providing an overview on recent and long - term effection on newborn infants.%虽然剖宫产已逐渐成为解决难产和高危妊娠等产科危重症的有效手段,但新生儿疾病的发病率及其 NICU 住院率并未因剖宫产率的不断增高而明显减少,相反,近年来国内外诸多研究发现相比较正常阴道分娩儿,剖宫产儿在出生后有较高的新生儿相关疾病发病率,以呼吸窘迫综合征、新生儿暂时性呼吸困难、持续肺动脉高压、感染等最为常见,更为值得关注的是剖宫产儿在儿童期和成年期也更易于患过敏性及免疫系统疾病和神经精神相关性疾病。现就剖宫产对新生儿近远期的影响进行综述。

  20. Mortalidade perinatal em cabritos no semi-árido da Paraíba Perinatal mortality in kids in the semiarid region of Paraíba, Brazil

    Directory of Open Access Journals (Sweden)

    Josemar Marinho de Medeiros

    2005-12-01

    Full Text Available As causas de mortalidade perinatal em cabritos foram estudadas de maio de 2002 a agosto de 2004. Em 118 cabritos necropsiados as causas de morte foram: infecção neonatal (50%, distocia (12,71%, complexo hipotermia/inanição (11,86%, malformações (7,62%, síndrome do cabrito mole (6,77% e abortos (1,69%. Com relação ao momento da morte 1,69% dos cabritos morreram antes do parto, 16,94% durante o parto e 81,34 % após o nascimento. A alta ocorrência de infecções neonatais, distocias e hipotermia/inanição é provavelmente devido a fatores relacionados com erros no manejo sanitário, reprodutivo e nutricional. Artogripose dos membros anteriores foi a principal malformação observada. Este defeito é endêmico em rebanhos de caprinos no semi-árido do Brasil. A maioria das mortes ocorreu após o nascimento (25,42% e do quarto ao vigésimo dia de vida (38,98% sugerindo que o cuidado com os cabritos durante os primeiros 28 dias de vida é importante para melhorar as taxas de sobrevivência dos mesmos.The causes of perinatal kid mortality were studied from May 2002 to August 2004 in the semiarid region of Paraíba. In 118 necropsied kids the frequency of different causes of death were neonatal infections (50%, distocia (12.71%, hypothermia/starvation (11.86%, malformations (7.62%, floppy kid (6.77% and abortions (1.69%. Regarding the time of death, 1.69% of the kids died before parturition, 16.94% during the parturition and 81.34 % after birth. The high occurrence of neonatal infections, dystocias, and hypothermia/starvation is probably to due to factors related with error in the sanitary, reproductive and nutritional management. Arthrogryposis of the forelimbs was the main malformation observed. This defect is endemic in goat flocks in the semi-arid of Brazil. Most deaths occurred after birth (25.42% and from the 4th to the 28th day of life (38.98% suggesting that care with the kids during their first 28 days of life is important for the

  1. Supplementing fresh bovine colostrum with gut-active carbohydrates reduces passive transfer of immunoglobulin G in Holstein dairy calves.

    Science.gov (United States)

    Brady, M P; Godden, S M; Haines, D M

    2015-09-01

    High concentrations of coliform bacteria in maternal colostrum (MC) have been associated with reduced IgG absorption in calves. Mannan-oligosaccharide, a gut-active carbohydrate (GAC) derived from yeast cell wall, has been shown to adsorb pathogens expressing type-1-fimbriae, reducing their ability to colonize the gastrointestinal tract. The objective of this study was to investigate if addition of a GAC to colostrum would result in increased IgG absorption in newborn calves. Newborn Holstein heifer and bull calves were enrolled in summer 2012 at a commercial transition cow facility in western Wisconsin. Each day, 7.6-L pools of fresh, first milking MC were created, split into 3.8-L aliquots, and refrigerated until feeding. Eligible newborn calves were removed from the dam 30 to 60min after birth, weighed, and randomly assigned to be fed either 3.8 L of the MC pool (control) or 3.8 L of the MC pool with 30 g of GAC mixed in immediately before feeding. Duplicate 10-mL samples of colostrum were collected and frozen at -20°C before feeding (and before addition of GAC) for bacterial culture and IgG determination. A 10-mL venous blood sample was collected from calves before feeding colostrum and 24 h after colostrum feeding, for laboratory determination of serum IgG using radial immunodiffusion analysis. Colostrum and calf characteristics, including colostrum IgG concentration (g/L), colostrum bacteria counts (log10, cfu/mL), calf dystocia scores (1 to 4), birth weights (kg), and age at first feeding (min) were not different between the group fed GAC (n=47) and the control group (n=48). Mixed linear regression analysis showed that calves fed colostrum supplemented with 30 g of GAC had lower mean (standard error) apparent efficiency of absorption of IgG and lower serum IgG concentrations at 24 h [23.9% (1.0); IgG=24.0 (1.1) g/L] than did control calves [30.4% (1.0); IgG=30.8 (1.0) g/L]. Given the negative effect observed in this study, it is not recommended that fresh

  2. IMPACT OF ADVANCED REPRODUCTIVE BIOTECHNOLOGIES ON ANIMAL HEALTH AND LIVESTOCK PRODUCTION EL IMPACTO DE LA BIOTECNOLOGÍA REPRODUCTIVA AVANZADA EN LA SALUD Y LA REPRODUCCIÓN ANIMAL

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    Bertolini Marcelo

    2009-05-01

    Full Text Available The in vitro production of bovine embryos by in vitro fertilization or nuclear transfer procedures is a powerful tool in wide use for scientific, conservationist and commercial purposes. However, developmental abnormalities are unpredictable consequences of such in vitro embryo manipulations, which may interfere with the pattern of fetal and placental growth and life ex utero, in a set of symptoms collectively called Large Offspring Syndrome (LOS. The economical significance of the syndrome is associated with increased rates of pregnancy losses, placental and fetal aberrations that culminate in abortion, hydrops of the fetal membranes, prolonged gestation, diminished signs of parturition, dystocia, and birth of large calves with lower postnatal survival. Lower pregnancy rates with higher gestational and postnatal losses represent significant economical losses for a lower prolificacy. The understanding of mechanisms of prenatal growth in normal development and in those related to the syndrome will be of significance for prevention or attenuation of abnormalities of common occurrence in cattle, with potential direct scientific and economical implications.La producción in vitro de embriones por fertilización in vitro o por procedimientos de transferencia de núcleos es una herramienta poderosa utilizada ampliamente para propósitos científicos, conservacionistas y comerciales. Sin embargo, las alteraciones del desarrollo son consecuencias impredecibles de tales manipulaciones in vitro, que pueden interferir con el patrón de de crecimiento fetal y placentario y la vida ex utero, que se agrupan en unos síntomas conocidos colectivamente como el síndrome del ternero grande (LOS. La importancia económica del síndrome está asociada con un incremento en las pérdidas gestacionales, aberraciones placentarias y fetales que culminan en aborto, condiciones hidópicas de las membranas fetales, gestaciones prolongadas, disminución en los signos de

  3. Milk fever and subclinical hypocalcaemia--an evaluation of parameters on incidence risk, diagnosis, risk factors and biological effects as input for a decision support system for disease control.

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    Houe, H; Østergaard, S; Thilsing-Hansen, T; Jørgensen, R J; Larsen, T; Sørensen, J T; Agger, J F; Blom, J Y

    2001-01-01

    other diseases and the effect on milk production, body weight and culling. The reproductive disorders included most importantly dystocia, uterine prolapse, retained placenta, metritis and repeat breeding, and occurrence of other diseases included ketosis, displaced abomasum and mastitis. The documentation was substantial and often quantifiable within certain limits. Overall it is concluded that the present documentation on milk fever concerning incidence, diagnosis, risk factors and effects seems sufficient for a systematic inclusion in a decision support system. A model on milk fever should take into consideration the variation in biological data and individual herd characteristics. The inclusion of subclinical hypocalcaemia would be more uncertain and probably should await further documentation on possibilities of determining the herd level incidence and also the effect of this condition on production.

  4. Comparative study on production, reproduction and functional traits between Fleckvieh and Braunvieh cattle

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    Ludovic-Toma Cziszter

    2017-05-01

    Full Text Available Objective Aim of the current comparative study was to evaluate production outputs, reproduction efficiency and functional traits in dual-purpose Fleckvieh and Braunvieh cows, reared under temperate European conditions. Methods A data-set from 414 Fleckvieh and 42 Braunvieh cows and 799 lactations was analysed. ID tag number, milk yield per milking session, number of steps/interval and milk conductivity were recorded and collected daily using AfiMilk 3.076 A-DU software (Afimilk Ltd., Kibbutz, Israel. Production and milk quality data were taken from the results of the official performance recordings and the reproductive outputs of cows were recorded by the research stations veterinarians. Comparisons between the two genotypes were carried out using the one way analysis of variance protocol, with categorical factor being considered the breed of cows. All the statistical inferences were carried out using Statistica software (StatSoft Inc., Tulsa, OK, USA. Results Fleckvieh cows significantly outperformed (p≤0.05 the Braunvieh herd, with average milk yields of 5,252.1±35.79 kg and 4,897.6±128.94 kg, respectively. Age at first calving was significantly (p≤0.01 influenced by the breed, with Fleckvieh heifers being more precocious (32.8±0.29 mo compared to those of Braunvieh breed (35.7±0.84 mo. Reproduction efficiency as defined by the number of inseminations per gestation, calving interval, dystocia, days dry and days open, was not influenced by genotype (p>0.05. Incidences of sub-clinical mastitis, clinical mastitis, lameness and abortions were not influenced by the breed factor (p>0.05. Stayability of cows was significantly (p≤0.001 influenced by genotype, with Braunvieh cows having an average age at culling of 117.88±11.78 months compared to 90.88±2.89 months in Fleckvieh. Conclusion Overall, results have shown that genotype significantly influenced milk yield, age at first calving and longevity.

  5. Hypoluteoidism in a dog associated with recurrent mammary fibroadenoma stimulated by progestin therapy.

    Science.gov (United States)

    Zedda, Maria Teresa; Bogliolo, Luisa; Antuofermo, Elisabetta; Falchi, Laura; Ariu, Federica; Burrai, Giovanni Pietro; Pau, Salvatore

    2017-09-06

    Hypoluteoidism in the bitch is characterized by insufficient production and secretion of progesterone by the corpora lutea. It is a rare pathologic condition and during pregnancy, it leads to embryonic resorption or fetal abortion. Supplementary therapy with progestins is indicated during pregnancy to obtain delivery of vital puppies but unwarranted side effects of such treatment are poorly documented. A 4-year-old, nulliparous, female Istrian Shorthaired Hound dog had been mated repeatedly in six heats with different dogs of proven fertility but signs of pregnancy did not develop. Estrous cycles, mating and pregnancies were monitored as hypoluteoidism or genital disease was suspected. During the first monitored estrus, the bitch was mated and on day 18 [day 0, day of estimated peak of luteinizing hormone (LH)], ultrasound examination showed three amniotic vesicles that were however found to be resorbed between day 20 and 23. Progesterone concentrations, measured by ELISA, were >8 ng/mL until day 12 and 1-2.5 ng/mL on days 20, 23 and 26. Primary hypoluteoidism was therefore suspected. In the second monitored estrus, the bitch was mated and during pregnancy, progesterone concentrations were >8 ng/mL until day 17 and 1-2.5 ng/mL on day 19. On days 20 and 22, two out of three embryonic vesicles had been resorbed. The bitch was treated with progesterone in oil from day 19 to day 58. Increase in the size of 2nd left thoracic mammary gland (T2-L) was observed and on day 46, ultrasound evaluation and biopsy were performed revealing a low-cellularity fibroadenoma. Parturition started spontaneously at day 65 but due to dystocia caused by fetal macrosomia, a Caesarean section was performed. During the next (third) monitored estrus, the bitch was bred again and during pregnancy, early decrease in progesterone concentration confirmed the diagnosis of primary hypoluteoidism. The bitch was treated with synthetic progestin (altrenogest) from day 8 to day 57. Five amniotic

  6. Parturition induction in ewes by a progesterone receptor blocker, aglepristone, and subsequent neonatal survival: Preliminary results.

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    Özalp, R G; Yavuz, A; Orman, A; Seker, I; Udum Küçükşen, D; Rişvanlı, A; Demiral, Ö O; Wehrend, A

    2017-01-01

    The clinical effects of aglepristone treatment to induce parturition in ewes and their newborns were reported. Three experimental groups were defined: group AG5 (n = 5), group AG10 (n = 5), and group CG (n = 5) in which ewes were injected twice with 5, 10 mg/kg of aglepristone, and saline solution of ewes, respectively. Different parameters associated with parturition in ewes and their newborns were investigated. Serum progesterone, oxytocin, and free and conjugated total estrogens were measured after treatments until parturition. No statistical difference was found from first aglepristone administration to onset of lambing between AG5 and AG10 (23.90 ± 6.20, 40.00 ± 6.71 hours). Parturition induction in two groups shortened the gestational length significantly compared with the control group (P = 0.003). Dystocia was observed in two ewes in group AG10. The placental weight showed statistically significant difference only between the AG10 and CG (P = 0.039), but no difference was observed in the placental expulsion period between the groups. Decrease in food consumption 24 to 36 hours after parturition in all ewes and skin necrosis in an ewe in group AG5 were observed. Progesterone concentration was significantly lower in AG5 than that in ewes in group AG10 and CG (P birth weight (4.29 ± 0.28 kg), which was significantly different from the induced groups. No significant difference of blood pH and blood gases values between groups was identified both at birth and 12 hours after parturition for lambs. Significant differences could clearly be observed in total protein and blood urea nitrogen and total protein findings 12 hours after parturition (P control lambing time without any side effects in either mothers or lambs. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. DIAGNOSIS AND THERAPEUTIC CONSIDERATIONS OF UTERINE INFECTIONS IN DAIRY CATTLE CONSIDERACIONES DIAGNÓSTICAS Y TERAPÉUTICAS PARA INFECCIONES UTERINAS EN VACAS LECHERAS

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    Risco Carlos

    2009-05-01

    Full Text Available From an animal health-well being, welfare, and performance perspective, the postpartum period is comprised of an early window where acute health and cow survival is an issue with the development of septic metritis. Subsequently, sustained presence of endometritis is likely to be contributing to sub-fertility in lactating dairy cows with an overall herd pregnancy rate of approximately 16%. The challenge is to integrate on commercial dairies preventive medicine programs with reproductive management to improve herd fertility. Cows affected by periparturient disorders such as hypocalcemia, dystocia, and retained fetal membranes are more likely to contract uterine infections than cows that calve normally are. Thus, appropriate management of the transition period is critical in the prevention of uterine infections at the herd level. In addition, a postpartum program to monitor health to provide treatment to cows in the early stages of disease should be implemented.Desde el punto de vista del bienestar animal y de la perspectiva de productividad, el periodo postparto puede estar comprometido por una pequeña ventana durante el postparto temprano, en la cual la salud y supervivencia de las vacas es un problemática, debido a la presentación de metritis séptica. Esta se perpetuán subsecuentemente con la presentación de endometritis, la cual muy posiblemente contribuye con los patrones de sub-fertilidad en vacas lactantes, generando en general bajas tasas de preñez del 16 %. El reto es entonces integrar en las explotaciones comerciales un programa de medicina veterinaria preventiva con el manejo reproductivo, con el fin de mejorar la fertilidad del hato. Se ha descrito que las vacas que sufren problemas durante el periparto tales como hipocalcemia y retención de las membranas fetales son más susceptibles de contraer infecciones uterinas, comparadas con aquellas vacas que tienen un parto normal. Por ello un manejo apropiado del periodo de transici

  8. A STUDY ON PLACENTAL MORPHOLOGY IN GESTATIONAL DIABETES

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    Katadi Venkata Sudha Madhuri

    2017-01-01

    Full Text Available BACKGROUND Gestational Diabetes Mellitus (GDM refers to any degree of glucose intolerance with onset or first recognition during pregnancy. Maternal diabetes constitutes an unfavourable environment for embryonic and foetoplacental development. The histomorphological changes in the placenta are associated with increased perinatal morbidity, increased risk of diabetes in the offspring and the mother in the ensuing years of life. Present study aims to study the morphological changes in the placenta along with maternal and foetal outcomes in pregnancies complicated by GDM. MATERIALS AND METHODS A descriptive observational case-controlled study was conducted from January 2013 to November 2016 in King George Hospital, Visakhapatnam. Hundred and sixty four women diagnosed with GDM and hundred women with normal gestation were enrolled in the study. Foetal surveillance was done by Doppler ultrasound and kick count technique during the gestation. Foetal and maternal outcome was evaluated and compared to the outcome of normal gestation. Placental specimens from term gestations (38-42 weeks diagnosed with GDM and normal full-term gestations were studied to assess the morphological parameters. Statistical analysis was done using descriptive statistical measures. RESULTS In the present study, 62.19% of the GDM cases terminated as normal gestations. Recurrent UTI was the most common complication (14.02% during the antenatal period. 17.68% of the foetuses from GDM mothers presented with macrosomia, however, there were no cases of congenital anomalies or shoulder dystocia. Placental tissue from the GDM cases was larger, heavier and more cotyledonous as compared to placenta from normal subjects. The umbilical cord showed eccentric and central attachment in all the controls and most of the cases and 5.48% of the cases showed marginal attachment of the umbilical cord. CONCLUSION The study describes the various maternal, foetal and placental outcomes in pregnancies

  9. Effect of early postpartum PGF2α treatment on reproductive performance in dairy cows with calving and puerperal traits.

    Science.gov (United States)

    Salasel, B; Mokhtari, A

    2011-12-01

    The objective of this study was to evaluate the effects of early postpartum PGF two alpha treatment on reproductive performance in dairy cows with calving and puerperal traits. A total of 363 Holstein cows (128 primiparous and 235 multiparous) were selected based on the presence of at least one of calving and puerperal traits (dystocia, retained placenta, twin, abortion, and postpartum uterine infections) and were assigned to two groups (treatment and control) irrespective of presence or absence of luteal tissue. Cows in the treatment group were treated twice with 25 mg dinoprost 8 h apart on day 20 postpartum, and for the control group saline placebo was administered. As it was speculated that the timing of a second dose would mimic the release of endogenous PGF2α from the uterus, our hypothesis was that two doses of PGF2α 8 h apart may increase the duration of elevated plasma prostaglandin F2α metabolite concentration in these cows. Recorded reproductive variables included days to first estrus, days to first AI, first service conception rate, pregnancy by 150 days in milk, service per conception, open days, and the percentage of repeat breeder animals. The data were analyzed using SPSS (Version 15) (IBM North America, New York, NY, USA) and Minitab (Version 14) (Minitab, State College, PA, USA). Although early postpartum PGF2α treatment had no effect on days to first estrus (36.7 days vs. 34.9 days, P = 0.056) and days to first AI (70.5 days vs. 72.2 days, P = 0.537), it increased first service conception rate (47.1% vs. 27.6%, P remarkable in primiparous cows (64.7% vs. 25%, P service per conception (1.92 vs. 2.72, P < 0.001) and the mean open days (112 days vs. 144 days, P < 0.001), and increased pregnancy by 150 days in milk (DIM) (80% vs. 66%, P = 0.004). The prevalence of repeat breeder syndrome in cows with calving and puerperal traits was reduced by PGF2α treatment (10% vs. 29.8%, P < 0.001). In conclusion, treatment of cows with calving and puerperal

  10. Riesgo reproductivo preconcepcional: análisis de su comportamiento en tres consultorios médicos Preconceptional reproductive risk: analysis of its behavior in three family physician’s offices

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    Yanet Cabrera Cao

    2005-08-01

    individual and comprehensive risk in the election of the contraceptive method according to the risk factor. In the cases with preconceptional risk, independently of their previous categorization or not, it was observed a direct relation to the obstetric and perinatal risk. Risk weight at birth, dystocia, toxemia, respiratory distress and acute fetal suffering were the most frequent.

  11. Elective caesarean section and neonatal respiratory diseases%择期剖宫分娩与新生儿呼吸系统疾病

    Institute of Scientific and Technical Information of China (English)

    岳少杰

    2011-01-01

    As an effective solution to high-risk pregnancy, dystocia and other obstetric critical diseases, the caesarean section plays an important role in reducing the perinatal morbidity and mortality. In spite of the effect of the eaesarean section on reducing the incidence of neonatal asphyxia, trauma and meeonium aspiration syndrome,however, recent studies found that it cannot reduce the neonatal mortality. Meanwhile, the elective caesarean can increase the probability of the occurrence of neonatal respiratory distress and of the admission to neonatal intensive care unit significantly. Based on the main types of respiratory diseases in term newborn infants caused by elective caesarean section, this paper briefly discusses the potential mechanisms and the principles of management for the respiratory diseases. The aims of this paper are lo increase the knowledge of adverse effects on the respiratory system caused by elective caesarean, and to reduce the occurrence of neonatal respiratory disease due to elective caesarean section, and to improve the prognosis.%剖宫分娩作为解决高危妊娠、难产等产科危重症的有效途径,在降低围产期母婴发病率和病死率中起着非常重要的作用.但近期研究发现剖宫分娩并未降低新生儿的死亡率,同时发现虽然剖宫分娩使新生儿窒息、创伤和胎粪吸入发生率降低,但择期剖宫分娩的新生儿发生呼吸窘迫和入住新生儿重症监护病房的概率明显增高.文章在简要介绍择期剖宫分娩足月儿出现呼吸系统疾病主要类型的基础上进一步讨论择期剖宫分娩的新生儿出现严重呼吸系统疾病的可能机制以及处理原则,以提高对择期剖宫分娩新生儿呼吸系统疾病的认识,减少择期剖宫分娩所致新生儿呼吸系统疾病的发生及改善预后.

  12. Effects of various procedures for synchronisation of parturition in sows. Assessment of sows with a complication-free birth.

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    Zaremba, W; Udluft, T; Bostedt, H

    2015-01-01

    The effects of various parturition controlling measures in sows on the relevant parameters for parturition were investigated. A total of 1975 study animals were divided into five groups: control group: A (n = 710); trial groups: B (n = 719), C (n = 180), D (n = 175), E (n = 191). The control group (A) included sows that spontaneously farrowed until day 114 of gestation. The remaining sows were administered a PGF2α-analogue (175 µg cloprostenol) on day 114. All sows that farrowed within 24 hours after prostaglandin-medication were summarised in trial group B. Dams that did not farrow until day 115 were either administered oxytocin (20 IU i. m., group C) or carbetocin in two different doses (70 µg, group D or 35 µg, group E). The sows were monitored during the peripartal period over 24 hours. 83.8% of the farrowings were without any complications. The percentage of dystocia varied between the individual groups. Given a complication-free farrowing the expulsion stage began 13.0 hours (group B), 2.4 hours (group C), 1.6 hours (group D) and 1.4 hours (group E) after medication. The expulsion interval of the farrowing of two piglets decreased from 21.1 minutes with spontaneous farrowings (group A) to 18.6 minutes (group E) as a result of the administration of 35 µg carbetocin. The rate of stillborn piglets as well as the incidence of puerperal disorders and the losses of the suckling piglets also gradually, partly even significantly (p ≤ 0.05) decreased from group A to E. The results of this study show that the use of the long-acting oxytocin carbetocin has advantages compared to oxytocin (e.   g. shortened duration of birth, reduction of stillbirths). The tested dosages of carbetocin (35 µg or 70 µg) proved to be equally effective. Administration of the lower dose is recommended, since this reduces use of the active ingredient.

  13. MATERNAL NEAR MISS IN A TERTIARY CARE HOSPITAL: A CROSS SECTIONAL STUDY

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    Namrata

    2016-06-01

    Full Text Available BACKGROUND Maternal mortality is one of the important indicators of maternal health. To overcome the challenge of reduction of maternal mortality, nationwide notion of SAMM (Severe Acute Maternal Morbidity and near miss event was introduced to access maternal health care. Maternal near miss case is defined as “A woman who nearly died, but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.” SAMM refers to a life-threatening disorder that can end up in near miss with or without residual morbidity or mortality. Women who develop SAMM during pregnancy share many pathological and circumstantial factors related to their condition. Although some of these women die, a proportion of them narrowly escape death. Near miss cases and maternal deaths together are referred to as Severe Maternal Outcome (SMO. AIMS AND OBJECTIVES 1. To determine the prevalence of maternal near miss due to severe obstetric complications or maternal disease in a tertiary hospital. 2. To determine Severe Maternal Outcome Ratio (SMOR, Maternal Near Miss Ratio (MNM Ratio and Maternal Mortality Ratio. MATERIALS AND METHODS Cross sectional observational study carried out from 01st October 2014 to 30th September 2015. The study was conducted in Obstetric Department of Krishna Hospital, Krishna Institute of Medical Sciences Deemed University, Karad. Near-miss case definition was based on validated specific criteria comprising of five diagnostic features and WHO Criteria: Haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. The main outcome measures were frequency and characteristics of nearmiss cases, total hospital stay, high dependency unit/ICU stay and development of multiple organ dysfunction. The maternal death to near-miss ratio was calculated. RESULT There were 4800 deliveries from October 2014 to September 2015, 220 near miss cases and 17 maternal deaths. Maternal death to near miss

  14. Background rates of adverse pregnancy outcomes for assessing the safety of maternal vaccine trials in sub-Saharan Africa.

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    Lauren A V Orenstein

    Full Text Available BACKGROUND: Maternal immunization has gained traction as a strategy to diminish maternal and young infant mortality attributable to infectious diseases. Background rates of adverse pregnancy outcomes are crucial to interpret results of clinical trials in Sub-Saharan Africa. METHODS: We developed a mathematical model that calculates a clinical trial's expected number of neonatal and maternal deaths at an interim safety assessment based on the person-time observed during different risk windows. This model was compared to crude multiplication of the maternal mortality ratio and neonatal mortality rate by the number of live births. Systematic reviews of severe acute maternal morbidity (SAMM, low birth weight (LBW, prematurity, and major congenital malformations (MCM in Sub-Saharan African countries were also performed. FINDINGS: Accounting for the person-time observed during different risk periods yields lower, more conservative estimates of expected maternal and neonatal deaths, particularly at an interim safety evaluation soon after a large number of deliveries. Median incidence of SAMM in 16 reports was 40.7 (IQR: 10.6-73.3 per 1,000 total births, and the most common causes were hemorrhage (34%, dystocia (22%, and severe hypertensive disorders of pregnancy (22%. Proportions of liveborn infants who were LBW (median 13.3%, IQR: 9.9-16.4 or premature (median 15.4%, IQR: 10.6-19.1 were similar across geographic region, study design, and institutional setting. The median incidence of MCM per 1,000 live births was 14.4 (IQR: 5.5-17.6, with the musculoskeletal system comprising 30%. INTERPRETATION: Some clinical trials assessing whether maternal immunization can improve pregnancy and young infant outcomes in the developing world have made ethics-based decisions not to use a pure placebo control. Consequently, reliable background rates of adverse pregnancy outcomes are necessary to distinguish between vaccine benefits and safety concerns. Local studies

  15. Uterine torsion in term pregnancy

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    Sparić Radmila

    2007-01-01

    authors who suggest bilateral plication of the round ligaments as a preventive procedure for repeated torsion in puerperium and following pregnancies. The effectiveness of this method requires further investigation. It is necessary to have in mind the possibility of uterine torsion in all cases of abdominal pain during pregnancy and dystocia.

  16. Obstetric near-miss and maternal mortality in maternity university hospital, Damascus, Syria: a retrospective study

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    Al Chamat Ahmad

    2010-10-01

    Full Text Available Abstract Background Investigating severe maternal morbidity (near-miss is a newly recognised tool that identifies women at highest risk of maternal death and helps allocate resources especially in low income countries. This study aims to i. document the frequency and nature of maternal near-miss at hospital level in Damascus, Capital of Syria, ii. evaluate the level of care at maternal life-saving emergency services by comparatively analysing near-misses and maternal mortalities. Methods Retrospective facility-based review of cases of near-miss and maternal mortality that took place in the years 2006-2007 at Damascus Maternity University Hospital, Syria. Near-miss cases were defined based on disease-specific criteria (Filippi 2005 including: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. Main outcomes included maternal mortality ratio (MMR, maternal near miss ratio (MNMR, mortality indices and proportion of near-miss cases and mortality cases to hospital admissions. Results There were 28 025 deliveries, 15 maternal deaths and 901 near-miss cases. The study showed a MNMR of 32.9/1000 live births, a MMR of 54.8/100 000 live births and a relatively low mortality index of 1.7%. Hypertensive disorders (52% and haemorrhage (34% were the top causes of near-misses. Late pregnancy haemorrhage was the leading cause of maternal mortality (60% while sepsis had the highest mortality index (7.4%. Most cases (93% were referred in critical conditions from other facilities; namely traditional birth attendants homes (67%, primary (5% and secondary (10% healthcare unites and private practices (11%. 26% of near-miss cases were admitted to Intensive Care Unit (ICU. Conclusion Near-miss analyses provide valuable information on obstetric care. The study highlights the need to improve antenatal care which would help early identification of high risk pregnancies. It also emphasises the importance of both: developing protocols to

  17. Reproductive Failure in UK Harbour Porpoises Phocoena phocoena: Legacy of Pollutant Exposure?

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    Sinéad Murphy

    Full Text Available Reproductive failure in mammals due to exposure to polychlorinated biphenyls (PCBs can occur either through endocrine disrupting effects or via immunosuppression and increased disease risk. To investigate further, full necropsies and determination of summed 25 polychlorinated biphenyls congeners (∑PCBs lipid weight in blubber were undertaken on 329 UK-stranded female harbour porpoises (1990-2012. In sexually mature females, 25/127 (19.7% showed direct evidence of reproductive failure (foetal death, aborting, dystocia or stillbirth. A further 21/127 (16.5% had infections of the reproductive tract or tumours of reproductive tract tissues that could contribute to reproductive failure. Resting mature females (non-lactating or non-pregnant had significantly higher mean ∑PCBs (18.5 mg/kg than both lactating (7.5 mg/kg and pregnant females (6 mg/kg, though not significantly different to sexually immature females (14.0 mg/kg. Using multinomial logistic regression models ΣPCBs was found to be a significant predictor of mature female reproductive status, adjusting for the effects of confounding variables. Resting females were more likely to have a higher PCB burden. Health status (proxied by "trauma" or "infectious disease" causes of death was also a significant predictor, with lactating females (i.e. who successfully reproduced more likely to be in good health status compared to other individuals. Based on contaminant profiles (>11 mg/kg lipid, at least 29/60 (48% of resting females had not offloaded their pollutant burden via gestation and primarily lactation. Where data were available, these non-offloading females were previously gravid, which suggests foetal or newborn mortality. Furthermore, a lower pregnancy rate of 50% was estimated for "healthy" females that died of traumatic causes of death, compared to other populations. Whether or not PCBs are part of an underlying mechanism, we used individual PCB burdens to show further evidence of

  18. TO COMPARE THE ACCURACY OF PREDICTED BIRTH WEIGHT BY ULTRASONOGRAPHIC MEASUREMENTS OBTAINED JUST BEFORE AND AT TERM

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    Debraj

    2015-03-01

    Full Text Available BACKGROUND: Fetal weight measurement by ultrasonographic methods can be considered as an important modality for antenatal prediction of fetal weight (preferable single USG should be done at 34 - 36.9wks to rule out various complications of pregnancy such as macrosomia, IUGR etc which enable us to be prepared for the delivery of the baby and prevent any further dreaded complications resulting out of these conditions including shoulder dystocia, severely compromised baby AIM: To compare the accuracy of predicted birth weight by ultrasonographic measurements obtained just before and at term. METHOD: The study was performed in a tertiary care Hospital in West Bengal between 1st July 2012 to 30th June 2013 on 100 Pregnant women attending Antenatal Clinic (34 - 36.9 wks with a live singleton pregnancy, all women underwent ultrasound examination twice( 37 weeks. The estimated fetal weight calculated using Hadlock’s formula. D ata were then compared for each pair of sonograms from the same patient using a paired t test. P value of <0.05 was considered statistically significant. RESULTS: The study included 100 patients undergoing 200 sonograms. The mean absolute error of the predicted birth weight was smaller for period 1 (34 - 36.9 wks than for period 2 (≥ 37 wks (152 ± 125g compared with 193.5 ± 121g, P=0.0001. The overall mean absolute percent errors in predicting birth weight were 5.6 ± 4.7 (Period 1 & 7.6 ± 4.3 (Period 2 for IUGR and 5.4 ± 3.9 (Period 1 & 6 ± 3 (Period 2 for Macrosomia. Averaging data from both gestational periods did not improve the prediction of birth weight. Our study did not show any correlation between latency and the accuracy of birth weight predictions. CONCLUSION: This study indicates that serial sonograms in the late third trimester do not improve the ability to predict birth weight, even in abnormally grown fetuses. So, a single sonogram between 34 and 37 weeks’ gestation is recommended for prediction of birth

  19. Mild gestational diabetes in pregnancy and the adipoinsular axis in babies born to mothers in the ACHOIS randomised controlled trial

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    De Blasio Miles J

    2007-04-01

    Full Text Available Abstract Background Mild gestational diabetes is a common complication of pregnancy, affecting up to 9% of pregnant women. Treatment of mild GDM is known to reduce adverse perinatal outcomes such as macrosomia and associated birth injuries, such as shoulder dystocia, bone fractures and nerve palsies. This study aimed to compare the plasma glucose concentrations and serum insulin, leptin and adiponectin in cord blood of babies of women (a without gestational diabetes mellitus (GDM, (b with mild GDM under routine care, or (c mild GDM with treatment. Methods 95 women with mild GDM on oral glucose tolerance testing (OGTT at one tertiary level maternity hospital who had been recruited to the ACHOIS trial at one of the collaborating hospitals and randomised to either Treatment (n = 46 or Routine Care (n = 49 and Control women with a normal OGTT (n = 133 were included in the study. Women with mild GDM (treatment or routine care group and OGTT normal women received routine pregnancy care. In addition, women with treated mild GDM received dietary advice, blood glucose monitoring and insulin if necessary. The primary outcome measures were cord blood concentrations of glucose, insulin, adiponectin and leptin. Results Cord plasma glucose was higher in women receiving routine care compared with control, but was normalized by treatment for mild GDM (p = 0.01. Cord serum insulin and insulin to glucose ratio were similar between the three groups. Leptin concentration in cord serum was lower in GDM treated women compared with routine care (p = 0.02 and not different to control (p = 0.11. Adiponectin was lower in both mild GDM groups compared with control (Treatment p = 0.02 and Routine Care p = 0.07, while the adiponectin to leptin ratio was lower for women receiving routine care compared with treatment (p = 0.08 and control (p = 0.05. Conclusion Treatment of women with mild GDM using diet, blood glucose monitoring and insulin if necessary, influences the

  20. "Near-miss" obstetric events and maternal deaths in Sagamu, Nigeria: a retrospective study

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    Daniel Olusoji J

    2005-11-01

    Full Text Available Abstract Aim To determine the frequency of near-miss (severe acute maternal morbidity and the nature of near-miss events, and comparatively analysed near-miss morbidities and maternal deaths among pregnant women managed over a 3-year period in a Nigerian tertiary centre. Methods Retrospective facility-based review of cases of near-miss and maternal death which occurred between 1 January 2002 and 31 December 2004. Near-miss case definition was based on validated disease-specific criteria, comprising of five diagnostic categories: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. The near-miss morbidities were compared with maternal deaths with respect to demographic features and disease profiles. Mortality indices were determined for various disease processes to appreciate the standard of care provided for life-threatening obstetric conditions. The maternal death to near-miss ratios for the three years were compared to assess the trend in the quality of obstetric care. Results There were 1501 deliveries, 211 near-miss cases and 44 maternal deaths. The total near-miss events were 242 with a decreasing trend from 2002 to 2004. Demographic features of cases of near-miss and maternal death were comparable. Besides infectious morbidity, the categories of complications responsible for near-misses and maternal deaths followed the same order of decreasing frequency. Hypertensive disorders in pregnancy and haemorrhage were responsible for 61.1% of near-miss cases and 50.0% of maternal deaths. More women died after developing severe morbidity due to uterine rupture and infection, with mortality indices of 37.5% and 28.6%, respectively. Early pregnancy complications and antepartum haemorrhage had the lowest mortality indices. Majority of the cases of near-miss (82.5% and maternal death (88.6% were unbooked for antenatal care and delivery in this hospital. Maternal mortality ratio for the period was 2931.4 per 100

  1. Epizootic of ovine congenital malformations associated with Schmallenberg virus infection.

    Science.gov (United States)

    van den Brom, R; Luttikholt, S J M; Lievaart-Peterson, K; Peperkamp, N H M T; Mars, M H; van der Poel, W H M; Vellema, P

    2012-02-01

    Epizootic outbreaks of congenital malformations in sheep are rare and have, to the best of our knowledge, never been reported before in Europe. This paper describes relevant preliminary findings from the first epizootic outbreak of ovine congenital malformations in the Netherlands. Between 25 November and 20 December 2011, congenital malformations in newborn lambs on sheep farms throughout the country were reported to the Animal Health Service in Deventer. Subsequently, small ruminant veterinary specialists visited these farms and collected relevant information from farmers by means of questionnaires. The deformities varied from mild to severe, and ewes were reported to have given birth to both normal and deformed lambs; both male and female lambs were affected. Most of the affected lambs were delivered at term. Besides malformed and normal lambs, dummy lambs, unable to suckle, were born also on these farms. None of the ewes had shown clinical signs during gestation or at parturition. Dystocia was common, because of the lambs' deformities. Lambs were submitted for post-mortem examination, and samples of brain tissue were collected for virus detection. The main macroscopic findings included arthrogryposis, torticollis, scoliosis and kyphosis, brachygnathia inferior, and mild-to-marked hypoplasia of the cerebrum, cerebellum and spinal cord. Preliminary data from the first ten affected farms suggest that nutritional deficiencies, intoxication, and genetic factors are not likely to have caused the malformations. Preliminary diagnostic analyses of precolostral serum samples excluded border disease virus, bovine viral diarrhoea virus, and bluetongue virus. In December 2011, samples of brain tissue from 54 lambs were sent to the Central Veterinary Institute of Wageningen University Research, Lelystad. Real-time PCR detected the presence of a virus, provisionally named the Schmallenberg virus, in brain tissue from 22 of the 54 lambs, which originated from seven of eight

  2. Introspection on the Constitutional Foundation in of Constitutional Reform in the Late Qing the Perspective Dynasty%从清末立宪反思宪政之根基

    Institute of Scientific and Technical Information of China (English)

    李昊鲁

    2011-01-01

    清末立究在客观上开启了中国传统政治文明的转型之门,是对两千年来专制政体的否定,其主流意义值得肯定。“立宪”之败是中国政治近代化的难产,表明不具备根基的“立宪”无法逃脱最终失败的命运;暴力革命不一定总能从根本上改造旧有的社会秩序,亦不能借此一蹴而就地实现宪政。宪政之根基在于建立在市场经济充分发展基础上的市民社会,只有期待其茁壮成长,构建其与国家权力之间的相互制衡、良性互动的新型社会治理模式,才能为宪政的实现打下坚实的根基,提供不懈的动力。这或许是清末立宪给予我们的深刻反思与启示。%Objectively, the constitutional reform in the late Qing Dynasty, as the rejection to autocracy for 2,000 years, had openedthe transformation portal of Chinese traditional political civilization so that whose mainstream significance always should be deserved affirmation. Violent revolution is not always able to transform the old social order fundamentally, and to achieve constitutionalism in an action; the losing of constitutional reform, also as the dystocia of China's political modernization, states clearly that constitutionalism without necessary foundation has to be sunk into lower depths of ruin. The constitutional foundation should be contained in civil society based on the full development of market economy. Only when civil society thrives and when new public governance model characterized by Checks and Balance & Benign interaction between that and state power succeeds to be established and only when the government seizes the opportunity to deepen the reform in time will the possible dangers during reform be prevented, and constitutionalism authentically own solid foundation and unremitting power. The above may be what the constitutional reform enlightens us.

  3. Discussion on"One to One"Responsibility Midwifery in Delivery Applications%浅谈"一对一"责任助产在分娩中的应用

    Institute of Scientific and Technical Information of China (English)

    王晶晶

    2014-01-01

    目的:探讨"一对一"责任助产在分娩中的应用效果。方法从2010年6月至今实行责任助产一对一的贴身服务。结果产妇在临产的关键时刻感受到助产人员的特别关爱,使产妇在分娩过程中的身体处于最佳状态,并且充分发挥产妇的积极性和主动性,使产程明显缩短,减少产后出血及新生儿窒息的发生,也减少了剖宫产及难产的发生率,提高了满意度。结论实施责任助产能促进产妇与助产士的情感交流,让整个产程进展顺利,产后恢复快,有利于提高产科质量,保证母婴安全,对改善医患关系有良好的促进作用。%Objective Discuss the application of "one to one" responsibility midwifery in childbirth.Methods Since June 2010 the responsibility midwifery one-on-one personalized service.Results Maternal in of a critical moment to feel the midwives in special care, make the maternal body in the best state, in the process of childbirth and give ful play to women's enthusiasm and initiative, make labor shortened obviously, reduce the incidence of postpartum hemor hage and neonatal asphyxia, and reduce the cesarean section and the incidence of dystocia, improve the satisfaction.Conclusion Implement responsibility midwifery can promote the emotional communication of mothers and midwives, let whole labor is progressing, postpartum recovery fast, is conducive to improve the obstetric quality, to ensure the safety of maternal and infant, to improve the doctor-patient relationship has a good role in promoting.

  4. 父源因素对胎儿生长发育的不良影响研究进展%Advances of the Adverse Effects of Paternal Factors on Fetal Development

    Institute of Scientific and Technical Information of China (English)

    周梦林; 应俊; 陈丹青

    2015-01-01

    The fetal development is closely related with the adverse pregnancy outcomes such as miscarriage, dystocia, congenital malformation, premature baby, low weight baby and so on. It is also a potential predictor of the fetal origin of some adult diseases. Most of the researches on the risk factors affecting fetal development were focused on the mother origin in recent years. The risk factors of father origin can be classified into two groups: the heredity-related factors such as age, diseases, somatotype, lifestyle and environmental exposure which could disturb the integrity of genomics of father origin or the genomic expression; the social and environmental factors such as psychological state, occupation and income which could mainly affect maternal pregnancy environment and life quality. Two kinds of factors can result in abnormal fetal development in uterus, which is related to adverse outcomes of pregnancy. It is benefit for the fetal development and the infant and adult health to offer genetic counseling to those couples with high-risk factors.%胎儿在宫内的生长发育不仅与流产、难产、畸形、早产、低体质量儿等不良妊娠结局密切相关,而且能用于评估成年期罹患某些疾病的风险。近年国内外关于胎儿生长发育的研究大多关注的是母源因素,对父源因素的研究相对较少。父亲影响胎儿发育的主要因素可以分为两类,即包括年龄、疾病、体型、生活方式、暴露环境在内的遗传因素和以心理状态、职业、经济收入为代表的社会环境因素,前者直接影响父源基因的完整性和表达情况,而后者主要影响母体的生活环境和生活质量,这两类因素的不良发展均可能导致胎儿在宫内的生长发育发生异常,从而出现各种不良妊娠结局。

  5. Congenital Malformations in River Buffalo (Bubalus bubalis)

    Science.gov (United States)

    Albarella, Sara; Ciotola, Francesca; D’Anza, Emanuele; Coletta, Angelo; Zicarelli, Luigi; Peretti, Vincenzo

    2017-01-01

    Simple Summary Congenital malformations (due to genetic causes) represent a hidden danger for animal production, above all when genetic selection is undertaken for production improvements. These malformations are responsible for economic losses either because they reduce the productivity of the farm, or because their spread in the population would decrease the total productivity of that species/breed. River buffalo is a species of increasing interest all over the world for its production abilities, as proved by the buffalo genome project and the genetic selection plans that are currently performed in different countries. The aim of this review is to provide a general view of different models of congenital malformations in buffalo and their world distribution. This would be useful either for those who performed buffalo genetic selection or for researchers in genetic diseases, which would be an advantage to their studies with respect to the knowledge of gene mutations and interactions in this species. Abstract The world buffalo population is about 168 million, and it is still growing, in India, China, Brazil, and Italy. In these countries, buffalo genetic breeding programs have been performed for many decades. The occurrence of congenital malformations has caused a slowing of the genetic progress and economic loss for the breeders, due to the death of animals, or damage to their reproductive ability or failing of milk production. Moreover, they cause animal welfare reduction because they can imply foetal dystocia and because the affected animals have a reduced fitness with little chances of survival. This review depicts, in the river buffalo (Bubalus bubalis) world population, the present status of the congenital malformations, due to genetic causes, to identify their frequency and distribution in order to develop genetic breeding plans able to improve the productive and reproductive performance, and avoid the spreading of detrimental gene variants. Congenital

  6. RETROSPECTIVE STUDY OF PRIMARY CAESAREAN SECTION AT A TERTIARY CARE CENTRE

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    S. Prasanna Lakshmi

    2016-12-01

    healthcare providers, medicolegal issues most likely contribute to the escalating caesarean delivery rates. The problems associated with caesarean delivery as compared to vaginal delivery are very many. The various recommendations cited maybe beneficial. It may be necessary to revisit the definition of labour dystocia because recent data show that contemporary labour progresses at a rate substantially slower than what was historically taught. Additionally, improved and standardised foetal heart rate interpretation and management may have an effect on curtailing the caesarean section rate.

  7. Expected net present value of pure and mixed sexed semen artificial insemination strategies in dairy heifers.

    Science.gov (United States)

    Olynk, N J; Wolf, C A

    2007-05-01

    the CR of conventional semen. Other potential advantages of sexed semen that were not quantified in the scenarios include biosecurity-related concerns, decreased dystocia due to increased numbers of heifer calves, and implications for internal herd growth.

  8. Application Experience of Non-pharmacological Pain Relief Method%非药物减痛方法的应用体会

    Institute of Scientific and Technical Information of China (English)

    李婉燕

    2013-01-01

      目的:探讨孕产妇产程中采取非药物减痛方法对促进产程及自然分娩的效果。方法:试验组128例产妇在产程中分别提供导乐陪伴分娩服务、指导自由体位的应用、拉玛泽呼吸法的应用、分娩球的应用和天然豆袋腰骶热敷减痛法;对照组128例采取常规分娩方法的护理措施。结果:试验组的顺产率、剖宫产率、新生儿阿氏评分发生率与对照组比较,差异有统计学意义(字2=68.271,P0.05)。结论:非药物镇痛方法分娩使产程更顺利,减小药物依赖性及其他刺激因素,使疼痛减轻,降低难产发生,加强护患沟通和满足孕产妇心理需求,让分娩变得更温馨更轻松,达到有效成功助产的最终目的。%Objective:To investigate the maternal adopt non-pharmacological pain relief method,to promote the birth process and the effect of natural childbirth.Methods:128 cases in the experimental group women during labor doula services,were provided guidance free posture applications,ramaze breathing method,childbirth ball application and natural bean bag lumbosacral hot compress pain-relieve method;The other random sampling 128 cases in the control group were taken the routine method of childbirth care measures.Results:The rate of vaginal delivery,cesarean section rate,neonatal score compared with the control group,there were statistically significant(X2=68.271,P0.05). Conclusion:Non-pharmacological pain relief method can make the process more smoothly,reduce drug dependence and other stimuli,so to alleviate pain, reduce dystocia,strengthen communication between nurses and patients and meet the psychological needs of pregnant women,make labor more warm easier,to achieve the ultimate goal of effective successful delivery.

  9. Effect of Dietary Nutrition and Health Education on Pregnant Women%孕期膳食营养健康教育对孕妇体质量及妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    侯爱军; 石艳丽; 孙秀艳; 杨立红; 马翠梅

    2017-01-01

    [目的]探讨孕期膳食营养健康教育对孕妇体质量及妊娠结局的影响.[方法]选取2013年6月至2015年6月在本院妇产科门诊初次建立孕产妇保健手册的妊娠13周前正常单胎初产妇900例,依据就诊单双号分为观察组和对照组,每组450例,观察组给予孕期膳食营养健康教育及个体化的营养指导,对照组仅给予常规孕期生理卫生知识的指导,比较两组孕妇孕期增长体质量、妊娠期高血压疾病、妊娠期合并贫血、巨大儿、剖宫产率、难产、子宫收缩乏力、新生儿窒息发生率.[结果]观察组孕期增长体质量在正常范围内的比率明显高于对照组(P<0.01),孕期体质量增重过少及增重过多的比率均低于对照组(P<0.01);观察组妊娠期高血压疾病、妊娠期合并贫血、巨大儿、难产、子宫收缩乏力的发生率均低于对照组(P<0.05),观察组剖宫产率明显低于对照组(P<0.01).[结论]孕期膳食营养健康教育对于控制孕妇孕期体质量增长有良好的效果,明显减少妊娠期并发症的发生率,改善妊娠结局.%[Objective]To explore the effect of dietary nutrition and health education on the weight and pregnancy outcome of pregnant women. [Methods]Ninety cases of primipara with 13 weeks of single pregnancy in the clinic of ob-stetrics and gynecology of our hospital from June 2013 to June 2015n were selected, and were divided into the observation group and control group on the basis of odd /even serial number, 450 cases in each group. The observation group was giv-en the nutrition and health education during pregnancy and the individual nutrition guidance, while the control group was only given the guidance of physiological health knowledge during pregnancy. Body mass, pregnancy induced hypertension, pregnancy with anemia, macrosomia, cesarean section rate, dystocia, uterine atony, incidence of neonatal asphyxia were compared between the two groups of pregnant women during

  10. Índice de masa corporal pregestacional y ganancia de peso materno y su relación con el peso del recién nacido Pre gestation body mass index and maternal weight gain, its relationship with new born weight

    Directory of Open Access Journals (Sweden)

    Manrique Leal-Mateos

    2008-09-01

    , episiotomy and presence of perineal tears. Neonatal outcomes analyzed were: sex, birth weight and height, cephalic circumference, 5 minutes Apgar score, wight/age relationship, shoulder dystocia, fetal lesion, need for neonatal resuscitation or newborn hospitalization. Results: Taking as a reference the group with normal BMI, the percentage of both either small for gestional age (SGA and large for gestional age (LGA newborns was higher in the group of low BMI and obesity, respectively. A significant relationship was observed between the length of labor and pregestational BMI. The presence of dystocia and fetal lesion were more frequent in obese patients. Weight gain during gestation was found to be related with neonatal authropometric measurements. The products of mothers whose weight vas higher than advisible weighted more, were taller and had a larger cephalic circumference and in general they were larger than expected for their gestational age. There was no significant difference between the influence of weight gain during pregnancy and the labor variables. Taking as a reference the group with adequate weight gain during pregnancy, the percentage of SGA and LGA newborns was similar between this group and the one with lower weight gain. In contrast, the incidence of LGA newborn was higher in those patients with greater weight gain. Conclusion: The present study demonstrated that BMI and weight gain during pregnancy influences the newborn weight.

  11. Rectal temperatures in postpartum cows/ Avaliação da temperatura retal em vacas leiteiras no pós-parto

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    Silvia Helena Venturolli Perri

    2001-08-01

    Full Text Available The purpose of this study was to evaluate parturition data with the rectal temperature in the early postpartum period of dairy cows. One hundred and eighty cows were randomly selected between September 1999 and July 2000, in seven dairy farms located in the Northwest region of São Paulo, Brazil. For the first ten days postpartum, rectal temperature (RT was taken between 5:00 and 8:00 a.m. using an electronic thermometer (M525 - GLA Agricultural Electronics, San Luis Obispo, CA 93401-7500. Cows with RT>39,5°C were enrolled and other signs like calving difficulties, dystocia due to twins, fetal membrane retention, ill appearance, off-feed, milk production and vaginal discharge were recorded. Significant association was observed between vaginal discharge and fever. Considering 180 animals, 26 (14,4% showed vaginal discharge, among them ten (38,5% were pyretic, while in cows without vaginal discharge only 27 (17,5% showed higher rectal temperatures. Difficult parturition and retained membranes also were statistically different, 37 cows (20,6% presented dystocia, among them eight (21,6% had retention of the afterbirth, while in the cows with normal parturition only six (4,2% showed retention of the fetal membranes. It was observed that cows with or without retained fetal membranes did not show clinical signs less a transitory reduction of appetite and milk production. This daily monitoring of rectal temperature represents an aditional tool indicating precociously reprodutive alterations, like uterine infections, maximizing milk production and future uterine performance.O trabalho teve como objetivo correlacionar dados da parturição com o acompanhamento diário da temperatura retal no pós-parto imediato em fêmeas bovinas. Foram selecionadas aleatoriamente 180 vacas leiteiras provenientes de sete propriedades, em Araçatuba (SP e região, sendo monitoradas durante o puerpério precoce, no período de setembro de 1999 a julho de 2000. Do primeiro

  12. Effect of prenatal diagnosis of macrosomia on delivery outcome%巨大儿的产前诊断对分娩结局的影响

    Institute of Scientific and Technical Information of China (English)

    周丽华; 温兰玲

    2011-01-01

    Objective: To explore the effect of prediction of macrosomia before delivery on delivery outcome, in order to reduce maternal and fetal complications. Methods: 339 macrosomia born in the hospital from September 2007 to August 2009 were analyzed retrospectively, then they were divided into prediction group (reaching 4 000 g, 212 cases) and neglection group (not reaching 4 000 g, 127 cases) according to fetal weight of clinical evaluation before delivery reaching 4 000 g or not, the delivery modes, common maternal and fetal complications in the two groups were compared. Results: The rate of selective cesarean section in prediction group was significantly higher than that in neglection group (P < 0. 01) , the rates of vaginal delivery and midwifery with obstetric forceps in prediction group were significantly lower than those in neglection group ( P < 0. 05 ) , there was no significant difference in failure rate of trail of labor between the two groups, the incidences of fetal distress, neonatal asphyxia, shoulder dystocia and postpartum haemorrhage in prediction group were lower than those in neglection group. Conclusion: Macrosomia is not an absolute indication of cesarean section, paying attention to prenatal diagnosis of macrosomia, enhancing monitoring of labor course, widening the indications of cesarean section and avoiding dangerous vaginal midwifery can reduce maternal and fetal complications effectively.%目的:探讨巨大儿分娩前的预测对分娩结局的影响,以降低母儿并发症.方法:对2007年9月~2009年8月分娩的339例巨大儿进行回顾性分析,以分娩前临床估计胎儿体重是否达到4 000 g为标准进行分组:产前预测达到4 000 g者为预测组(212例),产前预测<4 000 g者为忽略组(127例),比较两组分娩方式、母儿常见并发症.结果:剖宫产、选择性剖宫产预测组显著高于忽略组(P<0.01),阴道分娩、产钳助产预测组显著低于忽略组(P<0.05),两组

  13. Association among gestation length and health, production, and reproduction in Holstein cows and implications for their offspring.

    Science.gov (United States)

    Vieira-Neto, A; Galvão, K N; Thatcher, W W; Santos, J E P

    2017-02-01

    Objectives were to evaluate associations among gestation length (GL) and performance in Holstein cows and their offspring. A total of 8,095 Holstein cows and 3,635 female offspring born alive on 2 farms using only artificial insemination (AI) were evaluated. Gestation length averaged 276 ± 6 d in the 8,095 dams, and it was categorized as short (SGL; at least 1 SD below the population mean; mean = 266 d, range 256 to 269 d), average (AGL; population mean ± 1 SD; mean = 276 d, range 270 to 282 d), or long (LGL; at least 1 SD above the population mean; mean = 285 d, range 283 to 296 d). Responses evaluated in dams included incidence of diseases within 90 d in milk (DIM), pregnancy at first AI and by 300 DIM, and time to pregnancy. Milk yield and removal from the herd by culling or death were recorded for the first 300 DIM. Responses evaluated in female offspring born alive included removal from the herd and reproductive performance. Within primiparous cows, those with SGL had greater incidence of stillbirth, retained placenta, and metritis than primiparous with AGL or LGL; however, within multiparous cows, those with SGL or LGL had greater incidence of dystocia, stillbirth, retained placenta, and metritis than cows with AGL. Morbidity and rate of morbidity were greater for SGL and LGL than AGL. Rate of removal of dams from the herd was 38% faster for SGL than AGL. Milk production was greatest in AGL cows, but responses depended on parity. For primiparous cows, milk production was less in SGL and LGL than in AGL (AGL = 35.4, SGL = 34.6, LGL = 33.0 ± 0.4 kg/d), whereas for multiparous cows, production was less in SGL but greater in LGL than in AGL (AGL = 41.6, SGL = 38.6, LGL = 42.4 ± 0.3 kg/d). A smaller proportion of cows with SGL received at least one AI, but pregnancy at first AI did not differ among groups. Rate of pregnancy was 11% slower for LGL multiparous than for AGL multiparous. By 300 DIM, pregnancy was greater in AGL than SGL. Pregnancy by 300 DIM in

  14. Effect of pelvic floor muscle exercises combined with Doula on obstetric quality%孕期盆底肌锻炼联合导乐陪伴分娩对产科质量的影响

    Institute of Scientific and Technical Information of China (English)

    冯洁梅

    2012-01-01

    Objective To explore the effects of pelvic floor muscle exercises combined with Doula on labor quality and maternal and child health.Methods 292 pregnant women were included in this study.97 of the women began muscle function exercise at a gestational age of 28 weeks until childbirth and received Doula service during labor ( study group ):99 women received conventional prenatal examination and Doula service during labor ( control group 1 ):and another 96 women received tradional delivery care ( control group 2 ).Pelvic muscle tension was compared among the three groups.Duration of labor courses and vaginal delivery status were recorded.Results Muscle tension was stronger in the study group than in the control groups 1 and 2 ( P< 0.05 ).Duration of labor courses was shorter,rate of vaginal delivery markedly increased,and rates of C-section,assisted vaginal delivery,fetal distress and suffocation,and postpartum hemorrhage were lower in the study group,with a significant difference.Conclusions Prenatal pelvic floor muscle exercises combined with Doula during delivery can strengthen pelvic muscle tension,restrain adverse mood,shorten labor courses,enhance rate of vaginal delivery,reduce rates of dystocia,newborn suffocation,and postpartum hemorrhage,improve quality of childbirth,and guarantee maternal and child health.%目的 探讨孕期盆底肌锻炼联合导乐陪伴分娩对分娩质量及母婴健康的影响.方法 选取292例孕妇,97例于妊娠28周开始盆底肌功能锻炼至分娩前,分娩时实施导乐陪伴分娩服务模式(观察组);99例常规产前检查,分娩时实施导乐陪伴分娩服务模式(对照1组);96例按常规妊娠分娩处理(对照2组).对比各组分娩前盆底肌张力,并记录产程时间和阴道分娩情况.结果 观察组盆底肌张力强于对照1组和对照2组(P< 0.05),产程缩短,自然分娩率显著提高,剖宫产率、阴道助产率、胎儿窘迫率、新生儿窒息率、产后出血率均明

  15. Exploration of the correlation between the meconium aspiration syndrome and the pedi-atric asthma%胎粪吸入综合征与小儿哮喘发病的关系研究

    Institute of Scientific and Technical Information of China (English)

    高金瑞

    2015-01-01

    目的:探究胎粪吸入综合征(MAS)和儿童哮喘发病的相关性.方法:选自本院2010/2013收治的 MAS 患儿100例,设为观察组,另选本院同期健康出生儿童100例,设为对照组.通过对 MAS 患儿的相关围生期、遗传因素、环境因素以及哮喘发病状况等以回顾性方法进行分析,和对照组儿童进行对比,归纳 MAS 和儿童哮喘发病的关系.结果:相对于对照组,观察组患儿发生哮喘的概率显著高很多,两者对比差异存在统计学意义(P <0.05);患儿 MAS 病情严重程度和哮喘发病概率并不存在必然联系(P >0.05);性别、是否存在难产史、父母文化程度、家庭经济收入状况等为 MAS 患儿哮喘发病的相关因素(P <0.05).结论:MAS 和小儿哮喘发病之间存在密切联系,对于发现 MAS 胎儿的孕妇应该立即进行针对性孕期干预,防止出现胎儿胎粪感染以及宫内致敏的状况,能够有效降低 MAS 患儿出现哮喘的概率.%AIM:To explore the correlation between meconium aspiration syndrome (MAS)and the incidence of childhood asth-ma.METHODS:100 cases of children with MAS were selected as observation group from 2010 to 2013 in our hospital,another 100 cases of healthy children born in the same period as the con-trol group.A retrospective analysis was performed by children with MAS-related perinatal,genetic factors,environmental factors and asthma status,and a control group of children were com-pared,summed MAS and childhood asthma pathogenesis.RE-SULTS:Compared with the control group,the probability of the occurrence of asthma in children in the observation group was sig-nificantly higher,there was statistically significant difference be-tween the two groups (P 0.05);gender,the existence of dystocia history,parental education lev-el,family income status were related factors in children with asth-ma MAS(P <0.05).CONCLUSION:There is a close link be

  16. Desfecho da gravidez nas jovens adolescentes Teenage pregnancy outcome

    Directory of Open Access Journals (Sweden)

    José Metello

    2008-12-01

    subdivided in pregnant women under or over 16. The χ2 test has been used for statistical analysis. RESULTS: adolescents presented worse follow-up: first appointment after 12 weeks (46.4 versus 26.3% and less than four appointments (8.1 versus 3.1%, less dystocia (21.5 versus 35.1%, less caesarian sections (10.6 versus 20.7%, and lower need for inducing labor (16.5 versus 26.5%. There was no significant difference concerning gestational age at delivery and ratio of low weight newborns. Among adolescents, the ones under 16 had more low weight newborns (12 versus 7.4% and more deliveries between 34 and 37 weeks (10.8 versus 4.2%. CONCLUSIONS: in a hospital attending adolescents with social and psychological support, the fact of them having had a worse follow-up in the pre-natal phase, their performance has not been worse. Nevertheless, special attention might be given to pregnant women under 16.

  17. 拉玛泽减痛分娩法联合分娩球护理对分娩结局的影响研究%Effect of Ramaze Pain Relief Delivery Method Combined with Delivery Ball Care on the Outcome of Delivery

    Institute of Scientific and Technical Information of China (English)

    马婷

    2016-01-01

    目的:探讨拉玛泽减痛分娩法联合分娩球护理对分娩结局的影响。方法:选择2014年8月至2015年6月在我院产检并分娩的90例产妇为研究对象,以随机数字表法分组,观察组45例,对照组45例,对照组产妇接受常规分娩护理,观察组实施拉玛泽减痛分娩法配合分娩球护理,观察2组产妇分娩结局。结果:观察组产妇产程时间与对照组相比明显较短(P<0.05);观察组产妇胎位异常、宫缩乏力、胎儿宫内窘迫等情况发生率为4.44%,与对照组(33.33%)比较差异有统计学意义(P<0.05)。结论:拉玛泽减痛分娩法配合分娩球护理可缩短产程时间,降低难产率,减轻产妇痛苦,对改善母婴预后具有重要意义,值得推广。%Objective:To investigate the effect of Ramaze pain relief delivery method combined with delivery ball care on the outcome of delivery. Methods:A total of 90 puerpera who got antenatal examination and delivered in our hospital from Aug 2014 to Jun 2015 were selected and divided into 2 groups by random number table method. And 45 cases in the control group received conventional delivery care, while 45 cases in the observation group received Ramaze pain relief delivery method combined with delivery ball care. Their outcomes of delivery were observed. Results:Delivery process in the observation group were significantly shorter than in the control group (P<0.05) . The occurrence rate of maternal fetal abnormalities, uterine atony, fetal intrauterine distress in the observation group was 4.44%, which was significantly less than 33.33% in the control group (P<0.05) . Conclusions:Ramaze pain relief delivery method combined with delivery ball care can shorten delivery process,reduce the rate of dystocia,and reduce maternal pain. It is important in improving the prognosis of mothers and their infants,and worthy of promotion.

  18. Short communication: genetic evaluation of stillbirth in US Brown Swiss and Jersey cattle.

    Science.gov (United States)

    Yao, C; Weigel, K A; Cole, J B

    2014-01-01

    Stillbirth (SB) often results in reduced milk yield, compromised reproductive performance, and decreased dam longevity. Corrective mating can be used as a short-term solution to the problem, but long-term improvement of the population requires the routine calculation of genetic evaluations. Breeding values for SB have been available for Holstein (HO) bulls since 2006, but not for Brown Swiss (BS) or Jersey (JE) bulls. In this study, a multi-breed sire-maternal grandsire threshold model was used to perform genetic evaluations for SB of BS, JE, and HO bulls using more than 14 million purebred and crossbred calving records. Phenotypically, the percentage of SB (%SB) across all lactations were 3.7% in JE, 5.1% in BS, and 6.3% in HO. Direct heritabilities for BS, JE, and HO were 0.008, 0.007, and 0.008, and maternal heritabilities were 0.002, 0.016, and 0.021, respectively. Compared with HO, crossbred calvings from BS and JE bulls bred to HO cows lowered %SB by 1.5 and 1.2%, respectively. In general, %SB increased considerably as calving difficulty increased in all 3 breeds; however, in JE, %SB was constant for dystocia scores of 3 (needed assistance), 4 (considerable force), and 5 (extreme difficulty). Compared with purebred HO calvings, purebred BS and JE calvings had lower phenotypic %SB by up to 5.5 and 7.8%, respectively, and BS × HO and JE × HO crossbred calvings decreased %SB by up to 3.8 and 4.1%, respectively. As expected, SB rates in primiparous cows were higher than those in multiparous cows. Female calves had greater %SB than male calves in all parities for JE and in second-and-later parities for BS. Favorable (decreasing) phenotypic and genetic trends from 1999 to 2009 were observed in all 3 breeds. Heterosis of SB for BS and JE was -0.026 and -0.149, respectively, on the underlying scale, which corresponds to effects on service-sire SB (SSB) and daughter SB (DSB) predicted transmitting ability (PTA) of -0.3 and -0.5% in BS, and -1.5 and -2.7% in JE

  19. Analysis of Related Factors and Nursing Strategies of Cerebral Palsy in Children%小儿脑性瘫痪的相关影响因素及护理对策分析

    Institute of Scientific and Technical Information of China (English)

    李志琼; 张海英; 何亚娟; 冉珊

    2016-01-01

    0bjective: To analyze the related risk factors of cerebral palsy in children, and put forward the corresponding nursing measures. the related risk factors of cerebral palsy in children, and to put forward the corresponding nursing measures.Methods:Select from Mar 2013 to Feb 2015 in our hospital 100 cases of children with cerebral palsy in children for the study, divided according to the severity of cerebral palsy in children with mild group (observation group) and severe cerebral palsy group (control group), children with clinical data were retrospectively analyzed factors may affect children with cerebral palsy Logistic regression analysis.Results:By the Logistic multivariate analysis showed that the risk factors associated with cerebral palsy have intrauterine infection (OR=4.786,P=0.028), neonatal asphyxia (OR=3.004,P=0.000), low birth weight (OR=4.370,P=0.000), dystocia (OR=2.021,P=8.070),preterm birth (OR=2.130,P=0.007) and high bile hemoglobin (OR=1.810,P=0.019).Conclusion:Children with cerebral palsy and associated risk factors more, should make the appropriate preventive measures against the risk factors, many of comprehensive nursing intervention can improve the prognosis of patients with cerebral palsy.%目的:分析小儿脑性瘫痪的相关危险因素,并提出相应的护理措施。方法:选取2013年3月至2015年2月在我院就诊的小儿脑性瘫痪患儿100例为研究对象,根据患儿病情严重程度分为脑瘫轻症组(观察组)和脑瘫重症组(对照组),对患儿的临床资料进行回顾性分析,将可能与发生小儿脑性瘫痪的影响因素进行Logistic回归分析。结果:经Logistic多因素分析发现,与小儿脑性瘫痪相关的危险因素有宫内感染(OR=4.786,P=0.028)、新生儿窒息(OR=3.004,P=0.000)、低体重(OR=4.370, P=0.000)、难产(OR=2.021,P=8.070)、早产(OR=2.130,P=0.007)及高胆血红素(OR=1.810,P=0.019)。结论:与小儿脑

  20. Effect on Fetal Heart of Gestational Diabetes Mellitus%妊娠糖尿病对子代心脏的影响

    Institute of Scientific and Technical Information of China (English)

    马若嘉; 仇小强

    2014-01-01

    妊娠糖尿病(GDM)是妊娠期间首次发现的糖尿病,不包括妊娠前已有糖尿病的孕妇,占妊娠合并糖尿病的80%左右。GDM是一种发生在妊娠中晚期的高危妊娠,由各种原因引起的胰岛素分泌不足或胰岛素抵抗所致的妊娠期特有的疾病。母体内的高血糖通过胎盘进入胎儿体内,促使胎儿胰岛B细胞增生肥大,分泌大量胰岛素,导致胎儿高胰岛素血症,宫内窘迫、胎死宫内、羊水过多、早产、难产等不良妊娠结局。胎儿体内高血糖和高胰岛素血症作用于心脏,引起心肌细胞增生肥大,导致胎儿心脏在结构和功能上发生改变,由此影响胎儿整体的生理功能。近年来随着妊娠糖尿病的发病率逐年增高,妊娠糖尿病引起的子代心脏缺陷的越来越受到重视,故本文就妊娠糖尿病对胎儿心脏的影响作一综述。%Gestational diabetes meilltus is a condition in which without previously diagnosed diabetes exhibit high blood glucose level during pregnancy, except pregestational diabetes or gestational impaired glucose tolerance, gestational diabetes meilltus accounts for more than 80%. GDM is one of the high risk pregancy during the third trimester caused by abnormal insulin secretion and insulin resistance. Maternal high blood glyucose through the placenta into the fetus in the womb, prompting fetal islet B cell proliferous hypertrophy, secrete large amounts of insulin, and lead to fetal hyperinsulinemia intrauterine distress, fetal intrauterine, hydramnios, preterm birth, dystocia and other adverse pregnancy outcomes. Hyperglycemia and hyperinsulinemia in the fetus cause myocardial cell proliferous hypertrophy, induce fetal heart on structure and function change, thus affecting the overall physiological function. In recent years, with the incidence of gestational diabetes increased, fetus heart defects caused by GDM has been taken more and more seriously, so this paper

  1. Clinical presentation and management of diabetes mellitus in pregnancy

    Directory of Open Access Journals (Sweden)

    Al-Azemi N

    2013-12-01

    incidences of fetal anomaly (1.17%, shoulder dystocia (1.8%, and Erb’s palsy (1.8% were low. Conclusion: Gestational diabetes mellitus was diagnosed in 71.9% of the diabetic patients studied, and dietary control and increased physical activity were the main modalities of management. There was an increased rate of cesarean section in the study population, the incidences of maternal and perinatal morbidity were low, and the perinatal outcomes were satisfactory. Keywords: clinical features, diagnosis, GDM treatment outcom

  2. Factors Affecting SSR in Holstein Dairy Cows

    Directory of Open Access Journals (Sweden)

    Alireza Heravi Mosavi

    2016-08-01

    reports have shown that high environmental temperature and higher rates of evaporation from a week to a month before conception secondary sex ratio was increased. Materials and method The demographic, production and reproduction data of six large dairy farms between years 1375 and 1389 were used. The rolling average of 305 d fat corrected milk yield was 8145 kg with a range of 7578 to 8670 Kg. Breeding Center of Iran and the herds covered by the registration and recording them on a regular basis carried out by experts dairy cooperatives. The flocks were in the area northeast of the country. Production data (date corrected milk production and the cumulative production by 60 and 305 days of lactation, reproductive data (such as calving year, calving season, type of birth, sex of calf, the latest information on AI, days open , and details the possible removal of the flock or death were recorded. Data were collected from flocks before the analysis was re-verification. Used by sperm, sperm into four groups: Iranian, Canadian, American and other countries (including sperm taken from European countries groups. The data were analyzed using multivariate logistic regression model. Statistics 0/05 was used to ensure meaningful results. Results and discussion Results showed that the ratio of males to females was 53 to 47. Origin of the sires (including Iranian, American, or Canadian had no impact on secondary sex ratio. Type of calving (eutocia vs. non-eutocia calving including dystocia and still birth had significant impact on SSR (P

  3. WT1基因组蛋白乙酰化修饰对细胞核重编程的影响%Effect of histone acetylation modification of Wilms' tumor Ⅰ gene on nuclear reprogramming

    Institute of Scientific and Technical Information of China (English)

    高飞; 刘丽梅; 安培培; 谭文涛; 唐博; 李子义

    2012-01-01

    利用体细胞移植技术获得克隆动物的成功是几十年来生命科学领域取得的重大突破之一,这项技术引起了社会的广泛关注。然而,由于哺乳动物克隆效率低下,且克隆后代发育异常等问题,已成为目前制约动物克隆技术发展和应用的瓶颈。克隆动物中经常出现后代过大综合征(LOS),该病导致克隆动物早产、难产和易夭折。LOS类似于人的伯-伟综合征(BWS),BWS也称为Wlims瘤,表现为巨舌、内脏肿大等症状。研究发现BWS的发病机理与WT1基因(Wilms’tumor 1gene)异常表达有关。本文对体细胞核重编程和表观遗传学调控细胞重编程的研究进展进行综述,并对WT1基因组蛋白乙酰化修饰与体细胞重编程之间的联系进行简要介绍,以期为生命科学领域的进一步探索与研究提供借鉴。%The birth of animals produced by somatic cell nuclear transfer(SCNT) is one of major breakthroughs in life sciences in recent decades.The SCNT technology has aroused wide concern.However,due to the low efficiency of mammalian clone and the abnormal development of cloned offspring,its development and application has been restricted greatly.Large offspring syndrome(LOS) is one of abnormal developments in the cloned animals,which leads to premature delivery,dystocia and easy to die.LOS is similar to the BO-Wei syndrome(BWS) in human.BWS is also known as Wlims' tumor(WT),which performs for the giant tongue,swelling of visceral organ and other symptoms.It was found that the pathogenesis of BWS was associated with abnormal expression of WT1 gene.This review briefly describes the progress of somatic cell nuclear reprogramming and epigenetic regulation of cell reprogramming in past years.Also,it describes the relationship between the WT1 modification of histone acetylation and somatic cell reprogramming in order to provide the clue for further investigations.

  4. 导乐分娩在初产妇分娩的应用效果分析%Effect Analysis of Doula Delivery on the Delivery of Primiparae

    Institute of Scientific and Technical Information of China (English)

    陈素华; 倪伟平; 赵柏慧

    2016-01-01

    Objective To analyze application effect of doula delivery management measures among primiparae.Methods In total of 98 primiparae who had term delivery in our hospital from April 2013 to December 2014 were included in our study. According to the delivery order, primiparae were divided into observation group and control group averagely. Primiparae in control group received routine management of stage of labor in delivery room, while primiparae in observation group received not only routine management but also doula delivery management. The situation of primiparae in two groups during and after delivery were compared, and the effect of doula delivery management among primiparae was analyzed.Results The bleeding volume during delivery, postpartum bleeding volume, delivery time and hospital stay in observation group were less than these in control group, and the differences were significant (P <0.05). The occurrence rate of dystocia, the caesarean section and neonatal asphyxia was significantly lower than the control group, and the difference was significant (P <0.05). The postpartum satisfaction rate in observation group was significantly higher than that in control group, and the differences were significant (U=2.9494, P=0.0032).Conclusions Doula delivery management measures can ease the nervousness of primiparae during childbirth, improve the birth quality of newborns, and should be popularized.%目的探究全程人性化导乐分娩管理措施在初产妇中的应用效果分析。方法随机选取于2013年4月至2014年12月来到我院的足月分娩产妇总计98例作为本次研究对象,按照产妇分娩的先后顺序将其平均分为观察组和对照组,对照组产妇采用常规的产房产程管理方式,观察组产妇在此基础上采用全程人性化导乐分娩管理措施,比较两组产妇在分娩过程中的情况以及分娩后情况,分析全程人性化导乐分娩管理措施在初产妇中的应用效果。结果观察组

  5. The cardiac biomarkers troponin I and CK-MB in nonpregnant and pregnant goats, goats with normal birth, goats with prolonged birth, and goats with pregnancy toxemia.

    Science.gov (United States)

    Tharwat, M; Al-Sobayil, F; Al-Sobayil, K

    2012-10-15

    This study was designed to establish the reference range for the cardiac biomarkers cardiac troponin I (cTnI) and creatine kinase myocardial band (CK-MB) in nonpregnant and pregnant goats, goats with normal birth, goats with prolonged birth associated with dystocia, and goats with pregnancy toxemia. Fifty-seven does, categorized into three groups (G1 to G3), were used. These groups were comprised of 20 healthy does (G1), 19 does with prolonged birth (G2), and 18 does with pregnancy toxemia (G3). Six blood samples (T0 to T5) were collected from G1. The first blood sample (T0) was taken before insemination, the second (T1) at the first trimester, the third (T2) at the second trimester, the fourth (T3) at the last trimester, the fifth (T4) within 12 h of parturition, and the sixth blood sample (T5) was taken 10 days after parturition. A sample of blood was obtained from G2 and G3 upon admission to the hospital. At T0 to T3, no cTnI was detected in any of the 20 does in G1. At parturition (T4), seven of the 20 goats (35%) exhibited slightly elevated cTnI concentrations (range, 0.01 to 0.04 ng/mL). Ten days after parturition (T5), cTnI was not detected in any of the 20 goats. In 10 of the 19 goats (53%) with prolonged birth (G2), the cTnI was significantly elevated to a mean value of 0.094 ± 0.155 ng/mL, with a maximum value of 0.61 ng/mL. In 16 of the 18 goats (89%) with pregnancy toxemia (G3), the cTnI was significantly elevated to a value of 0.852 ± 1.472 ng/mL, with a maximum value of 5.219 ng/mL. Comparing the values of CK-MB in G1 (T0 to T5), G2 and G3 revealed nonsignificant differences. Only a slight elevation in the CK-MB levels in goats with prolonged birth (G2) was noted. We concluded that in healthy does, the cardiac biomarker cTnI is not elevated during normal pregnancy. The serum cTnI concentration may be elevated in a number of goats at normal vaginal or cesarean delivery. Finally, cTnI is significantly elevated in does with pregnancy toxemia and could

  6. The role of blood groups in the development of diabetes mellitus after gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Karagoz H

    2015-10-01

    Full Text Available Hatice Karagoz,1 Abdulsamet Erden,2 Ozerhan Ozer,2 Kubra Esmeray,2 Ali Cetinkaya,2 Deniz Avci,2 Samet Karahan,2 Mustafa Basak,2 Kadir Bulut,2 Hasan Mutlu,3 Yasin Simsek4 1Internal Medicine Department, Acibadem Kayseri Hospital, 2Internal Medicine Department, 3Medical Oncology Department, 4Endocrinology Department, Kayseri Training and Research Hospital, Kayseri, Turkey Introduction: Gestational diabetes mellitus (GDM is a common condition that is defined as glucose intolerance of varying degree with onset or first recognition during pregnancy and it affects approximately 5% of all pregnancies all over the world. GDM is not only associated with adverse pregnancy outcomes such as macrosomia, dystocia, birth trauma, and metabolic complications in newborns, but it is also a strong predictor of transitioning to overt DM postpartum. The association of ABO blood groups with DM has been observed before in several epidemiological and genetic studies and resulted with inconsistent findings, but still there are not enough studies in the literature about the association of ABO blood groups with GDM. In this study, we aimed at investigating any possible relationship between the ABO blood group system and GDM and also the transitioning of GDM to overt DM postpartum, in Turkey.Patients and methods: A total of 233 patients with GDM from Kayseri Training and Research Hospital between 2002 and 2012 were included in the study. The cases that have serologically determined blood groups and Rh factor in the hospital records were included in the study, and the patients with unknown blood groups were excluded. Patients were classified according to blood groups (A, B, AB, and O and Rh status (+/-. GDM was diagnosed based on the glucose cut-points of the International Association of the Diabetes and Pregnancy Society Groups. The distributions of blood groups of the patients with GDM were compared with the distribution of blood groups of 17,314 healthy donors who were

  7. Hyperglycaemia and risk of adverse perinatal outcomes: systematic review and meta-analysis

    Science.gov (United States)

    Simmonds, Mark; Bryant, Maria; Sheldon, Trevor A; Tuffnell, Derek; Golder, Su; Dunne, Fidelma; Lawlor, Debbie A

    2016-01-01

    Objectives To assess the association between maternal glucose concentrations and adverse perinatal outcomes in women without gestational or existing diabetes and to determine whether clear thresholds for identifying women at risk of perinatal outcomes can be identified. Design Systematic review and meta-analysis of prospective cohort studies and control arms of randomised trials. Data sources Databases including Medline and Embase were searched up to October 2014 and combined with individual participant data from two additional birth cohorts. Eligibility criteria for selecting studies Studies including pregnant women with oral glucose tolerance (OGTT) or challenge (OGCT) test results, with data on at least one adverse perinatal outcome. Appraisal and data extraction Glucose test results were extracted for OGCT (50 g) and OGTT (75 g and 100 g) at fasting and one and two hour post-load timings. Data were extracted on induction of labour; caesarean and instrumental delivery; pregnancy induced hypertension; pre-eclampsia; macrosomia; large for gestational age; preterm birth; birth injury; and neonatal hypoglycaemia. Risk of bias was assessed with a modified version of the critical appraisal skills programme and quality in prognostic studies tools. Results 25 reports from 23 published studies and two individual participant data cohorts were included, with up to 207 172 women (numbers varied by the test and outcome analysed in the meta-analyses). Overall most studies were judged as having a low risk of bias. There were positive linear associations with caesarean section, induction of labour, large for gestational age, macrosomia, and shoulder dystocia for all glucose exposures across the distribution of glucose concentrations. There was no clear evidence of a threshold effect. In general, associations were stronger for fasting concentration than for post-load concentration. For example, the odds ratios for large for gestational age per 1 mmol/L increase of

  8. Intravenous fluid rate for reduction of cesarean delivery rate in nulliparous women: a systematic review and meta-analysis.

    Science.gov (United States)

    Ehsanipoor, Robert M; Saccone, Gabriele; Seligman, Neil S; Pierce-Williams, Rebecca A M; Ciardulli, Andrea; Berghella, Vincenzo

    2017-07-01

    The National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine have emphasized the need to promote vaginal delivery and have offered recommendations to safely prevent primary cesarean delivery. However, there has been limited discussion regarding management of intravenous fluids and other aspects of labor management that may influence mode of delivery. Therefore the aim of our study was to determine whether an intravenous fluid rate of 250 vs. 125 mL/h is associated with a difference in cesarean delivery rate. Searches were performed in MEDLINE, OVID, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, Embase, Web of Science, and the Cochrane Library for randomized controlled trials. We included all randomized controlled trials comparing intravenous fluid rates of 250 vs. 125 mL/h in nulliparous women in spontaneous labor at term with singleton pregnancies at ≥36 weeks. Studies were included regardless of the type of intravenous fluids used and regardless of whether oral intake was restricted during labor. Studies including multiparous women or women whose labor was induced were excluded. The primary outcome was the incidence of cesarean delivery. We planned to assess a subgroup analysis according to type of fluids used and according to restriction of oral fluid intake. Seven trials including 1215 nulliparous women in spontaneous labor at term were analyzed; 593 (48.8%) in the 250 mL/h group, and 622 (51.2%) in the 125 mL/h group. Five studies used lactated Ringer's solution, one used normal saline in dextrose water, and in one study it was unclear which intravenous fluid was used. Women who received intravenous fluids at 250 mL/h had a significantly lower incidence of cesarean delivery for any indication (12.5 vs. 18.1%; RR 0.70, 95% CI 0.53-0.92; seven studies, 1215 participants; I(2) = 0%) and for dystocia (4.9 vs. 7.7%; RR

  9. [Investigation on the approach of delivery after previous cesarean section of Xinjiang Uyghur women].

    Science.gov (United States)

    Ding, Xin; Aimainilezi, Adalaiti; Jin, Yan; Abudula, Wuriguli; Yin, Chenghong

    2014-10-01

    To explore the appropriate approach of delivery after cesarean section of Uyghur women in primary hospitals in Xinjiang Uyghur Autonomous Region. A total of 5 154 women delivered in Luopu County People Hospital, Hetian Prefecture, Xinjiang Uyghur Autonomous Region from January 2011 to December 2012. Among them, 178 Uyghur women had cesarean section history. The interval between the previous cesarean section and this delivery varied from 1 year to 17 years. The number of cases attempting vaginal labor and the indications of the previous cesarean section were recorded. The indications for the second cesarean section were analyzed. The gestational weeks at delivery, blood loss in 2 hours after delivery, neonatal birth weight, newborn asphyxia, the rate of postpartum fever (≥ 38 °C) and hospitalization days were compared between the two approaches of delivery. (1) Among the 178 cases, 119 cases attempted vaginal labor, the rate of attempting vaginal labor was 66.9% (119/178). A total of 113 cases succeeded in vaginal delivery (the vaginal delivery group), with the successful rate of attempting vaginal delivery of 95.0% (113/119), and the successful rate of vaginal delivery was 63.5% (113/178). For those 119 women succeeded in vaginal delivery, the indications of the previous cesarean sections were as following: pregnancy complications (68.1%, 81/119), macrosomia(5.0%, 6/119), dystocia (14.3%, 17/119), pregnancies complicated with other diseases (5.0%, 6/119) and cesarean section on maternal request (7.6%, 9/119). (2) 15 cases in the cesarean section group had postpartum hemorrhage, with the incidence of 13.3% (15/113). The mean total labor time was (507 ± 182) minutes. 6 cases attempting vaginal delivery failed and turned to cesarean section. (3) 59 cases received the second cesarean section (the cesarean section group). The rate of second cesarean section was 33.1% (59/178). The indications of the second cesarean section were as following: contracted pelvis (5%, 3

  10. Breast feeding rate and its influencing factors in Haidian District of Beijing%北京市海淀区婴儿母乳喂养率及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    曹洁

    2014-01-01

    Objective To understand the breast feeding status in Haidian District and explore its influencing factors , so as to provide basis for improvement of infant nutrition .Methods A self-designed questionnaire survey was carried out among 580 mothers or caregivers , who took their babies aged 0-4 months for health care in child early department center of Haidian Maternal and Children Health Hospital in the period of January to December in 2012.Results The pure breast feeding rate of mothers with senior middle school education or lower was significantly higher than that of the mothers with vocational high school education or higher (χ2 =4.192,P<0.05).The rate of breast feeding was different among mothers with different occupation , and that was highest among unemployed women (χ2 =9.631,P<0.05). The rate of pure breast feeding of eutocia was higher than that of dystocia (χ2 =5.631,P<0.05).The rate of pure breast feeding of women with normal breast development was higher than that of women with abnormal breast development (χ2 =48.275, P<0.05).Conclusion Education , occupation , obstetrical way as well as breast development are the major influencing factors of breast feeding .Intervention program should be implemented by maternal and child health care workers .%目的:了解北京市海淀区婴儿母乳喂养情况,探讨影响母乳喂养的相关因素,为改善婴儿营养提供依据。方法采用随机抽样的方法,抽取在北京市海淀妇幼保健医院儿童早期发展中心进行健康检查的0~4个月龄婴儿580例,用自行设计的母乳喂养状况调查表,了解2012年1月至12月产妇母乳喂养情况。结果母亲高中文化程度以下较中专文化程度以上纯母乳喂养率高,差异有统计学意义(χ2=4.192,P<0.05)。不同职业的母乳喂养率差异有统计学意义,其中全职妈妈的母乳喂养率最高(χ2=9.631,P<0.05)。顺产组的纯母乳喂养率高于剖宫产组

  11. 营养指导对糖尿病合并妊娠患者及胎儿的发育影响分析%The analysis of nutrition guidance on pregnant women with pre-gestational diabetes and fetal development

    Institute of Scientific and Technical Information of China (English)

    罗力冰; 吴婷; 徐跃

    2014-01-01

    Objective To discuss the influence of nutrition guidance on pregnant women with pre -gestational diabetes and fetal development .Methods 138 pregnant women with pre -gestational diabetes were selected in Nanshan District Maternal and Child Health Hospital from June 2010 to January 2013, which were randomly divided into the nutritional guidance group ( 68 cases ) , treated by medical nutrition guidance , and routine diet group ( 70 cases), treated by conventional dietary guidance .The outcome of pregnancy and fetal development in the two groups were observed .Results The level of glycated hemoglobin and adiponectin in nutritional guidance group were lower than routine diet group ( P <0.05 ) .The incidences of pregnancy induced hypertension syndrome , urinary tract infection, ketoacidosis, hypoglycemia, polyhydramnios, dystocia, abortion and death in nutritional guidance group were lower than routine diet group ( P <0.05 ) . The incidences of congenital malformation , macrosomia , hypocalcemia , asphyxia and fetal distress in nutritional guidance group were lower than routine diet group (P<0.05).Conclusion A scientific and rational nutrition guidance can improve the nutriture of pregnant women with pre -gestational diabetes , promote the healthy development of fetus and reduce the incidence of the complications of mothers and infants .%目的:探讨营养指导对糖尿病合并妊娠患者及胎儿的发育影响。方法选择2010年6月至2013年1月在深圳市南山区妇幼保健院确诊为糖尿病合并妊娠患者138例,随机分为营养指导组68例和常规饮食组70例,营养指导组给予医学营养指导,常规饮食组给予常规饮食指导,观察两组妊娠结局及胎儿的发育情况。结果营养指导组糖化血红蛋白水平、脂联素水平低于常规饮食组( P<0.05);妊娠期高血压疾病、泌尿道感染、酮症酸中毒、低血糖、羊水过多、难产、流产和孕妇死亡的发生率

  12. Related high-risk factors of neonatal encephalopathy and its constitution analysis%新生儿脑病相关高危因素及构成分析

    Institute of Scientific and Technical Information of China (English)

    尚利宏; 王颍源; 李书津

    2014-01-01

    ,perinatal infection,septicemia and dystocia' etc.The acute anoxic events during production didn' t all lead to the occurrence of hypoxic ischemic encephalopathy.Conclusions The neonatal encephalopathy consists of hypoxic ischemic encephalopathy,intracranial hemorrhage,intracranial infection,congenital inherited metabolic diseases,bilirubin encephalopathy,chromosome disease,cerebral infarction,hypoglycemic encephalopathy,the main anatomical abnormalities,and neonatal hypoxic ischemic encephalopathy was related to many perinatal high-risk factors,therefore,the etiology of neonatal encephalopathy cannot simply be attributed to intrapartum acute hypoxic events.

  13. Effects of intrauterine infusion of Escherichia coli lipopolysaccharide on uterine health, resolution of purulent vaginal discharge, and reproductive performance of lactating dairy cows.

    Science.gov (United States)

    Moraes, João G N; Silva, Paula R B; Mendonça, Luís G D; Scanavez, Alexandre A; Silva, Joseane C C; Chebel, Ricardo C

    2017-06-01

    The objectives of the current experiment were to evaluate the effects of intrauterine infusion of Escherichia coli lipopolysaccharide (LPS) in cows diagnosed with purulent vaginal discharge (PVD) on intrauterine cell population, resolution of PVD, uterine health, and reproductive performance. Jersey cows (n = 3,084) were examined using the Metricheck device to diagnose PVD at 35 ± 6 d postpartum. Purulent vaginal discharge was defined as the presence of purulent (≥50% pus) discharge detectable in the vagina. Of the 310 cows positive for PVD, 267 cows were enrolled in the current experiment. To ensure proper timing of treatment and collection of samples, only 9 PVD-positive cows were treated per day. Selected cows were balanced at 35 ± 6 d postpartum for lactation number, body condition score, and milk yield and were randomly assigned to receive an intrauterine infusion of 20 mL of phosphate-buffered saline (PBS; control, n = 87), 20 mL of PBS with 150 µg LPS (LPS150, n = 91), or 20 mL of PBS with 300 µg of LPS (LPS300, n = 89). Uterine cytology was performed immediately before treatment and 1, 2, and 7 d after treatment to evaluate the effect of LPS treatment on intrauterine cell population. Cows were examined with the Metricheck device at 7 and 28 d after treatment to evaluate the effects of treatment on resolution of PVD. Reproductive status was recorded up to 200 d postpartum. Cows diagnosed with PVD had greater incidence of twinning, dystocia, retained placenta, and metritis after calving than cows without PVD. Count of polymorphonuclear leukocytes (PMNL) in uterine cytology 1, 2, and 7 d after intrauterine infusion was not statistically different among treatments. From d 0 to 1, however, PMNL count in uterine cytology of PBS cows increased by 5%, whereas the PMNL count in uterine cytology of LPS150 and LPS300 cows increased by 54 and 48%, respectively. Treatment did not affect the likelihood of cows being diagnosed with PVD 7 and 28 d after intrauterine

  14. Incidência de cesáreas segundo fonte de financiamento da assistência ao parto Incidence of cesarean delivery regarding the financial support source for delivery care

    Directory of Open Access Journals (Sweden)

    Marta Edna Holanda Diógenes Yazlle

    2001-04-01

    ão Preto. RESULTS: A total of 86,120 deliveries were registered during the study period; 5.4% were allocated in the private category, 28.7% in the prepayment category, and 65.9% in the public health system (SUS. It was observed a decrease in the private and SUS categories and an increase in the prepayment category. During the study period, the percentage of cesarean deliveries increased from 68.3% to 81.8% in the private category and from 69.1% to 77.9% in the prepayment category, and decreased from 38.7% to 32.1% in the SUS category. The major indications for cesarean section were fetal distress, with the incidence of 9.5%, 10.9% and 9.0% in the private, prepayment and SUS categories, respectively; and cephalopelvic dystocia, at the rates of 5.8%, 6.5% and 3.9%, respectively. CONCLUSION: The incidence of cesarean section varied according to admission category, with a rising trend as the pregnant woman's social status increased, but without a correlation with the obstetrical risk.

  15. 207 EFFICIENT GENERATION OF MYOSTATIN PROMOTER MUTATIONS IN BOVINE EMBRYOS USING THE CRISPR/Cas9 SYSTEM.

    Science.gov (United States)

    Pinzon, C A; Snyder, M; Pryor, J; Thompson, B; Golding, M; Long, C

    2016-01-01

    The myostatin gene or growth differentiation factor 8 is a member of the transforming growth factor-β superfamily that acts as a negative regulator of muscle growth. Mutations inactivating this gene occur naturally in Piedmontese and Belgian Blue cattle breeds, resulting in a dramatic increase in muscle mass, albeit with unwanted consequences of increased dystocia and decreased fertility. Modulation of muscle mass increase without the unwanted effects would be of great value for improving livestock growth and economic value of livestock. The objective of our work was to use the CRISPR-Cas9 genetic engineering tool to generate deletions of different elements in the myostatin promoter in order to decrease the level of expression and obtain an attenuated phenotype without the detrimental consequences of an inactivating mutation. To achieve this objective 4 different small guide RNA (sgRNA) targeting the promoter near the mutation were designed with PAM positions from transcription starting site of -1577, -689, -555, and -116. These sgRNA were cloned individually into the Cas9 plasmids (px461, and px462; Addgene®). These plasmids allow for a dual puromycin resistance (px462) and green fluorescent protein (px461) selection. We first tested the functionality of these sgRNA in vitro by co-transfecting bovine fetal fibroblasts with a combination of both plasmids (Set 1=sgRNA 1-4; Set 2=sgRNA 2-3). Cells were exposed to puromycin (0.2µgmL(-1)) for 72h, then single and mixed colonies positive for green fluorescent protein expression were separated for propagation. The DNA was extracted for PCR amplification of the targeted region. Multiple deletions and a few insertion events were observed after PCR, bands were cloned into TOPO® vector (Thermo Fisher Scientific, Waltham, MA, USA) and sequenced. Sequencing results confirmed the PCR products as insertions or deletions in the myostatin promoter region. We proceeded to modify the myostatin promoter directly in bovine zygotes

  16. A STUDY OF THE EFFECTS OF DROTAVERINE HYDROCHLORIDE AND HYOSCINE BUTYLBROMIDE IN THE ACCELERATION OF THE FIRST STAGE OF LABOUR IN PRIMIGRAVIDAE AT SMIMS

    Directory of Open Access Journals (Sweden)

    Shwetha

    2016-03-01

    Full Text Available BACKGROUND With regard to normal labour, many eminent obstetricians have aptly remarked that of all the journeys the most dangerous is the very first one we make through the last ten centimetres of the birth canal. Hence, it is imperative that this short but crucial process is made safest for the baby. The role of a good obstetrician is to convert an abnormal situation where the events are not happening to one in which order is regained. Methods that aim at minimizing the incidence of functional cervical dystocia and cutting short the 1st stage of labour are always accepted by the obstetricians and patients. OBJECTIVES To compare the effect of Inj. Buscopan IV and Inj. Drotaverine & to find out which of the above drugs is more effective in shortening the labour. METHODOLOGY This study was undertaken at Sree Mookambika Institute of Medical Sciences from June 2015 to December 2015. The sample size was calculated using the formula sample size n=2Z1 2 S 2 /d 2. , sample size required is 29. We have taken 50 sample sizes per group. This is a cross-sectional study. Inclusion criteria was primigravidae with full term gestation with vertex presentation in active labour. RESULTS The mean duration of 1st stage (active phase of labour in group D was 118.04 mins., that of group H 129.74 mins. and of group C 185.38 mins. The mean duration of 2nd stage of labour in group D was 23.20 mins., that of group H 25.38 mins. and of group C 23.97 mins. The mean duration of 3rd stage of labour in group D was 11.44 mins., that of group H 14.02 mins. and of group C 15.16 mins. Rate of cervical dilatation is significantly more in Group D when compared to Group C (3.147 mins. vs. 1.97 mins. (p<0.001. The rate of cervical dilatation is significantly more in Group H when compared to Group C (2.78 mins. vs. 1.97 mins. (p<0.001. Rate of cervical dilatation was also significantly more in Group D when compared to Group H (3.147 mins. vs. 2.78 mins. (p<0.001. Frequency of usage

  17. Enfermidades de cutias (Dasyprocta aguti criadas em cativeiro diagnosticadas pelo exame anatomopatológico Diseases of agouti (Dasyprocta aguti raised in captivity diagnosed by pathological examination

    Directory of Open Access Journals (Sweden)

    Jael S. Batista

    2010-06-01

    Full Text Available O exame necroscópico é especialmente útil no diagnóstico de enfermidades em animais silvestres. Em muitas ocasiões, as manifestações clínicas não são características como em animais domésticos, sendo frequente a ocorrência de óbitos em animais assintomáticos. Este trabalho objetivou realizar um estudo retrospectivo sobre as doenças de cutias diagnosticadas pelo Laboratório de Patologia Veterinária da Universidade Federal Rural do Semi-Árido, através do exame anatomopatológico no período de 2006 a 2009. Em 32 cutias submetidas à necropsia, as percentagens das enfermidades diagnosticadas foram: morte perinatal pelo complexo inanição/hipotermia (21,6%, urolitíase obstrutiva (6,24%, distocia (6,24%, obstrução do ceco por areia - sablose (6,24%, intussuscepção (3,20%, fecaloma (3,20% e obstrução do esôfago (3,20%. Dezesseis (16 animais permaneceram sem diagnóstico, dos quais nove (28,48% apresentavam avançado estado autolítico e em sete (21,60% não foram observadas lesões macro e microscópicas compatíveis com nenhuma enfermidade. Este artigo apresenta relatos de doenças ainda não descritas em cutias e seus resultados poderão produzir literatura sobre os aspectos patológicos destas enfermidades nessa espécie.Necroscopic examination is remarkably useful to diagnose wild animal's diseases. In several occasions the clinical signs are not charactheristic as in domestic animals and the occurrence of death in asymptomatic animals is frequent. Thus, the present work aimed to accomplish a retrospective study on agouti diseases diagnosed by pathological examination in the Laboratory of Veterinary Pathology, Federal Rural University of the Semi-arid, through January 2006 to December 2006. In 32 agoutis submitted to the necropsy, the percentage of diagnosed diseases was: perinatal death due hypothermia/ inanition complex (21.6%, obstructive urolithiasis (6.24%, dystocia (6.24%, cecum sablosis (6.24%, intussusceptions

  18. 山西省城市0~6个月龄婴儿母乳喂养现状调查%0-6 month-old infants breastfed Investigation in urban areas in Shanxi

    Institute of Scientific and Technical Information of China (English)

    任丽丽; 朱玲; 杨建平

    2016-01-01

    Objective To investigate the status and influencing factors of breastfeeding among infants of 0 to 6 months in urban areas in Shanxi,to increase the rate of breastfeeding.Methods A total of urban infants aged 0 -6 months were selected and their mothers were investigated by the questionnaire on site.Results A total of 4 868 urban infants aged 0 -6 months and their mothers were investigated.The rate of breastfeeding was 64.60%,the rate of mixed feeding was 27.90%,the rate of artificial feeding was 7.40%.The infants′mother′s age,culture level, the way of delivery(natural labor,dystocia,cesarean delivery),the situation of the nipple(normal,flat,concave), nutritional status during pregnancy,mother's self awareness of the amount of breasts supply(enough,not enough)were associated with breastfeeding(χ2 =62.367,25.021,67.419,60.941,16.675,8.241,3.081,all P <0.05 or P <0.01).Conclusion The corresponding measures should be taken according to the factors affecting breastfeeding in order to improve the rate of breastfeeding.%目的:了解目前山西省城市0~6个月龄婴儿母乳喂养现状及影响母乳喂养因素,提高母乳喂养率。方法采用现场问卷对城市0~6个月龄婴儿母乳喂养状况进行调查,对调查结果进行统计学分析。结果共调查0~6月龄婴儿及母亲4868例,母乳喂养率为64.60%,混合喂养率27.90%,人工喂养率7.40%。母乳喂养与婴儿母亲年龄、文化程度、分娩方式(顺产、难产、剖宫产)、乳头情况(正常、扁平、凹陷)、孕期营养状况、母亲自觉奶量(充足、不足)有关,差异均有统计学意义(χ2=62.367、25.021、67.419、60.941、16.675、8.241、3.081,均 P <0.05或 P <0.01)。结论应针对影响母乳喂养的因素采取相应措施,提高母乳喂养率。

  19. 低位产钳助产术的助产指征及并发症141例分析%Analysis of 141 cases of low forceps midwifery indications and complications

    Institute of Scientific and Technical Information of China (English)

    王冬梅; 马秀华

    2015-01-01

    Objective Discusses low forceps midwifery indications and complications, and the value of clinical appli-cation in obstetric delivery . Method Retrospective analysis of clinical data in our hospital in 2009~2013 years 141 cases of patients with low forceps. Result In the implementation of low forceps midwifery, the indications of mid-wifery are abnormal fetal distress, pillow, weakness of contractions, gestational hypertension disease, antepartum haemorrhage, hyperthyroidism merger, sinus tachycardia, expired pregnancy, pregnancy second prolonged labor. Mainly the indications of midwifery for abnormal fetal distress and pillow, both accounted for 90. 1% of the indica-tions of midwifery. Major maternal complication is vaginal injury, serious complication of neonatal is only 1. 4%. Fe-tal aspiration after failed forceps delivery group and directly for forceps delivery group, there are significant differ-ence in the maternal complications and neonatal complications (P<0. 05). The two groups in neonatal birth weight have significant difference(P<0. 05). Conclusion Correct evaluation and decision making, correct and skilled in the use of low forceps technique on mother and infant, small trauma. Low forceps delivery is to solve the head posi-tion dystocia, shorten the second stage of labor of the important operation method, it has the irreplaceable in obstet-rics childbirth.%目的:探讨低位产钳助产术的助产指征和并发症以及在产科分娩中的临床应用的价值。方法对本院2009~2013年实施的141例低位产钳术的临床资料进行回顾性分析。结果在实施低位产钳助产技术中助产指征有:胎儿窘迫、枕位异常、宫缩乏力、妊娠期高血压疾病、产前出血、甲亢合并妊娠、窦性心动过速、过期妊娠和第二产程延长。其中主要助产指征为胎儿窘迫及枕位异常,两者占助产指征的90.1%。母体并发症主要为阴道壁裂伤,而新生儿发

  20. Effects of prepartum diets supplemented with rolled oilseeds on calf birth weight, postpartum health, feed intake, milk yield, and reproductive performance of dairy cows.

    Science.gov (United States)

    Salehi, R; Colazo, M G; Oba, M; Ambrose, D J

    2016-05-01

    compared with cows fed no oilseeds, and a disproportionate increase in the birth weight of female calves was evident in cows fed oilseed. Total reproductive disorders tended to be greater in cows fed supplemental oilseed than those fed no oilseed (42 vs. 23%). Furthermore, cows fed sunflower seed had greater incidences of dystocia (35 vs. 18%) and total health disorders (52 vs. 32%) than those fed canola seed. Added oilseed and type of oilseed did not affect uterine inflammation at 25±1 d postpartum. Oilseed supplementation did not alter the intervals from calving to establishment of the first dominant follicle, preovulatory-size follicle, and ovulation, nor did it affect fertility (conception rate to first artificial insemination and proportion of pregnant cows by 150 d after calving). In summary, prepartum oilseed supplementation (6.2 to 7.4% ether extract, % of dietary dry matter) decreased DMI during the entire experimental period (pre- and postpartum), decreased milk yield during early lactation in multiparous cows, and increased calf birth weight with no significant improvement in ovarian function and reproductive performance.

  1. Multidisciplinary In Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project.

    Science.gov (United States)

    Lutgendorf, Monica A; Spalding, Carmen; Drake, Elizabeth; Spence, Dennis; Heaton, Jason O; Morocco, Kristina V

    2017-03-01

    obstetric emergencies and postpartum hemorrhage after simulation training compared to before training. For managing hypertensive emergencies, the post-training mean score was 4.14 compared to a pretraining mean score of 3.88 (p = 0.01, 95% confidence interval [CI] = 0.06-0.47). For shoulder dystocia, the post-training mean score was 4.29 compared to a pretraining mean score of 3.66 (p = 0.001, 95% CI = 0.41-0.88). For postpartum hemorrhage, the post-training mean score was 4.35 compared to pretraining mean score of 3.86 (p = 0.001, 95% CI = 0.36-0.63). We also observed a decrease in the time to prepare simulated blood products over the course of the simulation, and a decreasing trend of postpartum hemorrhage cases, which continued after initiating the postpartum hemorrhage simulation exercise. Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Comprehensive hemorrhage protocols have been shown to improve outcomes related to postpartum hemorrhage, and a critical component in these processes include communication, teamwork, and team-based practice/simulation. As medicine becomes increasingly complex, the ability to practice in a safe setting is ever more critical, especially for low-volume, high-stakes events such as postpartum hemorrhage. These events require well-functioning teams and systems coupled with rapid assessment and appropriate clinical action to ensure best patient outcomes. We have shown that a multidisciplinary in situ simulation exercise improves self-reported comfort with managing obstetric emergencies, and is a safe and effective way to practice skills and improve systems processes in the health care setting. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  2. Study on Temperament Characteristics of Premature Infants and Relative Influencing Factors%早产儿的气质特征及其影响因素研究

    Institute of Scientific and Technical Information of China (English)

    陈卫红; 王慧文; 汪颖烨

    2011-01-01

    persistence; fetal age and birth asphyxia influenced the phobotaxis; birth weight affected the rhythmic; mother's age, feeding patterns, and lung dysplasia at birth effected attention span. Fetal age, mode of delivery and living in incubator were related to the difficult type of premature infant temperament. Conclusion We can infer that the younger gestational age is the slower adaptability develops and the more transient persistence is. Premature infants with low gestational age, dystocia and necessity of infant incubator tend to suffer from difficult type of temperament. Mother's high educational level, sound family economic condition and appropriate antenatal care are helpful to develop good temperament for children.

  3. The participation of pregnan woment in pregnancy weight management and the effective measures%孕产妇参与孕期体重管理情况分析与有效措施

    Institute of Scientific and Technical Information of China (English)

    谢红密

    2011-01-01

    Objective To explore the effective measures for weight management in pregnant women and their influence on pregnancy outcomes.Methods 240 women with a singleton pregnancy who had a normal body mass index ( BMI ) before gastation or at the first trimester were randomly assigned to study group ( 120 women ),or control group ( 120 women ).Both group received conventional care,training and regular examination,and the study group received additional body weight intervention including reasonable dietary control,proper exercise,and basic perinatal education.Changes in BMI after labor were observed; the effective measures were analyzed and their influence on pregnancy outcomes was assessed.Results Theincidence rates of BMI ≥ 6,gestational hypertension,diabetes,vaginal delivery,fetal macrosomia,fetal distress,and postpartum hemorrhage was lower in the study group than in the control group ( x2=19.437,P< 0.01; x2=4.899,P< 0.05); x2=6.913,P< 0.01; x2=14.564,P< 0.001; x2=7.354,P< 0.05; x2=4.637,P< 0.05; and x2=6.913,P< 0.05).Conclusions Participation of pregnant women in pregnancy weight management can effectively reduce the complications during pregnancy and delivery and the rates of Cesarean section and dystocia,significantly improving pregnancy outcomes.%目的 探讨对孕产妇进行体重管理的有效措施,及其对妊娠结局的影响.方法 选取孕早期或孕前体重指数正常的单胎妊娠孕妇240例,随机抽取120例作为实验组,另外的作为对照组;对照组给予常规护理、培训和定期检查,实验组在对照组的基础上还进行体重干预,包括指导其进行合理控制饮食、适量运动、围产期基础知识培训等,观察分娩前后的体重指数变化,分析其有效措施并评价对妊娠结局的影响.结果 实验组体重指数变化≥6( 50.0% vs.76.7%)、妊高症(6.7%vs.15.8%)、糖尿病(2.5%vs.15.0%)、巨大儿( 5.0% vs 16.7%)、胎儿宫内窘迫(3.3%vs.12.5

  4. Manejo de novilhas prenhes aos 13/15 meses de idade em sistemas a pasto Pregnant heifers management at 13/15 months of age in grazing systems

    Directory of Open Access Journals (Sweden)

    Alcides Pilau

    2008-07-01

    de vaca.This experiment was carried out to evaluate the development of 32 primiparous beef heifers Aberdeen Angus and Angus crossbred raised and mating from 13 to the 15 months of age. The experiment had beginning in the pregnancy diagnosis of using ultra-sound technique, realized at 28 days after the ending of the reproductive period. The initial average weight and body condition (BC was 288 kg LW and 3.2 points, respectively. In this occasion, the beef heifers were uniformly distributed by genetic group, LW and conception order in two grazing systems. Grazing systems were: PMI - pregnant beef heifers maintained in the initial pregnancy period on pearl millet pasture (Pennisetum americanum, L.; PNA - pregnant heifers maintained in the initial pregnancy period on natural pasture. Grazed period was 67 days in pearl millet pasture. At end of the treatments the beef heifers were maintained as a unique group: on natural pasture at pre calving period, on annual ryegrass (Lolium multiflorum, Lam pasture at post calving period and on natural pasture at second reproductive period. In the initial pregnancy phase, the average daily gain (ADG of 0.899 kg and body condition gain (BCG, 0.34 points of the PMI heifers were higher then the ADG of 0.377 kg and BC lost of -0.15 for PNA heifers. The PMI beef heifers had post calving live weight (PCW and post calving body condition of 301 kg and 2.9 points, respectively, higher values than of PNA beef heifers, 267 kg and 2.7 points. Calving, dystocia, birth and weaning rates were not different between the feeding treatment. The PMI beef heifers were 31 kg heaviest and with more 0.30 point of BC at initial second reproductive period. The pregnancy rate (PR and estimations of calving productive efficiency (CPEE and weaning productive efficiency at 100 days of age (WPEE were not different between feeding treatments. Mean PR was 77%. Mean CPEE was 30.3 and WPEE 28.1 kg of weaning calf/100 kg of cow.

  5. Aspectos da gravidez e pós-parto de adolescentes portadoras de febre reumática Aspects of the pregnancy and post delivery of adolescents with rheumatic fever

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    Ana Julia Pantoja Moraes

    2004-09-01

    evaluated 510 patients, 123 (43% were female adolescents. Sixteen (13% patients became pregnant during this period, with a total of 19 gestations (one presented two gestations and another three; 14 realized the prenatal care appropriately. Age of the first gestation ranged from 14 to 19 years (mean 16.7; and age at the beginning of sexual activity ranged from 13 to 18 years (mean 15.2. Mitral insufficiency occurred in 15 cases associated with aortic insufficiency in 5. Intercurrent disease during prenatal care was observed in two patients: in one there was recurrence of RF with chorea and in the other HIV infection. Vaginal delivery occurred in seven adolescents, forceps delivery in three and cesarean in four: one with HIV, one with twin pregnancy and two with functional dystocia. Thirteen newborn were adequate for gestational age and only the twins were premature. In the postpartum, one patient presented infection in the surgical incision and another had mammary abscess. No patient reactivated RF in childbirth or postpartum. CONCLUSIONS: Pregnancies did not present cardiac decompensation, there was however predominance of mild valvulitis. Precocious sexual activity and greater incidence of pregnancy among adolescents are realities in the pediatric rheumatology clinics; consequently there is a need for improved orientation in relation to sexuality and use of birth-control methods in the routine of such services.

  6. Mortalidade perinatal de cordeiros no semi-árido da Paraíba Perinatal mortality of lambs in the semi-arid region of Paraíba, Brazil

    Directory of Open Access Journals (Sweden)

    Janduí Escarião da Nóbrega Jr

    2005-09-01

    the following frequency of different causes of death was found: neonatal infections (41.1%, malformations (23.3%, dystocia (10%, starvation/hypothermia (10%, abortion (4.4%, and predation (2.2%. Regarding the time of death, 4.4% of the lambs died before parturition, 10% during parturition, 30% on the first day after parturition, 20% between the second and the third day, and 35.6% between the 4th and the 28th day after parturition. The assistance during parturition, umbilical disinfection of the neonates, colostrum ingestion between 2 and 6 hours after parturition, and keeping the ewes in healthy environmental conditions during and after parturition could improve lamb surviving. The high frequency of malformations in different breeds suggests that malformations are due to a toxic plant. The main defects were permanent flexure of the front legs, brachygnathia, cleft palate, and other head malformations. In a recent report the authors demonstrated the teratogenic effects of Mimosa tenuiflora, a very common plant in the semiarid region, which is probably the cause of those malformations. Lambs which died due to starvation/hypothermia and had low birth weight (1.37 ± 0.70kg, suggesting that a better nutrition of the ewe during the last trimester of gestation is a way to control this cause of lamb mortality. Considering that in the northeastern region, in most farms, the rams stay with the ewes during the whole year, the adoption of a breeding season would help to control the different causes of perinatal lamb mortality.

  7. Changes of cesarean section rate and indications in recent seven years%医院近七年剖宫产率及剖宫产指征的变化

    Institute of Scientific and Technical Information of China (English)

    王婷婷; 杨海澜; 韩方

    2014-01-01

    Objective To study the changes of cesarean section rate,to evaluate the indications for cesarean section and to discuss how to reduce cesarean section rate.Methods Medical records of 6 402 cases of cesarean section were retrospectively analyzed.The rate of cesarean section and the percentage of various indications of cesarean section were observed.Results Cesarean section rate had been decreasing.The rate decreased from 71.7% (703/980) in 2006 to 61.1% (860/1407) in 2008.Cesarean rate increased slightly to 63.6% (963/1514) in 2009 ; cesarean section rate dropped from 58.3% (1047/1797) in 2010 to 45.9% (999/2176) in 2012.Social factors,pregnancy-associated complications and fetal distress were the 3 main cesarean section indications in 2006,2007,2009,2010.Social factors,pregnancy-associated complications and dystocia were the 3 main cesarean section indications in 2008.Social factors,pregnancy-associated complications and uterus scar were presented in the first 3 of cesarean section indications in 2011,2012.Pregnancy-associated complications consisted of hypertensive disorders complicating pregnancy,pregnancy combined with external and internal diseases,placenta previa and placental abruption,diabetes mellitus,gestational,intrahepatic cholestasis of pregnancy.Conclusions Pregnancy-associated complications,social factors and fetal distress are the key reasons of cesarean section indications.It is important to strengthen prenatal checks and health awareness,reduce the occurrence of pregnancy-associated complications,grasp the medical indication strictly,as well as to decrease the cesarean of social factors.%目的 探讨剖宫产率的变化,分析剖宫产各项指征的合理性.方法 对2006年1月至2012年12月山西医科大学第一医院产科6 402例行剖宫产手术分娩产妇的病历资料进行回顾性分析,计算每年剖宫产率及各项剖宫产指征所占比例.结果 2006-2008年剖宫产率从71.7%(703/980)下降到61.1% (860

  8. Epidemiological survey of urinary incontinence among adult women in Baoding City of Hebei Province%河北保定市成年女性尿失禁的流行病学调查

    Institute of Scientific and Technical Information of China (English)

    刘艳娟; 闫华

    2012-01-01

    Objective To investigate the prevalence of urinary incontinence (UI) among adult women in Baoding City and its relevant influencing factors. Methods Based on the principle of random sampling, women aged ≥18 years old who got physical examination in physical examination center of the third central hospital of Baoding City from November 2010 to November 2011 were given on-site questionnaire survey. Results A total of 3 986 valid questionnaires were collected. The survey results showed that the prevalence of urinary incontinence among adult women in Baoding City was 26.39% (1 052/ 3 986), of which stress urinary incontinence accounted for the major 21.70% (865/3 986). The prevalence of various types of urinary incontinence increased as the age and stabilized after the menopause.χ2 test showed that influencing factors of UI in adult women were age, BMI, heavy manual labor, chronic pelvic and abdominal pain, constipation, menopause, chronic cough, chronic hypertension and reproductive history (P 0.05). Comparison of vaginal delivery and planned cesarean section, obstructive dystocia cesarean section and planned cesarean section showed that their influences on stress urinary incontinence had statistically significant differences (P 0.05). Conclusion The prevalence of urinary incontinence among adult women in Baoding City is high, and stress urinary incontinence is the major type. Age, BMI, heavy manual labor, chronic pelvic and abdominal pain, constipation, menopause, chronic cough, chronic hypertension and reproductive history are the factors influencing the occurrence of urinary incontinence among adult women in Baoding City. Planned cesarean section is a protective factor for stress urinary incontinence.%目的 调查保定市成年女性尿失禁(UI)的患病率及其相关影响因素.方法 根据随机抽样原则,对2010年11月~2011年11月于保定市第三中心医院体检中心体检的年龄≥18岁的女性进行现场问卷调查.结果

  9. [Approach to sexuality in an AIDS context in Congo].

    Science.gov (United States)

    Courtois, R; Mullet, E; Malvy, D

    2001-01-01

    schoolboys and girls of Pointe-Noire, have shown that they had a high level of knowledge (about contamination by HIV). On the other hand, this has also been associated with a number of beliefs, which are higher than in France: relating to the possibilities of interpersonal contagion by saliva (by kissing), food. but also a contagion by mosquito bites. Some of these pupils (essentially boys) have asked us about the greater risk of contagion when the male sexual partner presents an irritation or a wound in the penis. This recurring question seemingly concerns a point of knowledge. However a more attentive analysis lets us think that there could be various interpretations. First of all, if the penis is healthy, the risk is low, nearly absent. The concern about a friction or about a wound in the penis could be associated with the concept of forbidden sexual positions (similar to animal positions). Proscriptions are explained by their traumatic character for the feminine device and because they are able to induce an infertility or dystocia (difficult) childbirth. Other beliefs have connected the origin of AIDS with prohibited sexual practices, committed by foreigners, who passed on them secondarily to the natives of the country. They are clearly blamed in their contributions to the decline of customs and the corruption of tradition. However this unfavourable evolution is not longer only their privilege. Sexual superactivity and "sexual wandering" are also concerned. It is dialectic of the pure and the impure. The rejection or the stigmatisation of foreign values can allow the group to find its led astray identity. Condoms are well known by Congolese pupils, but there is mistrust of their use, notably for the "elders", guarantor for the moral order. This mistrust is probably connected with the beliefs of risks of infertility, infection or weakening of the virile force. Condoms are mechanical barriers, made by foreigners, to protect native people from foreign troubles, which

  10. 饮食及营养指导预防孕期并发症及巨大儿的临床效果%Clinical effect of diet and nutrition guidance in the prevention of pregnancy complications and macrosomia

    Institute of Scientific and Technical Information of China (English)

    杨红芹

    2016-01-01

    Objective To study clinical effect of diet and nutrition guidance in the prevention of pregnancy complications and macrosomia.Methods 98 pregnant women who received examination in department of gynaecology and obstetrics of our hospital from June 2013 to August 2014 were selected,and randomly divided into intervention group and control group,49 cases in each group.Control group received routine examination without relevant guidance,while intervention group received diet and nutrition guidance.Increase speed of BMI in late pregnancy,BMI at delivery,SAS scores before and after the intervention,perinatal complications of pregnant women,macrosomia delivery rate of two groups were compared.Results Increase speed of BMI in late pregnancy in intervention group [(0.36±0.30)kg/week] was significantly slower than that in control group [(0.54±0.20)kg/ week],BMI at delivery [(25.60±2.20)kg/m2] was significantly less than that in control group [(28.90±7.40)kg/m2](P<0.05).There was no statistically significant difference in SAS score between two groups at the 30th week of pregnancy (P>0.05);SAS score at delivery in intervention group was significantly lower than that in control group [(52.7±5.2) vs.(67.5±3.4),P<0.05].Cesarean section rate,dystocia rate,macrosomia delivery rate in intervention group were 28.57%,2.04%,0.00%,significantly lower than 48.98%,12.25%,8.16% in control group (P<0.05).Conclusion Clinical efficacy of diet and nutrition guidance in the prevention of pregnancy complications and macrosomia is definite.%目的 研究饮食及营养指导预防孕期并发症及巨大儿的临床效果.方法 抽选2013年6月至2014年8月于本院妇产科门诊进行检查的孕妇98例,随机法分为干预组和对照组,每组49例,对照组产妇给予常规检查,不进行相关指导.干预组给予饮食和营养指导.比较两组孕妇孕晚期BMI增加速度、分娩时BMI、干预前后SAS评分及围生期孕妇并发

  11. Influence of weaning age on the reproductive efficiency of primiparous cows Influência da idade de desmame na eficiência reprodutiva de vacas primíparas

    Directory of Open Access Journals (Sweden)

    Ricardo Zambarda Vaz

    2010-02-01

    Full Text Available The effects of weaning age (90 days or 156 days of female beef calves were evaluated on their subsequent performance from the beginning of the first pregnancy and the end of the second breeding season, at 22/24 months of age. During pregnancy, heifers were managed as a single group on Brachiaria brizantha cv. Marandu pasture; after calving, on bristle oats (Avena strigosa Schreb and ryegrass (Lolium multiflorum Lam.; and on Brachiaria humidicula pasture during the second reproductive period. The characteristics studied were not influenced by calf weaning age. Heifers submitted to early or conventional weaning weighed 354.5 and 351.9 kg in the post-calving, and 363.4 and 359.2 kg when they weaned their calves. Average daily gain during the breeding season was 0.562 kg, and body condition score was 3.10 and 3.93 at the beginning and end of the experiment, respectively. Average calf birth and weaning weights were not influenced by dam weaning age, and were 28.7 ± 0.74; 86.5 ± 3.26 and 27.4 ± 0.92; 90.3 ± 4.04 kg, respectively, for dams submitted to early or conventional weaning. Dystocia, calving, birth, and weaning rates were not different between weaning ages, with mean values of 29.5; 95.3; 77.3 e 73.4%. Conception rates were 47.9% in the initial third and 40.8% in the second third versus 11.3% in the final third of the breeding season. Heifer average age at conception was 438 and 434 days for early weaning and conventional weaning. Pregnancy rates and production efficiency estimates at calving and calf weaning were not affected by heifer weaning age. Heifer early weaning did not affect their subsequent performance until the end of the second breeding season, at 22/24 months of age.Avaliaram-se os efeitos da idade de desmame (aos 90 dias e aos 156 dias de bezerras de corte sobre o seu desempenho subsequente entre o início da primeira gestação e o final do segundo período reprodutivo, aos 22/24 meses de idade. Durante a gestação, as