Sample records for endometritis

  1. Diagnosis of endometritis

    DEFF Research Database (Denmark)


    Composition useful for diagnosing, treating or activating dormant infection of pathogen e.g. endometritis in a subject, comprises compound selected from anti-dormancy factor, pro-inflammatory compound and resuscitation-promoting factor......Composition useful for diagnosing, treating or activating dormant infection of pathogen e.g. endometritis in a subject, comprises compound selected from anti-dormancy factor, pro-inflammatory compound and resuscitation-promoting factor...

  2. Microbiological diagnosis of postpartum endometritis

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    N. A. Korobkov


    Full Text Available The objective of the study was to compare the uterus microflora in healthy women and in the patients with postpartum endometritis using the method of quantitative assessment of contamination of the material. Further examination revealed polymicrobial etiology of the postpartum endometritis. The leading role in the etiological structure belongs to opportunistic microorganisms: enterococci, enterobacteria (preferably Enterococcus faecalis and Proteus mirabilis, and non-spore forming anaerobes (predominantly - Peptostreptococcus spp. аnd Bacteroides spp., located in the uterus, in most cases, a bulk quantity as aerobically-anaerobic associations.

  3. Endometritis (United States)

    ... the uterus. It can be due to chlamydia, gonorrhea, tuberculosis, or a mix of normal vaginal bacteria. ... be performed: Cultures from the cervix for chlamydia , gonorrhea , and other organisms Endometrial biopsy ESR ( erythrocyte sedimentation ...

  4. Postabortal endometritis and isolation of Chlamydia trachomatis. (United States)

    Barbacci, M B; Spence, M R; Kappus, E W; Burkman, R C; Rao, L; Quinn, T C


    A prospective study of 505 unselected women presenting for induced abortion was undertaken to determine the prevalence of Chlamydia trachomatis and to determine if cervical isolation of C trachomatis before abortion increases the risk of postabortal endometritis. A comparison of direct fluorescent antibody (slide) test with tissue culture for diagnosing C trachomatis infection also was evaluated in this population. C trachomatis was identified by culture in 89 patients (17.6%) and by direct slide test in 85 patients (16.8%). Six of 17 patients with postabortal endometritis were culture positive for C trachomatis, with a significant correlation between C trachomatis infection and development of endometritis observed (P less than .05). These data suggest C trachomatis may play an important role in postabortal endometritis.

  5. Xanthogranulomatous endometritis: an unusual pathological entity ...

    African Journals Online (AJOL)

    Xanthogranulomatous endometritis is an unusual pathological entity mimicking endometrial carcinoma. This shows sheets of foamy histiocytes alongwith other inflammatory cells. We, hereby, report a case of 45 year multigravida female with irregular menstrual history, clinically diagnosed as carcinoma and ...

  6. Definitions and diagnosis of postpartum endometritis in dairy cows. (United States)

    Dubuc, J; Duffield, T F; Leslie, K E; Walton, J S; LeBlanc, S J


    The objectives of this observational study were to determine and compare diagnostic criteria for postpartum endometritis in dairy cows. Data generated from 1,044 Holstein cows (6 herds) enrolled in a randomized clinical trial were used. Cows were examined for endometritis at 35±3 d (exam 1) and 56±3 d (exam 2) after parturition, using endometrial cytology (cytobrush technique), vaginal discharge scoring (Metricheck device; Simcrotech, Hamilton, New Zealand), and cervical diameter measurement (transrectal palpation). Reproductive data were recorded until 200 d after parturition. Diagnostic criteria for cytological and clinical endometritis were determined based on detrimental effect on subsequent reproductive performance, using logistic regression and Cox proportional hazard models accounting for the effect of herd clustering. Comparison of diagnostic criteria was performed using endometrial cytology as reference test or by quantifying the agreement between diagnostic approaches. At exam 1, diagnostic criteria were ≥6% polymorphonuclear cells and mucopurulent or worse (purulent or foul) vaginal discharge for cytological and clinical endometritis, respectively. At exam 2, diagnostic criteria were ≥4% polymorphonuclear cells and mucopurulent or worse vaginal discharge for cytological and clinical endometritis, respectively. Cows were classified as having cytological endometritis only, clinical endometritis only, or both cytological and clinical endometritis. Prevalence at exam 1 was 13.5, 9.4, and 5.8% for cytological endometritis only, clinical endometritis only, and both cytological and clinical endometritis, respectively. The detrimental effects of cytological and clinical endometritis on reproductive performance were additive. Among cows with clinical endometritis, only 38 and 36% had cytological endometritis at exam 1 and exam 2, respectively. Combination of diagnostic criteria improved neither the accuracy for predicting cytological endometritis nor the

  7. Prevention of postpartal endometritis: Antibiotic of choice

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    Jovanović Nebojša


    Full Text Available Introduction In spite of the advances of modern medicine, puerperal infection is still one of the leading causes of morbidity and mortality of women in postpartal period. Objective The aim of this study was to analyze the presence of microorganisms in the cervicovaginal region of women in labor, as well as the frequency of puerperal endometritis in order to determine optimal treatment for isolated microorganisms and to prevent postpartal endometritis. Methods In this study, all women who gave birth to a healthy child per vias naturalis during the past two years in a tertiary health institution, Institute of Gynaecology and Obstetrics, Clinical Centre of Serbia, were analyzed. The investigation involved 6,391 women in labor. Cervicovaginal smear was taken from all patients before labor, on admission for delivery, and sent to microbiological analysis. Standard procedures of bacterial cultivation were used. For statistical analysis of the results, we used the statistical programme SPSS 15. Results A single microorganism was isolated from each smear of 612 women and in 52 patients two microorganisms were registered in the same smear. We identified 10 sorts of microorganisms, out of which Escherichia coli (in 43.8% of cases, and Enterococcus spp. (in 27.9% of cases were the most frequent ones. Due to the appropriate approach, there were no cases of puerperal endometritis registered. Reactivity tests showed that Escherichia coli was sensitive to trimethoprim-sulphamethoxazole, Enterococcus spp. to macrolides and cephalosporines, while both types of microorganisms were sensitive to synthetic penicillins and fluoroquinolines. Conclusion The study results show that 10.9% of pregnant women have positive findings of the cervicovaginal smear and that infection prevention should be directed towards Escherichia coli and Enterococcus spp. by administration of the listed antibiotics.

  8. Risk factors for postpartum endometritis and the effect of endometritis on reproductive performance in dairy cows in Korea. (United States)

    Kim, Ill-Hwa; Kang, Hyun-Gu


    The objectives of this study were to determine the risk factors for postpartum endometritis by evaluating several reproductive factors in individual cows, and to determine the effect of endometritis on the subsequent reproductive performance in dairy herds in Korea. The data, including health status, parity and body condition score (BCS) of cows, and calving date, were collected from 320 cows in eight dairy herds calving from January 2001 to October 2002. We used logistic regression to evaluate the effects of these factors on endometritis. A stepwise procedure, used to obtain the appropriate model with alpha=0.05, revealed that retained placenta, metabolic disorders and parity are the important risk factors for endometritis. The mean intervals from calving to first service and conception were prolonged (Pconception rate was lower (Pconception was higher (P<0.05) in the endometritis group (1.9) than in the non-endometritis group (1.6). We conclude that retained placenta, metabolic disorders and cow parity are strongly correlated with the development of postpartum endometritis, which decreases reproductive performance in dairy herds in Korea.

  9. Endometritis post-cesárea: factores de riesgo.




    Objetivo: Determinar los factores de riesgo de endometritis post-cesárea (EPC). Materiales y métodos: Se realizó un estudio retrospectivo caso-control en el Servicio de Obstetricia del Hospital Nacional Cayetano Heredia del 1 de Enero de 1992 al 31 de Julio de1996. Para el análisis estadístico se utilizó análisis bivariado y multivariado de regresión logística. Resultados: Durante este período se detectaron 82 pacientes con diagnóstico clínico de endometritis, seleccionándose aleatoriamente i...

  10. Endometritis post-cesárea: factores de riesgo


    Burgos Salinas, Silvia; Carbajal Arroyo, Luz; Saona Ugarte, Pedro


    Objetivo: Determinar los factores de riesgo de endometritis post-cesárea (EPC). Materiales y métodos: Se realizó un estudio retrospectivo caso-control en el Servicio de Obstetricia del Hospital Nacional Cayetano Heredia del 1 de Enero de 1992 al 31 de Julio de1996. Para el análisis estadístico se utilizó análisis bivariado y multivariado de regresión logística. Resultados: Durante este período se detectaron 82 pacientes con diagnóstico clínico de endometritis, seleccionándose aleatoriamente i...

  11. Endometritis post-cesárea: factores de riesgo

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    Silvia Burgos Salinas


    Full Text Available Objetivo: Determinar los factores de riesgo de endometritis post-cesárea (EPC. Materiales y métodos: Se realizó un estudio retrospectivo caso-control en el Servicio de Obstetricia del Hospital Nacional Cayetano Heredia del 1 de Enero de 1992 al 31 de Julio de1996. Para el análisis estadístico se utilizó análisis bivariado y multivariado de regresión logística. Resultados: Durante este período se detectaron 82 pacientes con diagnóstico clínico de endometritis, seleccionándose aleatoriamente igual número de pacientes operadas de cesárea con puerperio normal. Los factores relacionados con un riesgo significativo de EPC fueron: edad materna menor de 21 años y valores de hematocrito post-operatorio menor o igual a 30%. En el grupo de pacientes con endometritis el 45.1% de las pacientes tuvieron infección concomitante, siendo la infección de herida operatoria (29.3% y la del tracto urinario (11% las más frecuentes. ( Rev Med Hered 1999; 10:105-110 .

  12. Clinical endometritis in an Argentinean herd of dairy cows: risk factors and reproductive efficiency. (United States)

    Giuliodori, M J; Magnasco, R P; Becu-Villalobos, D; Lacau-Mengido, I M; Risco, C A; de la Sota, R L


    The objectives of this study were to assess the clinical and metabolic risk factors for clinical endometritis, the likelihood for having a normal vaginal discharge during postpartum, and the effects of endometritis on milk yield, reproductive efficiency, and metabolic status in Holstein cows. The study was conducted in a commercial dairy herd (Cordoba, Argentina) where 303 Holstein cows were enrolled. Cows were body condition scored (1 to 5) and tail bled on -14, 7, 21, 31, 41, and 50 d relative to parturition. Cows having a vaginal discharge with presence of pus between 21 and 41 d postpartum (dpp) were diagnosed as having clinical endometritis. Plasma blood samples were analyzed for nonesterified fatty acids (NEFA), β-hydroxybutyrate (BHBA), and blood urea nitrogen using commercial kits and insulin-like growth factor 1, insulin, and leptin by RIA. Data were analyzed with PROC MIXED, PROC GENMOD, and PROC PHREG of SAS (SAS Institute Inc., Cary, NC). Abnormal calving and puerperal metritis increased the risk for endometritis [adjusted odds ratio (AOR)=2.21 for both]. High prepartum NEFA and high postpartum BHBA increased the risk for endometritis (AOR=1.003 and 1.001, respectively), whereas high prepartum blood urea nitrogen reduced it (AOR=0.853). Cut-offs of 456.6 μM NEFA and 402.5 μM BHBA had sensitivities of 0.69 and 0.58, and specificities of 0.88 and 0.86, respectively. The likelihood for having normal vaginal discharge increased with time (∼1% × dpp) and with normal calving. Cows with endometritis had higher milk yield than normal herdmates (27.8±0.9 vs. 25.7±0.4 kg/d), lower risk for pregnancy by 100 dpp (AOR=0.10), higher nonpregnancy risk by 200 dpp (AOR=2.87), and higher risk for culling than normal cows (AOR=2.28). Cows with endometritis had a lower hazard rate (0.44) for pregnancy and had approximately 70 d longer calving-to-conception intervals. Finally, endometritis had no effect on metabolic hormones. In conclusion, the risk for clinical

  13. Effects of prophylactic antibiotics on endometrial flora in women with postcesarean endometritis. (United States)

    Newton, E R; Wallace, P A


    To determine the effect of prophylactic antibiotics on endometrial and endocervical microflora upon diagnosis of postcesarean endometritis. The medical records of patients enrolled in open-label comparative trials of therapeutic antibiotics for postpartum endometritis between 1989 and 1994 were reviewed (n = 682). Endometritis was diagnosed by a standard definition that included fever and localizing signs. Endometrial cultures were obtained by a sheathed injection/aspiration technique. Aerobes and anaerobes were isolated by standard microbiologic techniques. The primary outcome, endometrial and endocervical microflora, was compared in women who received intravenous ampicillin (2 g every 6 hours for 1-3 doses), cephalosporin (2 g every 6 hours for 1-3 doses), or no prophylaxis. Secondary outcomes included the cure of endometritis and the prevalence of wound infection in the three groups. Four hundred sixty-five of 682 patients (67%) had a cesarean delivery. One hundred fifty-one patients received ampicillin prophylaxis, 100 patients received cefazolin prophylaxis, 18 patients received extended-spectrum antibiotics, and 196 patients received no prophylaxis. Patients who received cefazolin prophylaxis had a significant increase in enterococcus (P women who develop endometritis. Whereas these changes had no effect on endometritis cure rate (power > 80%), the association between cefazolin prophylaxis followed by an extended-spectrum cephalosporin and wound infection may warrant caution against the use of the combination.

  14. Endometritis treatment with a PGF2alpha analog does not improve reproductive performance in a large dairy herd in Argentina. (United States)

    Mejía, Miguel Eduardo; Lacau-Mengido, Isabel María


    In Argentina, most dairy cows with endometritis are treated with prostaglandin (PGF(2alpha) or its analogs) and insemination is withheld until there are no signs of endometritis. The objective of the present study was to evaluate if this method of managing endometritis enhances reproductive performance. Three experiments were conducted over 4 years in a large farm in the west of Buenos Aires province. In Experiment 1, half of the cows diagnosed with endometritis (>1.5-fold difference in diameter of uterine horns, as determined by rectal palpation) received standard endometritis management (treatment with tiaprost, a PGF(2alpha) analog, rectal palpation every 20 days, and withholding of AI until endometritis apparently resolved) and the other half was untreated, with AI at the first estrus after the voluntary waiting period. Untreated cows were inseminated and conceived 20 days earlier than treated cows, and the pregnancy rate by Day 90 postpartum was higher in the untreated group. In Experiment 2, cows with endometritis were divided into four groups according to the severity of symptoms; within each group, cows were allocated to treatment or control, as in Experiment 1. Although first service conception rate decreased as endometritis severity increased, reproductive performance in treated versus control cows was similar to that of Experiment 1 (with no interaction due to degree of endometritis). Re-evaluation of the treated cow (to confirm uterine "normality") may have been responsible for the delay in conception in both experiments. The objective of Experiment 3 was to determine the effects of tiaprost treatment on clinically normal postpartum cows (no evidence of endometritis). Tiaprost treatment reduced the interval from calving to conception in multiparous cows, but it delayed conception and reduced the conception rate in primiparous cows. In conclusion, treatment with tiaprost impaired reproductive performance in primiparous cows (in the absence of

  15. [Treatment of chronic bovine endometritis and factors for treatment success]. (United States)

    Feldmann, M; Tenhagen genannt Emming, S; Hoedemaker, M


    In a controlled field trial, 178 dairy cows with chronic endometritis and at least 21 days in lactation were randomly assigned to four different treatment groups: prostaglandin F2alpha intramuscularly (PG, 5 mg dinoprost (5 ml Dinolytic), n = 51), intrauterine antibiotics (AB; 400 mg ampicillin + 800 oxacillin (20 ml Totocillin), n = 49), intrauterine antiseptics (AS; 100 ml 4% Lotagen, n = 50); control (C, no initial treatment, n = 28). Before treatment, uterine swabs for bacteriologic examination and blood samples for determination of serum progesterone concentrations were collected. Two weeks following the first treatment, cows were reexamined. In case no clinical cure was diagnosed, treatment was repeated and control cows were treated for the first time with one of the three treatments mentioned above. The four treatment groups did not differ with respect to the clinical cure or reproductive performance. Therefore, factors that might have an influence on clinical cure and fertility were evaluated. With increasing duration of lactation, the clinical cure after a single treatment increased significantly over all treatment groups from 59.5% (treatment before day 42 postpartum) to 79.6% (treatment following day 42 postpartum) (P conception rate and a lower pregnancy index were obtained when the treatment was performed following day 42 postpartum (P size had a negative effect on clinical cure over all groups (first treatment clinical cure: 68.2% (small uteri) vs 44.4% (large uteri); P 0.05). Isolation of Arcanobacterium (A.) pyogenes negatively influenced first treatment clinical cure over all treatment groups (79.0% vs 31.5%) and within treatment groups (P conception increased compared with the other treatment groups, when A. pyogenes was detected. Isolation of unspecific bacteria and the presence or absence of a corpus luteum only had minor effects over all and within the PG, AS and C group. Within the AB group, presence of luteal tissue was connected with a

  16. [Evaluation of the diagnosis of subclinical endometritis in dairy cattle using ultrasound]. (United States)

    Lenz, Mirjam; Drillich, Marc; Heuwieser, Wolfgang


    The aim of this study was to determine signs of subclinical endometritis found by ultrasound that are associated with reduced fertility in dairy cows. The maximum diameter of the uterine lumen was determined by ultrasound in 324 cows without clinical signs of endometritis after evaluation of the genital tract 21 to 27 days postpartum. Cows were classified into healthy or with subclinical endometritis by three threshold values for the maximum uterine lumen diameter of 0.2 cm, 0.5 cm or 0.8 cm. Examinations by rectal palpation and ultrasound as well as classifications were repeated 14 days later. In addition, ovaries were scanned by ultrasound to determine the stage of the estrous cycle. In a subgroup of 103 cows the echotexture of the uterus and its contents was evaluated. In these cows the diagnosis of subclinical endometritis was performed by a scoring system. The diameter of the uterine lumen was significantly affected by stage of the estrous cycle at the time of examination. However, no effects were found for the stage of the cycle at the time of examination on subsequent reproductive performance. A uterine lumen with a maximum diameter of more than 0.2 cm showed a significant negative association with conception rate and proportion of cows pregnant. Classification based on higher threshold values did not reveal an association with reproductive performance. Echogenic content in the uterus also decreased reproductive performance. A classification based on the echotexture of the uterus and its contents revealed significant differences between healthy cows and cows with subclinical endometritis regarding the proportion of cows inseminated and pregnant. The results of this study showed that the diagnostic of bovine endometritis should be broadend by ultrasonography. The definition of subclinical endometritis diagnosed by means of ultrasonography has to be evaluated in further studies.

  17. Expression of cyclooxygenase-2 in the endometrium of gilts with different stages of endometritis. (United States)

    Roongsitthichai, Atthaporn; Srisuwatanasagul, Sayamon; Koonjaenak, Seri; Tummaruk, Padet


    The present study determined the association among the expression of COX-2, stages of endometritis, and types and number of local immune cells infiltrating into the gilts' endometrium. The uterine tissues from 24 Landrace x Yorkshire gilts identified as acute endometritis (n = 7), chronic endometritis (n = 7), and normal endometrium (n = 10) were included. The tissues were prepared for both histological and immunohistochemical investigations. The immunoexpression of COX-2 in every layer of the gilts' endometria was appraised by avidin-biotin-peroxidase complex method via image analysis; and was reported as percentage of positive area and staining index. The results revealed that the immunoexpression of COX-2 was found only in the surface epithelial layer. The gilts with acute endometritis possessed higher both percentage of positive area (68.99% versus 4.50% and 3.43%, P < 0.001) and staining index (1.13 versus 0.05 and 0.04, P < 0.001) than those with chronic endometritis and normal endometrium, respectively. Positive correlations between the number of surface epithelial neutrophils and percentage of COX-2 positive area (r = 0.47, P = 0.022), as well as mean staining index (r = 0.44, P = 0.032) were observed. In conclusion, the immunoexpression of COX-2 was found strongest in the gilts with acute endometritis, meanwhile it was not different between those with chronic endometritis and normal endometrium. This suggested that the expression of COX-2 might be dependent not only on the infiltration of local immune cells in the endometrium, but also on the duration of exposure with inflammatory agents.

  18. Vaginal Fornix Discharge Cellularity and Its Leukocyte Esterase Activity for Diagnosis of Endometritis in Dairy Cows

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    Abolfazl HAJIBEMANI


    Full Text Available The objective of the present study was to evaluate the application of some strip test markers (i.e., leukocyte esterase (LE activity, protein, nitrate and pH for diagnosis of endometritis in dairy cows using vaginal fornix discharge. Also, the total white blood cell count (t-WBC/l of this secretion and degenerative changes of neutrophils in cervical cytology were used as alternative methods to predict progression of the endometritis severity. Holstein cows (n=215 between 30-40 days in milk (DIM were included and examined. Giemsa-stained smear was prepared from cervical mucus. Cervical cytology test was considered as reference screening method for the detection of subclinical endometritis. The LE activity and t-WBC in the vaginal fornix discharge of subclinical endometritis cows were significantly higher than those from healthy cows. Sensitivity and specificity were 78% and 73% for LE10 activity (10 minutes after contacting with discharges and 60% and 69% for t-WBC (cut off point=210 cells/l for diagnosis of subclinical endometritis, respectively. There was a good agreement between LE10 activity, t-WBC and cervical cytology test with a Kappa coefficient of 0.4 and 0.42, respectively (P<0.0001. Total WBC count in discharge and degenerative neutrophils (DN percentages increase simultaneously with the degree and severity of endometritis. There was a highly significant (P<0.01 correlation between t-WBC and some reagent strip test markers (LE activity, protein and nitrate in clear discharge of studied cows. In conclusion, the present results suggest the LE activity and t-WBC in vaginal fornix discharge could be used as non-invasive reliable and valid methods for screening of subclinical endometritis in postpartum dairy herds.

  19. Profiling inflammatory biomarkers in cervico-vaginal mucus (CVM) postpartum: Potential early indicators of bovine clinical endometritis? (United States)

    Adnane, Mounir; Chapwanya, Aspinas; Kaidi, Rachid; Meade, Kieran G; O'Farrelly, Cliona


    Endometritis significantly impacts fertility and milk yield, thus reducing profitability of the dairy production. In cows that develop endometritis, normal postpartum endometrial inflammation is dysregulated. Here, we propose that endometrial inflammation is reflected in cervico-vaginal mucus (CVM) which could therefore be used as a prognostic tool. CVM was collected from 20 dairy cows (10 with clinical endometritis and 10 healthy) 7 and 21 days postpartum (DPP). Polymorphonuclear (PMN), mononuclear leukocyte and epithelial cells were counted, total protein levels were estimated and levels of IL-1β, IL-6, IL-8, serum amyloid A (SAA), haptoglobin (Hp) and C5b were analyzed by ELISA in CVM. PMN were consistently high in CVM from 7 to 21 DPP, but were higher in CVM from cows with clinical endometritis 21 DPP compared with healthy cows. In contrast, there were more epithelial cells in healthy cows 21 DPP than in clinical endometritis animals. Total protein levels decreased significantly in CVM from healthy cows between days 7 and 21 postpartum. All inflammatory biomarkers except C5b, remained high in cows with clinical endometritis from 7 to 21 DPP, indicating sustained and chronic endometrial inflammation. IL1, IL-6, IL-8 and Hp levels were higher in CVM from cows with clinical endometritis compared to healthy cows 21 DPP. Interestingly IL-1β levels were raised in CVM from clinical endometritis but not in healthy cows 7 DPP suggesting that early measurement of IL-1β levels might provide a useful predictive marker of clinical endometritis. In contrast, SAA and C5b levels were increased in healthy cows 21 DPP, compared to cows with clinical endometritis suggesting that these acute phase proteins might have an anti-inflammatory role. Our results show that CVM is convenient for profiling disease-associated changes in key inflammatory molecules postpartum and reaffirms that sustained inflammation is a key feature of clinical endometritis in the dairy cow. Copyright

  20. Cytological endometritis and its agreement with ultrasound examination in postpartum beef cows

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    N. Salah


    Full Text Available Background: Endometritis, which is one of the most common diseases in dairy cows postpartum, causes severe economic losses, including increased open days, calving intervals, and numbers of services to achieve conception. Aim: This study aimed to evaluate the ultrasound method and its agreement with the endometrium cytology method, which is used to diagnose cytological endometritis in beef cows. Moreover, we determined which method has higher sensitivity and specificity at 4 and 5 weeks postpartum. Materials and Methods: The study was conducted 20-35 days postpartum. A total of 53 clinically healthy beef cows (28 Brangus and 25 Kedah-Kelantan breeds from three beef farms were obtained. All cows were evaluated at 4 and 5 weeks postpartum, using ultrasound and cytobrush endometrial examination methods to diagnose cytological endometritis. Results: Endometrial cytology result showed that 11.3% (6/53 and 9.4% (5/53 of the cows exhibited cytological endometritis 4 and 5 weeks postpartum, respectively. A weak-to-moderate agreement found between the diagnostic methods (k=0.29 - 0.50; p<0.01 and k=0.38 - 0.49 at 4 and 5 weeks postpartum respectively. Conclusion: The percentage of beef cows that were positive to cytological endometritis was low (polymorphonuclear cells, =8% at 4 and 5 weeks postpartum. Results showed that the ultrasound method is useful and practical for diagnosing endometritis 4 and 5 weeks postpartum. This method exhibited 60% sensitivity, 93.8% specificity, and a 0.50 kappa value, especially when presence of intrauterine fluids and measurement of cervix diameter used in combination.

  1. Comparison of clinical signs and bacterial isolates of postpartum endometritis in holstein dairy cows in Iran

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    Mohammad Rahim Ahmadi


    Full Text Available The aim of this study was to determine the uterine bacteria in cows with endometritis and to compare other characteristics in cases of endometritis without bacterial growth, with Trueperella pyogenes (Arcanobacterium pyogenes or other bacteria. In total, 86 Holstein cows with postpartum endometritis from 13 commercial dairy herds were sampled once between 21-35 days postpartum. We used several diagnostic techniques for endometritis such as external observation, vaginal exam, rectal palpation, ultrasonography, and cervical and uterine cytological examination. Clear mucus with flakes of pus (E1, mucopurulent discharge (E2, and purulent discharge (E3 are three groups of endometritis. A transcervical double-guarded swab was used for bacterial sampling. The samples were cultured aerobic and anaerobically and biochemical tests were used for differentiation. Measurements were compared between groups: A, no growth (n=47; B, positive bacterial growth without T. pyogenes (n=21; and C, positive bacterial growth with T. pyogenes (n=18. There were no differences (P>0.05 in uterine wall thickness, body condition score (BCS and milk yield between the groups. The uterine horn diameter was largest in groups A (4.30±0.88 in comparison with groups B (4.81±1.17 and C (5.53±2.17 (P<0.05. The percentage of neutrophiles in smears of the uterine discharge (45.7±33.4 in group C was higher (P<0.05 than in groups A (14.5±22.7 and B (23.5±24.0. Eighty-three percent of group C have shown purulent discharge. In conclusion, the facultative anaerobe T. pyogenes may be the most common bacterial agent of postpartum endometritis in Holstein dairy cows in Iran.

  2. Implementation of vaginal cleansing prior to cesarean delivery to decrease endometritis rates. (United States)

    Felder, Laura; Paternostro, Amanda; Quist-Nelson, Johanna; Baxter, Jason; Berghella, Vincenzo


    Endometritis is a postpartum complication that is more common after cesarean delivery. It frequently requires intravenous antibiotic administration, prolonged hospital stays, and carries a risk of sepsis or abscess formation. Precesarean vaginal preparation has been shown to decrease the risk of endometritis in patients who have labored or have ruptured membranes. The objective of this study was to assess the practical implementation of a protocol for vaginal cleansing prior to cesarean delivery and the subsequent effect on endometritis rates in a clinical setting. This is a before-after retrospective cohort study evaluating the first 6 months of implementation of a vaginal cleansing protocol at a single institution. The primary outcome was the rate of implementation. Secondary outcomes included endometritis and other postoperative complications. The rate of implementation after 6 months was 68.3% (p < .001) and postoperative endometritis rates decreased from 14.0% before implementation to 11.7% after implementation (p .49, OR 0.77, CI 0.36-1.62). Postoperative fever decreased from 22.3% to 18.3% (p .256, OR 0.70, CI 0.37-1.30) and infectious wound complications were 4.5% and 5.8%, respectively (p .76, OR 1.07, CI 0.69-3.64). Implementation of a protocol for vaginal cleansing prior to cesarean delivery in women with ruptured membranes or in labor has high uptake, but in almost a third of eligible women it was not performed. The implementation, has led to a clinical, although not statistical, decrease in postoperative endometritis. Continued research is needed to explore how to improve uptake of this quality improvement measure.


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    Amel Ćutuk


    Full Text Available Goal of this research was to explore the efficiency of intrauterine application of 4% solution of Lotagen® in the treatment of chronic endometritis of different severity, and to examine the effects of therapy to the breeding-reproductive parameters in animals treated under the real field conditions. Research was conducted between May 2005 - March 2007 by analyzing the data from the protocol of artifitial insemination and treatment of sterility in the county of Sanski Most. Research included dairy cows from 95 stables when chronic endometritis was diagnosed by clinical examination (n=126 at the earliest 21 day postpartum. Animals were treated intrauterinelly with 100 to 180 ml (primiparous and multiparous of 4% solution of Lotagen® during puerperium or in estrus, after puerperium. Out of total of 126 dairy cows with chronic endometritis treated with Lotagen® once or more times, including a group of non-treated animals, clinical healing was noted in 117 animals (92,8%, artificial insemination was performed in 115 (87,3% and 95 animals had conception (86,3%. Due to the lack of clinical healing, fertility loss or some other reasons, 31 cows were excluded (24,6% from breeding and this research. The treatment results as well as some fertility parameters were affected by severity of chronic endometritis and time of therapy introduction. The more time elapsed from parturition, the severity of endometritis decreased. Consequently, the percentage of cured animals after the first treatment increased from 59,5% to 79,6% (P < 0,05. Percentage of healing in E 1-2 (endometritis catarrhalis et mucopurulenta was 68,2% after the first treatment and was significant in relation to 44,4% in E 3-4 (endometritis purulenta et pyometra. Taking into consideration the conception accomplished in two examined groups, obvious differences are shown: experimental group - 91,5%, control group - 76,9% (P<0,05. The effects of treatment to the breeding-reproductive parameters

  4. Clonal Streptococcus equi subsp. zooepidemicus post breeding endometritis in thoroughbred broodmares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Söderlind, Maja; Rydemann Rudefalk, Sofia

    Streptococcus equi subsp. zooepidemicus is one of the most commonly isolated pathogens from the uterus of mares with infectious endometritis. Its ability to cause chronic latent infection by residing deep within the endometrial tissue has previously been described. The aim of the study was to inv......Streptococcus equi subsp. zooepidemicus is one of the most commonly isolated pathogens from the uterus of mares with infectious endometritis. Its ability to cause chronic latent infection by residing deep within the endometrial tissue has previously been described. The aim of the study...... was to investigate whether clonal or genetically distinct S. zooepidemicus strains isolated from mares with endometritis were associated with mare risk factors and the outcome of natural cover. Uterine swabs were obtained from mares with intrauterine fluid after natural cover (n=31) at thoroughbred stud farms...... in Australia. Fifty two percent of the mares (n=16) were diagnosed with infectious endometritis, and S.zooepidemicus was isolated in 81% (n=13) of these mares. Up to four S. zooepidemicus isolates were selected from each mare with growth of S. zooepidemicus and isolates from an additional five mares were...

  5. Subclinical Endometritis Diagnosed through Cytobrush and Reproductive Performance in Cattle from the Municipality of Pupiales, Colombia

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    Darío Antonio Vallejo Timarán


    Full Text Available Objective: To determine the distribution of subclinical endometritis and the reproductive behavior of dairy cattle diagnosed through endometrial cytology from the Municipality of Pupiales, Nariño. Materials and methods: A reproductive assessment was carried out (rectal palpation, ultrasonography and evaluation of vaginal mucus to determine the absence of early gestation and of clinical signs of uterine infection, and 174 cows were sampled through cervical catheterization and the technique of Cytobrush starting 30 days after birth. Consequently, the population under study was organized based on ovarian function (empty cycling normal or anestrous and the status of the uterus (with or without endometritis. Results: 43 cows (24.7% showed cellular changes indicative of an active inflammatory process originated in the endometrium. 79.06% of the animals diagnosed with subclinical endometritis were cyclic and had low reproductive performance. Conclusion: The high impact of subclinical endometritis in fertility and reproductive efficiency was determined. An early reproductive assessment must be performed, together with tests that make it possible to determine the presence of concomitant subclinical conditions.

  6. Infectious endometritis is associated with endometrial expression of lactoferrin in broodmares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Møller Nielsen, Jesper

    with clinical signs of endometritis and/or a history of previous un-successful breeding were selected for the study. Two biopsies were obtained from each mare. One biopsy was used for bacterial culture and cytology and one biopsy was used for RNA extraction. Relative gene-expression analyses were performed...


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    A. A. Savchenko


    Full Text Available The aim of this study was to investigate phenotypic profile of B lymphocytes in peripheral blood of the patients with chronic endometritis and adnexitis. The study involved 89 women in their reproductive age (18 to 45 years with chronic endometritis (48 cases and adnexitis (41 cases. Ninety-eight healthy agematched women participated as a control group. Phenotypic B-cell subpopulations were analyzed by flow cytometry performed with direct immunofluorescent staining of peripheral cells from whole blood using the following antibody panel: CD5-FITC/CD23-PE/CD19-ECD/CD45-PC5/CD27-PC7. A significantly reduced B-lymphocyte content was revealed in peripheral blood of women with chronic endometritis and adnexitis. The reduced cell numbers occurred due to reduced B2 (main fraction of B-lymphocytes and as B1 cells (minor fraction which determines insufficient reactivity of specific humoral immune response, including immune reactions at the mucous membranes. However, percentage of B2-lymphocytes was decreased only in endometriosis, whereas patients with adnexitis showed decrease in both relative and absolute counts of this B cell subpopulation. A decreased content of naive B-cells in the peripheral blood is another feature of the B cell phenotypic profile in chronic endometritis and adnexitis. Moreover, the drop of the naive B-cell levels in patients with adnexitis proved to be more pronounced than in persons with endometritis. Expression of CD23- antigen (a low-affinity receptor for IgE has been investigated as a functional marker of B cells. All the studied peripheral B cell subpopulations expressing CD23 were decreased in the patients with chronic endometritis. The numbers of different B cell fractions expressing CD23 antigen were also reduced in the women with chronic adnexitis as compared to the levels detected in patients with chronic endometritis. Alterations of the B-cell immunity were more pronounced in chronic adnexitis, due to more extensive

  8. Neutrophil extracellular traps formation by bacteria causing endometritis in the mare. (United States)

    Rebordão, M R; Carneiro, C; Alexandre-Pires, G; Brito, P; Pereira, C; Nunes, T; Galvão, A; Leitão, A; Vilela, C; Ferreira-Dias, G


    Besides the classical functions, neutrophils (PMNs) are able to release DNA in response to infectious stimuli, forming neutrophil extracellular traps (NETs) and killing pathogens. The pathogenesis of endometritis in the mare is not completely understood. The aim was to evaluate the in vitro capacity of equine PMNs to secrete NETs by chemical activation, or stimulated with Streptococcus equi subspecies zooepidemicus (Szoo), Escherichia coli (Ecoli) or Staphylococcus capitis (Scap) strains obtained from mares with endometritis. Ex vivo endometrial mucus from mares with bacterial endometritis were evaluated for the presence of NETs. Equine blood PMNs were used either without or with stimulation by phorbol-myristate-acetate (PMA), a strong inducer of NETs, for 1-3h. To evaluate PMN ability to produce NETs when phagocytosis was impaired, the phagocytosis inhibitor cytochalasin (Cyt) was added after PMA. After the addition of bacteria, a subsequent 1-h incubation was carried out in seven groups. NETs were visualized by 4',6-diamidino-2-phenylindole (DAPI) and anti-histone. Ex vivo samples were immunostained for myeloperoxidase and neutrophil elastase. A 3-h incubation period of PMN + PMA increased NETs (p Ecoli or Scap (p < 0.05). Ex vivo NETs were present in mares with endometritis. Scanning electron microscopy showed the spread of NETs formed by smooth fibers and globules that can be aggregated in thick bundles. Formation of NETs and the subsequent entanglement of bacteria suggest that equine NETs might be a complementary mechanism in fighting some of the bacteria causing endometritis in the mare. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Activation of persistent Streptococcus equi subspecies zooepidemicus in mares with subclinical endometritis

    DEFF Research Database (Denmark)

    Petersen, Morten Rønn; Skive, Bolette; Christoffersen, Mette


    Endometritis in horses caused by Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) may be underdiagnosed due to traditional diagnostic methods lacking sensitivity and specificity. We serendipitously identified a bacterial growth medium (bActivate) that appeared capable of inducing...

  10. The effect of Zataria multiflora extract on the clinical endometritis and reproductive indices in lactating Holstein dairy cows


    Hajibemani, Abolfazl; Mirzaei, Abdolah; Rowshan Ghasrodashti, Abbas; Memarzadeh, Mohammad Reza


    In the present study, the effect of intrauterine infusion of Zataria multiflora extract on the clinical endometritis was investigated. Vaginal examination, transrectal palpation and ultrasonography were used to inspect the genital tract at 30-40 days in milk and two weeks later the same approach was applied. Cows with clinical endometritis were randomly divided into three treatment groups: Z. multiflora extract (n = 56), penicillin + streptomycin (pen + strep, n = 55), and placebo (n = 20). C...



    Amel Ćutuk; Nasir Sinanović; Benjamin Čengić; Tarik Mutevelić; Hidajet Pajić; Nazif Varatanović


    Goal of this research was to explore the efficiency of intrauterine application of 4% solution of Lotagen® in the treatment of chronic endometritis of different severity, and to examine the effects of therapy to the breeding-reproductive parameters in animals treated under the real field conditions. Research was conducted between May 2005 - March 2007 by analyzing the data from the protocol of artifitial insemination and treatment of sterility in the county of Sanski Most. Research inclu...


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    Eriky Akio de Oliveira Tongu


    Full Text Available Among different etiologic factors, fungal endometritis is a common cause of decreased mare’s fertility. Two experiments were conducted to evaluate the sensitivity of Dermatobac®, a microculture system originallydevelopedfortheisolationoffungithatconcerns Human Medicine. In Experiment 1, standard (ATCC strains of Candida (n=4 and Aspergyllus (n=1 were grown and visually analyzed daily for 7 days. For Experiment 2, 34 mares were selected and subjected to material harvesting for completion of uterine cytology as well as seeding with Dermatobac®. After 24h of cultivation, the macroscopic observation of all Candida and Aspergyllus strains (Experiment 1 was possible. In Experiment 2, five animals showed presence of yeast on cytologic slides (14.71%, results also confirmed sowing in Dermatobac® system (100% sensitivity. Five false positive cases were observed, characterized by microbiological growth in Dermatobac® but not confirmed by endometrial cytology, determining specificity of 85%. However, the results did not compromise the efficiency of Dermatobac® system given all contaminants presented differentiated morphology and higher growing time (P<0.05 when compared to the major etiological agents of equine fungal endometritis. The Dermatobac® system proved to be efficient for the macroscopic diagnosis of fungal endometritis in horses, showing conclusive information only after 24 hours of culture.

  13. Serum amyloid A and haptoglobin levels in crossbred cows with endometritis following different therapy

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    S. S. Biswal


    Full Text Available Aim: To determine the serum variations of two major acute phase proteins, serum amyloid A (SAA and haptoglobin (Hp levels in crossbred endometritis cows following pre and post immunomodulation therapy. Materials and Methods: 21 endometritis cows were randomly assigned to three groups (n=7 and treated with three different immunomodulators while seven healthy cows served as control. Uterine flushing collected from all animals was subjected to bacteriological study and serum samples were analyzed for SAA and Hp by sandwich ELISA method. Results: Escherichia coli was most prevalent Gram-negative bacteria (6.02 × 106 CFU/ml while Staphylococcus (0.86 × 106 CFU/ml and Streptococcus (0.52 × 106 CFU/ml were most predominant Gram-positive species isolated from uterine flushing. The pre-treatment SAA values (μg/ml varied significantly (p<0.01 between the treatment groups whereas no difference was observed in post-treatment groups. No significant difference (p<0.01 was observed for Hp values between the treatment groups, but the mean SAA (μg/ml and Hp (μg/ml levels were significantly (p<0.01 higher in pre-treatment when compared to post-treatment within the groups. Conclusion: In the diagnosis and monitoring of bovine endometritis, both SAA and Hp might serve as reliable biomarkers.

  14. Effect of diagnosis and treatment of clinical endometritis based on vaginal discharge score grading system in postpartum Holstein cows. (United States)

    Okawa, Hiroaki; Fujikura, Atsushi; Wijayagunawardane, Missaka M P; Vos, Peter L A M; Taniguchi, Masayasu; Takagi, Mitsuhiro


    In this study, the prevalence, effectiveness of diagnosis, and treatment based on vaginal discharge score (VDS) of clinical endometritis in cattle were evaluated. To detect clinical endometritis and classify its severity, vaginoscopy was performed during 21 to 60 days postpartum in 164 Holstein cows consisting of 229 lactations. Groups were defined using the 4-point VDS scale. Study groups included the following: non-endometritis (VDS=0; no/clear mucus; NEM group; n=168); mild endometritis, no treatment (VDS=1; mucus containing flecks of white/off-white pus; NTR group; n=30); and severe endometritis, treated with PGF2α (VDS≥2; discharge containing 50% pus, and fluid or uterine horn asymmetry; TEM group; n=31). Cows treated with PGF2α that did not recover (VDS≥1, n=5) received intrauterine procaine penicillin and streptomycin. Prevalence of clinical endometritis (VDS≥1) was 26.6%. The NTR group required significantly more artificial inseminations per pregnancy than NEM and TEM groups (2.8 ± 1.8 vs 2.0 ± 1.3, 1.9 ± 0.8, Pcows was higher in the NTR group compared to the NEM (P=0.012) and TEM (P=0.076) groups. In the TEM group, calving to first artificial insemination interval tended to be higher in cows treated 41 to 60 days postpartum than cows treated 29 to 40 days postpartum (97.2 ± 27.1 vs 74.4 ± 19.7, P=0.084). Our study suggests that cows with VDS=1 may require treatment to recover fertility. Diagnosis and treatment of clinical endometritis based on a VDS grading system may improve dairy herd reproductive performance.

  15. Therapy of bovine endometritis with prostaglandin F2α: a meta-analysis. (United States)

    Haimerl, P; Heuwieser, W; Arlt, S


    The objective of the conducted meta-analysis was to assess the efficacy of the treatment of bovine endometritis with PGF(2α) by statistical means. Postpartum uterine infections have a high prevalence and a very negative effect on reproductive performance in dairy cattle. Because of a wide discordance between research results, a meta-analysis of the efficacy of the treatment of bovine endometritis with PGF(2α) was conducted. A comprehensive literature search was performed using online databases to reveal a total of 2,307 references. In addition, 5 articles were retrieved by reviewing citations. After applying specific exclusion criteria and evaluating specific evidence parameters, 5 publications, comprising 6 trials, were eligible for being analyzed by means of meta-analysis. Data for each trial were extracted and analyzed using meta-analysis software Review Manager (version 5.1; The Nordic Cochrane Centre, Copenhagen, Denmark). Estimated effect sizes of PGF(2α) were calculated on calving to first service and calving to conception interval. Prostaglandin F(2α) treatment of cows with chronic endometritis had a negative effect on both reproductive performance parameters. Heterogeneity was substantial for calving to first service and calving to conception interval [I(2) (measure of variation beyond chance)=100 and 87%, respectively]; therefore, random-effects models were used. Sensitivity analysis as well as subgroup analysis showed that the performance of randomization was influential in modifying effect size of PGF(2α) treatment. The funnel plot illustrated a publication bias toward smaller studies that reported a prolonged calving to conception interval after a PGF(2α) treatment. We conclude that the investigation of this subject by means of meta-analysis did not reveal an improvement of reproductive performance of cows with endometritis after treatment with PGF(2α). Furthermore, there is a shortage of comparable high quality studies investigating

  16. Associations of prepartum body condition score with occurrence of clinical endometritis and resumption of postpartum ovarian activity in dairy cattle. (United States)

    Kadivar, Ali; Ahmadi, Mohammad Rahim; Vatankhah, Mahmood


    This study was performed to investigate the effect of periparturient body condition score on the occurrence of clinical endometritis and postpartum resumption of ovarian activity in dairy cows. Eighty-seven lactating Holstein cows, fed with a total mixed ration diet, were included into the study. Body condition scoring (using a 5-point scale with quarter-point divisions) was performed by the same investigator using the visual technique every 2 weeks, from 2 weeks before until 6 weeks after calving. Palpation of the reproductive tract and ultrasonographic assessment of ovaries for detection of corpus luteum using a rectal linear probe was also performed at 2, 4, and 6 weeks after calving. Cows with clinical endometritis had significantly lower body condition score (BCS) than normal cows at all weeks pre- and postcalving, and cows that did not ovulate until 45 days after calving had a significantly lower BCS pre- and postpartum. Cows that did not ovulate until 45 days after calving also lost more BCS from 2 weeks before to 4 weeks after calving. Besides, first ovulation after calving take occurred later in cows with clinical endometritis compared to normal cows (P < 0.05). In conclusion, low BCS is a risk factor for postpartum endometritis and delayed cyclicity in dairy cows. BCS loss from dry-off to early lactation and occurrence of clinical endometritis can significantly affect postpartum ovarian activity.

  17. Patients with secondary amenorrhea due to tuberculosis endometritis towards the induced anti-tuberculosis drug category 1. (United States)

    Perdhana, Raditya; Sutrisno, Sutrisno; Sugiri, Yani Jane; Baktiyani, Siti Candra Windu; Wiyasa, Arsana


    Tuberculosis (TB) is a disease which can affect various organs, including human's genital organs such as the endometrium. Tuberculosis endometritis can cause clinical symptoms of secondary amenorrhea and infertility. Infertility in genital TB caused by the involvement of the endometrium. The case presentation is 33-year-old woman from dr. Saiful Anwar Public Hospital to consult that she has not menstruated since 5 years ago (28 years old). The diagnosis was done by performing a clinical examination until the diagnosis of secondary amenorrhea due to tuberculosis endometritis is obtained. A treatment by using category I of anti-tuberculosis drugs was done for 6 months, afterward an Anatomical Pathology observation found no signs of the tuberculosis symptoms. Based on that, patient, who was diagnosed to have secondary amenorrhea due to tuberculosis endometritis, has no signs of tuberculosis process after being treated by using category I of anti-tuberculosis drugs for 6 months.

  18. Heuristic approach to the classification of postpartum endometritis and its forms

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    E. A. Balashova


    Full Text Available Тhe work is dedicated to the development of a method of automated medical diagnosis based on the description of biomedical systems using two parameters: energy, reflecting the interaction of its elements, and entropy characterizing the organization of the system. The violations of the energy-entropy cycle of biomedical systems is reflected in the symptoms of the disease. Statistical link between the symptoms of the condition of the body and the nature of excitation of its elements best expressed in the heuristic description of the system state. High accuracy classification of the patient's condition is achieved by using heuristic detection methods. In the proposed approach, allowing to estimate the probability of correct diagnosis increases the accuracy of the classification, and the estimated minimum amount of training samples and the capacity of its constituent signs. Classification technique consists in averaging the characteristic values in the selected classes, the preparation of the complex of symptoms of the most important signs of the disease, to conduct a "rough" diagnostic threshold rules that allow to distinguish severe forms of the disease, then differential diagnosis the severity of the disease. The proposed method was tested for classification of the forms of puerperal endometritis (mild, moderate, severe. The training sample contained 70 case histories. Syndrome to classify the patient's condition was composed of 17 characteristics. Threshold diagnosis has allowed to establish the presence of disease and to separate heavy. Differential diagnosis was used for classification of mild and moderate severity of postpartum endometritis. The accuracy of the classification of forms of postpartum endometritis amounted to 97.1%.

  19. The effect of Zataria multiflora extract on the clinical endometritis and reproductive indices in lactating Holstein dairy cows. (United States)

    Hajibemani, Abolfazl; Mirzaei, Abdolah; Rowshan Ghasrodashti, Abbas; Memarzadeh, Mohammad Reza


    In the present study, the effect of intrauterine infusion of Zataria multiflora extract on the clinical endometritis was investigated. Vaginal examination, transrectal palpation and ultrasonography were used to inspect the genital tract at 30-40 days in milk and two weeks later the same approach was applied. Cows with clinical endometritis were randomly divided into three treatment groups: Z. multiflora extract (n = 56), penicillin + streptomycin (pen + strep, n = 55), and placebo (n = 20). Cervical cytology, reagent strip test and cell counting by means of Neubauer hemocytometer were carried out in both examinations. Clinical cure rate of cows with endometritis of score 1 were 45.5, 34.5 and 53.6% in placebo, pen + strep and Z. multiflora , respectively. Clinical cure rate of cows with endometritis of score 2, 3 were 66.7, 84.6 and 56.0% in placebo, pen + strep and Z. multiflora , respectively. Overall, proportions of successfully treated cows were 55.0, 58.2 and 54.7% in placebo, pen + strep and Z. multiflora , respectively ( p > 0.05). In placebo, none of the parameters were significantly different between first and second examination, while we found the significant differences in percentage of neutrophils and leukocyte esterase activity in other groups ( p conception rate of cows was higher in Z. multiflora compared to other groups; however, this difference was not significant. In conclusion, pen + strep and Z. multiflora extract can be effective on the clinical endometritis and may improve reproductive performance. The extract of Z. multiflora can be useful as an alternative therapy for treatment of clinical endometritis in lactating dairy cows.

  20. Decreased rates of nosocomial endometritis and urinary tract infection after vaginal delivery in a French surveillance network, 1997-2003. (United States)

    Ayzac, Louis; Caillat-Vallet, Emmanuelle; Girard, Raphaële; Chapuis, Catherine; Depaix, Florence; Dumas, Anne-Marie; Gignoux, Chantal; Haond, Catherine; Lafarge-Leboucher, Joëlle; Launay, Carine; Tissot-Guerraz, Françoise; Vincent, Agnès; Fabry, Jacques


    To identify independent risk factors for endometritis and urinary tract infection (UTI) after vaginal delivery, and to monitor changes in nosocomial infection rates and derive benchmarks for prevention. Prospective study. We analyzed routine surveillance data for all vaginal deliveries between January 1997 and December 2003 at 66 maternity units participating in the Mater Sud-Est surveillance network. Adjusted odds ratios for risk of endometritis or UTI were obtained using a logistic regression model. The overall incidence rates were 0.5% for endometritis and 0.3% for UTI. There was a significant decrease in the incidence and risk of endometritis but not of UTI during the 7-year period. Significant risk factors for endometritis were fever during labor, parity of 1, and instrumental delivery and/or manual removal of the placenta. Significant risk factors for UTI were urinary infection on admission, premature rupture of membranes (more than 12 hours before admission), blood loss of more than 800 mL, parity of 1, instrumental delivery, and receipt of more than 5 vaginal digital examinations. Each maternity unit received a poster showing graphs of the number of expected and observed cases of UTI and endometritis associated with vaginal deliveries, which enabled each maternity unit to determine their rank within the network and to initiate prevention programs. Although routine surveillance means additional work for maternity units, our results demonstrate the usefulness of regular targeted monitoring of risk factors and of the most common nosocomial infections in obstetrics. Most of the information needed for monitoring is already present in the patients' records.

  1. Effect of immunomodulatory therapy on the endometrial inflammatory response to induced infectious endometritis in susceptible mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Woodward, Elizabeth; Bojesen, Anders Miki


    endometritis based on their endometrial histopathology and ability to clear an induced uterine inflammation. To investigate the effect of immunomodulatory therapy, the mares were inoculated with 10(5) colony forming units (CFU) Escherichia coli in three consecutive estrus cycles in a modified cross-over study...... inoculation. Endometrial biopsies were recovered 3, 24 and 72 h post inoculation. Relative gene-expression analyses were performed by quantitative reverse transcriptase PCR (qRT-PCR). Endometrial gene expression of inflammatory cytokines was modulated by administration of GC. Expression of proinflammatory...

  2. Is the use of Gunnera perpensa extracts in endometritis related to antibacterial activ

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    L.J. McGaw


    Full Text Available Rhizome extracts of Gunnera perpensa are used in traditional remedies in South Africa to treat endometritis both in humans and animals. An investigation was undertaken to determine whether this plant possesses antibacterial activity, which may explain its efficacy. Gunnera perpensa rhizome extracts were prepared serially with solvents of increasing polarity and tested for antibacterial activity. Test bacteria included the Gram-positive Enterococcus faecalis and Staphylococcus aureus and the Gram-negative Escherichia coli and Pseudomonas aeruginosa. A moderate to weak level of antibacterial activity in most of the extracts resulted, with the best minimal inhibitory concentration (MIC value of 2.61 mg ml-1 shown by the acetone extract against S. aureus. The extracts were also submitted to the brine shrimp assay to detect possible toxic or pharmacological effects. All the extracts were lethal to the brine shrimp larvae at a concentration of 5 mg ml-1. The acetone extract was extremely toxic at 1 mg ml-1, with some toxicity evident at 0.1 mg ml-1. The remainder of the extracts generally displayed little activity at concentrations lower than 5 mg ml-1. In summary, the results indicate that although the extracts demonstrated a level of pharmacological activity, the relatively weak antibacterial activity is unlikely to justify the use of G. perpensa rhizomes in the traditional treatment of endometritis. Rather, the slightly antibacterial nature of the rhizomes may contribute to an additive effect, along with their known uterotonic activity, to the overall efficacy of the preparation.

  3. Endometrial cytology as an indicator of subclinical endometritis of dairy cattle Holstein Friesian and Jersey breeds

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    Reátegui J


    Full Text Available In order to evaluate the presence of polymorphonuclear neutrophils (% PMN-N as an indicator of endometritis sub clinic in dairy cattle Holstein Friesian and Jersey breeds, by the method of endometrial cytology. 94 dairy cows were sampled, and were grouped by genotypic characteristics as: Group 1: 47 Holstein Friesian cows; Group 2: 47 Jersey cows, both between 21 and 56 days postpartum. It were evaluated: age, body condition, lactation number, number of birth, date of birth and days in milk to obtain the sample data were evaluated with a test of homogeneity based on statistical Chi square (p 0.05 was found in any of the variables studied, the% PMN-N reached a range between 0.4% and 4.4%, with an average of 2.2% still below the values indicating the present investigation reports the% PMN-N by genetic group both as multiparous or primiparous cows showed no significant differences between them. It has be concluded that the overall frequency for SE in different genotype cows did show statistically significant differences (p>0.05, however the presence of PMN-N as an indicator of subclinical endometritis in dairy cows of different genotype with 2 and 4 lactations showed differences statistically significant (p<0.05.

  4. Draft genome sequence of Streptococcus equi subsp. zooepidemicus strain S31A1, isolated from equine infectious endometritis

    DEFF Research Database (Denmark)

    da Piedade, Isabelle; Skive, Bolette; Christensen, Henrik


    We present the draft genome sequence of Streptococcus equi subsp. zooepidemicus S31A1, a strain isolated from equine infectious endometritis in Denmark. Comparative analyses of this genome were done with four published reference genomes: S. zooepidemicus strains MGCS10565, ATCC 35246, and H70 and S...

  5. The "RESEAU MATER": An efficient infection control for endometritis, but not for urinary tract infection after vaginal delivery. (United States)

    Ayzac, Louis; Caillat-Vallet, Emmanuelle; Girard, Raphaële; Berland, Michel

    "RESEAU MATER" is useful to monitor nosocomial infections in maternity and contributes to the decreasing trend of it, since its implementation. Specifically, this network demonstrates its efficiency in the control of endometritis following vaginal deliveries, but not in the control of urinary tract infections. The aim of this study is to determine whether the difference between the control of endometritis and of urinary tract infection could be explained by an unsuitable regression model or by an unsuitable care policy concerning urinary cares. This study includes (1) the analysis of historic data of the network and (2) the description of French guidelines for maternity cares and available evaluations, concerning endometritis and urinary tract infection prevention. Univariate and multivariate odds ratios (ORs) were calculated for the total study period of 1999-2013, for these infections and their risk factors. The endometritis frequency is decreasing, in association with no significant evolution of associated risk factors, but urinary tract infection frequency is constant, in association with a increasing trend of its risk factors such as intermittent catheterization and epidural analgesia. In French guidelines, all preventive measures against endometritis are clearly broadcasted by all field operators, and repeated audits have reinforced the control of their application. But preventive measures against urinary tract infection seem to be broadcasted exclusively in the circle of infection prevention agencies and not in the obstetrics societies or in the Health Ministry communication. Urinary tract infection prevention requires a clearer public and professional policy in favor of a more efficient urinary cares, with a specific target to maternity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Idrees Ali Zahid


    Full Text Available Bacteriology of endometritis and in vitro antibiotic sensitivity of the isolates in Holstein Friesian and Jersey cows maintained at Research Institute for Physiology of Animal Reproduction, Bhunikey, District Kasur were carried out. Out of 100 samples, 89 contained different strains of bacteria and 11 were found bacteriologically sterile. Different species of bacteria isolated from these samples were, Bacillus subtilis (08.99%, Corynebacterium pyogenes (19.10%, Escherichia coli (29.21%, Neisseria meningitides (03.37%, Staphylococcus aureus (23.60%, Streptococcus pneumonia (03.37% and Streptococcus pyogenes (12.36%. The in vitro antibiotic sensitivity test indicated that the highest number of isolates (92% were sensitive to neomycin, followed by doxycyline (89%. Clindramycin showed the lowest results in terms of in vitro antibiotic sensitivity (51%.

  7. Group A Streptococcal Endometritis: Report of an Outbreak and Review of the Literature

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    Ziad A Memish


    Full Text Available Two cases of group A streptococcus (gas postpartum endometritis were diagnosed within 24 h following uncomplicated vaginal delivery. Investigation by the infection control service identified all 10 obstetric personnel who performed any invasive procedure on both cases. These personnel were questioned about a recent history of sore throat, skin lesions, vaginal or rectal symptoms. Throat and rectal cultures were obtained for gas from all 10 personnel. A carrier was identified among the personnel screened. This nurse was removed from direct patient care and treated with a two-week course of oral clindamycin and rifampin with documentation of carrier eradication of gas at the end of therapy, 30 days, 60 days and six months post-treatment. All three isolated strains were identical by restriction endonuclease analysis and by M and T typing. Rapid implementation of infection control measures were successful in arresting this outbreak, with no further cases of gas occurring in the subsequent year.

  8. Categorization of endometritis and its association with ovarian follicular growth and ovulation, reproductive performance, dry matter intake, and milk yield in dairy cattle. (United States)

    Gobikrushanth, M; Salehi, R; Ambrose, D J; Colazo, M G


    The objectives were to evaluate the effect of different categories of endometritis on follicular growth and ovulation, reproductive performance, dry matter intake (DMI), and milk yield (MY) in dairy cows. Lactating Holstein cows (n = 126) were examined for endometritis on 25 ± 1 day postpartum (DPP) using vaginoscopy, transrectal ultrasonography, and endometrial cytology to determine the presence and type of vaginal discharge, uterine fluid, and proportion of polymorphonuclear (PMN) cells, respectively. Cows that had mucopurulent vaginal discharge and/or presence of uterine fluid, no mucopurulent vaginal discharge or uterine fluid but 8% or more PMN, and mucopurulent vaginal discharge and/or uterine fluid and 8% or more of PMN were defined as having clinical (CLIN; n = 45), cytological (CYTO; n = 15), and clinical and cytological (CLINCYTO; n = 30) endometritis, respectively. Cows that had none of the above pathological conditions were classified as unaffected (UNAF; n = 36). The diameter of the largest follicle at first examination, intervals from calving to first dominant (diameter = 10 mm) follicle, preovulatory size (diameter = 16 mm) follicle, ovulation, presence of follicular cyst, and proportion of ovular cows at 35 and 65 DPP were recorded as the measures of follicular growth and ovulation. None of the ovarian follicular parameters analyzed was affected by categories of endometritis. The first service conception rate tended (P = 0.06) to differ among categories of endometritis; cows that had CLIN and CLINCYTO endometritis were four times less likely to conceive to the first insemination compared to UNAF cows. Cows that had CLIN (hazard ratio: 0.52) and CLINCYTO (hazard ratio: 0.40) endometritis had decreased likelihood of pregnancy at 150 DPP compared to UNAF cows. Similarly, cows diagnosed as having CLINCYTO endometritis had decreased likelihood (hazard ratio: 0.48) of pregnancy at 250 DPP compared to UNAF cows. The DMI and MY up to 5

  9. A comparison of 3 antibiotic regimens for prevention of postcesarean endometritis: an historical cohort study. (United States)

    Ward, Erin; Duff, Patrick


    Prophylactic antibiotics are of proven value in decreasing the frequency of postcesarean endometritis. The beneficial effect of prophylaxis is enhanced when the antibiotics are administered before the surgical incision as opposed to after the clamping of the umbilical cord. However, the optimal antibiotic regimen for prophylaxis has not been established firmly. The purpose of this study was to compare 3 different antibiotic regimens for the prevention of postcesarean endometritis. This retrospective historical cohort study was conducted at the University of Florida, which is a tertiary care facility that serves a predominantly indigent patient population. In the period January 2003 to December 2007, our standard prophylactic antibiotic regimen for all women who had cesarean delivery was cefazolin (1 g) administered immediately after the baby's umbilical cord was clamped. In November 2008, we began to administer the combined regimen of cefazolin (1 g intravenously) plus azithromycin (500 mg intravenously); both were given 30-60 minutes before the skin incision. In the period of January-December 2014, we continued the dual agent regimen but based the dose of cefazolin on the patient's body mass index: 2 g intravenously if the body mass index was 30 kg/m(2). The surgical technique was consistent throughout all 3 time periods. Our primary endpoint was the frequency of endometritis in each time period. This diagnosis was based on fever ≥37.5°C, lower abdominal pain and tenderness, the exclusion of other localizing signs of infection, and the requirement for administration of therapeutic antibiotics. In the first year after beginning the new antibiotic regimen, we also monitored the frequency of neonatal sepsis evaluations and compared it with the frequency that was recorded during the year immediately preceding the change in antibiotic regimens. During the entire period 2003-2014, 29,633 women delivered at our institution; 6455 women (22%) had a cesarean delivery. In

  10. Mycoplasma infection in the uterus of early postpartum dairy cows and its relation to dystocia and endometritis. (United States)

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


    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

  11. Pyometra caused by carrying of an intrauterine device for a period of forty years and chronic endometritis

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    Todorović Nada 1


    Full Text Available Pyometra is the accumulation of pus in the uterine cavity, thus streaching its walls and thinning and enlarging the uterus. This change is characteristic of the senium period of life, when the uterus is atrophie with a stenotic cervical canal. It most frequently occurs as a result of secondary infection of the cancerogenic tissue of the uterus and additional stenosation and clogging up of cervical canal by a malignant process. Apart from carcinomas of the body and uterus cervix, pyometra less often can occur in other illnesses such as senile endometritis and senile colpitis. As pyometra most frequently occurs in uterine carcinomas, in detection of this state, we must think of malignancy and direct our examination to this direction. In this paper we present a patient in whom pyometra developed because she carried an intrauterine device for forty years that resulted in chronic endometritis. The main symptoms for which the patient was admited to hospital were abdominal pain and intensive suppurative vaginal excretion a month after removal of intrauterine device. The diagnosis of pyometra was made by gynaecological and ultrasound examinations, and also on the basis of gynecological and ultrasound examinations one month after chronic endometritis was confirmed. On the basis of this finding we suspected that chronic endometritis was caused by this state. By cytological, PAP and histopathological examinations of samples obtained by explorative curettage and biopsy of the uterine cervix, malignant changes were eliminated a possible cause. By laboratory analysis and bacteriological examination of the uterine cavity and vaginal excretion, inflammatory changes of the uterine mocous membrane were confirmed as a cause of the pyometra. This conditions was due to carrying the intrauterine device for more decades. The therapy consisted of dilatation of the cervical canal and evacuation of accumulated suppurative contents and irrigation of uterine cavity with 3

  12. Cytological evaluation of inflammation of the uterus and influence of endometritis on selected reproductive parameters in dairy cows

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    Brodzki Piotr


    Full Text Available There were two aims of this study. One was to evaluate the postpartum state of the reproductive system in cows based on ultrasonography, bacterial culture, and cytological examination of the uterus. The other was to determine whether postpartum endometritis affects the subsequent state of the endometrium, and, in consequence, selected reproductive parameters in cows. The study was conducted on 60 cows: the experimental group of 30 cows with endometritis, and 30 cows free of uterine inflammation (control. The percentage of leukocytes in both groups was similar only on day 5 of postpartum. In all subsequent tests (26, 40, 61 d postpartum, the percentage of leukocytes in the experimental group was statistically significantly higher than in the control (P < 0.001, both in samples collected with a brush and in lavage samples. Involution of the uterus in the experimental group was also slower (P < 0.001. The analysed reproductive parameters were markedly less favourable in the experimental group than in the control. The study showed that postpartum inflammation of the uterus can persist for a long time in the form of endometritis, causing substantial deterioration of reproductive parameters in cows. The authors suggest that cytological evaluation of the uterus, preferably using a brush, should be performed as soon as possible after parturition, even before day 21, up to which time puerperal metritis may still persist. Evaluation of the inflammatory process based on the number of leukocytes and the quality of endometrial cells is important.

  13. Effects of 1 or 2 treatments with prostaglandin F₂α on subclinical endometritis and fertility in lactating dairy cows inseminated by timed artificial insemination. (United States)

    Lima, F S; Bisinotto, R S; Ribeiro, E S; Greco, L F; Ayres, H; Favoreto, M G; Carvalho, M R; Galvão, K N; Santos, J E P


    The objectives of the current study were to investigate the efficacy of PGF₂α as a therapy to reduce the prevalence of subclinical endometritis and improve pregnancy per artificial insemination (P/AI) in cows subjected to a timed artificial insemination (AI) program. A total of 1,342 lactating Holstein dairy cows were allocated randomly at 25 ± 3 d in milk (DIM) to remain as untreated controls (control, n=454) or to receive a single PGF₂α treatment at 39 ± 3 DIM (1PGF, n=474) or 2 treatments with PGF(α at 25 ± 3 and 39 ± 3 DIM (2PGF, n=414). All cows were enrolled in the double Ovsynch program at 48 ± 3 DIM and were inseminated at 75 ± 3 DIM. A subset of 357 cows had uterine samples collected for cytological examination at 25 ± 3, 32 ± 3, and 46 ± 3 DIM to determine the percentage of polymorphonuclear leukocytes (PMNL). Subclinical endometritis was defined by the presence of ≥ 5% PMNL. Vaginal discharge score was evaluated at 25 ± 3 DIM and used to define the prevalence of purulent vaginal discharge. Body condition score was assessed at 25 ± 3 DIM. Pregnancy was diagnosed 32 d after AI and reconfirmed 28 d later. At 32 ± 3 DIM, the prevalence of subclinical endometritis was reduced by treatment with PGF₂α at 25 ± 3 DIM in 2PGF (control=23.5% vs. 1PGF=28.3% vs. 2PGF=16.7%); however, this benefit disappeared at 46 ± 3 DIM, and 14% of the cows remained with subclinical endometritis. One or 2 treatments with PGF₂α did not influence P/AI on d 32 or 60 after timed AI, which averaged 39.9 and 35.2%. Similarly, treatment with PGF₂α had no effect on pregnancy loss between 32 and 60 d of gestation (11.9%). Cows diagnosed with both purulent vaginal discharge and subclinical endometritis had the lowest P/AI and the highest pregnancy loss compared with those diagnosed with only 1 of the 2 diseases or compared with cows having no diagnosis of uterine diseases. Interestingly, subclinical endometritis depressed P/AI and increased pregnancy loss only

  14. The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. (United States)

    Moreno, Inmaculada; Cicinelli, Ettore; Garcia-Grau, Iolanda; Gonzalez-Monfort, Marta; Bau, Davide; Vilella, Felipe; De Ziegler, Dominique; Resta, Leonardo; Valbuena, Diana; Simon, Carlos


    Chronic endometritis is a persistent inflammation of the endometrial mucosa caused by bacterial pathogens such as Enterobacteriaceae, Enterococcus, Streptococcus, Staphylococcus, Mycoplasma, and Ureaplasma. Although chronic endometritis can be asymptomatic, it is found in up to 40% of infertile patients and is responsible for repeated implantation failure and recurrent miscarriage. Diagnosis of chronic endometritis is based on hysteroscopy of the uterine cavity, endometrial biopsy with plasma cells being identified histologically, while specific treatment is determined based on microbial culture. However, not all microorganisms implicated are easily or readily culturable needing a turnaround time of up to 1 week. We sought to develop a molecular diagnostic tool for chronic endometritis based on real-time polymerase chain reaction equivalent to using the 3 classic methods together, overcoming the bias of using any of them alone. Endometrial samples from patients assessed for chronic endometritis (n = 113) using at least 1 or several conventional diagnostic methods namely histology, hysteroscopy, and/or microbial culture, were blindly evaluated by real-time polymerase chain reaction for the presence of 9 chronic endometritis pathogens: Chlamydia trachomatis, Enterococcus, Escherichia coli, Gardnerella vaginalis, Klebsiella pneumoniae, Mycoplasma hominis, Neisseria gonorrhoeae, Staphylococcus, and Streptococcus. The sensitivity and specificity of the molecular analysis vs the classic diagnostic techniques were compared in the 65 patients assessed by all 3 recognized classic methods. The molecular method showed concordant results with histological diagnosis in 30 samples (14 double positive and 16 double negative) with a matching accuracy of 46.15%. Concordance of molecular and hysteroscopic diagnosis was observed in 38 samples (37 double positive and 1 double negative), with an accuracy of 58.46%. When the molecular method was compared to microbial culture

  15. Influence of subclinical endometritis on the reproductive performance of dairy cows

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    Barrio, M.; Vigo, M.; Quintela, L.A.; Becerra, J.J.; García-Herradón, P.J.; Martínez-Bello, D.; Fernandez-Sanchez, F.I.; Prieto, A.; Cainzos, J.; Peña, A.I.


    The aim of this study was to evaluate the influence of subclinical endometritis (SE) on the reproductive performance of dairy cows. Ninety-four dairy cows of parity 1 to 8, distributed in 25 herds, were examined once between 30 and 45 days in milk using transrectal palpation, vaginoscopy and ultrasonography. A cytological sample of the endometrium was taken only from cows with an apparent healthy uterus (n=65). Serum glucose, total cholesterol, triglycerides, non-esterified fatty acids, β-hydroxybutyrate, total proteins, albumin, urea and hepatic enzymes were analyzed. Reproductive indexes were recorded during the next 11 months. Endometrial cytology was considered indicative of SE if percentage of polymorphonuclear neutrophils was superior to 5% of all cells present in the smear, except erythrocytes. Results indicated that 14.9% of the cows sampled for uterine cytology had SE, and that healthy cows become pregnant significantly before than those with SE (hazard ratio=2.35; 95% confidece interval: 1.05-5.3). From all the metabolic and productive variables analyzed, only triglycerides affected negatively to reproduction; serum albumin concentration, body condition score and milk production had positive effects on the reproductive performance. In conclusion, our results indicate that SE has a negative impact on reproductive performance and uterine cytology is necessary to diagnose it since almost 15% of the affected animals were not detected by other diagnosis methods. (Author)

  16. Presence of superantigen genes and antimicrobial resistance in Staphylococcus isolates obtained from the uteri of dairy cows with clinical endometritis. (United States)

    Zhao, J-L; Ding, Y-X; Zhao, H-X; He, X-L; Li, P-F; Li, Z-F; Guan, H; Guo, X


    Clinical endometritis is an important disease of dairy cattle and results in decreased reproductive performance. This disease is caused by contamination of the uterus with a broad spectrum of microorganisms after calving. In this study, staphylococcal isolates from the uterus of dairy cows with clinical endometritis were tested for their distribution of superantigen (SAg) genes and antimicrobial resistance. Between the 127 staphylococcal isolates collected in this study, 10 species were identified. The predominant strain identified was Staphylococcus aureus (n=53), followed by Staphylococcus saprophyticus (n=38) and Staphylococcus chromogenes (n=22). PCR analysis demonstrated that most isolates (63.0 per cent) harboured at least one SAg gene. The most commonly observed SAg gene and genotype was selj (38.6 per cent) and sec-selj-seln (24.0 per cent), respectively. Most isolates were resistant to penicillin (79.5 per cent), ampicillin (71.7 per cent), erythromycin (56.7 per cent), and tetracycline (52.0 per cent). PCR analysis demonstrated that the antimicrobial resistance determinants ermA, ermB, ermC, tetK, tetM and blaZ were detected in 0 per cent, 44.4 per cent, 51.4 per cent, 68.2 per cent, 13.6 per cent and 86.1 per cent of the erythromycin, tetracycline and β-lactam resistant isolates, respectively. There were 22 (17.3 per cent of all isolates) coagulase-negative staphylococci shown to be methicillin resistant. In the methicillin-resistant isolates, significant resistances to ampicillin, erythromycin and penicillin were observed (P<0.01). The results of this study demonstrate that staphylococci recovered from dairy cows with clinical endometritis contain an extensive and complex prevalence of SAg genes. Significant resistances to antibiotics were also seen, highlighting the need for the rational appliance of antibiotics in veterinary medicine. British Veterinary Association.

  17. Higher prevalence of chronic endometritis in women with endometriosis: a possible etiopathogenetic link. (United States)

    Cicinelli, Ettore; Trojano, Giuseppe; Mastromauro, Marcella; Vimercati, Antonella; Marinaccio, Marco; Mitola, Paola Carmela; Resta, Leonardo; de Ziegler, Dominique


    To evaluate the association between endometriosis end chronic endometritis (CE) diagnosed by hysteroscopy, conventional histology, and immunohistochemistry. Case-control study. University hospital. Women with and without endometriosis who have undergone hysterectomy. Retrospective evaluation of 78 women who have undergone hysterectomy and were affected by endometriosis and 78 women without endometriosis. CE diagnosed based on conventional histology and immunohistochemistry with anti-syndecan-1 antibodies to identify CD138 cells. The prevalence of CE was statistically significantly higher in the women with endometriosis as compared with the women who did not have endometriosis (33 of 78, 42.3% vs. 12 of 78, 15.4% according to hysteroscopy; and 30 of 78, 38.5% vs. 11 of 78, 14.1% according to histology). The women were divided into two groups, 115 patients without CE and 41 patients with CE. With univariate analysis, parity was associated with a lower risk for CE, and endometriosis was associated with a statistically significantly elevated risk of CE. Using multivariate analysis, parity continued to be associated with a lower incidence of CE, whereas endometriosis was associated with a 2.7 fold higher risk. The diagnosis of CE is more frequent in women with endometriosis. Although no etiologic relationships between CE and endometriosis can be established, this study suggests that CE should be considered and if necessary ruled out in women with endometriosis, particularly if they have abnormal uterine bleeding. Identification and appropriate treatment of CE may avoid unnecessary surgery. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Trueperella pyogenes isolated from dairy cows with endometritis in Inner Mongolia, China: Tetracycline susceptibility and tetracycline-resistance gene distribution. (United States)

    Zhang, Dexian; Zhao, Jingcui; Wang, Qiuxia; Liu, Yaochuan; Tian, Chunlian; Zhao, Yujun; Yu, Lihui; Liu, Mingchun


    Trueperella pyogenes plays a crucial role in endometritis pathogenesis and is also associated with many infections, including metritis, mastitis, arthritis and liver abscessation, in many domestic animals. In this study, we investigated the prevalence of tetracycline resistance in T. pyogenes isolated from dairy cows with endometritis in Inner Mongolia, China, and we assessed tetracycline-resistance gene distribution among the isolates. Our results indicated that 68.7% and 62.5% of the isolates were resistant to tetracycline and doxycycline, respectively, and the rate of resistance to metacycline was 18.8%. The tetracycline resistance gene tetK was present in all isolates (n = 32), whereas the tetM gene was identified in 12.5% and 9.4% of the isolates, in the chromosome and plasmid, respectively. Strains carrying tetW were also common in the chromosome and plasmid, with abundances of 53.1% and 46.9%, respectively. However, tetO and otrA were absent in all isolates. The resistance phenotype analysis indicated that 6.3% of strains were susceptible to all tetracyclines, while 3.1% showed resistance to all tetracyclines. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Antibacterial Efficacy of Silver Nanoparticles on Endometritis Caused by Prevotella melaninogenica and Arcanobacterum pyogenes in Dairy Cattle

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    Sangiliyandi Gurunathan


    Full Text Available Bovine postpartum diseases remain one of the most significant and highly prevalent illnesses with negative effects on the productivity, survival, and welfare of dairy cows. Antibiotics are generally considered beneficial in the treatment of endometritis; however, frequent usage of each antibiotic drug is reason for the emergence of multidrug resistance (MDR of the pathogenic microorganisms, representing a major impediment for the successful diagnosis and management of infectious diseases in both humans and animals. We synthesized silver nanoparticles (AgNPs with an average size of 10 nm using the novel biomolecule apigenin as a reducing and stabilizing agent, and evaluated the efficacy of the AgNPs on the MDR pathogenic bacteria Prevotella melaninogenica and Arcanobacterium pyogenes isolated from uterine secretion samples. AgNPs inhibited cell viability and biofilm formation in a dose- and time-dependent manner. Moreover, the metabolic toxicity of the AgNPs was assessed through various cellular assays. The major toxic effect of cell death was caused by an increase in oxidative stress, as evidenced by the increased generation of reactive oxygen species (ROS, malondialdehyde, protein carbonyl content, and nitric oxide. The formation of ROS is considered to be the primary mechanism of bacterial death. Therefore, the biomolecule-mediated synthesis of AgNPs shows potential as an alternative antimicrobial therapy for bovine metritis and endometritis.

  20. Determination of optimal diagnostic criteria for purulent vaginal discharge and cytological endometritis in dairy cows. (United States)

    Denis-Robichaud, J; Dubuc, J


    The objectives of this observational study were to identify the optimal diagnostic criteria for purulent vaginal discharge (PVD) and cytological endometritis (ENDO) using vaginal discharge, endometrial cytology, and leukocyte esterase (LE) tests, and to quantify their effect on subsequent reproductive performance. Data generated from 1,099 untreated Holstein cows (28 herds) enrolled in a randomized clinical trial were used in this study. Cows were examined at 35 (± 7) d in milk for PVD using vaginal discharge scoring and for ENDO using endometrial cytology and LE testing. Optimal combinations of diagnostic criteria were determined based on the lowest Akaike information criterion (AIC) to predict pregnancy status at first service. Once identified, these criteria were used to quantify the effect of PVD and ENDO on pregnancy risk at first service and on pregnancy hazard until 200 d in milk (survival analysis). Predicting ability of these diagnostic criteria was determined using area under the curve (AUC) values. The prevalence of PVD and ENDO was calculated as well as the agreement between endometrial cytology and LE. The optimal diagnostic criteria (lowest AIC) identified in this study were purulent vaginal discharge or worse (≥ 4), ≥ 6% polymorphonuclear leukocytes (PMNL) by endometrial cytology, and small amounts of leukocytes or worse (≥ 1) by LE testing. When using the combination of vaginal discharge and PMNL percentage as diagnostic tools (n = 1,099), the prevalences of PVD and ENDO were 17.1 and 36.2%, respectively. When using the combination of vaginal discharge and LE (n = 915), the prevalences of PVD and ENDO were 17.1 and 48.4%. The optimal strategies for predicting pregnancy status at first service were the use of LE only (AUC = 0.578) and PMNL percentage only (AUC = 0.575). Cows affected by PVD and ENDO had 0.36 and 0.32 times the odds, respectively, of being pregnant at first service when using PMNL percentage compared with that of unaffected

  1. Using narrow-band imaging with conventional hysteroscopy increases the detection of chronic endometritis in abnormal uterine bleeding and postmenopausal bleeding. (United States)

    Ozturk, Mustafa; Ulubay, Mustafa; Alanbay, Ibrahim; Keskin, Uğur; Karasahin, Emre; Yenen, Müfit Cemal


    A preliminary study was designed to evaluate whether a narrow-band imaging (NBI) endoscopic light source could detect chronic endometritis that was not identifiable with a white light hysteroscope. A total of 86 patients with endometrial pathology (71 abnormal uterine bleeding and 15 postmenopausal bleeding) were examined by NBI endoscopy and white light hysteroscopy between February 2010 and February 2011. The surgeon initially observed the uterine cavity using white light hysteroscopy and made a diagnostic impression, which was recorded. Subsequently, after pressing a button on the telescope, NBI was used to reevaluate the endometrial mucosa. The median age of the patients was 40 years (range: 30-60 years). Endometritis was diagnosed histologically. Six cases of abnormal uterine bleeding (6/71, 8.4%, 95% confidence interval [CI] 0.03-0.17) and one case of postmenopausal bleeding (1/15, 6%, 95%CI 0.01-0.29) were only diagnosed with chronic endometritis by NBI (7/86, 8.1%, 95%CI 0.04-0.15). Capillary patterns of the endometrium can be observed by NBI and this method can be used to assess chronic endometritis. © 2015 Japan Society of Obstetrics and Gynecology.

  2. Investigating the microbiome of the bovine uterus in relation to endometritis, a costly disease for dairy farmers

    DEFF Research Database (Denmark)

    Rødtness Vesterby Knudsen, Lif; Rasmussen, Eva Láadal; Schou, Kirstine Klitgaard

    Endometritis is inflammation of the inner lining of the uterus, affecting up to 20% of the dairy cows after calving in Denmark. The disease causes reduced pregnancy rates, which often leads to culling of the cows and is costly for the farmer. Until now, investigations of which pathogens may cause....... Not being limited to bacteria that are suited to growth under laboratory conditions, this study promises a more comprehensive insight into the microbiome of the dairy cow uterus than has previously been offered. Cows (n=40) on a Danish dairy herd were randomly selected on the basis of a uterine score...... indicating that the cows had uterine pathology. Uterine fluid was aspirated and if necessary the uterus was flushed with 30 ml sterile saline solution in order to retrieve uterine material. The fluid was placed in RNAlater. An endometrial biopsy was retrieved and the tissue placed in RNAlater. The cows were...

  3. Tratamento da endometrite puerperal com antibioticoterapia parenteral exclusiva Treatment of puerperal endometritis using a regimen with exclusive parenteral antibiotics

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    Geraldo Duarte


    Full Text Available OBJETIVO: analisar a efetividade e segurança da antibioticoterapia parenteral hospitalar exclusiva para tratamento da endometrite puerperal, em população de baixo nível socioeconômico. MÉTODOS: estudo clínico prospectivo, que avaliou 21 puérperas com diagnóstico de endometrite puerperal, cujas gestações foram resolvidas em hospital universitário por cesárea (52,4% ou parto normal (47,6. A amostra caracterizou-se por baixo nível socioeconômico e de escolaridade. Foram submetidas ao regime de antibioticoterapia parenteral exclusiva, apenas durante o período de internação (grupo ATP-EX. Os resultados foram comparados com aqueles obtidos de série histórica do mesmo serviço (20 casos submetidas a antibioticoterapia parenteral hospitalar, complementada por terapia via oral ambulatorial (grupo ATP+VO. As pacientes foram avaliadas clinicamente em retornos periódicos visando identificar casos de recidivas e complicações infecciosas. RESULTADOS: uma paciente do grupo ATP+VO necessitou de reinternação no 6º dia após a alta por recrudescência da endometrite. Não foi observada nenhuma complicação entre as pacientes do grupo ATP-EX. CONCLUSÃO: para o tratamento de endometrite puerperal, não foi observado benefício adicional com a adição da antibioticoterapia oral complementar após a alta. Os resultados com o uso da antibioticoterapia parenteral exclusiva durante a internação indicam que esse esquema pode ser utilizado com segurança em população de baixo nível socioeconômico.PURPOSE: to analyze the effectiveness and safety of exclusive hospital parenteral antibiotic therapy to treat puerperal endometritis in a population of low socioeconomic level. METHODS: a prospective clinical trial evaluated 21 puerperae with a diagnosis of postpartum endometritis, whose deliveries occurred at a university hospital by cesarean section (52.4% or normal delivery (47.6%. The sample was characterized by low socioeconomic and

  4. Determination of the prevalence of subclinical endometritis and evaluation of molecular characterization of Escherichia coli (E-coli separated of them in mares repeat breeder in Yazd province

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    Taktaz Hafshejani Taghi


    Full Text Available Escherichia coli are known as the most common cause of reproductive tract infection in mare. Due to the progressive process of antibiotics use and increasing prevalence of antibiotic resistance, the aim of this study is evaluate the prevalence of subclinical endometritis and antibiotic resistance genes in Escherichia coli isolated. In this study, 60 mares were used with infertility background. Diagnosis of endometritis was performed using history and ultrasonography. Cytology, culture, Antibiogram were done of samples and PCR test was used to examine the gene virulence and antibiotic resistance. E-coli bacteria was isolated 48/33 % from sample culture. In PCR test 66/21 % of bacteria had virulence gene. It was determined, the lowest resistance to chloramphenicol about 38/15% and greatest resistance into ampicillin, tetracycline and streptomycin with 23/69 percent, respectively. 93% samples cytology had neutrophil more than two and the agent of 50% showed E. coli. The cause of half of subclinical endometritis in infertile maresis E-coli bacteriaEscherichia coli are known as the most common cause of reproductive tract infection in mare. Due to the progressive process of antibiotics use and increasing prevalence of antibiotic resistance, the aim of this study is evaluate the prevalence of subclinical endometritis and antibiotic resistance genes in Escherichia coli isolated. In this study, 60 mares were used with infertility background. Diagnosis of endometritis was performed using history and ultrasonography. Cytology, culture, Antibiogram were done of samples and PCR test was used to examine the gene virulence and antibiotic resistance. E-coli bacteria was isolated 48/33 % from sample culture. In PCR test 66/21 % of bacteria had virulence gene. It was determined, the lowest resistance to chloramphenicol about 38/15% and greatest resistance into ampicillin, tetracycline and streptomycin with 23/69 percent, respectively. 93% samples cytology had

  5. The effect of intrauterine infusion of dextrose on clinical endometritis cure rate and reproductive performance of dairy cows. (United States)

    Machado, V S; Oikonomou, G; Ganda, E K; Stephens, L; Milhomem, M; Freitas, G L; Zinicola, M; Pearson, J; Wieland, M; Guard, C; Gilbert, R O; Bicalho, R C


    The main objective of this study was to evaluate the intrauterine administration use of 200 mL of 50% dextrose solution as a treatment against clinical endometritis (CE); CE cure rate and reproductive performance were evaluated. Additionally, the association of several relevant risk factors, such as retained placenta (RP), metritis, CE, anovulation, hyperketonemia, and body condition score with reproductive performance, early embryonic mortality, and CE were evaluated. A total of 1,313 Holstein cows housed on 4 commercial dairy farms were enrolled in the study. At 7±3 DIM cows were examined for metritis and had blood collected to determine serum β-hydroxybutyrate concentration. To determine if cows had ovulated at least once before 44±3 DIM, the presence of a corpus luteum was evaluated by ovarian ultrasonography at 30±3 DIM and at 44±3 DIM. At 30±3 DIM, CE was diagnosed using the Metricheck device (SimcroTech, Hamilton, New Zealand); cows with purulent or mucopurulent vaginal discharge were diagnosed as having CE. Cows diagnosed with CE (n=175) were randomly allocated into 2 treatment groups: treatment (intrauterine infusion of 200 mL of 50% dextrose) or control (no infusion). Clinical endometritis cows were re-evaluated as described above at 44±3 DIM, and cows that were free of purulent or mucopurulent vaginal discharge were considered cured. Intrauterine infusion of dextrose tended to have a detrimental effect on CE cure rate, and treatment did not have an effect on first-service conception rate and early embryonic mortality. A multivariable Cox's proportional hazard model was performed to evaluate the effect of several variables on reproductive performance; the variables RP, CE, parity, anovulation, and the interaction term between parity and anovulation were associated with hazard of pregnancy. Cows that did not have RP or CE were more likely to conceive than cows that were diagnosed with RP or CE. Cows that had RP were at 3.36 times higher odds of

  6. Relationships between plasma insulin-like growth factor-1 and insulin concentrations in multiparous dairy cows with cytological endometritis. (United States)

    Valdmann, Merle; Kurykin, Jevgeni; Kaart, Tanel; Mällo, Gret-Kristel; Waldmann, Andres


    Cytological endometritis (CYTO) is a uterine inflammation characterised by the percentage of polymorphonuclear neutrophils in endometrial cytology. This observational study evaluated the association of blood plasma insulin-like growth factor-1 (IGF-1) and insulin concentrations at -2 weeks prepartum, +1 week and +3 weeks postpartum with the development of CYTO in 119 multiparous Holstein cows. Overall CYTO prevalence was 30.3 per cent. Multivariable logistic regression model revealed the odds of developing CYTO were 3.54 times (P=0.018) greater in cows with week -2 prepartum IGF-1 concentrations less than 74.6 ng/ml and 4.41 times (P=0.004) higher in cows with week +1 postpartum IGF-1 concentrations less than 13.2 ng/ml than the odds of this health outcome in cows with IGF-1 concentrations at least 74.6 and13.2 ng/ml, respectively. Additionally, cows with body condition score (BCS) up to 2.75 at week -2 prepartum and cows experiencing calving-related disorders and/or ill health had higher risk for CYTO compared with cows with BCS=3.50-3.75 (OR=6.8, P=0.049) and cows without health complications (OR=3.1, P=0.030). Insulin was not a significant predictor for CYTO in the model. Our findings provide further evidence that reduced dairy cow fertility associated with low plasma concentrations of IGF-1 is in part mediated through the inflammatory status of the uterus. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Long-term alteration of follicular steroid concentrations in relation to subclinical endometritis in postpartum dairy cows. (United States)

    Green, M P; Ledgard, A M; Beaumont, S E; Berg, M C; McNatty, K P; Peterson, A J; Back, P J


    The focus of this study was to investigate the effect of subclinical endometritis (scEndo) on ovarian follicular steroid concentrations in early postpartum pasture-fed dairy cows. Mixed-age lactating dairy cows (n = 169) were examined to ascertain uterine health status on d 21 postpartum (±3 d). From this herd, a cohort of scEndo and uninfected cows (n = 47) were selected using uterine cytology to determine scEndo. To ensure cows with scEndo were selected for the study, a conservative threshold [>18% polymorphonuclear (PMN) cells among uterine nucleated cells] was chosen as a selection threshold. Ovarian follicular dynamics were assessed by ultrasonography on d 21, 42, and 63 postpartum. On the latter 2 d, all follicles >4 mm in diameter were ablated, and 4 d later, the largest (F1) and second largest (F2) follicles were measured and their follicular fluid aspirated. Hematological variables and plasma metabolites were measured also on these days to further characterize scEndo cows. On d 21, the prevalence of scEndo was approximately 9% in this herd; by d 42 infections had self-resolved in the majority (81%) of those cows classified as having scEndo on d 21. The scEndo cows had a delayed return to cyclicity; however, no effect was evident on ovarian follicle size or growth rate. Weeks after scEndo had self-resolved and cyclicity was restored, decreased (P = 0.07) testosterone and increased (P = 0.07) cortisol concentrations were evident in F1 follicles of scEndo compared with uninfected cows. Progesterone concentrations of F1 increased (P cows, whereas estradiol, androstendione, and dehydroepiandrosterone concentrations were decreased (P cows. These 3 steroids also differed (P size categories of scEndo but not uninfected cows. On d 21, mean plasma albumin concentration was decreased (P = 0.02) in scEndo cows. In summary, early postpartum scEndo had surprisingly long-term influences on the steroid concentrations of ovarian follicles long after infections had self

  8. In Vitro Efficacy of Nonantibiotic Treatments on Biofilm Disruption of Gram-Negative Pathogens and an In Vivo Model of Infectious Endometritis Utilizing Isolates from the Equine Uterus. (United States)

    Ferris, Ryan A; McCue, Patrick M; Borlee, Grace I; Loncar, Kristen D; Hennet, Margo L; Borlee, Bradley R


    In this study, we evaluated the ability of the equine clinical treatments N-acetylcysteine, EDTA, and hydrogen peroxide to disrupt in vitro biofilms and kill equine reproductive pathogens (Escherichia coli, Pseudomonas aeruginosa, or Klebsiella pneumoniae) isolated from clinical cases. N-acetylcysteine (3.3%) decreased biofilm biomass and killed bacteria within the biofilms of E. coli isolates. The CFU of recoverable P. aeruginosa and K. pneumoniae isolates were decreased, but the biofilm biomass was unchanged. Exposure to hydrogen peroxide (1%) decreased the biofilm biomass and reduced the CFU of E. coli isolates, K. pneumoniae isolates were observed to have a reduction in CFU, and minimal effects were observed for P. aeruginosa isolates. Chelating agents (EDTA formulations) reduced E. coli CFU but were ineffective at disrupting preformed biofilms or decreasing the CFU of P. aeruginosa and K. pneumoniae within a biofilm. No single nonantibiotic treatment commonly used in equine veterinary practice was able to reduce the CFU and biofilm biomass of all three Gram-negative species of bacteria evaluated. An in vivo equine model of infectious endometritis was also developed to monitor biofilm formation, utilizing bioluminescence imaging with equine P. aeruginosa isolates from this study. Following infection, the endometrial surface contained focal areas of bacterial growth encased in a strongly adherent "biofilm-like" matrix, suggesting that biofilms are present during clinical cases of infectious equine endometritis. Our results indicate that Gram-negative bacteria isolated from the equine uterus are capable of producing a biofilm in vitro, and P. aeruginosa is capable of producing biofilm-like material in vivo. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  9. The significance of radiology in the diagnosis of pyometra (endometritis post oestrum) in dogs: An evaluation of the correlation between radiographic and laboratoy findings in 131 cases

    International Nuclear Information System (INIS)

    Bree, H. van; Schepper, J. de; Capiau, E.


    In 131 bitches with proven pyometra or endometritis post oestrum (E. P. O.) a retrospective study of the lateral abdominal radiograph was carried out. In 31 (24%) of the cases (group 1) the uterine silhouette could not be perceived on the survey radiograph. In the other 100 cases (group 2) the uterus was clearly visible. Its diameter was measured and compared to the length of the second lumbar vertebra. The values for this ratio ranged between 0.4 and 3.5. The smallest uterine diameter perceived on the plain lateral abdominal radiograph measured 12 mm. Within group 2 the degree of uterine distension was significantly correlated with the number of white blood cells and the serum haptoglobin concentration. This correlation suggests a relation between the degree of uterine distension, the amount of uterine pus, the degree of uterine inflammation and the general inflammatory and stress reaction. Renal failure was more frequently observed in bitches with a greatly enlarged uterus than with a normal or only slightly enlarged uterus, although the degree of renal failure was not correlated to the uterine diameter. Within group 2 the closed type of pyometra was associated with a more enlarged uterus, but not with a higher leucocytosis [de


    Directory of Open Access Journals (Sweden)

    Ciro Alexandre Alves Torres


    Full Text Available The aim of this study was to evaluate the efficiency of the postpartum bovine endometritis treatment by intrauterine and intramuscular administration of tetracycline. Forty six cross bred cows diagnosed by gynecological exam with postpartum endometritis were assigned randomly in two treatments: G1 (n=21 - animals were treated with one intramuscular (IM dose of tetracycline (20 mg/Kg of body weight, while in G2 (n=25 animals were treated with one intrauterine (IU dose of tetracycline (30 mg/Kg of body weight. No difference (p>0.05 was observed in the recovery rate between the two treatments (61.9 X 76.0%, G1 and G2, respectively. The interval from treatment until first estrous was 33.9±22.6 versus 14.8 ±10.9 days (P<0.05 and until first service was 54.7 ± 33.9 versus 27.2 ± 20.3 days (P<0.05; for G1 and G2, respectively. No difference (p>0.05 was observed in the number of services per conception between G1 (1.54 and G2 (1.3. The treatment cost was lower for the G1 (U$ 3.51 versus U$ 5.00. Although not to have had differences in the clinical recovery rate, the use of the oxitetracycline managed for way IU in the postpuerperal treatment of endometrites in cows revealed more efficient in the reduction of the interval between the treatment and first heat and first insemination, beyond presenting lower cost that the treatment with oxitetracycline managed for way IM

    KEY WORDS: Bovine, postpartum endometritis, intrauterine, intramuscular, oxitetracicline.
    Este trabalho teve por objetivo comparar a eficiência do uso da oxitetracilina, administrada pelas vias intramuscular (IM e intrauterina (IU, no tratamento de endometrites em vacas no período pós-puerperal. Foram utilizados 46 animais mestiços que apresentaram quadro clínico de endometrite, distribuídos aleatoriamente em dois tratamentos: G1 (n=21 – tratado com uma dose de 30 mg/Kg PV de oxitetraciclina por via IM, e G2 (n=25  – uma infusão de 20 mg/Kg PV de

  11. Endometrial IL-1beta, IL-6 and TNF-alpha, mRNA expression in mares resistant or susceptible to post-breeding endometritis. Effects of estrous cycle, artificial insemination and immunomodulation. (United States)

    Fumuso, Elida; Giguère, Steeve; Wade, José; Rogan, Dragan; Videla-Dorna, Ignacio; Bowden, Raúl A


    Endometrial mRNA expression of the pro-inflammatory cytokines interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-alpha) was assessed in mares resistant (RM) or susceptible (SM) to persistent post-breeding endometritis (PPBE). Eight RM and eight SM, were selected based on reproductive records and functional tests out of a herd of 2,000 light cross-type mares. Three experiments were done to study transcription patterns in (i) basal conditions; (ii) after artificial insemination (AI); and (iii) after administration of an immunomodulator at time of artificial insemination. Endometrial biopsies were taken during consecutive cycles: (i) at estrus, when follicles reached 35 mm and at diestrus (7 +/- 1 days after ovulation); (ii) at 24 h post-AI, with dead semen (estrus) and in diestrus; (iii) at 24 h after treatment with a Mycobacterium phlei cell-wall extract (MCWE) preparation and AI (with dead semen), and at diestrus. mRNA expression was quantitated by real time PCR. Under basal conditions, SM had significantly higher mRNA expression of all cytokines in estrus and of IL-1beta and TNF-alpha in diestrus, compared to RM. After AI, there were no differences between RM and SM in estrus; however, mRNA expression for all three pro-inflammatory cytokines was higher than under basal conditions. In diestrus, RM showed significantly lower IL-1beta and TNF-alpha mRNA expression than SM. When MCWE was administered at time of AI, no differences between cytokine induction from RM and SM were found. Globally, mRNA expression for all three cytokines correlated well among themselves when expression was high. The present study showed that (i) in basal conditions RM had lower mRNA expression of pro-inflammatory cytokines than SM with no effect of estrous cycle; (ii) AI upregulated mRNA expression for all three cytokines in both RM and SM, with persistance in diestrus in the latter; (iii) treatment with MCWE at time of AI down-regulated mRNA expression

  12. Inflammatory responses to induced infectious endometritis in mares resistant or susceptible to persistent endometritis

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Woodward, Elizabeth; Bojesen, Anders Miki


    . Endometrial biopsies were obtained 3, 12, 24 and 72 hours (h) after bacterial inoculation and blood samples were obtained during the 7 day period post bacterial inoculation. Expression levels of cytokines and SAA were determined by quantitative real-time reverse transcriptase PCR (qRT-PCR)....

  13. Reproductive performance of dairy cows affected by endometritis ...

    African Journals Online (AJOL)



    Jul 15, 2015 ... Author(s) agree that this article remains permanently open access under the terms of ... production of 26.7± 3.6 kg milk/day, and primiparous cows, with an ..... vaginal mucus reflects uterine bacterial infection and the immune.

  14. Cytomorphological monitoring in multimodality therapy of endometral cancer patients

    International Nuclear Information System (INIS)

    Galil-Ogly, G.A.; Titova, V.A.; Yarovaya, N.Yu.; Ingberman, Ya.Kh.; Bershchanskaya, A.M.; Pukhlikov, A.V.


    The paper is devoted to analysis of clinicomorphological data on the status of a primary endometrial tumor in 209 endometrial cancer patients, treated by radical and palliative radiation therapy (112 patients) and the combined method (88 patients) including preoperative intensive concentrated intracavitary irradiation and hormonotherapy. Dynamic cytological monitoring was performed during radiation therapy and in a period up to 12 mos. after the discontinuation of antitumor therapy. Dynamic cytomorphological monitoring is an important stage in patients who cannot be operated upon as a result of tumor spreading or somatic contraindications

  15. Value and indication of radiotherapy in the endometrical carcinoma

    International Nuclear Information System (INIS)

    Kucera, H.


    Today the endometrial carcinoma is the most frequent malignant tumor found in female genital tract. Endometrial carcinoma ought to be operated in all cases, if possible. Traditionally some form of adjuvant radiotherapy has been given. Despite the large number of patients treated by combined therapy over the last 30 years, surprisingly there is a lack of hard data on which to establish a theory for an improved outcome. It is generally accepted that the risk of local relapses in the vagina is lowered when postoperative vaginal irradiation is applied. The question of the value of additional external irradiation in stage I endometrial cancer still is unsetteled. Only two prospective studies led to the conclusion that only patients with poorly differentiated tumors and with deep infiltration of the myometrium might benefit from additional external radiotherapy. Therefore a simple score for these risk factors is proposed enabling assignment into patient groups of similar risk on the base of a point system due to individual prognostic factors. With a score of one to two points prognosis is very good and adjuvant irradiation seems not to be necessary. With three to four points local vaginal irradiation is recommended, with five and more points additionally external beam irradiation to the pelvis should be given. This is necessary in more than the half of the operated cases of endometrial carcinoma. The indication for such a treatment has become more individual and 'high risk' cases are treated more intensively, but 'low risk' cases have to be excepted from unnecessary adjuvant therapy. In order to judge an individual case of endometrial cancer histopathologic prognosticators have to be considered. Typical adenocarcinomas have a five-year survival of more than 80%, but unfavourable subtypes (adenosquamous, clearcell, serous-papillary carcinoms) of only 40%, respectively. Tumorgrading and depth of myometrial invasion are of high importance for individual prognosis. (orig./MG) [de

  16. Thymoptin in combined treatment of endometrical cancer patients

    International Nuclear Information System (INIS)

    Vusik, I.M.; Lozinskaya, I.N.; Kozyreva, T.V.; Kalmykova, I.Ya.; Skobel'tsina, E.S.; Yakimova, T.P.


    Examination of endometrial cancer patients revealed inhibition of function of the T-system of immunity with simultaneously increased levels of hydrocortisone. CEA and STH during combined treatment including operation and subsequent radiation therapy. The use of thymoptin during radiation therapy reduced the number of radiation reactions, prolonged a recurrence-free period, returned to normal the levels of STH, TSH, hydrocortisone, and CEA. The state of the T-system of immunity remained at the basal level

  17. Method for dose calculation in intracavitary irradiation of endometrical carcinoma

    International Nuclear Information System (INIS)

    Zevrieva, I.F.; Ivashchenko, N.T.; Musapirova, N.A.; Fel'dman, S.Z.; Sajbekov, T.S.


    A method for dose calculation for the conditions of intracavitary gamma therapy of endometrial carcinoma using spherical and linear 60 Co sources was elaborated. Calculations of dose rates for different amount and orientation of spherical radiation sources and for different planes were made with the aid of BEhSM-4M computer. Dosimet were made with the aid of BEhSM-4M computer. Dosimetric study of dose fields was made using a phantom imitating the real conditions of irradiation. Discrepancies between experimental and calculated values are within the limits of the experiment accuracy

  18. Metastases cerebrales d'un cancer de l'endometre: a propos d'une ...

    African Journals Online (AJOL)

    Mots clés: cancer, endomètre, métastases, cerveau, Lomé, Togo. English Title: Brain metastases of endometrial cancer: an observation at Lome and literature review. English Abstract. Introduction: document the clinical, paraclinical, therapeutic and prognostic of brain metastases of endometrial cancer in hospital in Togo.

  19. Molecular characterisation of the uterine microbiome of dairy cows suffering from endometritis, metritis, and pyometra

    DEFF Research Database (Denmark)

    Knudsen, Lif Rødtness Vesterby

    Postpartum uterine disease is a problem in dairy herds. Approximately 90% of dairy cows experience postpartum bacterial contamination of the uterus. Most of the cows are able to clear the infection within 8 weeks in the process of involution, but up to 20% of the cows develop metritis, which is i...

  20. Uterine Sarcoma Presenting with Sepsis from Clostridium perfringens Endometritis in a Postmenopausal Woman

    Directory of Open Access Journals (Sweden)

    Mary J. Kao


    Full Text Available Clostridium perfringens is an anaerobic gram positive rod that is found in normal vaginal and cervical flora in 1–10% of healthy women. Uterine infection with Clostridium perfringens is seen rarely but is often related to underlying uterine pathology and can progress quickly to sepsis. Early recognition of sepsis, prompt treatment with antibiotics, and source control with surgical management allow for optimal chance of recovery. We present a case of a postmenopausal woman who presented with sepsis, vaginal bleeding, and back pain who was found to have Clostridium perfringens infection in the setting of undifferentiated uterine sarcoma.

  1. CMV endometritis in a non- immunosuppressed patient presenting as recurrent pyometra- A case report

    Directory of Open Access Journals (Sweden)

    Dr. Geetha Vasudevan


    Full Text Available Cytomegalovirus infection of the female genital tract is a rare entity. We present a case of 70 year old woman who came with recurrent pyometra, but was otherwise in good health. Hysterectomy was done and the endometrium showed occasional stromal cells with karyomegaly and intranuclear eosinophilic inclusions consistent with cytomegaloviral infection and dense lymphoplasmacytic infiltrate. This was an incidental finding in an otherwise immunocompetent nonpregnant woman, hence being reported for its rarity and uncommon presentation. Keywords: cytomegalovirus, inclusions, endometrium. [J Interdiscipl Histopathol 2016; 4(2.000: 52-53

  2. RETRACTED: Evaluation of the risk of postcesarean endometritis with preoperative vaginal preparation with povidone–iodine: A randomized controlled

    Directory of Open Access Journals (Sweden)

    Ameer Ahamed Abdallah


    The authors have plagiarized part of a paper that had already appeared in Obstetrics and Gynecology, volume 20 (2015 246–250. DOI - 10.1097/01.AOG.0000164032.16599.7e. One of the conditions of submission of a paper for publication is that authors declare explicitly that their work is original and has not appeared in a publication elsewhere. Re-use of any data should be appropriately cited. As such this article represents a severe abuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.

  3. Impacto do uso de anÃlogos de GnRH sobre o tecido e metabolismo Ãsseo de pacientes endometrÃoticas


    Danyelle Craveiro de Aquino


    Este trabalho tem por objetivo avaliar mulheres portadoras de endometriose em uso de anÃlogos de GnRH investigando o metabolismo Ãsseo e massa Ãssea atravÃs da dosagem de marcadores sÃricos e realizaÃÃo de ultra-sonometria do calcÃneo, respectivamente. Trata-se de estudo observacional transversal tipo caso â controle prospectivo. Foi desenvolvido na Maternidade-Escola Assis Chateaubriand (MEAC) â UFC. Foram avaliadas 99 mulheres, divididas em 3 grupos, sendo 32 portadoras de endometriose diag...

  4. Adenocarcinoma of the endometrium treated with combined irradiation and surgery: study of 437 patients; Adenocarcinome de l'endometre traite par association radiochirurgicale: a propos de 437 cas

    Energy Technology Data Exchange (ETDEWEB)

    Touboul, E.; Belkacemi, Y.; Deniaud-Alexandre, E.; Ganansia, V.; Schlienger, M. [Hopital Tenon, Service d' Oncologie-Radiotherapie, 75 - Paris (France); Buffat, L. [Hopital Tenon, Service de Biostatistique, Centre des Tumeurs, 75 - Paris (France); Lefranc, J.P.; Blondon, J. [Groupe Hospitalier Pitie-Salpetriere, Service de Chirurgie Gynecologique, 75 - Paris (France); Lhuillier, P. [Centre Hospitalier de Fontainebleau, Service de Gynecologie Obstetrique, 77 - Fontainebleau (France); Uzan, S. [Hopital Tenon, Service de Gynecologie Obstetrique, Centre des Tumeurs, 75 - Paris (France); Jannet, D.; Milliez, J. [Hopital Saint Antoine, Service de Gynecologie Obstetrique, 75 - Paris (France); Uzan, M. [Hopital Jean Verdier, Service de Gynecologie Obstetrique, 93 - Bondy (France); Antoine, M. [Hopital Tenon, Service d' Anatomopathologie, 75 - Paris (France); Ginesty, C. [Groupe Hospitalier Pitie-Salpetriere, Service d' Anatomopathologie, 75 - Paris (France); Jamali, M. [Hopital Saint Antoine, Service d' Anatomopathologie, 75 - Paris (France)


    To identify prognostic actors and treatment toxicity in a series of operable endometrial adenocarcinomas. Between November 1971 and October 1992, 437 patients (pts) with endometrial carcinoma, staged according to the 1988 FIGO staging system, underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy without (n = 140) or with (n = 297) pelvic lymph node dissection. The chronology of RT was not randomized and depended on the usual practices of the surgical teams. Group I: 79 pts received preoperative utero-vaginal brachytherapy (mean total dose [MD]: 57 Gy). Group II: 358 pts received postoperative RT (196 pts received vaginal brachytherapy alone [MD: 50 Gy], 158 pts had external beam pelvis RT [EPRT] [MD: 46 Gy over 5 weeks] followed by vaginal brachytherapy [MD: 17 Gy], and 4 pts had EPRT alone [MD: 46 Gy over 5 weeks]). The mean follow-up was 128 months. The 10-year disease-free survival rate was 86%. From 57 recurrences, 12 were isolated loco-regionally. Multivariate analysis showed that independent factors decreasing the probability of disease-free survival were: histologic type (clear cell carcinoma, p = 0.038), largest histologic tumor diameter > 3 cm (p = 0.015), histologic grade (p = 0.008), myometrial invasion > 1/2 (p 0.0055), and 1988 FIGO staging system (p= 9.10{sup -8}). In group II, the addition of EPRT did not seem to improve locoregional control. The postoperative complication rate was 7%. The independent factors increasing the risk of postoperative complications were FIGO stage (p = 0.02) and pelvic lymph node dissection (p = 0.011). The 10-year rate for grade 3 and 4 late radiation complications according to the LENT-SOMA scoring system was 3.1 %. EPRT independently increased the 10-year rate for grade 3 and 4 late radiation complications (R.R.: 5.6, p = 0.0096). EPRT increases the risk of late radiation complications. After surgical and histopathologic staging with pelvic lymph node dissection, in a subgroup of intermediate risk patients (stage IA grade 3, IB-C and II), postoperative vaginal brachytherapy alone is probably sufficient to obtain a good therapeutic index. Results for patients with stage III tumor are not satisfactory. (author)

  5. Histopathological changes associated with oxidative stress induced by electromagnetic waves in rats' ovarian and uterine tissues

    Directory of Open Access Journals (Sweden)

    Ali S.H. Alchalabi


    Conclusion: Results executed that the potential alteration of antioxidant capacity may contribute to endometrial oxidative damage that could be related to pathogenesis and progression of endometritis.

  6. Inflammation and fertility in the mare

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Troedsson, Mats H.T.


    -inflammatory factors is required for resolving the breeding-induced inflammation within 24–36 hr in the reproductively healthy mare, whereas a subpopulation of mares is susceptible to development of a persistent infection that can interfere with fertility. The aetiology of persistent endometritis can be either...... bacterial or semen-induced and both scenarios can threaten the establishment of pregnancy. Several factors associated with susceptibility to persistent endometritis have been identified including altered innate immune response in the early inflammatory process, reduced myometrial contractions and impaired......) and bacterial endometritis in the mare....

  7. Prophylactic Cefazolin in Amnioinfusions Administered for Meconium-Stained Amniotic Fluid

    Directory of Open Access Journals (Sweden)

    R. K. Edwards


    Full Text Available Objective: To determine if amnioinfusion with an antibiotic solution decreased the rate of clinical chorioamnionitis and puerperal endometritis in patients with meconium-stained amniotic fluid.

  8. Inter-Pregnancy Interval

    African Journals Online (AJOL)


    1, 2 of the current pregnancy. This definition excludes. 1, 2 miscarriage as a preceding pregnancy event. Often the IPI is .... These include the type of caesarean section, post operative course ... puerperal endometritis, gestational diabetes and.

  9. Outbreak of Salmonella Dublin-associated abortion in Danish fur farms

    DEFF Research Database (Denmark)

    Dietz, Hans Henrich; Chriél, Mariann; Andersen, Thomas Holmen


    Outbreaks of Salmonella Dublin infections were recorded in 25 Danish mink and fox farms. All farms suffered extensive disease problems; clinical and pathological observations included abortion, stillbirths, necrotizing endometritis, and increased mortality. By genotyping with pulsed-field gel...

  10. Bartholin cyst or abscess (United States)

    ... Alternative Names Abscess - Bartholin; Infected Bartholin gland Images Female reproductive anatomy References Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, endometritis, and ...

  11. the capacity of megasphaera elsdenii strain ncimb 41125 to control ...

    African Journals Online (AJOL)


    SARA include grain treatment to reduce starch degradation, feed additives such as ... Keywords: Megasphaera elsdenii, ruminal acidosis, dairy cattle, beef cattle, sheep, ...... Mastitis. Retained foetal membranes. Metritis/endometritis. Ketosis.

  12. Postpartum Clostridium sordellii infection associated with fatal toxic shock syndrome

    DEFF Research Database (Denmark)

    Rørbye, C; Petersen, Ina Sleimann; Nilas, Lisbeth


    , respectively) are responsible for this potential. Reviewing the obstetric literature, only six cases of postpartum endometritis caused by C. sordellii, are described - all being fatal. In addition, one lethal case of spontaneous endometritis resulting from C. sordellii is reported. The clinical aspects...... of these cases include: - sudden onset with influenza-like symptoms in previously healthy women - progressive refractory hypotension - local and spreading tissue edema - absence of fever Laboratory findings include: - marked leukocytosis - elevated hematocrit. This paper reports the seventh fatal postpartum C...

  13. Postoperative intensity-modulated irradiation (IMRT) of endometrial cancers: results of the 'dummy run' quality assurance procedure for phase 2 RTCMIENDOMETRE multicentric French test; Irradiation avec modulation d'intensite (RCMI) postoperatoire des cancers de l'endometre: resultats de la procedure d'assurance de qualite -dummy run- de l'essai francais multicentrique de phase 2 RTCMIENDOMETRE

    Energy Technology Data Exchange (ETDEWEB)

    Kreps, S.; Barillot, I. [CHU de Tours, 37 - Tours (France); Peignaux, K. [Centre Georges FrancoisLeclerc, 21 - Dijon (France); Nickers, P. [Centre Oscar Lambret, 59 - Lille (France); Leblanc-Onfroy, M. [Centre Rene-Gauducheau, 44 - Nantes (France); Williaume, D. [Centre Eugene-Marquis, 35 - Rennes (France); Haie-Meder, C. [Institut Gustave-Roussy, 94 - Villejuif (France); Lerouge, D. [Centre Francois Baclesse, 14 - Caen (France)


    The authors report a study which aims at assessing the impact of the intensity-modulated conformational radiotherapy on the acute intestinal toxicity of a postoperative irradiation of stage I and II endometrial cancers. Seven radiotherapy centres participated to this study. They followed a 'dummy run' procedure in order to assess their ability to respect the irradiation protocol. The authors discuss the contouring correlation for different organs. The use of the Radiation Therapy Oncology Group (RTOG) atlas leads to a better concordance between the centres. Short communication

  14. Dicty_cDB: Contig-U10340-1 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available MCC Neurons Aplysi... 34 0.54 2 ( CO993311 ) UMC-pd6end2-014-g08 Endometrium gilt D6 of estrou... 34 0.54 2... ( CO987161 ) UMC-pd10en3-012-f02 Endometrium gilt D10 of estro... 34 0.54 2 ( CO987823 ) UMC-pd10en3-021-c11 Endometr...ium gilt D10 of estro... 34 0.54 2 ( CO992701 ) UMC-pd6end2-006-b04 Endometr

  15. Sangrado vaginal anormal, hábitos de vida y biopsia de endometri


    María Gamero de Ramos; Víctor Villasmil Araujo; Carlos Fonseca; Robert Silva


    Ir r egular or ex c es s ive uter ine bleeding is r efer r ed to as abnor mal uter ine bleeding; and when its c aus e is not k nown, tr eatment may be inadequate. The pur pos e of this des c r iptive s tudy was to es tablis h the r elations hip between uter ine bleeding, life habits and a his topathology s tudy of endometr ial biops y and endometr ial c ur ettage. The s ample c ons is ted of 100 appar ently healthy women attending a gynaec ology c linic between J une and December 2005 at “...

  16. An investigation of the microbiota in uterine flush samples and endometrial biopsies from dairy cows during the first 7 weeks postpartum

    DEFF Research Database (Denmark)

    Knudsen, Lif Rødtness Vesterby; Karstrup, Cecilia Christensen; Pedersen, Hanne Gervi


    Metritis and endometritis commonly occur in dairy cows after calving. Although numerous studies have been performed to identify the causative pathogens, a complete overview has not been done. Metagenomic studies have analyzed the bacterial populations of uterine flush samples from postpartum (pp......% and 13%, respectively, of the bacterial populations in the flush samples. The Mycoplasmataceae family was observed in much higher quantity in the flush samples than in the biopsies of the endometritis groups at weeks 4 and 7. Our findings support the observations of previous metagenomic studies...

  17. Streptococcus equi subsp zooepidemicus Invades and Survives in Epithelial Cells

    DEFF Research Database (Denmark)

    Skive, Bolette; Rohde, Manfred; Molinari, Gabriella


    Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) is an opportunistic pathogen of several species including humans. S. zooepidemicus is found on mucus membranes of healthy horses, but can cause acute and chronic endometritis. Recently S. zooepidemicus was found able to reside in the endo......Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) is an opportunistic pathogen of several species including humans. S. zooepidemicus is found on mucus membranes of healthy horses, but can cause acute and chronic endometritis. Recently S. zooepidemicus was found able to reside...

  18. Patients with secondary amenorrhea due to tuberculosis ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is a disease which can affect various organs, including human's genital organs such as the endometrium. Tuberculosis endometritis can cause clinical symptoms of secondary amenorrhea and infertility. Infertility in genital TB caused by the involvement of the endometrium. The case presentation is ...

  19. An investigation of the microbiota in uterine flush samples and endometrial biopsies from dairy cows during the first 7 weeks postpartum

    DEFF Research Database (Denmark)

    Knudsen, Lif Rødtness Vesterby; Karstrup, Cecilia Christensen; Pedersen, Hanne Gervi


    Metritis and endometritis commonly occur in dairy cows after calving. Although numerous studies have been performed to identify the causative pathogens, a complete overview has not been done. Metagenomic studies have analyzed the bacterial populations of uterine flush samples from postpartum (pp)...

  20. Experiment list: SRX524976 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524976 hg19 Histone H3K27ac Uterus Endometrial stromal cells NA 41684393,98.6,41....0,381 GSM1372870: H3K27ac case2 control; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  1. Optimization of dose designs in intracavitary radiotherapy of patients with uterine body carcinoma

    International Nuclear Information System (INIS)

    Ushakova, G.A.; Afanas'ev, B.P.


    The potentialities of mathematical optimization were investigated with respect to dosimetric design of radiation therapy of endometral cancer patients using Agat-B and Agat-apparatus. The effectiveness of linear programming for creating in a pathological focus and in normal tissues of a dose distribution, meeting clinical requirements to the maximum, was shown

  2. Experiment list: SRX524973 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524973 hg19 Histone H3K4me1 Uterus Endometrial stromal cells NA 30874750,99.0,35....9,273 GSM1372865: H3K4me1 case2 w/ EP; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  3. Experiment list: SRX524978 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524978 hg19 Histone H3K4me1 Uterus Endometrial stromal cells NA 33380447,98.8,42....4,350 GSM1372873: H3K4me1 case2 control; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  4. Experiment list: SRX524972 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524972 hg19 Histone H3K4me3 Uterus Endometrial stromal cells NA 41250134,99.0,60....9,132 GSM1372864: H3K4me3 case2 w/ EP; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  5. Experiment list: SRX524963 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524963 hg19 Histone H3K4me1 Uterus Endometrial stromal cells NA 35129046,97.1,39....6,336 GSM1372854: H3K4me1 case1 w/ EP; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  6. Experiment list: SRX524977 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524977 hg19 Histone H3K4me3 Uterus Endometrial stromal cells NA 35805072,98.7,42....0,260 GSM1372871: H3K4me3 case2 control; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  7. Experiment list: SRX524974 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524974 hg19 Histone H3K27me3 Uterus Endometrial stromal cells NA 42283456,99.2,4...9.5,267 GSM1372866: H3K27me3 case2 w/ EP; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  8. Experiment list: SRX524968 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524968 hg19 Histone H3K4me1 Uterus Endometrial stromal cells NA 38931729,88.0,38....6,429 GSM1372860: H3K4me1 case1 control; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  9. Experiment list: SRX524971 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524971 hg19 Histone H3K27ac Uterus Endometrial stromal cells NA 33306045,98.9,47....1,237 GSM1372863: H3K27ac case2 w/ EP; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  10. Experiment list: SRX524961 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524961 hg19 Histone H3K27ac Uterus Endometrial stromal cells NA 37682541,96.8,61....4,309 GSM1372852: H3K27ac case1 w/ EP; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  11. Experiment list: SRX524969 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524969 hg19 Histone H3K27me3 Uterus Endometrial stromal cells NA 31748052,87.8,3...4.4,342 GSM1372861: H3K27me3 case1 control; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  12. Experiment list: SRX735141 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX735141 hg19 Input control Input control Uterus Endometrial stromal cells NA 3802...6063,96.8,3.6,788 GSM1527530: input DNA; Homo sapiens; ChIP-Seq source_name=Endometrial stromal cells || cell type=Endometr

  13. Experiment list: SRX524966 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524966 hg19 Histone H3K27ac Uterus Endometrial stromal cells NA 41862514,87.6,64....2,491 GSM1372858: H3K27ac case1 control; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  14. Experiment list: SRX524964 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524964 hg19 Histone H3K27me3 Uterus Endometrial stromal cells NA 43370306,97.4,4...6.6,331 GSM1372855: H3K27me3 case1 w/ EP; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  15. Experiment list: SRX524979 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524979 hg19 Histone H3K27me3 Uterus Endometrial stromal cells NA 28877550,98.9,3...2.4,295 GSM1372875: H3K27me3 case2 control; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  16. Experiment list: SRX735140 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX735140 hg19 TFs and others Epitope tags Uterus Endometrial stromal cells NA 4717...6648,92.9,11.2,8048 GSM1527529: PGR-B ChIPSeq; Homo sapiens; ChIP-Seq source_name=Endometrial stromal cells || cell type=Endometr

  17. Experiment list: SRX524967 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524967 hg19 Histone H3K4me3 Uterus Endometrial stromal cells NA 31301498,87.3,68....2,344 GSM1372859: H3K4me3 case1 control; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  18. Experiment list: SRX735139 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX735139 hg19 TFs and others Epitope tags Uterus Endometrial stromal cells NA 5046...8720,97.1,10.0,3809 GSM1527528: PGR-A ChIPSeq; Homo sapiens; ChIP-Seq source_name=Endometrial stromal cells || cell type=Endometr

  19. Experiment list: SRX524962 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available SRX524962 hg19 Histone H3K4me3 Uterus Endometrial stromal cells NA 39005041,97.1,73....7,278 GSM1372853: H3K4me3 case1 w/ EP; Homo sapiens; ChIP-Seq source_name=Human endometrial stromal cells || tissue=Endometr

  20. Yeast Infection during Pregnancy (United States)

    ... disrupt the pH balance of the vagina. Common yeast infection symptoms include vaginal itching and a white, thick discharge that looks ... and Prevention. Accessed Aug. 27, ... Vagina, Cervix, Toxic Shock Syndrome, Endometritis, and Salpingitis. In: ...

  1. Evaluering af Landspatientregisteret. En undersøgelse af validiteten vedrørende udvalgte abortdiagnoser

    DEFF Research Database (Denmark)

    Schmidt, L; Damsgaard, M T; Nielsen, Jens Modvig


    . This is partly because most of the discharge records include a diagnosis which is difficult to use (ICD-code 644: abortion, not specified as induced or spontaneous) and partly because classification of diagnoses is given low priority in the hospital doctor's job. The article proposes teaching medical students...... and induced abortions (retention, haemorrhage, endometritis etc.). Udgivelsesdato: 1989-Dec-18...

  2. Case report

    African Journals Online (AJOL)



    Jun 13, 2017 ... Oxyuriasis's symptoms are extremely diverse in children, ranging from nausea, diarrhea, insomnia, irritability, recurrent cellulitis, loss of appetite, nightmares and endometritis. Here we report a curious case of oxyuriasis in the settings of a refugee camp in Greece. The patient was a. 10-year old Syrian ...

  3. Pre- and postpartum effects of starch and fat in dairy cows: A review

    African Journals Online (AJOL)

    Alain Useni


    Jan 30, 2018 ... dietary starch and/or fat to diets of dairy cows following parturition increased milk yield. .... lameness, mastitis, and endometritis) (Duffield et al., 2009; Ospina .... feedstuffs in the diet to prevent and/or treat NEB-related disorders ...

  4. Insights into the microbiota of the bovine uterus

    DEFF Research Database (Denmark)

    Rødtness Vesterby Knudsen, Lif; Christensen Karstrup, Cecilia; Gervi Pedersen, Hanne

    (Machado et al. 2012 and Galvão et al. 2012) while Escherichia coli, Trueperella Pyogenes, Prevotella species and Fusobacterium necrophorum have commonly been associated with endometritis (Sheldon 2006). Preliminary results indicate that we often find bacteria from phylum Actinobacteria in the healthy cows...

  5. The association of plasma glucose, BHBA, and NEFA with postpartum uterine diseases, fertility, and milk production of Holstein dairy cows. (United States)

    Bicalho, M L S; Marques, E C; Gilbert, R O; Bicalho, R C


    The objective of this study was to investigate the association between the metabolic indicators such as nonesterified fatty acids (NEFA), β-hydroxybutyrate (BHBA), and glucose during the transition period and the development of uterine diseases. In total, 181 Holstein dairy cows were enrolled in the study. Plasma glucose, NEFA, and BHBA concentrations were measured at -50, -6, 3, 7, and 14 days relative to parturition. All cows enrolled in the study were evaluated for retained placenta (RP), metritis, and endometritis. Metritis and RP were diagnosed and treated by trained farm personnel. Clinical endometritis was evaluated by a veterinarian at 35 days in milk using a Metricheck device. We found plasma glucose concentration to be associated with the occurrence of metritis and clinical endometritis. Moreover, cows with an increased calving-to-conception interval (>150 days) presented higher plasma glucose concentrations than cows that became pregnant within the first 150 days, whereas BHBA and NEFA were not associated with the occurrence of any uterine disorder. Receiver operating characteristic (ROC) curves were used in an attempt to determine the cow-level critical thresholds for the occurrence of metritis, and endometritis. In addition, pairwise comparisons of area under the curve (AUC) of ROC curves for the critical thresholds for glucose, BHBA, and NEFA predicting the same uterine disease were performed. Glucose at 3 days in milk was the best predictor for metritis and endometritis diagnosis, with AUC values of 0.66 and 0.67, respectively. Multivariable logistic regressions were performed and showed that cows with higher levels of glucose at Day 3 were at 6.6 times higher odds of being diagnosed with metritis, and 3.5 times higher odds of developing clinical endometritis, compared with cows with lower glucose levels. Finally, a simple linear regression analysis demonstrated a negative correlation between daily milk yield in the first and second weeks of

  6. Diagnostic double guarded low-volume uterine lavage in mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Brandis, Louise; Samuelsson, Julia


    Endometritis constitutes a major problem in the management of broodmares; hence diagnostic tests with a high sensitivity and specificity are desired. We hypothesize that a double guarded uterine flush technique for bacterial culture and cytology is comparable to standard diagnostic tests, the end......Endometritis constitutes a major problem in the management of broodmares; hence diagnostic tests with a high sensitivity and specificity are desired. We hypothesize that a double guarded uterine flush technique for bacterial culture and cytology is comparable to standard diagnostic tests...... (lavage: 11%, swab: 8%, biopsy: 7%) (positive bacterial growth > 4 Colony forming units (CFU)). Positive cytology was less likely to occur when E. coli was isolated from the diagnostic tests compared to the growth of β-hemolytic streptococci. Isolation of pathogens from uterine samples was highly...

  7. Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study

    Directory of Open Access Journals (Sweden)


    Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.



    Alena JEŽKOVÁ; Luděk STÁDNÍK; Mojmír VACEK; František LOUDA


    The objective of this study was to determine the relationship between calving year and season, parity, number of AI, day of lactation, milk production in the 1st 100 lactation days or diseases occurrence (retained placenta, endometritis or cysts), sperm motility (SM) during 30, 60 and 90 minutes of the cervical mucus survival test, cervical mucus crystallization (CMC) and their infl uence on days to fi rst insemination (interval), open days (SP), inseminations number for pregnancy (index), an...

  9. Bias associated with delayed verification in test accuracy studies: accuracy of tests for endometrial hyperplasia may be much higher than we think!


    Clark, T Justin; ter Riet, Gerben; Coomarasamy, Aravinthan; Khan, Khalid S


    Abstract Background To empirically evaluate bias in estimation of accuracy associated with delay in verification of diagnosis among studies evaluating tests for predicting endometrial hyperplasia. Methods Systematic reviews of all published research on accuracy of miniature endometrial biopsy and endometr ial ultrasonography for diagnosing endometrial hyperplasia identified 27 test accuracy studies (2,982 subjects). Of these, 16 had immediate histological verification of diagnosis while 11 ha...

  10. Effect of contamination on gynecological disease incidence in women

    International Nuclear Information System (INIS)

    Agamova, K.A.; Sotnikova, E.N.; Gladunova, Z.D.; Novikova, E.G.; Aleksandrova, L.M.


    Epithelial tissues of neck of the womb, cervical canal and endometritis in women residing on the territories with increased radiation background after the Chernobyl accident have been examined. The cytologic diagnosis method employed demonstrated a high information content. Incidence of background, precancer and inflammatory processes has been ascertained in compliance with cytological classification. Cytomorphological signs of possible radiation-induced injury of cells have been studied

  11. The effect of intrauterine cephapirin treatment after insemination on conception rate in repeat breeder dairy cows subjected to the progesterone-based Ovsynch protocol


    GÜMEN, Ahmet; MECİTOĞLU, Gülnaz YILMAZBAŞ; KESKİN, Abdulkadir; KARAKAYA, Ebru; ALKAN, Ali; TAŞDEMİR, Umut; OKUT, Hayrettin


    Subclinical endometritis contributes to repeat breeder syndrome in dairy cows. This study evaluated the effect of intrauterine cephapirin benzathine administration after timed artificial insemination (TAI) on the conception rate (CR) in repeat breeder dairy cows. To determine the antibiotic effects, all cows (n = 335) that had more than 3 services with no clinical abnormalities of the reproductive tract received the same combined synchronisation protocol: an ear implant containing progestagen...

  12. Evaluation of Efficacy of Herbal Intrauterine Infusion Uterofix Liquid in Treatment of Various Reproductive Disorders in Cows: A Field Study


    Verma, Satinder; Choudhary, Adarsh; Maini, Shivi; Ravikanth, K.


    Objective: To evaluate the efficacy of herbal intrauterine infusion Uterofix liquid in the treatment of various reproductive disorders in cows. Materials and Methods: Based on symptoms of endometritis, anestrous, metritis, and repeat breeders, 28 cows were selected to study the efficacy of herbal intrauterine infusion Uterofix liquid (M/S Ayurvet Limited) in uterine infections study. Group T0 (n = 8) cows served as control group, no treatment was given to this group, Group T1 (n = 5) repeat b...


    African Journals Online (AJOL)


    ). Thromboembolic event. 1(1.2). 0. Endometritis. 3(3.5). 0. Cystitis. 1(1.2). 2(2.3). Acute pyelonephritis. 2(2.4). 0. Hysterectomy. 1(1/2). 1(1.2). Re-operation. 3(3.5). 3(3.5). Readmission. 3(3.5). 3(3.5). PPH (atonic uterus). 1(1.2).

  14. Assessment of discharge after 24 hours following elective ...

    African Journals Online (AJOL)

    Readmission was needed for 41(2.8%), 15(1.1%) from study group and 26(1.8%) from control group. The reason in 24(1,7%) was wound infection, 5(0.3%) DVT, two with endometritis and eight (0.6%) due to non- pregnancy related infection. Although, there is slight increase in rate of readmission due to wound infection and ...

  15. Bacteriological, cytological and histopathological evaluation of the reproductive tract of slaughtered cows


    Casarin, Julia B.S.; Martini, Ana P.; Trentin, Janislene M.; Fiorenza, Mariani F.; Pessoa, Gilson A.; Barros, Severo S.; Rubin, Mara I.B.


    ABSTRACT: Reproductive diseases, mainly endometritis, are important hurdles in cattle raising, In the current study we evaluated gross, bacteriological, cytological, and histological findings from selected sites of the genital from 23 slaughtered cows and tested whether there is an association between these findings and the probability of reaching a reliable diagnosis. The results from the examinations of macroscopic aspects of uterine secretions, the cytological, bacteriological, and histopa...

  16. Prophylactic cefazolin in amnioinfusions administered for meconium-stained amniotic fluid. (United States)

    Edwards, R K; Duff, P


    OBJECTIVE: To determine if amnioinfusion with an antibiotic solution decreased the rate of clinical chorioamnionitis and puerperal endometritis in patients with meconium-stained amniotic fluid. METHODS: Patients in labor at 36 weeks of gestation or greater with singleton pregnancies and meconium-stained amniotic fluid were randomized to receive either cefazolin, 1 g/1,000 mL, of normal saline (n = 90) or normal saline (n = 93) amnioinfusion. Rates of clinically diagnosed chorioamnionitis and endometritis and of suspected and culture-proven neonatal infection were determined. RESULTS: Between the study and control groups, the incidences of clinical chorioamnionitis (7.8% vs. 8.6%), endometritis (2.4% vs. 3.5%), aggregate intrauterine infection (10.0% vs. 11.8%), suspected neonatal infection (17.8% vs. 21.5%), and proven neonatal infection (0.0% vs. 2.2%) were not significantly different. CONCLUSIONS: Prophylactic use of cefazolin in amnioinfusions did not significantly reduce rates of maternal or neonatal infection in patients with meconium-stained amniotic fluid. PMID:10371474

  17. Maternal infection rates after cesarean delivery by Pfannenstiel or Joel-Cohen incision: a multicenter surveillance study. (United States)

    Dumas, Anne Marie; Girard, Raphaële; Ayzac, Louis; Caillat-Vallet, Emmanuelle; Tissot-Guerraz, Françoise; Vincent-Bouletreau, Agnès; Berland, Michel


    Our purpose was to evaluate maternal nosocomial infection rates according to the incision technique used for caesarean delivery, in a routine surveillance study. This was a prospective study of 5123 cesarean deliveries (43.2% Joel-Cohen, 56.8% Pfannenstiel incisions) in 35 maternity units (Mater Sud Est network). Data on routine surveillance variables, operative duration, and three additional variables (manual removal of the placenta, uterine exteriorization, and/or cleaning of the parieto-colic gutter) were collected. Multiple logistic regression analysis was used to identify independent risk factors for infection. The overall nosocomial infection and endometritis rates were higher for the Joel-Cohen than Pfannenstiel incision (4.5% vs. 3.3%, 0.8% vs. 0.3%, respectively). The higher rate of nosocomial infections with the Joel-Cohen incision was due to a greater proportion of patients presenting risk factors (i.e., emergency delivery, primary cesarean, blood loss > or =800 mL, no manual removal of the placenta and no uterine exteriorization). However, the Joel-Cohen technique was an independent risk factor for endometritis. The Joel-Cohen technique is faster than the Pfannenstiel technique but is associated with a higher incidence of endometritis.

  18. Associations among serum pro- and anti-inflammatory cytokines, metabolic mediators, body condition, and uterine disease in postpartum dairy cows. (United States)

    Kasimanickam, Ramanathan K; Kasimanickam, Vanmathy R; Olsen, Jesse R; Jeffress, Erin J; Moore, Dale A; Kastelic, John P


    Adipose tissue is an active endocrine organ which secretes a wide range of hormones and protein factors, collectively termed adipokines. Adipokines affect appetite and satiety, glucose and lipid metabolism, inflammation and immune functions. The objectives were to evaluate serum concentrations of adipokines (adiponectin, leptin, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta and IL-6) in lactating dairy cows with postpartum uterine inflammatory conditions (metritis, clinical endometritis or subclinical endometritis) and in cows experiencing loss of body condition, and to assess the relationship of adipokines and body condition loss in the establishment of persistent uterine inflammatory conditions. Lactating multiparous Holstein cows (N = 40), with body condition scores (BCS) from 2 to 4 (eight cows for each 0.5 score increment) were enrolled. Body condition was monitored for all cows weekly for 7 weeks post calving; cows with uterine inflammatory conditions were also re-evaluated 2 weeks later. Blood samples were collected from 1 week prior to calving to 7 weeks after calving for determination of serum concentrations of adipokines, insulin and insulin like growth factor (IGF)-1. Cows with metritis or clinical endometritis had higher serum concentrations of adiponectin, leptin, TNF-alpha, IL-1beta and IL-6 compared to normal cows (P cows with subclinical endometritis compared to normal cows (P insulin and IGF-1 concentrations were lower in cows with metritis or clinical endometritis. Cows with low BCS (2 and 2.5) had significantly higher adiponectin, TNF-alpha, IL-1beta and IL-6 than those with high BCS (3 to 4). Cows with persistent uterine inflammatory conditions had higher adiponectin, leptin TNF-alpha, IL-1beta and IL-6 and insulin compared to normal and spontaneously recovered cows, except for IGF-1 (P insulin, and IGF-1 had significant associations with BCS categories (low vs. high) and postpartum uterine inflammatory conditions. Perhaps loss of

  19. Prevalence of cervicitis in dairy cows and its effect on reproduction. (United States)

    Hartmann, D; Rohkohl, J; Merbach, S; Heilkenbrinker, T; Klindworth, H P; Schoon, H A; Hoedemaker, M


    The objective of this study was to determine whether cervicitis in dairy cows is an independent disease or occurs concomitantly with inflammation of the uterus, and to clarify possible effects of cervicitis on reproductive performance. Dairy cows (n = 416) from 33 dairy farms were examined by rectal palpation and vaginoscopy between 42 and 50 days postpartum. Inclusion criteria for this study were absence of abnormal vaginal discharge and abnormalities of the uterus (fluctuation) at rectal palpation. Cervicitis was diagnosed when the second cervical fold was swollen and prolapsed with (C2) or without (C1) reddening. Cytobrush samples from the uterus (n = 370) and the cervix (n = 402) were collected, and the percentage of neutrophils in the uterus (PMNU) and the cervix as indicators of inflammation (threshold: ≥5%) was determined. In addition, endometrial biopsies for histology were collected, 300 of which were suitable for evaluation. Cervicitis (C1/C2) was diagnosed in 253 of 416 (60.8%) of cows. Of these, the prolapsed cervical mucosa was hyperemic (C2) in 29.1% of cases. Of 370 available uterine cytology samples, 221 cows had a clinical cervicitis; however, 170 (76.9%) had PMNU less than 5%. Of 300 uterine histologic examinations, 82 (27.3%) did not reveal any abnormalities; the remaining cows either had uterine inflammation and/or degenerative uterine changes such as endometriosis and angiosclerosis. Furthermore, of 300 biopsied animals, 184 revealed a cervicitis (C1/C2); however, 30.4% of these animals had no histopathologic uterine findings. For further analysis, only animals either without histopathologic findings and normal uterine cytology or with solely endometritis (defined as PMNU ≥ 5% and/or positive histopathology of the uterine tissue) were evaluated (n = 157). Of these, 95 cows had cervicitis. Unexpectedly, 63 of 95 (66.3%) cows had cervicitis without endometritis. With regard to reproductive performance, days to first service were

  20. Vaginal Cleansing Before Cesarean Delivery: A Systematic Review and Meta-analysis. (United States)

    Caissutti, Claudia; Saccone, Gabriele; Zullo, Fabrizio; Quist-Nelson, Johanna; Felder, Laura; Ciardulli, Andrea; Berghella, Vincenzo


    To assess the efficacy of vaginal cleansing before cesarean delivery in reducing postoperative endometritis. MEDLINE, Ovid, EMBASE, Scopus,, and Cochrane Library were searched from their inception to January 2017. Selection criteria included all randomized controlled trials comparing vaginal cleansing (ie, intervention group) with a control group (ie, either placebo or no intervention) in women undergoing cesarean delivery. Any method of vaginal cleansing with any type of antiseptic solution was included. The primary outcome was the incidence of endometritis. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of relative risk (RR) with 95% CI. Sixteen trials (4,837 women) on vaginal cleansing immediately before cesarean delivery were identified as relevant and included in the review. In most of the included studies, 10% povidone-iodine was used as an intervention. The most common way to perform the vaginal cleansing was the use of a sponge stick for approximately 30 seconds. Women who received vaginal cleansing before cesarean delivery had a significantly lower incidence of endometritis (4.5% compared with 8.8%; RR 0.52, 95% CI 0.37-0.72; 15 studies, 4,726 participants) and of postoperative fever (9.4% compared with 14.9%; RR 0.65, 95% CI 0.50-0.86; 11 studies, 4,098 participants) compared with the control group. In the planned subgroup analyses, the reduction in the incidence of endometritis with vaginal cleansing was limited to women in labor before cesarean delivery (8.1% compared with 13.8%; RR 0.52, 95% CI 0.28-0.97; four studies, 440 participants) or those with ruptured membranes (4.3% compared with 20.1%; RR 0.23, 95% CI 0.10-0.52; three studies, 272 participants). Vaginal cleansing immediately before cesarean delivery in women in labor and in women with ruptured membranes reduces the risk of postoperative endometritis. Because it is generally inexpensive and a

  1. Intrapartum amnioinfusion for meconium-stained fluid: meta-analysis of prospective clinical trials. (United States)

    Pierce, J; Gaudier, F L; Sanchez-Ramos, L


    To evaluate the effectiveness of intrapartum prophylactic amnioinfusion in pregnancies complicated by meconium-stained amniotic fluid. We identified prospective clinical trials of amnioinfusion in pregnancies complicated by meconium-stained amniotic fluid (AF) published in English by using computerized databases, references in published studies, and index reviews. We analyzed prospective studies of intrapartum amnioinfusion for meconium-stained AF. In every case, group allocation was based exclusively on meconium in AF. Only published studies with clearly documented outcome data were included. The trials were evaluated for meconium below the vocal cords, meconium aspiration syndrome, fetal acidemia, cesarean delivery, and postpartum endometritis. Each trial was evaluated for the quality of its methodology, inclusion and exclusion criteria, adequacy of randomization, amnioinfusion protocols, definition of outcomes, and statistical analyses. Thirteen studies met inclusion criteria for our systematic review. Odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated for each outcome. Estimates of ORs and risk differences for dichotomous outcomes were calculated using random and fixed-effects models. We tested for homogeneity across the studies. We found that intrapartum amnioinfusion significantly reduced the frequency of meconium aspiration syndrome (OR 0.30; 95% CI 0.19, 0. 46), of meconium below the vocal cords, and neonatal acidemia. Subjects allocated to receive amnioinfusion also had a significantly lower overall cesarean rate (OR 0.74, 95% CI 0.59, 0.93) without increased postpartum endometritis. Amnioinfusion in cases of meconium-stained fluid significantly improves neonatal outcome, lowers the cesarean delivery rate, and does not increase the postpartum endometritis rate.

  2. Risk factors and the economic impact of ovarian cysts on reproductive performance of dairy cows in Korea. (United States)

    Kim, Ki-Doek; Ki, Kwang-Sook; Kang, Hyun-Gu; Kim, Ill-Hwa


    The objectives of this study were to determine the risk factors for development of postpartum ovarian cysts by evaluating several reproductive factors in individual cows, and to determine the economic impact of ovarian cysts on subsequent reproductive performance in dairy herds in Korea. The data, including cow parity, abnormal puerperium, endometritis, body condition score (BCS), and breeding status were collected from 634 cows in 9 dairy herds. We used logistic regression to evaluate the effects of these factors on ovarian cysts. A stepwise procedure, used to obtain the appropriate model with alpha=0.05, revealed that cow parity was the most important risk factor for ovarian cyst development within 8 weeks postpartum, while development of endometritis and BCS loss>or=1 from the dry period to 8 weeks postpartum were the most important risk factors for ovarian cyst development beyond 8 weeks postpartum. The occurrence of ovarian cysts beyond 8 weeks postpartum prolonged (Pconception (77 days), and increased (Prate (7.8%), while ovarian cyst development within 8 weeks postpartum did not affect (P>0.05) the mean intervals from calving to first service and conception or the culling rate. The economic loss resulting from the occurrence of ovarian cysts was estimated at approximately 823,996 won ($687) due to effects on the cost of nutrition, average growth of calves, labor and medical costs, and culling. These results suggest that cow parity is correlated with the development of ovarian cysts within 8 weeks postpartum, and endometritis and BCS loss>or=1 from the dry period to 8 weeks postpartum are correlated with the development of ovarian cysts after 8 weeks postpartum, which decreases reproductive performance and results in economic loss in dairy herds in Korea.

  3. Polycystic Ovary Syndrome: An Under-recognized Cause of Abnormal Uterine Bleeding in Adolescents Admitted to a Children's Hospital. (United States)

    Maslyanskaya, Sofya; Talib, Hina J; Northridge, Jennifer L; Jacobs, Amanda M; Coble, Chanelle; Coupey, Susan M


    To evaluate whether ovulatory dysfunction due to polycystic ovary syndrome (PCOS) is a common underlying etiology of abnormal uterine bleeding (AUB) in adolescents who require hospitalization and to explore etiology, treatment, and complications of AUB with severe anemia in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We identified female patients aged 8-20 years admitted to a children's hospital for treatment of AUB from January 2000 to December 2014. Our hospital protocol advises hormonal testing for PCOS and other disorders before treatment for AUB. We reviewed medical records and recorded laboratory evaluations, treatments, and final underlying diagnoses as well as recurrences of AUB and readmissions in the subsequent year. Of the 125 subjects, the mean age was 16.5 ± 2.9 years; mean hemoglobin level was 7.0 ± 1.8 g/dL; 54% were overweight/obese; and 41% sexually active. PCOS accounted for 33% of admissions; hypothalamic pituitary ovarian axis immaturity 31%; endometritis 13%; bleeding disorders 10%. Girls with PCOS were more likely to be overweight/obese (74% vs 46%; P < .01) and girls with hypothalamic pituitary ovarian axis immaturity had lower hemoglobin levels (6.4 g/dL vs 7.4 g/dL; P < .05), than girls with all other etiologies of AUB. Treating physicians failed to diagnose endometritis as the etiology for AUB in 4 of 8 girls with positive tests for sexually transmitted infection and no other etiology. PCOS was the most common underlying etiology in adolescents hospitalized with AUB. Screening for hyperandrogenemia is important for early diagnosis of PCOS to allow ongoing management and prevention of comorbidities. Endometritis was frequently underestimated as an etiology for AUB. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  4. Analysis of postoperative vaginal vault radiotherapy of stage I endometrial cancer with different radionuclides

    International Nuclear Information System (INIS)

    Ryberg, M.; Einhorn, N.; Hamed, A.F.A.; Ruden, B.I.; Nilsson, B.


    A total of 213 patients in stage I grade 1 endometrical cancer were treated postoperatively with either radium or caesium vaginal applicators. The rate of complication and the incidence of second malignancies were studied in both groups. The frequency of grades 2 and 3 vaginal complications was higher among patients treated with caesium applicators but not statistically significant. The observed number of second malignancies was significantly higher than expected in the radium-treated group, in which the observed number of second malignancies with distant location was also significantly higher than expected, which could not be found in the caesium group. (orig.)

  5. The St.Petersburg school of oncogynecology, certain results and perspectives

    International Nuclear Information System (INIS)

    Bokhman, Ya.V.; Bishnevskij, A.S.; Maksimov, S.Ya.


    Basic results on studies, accomplished at the St.Petersburg school of oncogynecology, relative to the most frequent cases of Timor process localization (uterus cervix cancer, endometritis cancer, ovary cancer). It is shown that results of improved gynecological cancer treatment and decrease in mortality cases may be achieved not because of improving the surgical and radiation methods, the possibilities whereof are to a certain degree exhausted, but due to introduction of screening programs, enabling identification of early preclinical forms of cancer. Computerized and magnetoresonance tomography, USI and mammography are among the most efficient diagnostical methods. The perspectives of chemiohormone therapy and immunotherapy are also noted

  6. Mamary neoplasia in a closed beagle colony

    International Nuclear Information System (INIS)

    Taylor, G.N.; Shabestari, L.; Williams, J.; Mays, C.W.; Angus, W.; McFarland, S.


    The incidence rate of mammary neoplasia in a large colony of beagles and its relationship to internal skeletal and/or liver radiation, age, relatively late ovariectomy (4 years and older), endometritis, parity status, and adrenal weight was examined. Of these various factors, age was the only condition that was clearly correlated with changes in the mammary tumor incidence. The rate became significant at approximately eight years of age and increased progressively throughout the successively older age classes. Within the female dogs, the incidence of mammary cancer was higher that that of any other form of spontaneous malignancy

  7. The Utility of Amnioinfusion in the Prophylaxis of Meconium-Stained Amniotic Fluid Infectious Morbidity

    Directory of Open Access Journals (Sweden)

    C. D. Adair


    Full Text Available Objectives: To evaluate the utility of intrapartum amnioinfusion (AI in reducing the infectious morbidity of patients with meconium-stained fluid (MSF. Previous studies have shown increased intraamniotic infection (IAI and postpartum endometritis (PPE rates in patients with MSF. Intraamniotic infection has been reduced with the prophylactic administration of ampicillin–sulbactam in MSF. Intraamniotic infection and PPE have been reduced with the use of AI in patients with clear fluid. No investigators have specifically examined the efficacy of AI in reducing meconium-stained, amniotic-fluid-associated infectious morbidity.

  8. Postpartum complications

    International Nuclear Information System (INIS)

    Kronthal, A.J.; Kuhlman, J.E.; Fishman, E.K.


    This paper reports the CT findings of major postpartum complications and determine what role CT plays in their evaluation. The CT scans of nine patients with major postpartum complications were retrospectively reviewed. Patients had been referred to CT for evaluation of postpartum fever, abdominal pain, and elevated results of liver function tests. Complications identified at CT included hepatic infarctions (n = 2), endometritis (n = 2), postoperative wound abscess (n = 1), massive abdominal hemorrhage (n = 1), septic thrombophlebitis (n = 1), and renal vein thrombosis (n = 1). CT findings of hepatic infarction included wedge-shaped areas of decreased enhancement conforming to a vascular distribution

  9. [The risk of infection to the mother prior, during and after delivery. A registration of nosocomial infections]. (United States)

    Hirsch, H A; Niehues, U


    During 5 1/2 years all infections arising in the hospital (nosocomial infections) were registered prospectively by an infection control nurse. The incidence of all nosocomial infections in 3192 maternity patients was 2.1%. In 10,569 women following vaginal deliveries 2.6% and in 1,353 women following Caesarean section 21.1%. The commonest infections were urinary tract infections, endometritis, infections of the abdominal wound or the episiotomy, and a phlebitis of the intravenous infusion site. Measures to prevent infection resulted in a steadily decreasing incidence of infections during the 6 years of registration of nosocomial infections.

  10. Relationship of concentrations of cortisol in hair with health, biomarkers in blood, and reproductive status in dairy cows. (United States)

    Burnett, Tracy A; Madureira, Augusto M L; Silper, Bruna F; Tahmasbi, Abdolmansour; Nadalin, Audrey; Veira, Douglas M; Cerri, Ronaldo L A


    Hair cortisol has been used to measure chronic stress in dairy cows as it offers the advantage of being noninvasive, fast, and able to indicate levels of cortisol over long periods. The aim of this study was to determine the associations between hair cortisol with clinical disorders, reproductive status, and the development of subclinical endometritis in dairy cows. Furthermore, we aimed to determine the association between hair cortisol concentrations and blood markers associated with metabolic status and acute inflammation. In experiment 1, cows (n=64) were hair sampled every 3wk from the tail switch beginning at calving (d 0) until d 126 for cortisol analysis; blood samples were collected every 3wk from d 0 until 42 for β-hydroxybutyrate and glucose analysis. In experiment 2, cows (n=54) were chosen retrospectively by diagnosis of subclinical endometritis (END), subclinical endometritis and at least 1 clinical disease (END+CLIN), or as healthy (control) using a cytobrush and ultrasonography at 30±3d in milk. At the same time, animals were hair sampled for cortisol analysis and blood sampled for haptoglobin and ceruloplasmin analysis. Health records were recorded throughout both experimental periods. Animals with clinical disease presented higher cortisol concentrations than clinically healthy animals in experiment 1 [geometric mean (95% confidence interval); 8.8 (7.8, 9.9) vs. 10.7 (9.6, 12.0) pg/mg]; however, animals diagnosed with subclinical endometritis in experiment 2 did not differ in hair cortisol concentrations [11.7 (9.8, 14.0), 12.2 (9.3, 15.9), 10.5 (8.1, 13.6) pg/mg for control, END, and END+CLIN, respectively]. In experiment 1, an effect of sample day was noted, where d 21 had higher cortisol concentrations than d 42, 84, and 126, but not from d 0 for both parities. Within both experiments, a parity effect was present where multiparous animals consistently had higher cortisol concentrations than primiparous animals. Multiparous cows that became

  11. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. (United States)

    Haas, David M; Morgan, Sarah; Contreras, Karenrose


    Cesarean delivery is one of the most common surgical procedures performed by obstetricians. Infectious morbidity after cesarean delivery can have a tremendous impact on the postpartum woman's return to normal function and her ability to care for her baby. Despite the widespread use of prophylactic antibiotics, postoperative infectious morbidity still complicates cesarean deliveries. To determine if cleansing the vagina with an antiseptic solution before a cesarean delivery decreases the risk of maternal infectious morbidities, including endometritis and wound complications. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (21 July 2014). We included randomized and quasi-randomized trials assessing the impact of vaginal cleansing immediately before cesarean delivery with any type of antiseptic solution versus a placebo solution/standard of care on post-cesarean infectious morbidity. We independently assessed eligibility and quality of the studies. Five trials randomizing 1946 women (1766 analyzed) evaluated the effects of vaginal cleansing (all with povidone-iodine) on post-cesarean infectious morbidity. The risk of bias was generally low, with the quality of most of the studies being high. Vaginal preparation immediately before cesarean delivery significantly reduced the incidence of post-cesarean endometritis from 7.2% in control groups to 3.6% in vaginal cleansing groups (average risk ratio (RR) 0.39, 95% confidence interval (CI) 0.16 to 0.97, five trials, 1766 women). The risk reduction was particularly strong for women with ruptured membranes (1.4% in the vaginal cleansing group versus 15.4% in the control group; RR 0.13, 95% CI 0.02 to 0.66, two trials, 148 women). No other outcomes realized statistically significant differences between the vaginal cleansing and control groups. No adverse effects were reported with the povidone-iodine vaginal cleansing.The quality of the evidence using GRADE was low for post-cesarean endometritis

  12. Recurrent Streptococcus pyogenes genital infection in a woman: test and treat the partner!

    Directory of Open Access Journals (Sweden)

    Emilienne Verkaeren


    Full Text Available Group A Streptococcus (GAS is a well-known cause of vulvovaginitis in prepubescent girls, but it is rarely described in adult women. We describe the case of a 64-year-old woman who presented with endometritis revealed by GAS bacteraemia, followed by recurrent vulvovaginitis due to a wild-type strain of GAS. She relapsed twice despite amoxicillin treatment. Her husband was found to be an asymptomatic carrier after GAS was identified in nasal and rectal swabs. She was cured after eradication of carriage in both herself and her husband with amoxicillin and rifampin. When recurrent Streptococcus pyogenes genital infections occur, test and treat the partner.

  13. [Morbidity among mothers and infants after ambulatory deliveries]. (United States)

    Kierkegaard, O


    Postpartum early discharge programs are reviewed. Few programs were mandatory and both primi- and multiparae were included. Discharge varied from two to 72 hours after delivery. Nearly all programs had prenatal preparation and all patients had postpartum follow-up at home. Approximately one per cent of the infants were readmitted mostly on account of hyperbilirubinemia and infections, and half as many mothers were readmitted mostly for hemorrhage and endometritis. Infants discharged very early were readmitted more frequently than others. There were no statistical significant difference in mortality or morbidity between mothers or infants in early discharge groups and control groups.

  14. Anesthetic Management of Mitochondrial Encephalopathy With Lactic Acidosis and Stroke-Like Episodes (MELAS Syndrome) in a High-Risk Pregnancy: A Case Report. (United States)

    Bell, Josh D; Higgie, Kushlin; Joshi, Mital; Rucker, Joshua; Farzi, Sahar; Siddiqui, Naveed


    MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered. This is to our knowledge the first case report of obstetric complications in MELAS syndrome and highlights the salient metabolic sequelae of this syndrome.

  15. Frequency of endometrial tuberculosis in female infertility

    International Nuclear Information System (INIS)

    Yousaf, A.; Zaman, G.; Sultana, N.


    Objective: To determine the frequency of endometrial tuberculosis in infertility patients. Design: an observational analytical study. Place and Duration of Study: Military Hospital Rawalpindi and Armed Forces Institute of Pathology, Rawalpindi from August 1998 to April 1999. Subjects and Methods: Endometrial biopsies were taken from 50 cases of infertility and subjected to culture on BACTEC 460 TB instrument. Results: Tuberculous endometritis was found in 10 % (n=5) of cases. Conclusion: It was concluded that endometrial tuberculosis is not an infrequent cause of infertility in our setup. (author)

  16. Histopathological Findings of Endometrial Samples and its Correlation Between the Premenopausal and Postmenopausal Women in Abnormal Uterine Bleeding. (United States)

    Sharma, S; Makaju, R; Shrestha, S; Shrestha, A


    Abnormal uterine bleeding is considered as one of the most common problems among women. The therapy is incomplete without knowing the underlying pathology. To determine the types and frequency of endometrial pathologies in patients presenting with abnormal uterine bleeding at Dhulikhel Hospital Kathmandu university Hospital. This is retrospective study total 100 cases were included over a period of one year of Abnormal Uterine bleeding. Out of 100 cases of Abnormal uterine bleeding, 61% were due to non-organic cause with a commonest histopathological findings proliferative endometrium. 27% cases were due to organic cause with pregnancy related condition as most common finding. 12% were reported as inadequate. The rate of postmenopausal bleeding declined with increasing age in the postmenopausal period and endometritis was the predominant finding. There is an age specific association of Abnormal uterine bleeding with increased incidence in perimenopausal age group. Postmenopausal bleeding declined with increasing with endometritis the most common finding. Dilation and curettage is helpful to exclude other organic pathology. It is useful for diagnosis and to know pathological incidence of organic lesions in cases of Abnormal uterine bleeding prior to surgery.

  17. Bacterial contamination hypothesis: a new concept in endometriosis. (United States)

    Khan, Khaleque N; Fujishita, Akira; Hiraki, Koichi; Kitajima, Michio; Nakashima, Masahiro; Fushiki, Shinji; Kitawaki, Jo


    Endometriosis is a multifactorial disease that mainly affects women of reproductive age. The exact pathogenesis of this disease is still debatable. The role of bacterial endotoxin (lipopolysaccharide, LPS) and Toll-like receptor 4 (TLR4) in endometriosis were investigated and the possible source of endotoxin in the pelvic environment was examined. The limulus amoebocyte lysate test was used to measure the endotoxin levels in the menstrual fluid and peritoneal fluid and their potential role in the growth of endometriosis was investigated. Menstrual blood and endometrial samples were cultured for the presence of microbes. The effect of gonadotrophin-releasing hormone agonist (GnRHa) treatment on intrauterine microbial colonization (IUMC) and the occurrence of endometritis was investigated. Lipopolysaccharide regulates the pro-inflammatory response in the pelvis and growth of endometriosis via the LPS/TLR4 cascade. The menstrual blood was highly contaminated with Escherichea coli and the endometrial samples were colonized with other microbes. A cross-talk between inflammation and ovarian steroids or the stress reaction also was observed in the pelvis. Treatment with GnRHa further worsens intrauterine microbial colonization, with the consequent occurrence of endometritis in women with endometriosis. For the first time, a new concept called the "bacterial contamination hypothesis" is proposed in endometriosis. This study's findings of IUMC in women with endometriosis could hold new therapeutic potential in addition to the conventional estrogen-suppressing agent.

  18. Prophylactic amnioinfusion for intrapartum oligohydramnios: a meta-analysis of randomized controlled trials. (United States)

    Pitt, C; Sanchez-Ramos, L; Kaunitz, A M; Gaudier, F


    To evaluate the effectiveness of intrapartum prophylactic amnioinfusion in pregnancies complicated by oligohydramnios. Randomized controlled trials of prophylactic amnioinfusion in women with oligohydramnios were identified using computerized databases, index reviews, and references cited in original studies and review articles. We evaluated, abstracted data from, and analyzed randomized studies of prophylactic intrapartum amnioinfusion in women with oligohydramnios. In every study the group allocation was based exclusively on presence of oligohydramnios. Only published studies with clearly documented outcome data were included. The quality of each trial was evaluated for methodology, inclusion and exclusion criteria, adequacy of randomization, amnioinfusion protocols, definition of outcomes, and statistical analyses. The trials were evaluated concerning cesarean deliveries for fetal heart rate (FHR) abnormalities, overall cesarean rates, acidemia at birth, intrapartum fetal heart rate abnormalities, Apgar scores under 7 at 5 minutes, and postpartum endometritis. Thirty-five studies were identified, of which 14 met the inclusion criteria for this systematic review. They included 1533 patients, 793 in the amnioinfusion group, and 740 controls. Odds ratios (OR) with their 95% confidence intervals (CI) for each outcome were calculated. We calculated an estimate of the OR and risk difference for dichotomous outcomes using random and fixed-effects models. A test of homogeneity was done across studies. Women with oligohydramnios who received intrapartum amnioinfusion had lower incidence of cesarean for FHR abnormalities (OR 0.23; 95% CI 0.15, 0.35). Intrapartum amnioinfusion also was associated with lower overall rates of cesarean deliveries (OR 0.52; 95% CI 0.40, 0. 68), acidemia at birth (OR 0.40; 95% CI 0.30, 0.55), FHR abnormalities during labor (OR 0.24; 95% CI 0.17, 0.34), and Apgar scores under 7 at 5 minutes (OR 0.52; 95% CI 0.29, 0.91). Postpartum endometritis

  19. Expression of genes associated with immunity in the endometrium of cattle with disparate postpartum uterine disease and fertility

    Directory of Open Access Journals (Sweden)

    Herath Shan


    Full Text Available Abstract Background Contamination of the uterine lumen with bacteria is ubiquitous in cattle after parturition. Some animals develop endometritis and have reduced fertility but others have no uterine disease and readily conceive. The present study tested the hypothesis that postpartum cattle that develop persistent endometritis and infertility are unable to limit the inflammatory response to uterine bacterial infection. Methods Endometrial biopsies were collected several times during the postpartum period from animals that were subsequently infertile with persistent endometritis (n = 4 or had no clinical disease and conceived to first insemination (n = 4. Quantitative PCR was used to determine the expression of candidate genes in the endometrial biopsies, including the Toll-like receptor (TLR 1 to 10 family of innate immune receptors, inflammatory mediators and their cognate receptors. Selected proteins were examined by immunohistochemistry. Results The expression of genes encoding pro-inflammatory mediators such as interleukins (IL1A, IL1B and IL6, and nitric oxide synthase 2 (NOS2 were higher during the first week post partum than subsequently. During the first week post partum, there was higher gene expression in infertile than fertile animals of TLR4, the receptor for bacterial lipopolysaccharide, and the pro-inflammatory cytokines IL1A and IL1B, and their receptor IL1R2. The expression of genes encoding other Toll-like receptors, transforming growth factor beta receptor 1 (TGFBR1 or prostaglandin E2 receptors (PTGER2 and PTGER4 did not differ significantly between the animal groups. Gene expression did not differ significantly between infertile and fertile animals after the first week postpartum. However, there were higher ratios of IL1A or IL1B mRNA to the anti-inflammatory cytokine IL10, during the first week post partum in the infertile than fertile animals, and the protein products of these genes were mainly localised to the epithelium

  20. Antibiotic prophylaxis for term or near-term premature rupture of membranes: metaanalysis of randomized trials. (United States)

    Saccone, Gabriele; Berghella, Vincenzo


    The objective of the study was to evaluate the efficacy of antibiotic prophylaxis in women with term or near-term premature rupture of membranes. Searches were performed in MEDLINE, OVID, Scopus,, the PROSPERO International Prospective Register of Systematic Reviews, EMBASE,, MEDSCAPE, and the Cochrane Central Register of Controlled Trials with the use of a combination of key words and text words related to antibiotics, premature rupture of membranes, term, and trials from inception of each database to September 2014. We included all randomized trials of singleton gestations with premature rupture of membranes at 36 weeks or more, who were randomized to antibiotic prophylaxis or control (either placebo or no treatment). The primary outcomes included maternal chorioamnionitis and neonatal sepsis. A subgroup analysis on studies with latency more than 12 hours was planned. Before data extraction, the review was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42014013928). The metaanalysis was performed following the Preferred Reporting Item for Systematic Reviews and Meta-analyses statement. Women who received antibiotics had the same rate of chorioamnionitis (2.7% vs 3.7%; relative risk [RR], 0.73, 95% confidence interval [CI], 0.48-1.12), endometritis (0.4% vs 0.9%; RR, 0.44, 95% CI, 0.18-1.10), maternal infection (3.1% vs 4.6%; RR, 0.48, 95% CI, 0.19-1.21), and neonatal sepsis (1.0% vs 1.4%; RR, 0.69, 95% CI, 0.34-1.39). In the planned subgroup analysis, women with latency longer than 12 hours, who received antibiotics, had a lower rate of chorioamnionitis (2.9% vs 6.1%; RR, 0.49, 95% CI, 0.27-0.91) and endometritis (0% vs 2.2%; RR, 0.12, 95% CI, 0.02-0.62) compared with the control group. Antibiotic prophylaxis for term or near-term premature rupture of membranes is not associated with any benefits in either maternal or neonatal outcomes. In women with latency longer

  1. [Intrapartum amnioinfusion in patients with meconium-stained amniotic fluid]. (United States)

    Engel, Karina; Samborska, Monika; Bilar, Marek; Sipak-Szmigiel, Olimpia; Ronin-Walknowska, Elzbieta


    The aim of the study was to evaluate the effect of intrapartum amnioinfusion in the presence of meconium stained amniotic fluid. 93 women with meconium-stained amniotic fluid were assigned to receive amnioinfusion or no amnioinfusion (128 women). The trials were evaluated for fetal distress syndrome, route of delivery, fetal acidemia, Apgar score at 1 and 5 min., meconium aspiration syndrome, postpartum endometritis and maternal hospital stays. Amnioinfusion in cases of meconium-stained fluid did not improve the number of fetal distress symptoms during fetal heart rate monitoring. Amnioinfusion was associated with a significant decrease of neonatal acidemia although it did not improve Apgar score. In our study amnioinfusion was not associated with reduction in the incidence of neonatal outcome and puerperial complications.

  2. Radionuclide visualization of uterin fibromyoma as a new method of differential diagnosis

    International Nuclear Information System (INIS)

    Kalantarov, K.D.; Ashikhmina, I.G.; Juokov, V.A.


    Since fibromateous uterus is very vascularized, it is very promising to visualize this blood pool by using radionuclide technique. The study consists of 30 patients with fibromyoma, cyst and other diseases of genital system (salpingitis, ooforit etc.). Blood pool labeling was performed by ''in vivo'' labeling of red blood cells (chlorous tin injection followed by pertechnetate administration) or by intravenous injection of serum albumin labelled with Tc-99m. Both methods were found satisfactory. Gammacamera GKS-I (Soviet production) connected with data store and processing system (CINE-200) was positioned over region of uterus, radioactivity injected and data collected as dynamic study at I frame/sec during 60 seconds. Static visualization was performed 30 min after dynamic study. Radionuclide visualization can be considered as reliable and non-invasive tool in differential diagnosis of fibromyoma and cyst of uterus as well as of endometritis

  3. Congenic tuberculosis. Presentation of clinical case

    International Nuclear Information System (INIS)

    David Calabria, Milena; Ojeda Leon, Paulina


    We are presenting the case of less than to 2 month old and premature infant, she had hyaline membrane disease and required mechanical ventilation during 6 days, at the first month. She presented a viral rhinopharyngitis symptomatology, perioral cyanosis with apnoea, and respiratory distress, the chest x-ray showed multiple bilateral hyperlucid images, mainly at the right side afterwards the patient presented intermittent fever of long evolution and initially received treatment for cavitary bronchopneumonia and sequel of mechanical ventilation, receiving multiple antimicrobial antibiotics, the mother had intermittent fevers since the sixth month of pregnancy and was hospitalized for suspected endometritis after delivery, she presented clinical impairment which evolved to sepsis and died in the ICU, the endometrial histopathology showed granulomas suggesting tuberculosis, due to long history of fevers in the baby and the genital tuberculosis in the mother a tuberculosis study was performed in the girl which resulted positive

  4. Has the incidence of radiation-induced bowel damage following treatment of uterine carcinoma changed in the last 20 years

    International Nuclear Information System (INIS)

    Allen-Mersh, T.C.; Wilson, E.J.; Hope-Stone, H.F.; Mann, C.V.


    Radiation-induced bowel damage occurred in 4.3% of patients treated primarily by irradiation for uterine carcinoma during the period 1962-1982. There has been a progressive rise in the incidence of radiation damage and radiation-induced rectovaginal fistula during this 20-year period. Radiation from intracavitary sources was a contributory factor in 92% of injured cases. The rising incidence of bowel damage in our patients may be due to an increase in the number of patients receiving a high rectal dose from the intracavitary source. There was a significantly (P<0.01) higher incidence of radiation injury in cases of cervical carcinoma compared to endometrical carcinoma. This was because cervical carcinoma tended to present at a more advanced stage than endometrial carcinoma and was more frequently treated with combined external and intracavitary irradiation. There was no significant increase in the incidence of complications among patients undergoing hysterectomy. (author)

  5. Recurrence of gynecologic malignomas after combined and primary radiotherapy. Incidence and period until diagnosis

    International Nuclear Information System (INIS)

    Csaicsich, P.; Tatra, G.; Michalica, W.; Vienna Univ.


    A group of 1018 patients with gynecological malignancies after a combined or primary radiation therapy was studied for frequency and space of recidivs. In the first three years after therapy in cases with cervical cancer 95%, in cases with endometrical cancer 82% and in cases of ovarian cancer 98% of all recidivs were diagnosed. In cases of cancer of the vagina, the tube and vulva all recidivs were observed within the first three years. By results obtained it is put up for discussion to replace 'five-years-rate' by 'three-years-rate' in cases of gynecological malignancies with exception of mammarian carcinoma. Thereby the value of a model of therapy could be realized earlier than hitherto. (orig.) [de

  6. Calving body condition score combined with milk test data and rectal tempreture improved the prognostic value of non-invasive markers for infectious diseases in Holestein cows

    DEFF Research Database (Denmark)

    Mansouryar, M.; Mirzaei-Alamouti, H.; Banadaky, M. Dehghan


    Early lactating dairy cows, are predisposed for calving-related diseases. Early prediction of “at risk” animals increases the likelihood of a successful recovery. In this regard, test-days milk data and body condition score (BCS) at calving have been evaluated as potential indicators of cows at......), BCS at calving and at the first two milk test-days and RT measured daily from day 1 (parturition) to 14 postpartum. Cows were furthermore monitored for subclinical mastitis (SCM), metritis and endometritis in the postpartum period, and diseases diagnosed using standardized definitions. The predicting...... value of variables were evaluated by Receiver Operating Characteristic (ROC) analysis. None of the determined variables provided accuracy individually in prediction of post-partum diseases. Only the mean value of rectal temperature at week 2 (RT2) showed an area under the curve (AUC) higher than 0...

  7. Is the Modern High Potential Dairy Cow Suitable for Organic Farming Conditions?

    Directory of Open Access Journals (Sweden)

    Harðarson Grétar H


    Full Text Available It is not acceptable to compromise animal welfare in any system of farming. Feeding should be aimed at meeting the nutritional requirements at the various stages of production. This paper deals with the detrimental effects that organic, extensive or low input farming systems may have on the energy status in early lactation of the high potential dairy cow. Bovine ketosis is the most important disease resulting from insufficient energy intake in early lactation. It is also important to realize that ketosis is a part of the so-called periparturient disease complex, which includes milk fever, mastitis, retained placenta, endometritis and poor fertility also. All these diseases are interrelated and reflect to a large extent the nutritional status of the animal. If organic dairy farming is to be successful the breeding programmes have to divert from selection for high yields as a main goal, to more emphasis on a flatter lactation curve, less production diseases and longevity.

  8. [Bovine herpesvirus 4 (BoHV-4): general aspects of the biology and status in Argentina]. (United States)

    Morán, Pedro E; Pérez, Sandra E; Odeón, Anselmo C; Verna, Andrea E


    Bovine herpesvirus 4 (BoHV-4) has been isolated from cattle with respiratory infections, vulvovaginitis, mastitis, abortions, endometritis and from apparently healthy animals throughout the world. Although it has not yet been established as causal agent of a specific disease entity, it is primarily associated with reproductive disorders of cattle. This virus can infect a wide range of species, either in vivo or in vitro. Two groups of prototype strains were originated from the first isolates: the DN599-type strains (American group) and the Movar-type strains (European group). In Argentina, BoHV-4 was isolated and characterized in 2007 from vaginal discharge samples taken from cows that had aborted. So far, more than 40 isolates, mainly associated with aborting bovine females have been registered in our country. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. TV sonographic assessment in postmenopausal asymptomatic women. (United States)

    Tsikouras, P; Galazios, G; Liberis, V; Bouzaki, A; Grapsas, X; Maroulis, G


    The aim of this study was to evaluate retrospectively the usefulness of transvaginal sonography for the detection of endometrial disease in postmenopausal women without symptoms. The study involved 750 postmenopausal women aged 52-65 (mean 58.5). None of them were on hormone replacement therapy and all had had amenorrhea for more than two years. Transvaginal sonography was performed in 750 women. An endometrium of women) was not investigated further. The 627 cases of this group were reassessed one year later. In the remaining 123 postmenopausal women with suspicious endometrium > 5 mm, 19 endometrial polyps (7.13%), one cervical polyp with extension in the cavity (0.8%), 90 endometrial atrophies (73.17%), ten atrophic endometritis (8.13%), two simple hyperplasias (1.62%), and one hyperplasia with atypia (0.8%) were found. Transvaginal sonography is an efficient and acceptable noninvasive method for the early detection of endometrial pathology in postmenopausal asymptomatic women.

  10. Premature delivery due to intrauterine Candida infection that caused neonatal congenital cutaneous candidiasis: a case report. (United States)

    Ito, Fumitake; Okubo, Tomoharu; Yasuo, Tadahiro; Mori, Taisuke; Iwasa, Koichi; Iwasaku, Kazuhiro; Kitawaki, Jo


    Congenital cutaneous candidiasis is a very rare disease with less than 100 cases published in the medical literature. Neonates having this disease present with systemic skin lesions caused by intrauterine Candida infections. We present a case of threatened premature delivery due to Candida chorioamnionitis, which caused both maternal postpartum endometritis and neonatal congenital cutaneous candidiasis. A 34-year-old woman who was admitted for fetal membrane bulging at 20 weeks of gestation underwent McDonald cervical cerclage. We diagnosed threatened premature delivery due to intrauterine infection; therefore, we terminated the gestation by cesarean section at 24 weeks of gestation. Fungi-like yeast was detected in infantile gastric juice. Histopathological findings of the placenta revealed that Candida albicans mycelium invaded the placenta, chorioamniotic membrane and umbilical cord. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  11. Contraceptives with novel benefits. (United States)

    Su, Ying; Lian, Qing-Quan; Ge, Ren-Shan


    Progesterone receptor (PR) agonists (progestins) and antagonists are developed for female contraceptives. However, non-contraceptive applications of newer progestins and PR modulators are being given more attention. The newer PR agonists including drospirenone, nomegestrol, trimegestone, dienogest and nestorone are being evaluated as contraceptives with health benefits because of their unique pharmacological properties. The selective PR modulators (SPRM; PR antagonists with PR agonistic properties) are under development not only for emergency contraception but also for other health benefits such as the treatment of endometritis and leiomyoma. After searching the literature from PubMed, and patent database, this review focuses on the effects and mechanisms of these progestins, and SPRMs as contraceptives with other health benefits. PR agonists and antagonists that have novel properties may generate better contraceptive effects with other health benefits.

  12. Vernix caseosa peritonitis as a rare complication of cesarean section. A case report. (United States)

    Tawfik, O; Prather, J; Bhatia, P; Woodroof, J; Gunter, J; Webb, P


    Vernix caseosa peritonitis is a rare complication of cesarean section with distinctive histopathologic findings. Vernix caseosa peritonitis occurred in a 28-year-old, pregnant woman following emergency cesarean section. Exploratory laparotomy revealed right subphrenic and perihepatic fluid collections with multiple small abdominal abscesses. Cytopathologic examination of the peritoneal lavage specimen showed a purulent inflammatory exudate admixed with occasional squamous debris, portions of hair shafts, meconium pigment, and foamy and multinucleated giant cells. During hospitalization the patient had developed Clostridium perfringens acute endometritis, presumably due to aggressive treatment with broad-spectrum antibiotics. Pathologists are in a unique position to make the correct diagnosis in an otherwise-ambiguous clinical presentation because of the distinctive histopathologic and cytopathologic findings of this entity. Computed tomography-guided fine needle aspiration cytologic evaluation can be diagnostic in such cases.

  13. Prevalence of C.Trachomatis Infection among Ahvaz Females with Vaginal Discharge

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    Alireza Samarbaf-Zadeh


    Full Text Available Background: C. trachomatis is one of the most important agents of sexually transmitted diseases(STD. Untreated cases of vaginal infection with this bacterium may end up with infertility, scaring andectopic pregnancy. In most cases infection with C. trachomatis is silent (70-80% but when overtinfection occurs the symptoms include: cervicitis, urethritis, and endometritis.Since prevalence of C. trachomatis was not studied in our city, this project was performed to evaluatethe role of this bacterial agent in vaginosis.Material and Methods: Two hundred and two specimens from vaginal discharge of out-patientsreferring to gynecology ward of Ahvaz hospitals were collected and tested for C. trachomatis by PCR.Results: Out of 202 specimens, 33 (16.3% were positive for C. trachomatis.Conclusion: The findings of this study show a high prevalence of C. trachomatis which indicates thatspecial attention must be paid to detection and management of this infection.

  14. Postpartum infections: occurrence, healtcare contacts and association with breastfeeding

    DEFF Research Database (Denmark)

    Ahnfeldt-Mollerup, Peder; Petersen, Line Kirkeby; Kragstrup, J.


    % of all women had experienced one or more self-reported episode of infection. Breast infections (12%) were most frequent, followed by wound (3%), airway (3%), vaginal (3%) and urinary tract infections (3%), endometritis (2%) and "other infections" (2%). Of the women with an infection, 66% (265 of 395......Objective. To investigate the following: (i) the occurrence of postpartum infections; (ii) the frequency of contact with either a general practitioner or a hospital due to postpartum infections; and (iii) the association of postpartum infections with continuation of breastfeeding. Design. Cross...... from general practitioner and hospital records. Main outcome measures. The distribution of different infections, as well as the overall occurrence of any infection, was evaluated according to mode of delivery and breastfeeding status (stopped/continued). Results. Within four weeks after delivery, 24...

  15. Eggs containing larvae of Enterobius vermicularis in vaginal smear

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    Jyothi B Shetty


    Full Text Available Enterobius vermicularis also known commonly as pinworm is the most common intestinal parasite. It is a nematode that inhabits the human terminal ileum, colon and appendix. The fertilized female migrates to the perianal area where eggs are deposited but occasionally introduces itself into adjacent orifices, most commonly the female genitourinary tract. Thus the eggs can be seen in the vaginal smear as a result of contamination. We report a case wherein the patient presented with signs and symptoms of vulvovaginitis. In her vaginal smear there were eggs of Enterobius vermicularis which showed a coiled larva within it. In the background there were plenty of acute inflammatory cells. This patient responded favorably to antihelminthics. We report this case to highlight the morphology of the parasite and also to emphasize that such findings should not be neglected. Timely reporting and appropriate treatment of such cases will prevent further complications of this parasite including endometritis, salphingitis and peritonitis.


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    Sanjay C. Parmar


    Full Text Available The use of PGF2 α is based on its luteolytic effect causing regression of corpus luteum and allows development of dominant follicle on the ovary that result in estrus and ovulation in 72 to 96 hours after its administration. Moreover, the PGF2 α also causes relaxation of cervix and smooth muscle contractions of uterus. The use of PGF2 α may provide microbial resistance in uterine environment, on one hand and can favour and enhance body defense mechanism / phagocytic activity on the other hand. PGF2 α is widely used to get rid of from the conditions like luteal cystic ovarian disease, persistent corpus luteum, endometritis, abnormal pregnancy, pyometra, retention of placenta and mummification. It has been now in vogue to administer PGF2 α or its analogue in early postpartum cows and buffaloes in order to hasten early resumption of cyclic ovarian activity and thereby to increase the reproductive efficiency.

  17. Investigating uterine disease in the bitch: uterine cannulation for cytology, microbiology and hysteroscopy. (United States)

    Watts, J R; Wright, P J


    A technique for transcervical cannulation of the uterus of the bitch for the collection of samples for cytology and microbiology was developed. This technique involved passing a cannula into the uterus with the aid of an endoscope. The uterus was cannulated successfully in mature bitches (over 10 kg) 110 times in 144 attempts. Success of cannulation was influenced by the experience of the operator and ease of cannulation by the stage of the reproductive cycle, the size of the bitch and the type of cannula. Complications associated with the procedure were endometritis, vaginitis and vaginal tears. Uterine cannulation was generally possible in all bitches studied at all stages of the reproductive cycle. Techniques for the collection of samples from the uterus for cytology and microbiology and for the processing of samples for uterine cytology are outlined. Hysteroscopy was performed on seven occasions in post partum bitches and was found to be possible at least until day 17 after whelping.

  18. Spontaneous Uterine Perforation due to Pyometra Presenting as Acute Abdomen

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    Loabat Geranpayeh


    Full Text Available Spontaneous perforation of the uterus is rare, its incidence being about 0.01%–0.05%. We report a rare case of diffuse peritonitis caused by spontaneously perforated pyometra. A 63-year-old woman with severe abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy, about 900 mL of pus was found in the peritoneal cavity. There were no abnormal findings in the alimentary tract, liver, or gallbladder. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.

  19. The Utility of Amnioinfusion in the Prophylaxis of Meconium-Stained Amniotic Fluid Infectious Morbidity (United States)

    Weeks, J. W.; Johnson, G.; Burlison, S.; London, S.; Lewis, D. F.


    Objectives: To evaluate the utility of intrapartum amnioinfusion (AI) in reducing the infectious morbidity of patients with meconium-stained fluid (MSF). Previous studies have shown increased intraamniotic infection (IAI) and postpartum endometritis (PPE) rates in patients with MSF. Intraamniotic infection has been reduced with the prophylactic administration of ampicillin–sulbactam in MSF. Intraamniotic infection and PPE have been reduced with the use of AI in patients with clear fluid. No investigators have specifically examined the efficacy of AI in reducing meconium-stained, amniotic-fluid-associated infectious morbidity. Methods: A retrospective cohort study of all cases of MSF was conducted and included patients who delivered at Louisiana State University Medical Center–Shreveport during the one-year period from January to December 1996. Patients were identified from the perinatal database by the diagnosis code of MSF. The medical records were reviewed to determine the consistency of MSF and the presence or absence of infectious morbidity. Patient demographics, labor characteristics, and various risk factors for infection were sought. The main outcome measures were the occurrence of clinical IAI or PPE. Statistical analysis included two-tailed unpaired t-test, X2, ANOVA, and Fisher exact test when appropriate. Results: Two hundred seventy-three medical records of patients with MSF were studied. One hundred twenty nine patients received AI, and 144 did not receive AI. No significant differences in demographics, labor characteristics, or outcome variables were noted between the two groups. The incidences of IAI were 18.6% and 24.3%, P = 0.13, in the AI and non-AI groups, respectively. Postpartum endometritis occurred in 22.5% of AI patients and 21.5% of non-AI patients, P = 0.97. Conclusions: The use of AI confers no benefit for the reduction of infectious morbidity in patients with MSF. PMID:18476189

  20. Prophylactic amnioinfusion in preganancies complicated by chorioamnionitis: a prospective randomized trial. (United States)

    Parilla, B V; McDermott, T M


    The objective of this article is to prospectively investigate the efficacy of amnioinfusion as a means to reduce febrile morbidity in pregnancies complicated by chorioamnionitis. All laboring patients with a temperature > or =100.1 degrees F were approached for study participation. Exclusion criteria included amnionitis diagnosed at greater than 8 cm dilation, multiple gestation, placental abruption, or a nonreassuring fetal heart rate tracing. Consenting patients were randomized to receive antibiotics (ampicillin or penicillin with gentamicin) and acetaminophen with or without amnioinfusion. All patients received intrauterine pressure catheter placement. For study patients, normal saline at room temperature was infused at 10 mL/min for 60 min, then 3 mL/min until delivery. Postpartum endometritis was defined as a temperature = 100.4 degrees F accompanied by uterine tenderness more than 12 hr after delivery. Statistical analysis was performed using the Student's t-test for continuous data and Chi-square for discrete variables. Thirty-six patients were enrolled, and complete data were available for 34 patients (17 in each group). There were no differences between groups with respect to maternal age, gravidity, race, or gestational age. There were also no differences between groups in duration of rupture of membranes, temperature at randomization, interval from randomization to delivery, cesarean section rate, or umbilical cord arterial pH. The mean temperature at the time of delivery was 99.8+/-0.9 degrees F for the amnioinfusion group versus 100.5+/-1.0 degrees F for the control group (p=0.046). Three of 17 amnioinfusion patients and 3 of 17 control patients had postpartum endometritis. There was 1 neonatal infection in the treatment group and no neonatal infections among the control patients. Prophylactic amnioinfusion was associated with a decline in temperature at the time of delivery. No untoward effects from the amnioinfusion were identified.

  1. Pre-breeding ovaro-uterine ultrasonography and its relationship with first service pregnancy rate in seasonal-calving dairy herds. (United States)

    Mee, J F; Buckley, F; Ryan, D; Dillon, P


    The objectives of the study were to characterize an ultrasound reproductive tract scoring (URTS) system to assess suitability for breeding in dairy cows, to describe the prevalence of these scores in commercial dairy herds and to examine their relationship with subsequent fertility. Ultrasound examinations (7797) were performed on 5751 Holstein-Friesian cows prior to breeding in 62 seasonally calving herds over 2 years. Data recorded from images of both ovaries and the uterus were combined into a six point scoring system and the prevalence of cows with cystic ovarian follicles and uterine abscesses and adhesions was recorded separately. The prevalence of ovulatory cows which had completed uterine involution (score 1), or had mild (2) or moderate endometritis (3) was 62.5%, 21.7% and 2.2%, respectively. The prevalence of anovulatory cows with moderate endometritis (4), ovulatory cows with pyometra (5) and anovulatory cows which had completed uterine involution (6) was 3.3%, 2.2% and 8.1%, respectively. The interval between calving and examination differed between cows with each of the scores 1, 2, 5 and 6 (61, 46, 53 and 50 days, respectively, p scores 3 and 4 (37 and 35 days, respectively). Ovulatory cows which had completed uterine involution (score 1) had a higher likelihood of pregnancy to first service than ovulatory or anovulatory cows which had not completed uterine involution (p reproductive tract was 3.9% and 1.2%, respectively. In conclusion, 29% and 11% of cows in seasonally calving and breeding dairy herds had not completed uterine involution or were anovulatory prior to the mating start date, respectively. Both conditions, detected using a URTS system, significantly reduced first service pregnancy rate in these pasture-based dairy herds.

  2. Meningitis neonatal e infección puerperal por Streptococcus pneumoniae: Presentación de un caso

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    Cecilia Ortiz Rodríguez


    Full Text Available Las infecciones neonatales causadas por Streptococcus pneumoniae constituyen un fenómeno raro, poco reportado en la literatura médica; en el presente trabajo se describe el caso de una meningoencefalitis purulenta de aparición precoz, en un neonato nacido por parto eutócico, a termino y de buen peso. Se aisló el microorganismo en la sangre y en el líquido cefalorraquídeo del recién nacido, así como en los loquios de la madre. Las 3 antibiotipias fueron idénticas. La evolución del niño fue desfavorable, el cual falleció a las 81 horas de vida, en un cuadro de fallo multiorgánico. La necropsia corroboró el diagnóstico. La madre desarrolló una endometritis puerperal a los 4 días, con buena evolución.Neonatal infections caused by Streptococcus pneumoniae are a rare phenomenon that is barely reported in the medical literature. The present paper describes a case of early purulent meningoencephalitis occurred in an adequate birthweight neonate born to term eutocic delivery. The microorganism was isolated in the newborn's blood and cerebrospinal fluid as well as in his mother's lochia. The three antibiotypes were identical. The newborn did not recover and died after 81 hours due to a multiple organ failure. Necropsy confirmed the diagnosis. The mother developed puerperal endometritis after 4 days but did recover.

  3. Evaluation of Efficacy of Herbal Intrauterine Infusion Uterofix Liquid in Treatment of Various Reproductive Disorders in Cows: A Field Study. (United States)

    Verma, Satinder; Choudhary, Adarsh; Maini, Shivi; Ravikanth, K


    To evaluate the efficacy of herbal intrauterine infusion Uterofix liquid in the treatment of various reproductive disorders in cows. Based on symptoms of endometritis, anestrous, metritis, and repeat breeders, 28 cows were selected to study the efficacy of herbal intrauterine infusion Uterofix liquid (M/S Ayurvet Limited) in uterine infections study. Group T0 (n = 8) cows served as control group, no treatment was given to this group, Group T1 (n = 5) repeat breeder cows, Group T2 (n = 5) endometritis effected cows, Group T3 (n = 5) anoestrus cows, and Group T4 (n = 5) metritis suffered cows were treated with Uterofix liquid (25 ml as intrauterine infusion once a day for 3-5 days). Total observational period was 60 days. Number of treatments needed, nature of discharge in first posttreatment estrus (physical examination), after treatment number of animal showing heat/estrus out of total treated, and posttreatment conception rate were used as criteria to judge the success or failure of treatment. Results revealed that 18 out of 20 animals (90%) showed signs of heat with clear discharge, recovered completely without causing any irritation, or severe irritation/sloughing of genital mucous membrane after Uterofix liquid treatment. Herbal intrauterine infusion Uterofix liquid significantly treated the uterine infections in cows. Uterine infection is a major problem in reproductive management. A wide variety of genital tract diseases of female domestic animals are known to produce significant losses and responsible for poor fertility. Amongst these highly prevalent are metritis and repeat breeding in high-producing dairy cows which if remains untreated are associated with low conception rate per artificial insemination (AI), extended interval to pregnancy, increased culling, and economic losses. As herbal remedy the Uterofix liquid (Ayurvet Limited, India) was highly efficacious as an intrauterine infusion to treat different reproductive disorders.

  4. Influence of energy balance on the antimicrobial peptides S100A8 and S100A9 in the endometrium of the post-partum dairy cow (United States)

    Swangchan-Uthai, Theerawat; Chen, Qiusheng; Kirton, Sally E; Fenwick, Mark A; Cheng, Zhangrui; Patton, Joe; Fouladi-Nashta, Ali A; Wathes, D Claire


    Uterine inflammation occurs after calving in association with extensive endometrial remodelling and bacterial contamination. If the inflammation persists, it leads to reduced fertility. Chronic endometritis is highly prevalent in high-yielding cows that experience negative energy balance (NEB) in early lactation. This study investigated the effect of NEB on the antimicrobial peptides S100A8 and S100A9 in involuting uteri collected 2 weeks post partum. Holstein-Friesian cows (six per treatment) were randomly allocated to two interventions designed to produce mild or severe NEB (MNEB and SNEB) status. Endometrial samples were examined histologically, and the presence of neutrophils, macrophages, lymphocytes and natural killer cells was confirmed using haematoxylin and eosin and immunostaining. SNEB cows had greater signs of uterine inflammation. Samples of previously gravid uterine horn were used to localise S100A8 and S100A9 by immunohistochemistry. Both S100 proteins were present in bovine endometrium with strong staining in epithelial and stromal cells and in infiltrated leucocytes. Immunostaining was significantly higher in SNEB cows along with increased numbers of segmented neutrophils. These results suggest that the metabolic changes of a post-partum cow suffering from NEB delay uterine involution and promote a chronic state of inflammation. We show that upregulation of S100A8 and S100A9 is clearly a key component of the early endometrial response to uterine infection. Further studies are warranted to link the extent of this response after calving to the likelihood of cows developing endometritis and to their subsequent fertility. PMID:23533291

  5. Perspective on physiological/endocrine and nutritional factors influencing fertility in post-partum dairy cows. (United States)

    Thatcher, W W; Santos, J E P; Silvestre, F T; Kim, I H; Staples, C R


    Increasing reproductive performance of post-partum lactating dairy cows is a multi-factorial challenge involving disciplines of production medicine, nutrition, physiology and herd management. Systems of programmed timed insemination have been fine-tuned to achieve pregnancy per artificial inseminations (AI) approximating 45%. Systems have optimized follicle development, integrated follicle development with timing of induced corpus luteum regression and fine-tuned sequential timing of induced ovulation and AI. Use of programmes for insemination have identified occurrence of anovulatory ovarian status, body condition, uterine health and seasonal summer stress as factors contributing to reduced herd fertility. Furthermore, programmes of timed insemination provide a platform to evaluate efficacy of nutritional and herd health systems targeted to the transition and post-partum periods. The homeorhetic periparturient period, as cows deal with decreases in dry matter intake, results in a negative energy balance and is associated with a period of immunosuppression. Cows that transition well will cycle earlier and have a greater risk of becoming pregnant earlier post-partum. The innate arms of the immune system (acute and adaptive) are suppressed during the periparturient period. Cows experiencing the sequential complex of disorders such as dystocia, puerperal metritis, metritis, endometritis and subclinical endometritis are subsequently less fertile. Targeted strategies of providing specific nutraceuticals that provide pro- and anti-inflammatory effects, such as polyunsaturated fatty acids (e.g., linoleic, eicosapentaenoic/docosahexaenoic, conjugated linoleic acid), sequential glycogenic and lipogenic enrichment of diets, and organic selenium appear to differentially regulate and improve the immune and reproductive systems to benefit an earlier restoration of ovarian activity and increased fertility. © 2010 Blackwell Verlag GmbH.


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    Risco Carlos


    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


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    Radhika Gollapudi


    2.24% of women and complex hyperplasia with atypia in 10.11%. Glandular stromal dissociation and endometrial polyp each were observed in 7.86% of patients. Disordered proliferative endometrium was observed in 4.49% of patients. Chronic endometritis was seen in 4.5% of cases, which included 2.2% of tuberculous endometritis. Endometrial carcinoma was observed in 2.24% of patients. CONCLUSIONS Organic causes of AUB vary according to the age group. Endometrial sampling by D and C is a simple, reliable outpatient procedure to diagnose endometrial lesions. Histopathological examination of the obtained material during the procedure can help in diagnosing the proliferative lesions at an early stage and subsequent treatment preventing its further progression.

  8. Interrupciones de embarazo en adolescentes. Problemática social y humanística Abortion in adolescence, a social and humanistic problem

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    Alejandro Fonseca León


    Full Text Available Se realizó un estudio observacional, analítico y transversal para evaluar el comportamiento del aborto en adolescentes y su significado como problema social y humanístico en el Hospital Materno Infantil Ana Betancourt de Mora de la ciudad de Camagüey desde el 2001 al 2008. De un universo constituido por 31 876 interrupciones de embarazos, 9 952 fueron en adolescentes las cuales representan el 31,2 por ciento constituyendo la muestra del estudio. La edad de la primera relación sexual fue entre los 14 y 17 años. El factor de riesgo más frecuente fue la infección vaginal en 6 478 casos. El olvido y el exceso de confianza los motivos para no usar métodos anticonceptivos en 5 639 jóvenes. Las complicaciones más usuales fueron la endometritis y los restos ovulares con 265 y 73 respectivamente. Las fuentes de educación sexual suelen ser los padres, amigos y los programas escolares. La prevención del aborto en la adolescencia constituye un pilar importante en la disminución de sus complicaciones como problema social y biológico.We carried out a cross-sectional, analytic, observational study to assess abortion behavior in adolescents and its significance as a social and humanistic problem at Camagüey’s Ana Betancourt de Mora Maternal Hospital from 2001 to 2008. Out of a universe comprised by 31 876 abortions, we selected a sample of 9 952 cases of adolescents having firstly experienced sex at ages 14 to 17, representing 31, 2 percent. Vaginitis was the most frequent risk factor with 6 478 cases. Oversight and overconfidence motivated lack of contraception use in 5 639 cases. Endometritis and ovular remnants were the most common complications with 265 and 73, respectively. Usually, parents, friends, and school programs are the sources of sex education. Prevention is an important pillar to reduce social and biological complications.

  9. The effect of nutritional management of the dairy cow on reproductive efficiency. (United States)

    Roche, James F


    The cause of low fertility in dairy cows is multifactorial. Poor nutrition during the dry and early postpartum periods results in reduced glucose, insulin, insulin-like growth factor (IGF-I) and low LH pulse frequency with concomitant increases in beta-hydroxy butyrate, non-esterified fatty acids (NEFA) and triacylglycerol. Cows must mobilize large lipid, but also some protein reserves, with a consequent increased incidence of such metabolic disorders as hypocalcaemia, acidosis, ketosis, fatty liver and displaced abomasums. The occurrence of milk fever and ketosis affects uterine contractions, delays calving and increases the risk of retained foetal membranes (RFM) and endometritis. The nutritional risk factors that cause RFM are hypocalcaemia, high body condition score (BCS) at calving and deficiencies in Vitamin E and selenium. The risk factors for endometritis are hypocalcaemia, RFM, high triacylglycerol and NEFA. Thus, metabolic disorders predispose cows to gynaecological disorders, thereby reducing reproductive efficiency. Cows that are overconditioned at calving or those that lose excess body weight are more likely to have a prolonged interval to first oestrus, thereby prolonging days open. Nutritionally induced postpartum anoestrus is characterized by turnover of dominant follicles incapable of producing sufficient oestradiol to induce ovulation due to reduced LH pulse frequency. High nutrition can also increase metabolic clearance rate of steroid hormones such as progesterone or oestradiol. Lower concentrations of oestradiol on the day of oestrus are highly correlated with the occurrence of suboestrus, thereby making the detection of oestrus in high yielding cows even more difficult. Nutrition also affects conception rate (CR) to AI. Cows that develop hypocalcaemia, ketosis, acidosis or displaced abomasums have lower CRs and take longer to become pregnant. Excessive loss of BCS and excess protein content of the ration can reduce CR while supplemental fats

  10. Mycoplasma genitalium: An Emerging Cause of Pelvic Inflammatory Disease

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    Catherine L. Haggerty


    Full Text Available Mycoplasma genitalium is a sexually transmitted pathogen that is increasingly identified among women with pelvic inflammatory disease (PID. Although Chlamydia trachomatis and Neisseria gonorrhoeae frequently cause PID, up to 70% of cases have an unidentified etiology. This paper summarizes evidence linking M. genitalium to PID and its long-term reproductive sequelae. Several PCR studies have demonstrated that M. genitalium is associated with PID, independent of gonococcal and chlamydial infection. Most have been cross-sectional, although one prospective investigation suggested that M. genitalium was associated with over a thirteenfold risk of endometritis. Further, a nested case-control posttermination study demonstrated a sixfold increased risk of PID among M. genitalium positive patients. Whether or not M. genitalium upper genital tract infection results in long-term reproductive morbidity is unclear, although tubal factor infertility patients have been found to have elevated M. genitalium antibodies. Several lines of evidence suggest that M. genitalium is likely resistant to many frequently used PID treatment regimens. Correspondingly, M. genitalium has been associated with treatment failure following cefoxitin and doxycycline treatment for clinically suspected PID. Collectively, strong evidence suggests that M. genitalium is associated with PID. Further study of M. genitalium upper genital tract infection diagnosis, treatment and long-term sequelae is warranted.

  11. Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour. (United States)

    Novikova, Natalia; Hofmeyr, G Justus; Essilfie-Appiah, George


    Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity. The objective of this review was to assess the effects of prophylactic amnioinfusion for women in labour with oligohydramnios, but not fetal heart deceleration, compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 February 2012). Randomised trials comparing prophylactic amnioinfusion in women in labour with oligohydramnios but not fetal heart rate deceleration in labour with therapeutic amnioinfusion. The authors assessed trial quality and extracted data. One randomized trial of 116 women was included. No differences were found in the rate of caesarean section (risk ratio 1.29, 95% confidence interval 0.60 to 2.74). There were no differences in cord arterial pH, oxytocin augmentation, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (risk ratio 3.48, 95% confidence interval 1.21 to 10.05). There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.

  12. Prevention of pregnancy complications in iran following implementing a national educational program.

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    Maryam Moghani Lankarani


    Full Text Available To determine the impact of a national intervention program on some pregnancy complications in Iran.This multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- (of 3,978 and 3,958 pregnancies and post- (3,958 pregnancies measurements were 18 months. Self reported data on pregnancy complications were registered. Interviews were conducted by trained personnel. Participants were interviewed when admitted for delivery or at the time attending for vaccination of their 2 month infants.The following pregnancy complications were reduced significantly as compared to before intervention: 1 bleeding or spotting, 2 urinary tract complications, 3 blurred vision and severe headache, 4 premature labor pain, 5 anemia, 6 severe vomiting, 7 inappropriate weight gain, 8 endometritis, 9 urinary incontinence, 10 breast abscess or mastitis, 11 wound infection, and 12 bleeding was significantly reduced after intervention, compared to before intervention. Premature rupture of membrane showed a significant increase. These complications did not show a significant change: 1 hypertension, 2 fever and chills, 3 convulsion, shock, and loss of consciousness, and 4 obstetric fistula.National programs may be proved to be largely effective by decreasing some of the pregnancy complications in developing countries.

  13. Does vitamin C and vitamin E supplementation prolong the latency period before delivery following the preterm premature rupture of membranes? A randomized controlled study. (United States)

    Gungorduk, Kemal; Asicioglu, Osman; Gungorduk, Ozgu Celikkol; Yildirim, Gokhan; Besimoğlu, Berhan; Ark, Cemal


    To determine whether maternal vitamin C and vitamin E supplementation after the premature rupture of membranes is associated with an increase in the latency period before delivery. In the present prospective open randomized trial, 229 pregnant women with preterm premature rupture of membranes (PPROM) at ≥ 24.0 and vitamin C and 400 IU of vitamin E (n = 126) or a placebo (n = 123). The primary outcome was the latency period until delivery. Analysis was performed on an intention-to-treat basis. No significant differences in demographic or clinical characteristics were observed between the groups. Latency period until delivery was significantly higher in the group that received vitamins compared with the control group (11.2 ± 6.3 days versus 6.2 ± 4.0 days; p vitamin group compared with the control group (31.9 ± 2.6 weeks versus 31.0 ± 2.6 weeks; p = 0.01). No significant differences in adverse maternal outcome (i.e., chorioamnionitis or endometritis) or neonatal outcome (i.e., neonatal sepsis, neonatal death, necrotizing enterocolitis, or grade 3 to 4 intraventricular hemorrhage) were noted between groups. The findings of the present study suggest that the use of vitamins C and E in women with PPROM is associated with a longer latency period before delivery. Moreover, adverse neonatal and maternal outcomes, which are often associated with prolonged latency periods, were similar between the groups. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. A veterinary perspective of on-farm evaluation of nutrition and reproduction. (United States)

    Studer, E


    Reproductive herd health programs of the 1960s and 1970s focused primarily on the control of infectious and noninfectious diseases of the reproductive tract, estrus detection, breeding technique, semen quality and handling, and endocrine imbalances. Despite veterinary intervention, conception rates dropped from 55% before this period to 45% after this period, but milk production increased greatly. Because studies have shown that the additional nutritional needs for high producing cows may be a factor limiting reproduction, bovine practitioners have become more involved with dairy nutrition. New emphasis has been placed on the concept of total production medicine with the anticipation that improved nutrition would improve reproduction. Because of a better understanding of the dynamics of energy in the dairy cow and its effect on reproduction, fertility examinations now include nutrition monitoring and body condition scoring. Several relationships between nutrition and fertility have been identified: high producing thin cows that drop 0.75 to 1.0 in body condition score resulting in anestrus; fat dry cows that develop fatty livers and associated postpartum disease; heifers that have good milk production but prolonged anestrus; dry cows with ration imbalances during the transition period that develop milk fever, retained placenta, displaced abomasum, metritis, or endometritis; lactating cows with disease in midlactation, especially feet and leg problems, resulting in lowered fertility; and healthy, lactating cows with poor conception that have high concentrations of urea N in blood or milk.

  15. Radiosterilisation of the vagina in therapeutic doses - does it exist

    International Nuclear Information System (INIS)

    Gerstner, G.; Kucera, H.; Weghaupt, K.; Rotter, M.; Vienna Univ.


    The endogenous genital flora is a major source of infections of the female genital tract, especially in patients with cervical or endometrial cancer. Until recently the 'radiosterilisation of the vagina', respectively a prophylactic and/or therapeutic effect of irradiation (external highvoltage as well as intracavitary-radium) concerning infections was postulated in the literature. This theory was disproved in a prospective clinical and bacteriological study covering 48 patients with advanced cervical cancer undergoing primary intracavitary radium-irradiation and 38 patients with inoperable endometrical cancer, undergoing primary iridium-192-afterloading. Following intracavitary radium for cervical cancer some typical nosocomial pathogens like Streptococcus faecalis, Enterobacter, Klebsiella, Proteus and Pseudomonas were isolated significantly more frequently than before treatment. Likewise, the mean number of aerobic bacterial species increased significantly after irradiation. Also primary Ir-192 (afterloading) irradiation did not alter the frequency of isolation of the resident flora in endometrial cancer patients. Therefore, 'radiosterilisation' of the vagina as result of radiotherapy does not exist. (orig.) [de

  16. Genital Chlamydia trachomatis: An update

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    Meenakshi Malhotra


    Full Text Available Chlamydia trachomatis is the most common cause of curable bacterial sexually transmitted infection (STI worldwide. It manifests primarily as urethritis in males and endocervicitis in females. Untreated chlamydial infection in man can cause epididymitis and proctitis. Though most women with Chlamydia infection are asymptomatic or have minimal symptoms, some develop salpingitis, endometritis, pelvic inflammatory disease (PID, ectopic pregnancy and tubal factor infertility. It is associated with an increased risk for the transmission or acquisition of HIV and is also attributed to be a risk factor for the development of cervical carcinoma. Early diagnosis and treatment of infected individuals is required to prevent the spread of the disease and severe sequelae. Traditionally, tissue culture was considered the gold standard for the diagnosis. However, with the availability of newer diagnostic techniques particularly molecular methods which are not only highly sensitive and specific but are cost-effective also, the diagnosis has became fast and easy. The purpose of this review is to study the various aspects of genital C. trachomatis infection. Also the advances related to the clinical picture, various diagnostic modalities, prevention, treatment, drug resistance and control measures will be dealt with.

  17. Detection of Mycoplasma genitalium in female cervical samples by Multitarget Real-Time PCR

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    Sabina Mahmutović-Vranić


    Full Text Available Mycoplasma genitalum (MG is associated with variety of urogenital infections such as non-gonococcal urethritis (NGU, endometritis and cervicitis. The objective of this study was to demonstrate and evaluate a research polymerase chain reaction (PCR assay, for the detection of MG in cervical samples of a tested population of women attending gynecology clinics in Bosnia and Herzegovina. The Multitarget Real-Time (MTRT PCR, utilizing the ABI 7900HT, the sequence detection system, was performed for the detection of MG. Cervical samples (N=97 from females were divided into three types of patient groups: Group 1: patients who had known abnormal clinical cytology reports (N=34; Group 2: patients who reported a history of genitourinary infections (N=22; and Group 3: patients not in either groups 1 or 2 (N=41. Overall, 14,43% (14/97 of those tested were positive for MG. A positive sample was defined as having a cycle threshold cross point (Ct < 40,0 with a fluorescent detection comparable to the low positive control utilized during the run. This study validated the use of MTRT PCR as a reliable method for the detection of MG in clinical specimens and should facilitate large-scale screening for this organism.

  18. Maternal morbidity and mortality associated with delivery after intrauterine death

    International Nuclear Information System (INIS)

    Ifnan, F.; Jameel, M.B.


    To determine the maternal morbidity and mortality associated with delivery after intrauterine fetal death (IUFD) and to find out the place of fetal destructive procedures and cesarean section. All women were included in the present study who presented before the onset of labour pains, after intrauterine fetal death at 26 weeks or onward with singleton pregnancy. Assessment of maternal demographic characteristics, gestational age at fetal demise, delivery-IUFD interval, mode of delivery; vaginal with or without fetal destructive procedures/cesarean section and maternal complications were the main outcome measures. There were 1834 live birth and 63 deliveries with intrauterine fetal death. Mode of delivery was vaginal in 87.4% and cesarean section in 12.6% of the cases. Twelve (21%) of the vaginal deliveries were complicated by lower urogenital tract injuries in certain cases, whereas 75% (6/8) of patients delivered by cesarean section developed major postoperative complications like postpartum haemorrhage, shock, endometritis, peritonitis and wound dehiscence. No maternal death was identified. Rate of delivery with intrauterine fetal death was 34.3/1000 live-birth deliveries. (author)

  19. Toll-like receptors and their role in animal reproduction. (United States)

    Kannaki, T R; Shanmugam, M; Verma, P C


    Toll-like receptors (TLRs) are evolutionarily conserved innate immune receptors that recognize pathogen specific molecular pattern (PAMPs) in an efficient, non-self-reactive manner and initiate specific immune signaling that culminates in triggering antigen-specific adaptive responses. Different TLR genes in domestic animal species have been characterized and accumulating evidence from recent studies indicates an extended role for TLR signaling in reproductive physiology. In females, TLRs have been implicated in the regulation of ovulation, fertilization, gestation and parturition, as well as in pathological conditions such as endometritis and mastitis. In males, TLRs play a role in steroidogenesis and spermatogenesis. Use of TLR agonists has also been shown to be effective in the treatment of certain reproductive tract infections. Moreover, gene polymorphisms in TLRs have been associated with mastitis providing evidence that TLRs can potentially be exploited as markers in future breeding programs. The aim of this review is to provide a comprehensive treatise on role of TLRs in male and female reproductive physiology and associated pathology in domestic livestock. Copyright © 2011. Published by Elsevier B.V.

  20. Diagnosis of post-partum ovarian vein thrombophlebitis by color Doppler ultrasonography: about 10 cases. (United States)

    Giraud, J R; Poulain, P; Renaud-Giono, A; Darnault, J P; Proudhon, J F; Grall, J Y; Mocquet, P Y


    Post-partum ovarian vein thrombosis is often overlooked or mistaken for other complications such as endometritis. Color Doppler ultrasonography is a very good diagnostic method when properly indicated and correctly interpreted according to clinical data. This study reports ten cases that were retrospectively studied, during which color Doppler ultrasonography was used. The clinical signs and the results are reviewed. The lesions were clearly visualized in eight of the ten cases; one of the two failures resulted from a methodological fault (uninterpretable result); the other one was due to the lack of experience of the operator and nonrecognition of the clinical signs. Thrombosis appears as a hypoechogenic and tubular image. This type of examination is particularly indicated in the presence of certain clinical signs that were observed in our cases: fever and iliac pain are the main precursor signs, often associated with abdominal meteorism and slow digestive transit; provoked cul-de-sac pain during vaginal probing was the only constant sign, sometimes associated with painful swelling.

  1. Search for the lowest irradiation dose from literatures on radiation-induced cancer in uterus

    International Nuclear Information System (INIS)

    Yoshizawa, Yasuo; Kusama, Tomoko


    A survey of past case reports on radiation-induced cancer of the uterus was carried out with the main object of finding the lowest irradiation dose. Search of literature published since 1912 revealed 548 cases of radiation-induced cancer of the uterus. All of these cases of radiation-induced cancer had received radiation for the treatment of non-malignant disease. The primary gynecological conditions which were the object of radiation therapy were functional bleeding, endometrial hyperplasia, myoma, endometritis, and polyps. The lowest irradiation dose was estimated at 1000-1450 rad in the case of external X-ray irradiation, and 100 for intrauterine radium therapy, which corresponds to 100-1000 rad. It was noted that were more cases of corpus cancer than cervical cancer. Histopathological findings of radiation-induced uterine cancer were carcinoma, sarcoma, and mixed mesodermal tumors. The latent period was distributed in the range of 1 to 40 years, with the average of 10.1 years. (auth.)

  2. The ultrasonographic findings of acute pelvic inflammatory disease

    International Nuclear Information System (INIS)

    Choi, Yeon Nam; Park, Jai Soung; Lee, Hae Kyung; Chung, Moo Chan; Lee, Beong Ho; Kim, Ki Jung


    Although ultrasonographic findings of female pelvic mass are frequently reported, those of acute PID are not well established. But differentiation of fluid collection and mass lesion of PID is exactly made by ultrasonography. We analysed the ultrasonographic findings in 26 cases of acute PID having satisfactory operative or histological proofs, examined at Soonchunhyang University Hospital from Oct. 1985 to Feb. 1987. The results were as follows: 1. The age was ranged from 17 years to 53 years of age and the majority was between 21 years and 50 years of age. 2. Ultrasonographic findings are classified to fluid collection in cul de sac 17, tuboovarian abscess, 7 pyosalpix 2, endometritis 1 and normal 2 cases. 3. In cases of pelvic mass formation, their ecnogenecity were cystic form in 6 cases (22%), mixed form in 19 cases (71%), solid form in 2 cases (7%), and shapes were mainly ovoid with irregular, ill-defined margin. The location of mass is unilateral in 17 cases (63%) bilateral in 10 cases (37%)

  3. Search for the lowest irradiation dose from literatures on radiation-induced cancer in gastrointestinal tract

    International Nuclear Information System (INIS)

    Yoshizawa, Yasuo; Kusama, Tomoko


    A survey of past case reports about radiation-induced cancer in the gastrointestinal tract was carried out with the main object of finding the lowest irradiation dose. Search of the literature published since 1923 revealed 80 cases of radiation-induced large intestine cancer and one case of stomach cancer. The cases of radiation-induced cancer in the large intestine had received radiation for the treatment of non-malignant conditions, fibroma, ovarial cyste, myoma, endometritis and duodenal ulcer. The lowest irradiation dose was estimated at 460 rads. Adenocarcinoma was the histopathological finding in all cases of radiation-induced cancer in the caecum, colon and rectum, and squamous cell carcinoma in the cases of anal cancer. The latent period ranged from 1 to 31 years, with the average of 13.6 years. There were some reports of statistical studies of radiation-induced stomach cancer. Three groups were the subjects of these studies. The first group was composed of atomic bomb survivors, the second of patients who had undergone radiation treatment for ankylosing spondilitis, and the third of duodenal ulcer patients subjected to radiation treatment for the purpose of suppressing gastric acid secretion. These statistical studies showed no significant increase of the incidence of stomach cancer in the irradiated groups. (auth.)

  4. Dosimetry of irradiation models. The 96-well clonogenic assay for testing radiosensitivity of cell lines

    International Nuclear Information System (INIS)

    Kulmala, J.; Rantanen, V.; Turku Univ.; Pekkola-Heino, K.; Turku Univ.; Tuominen, J.; Grenman, R.; Turku Univ.


    Radiation experiments with cells in single cell suspension in test tubes and on 96-well plates were carried out and compared. The cells originated from cell lines established from carcinomas of the floor of the mouth and from endometrical carcinoma. Two irradiation models were constructed. Both models allowed the absorbed doses to the cells to be administered with a high accuracy in both experimental settings (better than 5.0%). These irradiation models were compared on cancer cell lines with dissimilar inherent radiation sensitivity and histologic type (UM-SCC-1 resistant, UM-SCC-14A sensitive, and UT-EC-2B highly sensitive); various radiation doses were used. The fractions of surviving cells as a function of radiation dose were compared: there was no significant difference between cells irradiated in test tubes and cells irradiated in 96-well plates. Thus, if the absorbed doses in cells suspended in a tube and in a plate were the same, the survival was similar regardless of the type of irradiation model. (orig.)

  5. Estrogen biosynthesis in human uterine adenomyosis

    International Nuclear Information System (INIS)

    Urabe, Mamoru; Yamamoto, Takara; Kitawaki, Jo; Honjo, Hideo; Okada, Hiroji


    Estrogen biosynthesis (aromatiase activity) was investigated in human adenomyosis tissue and compared with that of the normal myometrium, endometrium, and endometrical cancer tissues. Homogenates were incubated with [1,2,6,7- 3 H]androstenedione and NADPH at 37 deg. C for 1 h. After stopping the enzymatic reaction with ethyl acetate, [4- 14 C]estrone and [4- 14 C]estradiol-17β were added to the incubated sample. Estrone and estradiol were purified and identified by Bio-Rad AG1-X2 column chromatography, thin-layer chromatography and co-crystallization. Estrogen formed in the incubated sample was calculated from the 3 H/ 14 C ratio of the final crystal. The value for estrone formed from androstenedione was 52-132 fmol . h -1. g -1 wet weight. Aromatase activity in the adenomyosis tissues was higher than that in normal endometrial or myometrial tissues, but lower than that found in myometrial or endometrial tumour tissue. Furthermore, we investigated the effect of danazol, progresterone, and medroxyprogesterone acetate on adenomyosis cells in primary cultures. Aromatase activity in adenomyosis was blocked by danazol, but stimulated by progesterone and MPA. These results indicate that aromatase activity in adenomyosis may contribute to the growth of the ectopic endometrial tissue which occurs in this disease. (author)

  6. Frequency of primary uterine malignancy in hystrectomy specimens of postmenopausal women - a study of 255 cases at combined military hospital peshawar

    International Nuclear Information System (INIS)

    Bashir, S.; Bashir, J.


    Objective: To determine the frequency of primary uterine malignancy in hysterectomy specimens in women with postmenopausal bleeding. Study Design: A descriptive cross-sectional study. Place and Duration of study: It was conducted in the department of histopathology at Combined Military Hospital, Peshawar from 1st September 2010 to 31st May 2011. Material and Methods: A total of 255 hysterectomy specimens of postmenopausal women were examined grossly and microscopically to analyse the underlying pathology. Results: The mean age of patients with malignant diseases was 56.4 years and with benign diseases 49.3 years. Out of 255 patients 215 (95.6%) were found to have benign pathologies and 10 (4.4%) had malignant lesions. The frequency and histological pattern of primary uterine malignancy was; endometrial carcinoma 3.1%, cervical carcinoma 0.9% and leiomyosarcoma 0.4%. The benign pathologies included leiomyoma 35.6%, atrophic endometritis 16.4%, endometrial hyperplasia 15.1%, adenomysis 11.1%, endometrial polyp 10.2%, adenomyoma 6.7% and endometrial stromal nodule 0.4%. Conclusion: This study shows that frequency of malignancy in postmenopausal women is low in our set up and most of the underlying pathologies are benign. The most frequent malignancy found in postmenopausal women is endometrial carcinoma followed by cervical carcinoma. (author)

  7. An experimental study on tissue reaction of various contrast agents on endometrium, tuber mucosa, and peritoneum

    International Nuclear Information System (INIS)

    Kim, Jae Seung; Kim, Seung Hyup; Park, In Ae; Park, Jae Hyung; Yoon, Dae Young; Yeon, Kyung Mo


    To compare the tissue reactions of various water-soluble and oil-based contrast agents on the endometrium, salpingeal mumosa, and peritoneum. Thirty-three rabbits were used for evaluating the histologic reactions of uterine endometrium, salpinx, and peritoneum. Hysterosalpingography(HSG) was underwent in these rabbits by used Lipiodol, Hexabrix, Rayvist. Ultravist-300, Ultravist-370, and normal saline. Pathologic results were obtained in each of the six groups from the uterine endometrium, salpingeal mucosa, and peritoneum without knowledge of the contrast agent used and time interval from HSG. Mild inflammations were observed in the endometrium, salpingeal mucosa, and peritoneum during the first week of HSG in all rabbits in which water-soluble contrast agents were used. Although there was no significant difference in the degree of inflammation among the groups using various contrast agents, the group with oil-based contrast agent(Lipiodol) showed delayed absorption of contrast agent in the peritoneum, frequent intravasation, fat granuloma, peritoneal adhesion, or uterine infarction. Our results suggest that water-soluble contrast agents can be used safely for HSG, but the use of oil-based contrast agent is questional in safety and should be avoid in patients with tubal obstruction, salpingitis, or endometritis

  8. Validity of pipelle endometrial sampling in the patients with abnormaluterine bleeding

    International Nuclear Information System (INIS)

    Fakhar, S.; Saeed, G.; Khan, A.H.; Alam, A.Y.


    We compared endometrial sampling by pipelle endometrial curette withconventional dilatation and curettage (D and C) in patients with abnormaluterine bleeding. Endometrial sampling with pipelle curette was performed on100 patients followed by formal D and C. Samples were labeled as A and B,respectively, and sent to a histopathologist who was blinded as to the methodof sampling. The histopathology reports of both samples were compared, takingD and C as the gold standard. An adequate sample was obtained in 98% of casesby pipelle and in 100% of cases by D and C. Pipelle had sensitivity,specificity, positive predictive value of 100% for diagnosing endometrialcarcinoma, hyperplasia and secretory endometrium. Pipelle also had highdiagnostic sensitivity, specificity and negative predictive value (100%, 98%and 100%, respectively) for hyperplasia with atypia and low sensitivity (57%)and positive predictive value (57%), but high specificity (97%) and negativepredictive value (97%) for endometritis. Similarly, for proliferativeendometrium, the pipelle technique had values of 94% and 93% for sensitivityand specificity, respectively. Both samples labeled as inadequate forhistology by pipelle were polyps on the D and C report. Difficultendotracheal intubation was encountered in two cases of D and C. No othercomplications of the procedure were observed. The pipelle is a safe devicefor getting an adequate endometrial sample for histology, with a highsensitivity and specificity for detection of hyperplasia and malignancy.(author)

  9. Bias associated with delayed verification in test accuracy studies: accuracy of tests for endometrial hyperplasia may be much higher than we think!

    Directory of Open Access Journals (Sweden)

    Coomarasamy Aravinthan


    Full Text Available Abstract Background To empirically evaluate bias in estimation of accuracy associated with delay in verification of diagnosis among studies evaluating tests for predicting endometrial hyperplasia. Methods Systematic reviews of all published research on accuracy of miniature endometrial biopsy and endometr ial ultrasonography for diagnosing endometrial hyperplasia identified 27 test accuracy studies (2,982 subjects. Of these, 16 had immediate histological verification of diagnosis while 11 had verification delayed > 24 hrs after testing. The effect of delay in verification of diagnosis on estimates of accuracy was evaluated using meta-regression with diagnostic odds ratio (dOR as the accuracy measure. This analysis was adjusted for study quality and type of test (miniature endometrial biopsy or endometrial ultrasound. Results Compared to studies with immediate verification of diagnosis (dOR 67.2, 95% CI 21.7–208.8, those with delayed verification (dOR 16.2, 95% CI 8.6–30.5 underestimated the diagnostic accuracy by 74% (95% CI 7%–99%; P value = 0.048. Conclusion Among studies of miniature endometrial biopsy and endometrial ultrasound, diagnostic accuracy is considerably underestimated if there is a delay in histological verification of diagnosis.

  10. The Microbiota of the Vagina and Its Influence on Women’s Health and Disease (United States)

    Martin, David H.


    Explorations of the vaginal microbiota (VMB) began over 150 years ago. Using light microscopy and bacterial cultures the concept of normal versus abnormal microbiotain women began to emerge. The latter became known by the term “bacterial vaginosis” or BV. BV microbiota is dominated by Gardnerella vaginalis and includes a number of anaerobic organisms. In contrast normal flora is dominated various Lactobacilli. BV microbiota is associated with vaginal discharge, poor pregnancy outcomes, pelvic inflammatory disease, post-operative wound infections, and endometritis following elective abortions. Additionally, BV flora predisposes women to infection by HIV as well as other STDs. Application of molecular techniques over the last decade has significantly advanced our understanding of the VMB. It is far more complex than previously recognized and is comprised of many previously unknown organisms in addition to those already identified by culture. Analyses using high-throughput sequencing techniques have revealed unique microbial communities not previously recognized within the older, established vaginal flora categories. These new findings will inform the design of future clinical investigations of the role of the VMB in health and disease. PMID:22143133

  11. Bacterial vaginosis in association with spontaneous abortion and recurrent pregnancy losses

    Directory of Open Access Journals (Sweden)

    Gözde Isik


    Full Text Available Context: Bacterial vaginosis (BV is related to the increased risk of miscarriage, preterm labor, and postpartum endometritis. Aims: The aim of this study was to evaluate the association between BV and the history of spontaneous abortion and recurrent pregnancy losses. We also examined periods of gestation, including the first and second trimester miscarriages. Materials and Methods: The study population consisted of 200 fertile women. Sixty one (30.5% of 200 women had the history of a spontaneous abortion in the last six months (N = 30 and at least three recurrent pregnancy losses (N = 31. BV was diagnosed either by using Papanicolaou staining, Gram staining, or by culturing with BV-associated bacteria, Gardnerella vaginalis. Results: The presence of BV was statistically associated with the history of a spontaneous abortion in the last 6 months (P 0.05. These women were also evaluated in view of periods of gestation. Forty-seven (77% of 61 women had first trimester miscarriage (≤12 weeks and 14 (23% of 61 women had second trimester miscarriage (>12 weeks. There was a statistically significant relationship between BV and second trimester miscarriage (P 0.05. Conclusion: BV may contribute to spontaneous abortion and second trimester miscarriage.

  12. Investigations on brucellosis in Egyptian Baladi Does with emphasis on evaluation of diagnostic techniques. (United States)

    el-Razik, K A Abd; Desouky, H M; Ahmed, W M


    Investigations were carried out on caprine brucellosis in a costal area in Egypt. A total number of 577 Baladi Does was examined for Brucella infection using different serological tests. Specimens were taken from seropositive obligatory slaughtered Does (No = 33) for Brucella isolation, histopathological examination, Polymerase Chain Reaction (PCR) assay and determination of serum copper (Cu), zinc(Zn) and iron (Fe) concentrations. Results indicated that the incidence of brucellosis was 3.0-5.0%, by using the different serological tests. Buffered Acidified Plate Antigen Test (BAPAT) is of the highest sensitivity followed by Rose Bengal Plate Test (RBPT), L-ELISA, Complement Fixation Test (CFT), P-ELISA, Rivanol test (RVT) and Tube Agglutination Test (TAT). In seropostive Does, Brucella melitensis biovar 3 was isolated from 78.78% and PCR yielded expected products in 81.81%. Moreover, granulomatous endometritis, lymphocytic mastitis and lymphoid depletion in both lymph nodes and spleen were evident together with significant (p<0.001) decreases in serum Cu, Zn and Fe concentrations. In conclusion, more attention should be paid to goat in brucellosis epidemiology in the application of national program of brucella control and eradication.

  13. Stress and its effects on horses reproduction

    Directory of Open Access Journals (Sweden)

    Amal M. AboEl-Maaty


    Full Text Available A total of 90 mares and horses were subjected to blood sampling for determining the effect of management (farm, reproductive condition, sex, age, breed and month of the year during breeding on circulating levels of cortisol and sex hormones. Blood samples were collected from December to the following June from four farms. Blood sera underwent testosterone, estradiol, progesterone and cortisol assaying using ELISA kits. Cortisol levels were significantly low in lactating mares during their foal heat but significantly high levels were recorded in both repeat breeder mares and horses used for racing. High and significant testosterone and estradiol levels were recorded in both stallions used for breeding especially after semen collection and early pregnant mares. Similar testosterone levels were recorded in both early pregnant mares and racing horses but high levels were recorded in stallions. Estradiol was high in both early pregnant and mares with endometritis but the highest levels were observed in stallions. Horses held in private farms had high cortisol levels compared to those of governmental farms. In contrast to mares, horses had low cortisol and high estradiol levels. Cortisol levels were high from April to June (Spring and early summer compared to its levels from December to March (Winter. Arab horses had low cortisol compared to native and imported foreign breeds. In conclusion, environmental condition, exercise, breed, management and the purpose of raising horses all are affecting its cortisol levels.

  14. Distribution and chloramphenicol in the bovine genital tract and pharmacokinetic studies of florfenicol in cattle

    International Nuclear Information System (INIS)

    Bretzlaff, K.N.


    The objectives were to investigate selected aspects of the distribution of chloramphenicol (CAP) in the bovine genital tract and to conduct preliminary pharmacologic studies with florfenicol (FLO), a fluorinated analogue of thiamphenicol, in cattle. After 8 hours' continuous intravenous (IV) infusion of CAP to 7 postpartum cows, steady state plasma-to-genital tissue ratios of CAP were approximately 3. After intrauterine infusion of 20 mg CAP/kg to 3 postpartum cows, approximately 40% of the dose was absorbed into the bloodstream. Tissue concentrations were high at 8 hour postdosing in tissues lining the uterine lumen but were below desired therapeutic concentrations in the myometrium of 2 of the cows. Eighty cows with retained fetal membranes (RFM) were assigned to receive on the following treatments: (1) removal of membranes only; (2) removal plus CAP; (3) nonremoval; (4) nonremoval plus CAP. CAP treatment consisted of 5 g administered IU twice daily for 3 days. The majority of cows in all groups acquired endometritis, although CAP reduced the prevalence and severity of the disease. A quantitative assay for FLO in plasma was developed and validated on a high performance liquid chromatographic (HPLC) system. The pharmacokinetics of FLO determined after IV administration of 50 mg FLO/kg to 5 cows were best described by a three-compartment model. FLO was approximately 18% bound to plasma proteins as determined by equilibrium dialysis and ultrafiltration. In an in vitro system, 5, 125, or 1000 ug/ml of CAP had no effect on neutrophils from 6 cows

  15. [Hospital infection in the maternity department. 3 years of surveillance in 9,204 deliveries of which 1,333 were cesarean sections]. (United States)

    Tissot-Guerraz, F; Moussy, L; Agniel, F; André, A; Reverdy, M E; Miellet, C C; Audra, P; Putet, G; Sepetjan, M; Dargent, D


    Hospital or nosocomial infection, or infection acquired in hospitals, is a health problem in all hospital departments and particularly in the maternity department. We report on a prospective survey of surveillance of hospital-acquired infections both from the mother and the baby's point of view after delivery vaginally or with caesarean carried out at the obstetrical clinic of the Edouard Herriot Hospital in Lyon (France) over three successive years with a series of 9,204 deliveries. The incidence of infection in women who were delivered without caesarean section was 1.37% when urinary tract infections had been excluded but 13% in women who had caesarean sections. Endometritis, skin infections and urinary tract infections were the leading causes. As far as the newborn were concerned, hospital infection ran at about 2.60% and this in the main was due to staphylococcal pustules in the skin. These figures are still too high and prevention should be based on more information given and more care taken by the whole staff of such a hospital.

  16. Antibiotic prophylaxis at elective cesarean section: a randomized controlled trial in a low resource setting. (United States)

    Kandil, Mohamed; Sanad, Zakaria; Gaber, Wael


    To determine the best time to administer prophylactic antibiotics at Cesarean delivery in order to reduce the postoperative maternal infectious morbidity in a low resource setting. One hundred term primigravidae with singleton pregnancy were recruited and randomly allocated to two equal groups. Each woman received 2 g intravenous Cefazoline. Women in Group I received it prior to skin incision while those in Group II had it immediately after cord clamping. We measured the following outcome parameters: (1) Surgical site wound infection; (2) Endometritis and (3) Urinary tract infection. There was no significant difference in any of the patients' characteristics between both groups. In Group I, three cases developed surgical site infections but four in Group II (p > 0.05). In Group I, the infected cases had Cesarean because of malpresentations while in Group II, two cases had Cesarean because of patients' request, one because of maternal heart disease and one due to intra-uterine growth restriction. Seven and nine cases had urinary tract infection in Groups I and II, respectively, (p > 0.05). Prophylactic antibiotic administration either prior to surgery or after cord clamping is probably equally effective in reducing the postoperative infectious morbidity after Cesarean in low resource settings.

  17. Arcanobacterium pyogenes: Virulence factors, importance in mastitis etiology and therapeutic (impossibilities

    Directory of Open Access Journals (Sweden)

    Milanov Dubravka


    Full Text Available Arcanobacterium pyogenes is an opportunistic pathogen, a causative agent of suppurative infections of organs and tissues in economically important livestock species. Most frequently this bacteria is isolated from inflamed lung lesions in pigs and cattle, in samples of uterine mucus of cows with endometritis and milk from cows with clinical mastitis. A. pyogenes possesses a number of virulence factors: cholesterol-dependent cytolysin (pyolysin, two neuraminidases, several proteases, extracellular matrix-binding proteins, DNases, fimbriae. The virulence factors are well studied in laboratory conditions, but the role of these factors in the pathogenesis of A. pyogenes infections remains to be elucidated. Lately, the ability of A. pyogenes to form biofilm in vivo has also been implicated as a virulence factor and a possible cause of therapeutic failure. Despite the fact that A. pyogenes milk isolates in cows with mastitis in vitro are very sensitive to β-lactam drugs and tetracycline, experience has shown that therapy is usually ineffective, prognosis is poor and the affected quarter is lost for milk production.

  18. Relationships among ketosis, serum metabolites, body condition, and reproductive outcomes in dairy cows. (United States)

    Shin, Eun-Kyung; Jeong, Jae-Kwan; Choi, In-Soo; Kang, Hyun-Gu; Hur, Tai-Young; Jung, Young-Hun; Kim, Ill-Hwa


    We determined the relationships among ketosis, serum metabolites, body condition, and reproductive disorders and performance in dairy cows. Blood samples from 213 dairy cows were collected at 4 and 2 weeks prepartum, just after calving, and at 1, 2, 4, 6, and 8 weeks postpartum to measure serum β-hydroxybutyrate, nonesterified fatty acids (NEFAs), glucose, total cholesterol, urea nitrogen, aspartate aminotransferase, γ-glutamyltransferase, and progesterone concentrations. Cows were grouped on the basis of the β-hydroxybutyrate concentration at 1 and/or 2 weeks postpartum into two groups: the ketotic group (≥1200 μmol/L, n = 59) and the nonketotic group (50% pus), and subclinical endometritis was diagnosed by evaluation of uterine cytology (>18% neutrophils) at 4 weeks postpartum. Ovarian cysts were diagnosed by ultrasonography, and resumption of postpartum cyclicity was evaluated by progesterone concentrations (≥1 ng/mL) at 4, 6, and 8 weeks postpartum. In the ketotic group, NEFA levels were higher (P ≤ 0.0005), whereas glucose (P ketosis, increased reproductive disorders, and decreased reproductive performance in dairy cows. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. A systematic health assessment of indian ocean bottlenose (Tursiops aduncus and indo-pacific humpback (Sousa plumbea dolphins incidentally caught in shark nets off the KwaZulu-Natal Coast, South Africa.

    Directory of Open Access Journals (Sweden)

    Emily P Lane

    Full Text Available Coastal dolphins are regarded as indicators of changes in coastal marine ecosystem health that could impact humans utilizing the marine environment for food or recreation. Necropsy and histology examinations were performed on 35 Indian Ocean bottlenose dolphins (Tursiops aduncus and five Indo-Pacific humpback dolphins (Sousa plumbea incidentally caught in shark nets off the KwaZulu-Natal coast, South Africa, between 2010 and 2012. Parasitic lesions included pneumonia (85%, abdominal and thoracic serositis (75%, gastroenteritis (70%, hepatitis (62%, and endometritis (42%. Parasitic species identified were Halocercus sp. (lung, Crassicauda sp. (skeletal muscle and Xenobalanus globicipitis (skin. Additional findings included bronchiolar epithelial mineralisation (83%, splenic filamentous tags (45%, non-suppurative meningoencephalitis (39%, and myocardial fibrosis (26%. No immunohistochemically positive reaction was present in lesions suggestive of dolphin morbillivirus, Toxoplasma gondii and Brucella spp. The first confirmed cases of lobomycosis and sarcocystosis in South African dolphins were documented. Most lesions were mild, and all animals were considered to be in good nutritional condition, based on blubber thickness and muscle mass. Apparent temporal changes in parasitic disease prevalence may indicate a change in the host/parasite interface. This study provided valuable baseline information on conditions affecting coastal dolphin populations in South Africa and, to our knowledge, constitutes the first reported systematic health assessment in incidentally caught dolphins in the Southern Hemisphere. Further research on temporal disease trends as well as disease pathophysiology and anthropogenic factors affecting these populations is needed.

  20. A Systematic Health Assessment of Indian Ocean Bottlenose (Tursiops aduncus) and Indo-Pacific Humpback (Sousa plumbea) Dolphins Incidentally Caught in Shark Nets off the KwaZulu-Natal Coast, South Africa (United States)

    Lane, Emily P.; de Wet, Morné; Thompson, Peter; Siebert, Ursula; Wohlsein, Peter; Plön, Stephanie


    Coastal dolphins are regarded as indicators of changes in coastal marine ecosystem health that could impact humans utilizing the marine environment for food or recreation. Necropsy and histology examinations were performed on 35 Indian Ocean bottlenose dolphins (Tursiops aduncus) and five Indo-Pacific humpback dolphins (Sousa plumbea) incidentally caught in shark nets off the KwaZulu-Natal coast, South Africa, between 2010 and 2012. Parasitic lesions included pneumonia (85%), abdominal and thoracic serositis (75%), gastroenteritis (70%), hepatitis (62%), and endometritis (42%). Parasitic species identified were Halocercus sp. (lung), Crassicauda sp. (skeletal muscle) and Xenobalanus globicipitis (skin). Additional findings included bronchiolar epithelial mineralisation (83%), splenic filamentous tags (45%), non-suppurative meningoencephalitis (39%), and myocardial fibrosis (26%). No immunohistochemically positive reaction was present in lesions suggestive of dolphin morbillivirus, Toxoplasma gondii and Brucella spp. The first confirmed cases of lobomycosis and sarcocystosis in South African dolphins were documented. Most lesions were mild, and all animals were considered to be in good nutritional condition, based on blubber thickness and muscle mass. Apparent temporal changes in parasitic disease prevalence may indicate a change in the host/parasite interface. This study provided valuable baseline information on conditions affecting coastal dolphin populations in South Africa and, to our knowledge, constitutes the first reported systematic health assessment in incidentally caught dolphins in the Southern Hemisphere. Further research on temporal disease trends as well as disease pathophysiology and anthropogenic factors affecting these populations is needed. PMID:25203143

  1. Comparative transcriptome analysis of Trueperella pyogenes reveals a novel antimicrobial strategy. (United States)

    Zhao, Kelei; Li, Wujiao; Huang, Ting; Song, Xuhao; Zhang, Xiuyue; Yue, Bisong


    Trueperella pyogenes is a prevalent opportunistic bacterium that normally causes diverse suppurative lesions, endometritis and pneumonia in various economically important animals. Although the genomic information of this species has been announced, little is known about its functional profiles. In this study, by performing a comparative transcriptome analysis between the highly and moderately virulent T. pyogenes isolates, we found the expression of a LuxR-type DNA-binding response regulator, PloR, was significantly up-regulated in the highly virulent T. pyogenes. Protein crystal structure prediction and primary functional assessment suggested that, the quorum-sensing signal molecules of Gram-negative bacteria such as Pseudomonas aeruginosa and Escherichia coli could significantly inhibit the growth, biofilm production and hemolysis of T. pyogenes by binding to the upstream sensor histidine kinase, PloS. Therefore, the PloS/PlosR two-component regulatory system might dominate the virulence of T. pyogenes. Our findings provide a major advance in understanding the pathogenesis of T. pyogenes, and may shed new light on the development of novel therapeutic strategies to control T. pyogenes infection.

  2. Postoperative HDR afterloading brachytherapy: Vaginal tumor recurrence rates in patients with endometrial carcinoma dependent on treatment volumes

    International Nuclear Information System (INIS)

    Kloetzer, K.H.; Guenther, R.; Wendt, T.


    Patients and Method: At Jena University, Department of Radiotherapy, from 1981 to 1990 108 patients with endometrical carcinoma were postoperatively treated with high dose radiation brachytherapy of the vagina without additional percutaneous radiotherapy. Histology showed more or less differenciated adenocarcinoma in 90% of all patients, all patients were postoperatively stage I or II without proven lymphatic metastases. Dependent on individual figures patients were distributed to 3 different gorups: group A: 4 x 10 Gy, tissue-thickness of 1 cm (vaginal apex) respectively 0.5 cm (lower vaginal walls); group B: 4 x 10 Gy, tissue thickness of 1 cm (upper vaginal wall); group C: 4 x 10 Gy, tissue-thickness of 0.5 cm (both excluding the lower vaginal walls). Results: Both 3-year survival rates (group A: 96.6%, group B: 96.9%, group C: 97.7%) and tumor relapse rates of the vaginal apex (group A: 0, group B: 3.1%, group C: 2.2%) don't show significant differences. No case of local tumor recurrence was seen in the upper 2/3 of the vagina and the pelvic walls. Late side effects concerning bladder and rectum (grade III to IV, EORTC/RTOG) could be minimized by reducing the treatment volume (group A: 6.8%/12.6%, group B: 6,2%/3.1%, group C: 2.2%/0). (orig./AJ) [de

  3. [Factors influencing conception rate after synchronization of ovulation and timed artificial insemination--a review]. (United States)

    Tenhagen, B A


    This review describes factors that affect conception rate after synchronization of ovulation and timed artificial insemination. Intervals of 7 days between GnRH and PGF2alpha, 48 hours to the second GnRH treatment and a further 16 to 20 hours to the timed insemination have been proven to be most effective. Conception rates (CR) increase as lactation progresses up to 100 days in milk. Primiparous cows have higher CR than older cows. Anovular cows at the start of the synchronization protocols have poor CR. These are highest for cows started in early dioestrus. While poor body condition and some post partum and post insemination health disorders have negative effects on the CR, a significant effect of postpartum chronic endometritis could not be demonstrated. High milk yield was also not shown to have a negative effect on CR in almost all studies, while the negative effect of heat stress on fertility is also found in Ovsynch cows. However, the negative effects of high milk yields and heat stress on AI submission rates are overcome by the timed insemination protocol.

  4. Distribution of causes of abnormal uterine bleeding using the new FIGO classification system

    International Nuclear Information System (INIS)

    Qureshi, F.U.; Yusuf, A.W.


    Objective: To categorise all women with Abnormal Uterine Bleeding attending a tertiary care centre according to new classification system by the International Federation of Gynaecology and Obstetrics (FIGO). Methods: The descriptive cross-sectional study comprised all non-gravid women of reproductive age with unpredictable, excessive duration, abnormal volume, and/or abnormal frequency of menses for at least 3 months coming to the outpatient department of Lady Willingdon Hospital, Lahore, from August 2010 to July 2011. The subjects underwent structured history, physical examination and pelvic ultrasonography. Endometrium and hysterectomy specimen were obtained for histopathology where applicable. Possible underlying causes were categorised according to the new classification system. Results: A total of 2109 women comprised 19.6% of total of the 10712 woman who visited the gynecological outpatients clinic, 2109(19.6%) had abnormal uterine bleeding. PALM-COEIN categorization done in 991(47%) cases that showed 30(3%) polyp, 15(15%) adenomyosis, 250(25%) leiomyoma, 66(6.6%) malignancy and hyperplasia, 3(0.3%) coagulopathy, 236(24%) ovulatory dysfunction, 48(5%) endometritis, and 53(6%) iatrogenic. The remaining 155(15%) cases were uncategorised. Conclusion: The classification should facilitate multi-institutional investigation into the epidemiology, etiology and treatment of women with Abnormal Uterine Bleeding. (author)

  5. Neospora caninum versus Brucella spp. exposure among dairy cattle in Ethiopia: a case control study. (United States)

    Asmare, Kassahun


    This case-control study aimed at assessing the relative association of Neospora caninum and Brucella species exposure with reproductive disorders. The study was carried out between October 2011 and June 2012 on 731 dairy cows sampled from 150 dairy farms in selected 17 conurbations of Ethiopia. Two hundred sixty-six of the cows were categorized as cases based on their history of abortion or stillbirth while the remaining 465 were controls. The presence of antibody to N. caninum was screened using indirect ELISA, while Brucella spp. exposure was assayed serially using Rose Bengal Plate Test and Complement Fixation Test. Exposure to N. caninum was more frequently observed among cases (23.8%) than controls (12.7%), while no significant difference (p > 0.05) was noted for Brucella exposure between the two groups. Moreover, the proportion of cows with disorders like retention of fetal membrane, endometritis and increased inter-calving period were significantly higher (p Brucella spp. exposure. However, neither N. caninum nor Brucella spp. could explain the majority (73.2%) of the reported abortions and stillbirths in cattle. Hence, this observation underscores the need for more intensive investigation on the identification of causes of the aforementioned disorders in dairy cattle of Ethiopia.

  6. Assessing the prevalence of bacterial vaginosis among infertile women of Qom city. (United States)

    Ghiasi, Mahdieh; Fazaeli, Hoda; Kalhor, Naser; Sheykh-Hasan, Mohsen; Tabatabaei-Qomi, Reza


    Bacterial vaginosis (BV) is a common disorder which happens when the balance of bacterial flora in vagina is disrupted by a shift in concentration of lactobacillus and pathogenic bacteria.It has significant sequelae including increased rates of late miscarriage when diagnosed in early pregnancy, premature rupture of the membranes, endometritis, preterm labour and delivery and tubal factor infertility. So it seems to be necessary to evaluate the prevalence of BV among women with primary infertility. All specimens were collected during vagina examination by use of a speculum and swabbing. A sampling swab was introduced into vaginal canal and rotated for at least 8 seconds before withdrawal. The vaginal swabs were examined in standard microbiological analysis including of microscopy, culture and sensitivity examination. Totally identified Gram positive bacteria were significantly higher in number than the Gram negative bacteria. We found that the prevalence of bacterial vaginosis as 70.34% among infertile women of Qom city. Staphylococcus aureus was the most prevalent vaginal pathogen (57.33%) followed by E. coli (25.33%). S. aureus showed maximum sensitivity to penicillin and gentamicin. It means that fortunately in Qom, this bacterium has not acquired resistance against penicillin yet. So, all physicians must have a high index of suspicion and use readily available screening methods to recognize and treat the patients with infectious vaginitis adequately.

  7. Influence of sexually transmitted infections in a horse breeding

    Directory of Open Access Journals (Sweden)

    Kosec Marjan


    Full Text Available The most frequent problems in horses reproduction are generally divided into those of infectious and non infectious etiology. Common causes of infectious diseases are usual­ly viruses and bacteria, and less frequently protozoa, mykoplasma and fungi. In this work there are presented the most important fact about sexually transmitted diseases, their clinical picture, risk factors, preventive measures as well as measures to prevent and eradicate the diseases. The biggest risk factor for sexually transmitted diseases in horses are breeding stallions, both in natural mating and in artificial insemination. Therefore, in order to prevent genital infections in horses, it is essential that the stallions used for breeding are healthy (non-infected. That can be determined with certainty only if the stallions are examined (tested just before the breeding season on most frequent sexually transmitted diseases (CEM,EAV. It is well known that in most cases the clinical picture of sexually transmitted diseses is not manifested on genitals. As well, variations in clinical picture can be expected also in mares, depending on the stage of the disease and its etiology. Harms arising from sexually transmitted diseases can be divided into direct and indirect. Direct damage occurs in the form of endometritis, miscarriage, stillbirths and births of weak foals, and indirect in restricting the traffic of infected and suspicios animals, isolation of the infected ones as well as medical treatment and interrupting mating.

  8. Search for the lowest irradiation dose from literatures on radiation-induced cancer in gastrointestinal tract

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizawa, Y; Kusama, T [Tokyo Univ. (Japan). Faculty of Medicine


    A survey of past case reports about radiation-induced cancer in the gastrointestinal tract was carried out with the main object of finding the lowest irradiation dose. Search of the literature published since 1923 revealed 80 cases of radiation-induced large intestine cancer and one case of stomach cancer. The cases of radiation-induced cancer in the large intestine had received radiation for the treatment of non-malignant conditions, fibroma, ovarial cyste, myoma, endometritis and duodenal ulcer. The lowest irradiation dose was estimated at 460 rads. Adenocarcinoma was the histopathological finding in all cases of radiation-induced cancer in the caecum, colon and rectum, and squamous cell carcinoma in the cases of anal cancer. The latent period ranged from 1 to 31 years, with the average of 13.6 years. There were some reports of statistical studies of radiation-induced stomach cancer. Three groups were the subjects of these studies. The first group was composed of atomic bomb survivors, the second of patients who had undergone radiation treatment for ankylosing spondilitis, and the third of duodenal ulcer patients subjected to radiation treatment for the purpose of suppressing gastric acid secretion. These statistical studies showed no significant increase of the incidence of stomach cancer in the irradiated groups.

  9. Determination of estradiol, estrone and progesterone in serum and human endometrium in correlation to the content of steroid receptors and 17β-hydroxysteroid dehydrogenase activity during menstrual cycle

    International Nuclear Information System (INIS)

    Schmidt-Gollwitzer, M.; Eiletz, J.; Pachaly, J.


    A study has been carried out to compare the influence of estradiol estrone and progesterone on the estradiol and progesterone receptor levels and 17β-hydroxysteroid dehydrogenase (17β-HSD) activity in human endometrium. The steroid hormone concentrations were measured simultaneously in both serum and endometrial tissue. The estradiol receptor levels were highest during the early proliferative phase and were inversely correlated to the endometrial tissue and serum concentrations of estradiol and progesterone. The highest progesterone binding capacity was found in endometrical cytosol during the late proliferative phase (midcycle) of the menstrual cycle. The midcycle peak of the progesterone receptor level correlated well with the first peak of the serum and tissue concentrations of estradiol. During,the luteal phase, in contrast to the proliferative phase, the progesterone receptor level decreased whereas serum progesterone concentrations were high. Estrone concentrations were higher in secretory than proliferative endometrium and were correlated to the increase of progesterone receptor content and 17β-HSD activity during early secretory phase. The 17β-HSD activity was approximately 10-fold higher during the early secretory than during the proliferative phase. The progesterone receptor level was highly correlated to the specific 17β-HSD activity of the microsomal fraction whereas a significant inverse correlation between the enzyme activity and the estradiol receptor level was observed. (orig.) [de

  10. Comparison of Maternal and Fetal Outcomes in Pregnancies with Preterm Premature Rupture of Membrane (PPROM Terminating in 34th or 36th Gestational Weeks: A Clinical Trial

    Directory of Open Access Journals (Sweden)

    Shamsi Abbasalizadeh


    Full Text Available present  study,  we aimed at studying maternal  and  neonatal  outcomes  in  patients with terminated pregnancy in 34th  and  36th  gestational  weeks. Materials and methods: 40 pregnant women, with PPROM who underwent pregnancy termination at 34 group (A or 36 group (B gestational weeks, were included to be evaluated and compared for maternal and neonatal outcomes. Type of delivery, birth complications, chorioamnoionitis, endometritis, sepsis, maternal mortality, infant gender, birth weight, Apgar scores, respiratory distress syndrome, Meconium-stained amniotic fluid, NICU admission, abruption, umbilical cord prolapse, maternal and neonatal outcomes were compared between the two groups.  Results: There was no statistically significant difference between the two groups regarding maternal age, level of education, or gravity. The percentage of cases with birth weight between 1500 and 2500 g was significantly higher in group A P<0.001. Frequency of NICU admission in group A was significantly more than group B (P<0.001. In conclusion: Termination of pregnancy at 36 weeks compared to 34 weeks in pregnant women with PPROM is preferred in terms of neonatal outcomes and it is recommended; also, there might be no preference in terms of  maternal outcomes.

  11. Endometrial biopsy findings in postmenopausal bleeding

    International Nuclear Information System (INIS)

    Sarfraz, T.; Tariq, H.


    To study endometrial histopathology in women presenting with postmenopausal bleeding. A two-year study from January 2003 to December 2004 of 100 cases of postmenopausal bleeding was conducted at Combined Military Hospital, Sialkot. The histopathology of endometrial biopsy specimens was done to find out the causes of postmenopausal bleeding in these ladies. All these 100 patients had confirmed menopause and the average age was 55 years and above. The most common histopathological diagnosis was senile endometrial atrophy (27%), followed by simple cystic hyperplasia in (17%). Three cases of simple cystic hyperplasia had coexistent ovarian tumors. Glandular hyperplasia without atypia was seen in 6% and with atypia in 4%. Other causes were endometritis (13%), endometrial polyps (8%), proliferative phase endometrium (6%) and secretary phase endometrium (5%). Endometrial carcinoma was seen in (6%) cases, (8%) biopsy specimens were non-representative. Although senile endometrial atrophy was most commonly found in these ladies but a significant percentage of endometrial hyperplasia and endometrial cancer implies the need for investigating all cases of postmenopausal bleeding. Bimanual examination and pelvic ultrasonography should be combined with endometrial sampling so that rare pelvic pathologies may not be missed. (author)

  12. Peripartum Morbidity after Cesarean Delivery for Arrest of Dilation at 4 to 5 cm Compared with 6 to 10 cm. (United States)

    Dahlke, Joshua D; Sperling, Jeffrey D; Has, Phinnara; Lovgren, Todd R; Connealy, Brendan D; Rouse, Dwight J


     Given that recent consensus guidelines established to decrease cesarean delivery (CD) rates use 6 cm to define the onset of the active phase of labor, our objective was to evaluate maternal and neonatal outcomes after CD for the indication of arrest of dilation at 4 to 5 cm compared with ≥ 6 cm.  We performed a secondary analysis using data from the Maternal Fetal-Medicine Units Network Cesarean Registry. We included nulliparous women with term, singleton, vertex gestations who underwent primary CD for arrest of dilation. We compared those who reached a maximum cervical dilation of 4 to 5 cm with those of ≥6 cm. Our primary outcome was composite maternal morbidity that included chorioamnionitis, endometritis, transfusion, wound complication, operative injury, intensive care unit admission, or death.  Of the 73,257 women in the dataset, 5,681 met the inclusion criteria. After adjusting for confounders, there was no difference in composite maternal (adjusted odds ratio [aOR]: 1.19; 95% confidence interval [CI]: 0.94-1.52) or neonatal morbidity (aOR: 0.94; 95% CI: 0.79-1.10) between the groups.  In this historical cohort, maternal and neonatal outcomes after CD for arrest of dilation ≥ 6 cm were comparable to those performed at 4 to 5 cm and support recent labor management guidelines. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Postmenopausal bleeding: causes and risk of genital tract malignancy

    International Nuclear Information System (INIS)

    Dawood, N.S.; Peter, K.; Ibrar, F.; Dawood, A.


    Background: Postmenopausal bleeding (PMB) is bleeding occurring after 6-12 months of amenorrhea in a woman of age where the menopause can be expected. Objectives of this study were to ascertain various causes and prevalence of genital organ malignancy in patients presenting with postmenopausal bleeding. Methods: A prospective observational study carried out in the Department of Obstetrics and Gynaecology, Fauji Foundation Hospital, Rawalpindi comprising of 167 consecutive cases presenting with postmenopausal bleeding one year after menopause. Women having undergone hysterectomy and bilateral salpingo-oophorectomy, receiving radiotherapy or chemotherapy, suffered trauma to the genital tract, having coagulation disorder or on anticoagulant or hormone replacement therapy were excluded. Detailed history was obtained and a thorough clinical examination was conducted. Data were entered into hospital computer database (Medix) system. Mean +- SD were calculated for age, percentage was calculated for types of histopathological findings. Results: The commonest cause of PMB was atrophic endometritis and vaginitis 33 (21.2%). Overall incidence of various genital tract malignancies was 25 (16.0%). Conclusion: The overall incidence of genital tract malignancies in patients presenting with PMB is high (16.0%), therefore, it needs to be taken seriously and requires prompt and thorough investigations. (author)

  14. Menstrual induction in preference to abortion. (United States)

    Csapo, A I; Peskin, E G; Sauvage, J P; Pulkkinen, M O; Lampe, L; Godeny, S; Laajoki, V; Kivikoski, A


    In the early 1970s the effort was begun to examine the clinical benefits of "menstrual induction" (MI) at 6 weeks pregnancy (last menstrual period), in the belief that if pregnancy is to be terminated there was no sound medical nor psychological reason to delay the procedure. It was found that the transcervical, intrauterine delivery of a "PG-impact" compromised the conceptus and terminated pregnancy in 95% of the cases, with clinical symptoms of menstruation rather than abortion. The side-effects were acceptable; the prematurity rate did not increase in subsequent pregnancies. Yet, the need for strict asepsis limited the use of this otherwise simple and effective procedure. Recently, this limitation has been overcome by the development of the PGE2 analogue 16-phenoxy-w17,18,19,20 tetranor-PGE2-methyl sulfanylamide ('Sulproston'). Clinical trials have been done in terms of dealing with the questions of efficacy, acceptability, and preference. 90 volunteers have been studied. At 14 days follow-up the success rate (negative pregnancy test) was 96%. The side effects were acceptable -- vomiting 26%, diarrhea 10%, and endometritis 2%. Of the 42 patients interviewed, 90% were satisfied with the procedure. Of those who had previously experienced surgical interruption, 89% preferred this pharmacological method.

  15. Premature rupture of the membranes at term: time to reevaluate the management. (United States)

    Sadeh-Mestechkin, Dana; Samara, Nivin; Wiser, Amir; Markovitch, Ofer; Shechter-Maor, Gil; Biron-Shental, Tal


    To compare maternal and neonatal outcomes in induced vs. expectant management of term PROM. This retrospective study included patients with term PROM. A total of 325 were enrolled: 213 managed expectantly and 112 induced at admission and matched according to gestational age. Expectant management group patients were allowed to defer labour induction up to 48 h. Primary outcome measures were maternal or foetal signs of infection (chorioamnionitis, early neonatal sepsis or postpartum endometritis) and prolonged maternal hospitalization. Secondary outcome was caesarean delivery rate. All group characteristics were comparable except that expectant management included more nulliparous women. Women managed expectantly had a higher rate of prolonged hospitalization [15 (7 %) vs. 2 (1.8 %); P = 0.043] as an indication of maternal complications, compared to induction management. They also had a higher rate of caesarean delivery [34 (16.4 %) vs. 8 (7.1 %), respectively; P = 0.024]. Adjustment for parity did not change the results. Early neonatal outcomes were similar between groups. Expectant management increases the likelihood of caesarean delivery and prolonged maternal hospitalization. This should be considered when advising patients with term PROM regarding labour induction.

  16. Is postmenopausal endometrial fluid collection alone a risk factor for endometrial cancer? (United States)

    Yegin Akcay, Gulin Feykan; Tas, Emre Erdem; Yavuz, Ayse Filiz


    To determine the usefulness of single-layer, ultrasonographic measurement of endometrial fluid collection (EFC) volume to predict endometrial pathology in asymptomatic postmenopausal patients. One hundred fifty asymptomatic postmenopausal women were analysed retrospectively from January 2012 to December 2016. After patients with endometrial hyperplasia/neoplasia were included in Group-I, and those with insufficient tissue, endometrial atrophy, or endometritis were included in Group-II; Groups one and two were compared with respect to primary (correlations between endometrial thickness and EFC volume) and secondary (correlations between demographic characteristics and EFC volume) outcomes. There was no correlation between EFC volume and single-layer endometrial thickness ( P = 0.36). Likewise, demographic characteristics were not related to EFC ( P > 0.05). However, both EFC volume and single-layer endometrial thickness were thicker in Group-I compared to Group-II (4.8 ± 1.9 mm vs . 3.7 ± 2.5 mm; and 5.7 ± 9.4 mm vs . 2.7 ± 2.5 mm, respectively) ( P values were < 0.05). Although a cutoff value for endometrial thickness and EFC volume could not be recommended based on our study findings, it should be noted that 2% is a clinically significant rate of malignancy. Thus, postmenopausal patients with EFC should be evaluated for endometrial sampling.

  17. New techniques using transcervical uterine cannulation for the diagnosis of uterine disorders in bitches. (United States)

    Watts, J R; Wright, P J; Lee, C S; Whithear, K G


    A technique for collecting uterine samples from bitches without the need for surgery was developed. This technique involved visualizing the cervix with a rigid endoscope and passing a catheter through the cervix into the uterus. Samples for microbiology and cytology were obtained by the infusion and aspiration of sterile normal saline. This technique allowed uterine microbiology and cytology of the normal bitch throughout the reproductive cycle. Microorganisms were frequently recovered from the uterus during pro-oestrus and oestrus, but rarely at other stages of the reproductive cycle. The uterine microflora often reflected the vaginal microflora during pro-oestrus and oestrus. The cells found in uterine cytology samples from normal bitches included endometrial epithelial cells, leukocytes, erythrocytes, cervical cells, spermatozoa and bacteria. The types, proportions, morphology and numbers of cells varied throughout the reproductive cycle. The endoscope could be passed into the uterus and the endometrium examined from parturition until day 23 post partum. These procedures and contrast hysterography were used to investigate the reproductive tract of bitches. The above techniques have facilitated the diagnosis of postpartum metritis (n = 3), pyometra (n = 2), endometritis (n = 1), abortion (n = 1), retained placenta (n = 1), postpartum uterine rupture (n = 1), endometrial subinvolution (n = 1) and misalliance (n = 1) in 21 bitches investigated.

  18. Amnioinfusion for potential or suspected umbilical cord compression in labour. (United States)

    Hofmeyr, G Justus; Lawrie, Theresa A


    Amnioinfusion aims to prevent or relieve umbilical cord compression during labour by infusing a solution into the uterine cavity. To assess the effects of amnioinfusion for potential or suspected umbilical cord compression on maternal and perinatal outcome . We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2011). Randomised trials of amnioinfusion compared with no amnioinfusion in women with babies at risk of umbilical cord compression in labour. The original review had one author only (Justus Hofmeyr (GJH)). For this update, two authors (GJH and T Lawrie) assessed 13 additional trial reports for eligibility and quality. We extracted data and checked for accuracy. We have included 19 studies, with all but two studies having fewer than 200 participants. Transcervical amnioinfusion for potential or suspected umbilical cord compression was associated with the following reductions: caesarean section overall (13 trials, 1493 participants; average risk ratio (RR) 0.62, 95% confidence interval (CI) 0.46 to 0.83); fetal heart rate (FHR) decelerations (seven trials, 1006 participants; average RR 0.53, 95% CI 0.38 to 0.74); Apgar score less than seven at five minutes (12 trials, 1804 participants; average RR 0.47, 95% CI 0.30 to 0.72); meconium below the vocal cords (three trials, 674 participants, RR 0.53, 95% CI 0.31 to 0.92); postpartum endometritis (six trials, 767 participants; RR 0.45, 95% CI 0.25 to 0.81) and maternal hospital stay greater than three days (four trials, 1051 participants; average RR 0.45, 95% CI 0.25 to 0.78). Transabdominal amnioinfusion showed similar trends, though numbers studied were small.Mean cord umbilical artery pH was higher in the amnioinfusion group (seven trials, 855 participants; average mean difference 0.03, 95% CI 0.00 to 0.06) and there was a trend toward fewer neonates with a low cord arterial pH (less than 7.2 or as defined by trial authors) in the amnioinfusion group (eight trials, 972

  19. Screening for group B Streptococcus in pregnant women: a systematic review and meta-analysis Rastreo de Streptococcus del grupo B en gestantes: revisión sistemática y metanálisis Rastreamento de Streptococcus do grupo B em gestantes: revisão sistemática e metanálise

    Directory of Open Access Journals (Sweden)

    Mônica Taminato


    Full Text Available Infection with Group B Streptococcus (GBS is considered an important public health problem. It is associated with: Neonatal sepsis, meningitis, pneumonia, neonatal death, septic abortion, chorioamnionitis, endometritis and other perinatal infections. The aim of this study was to determine the best screening strategy for GBS in pregnant women. For this a systematic review and meta-analysis were carried out in the Nursing Department of the Federal University of São Paulo, Cochrane Center, Brazil. Sources used were, EMBASE, LILACS, Medline, list of references, personal communication and the Cochrane library. The criterion for the selection of the studies was; studies which analyze some type of screening for GBS in pregnant women. Independent of the comparator, all analyses were in favor of a universal screening program for reducing the incidence of neonatal sepsis. The evidence obtained in this study suggests that the strategy of universal screening of pregnant women associated with the use of prophylactic antibiotics is safe and effective.La infección por Streptococcus del grupo B (GBS es considerada un importante problema de salud pública. Los estreptococos están asociados a: sepsis neonatal, meningitis, neumonía, muerte neonatal, aborto séptico, corioamnionitis, endometritis y otras infecciones perinatales. El objetico del estudio fue determinar la mejor estrategia de rastreo de GBS en gestantes. Se trata de una revisión Sistemática con Metanálisis. Fue realizada en el Departamento de Enfermería de la Universidad Federal de Sao Paulo, Centro Cochrane de Brasil. Se utilizaron las siguientes fuentes: EMBASE, LILACS, Medline, lista de referencias bibliográficas, comunicación personal y Cochrane Library. Como criterio para la selección de los estudios, se escogieron los que analizaron algún tipo de rastreo para GBS en gestantes. Independientemente del comparador, todos los análisis fueron favorables al programa de screening universal

  20. Comparison of peripartum metabolic status and postpartum health of Holstein and Montbéliarde-sired crossbred dairy cows. (United States)

    Mendonça, L G D; Abade, C C; da Silva, E M; Litherland, N B; Hansen, L B; Hansen, W P; Chebel, R C


    Objectives of the current experiment were to evaluate plasma concentrations of metabolites and haptoglobin peripartum, uterine health and involution, and follicle growth and resumption of cyclicity of Holstein (HO) and Montbéliarde-sired crossbred cows. Cows (52 HO and 52 crossbred) were enrolled in the study 45 d before expected calving date. Cows had body weight and body condition score recorded on d -45, -14, 0, 1, 28, and 56 relative to calving. Dry matter intake was calculated for a subgroup of cows (25 HO and 38 crossbred) from 6 wk before to 6 wk after calving. Blood was sampled weekly from d -14 to 56 relative to calving for determination of glucose, nonesterified fatty acid, and β-hydroxybutyrate concentrations; from d -7 to 21 relative to calving for determination of haptoglobin concentration; and from d 14 to 56 postpartum for determination of progesterone concentration. Cows were examined at calving and on d 4, 7, 10, and 14 postpartum for diagnosis of postparturient diseases, on d 24 postpartum for diagnosis of purulent vaginal discharge, and on d 42 postpartum for diagnosis of subclinical endometritis. Uteri and ovaries were examined by ultrasonography every 3 d from d 14 to 41 postpartum. Milk yield and composition were measured monthly and yield of milk, fat, protein, and energy-corrected milk were recorded for the first 90 d postpartum. Body weight was not different between Holstein and crossbred cows, but HO cows had reduced body condition score compared with crossbred cows. Even though DMI from 6 wk before to 6 wk after calving tended to be greater for HO cows (16.8 ± 0.7 vs. 15.3 ± 0.5 kg/d), HO cows tended to have more pronounced decline in dry matter intake, expressed in percentage of body weight from d -15 to 0 relative to calving. Energy-corrected milk and nonesterified fatty acid and β-hydroxybutyrate concentrations were not different between breeds. No differences were observed in incidence of retained fetal membranes, metritis, and

  1. Efficacy of the Molded Carbon Sorbent VNIITU-1 Used in Obstetric Practice

    Directory of Open Access Journals (Sweden)

    V. T. Dolgikh


    Full Text Available Objective: to develop a technology for obtaining the molded sorbent VNIITU1, to study its physicochemical and biomedical properties, and to evaluate its efficacy in preventing and treating pyoinflammatory complications in obstetrics.Materials and methods. The molded sorbent VNIITU-1 was designed from the carbon porous material based on nanodispersed carbon by mixing with a vehicle, extruding the mixture, drying the extrudate in an inert atmosphere, thermally treating and activating by steam, followed by washing with distilled water and drying (TU 9398043710698342013. The molded sorbent VNIITU-1 is apyrogenic and nontoxic (Toxicity Study Conclusion No. 1998.013.P dated 14.08.2013; Engineering Testing Assessment No. 12.404 ORTI/2013 dated 26.08.2013, it is destined for single administration, sterile, placed in a removable thread capron mesh container, and used to treat and prevent pyoseptic complications in puerperas at risk for infection, such as acute nonspecific postpartum endometritis. A total of 52 puerperas were examined and treated. They had been divided into 2 groups: a study group (n=37 and a comparison group (n=15. In the study group, the hemosorbent VNIITU1 as a porous carbon applicator was postpartum inserted into the uterine cavity, by concurrently performing traditional antibiotic therapy to prevent infectious complications. The comparison group received only traditional antibiotic therapy. The uterine cavity aspirate was examined for IL1β and IL6 levels, its microbial profile, and microbial growth patterns in culture media. The data were processed using a package of applied STATISTICA6.1 programs and standard mathematical tables in Microsoft Excel. Descriptive and variation statistical methods were applied. The data were presented as Me [low quartilehigh quartile (LQHQ]; two pre and posttreatment dependent variables were compared using the Wilcoxon and Mann-Whitney tests.Results. The molded carbon sorbent VNIITU1 was


    Directory of Open Access Journals (Sweden)

    A. E. Meller


    Full Text Available Introduction: The distinctive features of modern inflammatory diseases are their indolent course and predisposition to chronicity. Chronic inflammation is the basis for the development of serious disorders, including autoimmune and oncologic ones, and a  cause of major functional abnormalities of the human body. Diagnostics of chronic inflammation is associated with a number of problems which originate from a variety of clinical phenotypes and morphological forms, on the one hand, and from the rising prevalence of their latent course, on the other. In its turn, an adequate treatment choice may be based on understanding and accurate detection of etiological and morphological types of the disease. In this connection, development of novel diagnostic techniques, such as optical coherence tomography (OCT, is of utmost importance. Aim: To demonstrate feasibility of OCT in detection of morphological abnormalities associated with chronic inflammatory disorders of various localizations. Materials and methods: OCT diagnostics was performed in addition to standard diagnostic procedures in 225 patients with chronic inflammatory disorders of various localizations, such as chronic recurrent rhinitis, chronic latent salpingitis and chronic endometritis. For OCT, an “OCT-1300U” system was used, with central wavelength of 1280 nm, spatial resolution of 15–20 μm, image acquisition rate of 8 frames per second, imaging depth of 1.4 mm and a probe diameter of 2.4 mm. The following techniques of quantitative processing were used for processing of the OCT images. Quantitative characterization of histograms and image texture was performed with further determination of values typical for various images groups corresponding to particular states of biological tissues. Neural network was also employed with histograms and 2D Fourier transforms of the images as input data. Results: OCT laparoscopy allowed to obtain three types of OCT images of fallopian

  3. A randomized open-label controlled trial of chlorhexidine-alcohol vs povidone-iodine for cesarean antisepsis: the CAPICA trial. (United States)

    Springel, Edward H; Wang, Xiao-Yu; Sarfoh, Vanessa M; Stetzer, Bradley P; Weight, Steven A; Mercer, Brian M


    Identification of optimal surgical site antisepsis preparations may reduce cesarean-related surgical site infections. Two recently published investigations examined efficacy of chlorhexidine-alcohol and iodine-alcohol preparations. No previous randomized controlled trial has compared chlorhexidine-alcohol to povidone-iodine aqueous scrub and paint in reduction of cesarean-related surgical site infection. The purpose of the study was to determine if chlorhexidine-alcohol would result in fewer surgical site infections than povidone-iodine when used as skin antisepsis preparation prior to cesarean delivery. This study was a single-center pragmatic randomized controlled trial at an urban tertiary care institution to compare chlorhexidine-alcohol 26-mL single-step applicator to povidone-iodine aqueous scrub and paint 236-mL wet skin tray as preoperative skin antiseptic preparation for women undergoing cesarean delivery. Patients were eligible for study participation if they could provide informed consent in English or Spanish, were ≥18 years of age, did not have clinical chorioamnionitis, were unlikely to be lost to follow-up, and had no sensitivities to chlorhexidine, betadine, or iodine. Treatment was assigned by computer-generated simple 1:1 randomization immediately before skin preparation. The primary outcome was surgical site infection occurring within 30 days of cesarean delivery including ≥1 of: superficial or deep surgical site infection, or endometritis, according to Centers for Disease Control and Prevention definitions. Analysis was by intent to treat. Categorical outcomes were compared using Fisher exact test. The Wilcoxon rank-sum test was performed for continuous outcomes. This trial was institutional review board approved and registered at (NCT02202577). In all, 932 subjects (461 assigned to chlorhexidine-alcohol, 471 assigned to povidone-iodine) were randomized from February 2013 through May 2016. Rate of follow-up evaluation

  4. Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas

    International Nuclear Information System (INIS)

    Nishino, Mizuki; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo


    Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss

  5. Human parasitic protozoan infection to infertility: a systematic review. (United States)

    Shiadeh, Malihe Nourollahpour; Niyyati, Maryam; Fallahi, Shirzad; Rostami, Ali


    Protozoan parasitic diseases are endemic in many countries worldwide, especially in developing countries, where infertility is a major burden. It has been reported that such infections may cause infertility through impairment in male and female reproductive systems. We searched Medline, PubMed, and Scopus databases and Google scholar to identify the potentially relevant studies on protozoan parasitic infections and their implications in human and animal model infertility. Literature described that some of the protozoan parasites such as Trichomonas vaginalis may cause deformities of the genital tract, cervical neoplasia, and tubal and atypical pelvic inflammations in women and also non-gonoccocal urethritis, asthenozoospermia, and teratozoospermia in men. Toxopalasma gondii could cause endometritis, impaired folliculogenesis, ovarian and uterine atrophy, adrenal hypertrophy, vasculitis, and cessation of estrus cycling in female and also decrease in semen quality, concentration, and motility in male. Trypanosoma cruzi inhibits cell division in embryos and impairs normal implantation and development of placenta. Decrease in gestation rate, infection of hormone-producing glands, parasite invasion of the placenta, and overproduction of inflammatory cytokines in the oviducts and uterine horns are other possible mechanisms induced by Trypanosoma cruzi to infertility. Plasmodium spp. and Trypanosoma brucei spp. cause damage in pituitary gland, hormonal disorders, and decreased semen quality. Entamoeba histolytica infection leads to pelvic pain, salpingitis, tubo-ovarian abscess, and genital ulcers. Cutaneous and visceral leishmaniasis can induce genital lesion, testicular amyloidosis, inflammation of epididymis, prostatitis, and sperm abnormality in human and animals. In addition, some epidemiological studies have reported that rates of protozoan infections in infertile patients are higher than healthy controls. The current review indicates that protozoan parasitic

  6. Detection of Chlamydia Trachomatis Infection in Female Partners of Infertile Couples

    Directory of Open Access Journals (Sweden)

    Seyed Mehdi Kalantar


    Full Text Available Background: The prevalence of infertility is about 10-15% among the couples overally. Several factors can affect fertility ability of men and women. Chlamydia is a non-motile gram negative obligatory interacellular pathogenic organism. It can cause infections in females as cervicitis, urethritis, endometritis, pelvic inflammatory disease also prostatitis and epidydidimitis in male as well. The aim of this survey is to mention the frequency of infection with Chlamydia in infertile female who were treated in Yazd Research & Clinical Center for Infertility.Materials and Methods: A questionnaire containing some demographic information and clinical features related to the infection was completed for each infertile woman. Specimen of vaginal discharge was collected by well trained nurses using sterile cotton swap from 91 women. Elisa test was done on blood serum. DNA extraction for Chlamydia was carried out using low salt method and PCR was done using MOMP and plasmid primers. DNA sequencing was performed on two PCR products using Chromas LITE ver.2.01 and analyzed by BLAST.Results: Of 91 blood samples collected in this survey, none of them was positive by ELISA. Also there was no positive PCR result. Four PCR products showed a questionable band which was not in the range of Chlamydia. The products underwent DNA sequencing and there were not any finding related to any other micro-organism.Conclusion: However, it is well known that Chlamydia as an infection plays a role in infertility. Nevertheless, there was not evidence of this organism in these infertile patients. It is necessary to design such a survey in larger populations of infertile patients especially on infertile women with tubal infertility and their husbands as well.

  7. Neonatal morbidity after spontaneous labor onset prior to intended cesarean delivery at term: a cohort study. (United States)

    Glavind, Julie; Milidou, Ioanna; Uldbjerg, Niels; Maimburg, Rikke; Henriksen, Tine B


    We aimed to investigate if labor onset before planned cesarean delivery (CD) affects the risk of neonatal admission, respiratory distress, or neonatal infectious morbidity. Our cohort included singleton term pregnant women with intended CD who delivered at Aarhus University Hospital from 1990 to 2012. Two groups of women were identified: women with intended CD performed before labor (nonlabor CD) and women with intended CD performed after spontaneous labor onset (labor-onset CD); in both groups there was no other maternal or fetal medical indication for an immediate CD or for early-term CD scheduling. Data were stratified in early-term (37-38 weeks) and full-term (39-40 weeks) deliveries. The main outcome measures were neonatal admission, respiratory distress and neonatal infectious morbidity. Among 103 919 live births, 5071 deliveries were nonlabor CDs and 731 were labor-onset CDs. Compared to nonlabor CD, labor-onset CD was associated with similar risks of neonatal admission and respiratory distress, both at early and full term, but with a two- to three-fold increased risk of newborn septicemia or antibiotic treatment at early term. Labor onset at early term was associated with a lower risk of maternal blood loss of more than 500 mL, but with a higher risk of postoperative antibiotic treatment and endometritis. Labor onset before planned CD was not associated with a decrease in neonatal respiratory morbidity, but may be associated with increased risks of neonatal infection. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  8. Distribution and chloramphenicol in the bovine genital tract and pharmacokinetic studies of florfenicol in cattle

    Energy Technology Data Exchange (ETDEWEB)

    Bretzlaff, K.N.


    The objectives were to investigate selected aspects of the distribution of chloramphenicol (CAP) in the bovine genital tract and to conduct preliminary pharmacologic studies with florfenicol (FLO), a fluorinated analogue of thiamphenicol, in cattle. After 8 hours' continuous intravenous (IV) infusion of CAP to 7 postpartum cows, steady state plasma-to-genital tissue ratios of CAP were approximately 3. After intrauterine infusion of 20 mg CAP/kg to 3 postpartum cows, approximately 40% of the dose was absorbed into the bloodstream. Tissue concentrations were high at 8 hour postdosing in tissues lining the uterine lumen but were below desired therapeutic concentrations in the myometrium of 2 of the cows. Eighty cows with retained fetal membranes (RFM) were assigned to receive on the following treatments: (1) removal of membranes only; (2) removal plus CAP; (3) nonremoval; (4) nonremoval plus CAP. CAP treatment consisted of 5 g administered IU twice daily for 3 days. The majority of cows in all groups acquired endometritis, although CAP reduced the prevalence and severity of the disease. A quantitative assay for FLO in plasma was developed and validated on a high performance liquid chromatographic (HPLC) system. The pharmacokinetics of FLO determined after IV administration of 50 mg FLO/kg to 5 cows were best described by a three-compartment model. FLO was approximately 18% bound to plasma proteins as determined by equilibrium dialysis and ultrafiltration. In an in vitro system, 5, 125, or 1000 ug/ml of CAP had no effect on neutrophils from 6 cows.

  9. [Fertility and sterility in domestic animals]. (United States)

    de Kruif, A


    For most of the domestic animals the fertility rate is generally very good. If a uniparous female animal is served during the oestrus period by a male with good sperm quality, the pregnancy rate is 60 to 70%. Among the animals that deliver more than one offspring, in many cases the pregnancy rate even reaches more than 90%. Nevertheless, veterinarians are very frequently consulted for fertility problems in individual animals or in cattle or swine herds. The main causes of subfertility are: Insufficient sperm quality An inseminator with insufficient professional knowledge. The majority of the cows, horses and pigs are inseminated artificially (AI). The insemination is not always carried out by experts. Not the right time for insemination. It especially occurs in animals with weak oestrus symptoms. Venereal infections. In earlier days these infections would occur very often. Due to the application of AI, most of these infections have been eradicated. The malfunctioning of the female genital system, which can be caused by various factors, such as cystic ovarian follicles, endometritis and anatomic abnormalities. The research on reproduction which has been going on during the past ten years in the department of Obstetrics, Reproduction and Herd Health, has been mainly concerned with: Embryo transplantation, in vitro fertilisation and ovum pick up The evaluation of sperm quality Improved freezing methods for both sperm and embryo's The development of new insemination techniques The composition of a new diluent for fresh sperm Cystic ovarian follicles in cows Subfertility in different species of animals Next to the above mentioned study fields, the department is also involved in the research into swine fever, respiratory diseases in pigs, antibiotic resistance in pigs and cattle, mastitis and metabolic problems in cattle and salmonella infections in pigs.

  10. Prevention and treatment strategy in pregnant women with group B streptococcal infection. (United States)

    Tevdorashvili, G; Tevdorashvili, D; Andghuladze, M; Tevdorashvili, M


    Group B streptococcus (GBS; Streptococcus agalactiae) are encapsulated gram-positive cocci belonging to Lancefield group B, that frequently colonizes the human genital and gastrointestinal tracts. It is an important cause of illness in three categories of population: infants, pregnant women, and adults with underlying medical conditions. In pregnant women and postpartum women, GBS is a frequent cause of asymptomatic bacteriuria, urinary tract infection, upper genital tract infection (i.e. intraamniotic infection or chorioamnionitis), postpartum endometritis (8%), pneumonia (2%), puerperal sepsis (2%), and bacteremia without a focal site (31%). It also can cause focal infections such as pneumonia, meningitis, and endocarditis, albeit rarely. Invasive maternal infection with GBS is associated with pregnancy loss and preterm delivery. Prior to the widespread use of maternal intrapartum chemoprophylaxis, maternal colonization with GBS conferred an increased risk of chorioamnionitis, and early postpartum infection. The serotype distribution of invasive GBS infection in pregnant women is similar to that of early-onset neonatal disease. The most common GBS serotypes causing invasive disease in adults and neonates are Ia, Ib, III, and V. Vaccination of adolescent women is considered an ideal solution. However, recent reports (April 2015) have shown that serotype IV GBS is emerging in pregnant carriers and causing infections in neonates and adults. This emergence is of concern because GBS conjugate vaccines that are being developed to prevent invasive disease may protect only against serotypes Ia, Ib, II, III, and V, or combinations thereof. Though research for the development of such a vaccine is underway, a good candidate vaccine has yet to surface.

  11. Practical applications of trace minerals for dairy cattle. (United States)

    Overton, T R; Yasui, T


    Trace minerals have critical roles in the key interrelated systems of immune function, oxidative metabolism, and energy metabolism in ruminants. To date, the primary trace elements of interest in diets for dairy cattle have included Zn, Cu, Mn, and Se although data also support potentially important roles of Cr, Co, and Fe in diets. Trace minerals such as Zn, Cu, Mn, and Se are essential with classically defined roles as components of key antioxidant enzymes and proteins. Available evidence indicates that these trace minerals can modulate aspects of oxidative metabolism and immune function in dairy cattle, particularly during the transition period and early lactation. Chromium has been shown to influence both immune function and energy metabolism of cattle; dairy cows fed Cr during the transition period and early lactation have evidence of improved immune function, increased milk production, and decreased cytological endometritis. Factors that complicate trace mineral nutrition at the farm level include the existence of a large number of antagonisms affecting bioavailability of individual trace minerals and uncertainty in terms of requirements under all physiological and management conditions; therefore, determining the optimum level and source of trace minerals under each specific situation continues to be a challenge. Typical factorial approaches to determine requirements for dairy cattle do not account for nuances in biological function observed with supplementation with various forms and amounts of trace minerals. Trace mineral nutrition modulates production, health, and reproduction in cattle although both formal meta-analysis and informal survey of the literature reveal substantial heterogeneity of response in these outcome variables. The industry has largely moved away from oxide-based programs toward sulfate-based programs; however, some evidence favors shifting supplementation strategies further toward more bioavailable forms of inorganic and organic trace


    Directory of Open Access Journals (Sweden)

    Alena JEŽKOVÁ


    Full Text Available The objective of this study was to determine the relationship between calving year and season, parity, number of AI, day of lactation, milk production in the 1st 100 lactation days or diseases occurrence (retained placenta, endometritis or cysts, sperm motility (SM during 30, 60 and 90 minutes of the cervical mucus survival test, cervical mucus crystallization (CMC and their infl uence on days to fi rst insemination (interval, open days (SP, inseminations number for pregnancy (index, and pregnancy rates (PR in Holstein cows (n=284. Signifi cant differences of interval, SP and index were detected also in relation to number of AI and day of lactation (P < 0.001. Cows without reproduction diseases (healthy had better results of interval, SP (P < 0.01, index and PR. Pregnancy rate of healthy cows was by 11.43% higher, but without statistical signifi cance. The higher results of PR (62.74% were discovered in relation to ferny-like crystallization of cervical mucus (P < 0.001. CMC affected results of cervical mucus survival test, the highest motility of sperms after the 60 and 90 minutes was assumed in the case of club moss – ferny (14.80% and 7.96% and ferny-like crystallization (13.82% and 8.47% with statistical signifi cance (P < 0.05. The choice of these characteristics and defi nition of their relations allows assuming their using for detailed study and determination of the cows´ biological ability to conceive, the one of the main components of effi ciency of cows´ reproduction.

  13. Infectious morbidity, operative blood loss, and length of the operative procedure after cesarean delivery by method of placental removal and site of uterine repair. (United States)

    Magann, E F; Washburne, J F; Harris, R L; Bass, J D; Duff, W P; Morrison, J C


    This study was done to determine the impact of the method of placental removal and the site of uterine repair on postcesarean infectious morbidity rates in women receiving prophylactic antibiotics at cesarean delivery. This prospective study included 284 women who underwent cesarean delivery and who were randomly assigned to four groups based on the method of placental removal and the site of uterine repair: group 1, spontaneous placental removal and in situ uterine repair; group 2, spontaneous placental removal and exteriorized uterine repair; group 3, manual placental removal and in situ uterine repair; and group 4, manual placental removal with exteriorized uterine repair. Exclusion criteria were repeat cesarean deliveries without labor, active infection at the time of cesarean delivery, and patient refusal to participate. There was no significant difference among the groups in maternal age, race, parity, weight, the length of time from rupture of membranes (ROM) or the number of vaginal examinations from ROM to cesarean delivery, or preoperative hematocrit. Intraoperatively, the type of uterine incision, anesthesia administered, incidence of meconium-stained amniotic fluid, Apgar scores, and cord gases were similar between groups. The incidence of postcesarean endometritis was greater in group 4 (32 [45 percent] of 71, p = 0.003) compared with group 1 (17 [24 percent] of 71), group 2 (12 [30 percent] of 71); and group 3 (13 [18 percent] of 71). Manual placental removal and exteriorization of the uterus for repair of the surgical incision increases the infectious morbidity rate in women receiving prophylactic antibiotics at the time of cesarean delivery and increases the length of hospitalization.

  14. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. (United States)

    Ganchimeg, T; Ota, E; Morisaki, N; Laopaiboon, M; Lumbiganon, P; Zhang, J; Yamdamsuren, B; Temmerman, M; Say, L; Tunçalp, Ö; Vogel, J P; Souza, J P; Mori, R


    To investigate the risk of adverse pregnancy outcomes among adolescents in 29 countries. Secondary analysis using facility-based cross-sectional data of the World Health Organization Multicountry Survey on Maternal and Newborn Health. Twenty-nine countries in Africa, Latin America, Asia and the Middle East. Women admitted for delivery in 359 health facilities during 2-4 months between 2010 and 2011. Multilevel logistic regression models were used to estimate the association between young maternal age and adverse pregnancy outcomes. Risk of adverse pregnancy outcomes among adolescent mothers. A total of 124 446 mothers aged ≤24 years and their infants were analysed. Compared with mothers aged 20-24 years, adolescent mothers aged 10-19 years had higher risks of eclampsia, puerperal endometritis, systemic infections, low birthweight, preterm delivery and severe neonatal conditions. The increased risk of intra-hospital early neonatal death among infants born to adolescent mothers was reduced and statistically insignificant after adjustment for gestational age and birthweight, in addition to maternal characteristics, mode of delivery and congenital malformation. The coverage of prophylactic uterotonics, prophylactic antibiotics for caesarean section and antenatal corticosteroids for preterm delivery at 26-34 weeks was significantly lower among adolescent mothers. Adolescent pregnancy was associated with higher risks of adverse pregnancy outcomes. Pregnancy prevention strategies and the improvement of healthcare interventions are crucial to reduce adverse pregnancy outcomes among adolescent women in low- and middle-income countries. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  15. Prognosis of endometrial carcinoma stage I in two Swedish regions

    International Nuclear Information System (INIS)

    Sorbe, B.; Kjellgren, O.; Stenson, S.; Umeaa Univ. Hospital; Uppsala Univ.


    A high dose-rate afterloading technique ( 60 Co) was compared with a low dose-rate packing method ( 226 Ra) in the treatment of endometrical carcinoma stage I. In all, 1021 patients treated during the period 1977-1986 at two Swedish gynecologic oncology centers were analyzed regarding treatment set-up, histopathologic outcome in the operative specimens, recurrence rates, survival rates and radiation side effects. Complete tumor eradication in the operative specimen was achieved in 80% after radium therapy and in 60% after irradiation by the high dose-rate technique. The overall recurrence rate was 15.7% in the radium packing series and 11.5% after cobalt afterloading treatment. The risk of pelvic recurrences increased by 2.1-2.6 if hysterectomy was replaced by dilatation and curettage. The two radiation techniques seemed t be comparable with regard to the risk of both pelvic recurrences and distant metastases. The 5-year crude survival rates were 85% in the afterloading series and 82% in the radium series. The corrected survival rates were similar (90%) for the two techniques. Age, tumor grade and uterine size were significant prognostic factors with regard to the probability of death due to cancer. Early radiation reactions had quite similar rates in the two series, whereas late radiation reactions were more frequent in the high dose-rate afterloading group in the 10-12 Gy dose fraction range, but not in the 5-8 Gy range. The radium packing method seemed to give a higher frequency of tumor-free operative specimens in this study, but with regard to recurrence rates and survival probabilities the techniques were comparable. Since the different proportion of surgery in the two series and the histopathologic evaluation might have influenced the rate of local tumor eradication in the operative specimens and the risk of pelvic recurrences the results must be assessed with great caution and only a crude comparison of the two treatment techniques could be made. (orig.)

  16. Antepartal insulin-like growth factor 1 and insulin-like growth factor binding protein 2 concentrations are indicative of ketosis in dairy cows. (United States)

    Piechotta, M; Mysegades, W; Ligges, U; Lilienthal, J; Hoeflich, A; Miyamoto, A; Bollwein, H


    A study involving a small number of cows found that the concentrations of insulin-like growth hormone 1 (IGF1) may be a useful predictor of metabolic disease. Further, IGF1 may provide also a pathophysiological link to metabolic diseases such as ketosis. The objective of the current study was to test whether the low antepartal total IGF1 or IGF1 binding protein (IGFBP) concentrations might predict ketosis under field conditions. Clinical examinations and blood sampling were performed antepartum (262-270 d after artificial insemination) on 377 pluriparous pregnant Holstein Friesian cows. The presence of postpartum diseases were recorded (ketosis, fatty liver, displacement of the abomasum, hypocalcemia, mastitis, retention of fetal membranes, and clinical metritis or endometritis), and the concentrations of IGF1, IGFBP2, IGFBP3, and nonesterified fatty acids were measured. Cows with postpartum clinical ketosis had lower IGF1 concentrations antepartum than healthy cows. The sensitivity of antepartal IGF1 as a marker for postpartum ketosis was 0.87, and the specificity was 0.43; a positive predictive value of 0.91 and a negative predictive value of 0.35 were calculated. The cows with ketosis and retained fetal membranes had lower IGFBP2 concentrations compared with the healthy cows. It can be speculated that lower IGF1 production in the liver during late pregnancy may increase growth hormone secretions and lipolysis, thereby increasing the risk of ketosis. Lower IGFBP2 concentrations may reflect the suppression of IGFBP2 levels through higher growth hormone secretion. In conclusion, compared with nonesterified fatty acids as a predictive parameter, IGF1 and IGFBP2 may represent earlier biomarkers of inadequate metabolic adaptation to the high energy demand required postpartum. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  17. Pathology of brucellosis in bison from Yellowstone National Park (United States)

    Rhyan, Jack C.; Gidlewski, T.; Roffe, T.J.; Aune, K.; Philo, L.M.; Ewalt, D.R.


    Between February 1995 and June 1999, specimens from seven aborted bison (Bison bison) fetuses or stillborn calves and their placentas, two additional placentas, three dead neonates, one 2-wk-old calf, and 35 juvenile and adult female bison from Yellowstone National Park (USA) were submitted for bacteriologic and histopathologic examination. One adult animal with a retained placenta had recently aborted. Serum samples from the 35 juvenile and adult bison were tested for Brucella spp. antibodies. Twenty-six bison, including the cow with the retained placenta, were seropositive, one was suspect, and eight were seronegative. Brucella abortus biovar 1 was isolated from three aborted fetuses and associated placentas, an additional placenta, the 2-wk-old calf, and 11 of the seropositive female bison including the animal that had recently aborted. Brucella abortus biovar 2 was isolated from one additional seropositive adult female bison. Brucella abortus was recovered from numerous tissue sites from the aborted fetuses, placentas and 2-wk-old calf. In the juvenile and adult bison, the organism was more frequently isolated from supramammary (83%), retropharyngeal (67%), and iliac (58%) lymph nodes than from other tissues cultured. Cultures from the seronegative and suspect bison were negative for B. abortus. Lesions in the B. abortus-infected, aborted placentas and fetuses consisted of necropurulent placentitis and mild bronchointerstitial pneumonia. The infected 2-wk-old calf had bronchointerstitial pneumonia, focal splenic infarction, and purulent nephritis. The recently-aborting bison cow had purulent endometritis and necropurulent placentitis. Immunohistochemical staining of tissues from the culture-positive aborted fetuses, placentas, 2-wk-old calf, and recently-aborting cow disclosed large numbers of B. abortus in placental trophoblasts and exudate, and fetal and calf lung. A similar study with the same tissue collection and culture protocol was done using six

  18. Effects of a bacterial lipopolysaccharide on the reproductive functions of rabbit does. (United States)

    Brecchia, G; Menchetti, L; Cardinali, R; Castellini, C; Polisca, A; Zerani, M; Maranesi, M; Boiti, C


    Systemic and local infections and inflammations are known to cause infertility in humans and animals. However, the mechanisms by which infection/inflammation induces infertility are only partially known. The objectives of this study were: (i) to provide models of systemic (acute) and local (sub-acute) inflammation by intra-peritoneal injection or intra-cervical deposition of lipopolysaccharide (LPS) in the rabbit and (ii) to assess their effects on uterine tissues and sperm transport in the genital tract of rabbit does. Intra-peritoneal administration of different doses of LPS induced systemic effects such as fever, anorexia and changes in white blood cells (WBC) count. In our study, LPS inoculation (100μg/kg) produced an inflammation-like status that lasted for about 3 days, with minimal distress for the animals. Intra-peritoneal administration of LPS 60h before artificial insemination induced a rapid increase of IL-1β concentrations. The intra-cervical inoculation of LPS did not show any systemic effects, as confirmed by the lack of changes in body temperature, feed intake and WBC count. Histological examination of uterine tissues showed an endometritis-like inflammation status in LPS-treated does, more severe in those inoculated intra-cervically. The number of spermatozoa recovered from uterine horns and oviducts of intra-cervically treated does was less than that retrieved from intra-peritoneally treated animals and controls. These results suggest (i) that sub-acute or acute inflammation may cause infertility by compromising the uterine environment and/or impairing sperm transport and (ii) that the LPS-induced -infection/inflammation experimental model is useful for studying the mechanisms involved in reproductive dysfunctions in the rabbit. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Microstructural changes of cows’ uterus in an infection caused by Haemophilus somnus

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    Danka Šťastná


    Full Text Available The reproductive form of Haemophilic infection caused by a microorganism Histophilus somni (Haemophilus somnus is in our conditions practically unknown and undiscovered disease of cow reproductive organs. The aim of this work was based on experimental work to provide a comprehensive view on the patho-histological and submicroscopic changes in the uterus of 60 cows, serological positive, crossbreeds Slovenske strakate x Holstein, aged 3.5 . 4.5 years, serological positive, which were up to 90 days after the parturition sterile. After the hormonal control of the oestrus cycle (PGF2ƒż-Oestrophan SPOFA the cows were inseminated and the non-gravid cows later killed. The reproductive organs of killed animals were pathologically . anatomically dissected with following histological and sub-microscopic study of uterus and cervix tissue. At the beginning of the experiment no clinical changes of the reproductive organs of group 1 animals with the titer of antibodies 1:25-100 were diagnosed and in group 3 with the titer 1:25. At an examination before killing were examined endometritis (EM of grade II. and vaginitis with vestibulitis in these groups. At the rest of animals appeared in every level of the titer of antibodies of EM II. and EM III. EM I. were not clinically diagnosed. Dissecting examination determined EM catarrhalis and cervicis catarrhalis in all groups. The histological examination pointed to EM catarrhalis chronica, EM interstitialis chronica, EM fibrousis and cervicis catarrhalis chronica. The leucocytes gained from a uterus lavage were in a comparison with stroma leucocytes mostly polynuclear (neutrophils and in smaller amount small forms of lymfocytes. At long-term sterility of cows, because of possible H. somnus infection, we regard as priority the serodiagnostics at which is taken into consideration any level of the titer of antibodies.

  20. La enfermedad perinatal y la prematuridad pertenecen a un síndrome clínico multifactorial: participación de la herencia de enfermedad vascular, la flora microbiana vaginal y el estado nutricional

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    Lilia Huiza


    Full Text Available OBJETIVOS: 1 Conocer las características maternas y la asociación de la flora microbiana vaginal (FMV en gestantes con riesgo alto de prematuridad (GAP; y, 2 Determinar la asociación de la FMV y el resultado materno-perinatal en dichas gestantes. DISEÑO: Estudio caso-control, desde enero 1994 hasta diciembre 1995. MATERIAL Y MÉTODOS: El grupo de casos incluyó 238 madres con gestaciones simples, internadas por amenaza de parto pretérmino, fluido vaginal aumentado, pielonefritis aguda e hipertensión arterial, a quienes se realizó estudio directo en lámina de la FMV. El grupo control consistió en 3 850 gestantes con feto único que tuvieron parto a término en el mismo período. Las gestantes del grupo de casos fueron separadas en aquellas que presentaron vaginitis bacteriana (n=136, vaginosis bacteriana (VB, n=57 y trichomonas vaginalis (TV, n=45. RESULTADOS: Las gestantes con TV y aquellas con VB tenían una pareja sexual. Los casos presentaron mayor riesgo de malnutrición materna, peso materno bajo, un familiar diabético/hipertenso crónico, prediabetes, anemia crónica, amenaza de aborto, cicatriz uterina, fiebre puerperal y endometritis. Los neonatos de los casos presentaron mayor riesgo de hiperbilirrubinemia, sepsis neonatal, prematuridad, dificultad respiratoria, morbilidad neonatal, infante pequeño y grande para la edad de gestación. CONCLUSIONES: La herencia y el medio ambiente determinan el estado de nutrición, el tipo de flora microbiana vaginal y la respuesta inflamatoria del huésped (madre/feto. La respuesta del huésped a varios factores estresores sería la responsable del síndrome del parto pretérmino, la prematuridad y la morbilidad neonatal.

  1. Complicaciones maternas de la cesárea en gestantes a término en periodo expulsivo en un hospital general de Lima, Perú

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    Javier Puma


    Full Text Available Objetivo: Describir las complicaciones maternas de la cesárea en gestantes a término en periodo expulsivo en un hospital general. Material y métodos: Estudio descriptivo, observacional, retrospectivo, tipo serie de casos, realizado en el Hospital Nacional Cayetano Heredia entre el 1 de enero de 2011 hasta el 31 diciembre de 2012. Se incluyeron 67 gestantes a término operadas en periodo expulsivo. Se revisaron las historias clínicas de las pacientes, se registraron las características clínicas y las complicaciones maternas. Resultados: En el periodo de estudio se realizaron 4 218 cesáreas, siendo el 1,84% hechas en periodo expulsivo. En general, 59/ 67 (88,1% presentaron algún tipo de complicación. Se observaron 8 casos de hipotonía uterina (11,9% y 2 (2,9% de atonía. En 5 (7,4% pacientes ocurrieron desgarros de segmento adyacente a la histerotomía, siendo 2 de ellos asociados a compromiso de cuerpo uterino y vagina, y 4 (5,9% casos a laceración de arteria uterina, uno fue bilateral. No se produjeron lesiones en tracto urinario ni digestivo y tampoco hubo necesidad de reintervención quirúrgica. Cuatro pacientes presentaron hemorragia puerperal, dos asociados a hipotonía uterina post cesárea. En 56 (83,5% casos ocurrió anemia post operatoria. Hubo 1 (1,5% caso de endometritis, 3 (4,5% infecciones de herida operatoria. Conclusiones: La cesárea realizada en período expulsivo ocasiona complicaciones frecuentes, algunas muy severas.

  2. Identifikasi Gangguan Reproduksi Sapi Betina di Peternakan Rakyat (IDENTIFICATION OF REPRODUCTIVE DISORDERS IN FEMALE CATTLE AT LOCAL FARMS

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    Sutiyono Sutiyono


    Full Text Available The aim of this research was to determine the female reproductive disorders in cattle reared by local farmers in the Distric of Kaliori, Rembang Regency, Central Java Province. A total of 94 cattle were used, in which had minimal one of each incisors had been replaced. The study used survey methods, and data were collected by interviewing with ranchers, rectal palpation, identification of the incisors, and body condition score of the cattle. In the implementation of the study, cattle were taken to a place determined by the chairman of the group of farmers (field or home page. The parameters of study were unheard of oestrus or not, the amount of artificial insemination, the number of incisors changed, body condition score of each cattle, the feed given, and their maintenance. The data were analyzed using statistical descriptive analysis on the mode, range, and percentage. The results showed that of the 94 cattle, which have disorders of reproductive activity as much as 80. Samples with impaired reproductive activity were divided into three groups. The first group was the old heifers that had no oestrus 25.00%, the second group was cattle that were more than three times applied artificial insemination and had not been pregnant 45.00%, and the third group was cattle that more than three months after the last giving birth had no oestrus 30.00%. The other reproductive disorders that occured in individual of the cattle was inactive ovaries (follicle undeveloped 2.50%, 6.25% ovary hypofunction, ovarian cystic 1.25%, endometritis 2.50% and 2.50% abnormal uterus. In conclusion, the largest reproductive disorders in cattle caused by nutritional factors that provided by the farmers, and small disturbances due to some diseases and abnormal reproductive organs.

  3. Puerperal infections. (United States)

    Eschenbach, D A; Wager, G P


    This comprehensive review on puerperal infections covers risk factors, causative bacteria, pathophysiology, diagnosis, therapy of specific entities, and prevention. Puerperal infection is problematic to define especially with antibiotics that change the course of fever. I may present as endometritis (most common), myometritis, parametritis, pelvic abscess, salpingitis, septic pelvic thrombophlebitis or septicemia, and also includes infections of the urinary tract, episiotomy, surgical wounds, lacerations or breast. Each of these is discussed in terms of contributing factors, microbiology, clinical findings, diagnosis, treatment, prevention and complications. Risk factors in general are cesarean section, premature rupture of the membranes, internal fetal monitoring, general anesthesia, pelvic examinations. The most common bacterial involved are group B and other streptococci, E. coli, Gardnerella vaginalis, Gram positive anaerobic cocci, Mycoplasma and pre-existing Chlamydial infections. Diagnosis of the causative organism is difficult because of polyinfection and difficulty of getting a sterile endometrial swab. Diagnosis of the infection is equally difficult because of the wide variety of symptoms: fever, abnormal lochia, tachycardia, tenderness, mass and abnormal bowel sounds are common. Therapy depends of the responsible microorganism, although 3 empirical tactics are suggested while awaiting results of culture: 1) choose an antibiotic for the most common aerobic bacteria; 2) an antibiotic effective against B. fragilis and one for aerobic bacteria, e.g. clindamycin and an aminoglycoside; 3) a nontoxic antibiotic active against most aerobic and anaerobic organisms, e.g. doxycycline or cefoxitin. An example of an infection recently described is pudendal-paracervical block infection, often signaled by severe hip pain. It is associated with vaginal bacteria, is usually complicated by abscess even with antibiotic coverage, and may end in paraplegia or fatal sepsis

  4. Coxiella burnetii associated reproductive disorders in domestic animals-a critical review

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    Agerholm Jørgen S


    Full Text Available Abstract The bacterium Coxiella burnetii has been detected in the fetal membranes, birth fluids and vaginal mucus, as well as in the milk and other excretions of several domestic mammals. The finding of C. burnetii in association with abortion, parturition and in the postpartum period has led to the hypothesis that C. burnetii causes a range of reproductive diseases. This review critically evaluates the scientific basis for this hypothesis in domestic mammals. The review demonstrates a solid evidence for the association between C. burnetii infection and sporadic cases of abortion, premature delivery, stillbirth and weak offspring in cattle, sheep and goats. C. burnetii induced in-herd epidemics of this complete expression of reproductive failure have been reported for sheep and goats, but not for cattle. The single entities occur only as part of the complex and not as single events such as generally increased stillbirth rate. Studies show that C. burnetii initially infects the placenta and that subsequent spread to the fetus may occur either haematogenous or by the amniotic-oral route. The consequences for the equine, porcine, canine and feline conceptus remains to the elucidated but that infection of the conceptus may occur is documented for most species. There is no solid evidence to support a hypothesis of C. burnetii causing disorders such as subfertility, endometritis/metritis, or retained fetal membranes in any kind of domestic animal species. There is a strong need to validate non-pathology based methods such as polymerase chain reaction for their use in diagnostic and research in relation to establishing C. burnetii as the cause of abortion and to adapt an appropriate study design and include adequate control animals when linking epidemiological findings to C. burnetii or when evaluating effects of vaccination in production herds.

  5. Effect of Calcium Borogluconate Injection pre and Immediately Postpartum on Production Performance, Incidence of Metabolic Disorders and Situation of the Uterus After Calving in Cows Fed Anionic Diets

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    H. Amanlou


    Full Text Available The objective of this study was to determine the effect of calcium borogluconate injection 48 and 24 hours prepartum and immediately after parturition on dry matter intake at day of calving, milk yield, incidence of metabolic disorders and uterine conditions during the first 21 days postpartum in cows fed anionic diets. Thirty six lactating dairy cows were balanced by parity (1, 2, 3+ and allocated to 4 subcutaneous injection treatments of 15.2 gr calcium as borogluconate at different times pre and postpartum than expected calving date . Group 1 consisted of 9 cows receiving no treatment before or after parturition. Group 2 consisted of 9 cows receiving calcium borogluconate 48 h prepartum.Group 3 consisted of 9 cows receiving calcium borogluconate 24 h prepartum. Group 4 consisted of 9 cows receiving 15.2 gr of ca as borogluconate immediately postpartum. Dry matter intake was in treatments 1, 2, 3 and 4 was 10.87, 12.32, 12.63 and 15.03 kg in the first 24 h after calving, respectively And indicated significantly difference among treatments. milk yield in 2, 3 and 4 treatments was significantly greater than group 1 in the first 21 days of lactation (38.7, 38.9, 40.3 vs 36.07 kg/d. Treatment had a significant effect on the subclinical hypocalcemia incidence so incidence risk of subclinical hypocalcemia in 1 treatment was 10 times more likely than 4 treatment. Data regression analysis indicated that 4 treatment had a significant effect on the ketosis incidence. So that the cows no calcium injection 2.43 times more likely to experience ketosis than 4 treatment. But experimental treatments were not significantly effect on the incidence of milk fever, displacement abomasum, retained placenta, metritis and endometritis. In general, calcium injection, especially immediately after parturation increased the dry matter intake in day of calving and reduced metabolic disorders such as hypocalcaemia and ketosis.

  6. Recurrent pregnancy loss: current perspectives

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    El Hachem H


    Full Text Available Hady El Hachem,1,2 Vincent Crepaux,3 Pascale May-Panloup,4 Philippe Descamps,3 Guillaume Legendre,3 Pierre-Emmanuel Bouet3 1Department of Reproductive Medicine, Ovo Clinic, Montréal, QC, Canada; 2Department of Obstetrics and Gynecology, University of Montreal, Montréal, QC, Canada; 3Department of Obstetrics and Gynecology, Angers University Hopsital, Angers, France; 4Department of Reproductive Biology, Angers University Hospital, Angers, France Abstract: Recurrent pregnancy loss is an important reproductive health issue, affecting 2%–5% of couples. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Other etiologies have been proposed but are still considered controversial, such as chronic endometritis, inherited thrombophilias, luteal phase deficiency, and high sperm DNA fragmentation levels. Over the years, evidence-based treatments such as surgical correction of uterine anomalies or aspirin and heparin for antiphospholipid syndrome have improved the outcomes for couples with recurrent pregnancy loss. However, almost half of the cases remain unexplained and are empirically treated using progesterone supplementation, anticoagulation, and/or immunomodulatory treatments. Regardless of the cause, the long-term prognosis of couples with recurrent pregnancy loss is good, and most eventually achieve a healthy live birth. However, multiple pregnancy losses can have a significant psychological toll on affected couples, and many efforts are being made to improve treatments and decrease the time needed to achieve a successful pregnancy. This article reviews the established and controversial etiologies, and the recommended therapeutic strategies, with a special focus on unexplained recurrent pregnancy losses and the empiric treatments used nowadays. It also discusses the current role of preimplantation genetic testing in the management of recurrent pregnancy

  7. Monitoring metabolic health of dairy cattle in the transition period. (United States)

    LeBlanc, Stephen


    This paper reviews the importance of energy metabolism in transition dairy cows, its associations with disease and reproduction, and strategies for monitoring cows under field conditions during this critical time. Essentially all dairy cattle experience a period of insulin resistance, reduced feed intake, negative energy balance, hypocalcemia, reduced immune function, and bacterial contamination of the uterus soon before, or in the weeks after calving. One-third of dairy cows may be affected by some form of metabolic or infectious disease in early lactation. Routine, proactive actions, observations, or analysis are intended to accurately and efficiently provide early detection of problems, to provide an opportunity for investigation and intervention in order to limit the consequences and costs of health problems and reduced animal performance or welfare. Methods of early detection include monitoring of disease and culling records, feed intake, milk production, body condition, and simple metabolic tests. Methods, strategies, and interpretation of measurement of peripartum concentrations of non-esterified fatty acids (NEFA) and beta-hydroxybutyrate (BHB) as indicators of aspects of energy status and disease risk are reviewed. High NEFA (> 0.4 mmol/l) in the last 7 to 10 days before expected calving is associated with increased risk of displaced abomasum (DA), retained placenta, culling before 60 days in milk, and less milk production in the first 4 months of lactation. Subclinical ketosis (serum BHB >1200 to 1400 micromol/l) in the first or second week after calving is associated with increased risk of DA, metritis, clinical ketosis, endometritis, prolonged postpartum anovulation, increased severity of mastitis, and lower milk production in early lactation. There are several validated and practical tools for cow-side measurement of ketosis.

  8. Correlates of vaginal colonization with group B streptococci among pregnant women

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    Tsering Chomu Dechen


    Full Text Available Background: A study of genital colonization by group B streptococcus (GBS was conducted in pregnant women in their third trimester, which is a known risk factor of morbidity and mortality among newborns. Aims: The present study was undertaken to study the prevalence and the correlates of vaginal colonization by GBS among pregnant women. Setting and Design: This observational cross-sectional study was conducted during September 2002 to March 2004 on 524 pregnant women. Materials and Methods: Three high vaginal swabs were obtained from all the pregnant women admitted at term and in preterm labor. Two swabs were used for aerobic culture and the third one for gram staining. The first set of swabs was cultured on 5% Sheep blood agar plates. The second set of swabs were inoculated into Todd-Hewitt broth and then subcultured in 5% Sheep blood agar plates. The main outcome measures were the presence of GBS infection in comparison to the age group, gravida, gestational age, premature rupture of membrane (PROM, preterm labor and association with febrile spells of the present pregnancy. Results: The culture positivity rate of GBS was 4.77% and coexistent organisms isolated were Candida species (36%, Staphylococcus aureus (8% and Enterococcus species (8%. Culture positivity in the age group of 18-25 years was 5.71%, of which 5.74% were in their first pregnancy. The correlation between age group and gravida with GBS culture positivity was statistically insignificant. The culture positivity in <36 weeks of gestational age was 6.93%. This relation was statistically significant. Twenty-eight percent developed PROM. Sixty-four percent of culture positives had preterm labor. Conclusion: GBS infection among pregnant women was significantly correlated with the gestational age, PROM and preterm labor. In pregnancy GBS colonization causes asymptomatic bacteriuria or UTI. It is a well known cause of puerperal infections with amnionitis,endometritis and sepsis being

  9. Correlation between transvaginal ultrasound measured endometrial thickness and histopathological findings in Turkish women with abnormal uterine bleeding. (United States)

    Ozer, Alev; Ozer, Serdar; Kanat-Pektas, Mine


    The present study aims to determine how transvaginal ultrasonography and histopathological examination findings are correlated in a cohort of premenopausal and postmenopausal Turkish women with abnormal uterine bleeding. This is a retrospective review of 350 Turkish women who underwent transvaginal ultrasonography and suction curettage as a result of abnormal uterine bleeding. Sonographic appearance of the endometrium was normal in 244 patients (69.7%), while homogeneous thickening was detected in 47 patients (13.4%) and cystic thickening in 21 patients (6.0%). A sonographic diagnosis of endometrial polyp was made in 38 patients (10.9%). Histopathological analysis of endometrial samplings revealed proliferative endometrium (36%), secretory endometrium (24.6%), decidualization (10.9%), endometrial polyp (8.3%), endometritis (6.8%), endometrial hyperplasia (4.6%), irregular shedding (3.7%), atrophic endometrium (3.1%), endometrial cancer (1.1%) and placental retention (0.9%). The sonographic and histopathological findings correlated significantly (χ(2) = 122 768, P = 0.001; r = 0.215, P = 0.001). Approximately 51% of the women with homogeneous endometrial thickening had proliferative endometrium. Only 44.7% of the women with ultrasonographically visualized endometrial polyps had histopathologically diagnosed endometrial polyps. Nearly 57% of the women with cystic endometrial thickening had proliferative endometrium. If there is no facility for hysteroscopy or hysteroscopy-guided endometrial biopsy for women with abnormal uterine bleeding, transvaginal ultrasonography findings can be efficiently used to make a preliminary diagnosis and, thus, notify the pathologists. © 2016 Japan Society of Obstetrics and Gynecology.


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    Marco González T


    Full Text Available Objetivo. Establecer la prevalencia de algunos gérmenes asociados con infertilidad infecciosa de bovinos del municipio de Montería. Materiales y métodos. Se recolectaron 384 muestras sanguíneas e igual número de hisopados cervicales de hembras que cumplieron con alguno de los siguientes criterios de inclusión: más de tres servicios sin concepción, vaginitis, cervicitis, metritis, endometritis, útero con contenido, momificación fetal, natimortos, reabsorciones embrionarias, antecedentes de abortos y/o hembras positivas a brucelosis. Las muestras cervicales se sembraron en agar Mc conkey, agar sangre, agar brucella y agar campylobacter. A las colonias sospechosas se le realizaron pruebas bioquímicas y la confirmación se llevó a cabo con pruebas serológicas. Para el serodiagnóstico de Brucella, los sueros fueron analizados por Rosa de Bengala y los positivos fueron confirmados con ELISA indirecta. Resultados. De las 384 muestras procesadas, hubo crecimiento en 281 (73,2%, las bacterias prevalentes fueron Escherichia coli, Bacilos Gram Negativos Oxidantes, Klepsiella spp y Pseudomonas spp, que correspondieron a 194 (69.1% aislamientos y cinco muestras equivalentes al 1.8% resultaron positivas para Campylobacter spp. Las pruebas serológicas para Brucella arrojaron como resultado 22 muestras positivas por ELISA (6.3%. Conclusiones. Los resultados de este trabajo describen de forma preliminar la posible asociación bacteriana en la infertilidad infecciosa en hembras vacunas, demostrando la presencia de una gran variedad de microorganismos.

  11. Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas

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    Nishino, Mizuki E-mail:; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo


    Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

  12. Influence of mycotoxin zearalenone on the swine reproductive failure

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    Prodanov-Radulović Jasna Z.


    Full Text Available Reproductive failure in swine is often a difficult diagnostic problem. If diagnoses of infectious disease or management related problems are not obtained, feed quality and safety may be questioned. Mycotoxins are often present in swine feed in the amount that can have detrimental impact on production and reproduction. Problems are expressed only as alterations of the reproductive cycle, reduced feed intake, slow growth or impaired feed efficiency. In Serbia, generally speaking, high concentrations of mycotoxins were noticed, especially mycotoxin zearalenone. High presence of zearalenone in swine feed is probably due to climatic influence and should be monitored constantly. This paper includes field observations regarding the influence of moldy feed containing mycotoxin zearalenone on the occurrence of the reproductive failure in swine breeding categories (sows, gilts and boars. The material for this research was obtained from four swine farms where certain reproductive disorders and health problems in breeding animals were detected. Depending on the specificity of each evaluated case and available material, the applied research methods included: anamnestic and clinical evaluation, pathomorphological examination, standard laboratory testing for detection of aerobic and anaerobic bacteria, and microbiological feed testing, in order to examine the presence of fungi and mycotoxins by applying the method of thin layer chromatography. On the basis of the obtained results, it could be concluded that mycotoxin zearalenone was detected in all examined feed samples. The presence of mycotoxin in feed was directly related to the reproductive failures in the examined swine categories (vulvovaginitis, endometritis, rebreeding, infertility. Swine reproduction represents the base for intensive swine production. The presence of mycotoxins in swine feed have influence on the reproduction and health status of pigs and under certain conditions may significantly

  13. Frequency of urogenital mycoplasma detection in women of Dnipropetrovsk

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    K. V. Bubalo


    Full Text Available The frequency of urogenital mycoplasmas detection in women of different ages was studied in culture with the help of DUO test-system in order to determine their etiological significance in the development of inflammatory processes of women urogenital tract. We identified the researched cultures Mycoplasma hominis, Ureaplasma urealyticum in the diagnostic titer >104 TEM/ml indicating severe contamination by microorganisms, and in the titer 104 TEM/ml, 104 TEM/ml was observed in 55 women (46% and 20 women (17%, respectively, and the titer of <103 CFU/ml U. urealyticum was observed in 20 women (17%, and M. hominis in 18 women (15%. Analysis of genital mycoplasmas distribution among women of different ages has shown that there was the certain correlation between the patient age and frequency of genital mycoplasmas detection: the highest detection rate was observed in women age of 24–29. The dominant pathogen of urogenital tract inflammatory processes in women in 24–29 age group is U. urealyticum. The comparison of DUO test-system and PCR data has shown that DUO test-system in culture allowed more sensitive quantitave characterization of mycoplasmas, however, for the more effective laboratory diagnostics it was necessary to use complex methods to increase the probability of pathogen detection. Incidence of mycoplasmas in women with the presence of inflammation was higher than in women having the inflammation in the genital tract. In this case, potential symptom-free carriers exist for the development of inflammation of urogenital tract of women. Scientists have proved that mycoplasma could cause vulvovaginitis, urethritis, paraurethritis, bartholinitis, adnexitis, salpingitis, endometritis, and ovaritis.

  14. [Application of sumamed in treatment of bacterial vaginal infections during pregnancy]. (United States)

    Nikolov, A; Shopova, E; Nashar, S; Dimitrov, A


    To study the efficacy of Sumamed in cases of endogenous bacterial vaginal infections during third trimester of pregnancy. 34 women in last trimester of pregnancy with Streptococcus group B, Streptococcus group A, alpha hemolytic Streptococci, S. aureus infections and intermediate state of vaginal ecosystem (Nugent score 4-6) were treated with Sumamed (Azithromycin, 500 mg. p.o. for 3 days). Patients were separated in two groups. First group included 19 women with symptomatic and microbiologically proven recurrent vaginal infection during last 6 months. Second group included 15 symptom free pregnant women, in whom, pathogenic bacteria were found on vaginal swab and culture. Culture revealed 2 cases of Streptococcus group A infection in the second study group. Streptococcus group B was isolated in 19 patients--11 group 1 and 8--group 2. S. aureus was found in 6 patients from group 1 and 3 patients from group 2. Alpha hemolytic streptococci were cultured in 4 cases--2 from group 1 and 2 from group 2. Isolated microorganisms showed in vitro sensibility toward Sumamed. After treatment completion, control swab and culture was performed in 26 cases (14 group 1 and 12 group 2 patients). In group 1 in 12 (85,7%) patients no pathological microorganisms were cultured, Nugent scores were between 0-3 and no subjective symptoms were reported. 2 (14,3%) patients had Candida infection. In the second group 10 patients (83,5%) had normal vaginal microbiology, 2(16,5%) remained with intermediate vaginal microflora state. No newborn infections and cases of endometritis were found in both study groups. Sumamed is an efficacious treatment in cases of streptococcal and staphylococcal vaginal infections during pregnancy. Application of Sumamed results in alleviation of clinical symptoms and in sanitation of birth canal.

  15. Histologic Changes Associated With Placental Separation in Gilts Infected with Porcine Reproductive and Respiratory Syndrome Virus. (United States)

    Novakovic, Predrag; Detmer, Susan E; Suleman, Muhammad; Malgarin, Carol M; MacPhee, Daniel J; Harding, John C S


    The placenta is a vital organ providing the developing fetus with nutrient and gas exchange, thermoregulation, and waste elimination necessary for fetal development, as well as producing hormones to maintain pregnancy. It is hypothesized that fetal pig death in porcine reproductive and respiratory syndrome may be attributed to pathology of the maternal-fetal interface leading to premature placental separation. This study was designed to evaluate the chronologic progression of porcine reproductive and respiratory syndrome virus (PRRSV)-induced lesions at the maternal-fetal interface, with particular focus on placental separation in experimentally challenged third-trimester gilts. Fifteen gilts were inoculated with a virulent strain of PRRSV-2 on gestation day 86 ± 0.4. On multiple days postinoculation, 3 gilts along with 1 sham-inoculated control per time point were euthanized, and uterine and fetal placental tissues corresponding to each fetus were collected for histopathologic evaluation. The presence of any fetal lesion was 23 times more likely in compromised (meconium-stained and decomposed) compared with viable fetuses ( P < .001). In PRRSV-infected gilts, endometritis was more severe than placentitis, and the severity of endometrial inflammation and vasculitis increased progressively from 2 to 14 days postinoculation. Neither placental vasculitis nor a chronologic progression in the severity of placental detachment was observed. Severe placental detachment was more frequently present in PRRSV-infected compared with noninfected samples and was most significantly associated with placental inflammation, compared with other uterine lesions, viral load, or termination day. The results of this study suggest that placental separation by itself is not sufficient to significantly compromise fetal viability in reproductive porcine reproductive and respiratory syndrome.

  16. An updated literature review on maternal-fetal and reproductive disorders of Toxoplasma gondii infection. (United States)

    Fallahi, S; Rostami, A; Nourollahpour Shiadeh, M; Behniafar, H; Paktinat, S


    Toxoplasma gondii infection is one of the most prevalent infectious disease with worldwide distribution. Congenital toxoplasmosis is annually responsible for 1.20 million disability-adjusted life years around the world, but often it is overlooked many countries. We performed an updated review to summarize the current researches on fetal, neonatal and maternal consequences of T. gondii infection and also adverse effects of toxoplasmosis on women reproductive organs. T. gondii infection could be cause of several abnormalities from hydrocephalus, microcephaly, deafness, abortion and still birth in fetal to psychomotor retardation, intellectual disability, hearing loss, slower postnatal motor development during the first year of life; and chorioretinitis, cryptogenic epilepsy and autism spectrum disorders in newborns. Moreover, this infection is related with neuropsychiatric disorders such as anxiety, schizophrenia spectrum disorders, depression, decreased weight, autoimmune thyroid diseases, self-directed violence, violent suicide attempts in mothers. This literature review emphasized that toxoplasmosis could be an important neglected factor endometritis, ovarian dysfunction, impaired folliculogenesis, ovarian and uterine atrophy, decrease in reproductive organs weight and reproductive performance in women. We reviewed role of the immunological profile such as pro-infiammatory cytokines and hormonal changes as main potential mechanisms related to this infection and development of maternal-fetal and reproductive disorders. T. gondii is associated with several brain related disorders in both mothers and newborns, and also it is cause of several abnormalities in reproductive organs. Early diagnosis and treatment of the infection could be effective to significantly improve the clinical outcome. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. High transverse skin incisions may reduce wound complications in obese women having cesarean sections: a pilot study. (United States)

    Walton, Robert B; Shnaekel, Kelsey L; Ounpraseuth, Songthip T; Napolitano, Peter G; Magann, Everett F


    Women having cesarean section have a high risk of wound complications. Our objective was to determine whether high transverse skin incisions are associated with a reduced risk of cesarean wound complications in women with BMI greater than 40. A retrospective cohort study was undertaken of parturients ages 18-45 with BMI greater than 40 having high transverse skin incisions from January 2010 to April 2015 at a tertiary maternity hospital. Temporally matched controls had low transverse skin incisions along with a BMI greater than 40. The primary outcome, wound complication, was defined as any seroma, hematoma, dehiscence, or infection requiring opening and evacuating/debriding the wound. Secondary outcomes included rates of endometritis, number of hospital days, NICU admission, Apgar scores, birth weight, and gestational age at delivery. Analysis of outcomes was performed using two-sample t-test or Wilcoxon rank-sum test for continuous variables and Fisher's exact test for categorical variables. Thirty-two women had high transverse incisions and were temporally matched with 96 controls (low transverse incisions). The mean BMI was 49 for both groups. There was a trend toward reduced wound complications in those having high transverse skin incisions, but this did not reach statistical significance (15.63% versus 27.08%, p = .2379). Those having high transverse skin incisions had lower five minute median Apgar scores (8.0 versus 9.0, p = .0021), but no difference in umbilical artery pH values. The high transverse group also had increased NICU admissions (28.13% versus 5.21%, p = .0011), and early gestational age at delivery (36.8 versus 38.0, p = .0272). High transverse skin incisions may reduce the risk of wound complications in parturients with obesity. A study with more power should be considered.

  18. Postpartum body condition score and results from the first test day milk as predictors of disease, fertility, yield, and culling in commercial dairy herds. (United States)

    Heuer, C; Schukken, Y H; Dobbelaar, P


    The study used field data from a regular herd health service to investigate the relationships between body condition scores or first test day milk data and disease incidence, milk yield, fertility, and culling. Path model analysis with adjustment for time at risk was applied to delineate the time sequence of events. Milk fever occurred more often in fat cows, and endometritis occurred between calving and 20 d of lactation more often in thin cows. Fat cows were less likely to conceive at first service than were cows in normal condition. Fat body condition postpartum, higher first test day milk yield, and a fat to protein ratio of > 1.5 increased body condition loss. Fat or thin condition or condition loss was not related to other lactation diseases, fertility parameters, milk yield, or culling. First test day milk yield was 1.3 kg higher after milk fever and was 7.1 kg lower after displaced abomasum. Higher first test day milk yield directly increased the risk of ovarian cyst and lameness, increased 100-d milk yield, and reduced the risk of culling and indirectly decreased reproductive performance. Cows with a fat to protein ratio of > 1.5 had higher risks for ketosis, displaced abomasum, ovarian cyst, lameness, and mastitis. Those cows produced more milk but showed poor reproductive performance. Given this type of herd health data, we concluded that the first test day milk yield and the fat to protein ratio were more reliable indicators of disease, fertility, and milk yield than was body condition score or loss of body condition score.

  19. Diversity and succession of bacterial communities in the uterine fluid of postpartum metritic, endometritic and healthy dairy cows.

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    Thiago M A Santos

    Full Text Available The diversity of the uterine bacterial composition in dairy cows is still poorly understood, although the emerging picture has shown to be increasingly complex. Understanding the complexity and ecology of microorganisms in the uterus of postpartum dairy cows is critical for developing strategies to block their action in reproductive disorders, such as metritis/endometritis. Here, we used PCR-Denaturing Gradient Gel Electrophoresis (DGGE and DNA pyrosequencing to provide a comprehensive description of the uterine bacterial diversity and compare its succession in healthy, metritic and endometritic Holstein dairy cows at three intervals following calving. Samples were collected from 16 dairy cows housed in a dairy farm located in upstate New York. PCR-DGGE revealed a complex profile with extensive differences in the community structure. With few exceptions, clustering analysis grouped samples from cows presenting the same health status. Analysis of >65,000 high-quality 16S rRNA gene sequences showed that the uterine bacterial consortia, regardless of the health status, is mainly composed of members of the phyla Bacteroidetes, Fusobacteria, Firmicutes, Proteobacteria, and Tenericutes. In addition to these co-dominant phyla, sequences from Spirochaetes, Synergistetes, and Actinobacteria appear less frequently. It is possible that some sequences detected in the uterine fluid resulted from the presence of fecal or vaginal contaminants. Overall, the bacterial core community was different in uterine fluid of healthy cows, when compared to cows suffering from postpartum diseases, and the phylogenetic diversity in all the combined samples changed gradually over time. Particularly at the 34-36 days postpartum (DPP, the core community seemed to be specific for each health status. Our finding reveals that the uterine microbiota in dairy cows varies according with health status and DPP. Also, it adds further support to the hypothesis that there is uterine

  20. Chlamydiaceae and Chlamydia-like organisms in the koala (Phascolarctos cinereus)--organ distribution and histopathological findings. (United States)

    Burach, Fabienne; Pospischil, Andreas; Hanger, Jon; Loader, Jo; Pillonel, Trestan; Greub, Gilbert; Borel, Nicole


    Chlamydial infections in koalas can cause life-threatening diseases leading to blindness and sterility. However, little is known about the systemic spread of chlamydiae in the inner organs of the koala, and data concerning related pathological organ lesions are limited. The aim of this study was to perform a thorough investigation of organs from 23 koalas and to correlate their histopathological lesions to molecular chlamydial detection. To reach this goal, 246 formalin-fixed and paraffin embedded organ samples from 23 koalas were investigated by histopathology, Chlamydiaceae real-time PCR and immunohistochemistry, ArrayTube Microarray for Chlamydiaceae species identification as well as Chlamydiales real-time PCR and sequencing. By PCR, two koalas were positive for Chlamydia pecorum whereas immunohistochemical labelling for Chlamydiaceae was detected in 10 tissues out of nine koalas. The majority of these (n=6) had positive labelling in the urogenital tract related to histopathological lesions such as cystitis, endometritis, pyelonephritis and prostatitis. Somehow unexpected was the positive labelling in the gastrointestinal tract including the cloaca as well as in lung and spleen indicating systemic spread of infection. Uncultured Chlamydiales were detected in several organs of seven koalas by PCR, and four of these suffered from plasmacytic enteritis of unknown aetiology. Whether the finding of Chlamydia-like organisms in the gastrointestinal tract is linked to plasmacytic enteritis is unclear and remains speculative. However, as recently shown in a mouse model, the gastrointestinal tract might play a role being the site for persistent chlamydial infections and being a source for reinfection of the genital tract. Copyright © 2014 Elsevier B.V. All rights reserved.


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    Ojaswini Patel


    Full Text Available BACKGROUND The incidence of PROM is about 10% of all pregnancies and 70% of them occur at term. Most of the Indian studies document an incidence of 7-12% for PROM of which 60-70% occurs at term. Rest of the 30-40% is contributed at preterm. The aim of the study is to study the usefulness of maternal CRP measurements in diagnosis of chorioamnionitis, puerperal endometritis, neonatal infectious morbidities and mortalities among patients with PROM ( both term and preterm. MATERIALS AND METHODS This is a hospital-based cross-sectional observational study where 100 premature rupture of membrane cases were diagnosed and observed for fetomaternal outcome by doing routine clinical, biochemical and serum CRP examinations. RESULTS Maximum number of chorioamnionitis (16% has developed when duration of rupture was for more than 36 hrs. PROM patients with latent period of ≥36 hrs had poorer neonatal outcome; i.e. 54.83% neonatal morbidity and 84.61% neonatal mortality were seen when duration of rupture was more than 36 hrs. 47.36% of CRP positive PROM women had developed chorioamnionitis during the course of delivery or postpartum. 49.12% of CRP positive PROM women had developed preterm delivery. CRP positive PROM women had poorer neonatal outcome; i.e. 82.35% neonatal morbidity and mortality has noted in babies delivered from CRP positive mother. CONCLUSION Careful antenatal monitoring, detection and prompt treatment of infection is necessary. Strict aseptic precautions, appropriate therapy, regular antenatal follow up are important features in the prevention and management of PROM. Evaluation of CRP in blood has helped to predict development of chorioamnionitis and preterm delivery following PROM and also perinatal morbidity and mortality.

  2. Depressed polymorphonuclear cell functions in periparturient cows that develop postpartum reproductive diseases. (United States)

    Islam, Rafiqul; Kumar, Harendra; Singh, Gyanendra; Krishnan, Binsila B; Dey, Sahadeb


    The study was planned to see if there is any important and significant changes in the PMN function in cows suffering from postpartum reproductive diseases (PRD). Blood sampling was done from 41 pregnant cows on 15 days prepartum (-15d), calving day (0d), 15 days (15d) and 30 days (30d) postpartum and thorough gynaecological examination was performed on 0d, 15d, 30d and 45d for diagnosis of PRD like retained placenta (RP), clinical metritis (CM), clinical endometritis (CE) and delayed involution of uterus (DIU). The heparinised blood was used for isolation of PMN leukocytes for estimation of superoxide (SO), hydrogen peroxide (H 2 O 2 ) and enzyme myeloperoxidase (MPO) activity in each group of cows. The SO production (ΔOD) was greater for normal (0.19 ± 0.05) than cows suffering from RP (-0.12 ± 0.09), CM (-0.15 ± 0.13) and CE (-0.07 ± 0.05) at -15d. The mean value was greater for normal cows (0.12) than the cows with PRD (0.05 to 0.9) at 30d. The H 2 O 2 production was greater for normal than cows with PRD at all sampling days and significantly greater than cows with RP and CE at 15d (p cows on 0d. The depressed capability of the PMN from the cows with PRD to produce SO, H 2 O 2 and MPO during the periparturient period indicated their association with the development of RP, CM and CE.

  3. Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital.

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    Lisa M Bebell

    Full Text Available Puerperal sepsis causes 10% of maternal deaths in Africa, but prospective studies on incidence, microbiology and antimicrobial resistance are lacking.We performed a prospective cohort study of 4,231 Ugandan women presenting to a regional referral hospital for delivery or postpartum care, measured vital signs after delivery, performed structured physical exam, symptom questionnaire, and microbiologic evaluation of febrile and hypothermic women. Malaria rapid diagnostic testing, blood and urine cultures were performed aseptically and processed at Epicentre Mbarara Research Centre. Antimicrobial susceptibility and breakpoints were determined using disk diffusion per EUCAST standards. Hospital diagnoses, treatments and outcomes were abstracted from patient charts.Mean age was 25 years, 12% were HIV-infected, and 50% had cesarean deliveries. Approximately 5% (205/4176 with ≥1 temperature measurement recorded developed postpartum fever or hypothermia; blood and urine samples were collected from 174 (85%, and 17 others were evaluated clinically. Eighty-four (48% had at least one confirmed source of infection: 39% (76/193 clinical postpartum endometritis, 14% (25/174 urinary tract infection (UTI, 3% (5/174 bloodstream infection. Another 3% (5/174 had malaria. Overall, 30/174 (17% had positive blood or urine cultures, and Acinetobacter species were the most common bacteria isolated. Of 25 Gram-negatives isolated, 20 (80% were multidrug-resistant and cefepime non-susceptible.For women in rural Uganda with postpartum fever, we found a high rate of antibiotic resistance among cultured urinary and bloodstream infections, including cephalosporin-resistant Acinetobacter species. Increasing availability of microbiology testing to inform appropriate antibiotic use, development of antimicrobial stewardship programs, and strengthening infection control practices should be high priorities.

  4. Porcine semen as a vector for transmission of viral pathogens. (United States)

    Maes, Dominiek; Van Soom, Ann; Appeltant, Ruth; Arsenakis, Ioannis; Nauwynck, Hans


    Different viruses have been detected in porcine semen. Some of them are on the list of the World Organization for Animal Health (OIE), and consequently, these pathogens are of socioeconomic and/or public health importance and are of major importance in the international trade of animals and animal products. Artificial insemination (AI) is one of the most commonly used assisted reproductive technologies in pig production worldwide. This extensive use has enabled pig producers to benefit from superior genetics at a lower cost compared to natural breeding. However, the broad distribution of processed semen doses for field AI has increased the risk of widespread transmission of swine viral pathogens. Contamination of semen can be due to infections of the boar or can occur during semen collection, processing, and storage. It can result in reduced semen quality, embryonic mortality, endometritis, and systemic infection and/or disease in the recipient female. The presence of viral pathogens in semen can be assessed by demonstration of viable virus, nucleic acid of virus, or indirectly by measuring serum antibodies in the boar. The best way to prevent disease transmission via the semen is to assure that the boars in AI centers are free from the disease, to enforce very strict biosecurity protocols, and to perform routine health monitoring of boars. Prevention of viral semen contamination should be the primary focus because it is easier to prevent contamination than to eliminate viruses once present in semen. Nevertheless, research and development of novel semen processing treatments such as single-layer centrifugation is ongoing and may allow in the future to decontaminate semen. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Maternal outcomes of term breech presentation delivery: impact of successful external cephalic version in a nationwide sample of delivery admissions in the United States. (United States)

    Weiniger, Carolyn F; Lyell, Deirdre J; Tsen, Lawrence C; Butwick, Alexander J; Shachar, BatZion; Callaghan, William M; Creanga, Andreea A; Bateman, Brian T


    We aimed to define the frequency and predictors of successful external cephalic version in a nationally-representative cohort of women with breech presentations and to compare maternal outcomes associated with successful external cephalic version versus persistent breech presentation. Using the Nationwide Inpatient Sample, a United States healthcare utilization database, we identified delivery admissions between 1998 and 2011 for women who had successful external cephalic version or persistent breech presentation (including unsuccessful or no external cephalic version attempt) at term. Multivariable logistic regression identified patient and hospital-level factors associated with successful external cephalic version. Maternal outcomes were compared between women who had successful external cephalic version versus persistent breech. Our study cohort comprised 1,079,576 delivery admissions with breech presentation; 56,409 (5.2 %) women underwent successful external cephalic version and 1,023,167 (94.8 %) women had persistent breech presentation at the time of delivery. The rate of cesarean delivery was lower among women who had successful external cephalic version compared to those with persistent breech (20.2 % vs. 94.9 %; p external cephalic version were also less likely to experience several measures of significant maternal morbidity including endometritis (adjusted Odds Ratio (aOR) = 0.36, 95 % Confidence Interval (CI) 0.24-0.52), sepsis (aOR = 0.35, 95 % CI 0.24-0.51) and length of stay > 7 days (aOR = 0.53, 95 % CI 0.40-0.70), but had a higher risk of chorioamnionitis (aOR = 1.83, 95 % CI 1.54-2.17). Overall a low proportion of women with breech presentation undergo successful external cephalic version, and it is associated with significant reduction in the frequency of cesarean delivery and a number of measures of maternal morbidity. Increased external cephalic version use may be an important approach to mitigate the high rate of

  6. Aplicación de un programa de control de infecciones intrahospitalarias en establecimientos de salud de la región San Martín, Perú.

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    Heriberto Arévalo R


    Full Text Available Objetivo: Aplicar un programa de control de infecciones intrahospitalarias (IIH para modificar conocimientos, actitudes y prácticas (CAP del personal de salud y su efecto sobre la prevalencia de IIH en establecimientos de salud de San Martín, Perú, julio 2000 - enero 2001. Materiales y métodos: Estudio prospectivo de intervención. Se determinó la prevalencia basal, intermedia y final de IIH y se evaluó los cambios en CAP con la metodología investigación-acción. Participó personal del Hospital de Apoyo Banda de Shilcayo (HABS, Hospital Nueva Cajamarca (HNC, Centro Materno Perinatal, Centro de Salud Lluyllucucha, localizados en zonas rurales. Se utilizaron indicadores estandarizados nacionales. Resultados: Los médicos tuvieron la menor participación (62,0%; y el personal técnico la mayor (90,0%. Las prácticas adecuadas de lavado de manos y materiales, utilización de ropa y guantes, manejo de objetos punzo-cortantes y exposición a fluidos aumentaron significativamente (p<0,01. El mismo comportamiento tuvieron las actitudes de limpieza, desinfección y esterilización en centro quirúrgico. El HABS presentó la prevalencia basal más alta de IIH (26,8%, mientras que el HNC la menor (15,4%. 36,0% fueron casos de gérmenes aislados en hemocultivos de pacientes sin foco infeccioso establecido. 36,0% correspondió a infecciones de herida operatoria, 5,0% neumonías, 2,0% endometritis puerperales, 5,0% infecciones en pacientes quemados y 16,0% infecciones urinarias. Enterobacter aerogenes (32,0% y Pseudomonas aeuroginosa (24,0% fueron las bacterias más frecuentes. La prevalencia de IIH disminuyó (de 25,7% a 15,2% (p0,05. Conclusiones: La aplicación de un programa de control de IIH logró mejorar significativamente las actitudes y prácticas en establecimientos de salud de San Martín, Perú.

  7. Prevalence and risk factor's analysis of bovine brucellosis in peri-urban areas under intensive system of production in Gujarat, India

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    M. D. Patel


    Full Text Available Aim: A study on surveillance of bovine brucellosis in dairy herds of peri-urban areas under intensive system of production was carried out by milk-ELISA. Various risk factors were identified having significant association with occurrence of bovine brucellosis in dairy herds of peri-urban areas. Materials and Methods: Five randomly selected peri-uban areas of six cities of Gujarat were included in the present study. Five randomly selected dairy herds under intensive system of production from each selected peri-urban area were included for further investigation. In total, 199 bulk and 582 individual milk samples were screened by milk-ELISA. Forty three different risk factors were identified and grouped into four major categories as general characteristics of farms, introduction of infection to farms, management systems of farms and exposure of disease. Further, their distribution and association with prevalence of bovine brucellosis was studied. Results: The overall herd and animal prevalence in peri-urban areas was 33.70 and 11.90%, respectively. Out of 11 risk factors on general characteristics of dairy farms, only five (herd size, type of animals, type of breed, age of owner and knowledge gained by owners showed significant (p<0.05 association with occurrence of bovine brucellosis. None of risk factors on introduction of infection to farms (n=6 and management systems of farms (n=11 was found significantly associated with occurrence of brucellosis. Among risk factors on exposure of disease (n=15, history of abortion, retention of placenta, still birth and metritis/endometritis showed significant (p<0.05 association with prevalence of bovine brucellosis. Conclusion: It was concluded that prevalence of bovine brucellosis in dairy herds under intensive system of production in peri-urban areas of Gujarat was comparatively higher than reported overall prevalence of brucellosis. Risk factors like larger herd in close confinement without adequate sheds

  8. Frequency of endometrial carcinoma in patients with postmenopausal bleeding

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    Yousaf, S.; Shaheen, M.; Rana, T.


    Introduction: Postmenopausal bleeding (PMB) is defined as bleeding that occurs after 1 year of amenorrhea in a woman who is not receiving hormone replacement therapy (HRT). About 10% of women with postmenopausal bleeding have a primary or secondary malignancy. Common malignancies among them are endometrial cancer (80%), cervical cancer or an ovarian tumour. Endometrial cancer is the second most common cancer associated with hereditary non-polyposis colorectal cancer. Ninety percent of patients have benign causes. Objective: The objective of this study was to determine the frequency of endometrial carcinoma in patients with post-menopausal bleeding. Study Design: Descriptive case series study. Setting: Department of obstetrics and gynaecology, Lady Willingdon, Lahore. Duration of Study: This study was conducted over a period of six months from January, 1 2009 to June 30, 2009. Subjects and Methods: 50 cases with postmenopausal bleeding. Results: During the period of this study a total number of 50 consecutive patients who met inclusion criteria were enrolled in the study. Ages of the patients who presented with PMB ranged between 48 years and 80 years with a mean age of 59 years. Malignancy was found in 18 out of 50 cases (36%).Cases with endometrial CA were 14 out of 50 cases (28%) and CA cervix constituted 4 out of 50 cases (8%). Benign pathology was more frequent (64%). 13 of 50 cases (26%) had hyperplasia out of which 1 case (2%) was of atypical hyperplasia. Endometrial polyp was found in 4 of 50 cases (8%). 3 of 50 cases (6%) had chronic endometritis. 5 of 50 cases (10%) had chronic cervicitis. While 7 cases (14%) had postmenopausal bleeding due to decubitus ulcer of uterovaginal prolapse. Among malignancies (36%), endometrial cancer is the most frequent malignancy in women with postmenopausal bleeding with mean age of 65 years. Conclusion: In this study it was concluded that the majority of cases of PMB would be expected to be suffering from benign problems

  9. Postoperative radiotherapy for endometrial carcinoma. A retrospective analysis of 541 cases

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    Haensgen, G.; Nagel, M.; Dunst, J.; Enke, H.


    Purpose: This retrospective study was designed to evaluate the role of adjuvant radiotherapy for surgically treated endometrial carcinoma. Patients and methods: From 1980 through 1988, 541 patients were treated with either intravaginal cuff irradiation with a high-dose-rate (HDR) Iridium-192 remote afterloading technique (n=294) or with combined HDR-brachytherapy and additional external pelvic irradiation to 54 Gy (n=247) after surgery for endometrical cancer. Afterloading irradiation was administered in 4 fractions 4 to 6 weeks after surgery. A dose of 30 Gy was delivered at a depth of 0,5 cm from the vaginal mucosa. Results: Patients with HDR-brachytherapy alone showed a 5-year survival of 94.3% for Stage I and 73.6% for Stage II (p=0.0007). Patients who received both brachytherapy and additional pelvic irradiation had a 5-year survival of 94.1% for Stage I, 81.1% for Stage II, 70.4% for Stage III and 46.9% for Stage IV (p=0.0001). The main predictors for survival in a multivariate analysis were stage and grading. Patients with combined readiotherapy had a local recurrence rate of 3.2%, whereas patients with brachytherapy alone who were better selected and had more favorable prognostic factors showed a recurrence rate of 2%. Low-risk patients (Stage I, Grade 1, low infiltration) in the HDR-brachytherapy group had 6 relapses, mainly caused by insufficient treatment on the basis of papillary histology. High-risk patients with poorly differential tumors, which infiltrate more than half the myometrial wall might benefit from additional external radiotherapy in terms of reduction of local recurrence and better survival. Five-year actuarial survival rate was 93.6% after combined radiotherapy vs 86.7% after brachytherapy alone. Complications were graded according to the RTOG scoring system. Severe late complications were fistulas of bladder and/or bowel, which occurred in 2.8% in the combined radiotherapy group, and 0.7% in the HDR brachytherapy group. (orig.) [de

  10. Dynamics of the microbiota found in the vaginas of dairy cows during the transition period: Associations with uterine diseases and reproductive outcome. (United States)

    Bicalho, M L S; Santin, T; Rodrigues, M X; Marques, C E; Lima, S F; Bicalho, R C


    We investigated the microbiota found in the vaginas of Holstein dairy cows during the transition period and described the differences in bacterial composition and total bacterial load (TBL) associated with disease and fertility. Vaginal swabs were collected at -7, 0, 3, and 7 d relative to parturition from 111 dairy cows housed on a commercial dairy farm near Ithaca, New York. Microbiota were characterized by next-generation DNA sequencing of the bacterial 16S rRNA gene, and TBL was determined by real-time quantitative PCR. We applied repeated-measures ANOVA to evaluate the associations of uterine disease and related risk factors with the microbiota and TBL. We estimated phylum-specific bacterial load by multiplying the TBL by the relative abundance of each phylum observed in the metagenomics results. We confirmed the validity of this approach for estimating bacterial load by enumerating the number of bacteria in an artificial sample mixed in vitro and in clinical and healthy vaginal samples. Phyla associated with uterine disease and related risk factors were Proteobacteria, Fusobacteria, and Bacteroidetes. Cows with retained placenta and healthy cows had similar TBL at the day of parturition, but at d 7 postpartum, cows with retained placenta showed a significantly higher TBL, mainly driven by higher estimated loads of Fusobacteria and Bacteroidetes. Cows diagnosed with metritis had a significantly higher estimated load of Proteobacteria at d -7 and at calving and higher estimated loads of Fusobacteria in the postpartum samples. Additionally, the estimated load of Bacteroidetes at d 7 postpartum was higher for cows diagnosed with endometritis at 35 days in milk. Higher estimated loads of Fusobacteria and Bacteroidetes were also evident in cows with postpartum fever, in primiparous cows, in cows with assisted parturition, and in cows that gave birth to twins. Our findings demonstrated that microbiota composition and TBL were associated with known periparturient

  11. An epidemiological study of reproductive failure in dairy herds from Goiânia Estudo epidemiológico de problemas reprodutivos em rebanhos bovinos na bacia leiteira de Goiânia

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    J.R.A. Andrade


    Full Text Available An epidemiological study was carried out on 2823 cows from 34 dairy herds from Goiania in the State of Goias-Brazil during 2001 to 2002. The pregnancy rate was 47.8%. In 1473 non-pregnant cows, causes of reproductive failure problems were sought. The most prevalent uterine infection was endometritis (17.0%. Uterine disorders such as partial hypoplasia of the genital system (0.04%, macerate fetus (0.01%, adhesion of ovaries (0.04%, stillbirth (0.04%, retained placenta (0.01%, cervix inflammation (0.6% and abortion (0.88% also were found. Uterine swabs were collected aseptically for microbiological culture. Gram positives cocci (41.3% and Gram negatives rods (52.6% were found, and Staphylococcus aureus and Escherichia coli were the most prevalent pathogens. Susceptibility patterns of microorganisms suggested the use of chloramphenicol, gentamicin and neomycin for antimicrobial therapy.No período de março 2001 a julho 2002 foram estudadas 2823 fêmeas bovinas, em idade de reprodução, mestiças das raças Holandesa e Gir, pertencentes a 34 propriedades da bacia leiteira de Goiânia. A taxa de prenhez foi 47,8%. Entre os animais não gestantes (n= 1473, 17% apresentaram alterações inflamatórias do útero. Outras anormalidades encontradas foram: aplasia parcial do sistema genital (0,04%, feto macerado (0,01%, ovário aderido (0,04%. Casos de natimortalidade (0,04%, retenção placentária (0,01% e cervicite (0,6% e taxas de abortos (0,88% também foram registrados. Cocos Gram positivos (41,3% e bastonetes Gram negativos (52,6% foram os microrganismos mais isolados, sendo Staphylococcus aureus e Escherichia coli os principais patógenos encontrados nas infeccções uterinas. Testes in vitro mostraram que esses microrganismos apresentaram maior susceptibilidade frente ao cloranfenicol, à gentamicina e à neomicina.

  12. Associations between intrauterine bacterial infection, reproductive tract inflammation, and reproductive performance in pasture-based dairy cows. (United States)

    de Boer, Melvin; Buddle, Bryce M; Heuer, Cord; Hussein, Hassan; Zheng, Tao; LeBlanc, Stephen J; McDougall, Scott


    Reproductive tract bacterial infections, particularly those caused by Escherichia coli and Trueperella pyogenes, can have a negative impact on reproductive performance. It has been hypothesized that the presence of E coli early postpartum may increase the risk of isolation of T pyogenes later postpartum. The objective of the present study was to examine associations between intrauterine bacterial infections with E coli and T pyogenes and any bacterial growth (irrespective of bacterial species), purulent vaginal discharge (PVD), cytologic evidence of endometritis (an increased proportion of polymorphonuclear cells [PMNs]), and reproductive performance. Dairy cows (n = 272) from six herds were examined at Days 0 (median, 2 days in milk), 21 and 42 postpartum. From each cow two intrauterine samples were collected via triple-guarded cytobrush at Days 0 and 21. The first cytobrush was used for bacteriologic culture. Escherichia coli and T pyogenes were isolated by culture, and E coli isolates were assigned to one of four phylogenetic groups using a two-step triplex polymerase chain reaction. In addition, T pyogenes was confirmed by polymerase chain reaction. The second cytobrush was used to prepare a cytology slide. Nucleated cells (n = 200) were categorized as epithelial cells, PMNs, or macrophages. Cows were also assessed for body condition score, PVD score, the presence of a CL, and pregnancy. Statistical analysis was performed using multivariable models. There was no association between the presence of E coli at Day 0 and probability of isolation of T pyogenes 3 weeks later; however, E coli positive cows at Day 0 were more likely to be diagnosed with E coli at Day 21 (relative risk [RR] = 2.0, P bacterial growth at Day 21, irrespective of species, were less likely to conceive within 3 weeks after the start of the seasonal breeding program (RR = 0.8; P = 0.05). Interestingly, cows with 25% PMNs or greater at Day 0 had shorter time to pregnancy (hazard ratio = 1.32; P

  13. Diagnostic test of endometrial cytobrush in cases of perimenopausal and postmenopausal hemorrhage

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    Andrijono Andrijono


    Full Text Available Perimenopausal menopausal hemorrhage can be due to by a variety of causative factors. One of its dangerous causes is atypical hyperplasia and endometrial carcinoma. There are a number of risk factors for the occurrence of endometrial carcinoma. The group that has this risk belongs to high-risk group. In this high-risk group, it is necessary to have a method to identify the changes in endometrial abnormality. One of the alternatives is the examination of endometrial cytology. The objective of this study was to evaluate the sensitivity, specificity and correlation test between endometrial cytology and endometrial histology. This study was a diagnostic test of cytological examination of the endometrium as compared with endometrial histology. Endometrial cytology was performed with a modification of cytubrush and IUD shell. Specimen was dissolved into the centrifuged NaCl, and its deposits were then processed for cytological examination with Papanicolaou and Giemsa staining. After the taking of cytology, the process was continued with curettage of the endometrium, and the specimens were processed for cytological examination. Both of them were examined by anatomic pathologist. Statistical analysis used diagnostic test using histological examination of curetage specimens as gold standard. During the period of study 45 study samples were collected, among which 12 (26.66% were endometrial adenocarcinoma, 6 (13.33% with atypical hyperplasia, 11 (24.44% with non-atypical hyperplasia, 15 (33.33% were samples without abnormality, and one sample with endometritis. Actual correlation value was 57.8%, correlation because of possibility 3.38%, and correlation not because of possibility 54.42%, potential correlation not because of possibility 96.62%, and Kappa value 0.56. It was concluded that cytological examination of the endometriurn with cytobrush could be employed as a screening method in the abnormalities of endometrial thickness, with

  14. Effect of uterine immunomodulation on hematobiochemical parameters in cyclic non-breeding cows

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    Saraswat Sahoo


    Full Text Available Aim: To study the effect of uterine immunomodulation on hematobiochemical parameters and total immunoglobulin concentration in cyclic non-breeding cows. Materials and Methods: Twenty-one repeat breeding cows around Bhubaneswar area were screened by white side test to detect and treat the endometritis and were assigned to three treatment protocols with an equal number of seven animals in each group. Cows in control group were administered with 50 ml of normal saline while treatment Group I animals were given single intrauterine infusion of 20 ml of fresh colostrum and treatment Group II animals received nonpathogenic Escherichia coli in 10 ml sterile saline. The blood samples were collected from all the experimental animals, and hematobiochemical parameters and total immunoglobulin concentration were estimated. Results: A high significant difference (p<0.01 was accounted in lymphocyte count of E. coli treated group within different days of sampling. Analysis of variance recorded a highly significant difference with neutrophil percent in E. coli lavaged cows. In colostrum treated group monocyte count showed a significant difference (p<0.01 between 0 and 14th day of sampling. The analysis of hematocrit values did not show any significant difference apart from the erythrocyte sedimentation rate parameter in the colostrum infused group with the highest significant (p<0.01 variation being observed between 7th and 14th day of sampling. The analysis of aspartate amino transferase values in the colostrum lavaged cows revealed a significant difference, but that of alanine amino transferase values did not show any significant difference. Comparison of immunoglobulin values for different days in all the treatment protocol revealed a highly significant (p<0.05 difference within various days of sampling. Conclusion: In the present study, the local immunomodulation by different agents have been highlighted and which indicated potentiation of uterine immunity

  15. The comparison of placental removal methods on operative blood loss

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    Waqar, F.; Fawad, A.


    On an average 1 litre of blood is lost during Caesarean Section. Many variable techniques have been tried to reduce this blood loss. Many study trials have shown the spontaneous delivery of placenta method to be superior over manual method because of reduced intra operative blood loss and reduced incidence of post operative endometritis. The main objective of our study was to compare the risk of blood loss associated with spontaneous and manual removal of the placenta during caesarean section. This study was conducted at Department of Obstetrics and Gynaecology, Islamic International Medical Complex, Islamabad from September 2004 to September 2005. All Women undergoing elective or emergency caesarean section were included in the study. Exclusion criteria were pregnancy below 37 weeks, severe maternal anaemia, and prolonged rupture of the membranes with fever, placenta praevia, placenta accreta and clotting disorders. Patients were allocated to the two groups randomly. Group A comprised of women in whom the obstetrician waited a maximum of 5 minutes till the placenta delivered spontaneously. In group B the obstetrician manually cleaved out the placenta as soon as the infant was delivered. The primary outcome measures noted were difference in haemoglobin of >2 gm/dl (preoperatively and postoperatively), time interval between delivery of baby and placenta, significant blood loss (>1000 cc), additional use of oxytocics, total operating time and blood transfusions. Data was analysed by SPSS. Statistical tests used for specific comparison were chi square-test and Student's t-test. One hundred and forty-five patients were allocated to two groups randomly. Seventy-eight patients were allocated to group A and 67 patients allocated to group B. Mean maternal age, birth weight, and total operating time were the same in two groups, but blood loss as measured by a difference in haemoglobin of greater then 2 grams/dl was statistically significant. Significant blood loss (>1000 cc

  16. [The relevance of the trace elements zinc and iron in the milk fever disease of cattle]. (United States)

    Heilig, M; Bäuml, D; Fürll, M


    The aim of this study was to analyse the concentrations of Zn and Fe as well as their relationships to metabolic parameters in milk fever cows. A total of 195 Simmental cows, downer cows and clinically healthy control animals were divided into five groups: a) control group (CG, n = 21), b) all cows with milk fever (MF) (n = 174), c) MF cows without additional diseases (n = 145), d) cows with MF and mastitis (n = 10) and e) cows with retained placenta or endometritis (n = 19). Selenium (Se), zinc (Zn), iron (Fe), calcium (Ca), inorganic phosphorus (Pi), tumour necrosis factor α (TNFα), haptoglobin (Hp), antioxidants (Trolox Equivalent Antioxidative Capacity: TEAC), non-esterified fatty acids (NEFA), beta-hydroxybutyrate (BHB), bilirubin, urea, creatinine, glucose, cholesterol, gamma-glutamyl transferase (GGT) and alkaline phosphatase (AP) were analysed in the blood serum. The concentrations of Zn, Fe, Ca, Pi and TEAC were lower in groups b) to e) whereas Hp was higher than in the CG (p ≤ 0.05). In group c), lower Ca and Pi concentrations were found when compared to groups d) and e) (p ≤ 0.05). In group e), Zn concentrations were significantly lower than in group c) (p ≤ 0.05). Zn was negatively correlated with K (CG) and positively correlated with TEAC, Cu, Mn and Fe (groups b and c) and with Mn (group e) (p ≤ 0.05). Fe was positively correlated with Ca (group c), Pi (group c), K (groups b and c) and Mg (groups b-d) as well as with Zn, Cu and Se (groups b and c) (p ≤ 0.05). In groups b) and c), TNFα was increased and negatively correlated with Fe (p ≤ 0.05). AP activity in groups b) and e) was lower than in the CG (p ≤ 0.05). These results and literature data support the hypothesis that Zn and Fe could be engaged in bone metabolism and be involved in the pathogenesis of MF. The concentrations of Hp and TEAC support this interpretation. Control of the Zn and Fe status of cows and Zn supplementation should be included in the

  17. Echography of clinically relevant disorders in the genital tract of female dromedary camels. (United States)

    Ali, Ahmed; Derar, Derar; Alsamri, Ali; Al Sobayil, Fahd


    The aim of this study was to characterize the clinically relevant genital tract disorders of dromedary camels. Reproductive tract examinations were performed via transrectal palpation, ultrasonography and vaginal exploration. The ultrasonic appearance of the reproductive pathology was described and compared with its morphology at laparotomy, after surgical removal, during postmortem examination or upon slaughter. Diagnosis was also confirmed by histopathology. The most frequently encountered follicular structures were larger than typical follicles (56/338, 16.6%) having three echo textures: 1) thin walls and clear hyperechogenic content (11.6%); 2) thick walls and few fibrous trabeculae (33.7%); and 3) thick walls and many echogenic transecting fibrinous strands (54.7%). Corpora lutea with non-echoic central cavity (5/31, 16.1%) were greater in diameter than those with no cavity (26/31, 83.9%) (P=0.03). A granulosa cell tumor (1/338, 0.3%) was multilocular and honeycombed in shape. Presence of a large, well-demarcated, hypoechogenic sac lateral to or beneath the uterine horn encasing the ovary was diagnostic for ovarian hydrobursitis (102/338, 30.2%). Hydrosalpinx and pyosalpinx (6/338, 1.8%) were beaded in appearance, with the ovary located outside these structures. Clinical endometritis/cervicitis (122, 36.1%) was characterized by changes in the homogeneity in about half of the cases. A greatly dilated uterus with clear, hypoechogenic or echogenic contents with signs of hydrometra and pyometra, respectively, was another categorization of a reproductive pathology (24/338, 7.1%). Highly reflective, linear structures were observed in cases with intrauterine fetal bone retention (1/338, 0.3%). In conclusion, reproductive pathologies in dromedary camels can be efficiently imaged by use of ultrasonic technologies, thus familiarizing the practitioner with these disorders and facilitating application of these technologies so that suitable treatment can occur is important

  18. Short communication: Evaluation of vaginal discharge following treatment with a progesterone insert. (United States)

    Fischer-Tenhagen, C; von Krueger, X; Heuwieser, W


    Yellowish discharge after application of intravaginal progesterone releasing inserts is frequently observed in cows. The objective of this study was to compare the bacteriological contamination of the vagina and uterus before and after a treatment with a progesterone insert in heifers. Forty-two Holstein heifers received a progesterone releasing insert [Eazi-Breed controlled internal drug release (CIDR) insert; Pfizer Animal Health, Berlin, Germany] for 7d. The protruding tail had been removed from half of the inserts (no tail group: n=21; tail group: n=21). Nine heifers from the tail group lost the insert within the 7-d treatment interval and were excluded. Heifers identified in estrus were artificially inseminated on d 9 or 10. Vaginal discharge was scored on a 4-point scale [vaginal discharge score (VDS) 0 to 3] and vaginal swabs were taken for bacteriological examination on d 0 and 7 and the day of artificial insemination (AI). Furthermore, cytological and bacteriological samples were obtained from the uterus on d 7 and the day of AI. On d 0, coliforms and Streptococcus spp. were found in vaginal swabs of 21 heifers (64%). On d 7, all heifers showed purulent vaginal discharge (VDS 2 to 3). The VDS was higher in the tail group compared with the no tail group. Arcanobacterium pyogenes, coliforms, and Streptococcus spp. were isolated from the vaginal swabs in 32 of 33 (96%) heifers on d 7. On the day of AI, VDS had improved to 0 or 1 in 96% of the heifers. However, A. pyogenes, coliforms, and Streptococcus spp. were still isolated in 17 of 33 (53%) heifers from the vagina and in 32 of 33 (96%) heifers from the endometrium. Endometrial cytology revealed polymorphonuclear neutrophils (PMN) in 11 heifers (6 to 32% PMN). Five samples exceeded the threshold of 5% PMN, and 2 samples exceeded the 10% PMN threshold, indicative of subclinical endometritis. In conclusion, pyogenic bacteria were found in the vagina and uterus on d 7 and the day of AI after intravaginal

  19. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. (United States)

    Jauniaux, Eric; Collins, Sally; Burton, Graham J


    Placenta accreta spectrum is a complex obstetric complication associated with high maternal morbidity. It is a relatively new disorder of placentation, and is the consequence of damage to the endometrium-myometrial interface of the uterine wall. When first described 80 years ago, it mainly occurred after manual removal of the placenta, uterine curettage, or endometritis. Superficial damage leads primarily to an abnormally adherent placenta, and is diagnosed as the complete or partial absence of the decidua on histology. Today, the main cause of placenta accreta spectrum is uterine surgery and, in particular, uterine scar secondary to cesarean delivery. In the absence of endometrial reepithelialization of the scar area the trophoblast and villous tissue can invade deeply within the myometrium, including its circulation, and reach the surrounding pelvic organs. The cellular changes in the trophoblast observed in placenta accreta spectrum are probably secondary to the unusual myometrial environment in which it develops, and not a primary defect of trophoblast biology leading to excessive invasion of the myometrium. Placenta accreta spectrum was separated by pathologists into 3 categories: placenta creta when the villi simply adhere to the myometrium, placenta increta when the villi invade the myometrium, and placenta percreta where the villi invade the full thickness of the myometrium. Several prenatal ultrasound signs of placenta accreta spectrum were reported over the last 35 years, principally the disappearance of the normal uteroplacental interface (clear zone), extreme thinning of the underlying myometrium, and vascular changes within the placenta (lacunae) and placental bed (hypervascularity). The pathophysiological basis of these signs is due to permanent damage of the uterine wall as far as the serosa, with placental tissue reaching the deep uterine circulation. Adherent and invasive placentation may coexist in the same placental bed and evolve with advancing

  20. Importancia clínica de las Chlamydias

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    Digna Llorente Molina

    Full Text Available Introducción: las infecciones por Chlamydia han alcanzado alta incidencia en el mundo. Constituyen importantes patógenos para los animales y el hombre. En la especie humana pueden ocasionar múltiples infecciones en diferentes órganos y sistemas de órganos. Objetivo: resumir los aspectos más novedosos relacionados con las Chlamydias en cuanto a sus características y formas de evitarla. Métodos: se realizó una revisión bibliográfica sobre la importancia clínica de las Chlamydias en la especie humana y su elevada incidencia. Se consultó la base de datos Medline disponible en INFOMED, de donde se extrajeron referencias bibliográficas entre los años 1995 y 2011, acerca de algunos aspectos etiológicos, clínicos, diagnósticos y terapéuticos de acuerdo a los últimos apuntes más relevantes en la literatura médica sobre Chlamydias y su relación con el hombre. Resultados: la Chlamydia Trachomatis en particular responsable del tracoma, primera causa de ceguera prevenible, provoca un impacto deletéreo en la salud reproductiva, produciendo entidades como abortos espontáneos, rotura prematura de membranas, restricción del crecimiento intrauterino, endometritis, conjuntivitis y neumonía del recién nacido. Es responsable además de Linfogranuloma Venéreo, Uretritis no Gonocóccica, Síndrome de Reiter, Enfermedad Inflamatoria Pélvica, Síndrome de Fitz Hugh Curtis, Embarazo Ectópico Crónico, Dolor Pélvico Crónico y más recientemente Carcinoma Cervical, entre otras. Conclusiones: partiendo de la base del impacto social y económico que tiene la infección por Chlamydias en el mundo y en nuestro país, pudimos resumir los aspectos más novedosos en cuanto a los tipos, infecciones que causan y sus características, diagnóstico, terapéutica y medidas generales para evitarlas o reducir su impacto negativo en la sociedad.

  1. The impact of time of delivery on gestations complicated by preterm premature rupture of membranes: daytime versus nighttime. (United States)

    Moussa, Hind; Hosseini Nasab, Susan; Fournie, David; Ontiveros, Alejandra; Alkawas, Rim; Chauhan, Suneet; Blackwell, Sean; Sibai, Baha


    receiving steroids and the doses of steroids. Antibiotic prophylaxis was also equal in both groups. Postpartum endometritis, chorioamnionitis and the latency to delivery were also equivalent between both groups. Cesarean delivery for distress was the only different outcome, more prevalent in daytime deliveries (157 (44.7%) versus 108 (35.9%) of the nighttime ones p = 0.02). Neonatal adverse outcomes as well as long-term outcomes similar between the two groups. In the setting of delivery at a tertiary care center, and in the era of universal use of steroids, and latency antibiotics for the management of preterm premature of membranes, there is no marked difference in pregnancy, neonatal as well as long-term outcomes for infants delivered in the daytime versus nighttime.

  2. Remote prognosis after primary cesarean delivery: the association of VBACs and recurrent cesarean deliveries with maternal morbidity

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    Erez O


    Full Text Available Offer Erez1, Lena Novack2, Vered Kleitman-Meir1, Doron Dukler1, Idit Erez-Weiss3, Francesca Gotsch4, Moshe Mazor11Department of Obstetrics and Gynecology, Soroka University Medical Center, 2Department of Epidemiology, 3Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; 4Obstetrics and Gynecology Departement, Policlinico GB Rossi Azienda Ospedaliera Universitaria Integrata Verona, ItalyPurpose: To determine the effects of vaginal birth after cesarean (VBAC versus repeated cesarean sections (RCS after a primary cesarean section (CS, on the rate of intraoperative and postpartum maternal morbidity.Patients and methods: This is a retrospective population-based cohort study. During the study period (1988–2005 there were 200,012 deliveries by 76,985 women at our medical center; 16,365 of them had a primary CS, of which 7429 women delivered a singleton infant after the primary CS, met the inclusion criteria, were included in our study, and were followed for four consecutive deliveries. Patients were divided into three study groups according to the outcome of their consecutive delivery after the primary CS: VBAC (n = 3622, elective CS (n = 1910, or an urgent CS (n = 1897. Survival analysis models were used to investigate the effect of the urgency of CS and the numbers of pregnancy predating the primary CS on peripartum complications.Results: Women who failed a trial of labor had a higher rate of uterine rupture than those who had a VBAC. Patients who delivered by CS had a higher rate of endometritis than those giving birth vaginally. The rate of cesarean hysterectomy and transfer to other departments increased significantly at the fourth consecutive surgery (P = 0.02 and P = 0.003, respectively. VBAC was associated with a 55% reduction in the risk of intrapartum complications in comparison to a planned CS (hazard ratio [HR] 0.45; 95% confidence interval [CI]: 0.22–0.89. A greater

  3. Acanthus montanus: An experimental evaluation of the antimicrobial, anti-inflammatory and immunological properties of a traditional remedy for furuncles

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    Nwoye Anthonia C


    Full Text Available Abstract Background Acanthus montanus (Nees T. Anderson (Acanthaceae is a shrub widespread in Africa, the Balkans, Romania, Greece and Eastern Mediterranean. It is used in African traditional medicine for the treatment of urogenital infections, urethral pain, endometritis, urinary disease, cystitis, leucorrhoea, aches and pains. In southeastern Nigeria, the root is popular and acclaimed highly effective in the treatment of furuncles. This study was undertaken to experimentally evaluate the antimicrobial and anti-inflammatory properties of the root extract as well as its effect on phagocytosis and specific cell-mediated immune response which may underlie the usefulness of the roots in treatment of furuncles. Methods The aqueous root extract (obtained by hot water maceration of the root powder was studied for effects on the growth of clinically isolated strains of Pseudomonas aeruginosa and Staphylococcus aureus. The anti-inflammatory activity was investigated using acute topical edema of the mouse ear induced by xylene, acute paw edema induced by agar in rats, formaldehyde arthritis in rats, vascular permeability induced by acetic acid in mice and heat- and hypotonicity-induced haemolysis of ox red blood cells (RBCs. Also evaluated were the effects on in vivo leukocyte migration induced by agar, phagocytic activity of macrophages on Candida albicans and specific cell-mediated immune responses (delayed type hypersensitivity reaction (DTHR induced by sheep red blood cell (SRBC. The acute toxicity and lethality (LD50 in mice and phytochemical constituents of the extract were also determined. Results The extract moderately inhibited the growth of the test organisms and significantly (P P P P C. albicans at 800 mg/kg dose, and significantly (P 50 greater than 5,000 mg/kg. Conclusion The effectiveness of the root of A. montanus in the treatment of furuncles may largely derive from mobilization of leukocytes to the site of the infection and activation

  4. Amnioinfusion for chorioamnionitis. (United States)

    Hofmeyr, G Justus; Kiiza, Joseph A K


    intrauterine pressure catheter, acetaminophen and antibiotics (ampicillin or, if receiving Group B beta streptococcal prophylaxis, penicillin and gentamycin). We did not identify any trials that used transabdominal amnioinfusion.Compared to no amnioinfusion, transcervical amnioinfusion had no clear effect on the incidence of postpartum endometritis (risk ratio (RR) 1.50, 95% confidence interval (CI) 0.29 to 7.87; absolute risk 176/1000 (95% CI 34 to 96) versus 118/1000;low-quality evidence). Nor was there a clear effect in the incidence of neonatal infection (RR 3.00, 95% CI 0.13 to 68.84; absolute risk 0/1000 (95% CI 0 to 0) versus 0/1000; low-quality evidence). The outcome of perinatal death or severe morbidity (such as neonatal encephalopathy, intraventricular haemorrhage, admission to intensive/high care) was not reported in the included trial.In terms of this review's secondary outcomes, the rate of caesarean section was the same in both groups (RR 1.00, 95% CI 0.35 to 2.83; absolute risk 294/1000 (95% CI 103 to 832) versus 294/1000; low-quality evidence). There was no clear difference in the duration of maternal antibiotic treatment between the amnioinfusion and no amnioinfusion control group (mean difference (MD) 16 hours, 95% CI -1.75 to 33.75); nor in the duration of hospitalisation (MD 3.00 hours, 95% CI -15.49 to 21.49). The study did not report any information about how many babies had a low Apgar score at five minutes after birth.Women in the amnioinfusion group had a lower temperature at delivery compared to women in the control group (MD -0.38°C, 95% CI -0.74 to -0.02) but this outcome was not pre-specified in the protocol for this review.The majority of this review's secondary outcomes were not reported in the included study. There is insufficient evidence to fully evaluate the effectiveness of using transcervical amnioinfusion for chorioamnionitis and to assess the safety of this intervention or women's satisfaction. We did not identify any trials that used

  5. Antibioticoprofilaxia com ampicilina na rotura prematura das membranas: estudo randomizado e duplo cego Ampicillin prophylaxis in premature rupture of membranes: randomized and double-blind study

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    José Elias Soares da Rocha


    avoid or reduce maternal and perinatal infectious morbidity caused by premature rupture of membranes (PROM, and to extend the gestation period in those women. Methods: this was a prospective, randomized and double-blind study, carried out evaluating 121 pregnant women with PROM, randomized into two study groups. The treatment group (61 patients received ampicillin and the control group (60 patients received placebo. The placebo had the same characteristics as ampicillin (kind of packaging and color of the capsules and was used in the same time regimen. The considered parameters for maternal infection were febrile morbidity (fever index, and the presence of chorioamnionitis and/or endometritis. The studied neonatal parameters were Apgar score (1st and 5th minutes, bacterial colonization of auditory canal, and blood culture. The statistical tests performed were Fisher's exact test, Wilcoxon, and chi². Results: it was observed that ampicillin did not prolong the gestation, nor did it reduce the postpartum febrile morbidity or the rates of chorioamnionitis and/or endometritis. Ampicillin did not reduce the perinatal infectious morbidity nor improve the birth outcomes. All these results were consistent in cases of less than 72 h PROM. The limited number of cases with time of PROM greater than 72 h did not permit statistical analysis free of type II error. Conclusions: based on these results it was possible to conclude that the prophylactic use of ampicillin by pregnant women with less than 72 h PROM did not reduce either infectious maternal or perinatal morbidity. However, the presence of group B Streptococcus agalactiae in the blood culture from a neonate in the control group showed the necessity to start antibiotic treatment of pregnant women colonized by this microorganism.

  6. Different classes of antibiotics given to women routinely for preventing infection at caesarean section. (United States)

    Gyte, Gillian M I; Dou, Lixia; Vazquez, Juan C


    Caesarean section increases the risk of postpartum infection for women and prophylactic antibiotics have been shown to reduce the incidence; however, there are adverse effects. It is important to identify the most effective class of antibiotics to use and those with the least adverse effects. To determine, from the best available evidence, the balance of benefits and harms between different classes of antibiotic given prophylactically to women undergoing caesarean section. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2014) and reference lists of retrieved papers. We included randomised controlled trials comparing different classes of prophylactic antibiotics given to women undergoing caesarean section. We excluded trials that compared drugs with placebo or drugs within a specific class; these are assessed in other Cochrane reviews. Two review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. We included 35 studies of which 31 provided data on 7697 women. For the main comparison between cephalosporins versus penicillins, there were 30 studies of which 27 provided data on 7299 women. There was a lack of good quality data and important outcomes often included only small numbers of women.For the comparison of a single cephalosporin versus a single penicillin (Comparison 1 subgroup 1), we found no significant difference between these classes of antibiotics for our chosen most important seven outcomes namely: maternal sepsis - there were no women with sepsis in the two studies involving 346 women; maternal endometritis (risk ratio (RR) 1.11, 95% confidence interval (CI) 0.81 to 1.52, nine studies, 3130 women, random effects, moderate quality of the evidence); maternal wound infection (RR 0.83, 95% CI 0.38 to 1.81, nine studies, 1497 women, random effects, low quality of the evidence), maternal urinary tract infection (RR 1.48, 95% CI 0.89 to 2.48, seven studies, 1120

  7. Effects of prepartum diets supplemented with rolled oilseeds on calf birth weight, postpartum health, feed intake, milk yield, and reproductive performance of dairy cows. (United States)

    Salehi, R; Colazo, M G; Oba, M; Ambrose, D J


    The objectives were to determine the effects of supplemental fat (no oilseed vs. oilseed) during late gestation and the source of fat (canola vs. sunflower seed), on dry matter intake (DMI), plasma metabolite concentrations, milk production and composition, calf birth weight, postpartum health disorders, ovarian function and reproductive performance in dairy cows. Pregnant Holstein cows, blocked by body condition and parity, were assigned to 1 of 3 diets containing rolled canola seed (high in oleic acid; n=43) or sunflower (high in linoleic acid; n=45) at 8% of dry matter, or no oilseed (control; n=43), for the last 35±2 d of pregnancy. After calving, all cows received a common lactation diet. Blood samples were collected at wk -3 (i.e., 2 wk after initiation of prepartum diets) and at wk +1, +2, +3, +4 and +5 postpartum to determine the concentration of fatty acids (mEq/dL), β-hydroxybutyrate (mg/dL), and glucose (mg/dL). Ovarian ultrasonography was performed twice weekly to determine the first appearance of dominant (10mm) and preovulatory-size (≥16mm) follicles, and ovulation. Uterine inflammatory status based on the proportion of polymorphonuclear leukocytes (PMN; subclinical endometritis: >8% PMN) was assessed at d 25±1 postpartum. Significant parity by treatment interactions were observed for DMI and milk yield. Prepartum oilseed supplementation, more specifically sunflower seed supplementation, increased postpartum DMI in primiparous cows without affecting prepartum DMI or milk yield. Contrarily, in multiparous cows, prepartum oilseed supplementation decreased both prepartum and postpartum DMI and milk yield during the first 2 wk. Regardless of parity, prepartum feeding of canola reduced postpartum DMI compared with those fed sunflower. Mean fatty acids concentrations at wk -3 were greater in cows given supplemental oilseed than those fed no oilseeds. Gestation length and calf birth weight were increased in cows given supplemental oilseed prepartum

  8. [Lower Uterine Segment Trial: A pragmatic open multicenter randomized trial]. (United States)

    Rozenberg, P; Deruelle, P; Sénat, M-V; Desbrière, R; Winer, N; Simon, E; Ville, Y; Kayem, G; Boutron, I


    performed by expert sonographers after certification by the main investigator. Women aged 18 years or older are eligible for this trial if they have a singleton pregnancy in cephalic presentation at a gestational age from 36 to 38 weeks, a previous low transverse cesarean delivery and sign the informed consent sheet. Women will be asked to participate in this study when they reach a term of 36 to 38 weeks of gestation. After agreement, women will be randomized into two groups: in the study group, they will have the LUS measured by ultrasound and the patient will be informed that, based on a threshold value of 3.5mm for the ultrasound measurement of the LUS thickness, the patient with a higher measurement will be considered at low risk and will be encouraged to choose a trial of labor whereas the patient with a measurement is equal to or less than this threshold will be considered at risk and encouraged to choose an elective repeat cesarean; in the control group, ultrasound LUS measurement will not be performed. The mode of delivery will be decided according to standard practice at the center. The primary composite outcome will include: uterine rupture, uterine dehiscence, hysterectomy, thromboembolic complications, transfusion, endometritis, maternal mortality, fetal prenatal and intrapartum mortality, hypoxic-ischemic encephalopathy and neonatal mortality. This trial assesses the efficacy of ultrasound measurement of the lower uterine segment in women with a prior cesarean delivery in reducing fetal and maternal morbidity and mortality and it will provide evidence in order to establish clinical recommendations. identifier: NCT01916044 (date of registration: 5 August 2013). Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  9. [100 years of Hashimoto thyroiditis, still an intriguing disease]. (United States)

    Baretić, Maja


    In 1912 Japanese physician Hashimoto Hakaru described 4 patients with chronic thyroid disease. The histopathology findings exactly 100 years ago described lymphocyte infiltration, fibrosis, parenchymal atrophy and eosinophilic changes of some acinar cells. Those findings are typical for the autoimmune thyroid disease named by the author Hashimoto thyroiditis or lymphocytic thyroiditis. Hashimoto thyroiditis: The pathophysiology of thyroid autoimmunity during the past decades was described in details. Many thyroid antigens were identified (thyroid - stimulating hormone or TSH, thyroglobulin, thyreoperoxidase) and antibodies are directed towards them. Thyreocyte is also able to function as antigen presenting cell. It presents antigen on its surface and expresses MHC class II and class I molecules. Etiology of autoimmune thyroiditis combines genetic and environmental factors. Genetic factors dominate, and influence with about 80% on the occurrence of immunity. Some HLA genes (HLA-DR3, HLA-DR4, HLA-DR5 and HLA-DQA) and some non-HLA genes (cytotoxic T-lymphocyte antigen 4 -CTLA-4, CD40 gene, gene for protein tyrosine phosphatase 22 -PTPN22, thyroglobulin and TSH gene) are involved. 20% of etiology is attributed to environmental factors (smoking, iodine intake, selenium deficiency, pollution, infectious conditions, physical and emotional stress) and physiological states (puberty, rapid growth, pregnancy, menopause, aging, female gender). Although Hashimoto thyroiditis is known for many years, it is still sometimes presented with surprisingly diverse clinical entities and frequently astonishes many physicians. A case of a female patient with long-standing hypothesis (fine needle aspiration showed lymphocytic infiltration, thyreoperoxidase antibodies were positive) is presented. During the postpartum period, complicated with septic endometritis a new onset of hyperthyreosis appeared. The etiology of hyperthyroidism was unclear, with three possible explanations. The first

  10. Avaliação histeroscópica em pacientes com infertilidade Hysteroscopic evaluation in patients with infertility

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    Ricardo Bassil Lasmar


    polyps in 66 (6.0%, submucosal myomas in 47 (4.9%, endometrial hyperplasia in 39 (4.1%, adenomyosis in five (0.5%, endometritis (with histopathological confirmation in four (0.4%, endometrial bone metaplasia in two (0.4%, and cancer of the endometrium in one case (0.1%. Morphological and functional changes of the uterus were detected in 5.6% of the cases, including uterine malformations in 32 (3.4% and isthmus-cervical incompetence in 21 (2.2%. CONCLUSIONS: intrauterine synechiae were the most frequent abnormal findings in patients evaluated for infertility. Patients with a history of abortion and infertility should be submitted to hysteroscopy in order to rule out intrauterine synechiae as a possible cause of infertility.

  11. Experimental intoxication of pregnant goats with Tetrapterys multiglandulosa A. Juss. (Malpighiaceae Intoxicação experimental por Tetrapterys multiglandulosa A. Juss. (Malpighiaceae em cabras gestantes

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    M.M. Melo


    Full Text Available Green leaves of Tetrapterys multiglandulosa A. Juss were fed to pregnant goats from day 35 of pregnancy. Five goats received 10g/kgBW (group I, five received 20g/kgBW (group II and five were used as control (group III, and received only hay, fresh grass and commercial ration. All animals were clinically examined daily and submitted to ultrasonography every three days. Fetal death and vulvar catarrhal discharge with subsequent abortion were observed at the end of the second month of pregnancy in group II and at the third month of pregnancy in group I. Animals from groups I and II were slaughtered after abortion and necropsied. Goats from the control group were necropsied at the same time. The main lesions in the aborted goats were focal placentitis with early involution (apoptosis and placentary coagulation necrosis, acute focal endometritis and vulvo-vaginal petechiae. All aborted fetuses were underdeveloped when compared to control fetuses, probably due to fetal malnutrition, since no congenital malformations could be noted. The majority of aborted fetuses showed some degree of autolysis, as fetal death occurred five and three days before abortion, in groups I and II, respectively. The most remarkable fetal lesions were focal or diffuse hemorrhages in the skin, meninges and visceral serosae.Com o objetivo de investigar a toxicidade da Tetrapterys multiglandulosa A. Juss. foram utilizadas 15 cabras gestantes, divididas aleatoriamente em três grupos (GI, GII e GIII com cinco animais cada. Após estabelecer o diagnóstico de gestação no tempo médio de 35 dias, eram oferecidas diariamente doses de 10 e 20g/kg PV das folhas (jovens e maduras de Tetrapterys multiglandulosa para os grupos I e II, respectivamente, junto ao capim picado, feno e concentrado. Para o grupo III, usado como controle, foram fornecidos somente capim picado, feno e concentrado. Todos os animais foram submetidos a exames clínicos diários e a ultra-sonografia a cada tr

  12. Antibiotic prophylaxis for episiotomy repair following vaginal birth. (United States)

    Bonet, Mercedes; Ota, Erika; Chibueze, Chioma E; Oladapo, Olufemi T


    risk of bias because women were randomised according to even and odd numbers, allocation concealment was based on protocol number, there was no treatment or placebo administered in the control group, we were unclear about the blinding of outcome assessments, and outcomes were incompletely reported. We considered the other domains to be at low risk of bias. We downgraded the quality of the evidence for very serious design limitations (related to lack of random sequence generation, allocation concealment, and blinding) and imprecision of effect estimates (small sample sizes and wide confidence intervals (CI) of effect estimates).We found very low-quality evidence, from one trial of 73 women, that there was no clear indication that prophylactic antibiotics reduced the incidence of episiotomy wound dehiscence with infection (risk ratio (RR) 0.13, 95% CI 0.01 to 2.28), or without infection (RR 0.82, 95% CI 0.29 to 2.34). No cases of other puerperal infections (e.g. endometritis) were reported in either the antibiotic or control group.The trial did not report on any of the secondary outcomes of interest for this review, including severe maternal infectious morbidity, discomfort or pain at the episiotomy wound site, sexual function postpartum, adverse effects of antibiotics, costs of care, women's satisfaction with care, and individual antimicrobial resistance. There was insufficient evidence to assess the clinical benefits or harms of routine antibiotic prophylaxis for episiotomy repair after normal birth. The only trial included in this review had several methodological limitations, with very serious limitations in design, and imprecision of effect estimates. In addition, the trial tested an antibiotic with limited application in current clinical practice. There is a need for a careful and rigorous assessment of the comparative benefits and harms of prophylactic antibiotics on infection morbidity after episiotomy, in well-designed randomised controlled trials, using common

  13. Genetic merit for fertility traits in Holstein cows: IV. Transition period, uterine health, and resumption of cyclicity. (United States)

    Moore, S G; Fair, T; Lonergan, P; Butler, S T


    (2.98 vs. 2.74 units). Moreover, Fert+ cows had better uterine health compared with Fert- cows, as evidenced by lower weekly vaginal mucus scores from wk 2 to 6 postpartum and, based on uterine cytology, smaller proportions were classified as having endometritis at wk 3 (0.42 vs. 0.78) and 6 (0.25 vs. 0.75). Also, a significantly greater proportion of Fert+ cows had resumed cyclicity by wk 6 postpartum (0.86 vs. 0.20) compared with Fert- cows. Hence, we report for the first time that genetic merit for fertility traits is associated with postpartum uterine health status. Superior uterine health and earlier resumption of cyclicity may be mediated through differences in DMI, energy balance, insulin, insulin-like growth factor-I, and body condition score profiles. Importantly, phenotypic improvement in fertility traits was achieved without antagonizing milk production. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  14. Comparative analysis between the cytobrush and low-volume uterine flush techniques for endometrial cytology in clinically normal postpartum crossbred dairy cowsComparação das técnicas de citologia endometrial escova citológica e lavado uterino de baixo volume no pós-parto de vacas leiteiras mestiças

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    João Paulo Elsen Saut


    Full Text Available This study compared two frequently employed techniques for the collection of endometrial and inflammatory cells and characterized postpartum endometrial cytology (EC of clinically normal postpartum crossbred dairy cows in dairy farming system in Southwestern Brazil. Thirty-four crossbred, clinically healthy dairy cows with normal delivery and puerperium, complete uterine involution and without any treatment were monitored until 42 days in milk (DIM. All cows were evaluated by complete clinical and gynecological examinations at days 0, 7, 14, 21, 28, and 42 DIM. The gynecological examinations were done by transrectal palpation, ultrasonography, vaginoscopy, evaluation of the vaginal mucus and EC by using the cytobrush (CB and low-volume uterine flush (LVF techniques. The agreement (Kappa statistic between the two technicians was good for CB (86% and LVF (80.3% for the counting of the percentage of neutrophils. The average number of neutrophils was significantly higher throughout the experiment for LVF, but a reduced percentage of neutrophils were observed during the postpartum period for both techniques. The amount of macrophages, lymphocytes, and eosinophils were not affected during postpartum and there was no significant difference relative to these cells when the two techniques were compared. There were significant differences in the percentage of cows with subclinical endometritis only at d28 by CB (22.2% and LVF (59.3%. Objetivou-se comparar duas técnicas frequentemente usadas na colheita de células endometriais e inflamatórias e caracterizar a citologia endometrial (CE de vacas leiteiras mestiças no pós-parto fisiológico, criadas em sistemas de fazendas leiteiras do sudoeste do Brasil. Foram utilizadas 34 vacas clinicamente sadias com parto e puerpério fisiológico, completa involução uterina e sem qualquer tratamento até os 42 dias pós-parto (dpp. Realizou-se o exame clínico e ginecológico no parto e aos 7, 14, 21, 28 e 42 dpp

  15. Proteomics and metabolomics characterizing the pathophysiology of adaptive reactions to the metabolic challenges during the transition from late pregnancy to early lactation in dairy cows. (United States)

    Ceciliani, Fabrizio; Lecchi, Cristina; Urh, Christiane; Sauerwein, Helga


    expression, i.e. transcriptomics. For extending the knowledge towards the proteome and the metabolome, the respective technologies are of increasing importance and can provide an overall view of how dairy cows react to metabolic stress, which is needed for an in-depth understanding of the molecular mechanisms of the related diseases. We herein review the current findings from studies applying proteomics and metabolomics to transition-related diseases, including fatty liver, ketosis, endometritis, hypocalcaemia and laminitis. For each disease, a brief overview of the up to date knowledge about its pathogenesis is provided, followed by an insight into the most recent achievements on the proteome and metabolome of tissues and biological fluids, such as blood serum and urine, highlighting potential biomarkers. We believe that this review would help readers to be become more familiar with the recent progresses of molecular background of transition-related diseases thus encouraging research in this field. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Techniques for assisting difficult delivery at caesarean section. (United States)

    Waterfall, Heather; Grivell, Rosalie M; Dodd, Jodie M


    randomisation.Three comparisons were included. 1. Tocolysis versus no tocolysisA single randomised trial involving 97 women was identified and included in the review. Birth trauma was not reported. There were no cases of any maternal side-effect reported in either the nitroglycerin or the placebo group. No other maternal and infant health outcomes were reported. 2. Reverse breech extraction versus head push for the deeply impacted head at full dilation at caesarean section Four randomised trials involving 357 women were identified and included in the review. The primary outcome of birth trauma was reported by three trials and there was no difference between reverse breech extraction and head push for this rare outcome (three studies, 239 women, risk ratio (RR) 1.55, 95% confidence interval (CI) 0.42 to 5.73). Secondary outcomes including endometritis rate (three studies, 285 women, average RR 0.52, 95% CI 0.26 to 1.05, Tau I² = 0.22, I² = 56%), extension of uterine incision (four studies, 357 women, average RR 0.23, 95% CI 0.13 to 0.40), mean blood loss (three studies, 298 women, mean difference (MD) -294.92, 95% CI -493.25 to -96.59; I² = 98%) and neonatal intensive care unit (NICU)/special care nursery (SCN) admission (two studies, 226 babies, average RR 0.53, 95% CI 0.23 to 1.22, Tau I² = 0.27, I² = 74%) were decreased with reverse breech extraction. No differences were observed between groups for many of the other secondary outcomes reported (blood loss > 500 mL; blood transfusion; wound infection; mean hospital stay; average Apgar score).There was significant heterogeneity between the trials for the outcomes mean blood loss, operative time and mean hospital stay, making comparison difficult. However the operation duration was significantly shorter for reverse breech extraction, which may correspond with ease of delivery and therefore, the amount of tissue trauma and therefore, significantly less blood loss. Given the heterogeneity, we cannot define the amount of

  17. Prevalência da colonização vaginal e anorretal por estreptococo do grupo B em gestantes do terceiro trimestre Prevalence of vaginal and anorectal colonization by group B streptococcus in pregnant women in the last three months of gestation

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    Cláudio Beraldo


    materna inferior a 20 anos e nível sócio econômico baixo e a prevalência da infecção.PURPOSE: to study the prevalence of colonization by group B Streptococcus in pregnant women in the last three months of gestation, and to evaluate the association of colonization with demographic and clinical maternal variables. METHODS: from October 8, 2002 to March 26, 2003, a transversal study of prevalence of colonization by group B Streptococcus was carried out in 309 pregnant women in the last three months of gestation. Samples of vaginal and anorectal secretions were collected and were tested for presumptive identification of group B Streptococcus. The pregnant women were studied according to race, age, level of instruction, family income, number of gestations, gestational age, history of urinary tract infection during present pregnancy, premature rupture of membranes and duration of ruptured membranes, intrapartum fever, chorioamnionitis, meconium in the amniotic fluid, spontaneous or cesarean section delivery, postpartum fever, and postpartum endometritis. RESULTS: fourty-six pregnant women were diagnosed with group B Streptococcus: 26 of them (56.5% had positive vaginal culture, 8 (17.4% positive anorectal culture and 12 (26.5% had both vaginal and anorectal positive cultures. None of the maternal variables were statistically significant with respect to group B Streptococcus colonization. The results were submitted to chi2 bivariate analysis and, when appropriate, Fisher's exact test. CONCLUSION: the prevalence rate of vaginal and anorectal colonization by group B Streptococcus in pregnant women in the last three months of gestation, in Londrina - Paraná, was 14.9%.

  18. Paraneoplastic Scleroderma: Are There Any Clues? (United States)

    Jedlickova, Hana; Durčanská, Veronika; Vašků, Vladimír


    with diffusely tough skin on her extremities and trunk, present for 2 months. Examination revealed cervicitis with a benign endometric polyp, cholecystolithiasis, borderline pulmonary hypertension, and a hormonally inactive suprarenal adenoma. She was given prednisone 40 mg/day and penicillamine with effect. In the 3rd year of therapy she has residual induration of her lower legs and a scleroderma plaque in the lumbar region. She is monitored for her suprarenal adenoma. Two patients had scleroderma at the same time as a malignant tumor; in one patient the localized scleroderma worsened rapidly at the time of the tumor diagnosis, and in one patient a clinically silent adenoma was found. Adrenal tissue can secrete molecules such as serotonine or bFGF involved in fibroplasia (3,6). One patient died of a metastatic disease, two patients after the successful treatment of the tumor, and the patient with suprarenal adenoma experienced softening of the skin and regression of scleroderma. Although paraneoplastic scleroderma is often classified as a pseudoscleroderma, we regard neoplasia as a distinct triggering impulse for scleroderma. Recently, an association between RNA polymerase I/III antibodies in systemic scleroderma and cancer was suggested (8). Such studies may confirm the true link between scleroderma and malignancy. These patients are characterized by older age, sudden onset, diffuse thickening of the skin, and/or generalized morphea with a concurrent neoplastic process. In the case of a successful tumor treatment, skin changes regress.

  19. Use of Biopsy Tissue Samples, Incubated In Vitro for Autoradiographic Measurement of Cell Proliferation in Human Tissues; Utilisation de Biopsies Incubees In Vitro pour la Mesure Autoradiographique de la Proliferation Cellulaire de Tissus Humains

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    Galand, P. [Faculte de Medecine de l' Universite Libre de Bruxelles, Bruxelles (Belgium)


    'intervalle de temps (t) entre les deux marquages. D'apres le pourcentage de cellules fortement marquees par rapport a la population totale (LI), on peut obtenir le temps de generation (TG) d'apres la formule: TG = S/LI x 100. Des biopsies rectales et gastriques de patients ont ete etudiees a l'aide de cette methode qui, etant donne la brievete du temps d'experience, exige des conditions de simple survie. Des cas normaux et des cas pathologiques ont ete etudies. Des tissus d'endometre font aussi actuellement l'objet d'etudes. Parallelement, des experiences ont ete executees sur des tissus animaux afin de comparer, pour le meme sujet, les mesures in vitro et in vivo. Les mesures in vivo ont ete effectuees au moyen de la methode classique de la 'courbe des mitoses marquees'. Les questions suivantes ont ete etudiees: 1) Choix des doses de thymidine tritiee permettant de distinguer les cellules 'faiblement' et 'fortement' marquees; 2) Determination de la zone de l'echantillon ou le marquage des noyaux est homogene apres diffusion de la thymidine tritiee; 3) Etude de la stabilite de la biopsie pendant l'incubation. A cette fin, l'auteur a fait varier l'intervalle de temps entre les deux administrations de thymidine tritiee. La concordance des resultats obtenus de cette maniere constitue egalement un argument en faveur de la validite de la methode du double marquage. L'auteur conclut que cette methode pourrait etre appliquee a plusieurs types de tissus, a condition que ceux-ci puissent etre preleves par biopsie et que les precautions necessaires soient prises, en ce qui concerne l'intervalle des doses et la definition de la population de cellules qui prolifere. (author)

  20. Antibiotics for treating gonorrhoea in pregnancy. (United States)

    Comunián-Carrasco, Gabriella; Peña-Martí, Guiomar E; Martí-Carvajal, Arturo J


    Gonorrhoea is a sexually transmitted infection that is caused by Neisseria gonorrhoeae, and is a major public health challenge today. N gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth, and can cause gonococcal ophthalmia neonatorum as well as systemic neonatal infections. It can also cause endometritis and pelvic sepsis in the mother. This review updates and replaces an earlier Cochrane Review on antibiotics for treating this infectious condition. To assess the clinical effectiveness and harms of antibiotics for treating gonorrhoea in pregnant women. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2017), LILACS database (1982 to April 5, 2017), the WHO International Clinical Trials Registry Platform (ICTRP; April 5, 2017), (April 5, 2017), the ISRCTN Registry (April 5, 2017), and Epistemonikos (April 5, 2017). We also searched reference lists of all retrieved articles. We included randomised controlled trials (RCTs) comparing the use of antibiotics for treating gonorrhoea in pregnancy. The antibiotics could have been used alone or in combination, were administered parenterally, orally, or both, and were compared with another antibiotic.We included RCTs regardless of their publication status (published, unpublished, published as an article, an abstract, or a letter), language, or country. We applied no limits on the length of follow-up.We excluded RCTs using a cluster- or cross-over design, or quasi-RCTs. Three review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked them for accuracy. We included two RCTs, that randomised 514 pregnant women (347 women analysed) at a mean gestational age of 22 weeks. Both trials were conducted in the outpatient department of the same two hospitals in the USA between 1993 and 2001, and had a follow-up of 14 days. One of the trials was sponsored by a drug company. We considered both trials to