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Sample records for post partum period

  1. [Hypertension and pregnancy: Post-partum period].

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    Hugon-Rodin, Justine; Plu-Bureau, Geneviève

    2016-01-01

    Post-partum period is associated with specific characteristics in women with gestational disorders or preeclampsia. For breastfeeding women, the choice of antihypertensive treatment should take into account the impact on child health. The impact of breastfeeding on health mother must be also discussed. Moreover, for lactation inhibition, bromocriptine should not be used, especially in the context of gestational disorders. In post-partum period, the best contraceptive strategy is only-progestin contraception or non-hormonal contraceptives use. However, this choice will depend on the stabilization or normalization of blood pressure in early post-partum period. Finally, several consultations should be suggested: an information and announcement to explain the consequences of these gestational disorders and organize their multidisciplinary management and follow-up. A preconceptional consultation takes its place to anticipate potential recurrent preeclampsia or gestational hypertension and to schedule a future pregnancy in optimal conditions. Copyright © 2016. Published by Elsevier Masson SAS.

  2. [Post-partum thyroiditis].

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    Neves, Celestino; Alves, Marta; Delgado, Luís; Medina, J Luís

    2009-01-01

    In the post-partum period the immune alterations are associated with the multiple autoimmune diseases relapse. After birth, immune-tolerance variation slowly disappear, and is observed a return to a normal state - after an exacerbation period - of autoimmune reactivity, during which a great increase in T cells and autoantibodies is observed. In this period - 3 to 9 months after birth - the thyroid autoimmune disease relapses or reappears. The reactivation of the immune system in the post-partum period unchains an acute phase of celular destruction which characterizes the post-partum thyroiditis.

  3. Dry period management and optimization of post-partum reproductive management in dairy cattle.

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    Gumen, A; Keskin, A; Yilmazbas-Mecitoglu, G; Karakaya, E; Wiltbank, Mc

    2011-09-01

    Dry period and early post-partum management are decisive factors for fertility in lactating dairy cows. Previous studies have shown that decreased dry matter intake (DMI) and increased non-esterified fatty acids (NEFA) negatively affect fertility and subsequent milk production. The traditional dry period decreases DMI prior to parturition, resulting in a decrease in energy intake. A negative energy balance increases NEFA concentration, and increased NEFA may impair the immune system, especially by decreasing neutrophil function prior to parturition. Earlier studies have shown that post-partum health disorders, including retained placenta and metritis, were correlated with periparturient neutrophil function. In addition, decreased DMI is also linked to a reduced body condition score (BCS) in dairy cows. These events in the periparturient period negatively affect fertility. Some manipulation, such as shortening the dry period, may be a solution to increased DMI in the periparturient period, preventing post-partum disorders and subsequent fertility issues. This article aims to explain the effects of shortening the dry period on reproduction and early post-partum treatments to improve fertility. In addition, timed artificial insemination protocols will be discussed for use during the post-partum period to improve fertility in dairy cows. © 2011 Blackwell Verlag GmbH.

  4. Cranial neuroimaging in pregnancy and the post-partum period

    International Nuclear Information System (INIS)

    Mortimer, A.M.; Bradley, M.D.; Likeman, M.; Stoodley, N.G.; Renowden, S.A.

    2013-01-01

    Several diverse neurological conditions may be seen during pregnancy and the post partum period. These usually require neuroimaging for definitive diagnosis and range from a predisposition to neurovascular abnormalities, such as acute ischaemic stroke and cerebral venous sinus thrombosis, through to more specific pregnancy-related conditions, such as eclampsia/posterior reversible leukoencephalopathy and post-partum angiopathy. Additionally, the pregnant patient is predisposed to pituitary disease. It is necessary that the radiologist has an awareness of these conditions to allow swift specific diagnoses or suggest the most appropriate diagnosis when imaging findings are non-specific. We describe epidemiological and radiological features to allow the radiologist to guide the clinician in management, and review guidelines for safe cranial imaging of the pregnant patient

  5. Post-partum acute kidney injury

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    Naresh Pahwa

    2014-01-01

    Full Text Available To determine the risk factors, course of hospital stay and mortality rate among women with post-partum acute kidney injury (AKI, we studied (of 752 patients with AKI admitted to a tertiary care center during the study period between November 2009 and August 2012 27 (3.59% women with post-partum AKI. The data regarding age, parity, cause of renal failure, course of hospital stay and requirement of dialysis were recorded. Sepsis was the major cause (70.3% of post-partum AKI. Other causes included disseminated intravascular coagulation (55.5%, pre-eclampsia/eclampsia (40.7%, ante- and post-partum hemorrhage (40.7% and 22.2% and hemolytic anemia and elevated liver enzymes and low platelet count syndrome (29.6%; most patients had more than one cause of AKI. We found a very high prevalence (18.5% of cortical necrosis in our study patients. A significant correlation was also found between the creatinine level on admission and the period of onset of disease after delivery. In conclusion, several factors are involved in causing post-partum AKI in our population, and sepsis was the most common of them.

  6. Breastfeeding Initiation and Duration in First-Time Mothers: Exploring the Impact of Father Involvement in the Early Post-Partum Period

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    Theresa Hunter

    2014-12-01

    Full Text Available Background: The early post-partum period is a crucial time for breastfeeding support. Mothers who have physical and emotional support during this period are more likely to be successful in breastfeeding. This study examined the relationship between father involvement and support for breast feeding initiation and duration in first-time mothers. Methods: Overall, 146 women who attended a childbirth education class or breastfeeding course at BABS were asked to fill out the Childbirth Experiences Survey, which explored key topics such as (1 breastfeeding initiation, (2 early post-partum breastfeeding, (3 breastfeeding plan, (4 post-partum breastfeeding support and (5 breast feeding duration. This was a voluntary self-reported questionnaire. The surveys were completed by the mothers during the post-partum period. Results: 45.9% (n=67 of mothers received helped from their husband or partner with breastfeeding while in the hospital, while 54.1% (n=79 of mothers did not receive support from their partners. Mothers who received early post-partum breastfeeding support were more likely to continue breastfeeding after leaving the hospital. Conclusion: First-time mothers who identified as having breastfeeding support from their partners, the infant’s father, during the early post-partum period were more likely to initiate breastfeeding and had longer breastfeeding durations.

  7. Limbic encephalitis presenting as a post-partum psychiatric condition.

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    Gotkine, Marc; Ben-Hur, Tamir; Vincent, Angela; Vaknin-Dembinsky, Adi

    2011-01-01

    OBJECTIVE: We describe a woman who presented with a psychiatric disorder post-partum and subsequently developed seizures and cognitive dysfunction prompting further investigation. A diagnosis of limbic encephalitis (LE) was made and antibodies to voltage-gated potassium channel complex (VGKC) detected. These antibodies are found in many non-paraneoplastic patients with LE. Although antibody-mediated conditions tend to present or relapse post-partum, VGKC-LE in the post-partum period has not b...

  8. Spontaneous spinal epidural haematoma: a rare cause of quadriplegia in the post-partum period.

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    Bose, S; Ali, Z; Rath, G P; Prabhakar, H

    2007-12-01

    Spontaneous spinal epidural haematoma (SSEH) is a rare cause of neurological deficit in the pregnant and post-partum patients. However, SSEH with associated myelitis presenting as quadriplegia and respiratory paralysis in the post-partum period has never been reported. We report the development of acute onset quadriplegia progressing to respiratory arrest in a 24-yr-old woman 2 weeks after normal vaginal delivery. There was no history suggestive of any coagulopathy (inherited or acquired), eclampsia, pre-existing neurological deficit, or iatrogenic manipulations such as spinal/epidural injections. Magnetic resonance imaging revealed a posterior epidural haematoma extending from C4-C7 and areas of signal changes in spinal cord from cervicomedullary junction to D5 level (suggestive of demyelination). We highlight this rare cause of quadriplegia; focusing on the altered dynamics of the epidural vasculature in the peripartum period leading to SSEH.

  9. Limbic encephalitis presenting as a post-partum psychiatric condition.

    Science.gov (United States)

    Gotkine, Marc; Ben-Hur, Tamir; Vincent, Angela; Vaknin-Dembinsky, Adi

    2011-09-15

    We describe a woman who presented with a psychiatric disorder post-partum and subsequently developed seizures and cognitive dysfunction prompting further investigation. A diagnosis of limbic encephalitis (LE) was made and antibodies to voltage-gated potassium channel complex (VGKC) detected. These antibodies are found in many non-paraneoplastic patients with LE. Although antibody-mediated conditions tend to present or relapse post-partum, VGKC-LE in the post-partum period has not been described. Case report. Clinical and imaging data were consistent with limbic encephalitis. High titres of anti-VGKC-complex antibodies confirmed the diagnosis of VGKC-LE. The similarities between the psychiatric symptomatology of VGKC-LE and post-partum psychiatric disorders raise the possibility that some instances of post-partum psychiatric conditions are manifestations of immune-mediated, non-paraneoplastic LE. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Predictors of post-partum stress in Vietnamese immigrant women in Taiwan.

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    Lee, Li-Chun; Hung, Chich-Hsiu

    2016-01-01

    The post-partum period is a stressful time of change, particularly for immigrant women, but, to the best of the present authors' knowledge, the subject has not been explored. This study aimed to examine immigrant women's post-partum stress, depression, and levels of social support, and to determine the predictors of post-partum stress for Vietnamese immigrant women in Taiwan. A cross-sectional design was used. In this descriptive survey, 208 Vietnamese immigrant women were telephone interviewed by a trained Vietnamese research assistant during one of their 6 weeks post-partum. Data were collected through telephone interviews using three questionnaires, including the Hung Postpartum Stress Scale, Beck Depression Inventory, and Social Support Scale. The result shows that Vietnamese women had low level post-partum stress scores. Participants' family support rated higher than friend support. The incidence of depression was 0.5%. Social support, number of post-partum days, and family income were found to be predictors for post-partum stress, accounting for 26.6% of the variance. The Vietnamese immigrant women experienced significant stress regarding their maternal roles and received most of their support from their families rather than from friends. Nurses caring for this cohort should therefore consider these factors in order to help them cope with their post-partum stress. Healthcare providers should offer available resources to these immigrant women and their spouses during this critical period in their lives. For instance, antenatal education classes could be provided to help immigrant women manage and overcome post-partum issues. © 2015 Japan Academy of Nursing Science.

  11. [Risk factors in post partum depression].

    Science.gov (United States)

    Marino, Monica; Battaglia, Eliana; Massimino, Marta; Aguglia, Eugenio

    2012-01-01

    It is commonly believed that pregnancy is a time of good mental health. However it has been observed, until recently, that many pregnant women, above all in post partum period, manifest depressive symptoms like sadness, social withdrawal and lack of motivation. The consequences are enormous, for mother mental health and for the psychical development of the baby. It becomes therefore necessary to screening and to precociously intervene on these pathological conditions and thanks also to the suitable knowledge of the risk factors for the potential development of depression post partum.

  12. Studies on post-partum anoestrus in Alentejano beef cows

    International Nuclear Information System (INIS)

    Horta, A.E.M.; Vasques, M.I.; Leitao, R.M.; Robalo Silva, J.

    1990-01-01

    Post-partum ovarian activity in Alentejano beef cows maintained on natural pastures was monitored by measuring plasma progesterone levels using the radioimmunoassay method. Post-partum anoestrus was compared in cows calving in two different seasons (winter and summer). Differences between primiparous and multiparous cows, the effect of short term nursing interruption (72 hours by the 20th day post-partum) and the dam's body weight at calving (BWC) were also considered with respect to their influence on the onset of post-partum ovarian activity. Fertility after two breeding seasons of natural mating (April-May) and November-December) was also studied. Post-partum anoestrus was significantly longer in winter calving cows than in those calving in summer, in both multiparous and primiparous cows (73.9 versus 33.1 and 111.1 versus 35.6 days, respectively; P 2 =0.41; P<0.03). Because of a longer post-partum anoestrus, fertility was reduced in cows calving during the winter season compared with those calving in summer in all three years of the study (63.9 versus 76.9%, 57.8 versus 62.9% and 36.5 versus 60.6%, for 1984, 1985 and 1986, respectively). The results presented show that the winter period in Portugal impairs the return to ovarian activity post-partum in this breed. 19 refs, 2 figs, 4 tabs

  13. Post-partum depression in the community: a qualitative study from rural South India.

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    Savarimuthu, R J S; Ezhilarasu, P; Charles, H; Antonisamy, B; Kurian, S; Jacob, K S

    2010-01-01

    Post-partum depression, although heterogeneous, is often considered a medical disease when viewed from the biomedical perspective. However, recent reports from the Indian subcontinent have documented psychosocial causal factors. This study employed qualitative methodology in a representative sample of women in rural South India. Women in the post-partum period were assessed using the Tamil versions of the Short Explanatory Model Interview, the Edinburgh Postnatal Depression Scale and a semi-structured interview to diagnose ICD 10 depression. Socio-demographic and clinical details were also recorded. Some 137 women were recruited and assessed, of these, 26.3% were diagnosed to have post-partum depression. The following factors were associated with post-partum depression after adjusting for age and education: age less than 20 or over 30 years, schooling less than five years, thoughts of aborting current pregnancy, unhappy marriage, physical abuse during current pregnancy and after childbirth, husband's use of alcohol, girl child delivered in the absence of living boys and a preference for a boy, low birth weight, and a family history of depression. Post-partum depression was also associated with an increased number of causal models of illness, a number of non-medical models, treatment models and non-medical treatment models. Many social and cultural factors have a major impact on post-partum depression. Post-partum depression, when viewed from a biomedical framework, fails to acknowledge the role of context in the production of emotional distress in the post-partum period.

  14. Stability of depressive symptoms over 3 months post-partum.

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    Abdollahi, Fatemeh; Zarghami, Mehran; Sazlina, Shariff-Ghazali; Lye, Munn-Sann

    2017-02-01

    Prolonged depression during the post-partum period is associated with maternal and infant mortality and morbidity. Less attention has been given to factors that predict the persistence of depression beyond the first 3 months post-partum. From a longitudinal cohort of 2279 women who attended Mazandaran's primary health centres in 2009, 478 women with an Edinburgh Postnatal Depression Scale (EPDS) score of 12 or greater in the third trimester of pregnancy were recruited. Persistently depressed women (depressed at all three occasions: during pregnancy, and at 2 and 12 weeks post-partum) were compared with those without depression to determine demographic, cultural, obstetric and biopsychosocial predictors for persistence of depression. Data were analysed using chi-square test, t-test and logistic regression models. The stability of depression was found in 193 (46.2 %) of 418 depressed cases who were followed up over the study period. Of those mothers who scored more than the threshold of 12 during the third trimester of pregnancy, 277 (66.3%) and 221 (52.9%) had high EPDS at 2 and 12 weeks post-partum. Psychological distress (based upon the General Health Questionnaire), low maternal parental self-efficacy (based upon the Parental Expectation Survey) and perceived social isolation (based upon the Network Orientation Scale) were independent predictors of persistent depression. Fewer depressed mothers in this study were found to recover during the first 3 months after giving birth. Psychosocial factors predicted sustained depression from pregnancy to 3 months post-partum. The findings highlight the significance of support in enhancing maternal mental health. © 2015 Wiley Publishing Asia Pty Ltd.

  15. Short term post-partum heat stress in dairy cows

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    Fuquay, J. W.; Chapin, L. T.; Brown, W. H.

    1980-06-01

    Since many dairy cows calve during late summer, the objective was to determine if heat stress immediately post-partum would (1) alter metabolism, thus, increasing susceptibility to metabolic disorders, (2) affect lactation and/or (3) affect reproduction. Forty four cows, calving during late summer, were paired with one member of each pair stressed (HS) for the first 10 post-partum days in a hot barn. Controls (CC) were kept in a cooled section of the barn. Plasma drawn weekly for 7 weeks was analyzed in an autoanalyzer for calcium, inor. phosphorus, protein, glucose and cholesterol and by radioimmunoassay for cortisol and progesterone. Ovaries and uteri were palpated weekly. Rectal temperatures were significant higher for HS during the first 10 post-partum days. No significant effects on plasma constituents were observed during the 10-day treatment period. For the 7-week period, glucose and cholesterol were lower in HS, as were cyclic peaks of progesterone and cortisol. Both calcium and inorganic phosphorus remained clinically low for the 7 weeks, but no treatment effects were seen. Uteri of HS involuted more rapidly than the CC. Treatment did not affect reproductive efficiency. Lactation milk yields did not differ, but milk fat percent was lower in HS. Heat stress immediately post-partum altered lipid metabolism, but the animal's compensatory mechanisms prevented reduction in milk production or reproductive efficiency.

  16. Risk factors for suicide attempt in pregnancy and the post-partum period in women with serious mental illnesses.

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    Gressier, Florence; Guillard, Virginie; Cazas, Odile; Falissard, Bruno; Glangeaud-Freudenthal, Nine M-C; Sutter-Dallay, Anne-Laure

    2017-01-01

    Suicide is a major public health concern worldwide, and mental disorders have been identified as a main risk factor. Suicide is also one of the leading causes of perinatal maternal mortality, but very few studies have focused on suicide attempts (SA) in the perinatal period. This work aims to assess risk factors associated with SA in pregnancy and in the post-partum period in women with mental health disorders. Women (n = 1439) with psychiatric disorders jointly admitted with their infant to 16 psychiatric Mother-Baby Units over 10 years (2001-2010) were assessed retrospectively for the occurrence of SA in pregnancy or the postpartum period. Multinomial logistic regression was used to explore the independent impact of maternal sociodemographic characteristics, history of childhood maltreatment and abuse, current mental illness and pregnancy data on SA in pregnancy and/or postpartum. One hundred and fifty-four women (11.68%) attempted suicide: 49 in pregnancy (3.71%) and 105 (7.97%) in the post-partum period. SA in pregnancy was related to alcohol use (OR = 2.37[1.02-5.53]; p = 0.04) and smoking during pregnancy (OR = 1.87[1.01-3.49]; p = 0.04) and also to a history of miscarriage (OR = 2.29[1.18-4.41]; p = 0.01). SA in the post-partum period was associated with major depressive episode (OR = 2.72[1.40-5.26]; p = 0.003) or recurrent depression (OR = 4.12[2.25-7.51], p depression in the perinatal period. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Role of Some Hormones and Blood Components during Pregnancy and Post Partum Periods in Baladi Cows

    International Nuclear Information System (INIS)

    Nessim, M.Z.

    2010-01-01

    The experiment was carried out on seven native Baladi pregnant cows similar in age and on the second parity during last stage of pregnancy as detected by rectal palpation test, during December (mild climate) and continued until calving during January and February (postpartum). Blood sample from each cow was taken at three weeks before calving and three weeks after calving to determine blood plasma levels of progesterone, estradiol, total T 3 , cortisol and parathormone hormone and other biochemical parameters, such calcium phosphorus, triglycerides, ALT and AST. The maximum temperature humidity index (THI) during December and January was 70 THI and 73 THI, respectively. A comparison was done between pre-partum and post-partum of the same group to estimate biological changes after calving. Results indicated an increase (p 3 , Phosphorus, AST and triglycerides (p<0.05) post-partum. While, it induced a decrease (p<0.01) in progesterone, cortisol , parathormone hormones, calcium and ALT level. Negative correlation was observed between calcium and phosphorus in both pre-partum and post-partum

  18. Using animal models to study post-partum psychiatric disorders.

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    Perani, C V; Slattery, D A

    2014-10-01

    The post-partum period represents a time during which all maternal organisms undergo substantial plasticity in a wide variety of systems in order to ensure the well-being of the offspring. Although this time is generally associated with increased calmness and decreased stress responses, for a substantial subset of mothers, this period represents a time of particular risk for the onset of psychiatric disorders. Thus, post-partum anxiety, depression and, to a lesser extent, psychosis may develop, and not only affect the well-being of the mother but also place at risk the long-term health of the infant. Although the risk factors for these disorders, as well as normal peripartum-associated adaptations, are well known, the underlying aetiology of post-partum psychiatric disorders remains poorly understood. However, there have been a number of attempts to model these disorders in basic research, which aim to reveal their underlying mechanisms. In the following review, we first discuss known peripartum adaptations and then describe post-partum mood and anxiety disorders, including their risk factors, prevalence and symptoms. Thereafter, we discuss the animal models that have been designed in order to study them and what they have revealed about their aetiology to date. Overall, these studies show that it is feasible to study such complex disorders in animal models, but that more needs to be done in order to increase our knowledge of these severe and debilitating mood and anxiety disorders. © 2014 The British Pharmacological Society.

  19. Recurrent post-partum coronary artery dissection

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    Resnic Frederic S

    2010-10-01

    Full Text Available Abstract Coronary artery dissection is a rare but well-described cause for myocardial infarction during the post-partum period. Dissection of multiple coronary arteries is even less frequent. Here we present a case of recurrent post-partum coronary artery dissections. This unusual presentation poses unique problems for management. A 35 year-old female, gravida 3 para 2, presented with myocardial infarction 9 weeks and 3 days post-partum. Cardiac catheterization demonstrated left anterior descending (LAD dissection but an otherwise normal coronary anatomy. The lesion was treated with four everolimus eluting stents. Initially the patient made an unremarkable recovery until ventricular fibrillation arrest occurred on the following day. Unsynchronized cardioversion restored a normal sinus rhythm and repeat catheterization revealed new right coronary artery (RCA dissection. A wire was passed distally, but it was unclear whether this was through the true or false lumen and no stents could be placed. However, improvement of distal RCA perfusion was noted on angiogram. Despite failure of interventional therapy the patient was therefore treated conservatively. Early operation after myocardial infarction has a significantly elevated risk of mortality and the initial dissection had occurred within 24 hours. This strategy proved successful as follow-up transthoracic echocardiography after four months demonstrated a preserved left ventricular ejection fraction of 55-60% without regional wall motion abnormalities. The patient remained asymptomatic from a cardiac point of view.

  20. Prevalence and treatment of post partum urinary incontinence

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    Siv Mørkved

    2009-10-01

    Full Text Available  SUMMARYChildbirth is often considered the main etiological factor in the development of female urinary incontinence(UI. For that reason women in the western countries have been encouraged to engage in post partumpelvic floor muscle (PFM exercise in order to strengthen the pelvic floor. However, the effect of post partumPFM exercise has been sparsely documented. The aim of this article is to review and discuss literaturerelated to prevalence of post partum UI and effect of post partum PFM exercise in the treatment of UI. Thereported prevalence of UI post partum varies from 0.7% to 44%. The variation may be explained bydifferent definitions of UI used in the questionnaires and that the registration of incontinence was done atdifferent intervals after delivery. A few studies have tried to evaluate the effect of post natal PFM exercise.Some have evaluated PFM strength, others the frequency of UI. PFM strength is difficult to measure andthe reliability and validity of the methods used is open to question. Another flaw in some of the previousstudies is the training protocol applied to improve PFM strength. Mørkved and Bø tried to take intoaccount the above mentioned methodological considerations, in a study aiming to evaluate the effect ofpost partum PFM exercise. The results demonstrate that post partum PFM exercise is effective instrengthening the PFM and in the treatment of UI. However, success of PFM exercise is dependent uponboth the training frequency and intensity. This requires a closer follow up of the post partum women, thanthe written information that usually serves this purpose at the present time.Key words  : physiotherapy, pelvic floor muscles, urinary incontinence, post partum exercise, prevalence

  1. Variation of transaminases, HCV-RNA levels and Th1/Th2 cytokine production during the post-partum period in pregnant women with chronic hepatitis C.

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    Angeles Ruiz-Extremera

    Full Text Available This study analyses the evolution of liver disease in women with chronic hepatitis C during the third trimester of pregnancy and the post-partum period, as a natural model of immune modulation and reconstitution. Of the 122 mothers recruited to this study, 89 were HCV-RNA+ve/HIV-ve and 33 were HCV-RNA-ve/HIV-ve/HCVantibody+ve and all were tested during the third trimester of pregnancy, at delivery and post-delivery. The HCV-RNA+ve mothers were categorized as either Type-A (66%, with an increase in ALT levels in the post-partum period (>40 U/L; P<0.001 or as Type-B (34%, with no variation in ALT values. The Type-A mothers also presented a significant decrease in serum HCV-RNA levels in the post-delivery period (P<0.001 and this event was concomitant with an increase in Th1 cytokine levels (INFγ, P = 0.04; IL12, P = 0.01 and IL2, P = 0.01. On the other hand, the Type-B mothers and the HCV-RNA-ve women presented no variations in either of these parameters. However, they did present higher Th1 cytokine levels in the partum period (INFγ and IL2, P<0.05 than both the Type-A and the HCV-RNA-ve women. Cytokine levels at the moment of delivery do not constitute a risk factor associated with HCV vertical transmission. It is concluded that differences in the ALT and HCV-RNA values observed in HCV-RNA+ve women in the postpartum period might be due to different ratios of Th1 cytokine production. In the Type-B women, the high partum levels of Th1 cytokines and the absence of post-partum variation in ALT and HCV-RNA levels may be related to permanent Th1 cytokine stimulation.

  2. Catatonic features noted in patients with post-partum mental illness.

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    Lai, Jiun-Yang; Huang, Tiao-Lai

    2004-04-01

    The purpose of the present study was to investigate the prevalence, distribution of psychiatric diagnoses, and treatment responses of patients with post-partum mental illness at an emergency unit at Chang Gung Memorial Hospital at Kaohsiung in Taiwan. During a 1 year period a total of 636 Taiwanese women received psychiatric consultation on their visits to the emergency room. Fifteen of these were noted to have post-partum mental illnesses. All subjects were followed up for a minimum of 3-6 months. The prevalence of patients with post-partum mental illness at an emergency unit at Chang Gung Memorial Hospital at Kaohsiung was 2.4% (15/636). The distribution of psychiatric diagnoses according to Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria included eight cases of major depressive disorders (53.3%), three cases of bipolar I disorder (20%), three cases of schizophrenia (20%), and one case of psychotic disorder due to a general medical condition (6.7%). Four subjects manifested catatonic features. Of these four, three had complete remission in catatonic symptoms after receiving intramuscular injection of lorazepam. The fourth subject died of multiple medical diseases. The treatment results suggest that most of the clinical presentations in patients with post-partum mental illness could be relieved by antipsychotics, mood stabilizers or antidepressants. In addition, it was found that intramuscular injection of lorazepam was also effective in patients with catatonic features and post-partum depression or psychosis.

  3. Post-traumatic Stress Disorder Post Partum

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    Schwab, W.; Marth, C.; Bergant, A. M.

    2012-01-01

    Traumatic birth experiences may lead to serious psychological impairment. Recent studies show that a considerable number of women can develop post-traumatic stress disorder (PTSD), in some cases in a subsyndromal form. Until now, the possibility that postpartum psychological symptoms might be a continuum of a pre-existing disorder in pregnancy has rarely been considered. This study therefore aimed to evaluate the proportion of women who develop post-traumatic stress disorder as a result of childbirth. Materials and Methods: 56 multiparous women were recruited for the study. The diagnosis of PTSD was made according to the criteria for psychological disorders in the DSM-IV (Diagnostics and Statistical Manual of Mental Disorders). The data were collected in structured interviews in the 30th to 38th week of gestation and in the 6th week post partum. Results: Of the 56 women participating, 52 (93 %) completed the survey. Uncontrolled results showed that 21.15 % of the multiparous women met the full diagnostic PTSD criteria in the 6th week post partum. After the exclusion of all cases already characterised by all criteria or a subsyndromal form of PTSD caused by previous traumatisation, the PTSD rate was below 8 % at 6 weeks postpartum (= incidence rate of PTSD post partum). Conclusions: The present study is the first prospective longitudinal study to demonstrate the occurrence of full criteria PTSD in multiparous women as a result of childbirth after having excluded pre-existing PTSD. The results of our study show a high prevalence rate of PTSD during pregnancy. A number of women report all aspects of post-traumatic stress disorder as a result of childbirth. PMID:25253905

  4. Psychosocial risk factors and treatment of new onset and recurrent depression during the post-partum period.

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    Kettunen, Pirjo; Hintikka, Jukka

    2017-07-01

    When developing maternity care services, it is important to know how psychosocial factors affect the course of post-partum depression (PPD), and how depressed mothers are treated. The aim of this study is to assess how adverse childhood experiences, poor present support and violence, and low socioeconomic status (SES) associate with PPD, specifically in new onset and recurrent post-partum depression. The second aim is to assess the treatment received for PPD. This is a cross-sectional study. The study group comprises 104 mothers with a current episode of PPD, and a control group of 104 mothers without an episode. The Structured Clinical Interview for DSM-IV Axis I Disorders was used for data collection. Psychosocial risk factors, treatment issues, and the course of depression were assessed with a structured self-report questionnaire. In age-adjusted multivariate analyses, adverse childhood experiences, a low level of present support in close relationships, and a poor SES were associated significantly with PPD. Childhood adversity was associated with both new onset and recurrent depression. Nevertheless, a low level of support and a poor SES were also associated with recurrent depression. A quarter of mothers with a major depressive episode in the post-partum period attended psychiatric services. In mothers with new onset depression, the proportion was only 5%. There is an urgent need to develop the diagnostics of depression in maternity care services. An awareness of psychosocial risk factors might help in this. More depressed mothers should be referred to psychiatric services.

  5. PRIMIPARA POST PARTUM DEPRESSION DIAGNOSIS AND TREATMENT

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    Esha Pradnyana

    2013-02-01

    Full Text Available Pregnancy and the first child birth is an influential complex event for a mother, which is where everything including phsycal and psyological aspects. This change can make mother psyological disorder, that can lead into depression after childbearing that call post childbearing depression or post partum depression. A wide review at 59 study make a result that 13% among primipara can suffer post partum depression 12 weeks after childbearing. Estabilishmet of this diagnosis, besides from history and symptoms, and can be supported through test Edinburgh Postnatal Depression Scale( EPDS . Patient with post partum depression, given treatment with antidepressant drug. Breastfeeding is not only to reduce stress for the mother, but also reduce the level of stress on a baby when his mother suffered depression

  6. Post-partum posterior reversible encephalopathy syndrome

    OpenAIRE

    B. V. Triveni; Salman Mohammed Sheikh; Deepak Shedde

    2014-01-01

    Posterior Reversible Encephalopathy Syndrome (PRES) is a clinicopathological syndrome associated with various clinical conditions presenting with headache, encephalopathy, seizure and cortical visual disturbances. Radiological findings in PRES are thought to be due to vasogenic edema predominantly in posterior cerebral hemispheres and are reversible with appropriate management. We present a case of post partum PRES,A 29 year old primigravida of 33 weeks 3 days period of gestation who prese...

  7. Prevalence and factors associated with depressive symptoms among post-partum mothers in Nepal.

    Science.gov (United States)

    Giri, Rajendra Kumar; Khatri, Resham Bahadur; Mishra, Shiva Raj; Khanal, Vishnu; Sharma, Vidya Dev; Gartoula, Ritu Prasad

    2015-03-31

    Post-partum depression is a common complication of women after childbirth. The objective of this study was to determine the prevalence of and factors associated with depressive symptoms among post-partum mothers attending a child immunization clinic at a maternity hospital in Kathmandu, Nepal. This cross-sectional study was conducted among 346 post-partum mothers at six to ten weeks after delivery using systematic random sampling. Mothers were interviewed using a semi-structured questionnaire. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for depressive symptoms. Logistic regression analysis was used to calculate the association of post-partum depressive symptoms with socio-demographic and maternal factors. The prevalence of post-partum depressive symptoms among mothers was 30%. Mothers aged 20 to 29 years were less likely to have depressive symptoms (adjusted odds ratio (aOR) = 0.40; 95% CI: 0.21-0.76) compared to older mothers. Similarly, mothers with a history of pregnancy-induced health problems were more likely to have depressive symptoms (aOR = 2.16; CI: 1.00-4.66) and subjective feelings of stress (aOR = 3.86; CI: 1.84-4.66) than mothers who did not. The number of post-partum mothers experiencing depressive symptoms was high; almost one-third of the participants reported having them. Pregnancy-induced health problems and subjective feelings of stress during pregnancy in the post-partum period were found to be associated with depressive symptoms among these women. Screening of depressive symptoms should be included in routine antenatal and postnatal care services for early identification and prevention.

  8. [Unusual leukoencephalopathy of post-partum].

    Science.gov (United States)

    Hsaini, Y; Karouache, A; Bourazza, A

    2011-08-01

    Neurologic complications of post-partum are serious and usually secondary to eclampsia or stroke. We here report a 26-year-old female who presented with severe headaches, blurred vision, and repeated generalized seizures secondary to posterior reversible encephalopathy that occurred after a caesarean section for fetal death in utero. Outcome was favourable. Although uncommon, this neurologic complication of the post-partum should be discussed in the presence of any sign of encephalopathy occurring in the context of acute hypertension. Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  9. the occurrence of post partum anoestrus in bonsmara cows

    African Journals Online (AJOL)

    duration of post partum anoestrus than gain in body mass. Post pactum ... and Bos Taurus cattle to improve fertility and milk pro- duction in high .... The occurrence of post partum anoestrus in beef cows under ranching conditions. Proc.

  10. Changing the risky beliefs of post-partum women about therapeutic sun-exposure.

    Science.gov (United States)

    Harrison, Simone L; Devine, Susan G; Saunders, Vicki L; Smith, Annika D; Buettner, Petra G; Nowak, Madeleine J

    2013-09-01

    Many post-partum women hold risky beliefs about perceived therapeutic benefits of sun-exposure in the post-partum period and infancy. Can a maternity hospital based educational intervention reduce the prevalence of such beliefs among post-partum women? In this outcome evaluation of an interventional study, two groups of healthy post-partum women (hospital inpatients) were interviewed, 1-4 days following delivery. The first cross-section (106 women) was recruited prior to in-services for maternity staff; the second (203 women) was recruited after completion of the in-services. Data were compared between the groups. More pre-intervention than post-intervention women reported they would expose their baby to sunlight to treat suspected jaundice (28.8% vs. 13.3%; p<0.001) or help his/her skin adapt to the sun (10.5% vs. 2.5%; p=0.003); or use sunlight to manage breastfeeding-associated sore/cracked nipples (7.6% vs. 2%; p=0.026). This simple, effective educational intervention could be implemented in programmes for parents, health professionals and students. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  11. Cognitive factors and post-partum depression: What is the influence of general personality traits, rumination, maternal self-esteem, and alexithymia?

    Science.gov (United States)

    Denis, Anne; Luminet, Olivier

    2018-03-01

    The objective was to assess the impact of cognitive factors on post-partum depression (PPD) symptoms. Because most of the literature data concern the immediate post-partum period or the first year post-partum, we notably sought to assess the longer term impact of cognitive factors on the symptoms of PPD. Two studies were performed. In a pilot study, 1-month post-partum, 63 women filled out a sociodemographic information sheet and completed the abbreviated, revised Eysenck Personality Questionnaire, the Ruminative Responses Scale, the Maternal Self-Report Inventory, and the Edinburgh Post-Natal Depression Scale. In the main study, 124 women additionally completed the Toronto Alexithymia Scale. The main study population was divided into 2 subgroups: women in the first year post-partum (n = 74) and those in the second year post-partum (n = 50). In the pilot study performed 1-month post-partum, brooding rumination and low self-esteem were significant predictors of the PPD symptom intensity. Neuroticism, brooding rumination, and low maternal self-esteem were also significant predictors of the PPD symptoms reported in the first year post-partum. Lastly, ruminative thoughts and alexithymia were significant predictors of the PPD symptoms reported in the second year post-partum. Our results suggest that alexithymia may be an important predictor of the incidence of this condition. The observation of differences in the PPD models as a function of the post-partum period may open up opportunities for developing novel PPD prevention/treatment programs. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Development of a prenatal psychosocial screening tool for post-partum depression and anxiety.

    Science.gov (United States)

    McDonald, Sheila; Wall, Jennifer; Forbes, Kaitlin; Kingston, Dawn; Kehler, Heather; Vekved, Monica; Tough, Suzanne

    2012-07-01

    Post-partum depression (PPD) is the most common complication of pregnancy in developed countries, affecting 10-15% of new mothers. There has been a shift in thinking less in terms of PPD per se to a broader consideration of poor mental health, including anxiety after giving birth. Some risk factors for poor mental health in the post-partum period can be identified prenatally; however prenatal screening tools developed to date have had poor sensitivity and specificity. The objective of this study was to develop a screening tool that identifies women at risk of distress, operationalized by elevated symptoms of depression and anxiety in the post-partum period using information collected in the prenatal period. Using data from the All Our Babies Study, a prospective cohort study of pregnant women living in Calgary, Alberta (N = 1578), we developed an integer score-based prediction rule for the prevalence of PPD, as defined as scoring 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS) at 4-months postpartum. The best fit model included known risk factors for PPD: depression and stress in late pregnancy, history of abuse, and poor relationship quality with partner. Comparison of the screening tool with the EPDS in late pregnancy showed that our tool had significantly better performance for sensitivity. Further validation of our tool was seen in its utility for identifying elevated symptoms of postpartum anxiety. This research heeds the call for further development and validation work using psychosocial factors identified prenatally for identifying poor mental health in the post-partum period. © 2012 Blackwell Publishing Ltd.

  13. Demographic, maternal, and infant health correlates of post-partum depression in Jordan.

    Science.gov (United States)

    Safadi, Reema R; Abushaikha, Lubna A; Ahmad, Muayyad M

    2016-09-01

    This cross-sectional correlational study examined post-partum depression and its relationship with demographic, maternal, and infant health problems in urban Jordanian women. Participants (n = 315) were selected from five maternal child healthcare centers and one major hospital in Amman, Jordan. Patient Health Questionnaire-9 was used to measure post-partum depression within 12 weeks of birth. A number of socio-demographic and health problems were examined for an association with post-partum depression. Results showed that 25% of post-partum women suffered moderate to severe depression and 50% of the sample had mild depression. None of the socio-demographic variables (age, education, employment, income) were significantly related to post-partum depression; however, two obstetric/infant variables (mode of birth and breastfeeding), were significantly associated with post-partum depression. There was a significant association between post-partum depression and 15 health problems of obstetric, gynecologic (i.e. episiotomy pain, infection), and general health conditions (i.e. fatigue, headache). Nurses and midwives need to emphasize post-partum depression screening, follow-up, and proper management of maternal and infant health factors predisposing to post-partum depression rather than merely focusing on women's inherent demographic factors. © 2015 Wiley Publishing Asia Pty Ltd.

  14. Cognitive factors and post-partum depression: What is the influence of general personality traits, rumination, maternal self-esteem, and alexithymia?

    OpenAIRE

    Denis, Anne; Luminet, Olivier

    2017-01-01

    OBJECTIVES: The objective was to assess the impact of cognitive factors on post-partum depression (PPD) symptoms. Because most of the literature data concern the immediate post-partum period or the first year post-partum, we notably sought to assess the longer term impact of cognitive factors on the symptoms of PPD. METHODS: Two studies were performed. In a pilot study, 1-month post-partum, 63 women filled out a sociodemographic information sheet and completed the abbreviated, revised Eysenck...

  15. Determinants of Post - partum contraception practices in urban slums of central Karnataka, India

    Directory of Open Access Journals (Sweden)

    Shubha Davalagi B

    2016-09-01

    Full Text Available Background: The largest proportion of women with an unmet need for contraception is found among those in their first year after childbirth; concentrating efforts to reduce unmet need among these women could have additionally bigger impact on increasing contraceptive use than concentrating on any other group. Aims & Objectives: To know the knowledge & practices of postpartum contraception among mothers in urban slums. Material & Methods: Cross sectional study conducted in urban slums for duration of six months. Study population included mothers in extended postpartum period residing in urban slums. Mothers were interviewed using pre – tested, semi – structured questionnaire. Data was analyzed using SPSS v 22.0 and, chi square test and logistic regression analysis was employed. P value of <0.05 was considered statistically significant. Results: Majority of the mothers in our study were in the age group of 20-24 years (46%. Mean age was 21.6 ± 3.1years. Majority of the mothers (56% were Hindus. Mean age of marriage observed was 18.2±2.1years. In the present study, majority (76% had knowledge of postpartum contraceptive methods, but only 17% of the mothers were using contraception. Unmet need for postpartum contraception was found among 49% of mothers. Conclusions: Inspite of being aware, the practice of family planning was very low among post-partum mothers. The study highlights the impact of socio cultural factors like religion, caste, number of living children, duration of marriage and ANC service utilization on postpartum contraception usage among mothers.

  16. High resolution computed tomography of the post partum pituitary gland

    International Nuclear Information System (INIS)

    Hinshaw, D.B.; Hasso, A.N.; Thompson, J.R.; Davidson, B.J.

    1984-01-01

    Eight volunteer post partum female patients were examined with high resolution computed tomography during the week immediately after delivery. All patients received high dose (40-70 gm) intravenous iodine contrast administration. The scans were examined for pituitary gland height, shape and homogeneity. All of the patients had enlarged glands by the traditional standards (i.e. gland height of 8 mm or greater). The diaphragma sellae in every call bulged upward with a convex domed appearance. The glands were generally inhomogeneous. One gland had a 4 mm focal well defined area of decreased attenuation. Two patients who were studied again months later had glands which had returned to ''normal'' size. The enlarged, upwardly convex pituitary gland appears to be typical and normal for the recently post partum period. (orig.)

  17. Changes of progesterone levels in the milk of dairy cows in post-partum

    Energy Technology Data Exchange (ETDEWEB)

    Yongpeng, Li

    1985-06-01

    Progesterone levels were measured by radioimmunoassay in the last milk of seven dairy cows in 5-75 days post-partum. The progesterone levels were from 0.1 to 1.5 ng/ml and averaged 0.4 +- 0.2 ng/ml for the last milk of the seven cows. A range of 0.3 to 0.7 ng/ml for average progesterone levels of the seven cows can be estimated. Two ovarian cycle activities in post-partum of cow No. 43 were observed and a ovulation on 15-20 days post-partum was revealed. The peak value after 20 days post-partum was 3.0 ng/ml. The progesterone level after peak value was declined, and reached to about 0.2 ng/ml on 35 days post-partum. The changes of ovarian activities were exhibited again in 35-55 days post-partum. The progesterone levels of cow No. 43 were lower in luteal phase oestrous cycles post-partum than that from the other cows in normal luteal phase oestrous cycles.

  18. A CLINICAL EVALUATION OF POST-PARTUM DEPRESSION IN COASTAL KARNATAKA

    Directory of Open Access Journals (Sweden)

    Annappa Shetty

    2016-09-01

    Full Text Available BACKGROUND Psychological mood changes, depression is very common in Post-partum period ranging from mild and transient “baby blues” experienced by 50-80% of women to postpartum Psychosis which affects 1% of women. AIMS AND OBJECTIVE To evaluate the association of different factors with Post-Partum depression in coastal Karnataka region, (Karwar. MATERIAL & METHODS  A Prospective study was conducted in the department of Obstetrics and Gynaecology, KAIMS, Karwar, Karnataka.  A total one thousand patients 4-7 Post-partum days were selected and interrogated using Edinburgh Postnatal depression scale (EPDS. Socio-demographic factors (age, Parity, literacy, socio-economic status, marital status and family structure, history of psychiatric disorders and abuse, mode of delivery and the obstetric outcome were recorded. The results were analysed statistically using Chi-square chart. STATISTICAL ANALYSIS AND RESULTS: The incidence of PPD was 22%. Significant association of PPD was seen with low socio-economic status group (P<005, poor literacy (P<0.001, nuclear family structure (P<0.05, single mother (P<0.001, past history of abuse (P<0.05 and poor obstetric outcome (P<0.001. CONCLUSION This study provides useful information about the prevalence of PPD and the association of socio economic, cultural practices prevalent in coastal Karnataka with PPD.

  19. Bacteria Isolated from Post-Partum Infections

    Directory of Open Access Journals (Sweden)

    Nahid Arianpour

    2009-06-01

    Full Text Available Objective: This study was undertaken with an aim to determine bacterial species involved in post partum infections and also their abundance in patients admitted to at Khanevadeh hospital. In this study out of three different kinds of postpartum infections (i.e. genital, breast and urinary tract, only genital infection is considered.Materials and Methods: Post partum infection among 6077 patients (inpatients and re-admitted patients of Khanevadeh hospital from 2003 till 2008 was studied in this descriptive study. Samples were collected from patients for laboratory diagnosis to find out the causative organisms.Results: Follow up of mothers after delivery revealed 7.59% (461 patients had post partum infection, out of which 1.03% (63 patients were re-hospitalized. Infection was more often among younger mothers. Bacteria isolated and identified were both aerobic and anaerobic cocci and bacilli, majority of which were normal flora of the site of infection. Though, some pathogenic bacteria like Staphylococcus aureus, Neisseria gonorrhea, Chlamydia trachomatis,were also the causative agents. The commonest infection was infection at the site of episiotomy. Conclusion: Puerperal infection was detected in of 7.59% mothers. Bacteria isolated were both aerobic and anaerobic cocci and bacilli, majority of which were normal flora. However; some pathogenic bacteria were isolated.

  20. Hormonal profile and body condition scoring in dairy cows during pre partum and post partum periods

    Directory of Open Access Journals (Sweden)

    Mária Vargová

    2015-01-01

    Full Text Available The aim of this study was to evaluate the dynamics of selected indicators of energy, hormonal profile, body condition score (BCS and their relationships in dairy cows of the Slovak Pied Cattle from 3 weeks before parturition to 9 weeks after. Significant differences were found in the mean values of non-esterified fatty acids (NEFA (P P post partum (P P P P P P < 0.05. These data provide evidence that the variations in the concentrations of leptin, ghrelin, and insulin are related to variations in the BCS. Negative correlation between leptin and ghrelin contributes to the argument that leptin negatively regulates ghrelin.

  1. Maternal social support, quality of birth experience, and post-partum depression in primiparous women.

    Science.gov (United States)

    Tani, Franca; Castagna, Valeria

    2017-03-01

    Social relationships provide individuals with a general sense of self-worth, psychological wellbeing, as well as allowing them access to resources during stressful periods and transitions in life. Pregnancy is a time of significant life change for every woman. The aim of this study was to verify the influence of social support perceived by mothers during pregnancy on the quality of their birth experience and post-partum depression. A longitudinal study at three different times was carried out on 179 nulliparous pregnant women. Women completed a Maternal Social Support Questionnaire during the third trimester of their pregnancy. Then, on the first day after childbirth, clinical birth indices were collected. Finally, a month after childbirth, the Edinburgh Postnatal Depression Scale was administered. Post-partum depression was influenced negatively by maternal perceived social support and positively by negative clinical birth indices. In addition to these direct effects, analyses revealed a significant effect of maternal perceived social support on post-partum depression, mediated by the clinical indices considered. Social support perceived by mothers during pregnancy plays a significant role as a protection factor against post-partum depression, both directly and indirectly, reducing the negative clinical aspects of the birth experience.

  2. Health and economic burden of post-partum Staphylococcus aureus breast abscess.

    Science.gov (United States)

    Branch-Elliman, Westyn; Lee, Grace M; Golen, Toni H; Gold, Howard S; Baldini, Linda M; Wright, Sharon B

    2013-01-01

    To determine the health and economic burdens of post-partum Staphylococcus aureus breast abscess. We conducted a matched cohort study (N = 216) in a population of pregnant women (N = 32,770) who delivered at our center during the study period from 10/1/03-9/30/10. Data were extracted from hospital databases, or via chart review if unavailable electronically. We compared cases of S. aureus breast abscess to controls matched by delivery date to compare health services utilization and mean attributable medical costs in 2012 United States dollars using Medicare and hospital-based estimates. We also evaluated whether resource utilization and health care costs differed between cases with methicillin-resistant and -susceptible S. aureus isolates. Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. Breastfeeding cessation (41%), milk fistula (11.1%) and hospital readmission (50%) occurred frequently among case patients. Breast abscess case patients had high rates of health services utilization compared to controls, including high rates of imaging and drainage procedures. The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340-$4,012, depending on the methods and data sources used. Mean attributable costs were not significantly higher among methicillin-resistant vs. -susceptible S. aureus cases. Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. Future study is needed to determine the optimal treatment and prevention of these infections.

  3. Health and economic burden of post-partum Staphylococcus aureus breast abscess.

    Directory of Open Access Journals (Sweden)

    Westyn Branch-Elliman

    Full Text Available To determine the health and economic burdens of post-partum Staphylococcus aureus breast abscess.We conducted a matched cohort study (N = 216 in a population of pregnant women (N = 32,770 who delivered at our center during the study period from 10/1/03-9/30/10. Data were extracted from hospital databases, or via chart review if unavailable electronically. We compared cases of S. aureus breast abscess to controls matched by delivery date to compare health services utilization and mean attributable medical costs in 2012 United States dollars using Medicare and hospital-based estimates. We also evaluated whether resource utilization and health care costs differed between cases with methicillin-resistant and -susceptible S. aureus isolates.Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. Breastfeeding cessation (41%, milk fistula (11.1% and hospital readmission (50% occurred frequently among case patients. Breast abscess case patients had high rates of health services utilization compared to controls, including high rates of imaging and drainage procedures. The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340-$4,012, depending on the methods and data sources used. Mean attributable costs were not significantly higher among methicillin-resistant vs. -susceptible S. aureus cases.Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. Future study is needed to determine the optimal treatment and prevention of these infections.

  4. Gestational Diabetes Mellitus: Post-partum Risk and Follow Up.

    Science.gov (United States)

    Poola-Kella, Silpa; Steinman, Rachel A; Mesmar, Bayan; Malek, Rana

    2018-01-31

    Women with gestational diabetes mellitus (GDM) are at an increased risk for developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. In this review, we will discuss postpartum cardiovascular and diabetes risk in women with a history of GDM and different ways to improve postpartum screening. This review involves a comprehensive literature review on gestational diabetes and postpartum risk for cardiovascular disease and diabetes mellitus as well as post-partum screening methods. Cardiovascular risk post-partum is potentiated by increased inflammatory markers leading to worsening atherosclerosis and cardiovascular events downstream. Decreased insulin sensitivity and β cell compensation, recurrent GDM, maternal factors such as pre and post-partum weight gain and lactation may contribute to T2DM risk. Postpartum glucose testing is essential in screening women as hyperglycemia in pregnancy has long term effects on both cardiovascular disease and diabetes risk on the mother. Long and short term improvement to post-partum glucose testing is essential to decreasing cardiometabolic and diabetes risk in women with gestational diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Post-partum reproductive performance of the Icelandic dairy cow

    International Nuclear Information System (INIS)

    Eldon, J.; Olafsson, T.; Thorsteinsson, T.

    1990-01-01

    The aim of the studies was to monitor the reproductive performance of Icelandic dairy cow herds with and without histories of fertility problems under normal farming conditions. Artificial inseminations and calvings were recorded, pregnancy was diagnosed by rectal palpation, and progesterone concentration was measured by radioimmunoassay in sequential samples of milk. Blood samples were collected at regular intervals and the concentrations of glucose, urea, calcium and magnesium were determined. Clinical ketosis and low glucose were found in one third of the cows on problem farms. The mean time of first post-partum ovulation was 49 days for cows with ketosis, compared with 34 days for cows free of ketosis. Cows in the normal herds ovulated considerably later than is reported for many other breeds of dairy cows; however, the time of first post-partum AI, the time of conception and the conception rate were similar to those reported for other breeds. The effects of season and herd were statistically significant for the time of first post-partum ovulation, AI and conception; the effect of area was highly significant for the time of ovulation. Progesterone profiles showed that over 50% of the first post-partum ovarian cycles were short and had low progesterone concentrations. Season had significant effects on the length of the interval from calving to first post-partum ovulation, AI and conception, on the conception rate to first AI and consequently on the number of AIs per conception, and on the blood levels of glucose, urea and calcium. (author). 28 refs, 3 figs, 3 tabs

  6. Prevalence rates and socioeconomic characteristics of post-partum depression in Hungary.

    Science.gov (United States)

    Nagy, Emese; Molnar, Peter; Pal, Attila; Orvos, Hajnalka

    2011-01-30

    The rapid socioeconomic transition in post-communist Hungary adversely affected the overall morbidity and mortality rates in the 1990s. Prevalence data on depressive disorders from the region are still scarce, however. This study reports the findings of the first epidemiological survey, using the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI), on the prevalence of post-partum depression and the associated risk factors in Hungary. A total of 1030 mothers who delivered their babies between May and July 1999 in 16 counties in Hungary were screened for depressive symptoms 3-26 weeks post-partum. The survey found that 10.81% of the sample was above the cut-off score of 13, and the EPDS detected post-partum depressive symptoms with 76% (95% confidence interval (CI)=60.5-87.1) sensitivity and 92% (95% CI=90.5-94.1) specificity. In addition, 24 socio-demographic, socio-psychiatric data and personal and obstetric variables were surveyed. Results of a hierarchical logistic regression analysis showed that depression of the mother during pregnancy was the strongest predictor of depressive symptoms post-partum. Depression before pregnancy, housing conditions, marital relationship status and family history of alcohol problems were also identified as predictors for post-partum depressive symptoms. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. Urinary incontinence and weight changes during pregnancy and post partum: a pending challenge.

    Science.gov (United States)

    Ruiz de Viñaspre Hernández, Regina; Rubio Aranda, Encarnación; Tomás Aznar, Concepción

    2013-12-01

    to analyse the association between urinary incontinence and maternal weight, and its variations in pregnancy and post partum. observational study of a cohort of women from the start of pregnancy until six months post partum. Hospital San Pedro in La Rioja, Spain. 402 pregnant women without urinary incontinence at the start of pregnancy. the dependent variable was urinary incontinence, assessed using the Urogenital Distress Inventory-Short Form questionnaire. The main independent variables were body mass index (BMI) at the first antenatal visit and six months post partum, weight gain during pregnancy, postpartum weight loss, and weight retained from the start of pregnancy to six months post partum. The association between urinary incontinence and the main independent variables was measured using Student's t-test. Three simple logistic regression models were used to assess the strength of this association, one for each of the independent variables that showed a significant association with urinary incontinence (p<0.05), and three multiple regression models that included the possible variable effect modifiers were also used. At the start of pregnancy, 20.1% of the women were overweight and 8.7% were obese. Six months post partum, 30.3% of the women were overweight and 11.4% were obese. The mean (±standard deviation) retained weight was 2 (±3.1) kg. Postpartum urinary incontinence was associated with BMI at six months post partum, postpartum weight loss and retained weight at six months post partum (p<0.05). The association of urinary incontinence with these variables was significant, and remained stable in both simple and multiple regression analyses with BMI at six months post partum [odds ratio (OR) 1.09 versus 1.08], weight loss from delivery to six months post partum (OR 0.88 versus 0.88), and retained weight from the beginning of pregnancy until six months post partum (OR 1.23 versus 1.19). high BMI and weight retention at six months post partum increase the

  8. [Maternal care after vaginal delivery and management of complications in immediate post-partum--Guidelines for clinical practice].

    Science.gov (United States)

    Simon, E-G; Laffon, M

    2015-12-01

    To provide recommendations on maternal care after vaginal delivery, and management of complications in immediate post-partum period. Bibliographic research from the Pubmed database and recommendations issued by the main scientific societies, and assignment of a level of evidence and a recommendation grade. After a vaginal delivery, monitoring of blood pressure, heart rate, bleeding, uterine involution, genital pain, urination, temperature, transit and signs of phlebitis is recommended (professional consensus). Post-partum Anemia is defined by a hemoglobinpost-partum hypertension or de novo preeclampsia, the prescription rules for antihypertensive treatments and magnesium sulfate are the same as in prenatal period (professional consensus). Oral NSAIDs are effective for perineal pain and uterine involution (EL2). In case of broken down perineal wounds following childbirth, there is no argument in favor of suturing or not suturing, however the suturing is to be preferred for large dehisced perineal wounds (professional consensus). Infection of perineal scar justifies an oral broad-spectrum antibiotics, in addition to local nursing (professional consensus). In case of obstetric anal sphincter injuries, an antibiotic prophylaxis is recommended (grade B). Hygiene advice should be given to all women who had an episiotomy or a perineal tear (professional consensus). The only etiological treatment of post-dural puncture headache is the blood patch (EL2). It must not be carried out before 48 hours (professional consensus). Thromboembolic risk after a vaginal birth is about 1‰ (EL2). The prescription of thromboprophylaxis with LMWH and graduated compression stockings should be based on risk factors (professional consensus). During the immediate post-partum period, complications may be unrecognized or confused with the natural post-partum evolution, which implies a strong vigilance from practitioners. This vigilance is all the more necessary that the maternal residence

  9. Evaluation of reproductive tract infection during early post-partum period and its relationship with subsequent reproductive performance in high milk producing dairy cows.

    Science.gov (United States)

    Senosy, W; Uchiza, M; Tameoka, N; Izaike, Y; Osawa, T

    2012-04-01

    Clinically normal Holstein-Friesian cows (n = 43) were used to establish a relationship between the evaluations of the uterine condition by vaginoscopy, Metricheck, endometrial cytology (EC) and ultrasonography (US) during post-partum period (pp), and subsequent reproductive performance. The uterine status of the selected cows was evaluated by EC, Metricheck, US and vaginoscopy on a weekly basis from the third week (W3) to the seventh week (W7) pp. The animals were bred after a voluntary waiting period of 45-60 days pp and diagnosed for pregnancy status at 45 days after breeding by US. First service conception rate (FSCR) of bred animals was 32.6% (14/43). There was no significant difference in polymorphonuclear leucocyte percentage between conceived and non-conceived cows during different weeks post-partum. First service conception rate in animals with normal vaginal discharge as detected by Metricheck was significantly low when compared to those of abnormal discharge during W3 (2.3% vs 30.3%; p reproductive performance of dairy cattle. © 2011 Blackwell Verlag GmbH.

  10. Barriers and facilitators to smoking cessation in pregnancy and in the post-partum period: The health care professionals' perspective.

    Science.gov (United States)

    Naughton, Felix; Hopewell, Sarah; Sinclair, Lesley; McCaughan, Dorothy; McKell, Jennifer; Bauld, Linda

    2018-05-15

    Health care professionals and the health care environment play a central role in protecting pregnant and post-partum women and their infants from smoking-related harms. This study aimed to better understand the health professional's perspective on how interactions between women, health care professionals, and the environment influence how smoking is managed. Semi-structured interviews and focus groups. Data were from 48 health care staff involved in antenatal or post-partum care at two UK sites, including midwives, obstetricians, health visitors, GPs, pharmacists, service commissioners, and Stop Smoking Service (SSS) advisors and managers. Thematic analysis was guided by a social-ecological framework (SEF). Themes were divided across three SEF levels and represented factors connected to the management of smoking in the health care context and the beliefs and behaviour of pregnant or post-partum smokers. Organizational level: Service reconfigurations, 'last resort' nicotine replacement therapy prescribing policies, and non-mandatory training were largely negative factors. There were mixed views on opt-out referral pathways and positive views on carbon monoxide monitoring. Interpersonal level: Protection of client-professional relationships often inhibited frank discussions about smoking, and weak interservice relationships affected SSS referral motivation and quality. Individual level: Professionals felt community midwives had primary responsibility for managing smoking, although midwives felt underskilled doing this. Midwives' perceived priority for addressing smoking was influenced by the demands from unrelated organizational initiatives. Opportunities to improve clinical support for pregnant smokers exist at organizational, interservice, and health care professional levels. Interactions between levels reflect the importance of simultaneously addressing different level-specific barriers to smoking cessation in pregnancy. Statement of contribution What is already

  11. The influence of psychological factors on post-partum weight retention at 9 months.

    Science.gov (United States)

    Phillips, Joanne; King, Ross; Skouteris, Helen

    2014-11-01

    Post-partum weight retention (PWR) has been identified as a critical pathway for long-term overweight and obesity. In recent years, psychological factors have been demonstrated to play a key role in contributing to and maintaining PWR. Therefore, the aim of this study was to explore the relationship between post-partum psychological distress and PWR at 9 months, after controlling for maternal weight factors, sleep quality, sociocontextual influences, and maternal behaviours. Pregnant women (N = 126) completed a series of questionnaires at multiple time points from early pregnancy until 9 months post-partum. Hierarchical regression indicated that gestational weight gain, shorter duration (6 months or less) of breastfeeding, and post-partum body dissatisfaction at 3 and 6 months are associated with higher PWR at 9 months; stress, depression, and anxiety had minimal influence. Interventions aimed at preventing excessive PWR should specifically target the prevention of body dissatisfaction and excessive weight gain during pregnancy. What is already known on this subject? Post-partum weight retention (PWR) is a critical pathway for long-term overweight and obesity. Causes of PWR are complex and multifactorial. There is increasing evidence that psychological factors play a key role in predicting high PWR. What does this study add? Post-partum body dissatisfaction at 3 and 6 months is associated with PWR at 9 months post-birth. Post-partum depression, stress and anxiety have less influence on PWR at 9 months. Interventions aimed at preventing excessive PWR should target body dissatisfaction. © 2013 The British Psychological Society.

  12. Ibuprofen versus acetaminophen as a post-partum analgesic for women with severe pre-eclampsia: randomized clinical study.

    Science.gov (United States)

    Vigil-De Gracia, Paulino; Solis, Valentin; Ortega, Nelson

    2017-06-01

    To compare differences in blood pressure levels between patients with severe post-partum pre-eclampsia using ibuprofen or acetaminophen. A randomized controlled trial was made in women with severe pre-eclampsia or superimposed pre-eclampsia after vaginal birth. The patient was randomly selected to receive either 400 mg of ibuprofen every 8 h or 1 g of acetaminophen every 6 h during the post-partum. The primary variable was systolic hypertension ≥150 mmHg and/or diastolic hypertension ≥100 mmHg after the first 24 h post-partum. Secondary variables were the arterial blood pressure readings at 24, 48, 72, and 96 h post-partum and maternal complications. A total of 113 patients were studied: 56 in the acetaminophen group and 57 in the ibuprofen group. With regard to the primary outcome, more cases were significantly hypertensive in the ibuprofen group (36/57; 63.1%) than in the acetaminophen group (16/56; 28.6%). Severe hypertension (≥160/110 mmHg) was not significantly different between the groups, 14.5% (acetaminophen) and 24.5% (ibuprofen). The levels of arterial blood pressure show a hammock-shaped curve independent of the drug used, however, is more noticeable with ibuprofen. This study shows that ibuprofen significantly elevates blood pressure in women with severe pre-eclampsia during the post-partum period.

  13. "We have been working overnight without sleeping": traditional birth attendants' practices and perceptions of post-partum care services in rural Tanzania.

    Science.gov (United States)

    Mahiti, Gladys R; Kiwara, Angwara D; Mbekenga, Columba K; Hurtig, Anna-Karin; Goicolea, Isabel

    2015-02-03

    In many low-income countries, formal post-partum care utilization is much lower than that of skilled delivery and antenatal care. While Traditional Birth Attendants (TBAs) might play a role in post-partum care, research exploring their attitudes and practices during this period is scarce. Therefore, the aim of this study was to explore TBAs' practices and perceptions in post-partum care in rural Tanzania. Qualitative in-depth interview data were collected from eight untrained and three trained TBAs. Additionally, five multiparous women who were clients of untrained TBAs were also interviewed. Interviews were conducted in February 2013. Data were digitally recorded and transcribed verbatim. Qualitative content analysis was used to analyze data. Our study found that TBAs take care of women during post-partum with rituals appreciated by women. They report lacking formal post-partum care training, which makes them ill-equipped to detect and handle post-partum complications. Despite their lack of preparation, they try to provide care for some post-partum complications which could put the health of the woman at risk. TBAs perceive that utilization of hospital-based post-partum services among women was only important for the baby and for managing complications which they cannot handle. They are poorly linked with the health system. This study found that the TBAs conducted close follow-ups and some of their practices were appreciated by women. However, the fact that they were trying to manage certain post-partum complications can put women at risk. These findings point out the need to enhance the communication between TBAs and the formal health system and to increase the quality of the TBA services, especially in terms of prompt referral, through provision of training, mentoring, monitoring and supervision of the TBA services.

  14. Magnetic resonance imaging of degeneration of uterine adenomyosis during pregnancy and post-partum period.

    Science.gov (United States)

    Hirashima, Hiroto; Ohkuchi, Akihide; Usui, Rie; Kijima, Shigeyoshi; Matsubara, Shigeki

    2018-03-08

    Degeneration of adenomyosis during pregnancy and the post-partum period is very rare. A 42-year-old Japanese parous woman with four normal-term deliveries, who presented with abdominal pain and fever at 22 weeks of gestation with transient increases of the white blood cell count and C-reactive protein, demonstrated sustained inflammation after cesarean section at 29 weeks of gestation due to the occurrence of gestational hypertension with late deceleration. The noncontrast-enhanced magnetic resonance imaging (MRI) at 22 weeks demonstrated a poorly demarcated hypointense area at the posterior uterine wall on T1- and T2-weighted imaging. The 2nd MRI 2 weeks after the cesarean section showed hypointensity on a T1-weighted image and hyperintensity on a T2-weighted image, allowing confirmation of the diagnosis of degeneration of adenomyosis. Repeated MRIs were clinically useful to diagnose the degeneration of adenomyosis. © 2018 Japan Society of Obstetrics and Gynecology.

  15. The enhanced reproduction of cow parent brahman cross post partum with feed supplement multinutrient block medicated

    International Nuclear Information System (INIS)

    Nursyam Andi Syarifuddin; Anis Wahdi

    2011-01-01

    One of the problems in breeding Brahman Cross cattle reproduction efficiency is low due to the length of postpartum anestrus and the high number of services per conception is partly due to the low nutrient content of rations. This study aims to improve the performance of reproductive cows parent Brahman Cross post partum through feeding strategy supplement Multi nutrient Block plus Medicated (MBPM) which starts with the correct parent condition score so that it can accelerate the process appear oestrus post partum then increasing conception rate to minimize the number of service per conception as well as to improve the growth calf produced. This research uses 16 cows parent Brahman Cross post partum not exceeding 90 days comprising 9 tails were given feed supplements MBPM compared with 7 tail not given feed supplements MBPM as control. Research results show that feeding supplements MBPM can enhanced reproductive cow parent Brahman Cross post partum i.e. : maintain parent condition score in early post partum until the occurrence of pregnant, accelerating day 24,8 appear oestrus post partum, number service per conception = 1 and conception rate can reach 60%, maintaining the levels of urea plasma of blood and blood glucose levels within normal limits either at the time of post partum and oestrus post partum. Feeding supplements MBPM on cows parent Brahman Cross post partum can give added daily gain 0,51 kg on calf is suckling. (author)

  16. The barriers and facilitators to smoking cessation experienced by women's partners during pregnancy and the post-partum period: a systematic review of qualitative research.

    Science.gov (United States)

    Flemming, Kate; Graham, Hilary; McCaughan, Dorothy; Angus, Kathryn; Bauld, Linda

    2015-09-03

    Smoking in pregnancy can cause substantial harm and, while many women quit, others continue to smoke throughout pregnancy. The role of partners is an important but relatively under-researched factor in relation to women's smoking in pregnancy; partner's smoking status and attitudes to smoking cessation are important influences in a pregnant women's attempt to quit. Further understanding of how partners perceive the barriers and facilitators to smoking cessation in pregnancy is needed, particularly from qualitative studies where participants describe these issues in their own words. A synthesis of qualitative research of partners' views of smoking in pregnancy and post-partum was conducted using meta-ethnography. Searches were undertaken from 1990 to January 2014 using terms for partner/household, pregnancy, post-partum, smoking, qualitative in seven electronic databases. The review was reported in accordance with the 'Enhancing transparency in reporting the synthesis of qualitative research' (ENTREQ) statement. Nine studies reported in 14 papers were included, detailing the experience of 158 partners; the majority were interviewed during the post-partum period. Partners were all male, with a single exception. Socioeconomic measures indicated that most participants were socially disadvantaged. The synthesis identified recurring smoking-related perceptions and experiences that hindered (barriers) and encouraged (facilitators) partners to consider quitting during the woman's pregnancy and into the post-partum period. These were represented in five lines of argument relating to: smoking being an integral part of everyday life; becoming and being a father; the couple's relationship; perceptions of the risks of smoking; and their harm reduction and quitting strategies. The cluster of identified barriers and facilitators to quitting offers pointers for policy and practice. The workplace emerges as an important space for and influence on partners' smoking habits

  17. Which mothers receive a post partum home visit in Queensland, Australia? A cross-sectional retrospective study.

    Science.gov (United States)

    Brodribb, Wendy; Miller, Yvette

    2015-06-01

    Although home visiting in the early post partum period appears to have increased, there are limited data defining which women receive a visit and none that include Queensland. We aimed to investigate patterns of post partum home visiting in the public and private sectors in Queensland. Data were collected via a retrospective cross-sectional survey of women birthing in Queensland between 1 February and 31 May 2010 at 4 months post partum (n = 6948). Logistic regression was used to assess associations between receiving a home visit and sociodemographic, clinical and hospital variables. Analyses were stratified by public and private birthing sector because of significant differences between sectors. Public sector women were more likely to receive a visit from a nurse or midwife (from the hospital or child health sector) within 10 days of hospital discharge (67.2%) than private sector women (7.2%). Length of hospital stay was associated with home visiting in both sectors. Some vulnerable subpopulations in both sectors were more likely to be visited, whereas others were not. Home visiting in Queensland varies markedly between the public and private sector and is less common in some vulnerable populations. Further consideration to improving the equity of community post partum care in Queensland is needed.

  18. The effect of dietary protein on reproduction in the mare. V. Endocrine changes and conception during the early post partum period

    Directory of Open Access Journals (Sweden)

    F.E. Van Niekerk

    1998-07-01

    Full Text Available Pregnant Anglo-Arab and Thoroughbred mares (n = 24 were divided randomly according to age and breed into 4 groups of 6 mares each from approximately 6 weeks before their expected foaling date. Diets received by the 4 groups varied in essential amino-acid and total protein contents. Serum progestagen, FSH and LH concentrations were determined from the day of parturition until foal heat and during the 1st oestrous cycle following foal heat. Serum progestagen, FSH and LH concentrations did not differ between the treatment groups. Progestagen concentrations were high (c = 7.0: 5.2-16.4 ng/mℓ at parturition but decreased rapidly within 48 h. As progestagen concentrations decreased LH concentrations increased from Days 3-6 post partum to reach maximum values at, or the day after ovulation. FSH concentrations declined 3-4 d after parturition and increased 2-3 d before ovulation at foal heat. The duration of elevated progestagen concentrations during the luteal phase of the subsequent oestrous cycle affected the interovulatory period. A 12-14 d FSH cyclical releasing pattern occurred. Season/photoperiod affected the resumption of normal oestrous cyclicity during the post partum period. The duration of the 1st oestrous cycle after foal heat in mares fed a low-quality protein diet showed a greater range (13-30 d compared to mares fed a high-quality protein diet (18-26 d.

  19. Post-partum depressive symptoms and medically assisted conception: a systematic review and meta-analysis.

    Science.gov (United States)

    Gressier, F; Letranchant, A; Cazas, O; Sutter-Dallay, A L; Falissard, B; Hardy, P

    2015-11-01

    Does medically assisted conception increase the risk of post-partum depressive symptoms? Our literature review and meta-analysis showed no increased risk of post-partum depressive symptoms in women after medically assisted conception. Women who conceive with medically assisted conception, which can be considered as a stressful life event, could face an increased risk of depressive symptoms. However, no previous meta-analysis has been performed on the association between medically assisted conception and post-partum depressive symptoms. A systematic review with electronic searches of PubMed, ISI Web of Knowledge and PsycINFO databases up to December 2014 was conducted to identify articles evaluating post-partum depressive symptoms in women who had benefited from medically assisted conception compared with those with a spontaneous pregnancy. Meta-analyses were also performed on clinically significant post-partum depressive symptoms according to PRISMA guidelines. From 569 references, 492 were excluded on title, 42 on abstract and 17 others on full-text. Therefore, 18 studies were included in the review and 8 in the meta-analysis (2451 women) on clinically significant post-partum depressive symptoms after medically assisted conception compared with a spontaneous pregnancy. A sensitivity meta-analysis on assisted reproductive technologies and spontaneous pregnancy (6 studies, 1773 women) was also performed. The quality of the studies included in the meta-analyses was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology Statement for observational research. The data were pooled using RevMan software by the Cochrane Collaboration. Heterogeneity between studies was assessed from the results of the χ(2) and I(2) statistics. Biases were assessed with funnel plots and Egger's test. A fixed effects model was used for the meta-analyses because of the low level of heterogeneity between the studies. The systematic review of studies examining

  20. Perspective on physiological/endocrine and nutritional factors influencing fertility in post-partum dairy cows.

    Science.gov (United States)

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

    2010-09-01

    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.

  1. Predicting early post-partum depressive symptoms among older primiparous Japanese mothers.

    Science.gov (United States)

    Iwata, Hiroko; Mori, Emi; Tsuchiya, Miyako; Sakajo, Akiko; Maehara, Kunie; Ozawa, Harumi; Morita, Akiko; Maekawa, Tomoko; Aoki, Kyoko; Makaya, Miyuki; Tamakoshi, Koji

    2015-10-01

    The number of older primiparas is increasing in Japan. These women have been shown to be more vulnerable to post-partum depression. This study aimed to identify factors for predicting post-partum depressive symptoms during hospitalization after childbirth in Japanese primiparas aged 35 years and over. The present authors used the data of 479 primiparas aged 35 years and over from a prospective cohort study. Data were collected using self-report questionnaires on the day before hospital discharge. The questionnaire consisted of: demographics and background information; depressive symptoms; fatigue; maternal confidence and maternal satisfaction; child-care values; physical symptoms; perceptions of daily life during hospitalization; concerns about child care and daily life; and infant feeding. Additionally, vital records data were obtained from the hospitals. A stepwise logistic regression analysis was performed on the binary outcome variable of depressive symptoms, measured by the Japanese version of the Edinburgh Postnatal Depression Scale. Women who scored 9 or more were considered to be at high risk for post-partum depression. The authors obtained informed consent from all participants and institutional ethics approvals before initiating the study. The following six variables reliably predicted the risk of post-partum depression: emergency cesarean section, lower satisfaction with birth experience, higher physical burden in daily life, long-term complications with the newborn, more concerns about newborn caretaking after discharge, and more concerns about one's own life after discharge. Recognition of women with these factors will help nurses to identify those at risk for developing post-partum depression and to provide appropriate care during hospitalization after childbirth. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

  2. The role of steroids in the development of post-partum mental disorders.

    Science.gov (United States)

    Paskova, Andrea; Jirak, Roman; Mikesova, Michaela; Adamcova, Karolina; Fartakova, Zdenka; Horakova, Vladimira; Koucky, Michal; Hill, Martin; Hruskovicova, Hana; Starka, Luboslav; Duskova, Michaela; Parizek, Antonin

    2014-09-01

    Unfavorable post-partum changes to mental well-being affect more than half of all women, and are a risk to the health of both mother and baby. Their effects place strains on health and social systems. Currently, no generally accepted theory exists of the causes and mechanisms of post-partum mental disorders. Literature search up to 2012, using PubMed and search words: neuroactive steroids, post-partum mental disorders, depression, corticotropin-releasing hormone and estrogens. There are several theories for post-partum depression. One is that autoimmune diseases are involved. Others revolve around genes responsible or that lead to increased disposition to the disorder. It is likely however that the process is associated with the separation of the placenta and the fetal zone of fetal adrenal gland, the main sources of corticotropin-releasing hormone and sexual and neuroactive steroids during pregnancy, and the ability of the receptor system to adapt to these changes. The central nervous system is able to produce neurosteroids, but the drop in levels of peripheral steroids likely leads to a sudden deficit in neuroinhibitory steroids modulating ionotropic receptors in the brain. Post-partum depression is a multifactorial disease with unknown etiology. It is probably associated with sudden changes in the production of hormones influencing the nervous system, and on the other hand the ability of the receptor system to adapt to these changes. When the relative changes in concentrations of hormones, rather than their absolute levels, is likely more important.

  3. A case report of spontaneous rupture of a renal angiomyolipoma in a post-partum 21-year-old patient.

    Science.gov (United States)

    Lucky, Marc A; Shingler, Simon N; Stephenson, Richard N

    2009-10-01

    Renal angiomyolipomas (AML) are benign tumours containing vascular, smooth muscle and fatty elements. The majority of renal AML run an asymptomatic, benign course. The main associated complication is that of retro-peritoneal or intra-tumoural haemorrhage. Treatment options include conservative management versus interventional procedures such as total or partial nephrectomy, cryotherapy or embolization. We describe a case of symptomatic, spontaneous rupture of AML in the immediate post-partum period of a patient treated under our care. This case highlights the presentation in the form of an acute abdomen in the immediate post-partum period. This is important as acute abdomen following delivery can be attributed to a number of other causes. It also demonstrates that further complications of renal angiomyolipoma rupture can arise, emphasising the importance of post treatment vigilance for signs of infection, further haemorrhage and post embolic events.

  4. Post-partum anaphylaxis: universal but successful management protocol should not deter appreciation of underlying etio-pathogenesis plethora.

    Science.gov (United States)

    Gupta, Deepak; Rubens, Andrew; Marjanovic, Milos

    2012-03-30

    Post-partum Anaphylaxis in mothers is extremely rare and has been reported secondary to initiation of the breast-feeding. However, we hereby report the occurrence of post-partum anaphylaxis in a post-partum patient in the absence of the initiated breast-feeding.

  5. Perbandingan Kejadian Post Partum Blues pada Ibu Post Partum dengan Persalinan Normal dan Sectio Caesarea

    OpenAIRE

    Miyansaski, Andrew Umaya; -, Misrawati -; Sabrian, Febriana -

    2014-01-01

    Childbirth and section caesarea. This research used comparative study design with cross sectional. Research has been done in outpatient of obstetric of mother and child hospital Andini in Pekanbaru on 56 post partum mothers which was chosen by using purposive sampling technique by considering inclusion criteria. Measurement tools that has been used is questionnaire of Edinburgh Postnatal Depression Scale (EPDS) that has been tested with validity and reliability test. Analysis that was used is...

  6. Post-partum recovery course in patients with gestational hypertension and pre-eclampsia.

    Science.gov (United States)

    Mikami, Yukiko; Takagi, Kenjiro; Itaya, Yukiko; Ono, Yoshihisa; Matsumura, Hideyoshi; Takai, Yasushi; Seki, Hiroyuki

    2014-04-01

    We examined the post-partum recovery course in patients with pre-eclampsia (PE) and gestational hypertension (GH) and evaluated the associated factors. In a retrospective review of 145 patients with GH or PE who gave birth between 1 January 2008 and 30 October 2011 at our institution, there were 125 PE and 20 GH cases. Data collected included the gestational age at initial examination and delivery, delivery mode, time for normalization of blood pressure (BP), and time until resolution of proteinuria in PE patients. Comparisons were made between singleton and multiple pregnancies, onset (early, hypertension and proteinuria, respectively. The time for BP normalization was longer in the early-onset group. The time for resolution of proteinuria was not affected by any factor examined. A post-partum observation period of 12 weeks is acceptable for differentiating PE and GH from chronic hypertension or renal disease. GH severity did not affect the recovery period, but proteinuria severity did. Onset time was a factor influencing the recovery from PE and GH. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  7. The role of melatonin in post-partum psychosis and depression associated with bipolar disorder.

    Science.gov (United States)

    Anderson, George

    2010-11-01

    Recent data has highlighted the association of a bipolar disorder (BD) with an increased risk of post-partum psychosis and depression. It is suggested that genetic- and environmental-induced decrease in the levels of melatonin in BD contributes to post-partum disorders. Melatonin may also have some efficacy in the treatment of BD, especially in decreasing the side-effects associated with lithium and the neuroleptics. It is proposed that the optimization of melatonin levels, perhaps in conjunction with optimized vitamin D3 level, would decrease post-partum psychosis and depression associated with BD.

  8. EFEKTIVITAS AROMATERAPI BITTER ORANGE TERHADAP NYERI POST PARTUM SECTIO CAESAREA

    Directory of Open Access Journals (Sweden)

    Sri Utami

    2016-10-01

    Full Text Available Surgery that causes severe pain physiological response as compared to a normal delivery was called sectio caesarea. The alternative to reduce pain with bitter orange aroma therapy. Bitter orange aroma therapy is to give the effect of reducing the muscle tensions and stress the body as a whole with the goal of keeping the body and mind into a relaxed. This research was aimed to explore the effectiveness of bitter orange aroma therapy for reduction pain in post partum sectio caesarea. The method used this research was quasi experimental with pre test and post test design with control group. The instruments used numeric rating scale to measure pain intensity. The sampling technique used purposive sampling where the quantity of research sample 34 respondents which are divided into 2 groups, namely intervention group and control group. bitter orange aroma therapy carried out for 15 minutes each day for 2 days. The univariate analysis was conducted to show pain distribution and bivariate analysis was conducted by Wicoxon and Mann Whitney. The result show that after bitter orange aroma therapy was applied towards intervered group, it was obtained that mean of respondents category pain was reducing at 3,44 (low pain with the reduction was 1,47 and mean of post partum sectio caesarea pain without given bitter orange aroma therapy in control group was 4,82 (moderate pain with the reduction was 0. The statistic showed up p value (0,000< 0,05 which mean that kneading techniques effective to reduce pain of post partum sectio caesarea. Based on the result, bitter orange aroma therapy can be recommended as nursing intervention of post partum sectio caesarea.

  9. High post-partum levels of corticosterone given to dams influence postnatal hippocampal cell proliferation and behavior of offspring: A model of post-partum stress and possible depression.

    Science.gov (United States)

    Brummelte, Susanne; Pawluski, Jodi L; Galea, Liisa A M

    2006-09-01

    Post-partum stress and depression (PPD) have a significant effect on child development and behavior. Depression is associated with hypercortisolism in humans, and the fluctuating levels of hormones, including corticosterone, during pregnancy and the post-partum, may contribute to PPD. The present study was developed to investigate the effects of high-level corticosterone (CORT) post-partum in the mother on postnatal neurogenesis and behavior in the offspring. Sprague-Dawley dams were treated with either CORT (40 mg/kg) or sesame oil injections daily for 26 days beginning the day after giving birth. Dams were tested in the forced swim test (FST) and in the open field test (OFT) on days 24-26 post-partum. Results showed that the dams exposed to CORT expressed "depressive-like" behavior compared to controls, with decreased struggling behavior and increased immobility in the FST. To investigate the effects of treatment on hippocampal postnatal cell proliferation and survival in the offspring, males and females from treated dams were injected with BrdU (50 mg/kg) on postnatal day 21 and perfused either 24 h (cell proliferation) or 21 days (cell survival) later. Furthermore, male and female offspring from each litter were tested in adulthood on various behavioral tests, including the forced swim test, open field test, resistance to capture test and elevated plus maze. Intriguingly, male, but not female, offspring of CORT-treated dams exhibited decreased postnatal cell proliferation in the dentate gyrus. Both male and female offspring of CORT-treated dams showed higher resistance to capture and greater locomotor activity as assessed in the open field test. As high levels of CORT may be a characteristic of stress and/or depression, these findings support a model of 'CORT-induced' post-partum stress and possibly depression and demonstrate that the offspring of affected dams can exhibit changes in postnatal neurogenesis and behavior in adulthood.

  10. [Post partum depression: future perspectives].

    Science.gov (United States)

    Pinna, Martina; Zompo, Maria Del

    2012-01-01

    Post partum depression (PPD) is a psychiatric illness approximately affecting 10-20% of women after childbirth. The objective of this work is to update our knowledge of PPD giving particular emphasis to etiopathogenetic hypotheses. An accurate search of the literature on this topic was conducted using free dedicated websites such as PubMed. The most recent studies reveal that PPD is a complex disease, whose pathogenesis is not yet clarified, determined by a mix of genetic, biological and environmental factors. Genetic studies have shown a possible involvement of polymorphisms of genes coding for serotonin transporter, 5HT2A and 5HT2C receptors, HMCN1 and METTL13 genes, D2 receptor and GABAA receptor (GABAAR). The involvement of these systems might provide an explanation of the relations among genetic alterations, hormonal fluctuations in the post partum, changes in neurotransmission and mood fluctuations typical of PPD. The results obtained so far are not exhaustive. However, there is a substantial evidence showing that patients with PPD may have a high genetic vulnerability, although we have not been able yet to pinpoint a specific biological marker of the disease. Recent research is focusing on the δ subunit of GABAAR and the possible role of selective agonists of this subunit, such as gaboxadol, in the treatment of PPD.

  11. Immediate post-partum haemorrhage: Epidemiological aspects and maternal prognosis at South N’djamena District Hospital (Chad

    Directory of Open Access Journals (Sweden)

    Gabkika Bray Madoue

    2015-05-01

    Full Text Available Background: Post-partum haemorrhage defined as blood loss after delivery over 500mls, affects all countries and is the commonest cause of maternal mortality. It is a frequent obstetric emergency in developing countries. Objective: To identify the causes of post-partum haemorrhage and identify adequate management of immediate post-partum haemorrhage and thus reduce maternal mortality. Patients and methods: This was a prospective and descriptive study of one year from 1st January 2014 to 31stDecember 2014 conducted at South N’Djamena district hospital. Before including a patient in our survey her consent was obtained after explaining to her the need for the survey. All consenting patients with post-partum haemorrhage were included. Data were analyzed using SPSS17.0. Results: We recorded 100 cases of post-partum haemorrhage among 6815 deliveries giving an incidence of 1.47%. The average age of the women was 25.0 years. The majority of deliveries (90% were vaginal. The main cause of immediate post-partum haemorrhage was a third stage of labour bleeding (66% followed by genital lesions (32%. The management was medical (uterotonic drug, fluid replacement and blood transfusion, obstetric (manual removal of placenta or clot, and surgical (suture of lesions, vascular ligature and hysterectomy. There were two maternal deaths (2%. Conclusion: Post-partum haemorrhage is often fatal in our region. Preventive measures and efficient management can help to improve maternal prognosis.

  12. Physical health after childbirth and maternal depression in the first 12 months post partum: results of an Australian nulliparous pregnancy cohort study.

    Science.gov (United States)

    Woolhouse, Hannah; Gartland, Deirdre; Perlen, Susan; Donath, Susan; Brown, Stephanie J

    2014-03-01

    to investigate the relationship between maternal physical health problems and depressive symptoms in the first year after childbirth. prospective pregnancy cohort study. Melbourne, Victoria, Australia. 1507 nulliparous women. women were recruited from six public hospitals between six and 24 weeks gestation. Written questionnaires were completed at recruitment and at three, six and 12 months post partum. Edinburgh Postnatal Depression Scale (EPDS); standardised measures of urinary and faecal incontinence, a checklist of symptoms for other physical health problems. overall, 16.1% of women reported depressive symptoms during the first 12 months post partum, with point prevalence at three, six and 12 months post partum of 6.9%, 8.8% and 7.8% respectively. The most commonly reported physical health problems in the first three months were tiredness (67%), back pain (47%), breast problems (37%), painful perineum (30%), and urinary incontinence (29%). Compared with women reporting 0-2 health problems in the first three months post partum, women reporting 5 or more health problems had a six-fold increase in likelihood of reporting concurrent depressive symptoms at three months post partum (Adjusted OR=6.69, 95% CI=3.0-15.0) and a three-fold increase in likelihood of reporting subsequent depressive symptoms at 6-12 months post partum (Adjusted OR=3.43, 95% CI 2.1-5.5). poor physical health in the early postnatal period is associated with poorer mental health throughout the first 12 months post partum. Early intervention to promote maternal mental health should incorporate assessment and intervention to address common postnatal physical health problems. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders.

    Science.gov (United States)

    Uguz, Faruk; Akman, Cemal; Sahingoz, Mine; Kaya, Nazmiye; Kucur, Rahim

    2009-06-01

    Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.

  14. Exogenous estradiol enhances apoptosis in regressing post-partum rat corpora lutea possibly mediated by prolactin

    Directory of Open Access Journals (Sweden)

    Telleria Carlos M

    2005-08-01

    Full Text Available Abstract Background In pregnant rats, structural luteal regression takes place after parturition and is associated with cell death by apoptosis. We have recently shown that the hormonal environment is responsible for the fate of the corpora lutea (CL. Changing the levels of circulating hormones in post-partum rats, either by injecting androgen, progesterone, or by allowing dams to suckle, was coupled with a delay in the onset of apoptosis in the CL. The objectives of the present investigation were: i to examine the effect of exogenous estradiol on apoptosis of the rat CL during post-partum luteal regression; and ii to evaluate the post-partum luteal expression of the estrogen receptor (ER genes. Methods In a first experiment, rats after parturition were separated from their pups and injected daily with vehicle or estradiol benzoate for 4 days. On day 4 post-partum, animals were sacrificed, blood samples were taken to determine serum concentrations of hormones, and the ovaries were isolated to study apoptosis in situ. In a second experiment, non-lactating rats after parturition received vehicle, estradiol benzoate or estradiol benzoate plus bromoergocryptine for 4 days, and their CL were isolated and used to study apoptosis ex vivo. In a third experiment, we obtained CL from rats on day 15 of pregnancy and from non-lactating rats on day 4 post-partum, and studied the expression of the messenger RNAs (mRNAs encoding the ERalpha and ERbeta genes. Results Exogenous administration of estradiol benzoate induced an increase in the number of apoptotic cells within the CL on day 4 post-partum when compared with animals receiving vehicle alone. Animals treated with the estrogen had higher serum prolactin and progesterone concentrations, with no changes in serum androstenedione. Administration of bromoergocryptine blocked the increase in serum prolactin and progesterone concentrations, and DNA fragmentation induced by the estrogen treatment. ERalpha and

  15. Post partum posteriort reversibeltencefalopati-syndrom

    DEFF Research Database (Denmark)

    Aaen, Anne Albers; Jeppesen, Jørgen; Obaid, Hayder

    2015-01-01

    and treatment is important for the reversibility of the condition. In this case report we emphasize the importance of blood pressure control in a post-partum woman, who had a rather complicated pregnancy. The symptoms of PRES were not recognized immediately because of failure to use and acknowledge a blood......Posterior reversible encephalopathy syndrome (PRES) is a complex clinical condition with vasogenic subcortical oedema caused by hypertension. Oedema is often seen on magnetic resonance imaging. The wide clinical spectrum ranges from headaches to vision loss and even death. Early diagnosis...

  16. [Severe post-partum hemorrhage: descriptive study at the Robert-Debré Hospital maternity ward].

    Science.gov (United States)

    Reyal, F; Deffarges, J; Luton, D; Blot, P; Oury, J F; Sibony, O

    2002-06-01

    To analyze the prevalence, cause, treatment, and risk factors of severe post-partum hemorrhage (transfusion, surgery, radiology) observed at the maternity ward of the Robert-Debré Hospital, Paris. Method. This retrospective cohort was collected from a database including 19182 deliveries from 1992 to 1998. The entire medical file was reviewed in cases of severe hemorrhage. The prevalence of severe post-partum hemorrhage was 23 per 10,000 deliveries (44 patients). Transfusion was performed in 44/44 and hysterectomy in 3/44. Three patients were transferred to the intensive care unit. There were no deaths. At multivariate analysis, risk factors for severe post-partum hemorrhage were: abnormal placental insertion (OR=7.2; 95CI: 2.18-18.3), cesarean (OR=5.8; 95CI: 2.9-11.6), multiple pregnancy (OR=3.2; 95CI: 1.3-7.8), prematurity (OR=3, 95CI: 1.5-6.2), hypertension (OR=2.9; 95CI: 1.3-6.3). Twenty-six percent of the patients had no risk factors. The prevalence of severe pot-partum hemorrhage is low in our experience. The methodology used for this retrospective cohort does not enable an explanation. Intensive obstetrical care is necessary in case of abnormal placenta insertion. In 10 out of 44 cases, severe post-partum hemorrhage occurred in a context of insufficient monitoring, late or erroneous diagnosis, or incorrect treatment.

  17. Position in the second stage of labour and de novo onset of post-partum urinary incontinence.

    Science.gov (United States)

    Serati, Maurizio; Di Dedda, Maria Carmela; Bogani, Giorgio; Sorice, Paola; Cromi, Antonella; Uccella, Stefano; Lapenna, Martina; Soligo, Marco; Ghezzi, Fabio

    2016-02-01

    The aim of this study was to evaluate the role of the maternal position at the time of delivery on the onset of de novo symptoms of urinary incontinence (UI) in the post-partum period. This prospective study evaluated the data of consecutive women undergoing labour and delivery, between January 2014 and July 2014. We included only women with a singleton pregnancy undergoing vaginal delivery. During the study period, patients chose to deliver in the position that they considered the most comfortable. The onset of UI was evaluated according to the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-sf). Overall, 716 primiparous women were included in the study. Sixty women refused the 12-week post-partum interview (8.4%). Women were divided in two groups: 296 women (45.1%) who chose an upright position during delivery (group 1) and 360 women (54.9%) who chose a supine position (group 2). Group 1 had a significantly lower episiotomy rate, but a higher rate of greater than second degree perineal tears. In group 1 we found a significantly lower rate of de novo UI (40.5% vs 48.9%, p = 0.03) and in particular of stress urinary incontinence. Via multivariate analysis, birth position was the only factor correlating with the occurrence of urinary incontinence in the post-partum period (OR: 1.52; 95%CI: 1.06, 2.18; p = 0.02). Upright positions at delivery are related to a lower episiotomy rate and a higher rate of greater than second degree perineal tears. Supine positions are an independent risk factor for the onset of de novo UI.

  18. Brexanolone (SAGE-547 injection) in post-partum depression: a randomised controlled trial.

    Science.gov (United States)

    Kanes, Stephen; Colquhoun, Helen; Gunduz-Bruce, Handan; Raines, Shane; Arnold, Ryan; Schacterle, Amy; Doherty, James; Epperson, C Neill; Deligiannidis, Kristina M; Riesenberg, Robert; Hoffmann, Ethan; Rubinow, David; Jonas, Jeffrey; Paul, Steven; Meltzer-Brody, Samantha

    2017-07-29

    Post-partum depression is a serious mood disorder in women that might be triggered by peripartum fluctuations in reproductive hormones. This phase 2 study investigated brexanolone (USAN; formerly SAGE-547 injection), an intravenous formulation of allopregnanolone, a positive allosteric modulator of γ-aminobutyric acid (GABA A ) receptors, for the treatment of post-partum depression. For this double-blind, randomised, placebo-controlled trial, we enrolled self-referred or physician-referred female inpatients (≤6 months post partum) with severe post-partum depression (Hamilton Rating Scale for Depression [HAM-D] total score ≥26) in four hospitals in the USA. Eligible women were randomly assigned (1:1), via a computer-generated randomisation program, to receive either a single, continuous intravenous dose of brexanolone or placebo for 60 h. Patients and investigators were masked to treatment assignments. The primary efficacy endpoint was the change from baseline in the 17-item HAM-D total score at 60 h, assessed in all randomised patients who started infusion of study drug or placebo and who had a completed baseline HAM-D assessment and at least one post-baseline HAM-D assessment. Patients were followed up until day 30. This trial is registered with ClinicalTrials.gov, number NCT02614547. This trial was done between Dec 15, 2015 (first enrolment), and May 19, 2016 (final visit of the last enrolled patient). 21 women were randomly assigned to the brexanolone (n=10) and placebo (n=11) groups. At 60 h, mean reduction in HAM-D total score from baseline was 21·0 points (SE 2·9) in the brexanolone group compared with 8·8 points (SE 2·8) in the placebo group (difference -12·2, 95% CI -20·77 to -3·67; p=0·0075; effect size 1·2). No deaths, serious adverse events, or discontinuations because of adverse events were reported in either group. Four of ten patients in the brexanolone group had adverse events compared with eight of 11 in the placebo group. The most

  19. In first-time mothers, post-partum depressive symptom prospectively predict symptoms of post-traumatic stress.

    Science.gov (United States)

    Shahar, Golan; Herishanu-Gilutz, Shirley; Holcberg, Gershon; Kofman, Ora

    2015-11-01

    Symptoms of both depression and Post-Traumatic Stress Disorder (PTSD) are prevalent among first-time mothers following birth. However, the direction of the association between the two types of symptoms is unclear. Ninety six first-time mothers giving birth via vaginal delivery (N=38), emergency C-Section (N=27) and planned C-Section (N=21) were assessed for depression and PTSD twice: Six weeks post-partum and six-weeks later. Cross-lagged Structural Equation Modeling (SEM) analyses revealed a prospective effect of depressive symptoms on PTSD symptoms. No moderating factors were identified. A relatively modest sample size and only two assessment waves. An early detection and intervention with symptoms of post-partum depression might also prevent the development of PTSD symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Effects of feeding dry glycerol to primiparous Holstein dairy cows on follicular development, reproductive performance and metabolic parameters related to fertility during the early post-partum period.

    Science.gov (United States)

    Karami-Shabankareh, H; Kafilzadeh, F; Piri, V; Mohammadi, H

    2013-12-01

    This study examined the effects of dry glycerol supplementation on follicular growth, post-partum interval to first ovulation, concentration of serum metabolites and hormones related to fertility, body condition score (BCS) and body weight (BW) in primiparous Holstein dairy cows. Sixty primiparous Holstein dairy cows were randomly assigned to two groups (control: n = 30 and glycerol supplemented: n = 30). Dry glycerol (250 g/day/cow) was fed as a top dressing to the common lactating total mixed ration (TMR) from parturition to 21 days post-partum. Ovaries were examined four times using ultrasonography on days 13, 19, 25 and 36 post-partum to determine ovarian follicular growth. Concentration of serum metabolites and hormones was determined weekly. Body condition score was evaluated weekly from weeks 1 to 5 after parturition, and BWs were recorded three times on days 1, 11 and 21 during the experimental period. The cows fed dry glycerol had more large follicles (p cows. Days to the first ovulation (p = 0.06), days to first oestrus (p = 0.05), services per conception (p = 0.06) and days open (p = 0.004) were positively affected by dry glycerol supplementation. Serum concentration of glucose and insulin was higher in dry glycerol-supplemented cows (p = 0.1; p = 0.06, respectively). Feeding glycerol had no effect on mean serum concentrations of β-hydroxybutyrate, non-esterified fatty acids and IGF-1 during the experimental period. However, significant differences were observed at concentration of BHBA and IGF-1 (p = 0.02 and p = 0.04, respectively) between two groups on day 21 after calving. The cows in the glycerol-fed group had higher serum progesterone concentrations on days 33 (p = 0.007) and 36 (p = 0.004) after calving. Supplemented cows had lower body condition loss during weeks 1-5 after calving compared with the control cows (0.34 vs 0.41 BCS). In week 13 post-partum, the proportion of cycling cows was 83.3 and 69.9% for those which

  1. Effective strategies for weight loss in post-partum women

    DEFF Research Database (Denmark)

    Lim, S.; O'Reilly, S.; Behrens, H.

    2015-01-01

    Post-partum weight loss is critical to preventing and managing obesity in women, but the results from lifestyle interventions are variable and the components associated with successful outcomes are not yet clearly identified. This study aimed to identify lifestyle intervention strategies associated...

  2. Effectiveness of home visits by mental health nurses for Japanese women with post-partum depression.

    Science.gov (United States)

    Tamaki, Atsuko

    2008-12-01

    Post-partum depression affects 10-13% of Japanese women, but many do not receive appropriate treatment or support. This intervention study evaluated the effectiveness of home visits by mental health nurses for Japanese women with post-partum depression. Eighteen post-partum women met the inclusion criteria and were randomly allocated into the intervention (n = 9) or control (n = 9) group at 1-2 months after giving birth. The intervention group received four weekly home visits by a mental health nurse. Control group participants received usual care. Two women in the intervention group did not complete the study. Depressive symptoms and quality of life were measured at 1 and 6 weeks' postintervention. In addition, participants completed an open-ended questionnaire on satisfaction and meaning derived from the home visits. Women in the intervention group had significant amelioration of depressive symptoms over time and reported positive benefits from the home visits, but there were no statistically significant differences between groups. Significant differences (P post-partum depression. A larger trial is warranted to test this approach to care.

  3. Memory in pregnancy and post-partum: Item specific and relational encoding processes in recall and recognition.

    Science.gov (United States)

    Spataro, Pietro; Saraulli, Daniele; Oriolo, Debora; Costanzi, Marco; Zanetti, Humberto; Cestari, Vincenzo; Rossi-Arnaud, Clelia

    2016-08-01

    It has been recently proposed that pregnant women would perform memory tasks by focusing more on item-specific processes and less on relational processing, compared to post-partum women (Mickes, Wixted, Shapiro & Scarff, ). The present cross-sectional study tested this hypothesis by directly manipulating the type of encoding employed in the study phase. Pregnant, post-partum and control women either rated the pleasantness of word meaning (which induced item-specific elaboration) or named the semantic category to which they belonged (which induced relational elaboration). Memory for the encoded words was later tested in free recall (which emphasizes relational processing) and in recognition (which emphasizes item-specific processing). In line with Mickes et al.'s () conclusions, pregnant women in the item-specific condition performed worse than post-partum women in the relational condition in free recall, but not in recognition. However, compared to the other two groups, pregnant women also exhibited lower recognition accuracy in the item-specific condition. Overall, these results confirm that pregnant women rely on relational encoding less than post-partum women, but additionally suggest that the former group might use item-specific processes less efficiently than post-partum and control women. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  4. [Post-partum depressive symptoms: Prevalence, risk factors and relationship with quality of life].

    Science.gov (United States)

    Cherif, R; Feki, I; Gassara, H; Baati, I; Sellami, R; Feki, H; Chaabene, K; Masmoudi, J

    2017-10-01

    The objective of our study was to estimate the prevalence of the post-partum depressive symptomatology in a sample of Tunisian women, to study associated factors and to assess its relationship to quality of life. This is a prospective study carried out in two stages: during the first week (T1), then between sixth and eighth week post-partum (T2). Depressive symptomatology and quality of life were assessed respectively by the Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life scale. In the first stage, the prevalence of depressive symptomatology in the total sample (150 women) was 14.7% and was related to age above 35 years, low school level, personal psychiatric history, multiparity, caesarean delivery or forceps in the previous pregnancy and unplanned pregnancy. This prevalence was 19.8% among the 126 women reviewed in T2 and was correlated with the exaggerated sympathetic signs during pregnancy, namely perversion of taste and fatigue. Quality of life was strongly correlated with depressive symptoms in T1 and T2. Post-partum depressive symptoms were common in our sample and were correlated with quality of life. Therapeutic measures should be proposed for women with post-partum depressive symptoms and particularly with several risk factors in order to improve their quality of life. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Dextroamphetamine sulfate provided quick relief of severe post-partum depression that was recalcitrant to standard antidepressants and psychotherapy.

    Science.gov (United States)

    Check, J H; Jaffe, A

    2017-01-01

    To determine if dextroamphetamine sulfate could improve symptoms of post-partum depression. A woman with severe post-partum depression that was resistant to standard antidepressant therapy and psychotherapy was treated with dextroamphetamine sulfate extended release capsules 15 mg/day. A quick and complete abrogation of the depression ensued along with improvement of migraine headaches, insomnia, and chronic fatigue. Dextr6amphetamine sulfate should be considered as a treatment modality for post-partum depression.

  6. NON INVASIVE PAIN MANAGEMENT IN POST PARTUM MOTHER WITHEVIDENCE BASED PRACTICE APPROACH

    Directory of Open Access Journals (Sweden)

    Nikmatur Rohmah

    2017-04-01

    Full Text Available Introduction: Pain is a sensation of discomfort that most post-partum mothers complain about, in the case of prolonged pain, the risk of post-partum blues is higher. The usage of evidence based practice method gives a bigger opportunity for nurse and medical attendants to think more critically in making decisions and in performing the appropriate treatment in accordance with the patient's problem and uniqueness. This research aimed to applicate management of non-invasive pain on post partum mother through the approach of evidence based practice. Method: This was a case-study, performed to client Mrs. A P1-1 A0 post sectio caesarea day 1 as there is an indication of suspect cepalo pelvis disproportion secondary arrest. Data were collected at maternity room, dr. Soebandi Regional General Hospital. Using interview, observation, and physical examination. Data analysis was conducted through a descriptive analysis. Result: Through a careful nursing, it is found out that pain location and spreading that generally spotted at the patient’s back during the contraction in the uterus, occurred around the shoulders when evidence-base practice is applied. The basic principle of applying an intervention to non invasive pain based on evidence–base practice are: cutaneous stimulation and distraction, while massaging area was set on the face, while the distraction media was interaction with the baby. Evaluation on evidence –based practice showed that pain is reduced to scale 2, while face and mobilitation become more relaxed. Discussion: Massage was intended to stimulated the production of endorphine and dinorphine that play an important roke to block the pain transmission through the descendent control system. Interaction with the baby was intended to function as a distraction media to dominate the incoming impuls into the ascendant control system,which further may close the gate of the pain transmitter. Both of the interventions were axpected to work

  7. Dukungan Social dan Kecenderungan Depresi Post Partum pada Ibu Primipara di Daerah Gempa Bantul

    OpenAIRE

    Urbayatun, Siti

    2010-01-01

    This research examined a correlation between Social Support and Post Partum Depression. Quantitatif analytical test was done by application of SPSS 15.00 for Windows software. The subject of this research were 60 primipara mother at RB Bina Sehat and RSKIA Ummi Khasanah, Bantul, Yogyakarta. The result of this research indicates that: There was significantly negative correlation between Social Support and Post Partum Depression. (r = -0.545, p= 0.00, p

  8. [Parental care and post partum depression: a case report].

    Science.gov (United States)

    Aceti, Franca; Carluccio, Giuseppe Mattia; Meuti, Valentina; Piperno, Francesca; Sogos, Carla; Straniero Sergio, Bianca; Nicolis, Sara

    2012-01-01

    The post partum depression (PPD) is a severe risk factor for the emotional and cognitive development of offspring. The Authors describe the relationship between mother with PPD and her two-year old child. The mother repeats patterns of parental care experienced during her own childhood.

  9. Experimental gingivitis during pregnancy and post-partum: immunohistochemical aspects

    NARCIS (Netherlands)

    Raber-Durlacher, J. E.; Leene, W.; Palmer-Bouva, C. C.; Abraham-Inpijn, L.

    1993-01-01

    The histoimmunological response of 8 individuals was studied longitudinally in relation to the development of experimental gingivitis during pregnancy and post-partum. At day 0 as well as at day 14 of experimental gingivitis the mean periodontal pocket bleeding index (PPBI) was higher during

  10. Efektifitas Skala Edinburgh dan Skala Beck dalam Mendeteksi Risiko Depresi Post Partum di Rumah Sakit Umum Prof. DR. Margono Soekarjo Purwokerto

    OpenAIRE

    Latifah, Lutfatul; Hartati

    2006-01-01

    The aim of this study is to evaluate the effectiveness of Edinburgh post partum depression scale (EPDS) and Beck Depression Inventory (BDI) scale to detect risk of post partum depression. This study utilized survey with quantitative approach. Of 25 patients were chosen with purposive sampling method. The criteria of sample was post partum mother who admitted at Margono Soekardjo hospital in the sixth days. The assessment of post partum mother was evaluated directly to the target population ...

  11. Post-partum posterior reversible encephalopathy syndrome

    DEFF Research Database (Denmark)

    Aaen, Anne Albers; Jeppesen, Jørgen; Obaid, Hayder

    2015-01-01

    Posterior reversible encephalopathy syndrome (PRES) is a complex clinical condition with vasogenic subcortical oedema caused by hypertension. Oedema is often seen on magnetic resonance imaging. The wide clinical spectrum ranges from headaches to vision loss and even death. Early diagnosis...... and treatment is important for the reversibility of the condition. In this case report we emphasize the importance of blood pressure control in a post-partum woman, who had a rather complicated pregnancy. The symptoms of PRES were not recognized immediately because of failure to use and acknowledge a blood...

  12. Post-partum posterior reversible encephalopathy syndrome

    DEFF Research Database (Denmark)

    Aaen, Anne Albers; Jeppesen, Jørgen; Obaid, Hayder

    2015-01-01

    and treatment is important for the reversibility of the condition. In this case report we emphasize the importance of blood pressure control in a post-partum woman, who had a rather complicated pregnancy. The symptoms of PRES were not recognized immediately because of failure to use and acknowledge a blood......Posterior reversible encephalopathy syndrome (PRES) is a complex clinical condition with vasogenic subcortical oedema caused by hypertension. Oedema is often seen on magnetic resonance imaging. The wide clinical spectrum ranges from headaches to vision loss and even death. Early diagnosis...

  13. [Post-partum posterior reversible encephalopathy syndrome].

    Science.gov (United States)

    Aaen, Anne Albers; Jeppesen, Jørgen; Obaid, Hayder; Bülow, Hans Henrik

    2015-11-23

    Posterior reversible encephalopathy syndrome (PRES) is a complex clinical condition with vasogenic subcortical oedema caused by hypertension. Oedema is often seen on magnetic resonance imaging. The wide clinical spectrum ranges from headaches to vision loss and even death. Early diagnosis and treatment is important for the reversibility of the condition. In this case report we emphasize the importance of blood pressure control in a post-partum woman, who had a rather complicated pregnancy. The symptoms of PRES were not recognized immediately because of failure to use and acknowledge a blood pressure test.

  14. Faktor Risiko yang Mempengaruhi Lama Penyembuhan Luka Perineum pada Ibu Post Partum

    Directory of Open Access Journals (Sweden)

    Anur Rohmin

    2017-11-01

    Full Text Available Perineal trauma is an injury that occurs in the perineum during delivery and it happened  70% among woman who labors vaginally. The perineal wound was healed when the wound is to be dry, no redness, no swelling, tissue fused and cured ≤7 days post-partum. The aim of this study to find out the influenced factors of the length perineal wound healing in post partum mothers. This study carried in 10th March until 11th July 2016. Methode: A  survey analytic design with cross sectional design was used in this study. The samples of this study were 128 post partum. others. Data were analyzed by univariate, bivariate using Chi-square and multiple logistic regression. The results of this study found that mothers who the length of perineum wound ≤ 7 days (62.5% and >7 days (37.5%. Based on bivariate analysis there were a significant relationship between age, early mobilization, parity and kind of wound (p <0.05. Based on the multivariate analysis the most influencing factor was early mobilization (OR 7.613. The suggestion of this study is increasing the awareness of mother to do early mobilization.

  15. Bakri balloon as a uterus preserving treatment of uncontrollable haemorrhage one month post-partum

    DEFF Research Database (Denmark)

    Bonnici, Mia; Markauskas, Algirdas; Munk, Torben

    2014-01-01

    In this case Bakri balloon was used to stop haemorrhage one month post-partum. The case introduces the use of this device outside usual indications. A 27-year-old woman was admitted several times with vaginal bleeding after caesarean section. She was treated pharmacologically and with curettage. ....... One month post-partum hysteroscopic removal of placental tissue was done. During this uncontrollable haemorrhage occurred and hysterectomy was considered. An attempt to save the uterus with Bakri balloon was made succesfully....

  16. Patterns of ovarian and oestrous activity and induction of cyclic activity during the post-partum period in Egyptian buffaloes

    International Nuclear Information System (INIS)

    Aboul-Ela, M.B.; Shafie, M.M.

    1988-01-01

    This report covers three studies. In the first study, ovarian and oestrous activity were monitored in 47 buffaloes for 90 days following parturition. Failure to resume ovarian cyclicity after calving was found to be the main reason for the delay in conception. High incidence of ovulatory anoestrus (64%) constitutes also a major problem in Egyptian buffaloes. In the second study, buffaloes with inactive ovaries were treated at 90 days post-partum with either GnRH or progesterone, given either intravaginally (PRID) or orally (CAP). Both GnRH and PRID were effective in inducing ovulation but GnRH administration was followed by a high incidence of silent ovulation. Within the 35 days following treatment, about 50% of the PRID treated animals got in calf vs. 44 and 22% for GnRH and CAP treated animals, respectively. In the third study, buffaloes were treated with either 6 or 12μg GnRH at either 7 or 15 days post-partum. GnRH treatment resulted in significant reductions in the intervals from calving to first ovulation, first detected oestrus and time to first rise in serum progesterone concentration (> 1 ng/mL). (author). 26 refs, 5 figs, 4 tabs

  17. Does prenatal care benefit maternal health? A study of post-partum maternal care use.

    Science.gov (United States)

    Liu, Tsai-Ching; Chen, Bradley; Chan, Yun-Shan; Chen, Chin-Shyan

    2015-10-01

    Most studies on prenatal care focus on its effects on infant health, while studying less about the effects on maternal health. Using the Longitudinal Health Insurance claims data in Taiwan in a recursive bivariate probit model, this study examines the impact of adequate prenatal care on the probability of post-partum maternal hospitalization during the first 6 months after birth. The results show that adequate prenatal care significantly reduces the probability of post-partum maternal hospitalization among women who have had vaginal delivery by 43.8%. This finding suggests that the benefits of prenatal care may have been underestimated among women with vaginal delivery. Timely and adequate prenatal care not only creates a positive impact on infant health, but also yields significant benefits for post-partum maternal health. However, we do not find similar benefits of prenatal care for women undergoing a cesarean section. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Dependency and self-criticism in post-partum depression and anxiety: a case control study.

    Science.gov (United States)

    Vliegen, Nicole; Luyten, Patrick

    2009-01-01

    This study investigates the role of self-criticism and dependency in inpatient post-partum depressed women (n = 55) and non-depressed controls (n = 37) as well as the relationship between both personality dimensions and severity of depression and anxiety. As expected, mothers with post-partum depression showed not only increased levels of depression but also anxiety compared with non-depressed mothers. Furthermore, they had significantly higher levels of self-criticism, but not of dependency. In the post-partum depressed mothers, both personality dimensions were positively associated with severity of depression. However, in non-depressed mothers, self-criticism was positively associated with depression, while there was an inverse relationship between dependency and severity of depression. In both samples, self-criticism, but not dependency, was related to state anxiety. The cross-sectional nature of this study limits the ability to draw causal conclusions. The study was based on self-report and conducted in relatively small samples.

  19. Predictors and incidence of post-partum depression: a longitudinal cohort study.

    Science.gov (United States)

    Abdollahi, Fatemeh; Zarghami, Mehran; Azhar, Md Zain; Sazlina, Shariff-Ghazali; Lye, Munn-Sann

    2014-12-01

    This study was designed to identify the incidence and the related factors contributing to post-partum depression (PPD) in women in Iran for the first time. A total of 2279 eligible pregnant women from 32-42 weeks of pregnancy to 12 weeks post-partum (2009) who attended primary health centers in Mazandaran province were screened for depression using the Iranian version of the Edinburgh Postnatal Depression Scale. Pregnant women free from depression were assessed using validated questionnaires, including the Premenstrual Syndrome Questionnaire, Social Support Appraisal Scale, Network Orientation Scale, General Health Questionnaire, Marital Inventory, Life Events Rating Scale and Parental Expectation Survey. Logistic regression analysis was used to determine the risk factors of PPD. Of 1801 women who screened negative for depression at 32-42 weeks' gestation, cumulative incidence proportions were 6.7%, 4.3% and 4.5% during 0-2, >2-8 and >8-12 weeks post-partum, respectively. The factors predictive of PPD were: history of depression during the first two trimesters of pregnancy (odds ratio [OR] = 2.55, 95% confidence interval [CI] = 1.59-4.1); psychiatric disorder during pregnancy (OR = 1.08, 95%CI = 1.06-1.11); gestational diabetes (OR = 2.93, 95%CI = 1.46-5.88); recurrent urinary infection (OR = 2.25, 95%CI = 1.44-3.52); unwanted pregnancy (OR = 2.5, 95%CI = 1.69-3.7) and low household income (OR = 3.57, 95%CI = 1.49-8.5). The risk was decreased with increasing age (OR = 0.88, 95%CI = 0.84-0.92) and those with high self-efficacy for mothering (OR = 0.7, 95%CI = 0.62-0.78). A high rate of new cases of PPD was identified in Iranian women. A combination of psychological, sociological, obstetric and sociodemographic factors can render mothers vulnerable to post-partum depression. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  20. [Posterior reversible encephalopathy syndrome and cerebrovascular constriction syndrome in the differential diagnosis of post-partum headaches].

    Science.gov (United States)

    Ruiz López, N; Cano Hernández, B; Balbás Álvarez, S

    2016-02-01

    Postpartum headache can be due to many causes. In a patient with previous epidural analgesia, the headache can be attributed to post-dural puncture headache, even if the symptoms are not typical of this clinical entity. We report a case of a post-partum with accidental dural tap during the insertion of an epidural catheter for labour analgesia, and who referred to headaches in the third post-partum day. Initially, a post-dural puncture headache was suspected, but the subsequent onset of seizures and visual impairment meant that the diagnosis had to be reconsidered. In this case report, the clinical and pathophysiological features of posterior reversible encephalopathy syndrome and reversible cerebral vasoconstriction syndrome, as well as the differential diagnosis of post-partum headaches are described. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Post-partum oestrusgedrag bij zeugen gaat niet gepaard met ovulatie

    NARCIS (Netherlands)

    Souren, N.Y.P.; Langendijk, P.; Soede, N.M.

    2005-01-01

    Sows occasionally show oestrous behaviour within 5 days of farrowing: this is termed post-partum oestrus (PPO). This study investigated the incidence and possible causes of PPO on nine Dutch farms. Lactation records (n = 1374) were used, hack fat thickness was measured (n=25), and ovarian condition

  2. An Overview of Risk Factors Associated to Post-partum Depression in Asia.

    Science.gov (United States)

    Mehta, Shubham; Mehta, Nidhi

    2014-03-04

    Post partum depression (PPD) is an important complication of child-bearing. It requires urgent interventions as it can have long-term adverse consequences if ignored, for both mother and child. If PPD has to be prevented by a public health intervention, the recognition and timely identification of its risk factors is must. We in this review have tried to synthesize the results of Asian studies examining the risk factors of PPD. Some risk factors, which are unique to Asian culture, have also been identified and discussed. We emphasize on early identification of these risk factors as most of these are modifiable and this can have significant implications in prevention of emergence of post partum depression, a serious health issue of Asian women.

  3. An overview of risk factors associated to post-partum depression in Asia

    Directory of Open Access Journals (Sweden)

    Shubham Mehta

    2014-03-01

    Full Text Available Post partum depression (PPD is an important complication of child-bearing. It requires urgent interventions as it can have long-term adverse consequences if ignored, for both mother and child. If PPD has to be prevented by a public health intervention, the recognition and timely identification of its risk factors is must. We in this review have tried to synthesize the results of Asian studies examining the risk factors of PPD. Some risk factors, which are unique to Asian culture, have also been identified and discussed. We emphasize on early identification of these risk factors as most of these are modifiable and this can have significant implications in prevention of emergence of post partum depression, a serious health issue of Asian women.

  4. EFFECT OF SHEARING DURING PREGNANCY ON PRODUCTIVE PERFORMANCE IN THE POST-PARTUM PERIOD OF EWES ON EXTENSIVE HUSBANDRY

    Directory of Open Access Journals (Sweden)

    Viviane Marques Guyoti

    2015-04-01

    Full Text Available The use of shearing during pregnancy has been described as a tool for improving productivity in sheep and for minimizing perinatal mortality in lambs through the increase of fetal development. This study assessed the effect of shearing around 74 days of gestation on the productive performance of ewes and lambs during the first month of life. Forty Corriedale ewes were inseminated in autumn in Southern Brazil. All ewes were kept together at the same pasture under extensive husbandry conditions. The ewes were randomly separated into two treatment groups: twenty animals were completely sheared at 74 ± 6 days of pregnancy, and twenty were kept without sheared during pregnancy, composing the control group. Ewes and their lambs were evaluated at three different times during the experiment: at birth, between 15 and 21 days post-partum and between 22 and 45 days post-partum. Ewes had their body condition score, body weight, placental weight, milk production and serum concentrations of beta-hydroxybutyrate measured, while lambs had hematocrit, hemoglobin, and plasma lactate and glucose, as well as body weight at birth and until wean determined. Values of hematocrit and hemoglobin were lower and body weight at birth and at wean was higher in the group of lambs born from sheared ewes. Placenta weight was higher in sheared ewes. Body condition score and beta-hydroxybutyrate showed no differences between groups. Milk production of sheared ewes (1.26 L/day was higher than in control group (0.93 L/day. Shearing ewes at 74 days of pregnancy was efficient for the better development of lambs at post-birth, reducing perinatal mortality rates.

  5. Differentiating maternal fatigue and depressive symptoms at six months and four years post partum: Considerations for assessment, diagnosis and intervention.

    Science.gov (United States)

    Giallo, Rebecca; Gartland, Deirdre; Woolhouse, Hannah; Brown, Stephanie

    2015-02-01

    fatigue and depressive symptoms are common among women in the postpartum period, and it has been proposed that fatigue is a risk factor for later depression. To progress this research, there is a need to clarify the conceptual and measurement issue of whether these two sets of symptoms are distinct constructs. There is also a need to determine whether they are distinct constructs beyond the postnatal period. The aim of the study was to assess the construct and discriminant validity of fatigue and depressive symptoms as measured by the SF-36 Vitality subscale (SF-36) and the Edinburgh Postnatal Depression Scale (EPDS) at six months and at four years post partum. data from over 1000 women participating in the Maternal Health Study, a longitudinal study of women׳s physical and psychological health and recovery after childbirth were used. confirmatory factor analysis revealed a two-factor model of fatigue and depressive symptoms represented as distinct but related constructs was a better fit to the data than a one-factor model of fatigue and depression sharing the same underlying construct at both six months and four years post partum. this study provides empirical evidence that maternal fatigue and depression in the first year after having a baby and at four years post partum are best understood as separate psychological constructs or experiences. The findings have important implications for clinical practice, in particular underlining the importance of differentiating tiredness from depression. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Intravenous iron vs blood for acute post-partum anaemia (IIBAPPA): a prospective randomised trial.

    Science.gov (United States)

    Chua, Seng; Gupta, Sarika; Curnow, Jennifer; Gidaszewski, Beata; Khajehei, Marjan; Diplock, Hayley

    2017-12-19

    Acute post-partum anaemia can be associated with significant morbidity including a predisposition for postnatal depression. Lack of clear practice guidelines means a number of women are treated with multiple blood transfusions. Intravenous iron has the potential to limit the need for multiple blood transfusions but its role in the post-partum setting is unclear. IIBAPPA is a multi-centre randomised non-inferiority trial. Women with a primary post-partum haemorrhage (PPH) >1000 mL and resultant haemoglobin (Hb) 5.5-8.0 g/dL after resuscitation with ongoing symptomatic anaemia who are otherwise stable (no active bleeding) are eligible to participate. Patients with sepsis or conditions necessitating rapid Hb restoration are excluded. Eligible participants are randomised to receive a blood transfusion or a single dose of intravenous iron polymaltose calculated using the Ganzoni formula. Primary outcome measures include Hb, Ferritin and C-Reactive Protein levels on Day 7. Secondary outcomes evaluate (i) Hb, Ferritin and CRP levels on Day 14, 28, (ii) anaemia symptoms on Day 0, 7, 14 and 28 using structured health related quality of life questionnaires, (iii) treatment safety by assessing adverse reactions and infection endpoints and (iv) the quantitative impact of anaemia on breast feeding quality using a hospital designed questionnaire. If equivalence in Hb and ferritin levels, symptom scores and safety endpoints is demonstrated, intravenous iron may become the preferred treatment for women with acute post-partum anaemia to minimise transfusion reactions and costs. Australian and New Zealand Clinical Trials Registry: ACTRN12615001370594 on 16th December, 2015 (prospective approval).

  7. Predictors of depressive symptoms in older Japanese primiparas at 1 month post-partum: A risk-stratified analysis.

    Science.gov (United States)

    Iwata, Hiroko; Mori, Emi; Tsuchiya, Miyako; Sakajo, Akiko; Maehara, Kunie; Ozawa, Harumi; Morita, Akiko; Maekawa, Tomoko; Aoki, Kyoko; Tamakoshi, Koji

    2016-01-01

    Older maternal age has become more common in Japan. Studies suggest that older maternal age and primiparity are associated with post-partum depression. The present study aimed to identify predictors of post-partum depression in older Japanese primiparas at 1 month post-partum. Participants were 479 primiparas aged 35 years and over, drawn from a prospective cohort study. Data were collected using self-report questionnaires. Depression was measured with the Japanese version of the Edinburgh Postnatal Depression Scale. Stepwise logistic regression analysis was conducted on binary outcome variables of depression at 1 month post-partum, along with a stratified analysis based on the risk status of depression. Five predictors were identified: (i) the depression score during hospital stay; (ii) financial burden; (iii) dissatisfaction with appraisal support; (iv) physical burden in daily life; and (v) concerns about infant caretaking. Stratified analysis identified dissatisfaction with instrumental support in the low-risk group, and the Child-care Value Scale score as unique predictors in the high-risk group. These results highlight the importance of early assessment of depressive symptoms and the provision of continuous care. © 2015 Japan Academy of Nursing Science.

  8. An Endocrine Cause of Acute Post-partum Hypertension

    OpenAIRE

    Bretherton, Ingrid; Pattison, David; Pattison, Sarah; Varadarajan, Suresh

    2013-01-01

    This is a case of acute peri-partum hypertension secondary to Conn's syndrome. The timing of presentation offers a rare insight into the hormonal physiology of pregnancy and its impact on blood pressure regulation. This case highlights the challenges of diagnosing primary hyperaldosteronism in the peripartum period and the high index of suspicion required by the obstetric physician.

  9. An Endocrine Cause of Acute Post-partum Hypertension.

    Science.gov (United States)

    Bretherton, Ingrid; Pattison, David; Pattison, Sarah; Varadarajan, Suresh

    2013-03-01

    This is a case of acute peri-partum hypertension secondary to Conn's syndrome. The timing of presentation offers a rare insight into the hormonal physiology of pregnancy and its impact on blood pressure regulation. This case highlights the challenges of diagnosing primary hyperaldosteronism in the peripartum period and the high index of suspicion required by the obstetric physician.

  10. Immigrant and refugee women's post-partum depression help-seeking experiences and access to care: a review and analysis of the literature.

    Science.gov (United States)

    O'Mahony, J; Donnelly, T

    2010-12-01

    • This literature review on post-partum depression (PPD) presents an analysis of the literature about PPD and the positive and negative factors, which may influence immigrant and refugee women's health seeking behaviour and decision making about post-partum care. • A critical review of English language peer-reviewed publications from 1988 to 2008 was done by the researchers as part of a qualitative research study conducted in a western province of Canada. The overall goal of the study is to raise awareness and understanding of what would be helpful in meeting the mental health needs of the immigrant and refugee women during the post-partum period. • Several online databases were searched: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, MEDLINE (Ovid), EBM Reviews - Cochrane Database of Systematic Reviews. • Review of the literature suggests: 1 Needs, issues and specific risk factors for PPD among immigrant and refugee women have been limited. 2 Descriptive accounts regarding culture and PPD are found in the literature but impact of cultural factors upon PPD has not been well studied. 3 Few studies look at how social support, gender, and larger institutions or organizational structures may affect immigrant and refugee women's help-seeking and access to mental health care services. 4 More research is needed to hear the immigrant and refugee women's ideas about their social support needs, the difficulties they experience and their preferred ways of getting help with PPD. This review and analysis of the literature is about the phenomenon of post-partum depression (PPD) and the barriers and facilitators, which may influence immigrant and refugee women's health seeking behaviour and decision making about post-partum care. As part of a qualitative research study conducted in a western province of Canada a critical review of English language peer-reviewed publications from 1988 to 2008 was undertaken by the researchers. The overall goal

  11. An Investigation on the Role of Personality Style Vulnerability, Spouse Violence, and Coping Responses in Prediction of Post Partum Depression

    Directory of Open Access Journals (Sweden)

    حمیده قاسمی

    2015-12-01

    Full Text Available This study aims to examine the role of the vulnerability of personality style, spouse violence and coping responses in prediction of post-partum depression. A sample of 140 pregnant women were recruited. Data collection included two phases. In third trimester of pregnancy, demographic information, vulnerable personality style, spouse violence and coping responses were collected. The second phase was carried out after 2 weeks to 6 months after parturition that the post-partum depression questionnaire was completed. The results demonstrated that 49% of post-partum depression variances can be shown by vulnerability of personality style, spouse violence and coping responses. It seems that one of the most important factors for depression after parturition is vulnerability of personality style. Women with this personality style perceive higher levels of stress and use maladaptive coping responses. So they are more disposed to post-partum depression.

  12. Post-partum blues among Korean mothers: a structural equation modelling approach.

    Science.gov (United States)

    Chung, Sung Suk; Yoo, Il Young; Joung, Kyoung Hwa

    2013-08-01

    The objective of this study was to propose the post-partum blues (PPB) model and to estimate the effects of self-esteem, social support, antenatal depression, and stressful events during pregnancy on PPB. Data were collected from 249 women post-partum during their stay in the maternity units of three hospitals in Korea using a self-administered questionnaire. A structural equation modelling approach using the Analysis of Moments Structure program was used to identify the direct and indirect effects of the variables on PPB. The full model had a good fit and accounted for 70.3% of the variance of PPB. Antenatal depression and stressful events during pregnancy had strong direct effects on PPB. Household income showed indirect effects on PPB via self-esteem and antenatal depression. Social support indirectly affected PPB via self-esteem, antenatal depression, and stressful events during pregnancy. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

  13. Relationships between antenatal and postnatal care and post-partum modern contraceptive use: evidence from population surveys in Kenya and Zambia.

    Science.gov (United States)

    Do, Mai; Hotchkiss, David

    2013-01-04

    It is often assumed, with little supportive, empirical evidence, that women who use maternal health care are more likely than those who do not to use modern contraceptives. This study aims to add to the existing literature on associations between the use of antenatal (ANC) and post-natal care (PNC) and post-partum modern contraceptives. Data come from the most recent Demographic and Health Surveys (DHS) in Kenya (2008-09) and Zambia (2007). Study samples include women who had a live birth within five years before the survey (3,667 in Kenya and 3,587 in Zambia). Multivariate proportional hazard models were used to examine the associations between the intensity of ANC and PNC service use and a woman's adoption of modern contraceptives after a recent live birth. Tests of exogeneity confirmed that the intensity of ANC and PNC service use and post-partum modern contraceptive practice were not influenced by common unobserved factors. Cox proportional hazard models showed significant associations between the service intensity of ANC and PNC and post-partum modern contraceptive use in both countries. This relationship is largely due to ANC services; no significant associations were observed between PNC service intensity and post-partum FP practice. While the lack of associations between PNC and post-partum FP use may be due to the limited measure of PNC service intensity, the study highlights a window of opportunity to promote the use of modern contraceptives after childbirth through ANC service delivery. Depending on the availability of data, further research should take into account community- and facility-level factors that may influence modern contraceptive use in examining associations between ANC and PNC use and post-partum FP practice.

  14. Post Partum Depression and Thyroid Function

    Directory of Open Access Journals (Sweden)

    Farahnaz Keshavarzi MD

    2011-09-01

    Full Text Available Objective: Risk of depression is particularly high for women during the prenatal period. Various investigators have attempted to establish a link between thyroid function and post partum depression. This study aimed to investigate whether thyroid function differs in women with postpartum depression compared to a control group.Methods: In this case-control study, subjects were selected from Obstetrics & Gynecology and Psychiatric clinics of Kermanshah University of Medical Sciences. Forty eight patients suffering from postpartum depression according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition totally revised (DSM-IV-TR, and 65 normal controls underwent diagnostic evaluation by one trained psychiatrist using Structured Clinical Interview for DSM-IV-TR. Then, the demographic questionnaire and the Persian version of Edinburgh Postnatal Depression Scale (EPDS were completed by the participants. Finally, their thyroid functions were assessed. Data analyses were done using the SPSS program 13.Results: No statistically significant differences were observed between thyroid function tests and postpartum depression. According to multiple regression analysis with stepwise method, subjects with lower serum TSH, T3RU, T3 levels, younger age and longer period after delivery tended to have higher EPDS scores (P-value=0.008. Conclusion:The present study reports that those women with postpartum depression had a no greater prevalence of thyroid dysfunction than the control subjects. It seems that thyroid dysfunction should be considered in women with postpartum depression individually, but the role of thyroid as an important cause of this condition is not yet established. This suggests that future studies should concentrate on this concept in postpartum depression.

  15. Improving non-technical skills (teamwork) in post-partum haemorrhage: A grouped randomised trial.

    Science.gov (United States)

    Letchworth, Pippa M; Duffy, Shane P; Phillips, Dan

    2017-10-01

    To determine the effect of a decision support technology on teamwork and associated non-technical (NTS) and technical skills when teams manage post-partum haemorrhage (PPH) in the simulated environment. Multidisciplinary (MDT) maternity teams were taught how to manage post partum haemorrhage. They were randomised to the intervention: using a decision support mobile digital platform or a control group. Each team managed a post-partum simulation, which was recorded and reviewed by assessors. Primary outcome measures to assess teams NTS were the validated Global Assessment of Obstetric Team Performance (GAOTP) and Clinical Teamwork Scale (CTS). Secondary outcome measures were the 'friends and family test', technical skills, and the System Usability Scale (SUS). Sample size estimation was calculated by using 80% power 5% significance two tailed test (p1=85% p2=40%) n=34. 38 teams from August 2014-February 2016, were recruited, technical issues with failure of recording equipment meant 4 teams were excluded from teamwork analysis (1 intervention 3 control). Teamwork improved across all domains with the intervention (using a decision support mobile digital platform) p teamwork by 25% using CTS and 22% using GAOTP. Fewer technical skills were missed with the intervention (pteamwork is often cited as the cause of failures in care and we report a usable technology that assists with and improves teamwork during an emergency. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Relationships between antenatal and postnatal care and post-partum modern contraceptive use: evidence from population surveys in Kenya and Zambia

    Directory of Open Access Journals (Sweden)

    Do Mai

    2013-01-01

    Full Text Available Abstract Background It is often assumed, with little supportive, empirical evidence, that women who use maternal health care are more likely than those who do not to use modern contraceptives. This study aims to add to the existing literature on associations between the use of antenatal (ANC and post-natal care (PNC and post-partum modern contraceptives. Methods Data come from the most recent Demographic and Health Surveys (DHS in Kenya (2008–09 and Zambia (2007. Study samples include women who had a live birth within five years before the survey (3,667 in Kenya and 3,587 in Zambia. Multivariate proportional hazard models were used to examine the associations between the intensity of ANC and PNC service use and a woman’s adoption of modern contraceptives after a recent live birth. Results Tests of exogeneity confirmed that the intensity of ANC and PNC service use and post-partum modern contraceptive practice were not influenced by common unobserved factors. Cox proportional hazard models showed significant associations between the service intensity of ANC and PNC and post-partum modern contraceptive use in both countries. This relationship is largely due to ANC services; no significant associations were observed between PNC service intensity and post-partum FP practice. Conclusions While the lack of associations between PNC and post-partum FP use may be due to the limited measure of PNC service intensity, the study highlights a window of opportunity to promote the use of modern contraceptives after childbirth through ANC service delivery. Depending on the availability of data, further research should take into account community- and facility-level factors that may influence modern contraceptive use in examining associations between ANC and PNC use and post-partum FP practice.

  17. Maternal educational level and the risk of persistent post-partum glucose metabolism disorders in women with gestational diabetes mellitus.

    Science.gov (United States)

    Gante, Inês; Ferreira, Ana Carina; Pestana, Gonçalo; Pires, Daniela; Amaral, Njila; Dores, Jorge; do Céu Almeida, Maria; Sandoval, José Luis

    2018-03-01

    Gestational diabetes mellitus (GDM) occurs in 5-15% of pregnancies, and lower maternal educational attainment has been associated with higher risk of GDM. We aimed to determine if maternal education level is associated with persistent post-partum glucose metabolism disorders in women with GDM. Retrospective cohort study of women with GDM followed in 25 Portuguese health institutions between 2008 and 2012. Educational attainment was categorised into four levels. Prevalence of post-partum glucose metabolism disorders (type 2 diabetes mellitus, increased fasting plasma glucose or impaired glucose tolerance) was compared and adjusted odds ratios calculated controlling for confounders using logistic regression. We included 4490 women diagnosed with GDM. Educational level ranged as follows: 6.8% (n = 307) were at level 1 (≤ 6th grade), 34.6% (n = 1554) at level 2 (6-9th grade), 30.4% (n = 1364) at level 3 (10-12th grade) and 28.2% (n = 1265) at level 4 (≥ university degree). At 6 weeks post-partum re-evaluation, 10.9% (n = 491) had persistent glucose metabolism disorders. Educational levels 1 and 2 had a higher probability of persistent post-partum glucose metabolism disorders when compared to level 4 (OR = 2.37 [1.69;3.32], p women with GDM and associated with lower maternal educational level. Interventions aimed at this risk group may contribute towards a decrease in prevalence of post-partum glucose metabolism disorders.

  18. PP108. Post-partum evaluation of the blood pressure and the kidney function in pre-eclamptic women.

    Science.gov (United States)

    Pechère-Bertschi, A; Montillier, P; Boulvain, M; Wuerzner, G; Gaspoz, J-M; Burnier, M; Irion, O P

    2012-07-01

    Recent data have shown that preeclampsia is not just a disease of pregnancy that resolves with delivery. Preeclampsia may be considered a 'risk marker' for later-life diseases, including cardiovascular and renal diseases and the metabolic syndrome. We aimed a longitudinal prospective study to analyze the renal abnormalities in the post-partum. We studied 127 post-preeclamptic women at 6 weeks post-partum. Twenty-four hour urine collection, ambulatory blood pressure and renal function were evaluated. The mean age (±SD) was 32±6years, BMI was 29.4±5.7, the race distribution was Caucasian 69%, Hispanic 14%, Black 12% and Orient 5%. Ten % were active smokers, 10% have been suffering from gestational diabetes. The mean duration of the pregnancy was 36 weeks 3/7±4. Our results show that the prevalence of hypertension defined by office blood pressure ⩾140/90 mmHg or ongoing antihypertensive treatment was 35%. The daytime ambulatory blood pressure (ABPM) was 122±16/85±11 mmHg, heart rate 84±8, and 111±20/75±11 mmHg at nighttime.Sixteen % had a daytime ABPM ⩾135/85mmHg corresponding to the definition of ambulatory hypertension. Ultrasensitive CRP was 4.9±5.1mg/ml, of them 31% had a frank elevation of the CRP >4. The glomerular filtration rate evaluated by the Gault-Cockroft equation showed a hyperfiltration with a mean value of 150±42ml/min. Eleven% had a decreased GFR post-partum period, women having suffered from a pre-eclampsia display many cardiovascular risk factors with a high prevalence of hypertension, microalbuminuria, renal hyperfiltration and elevated CRP. These women should be carefully screened, and sub-groups with the higher risk have to be targeted for prevention and treatment, and close follow-up. Copyright © 2012. Published by Elsevier B.V.

  19. Phytosterols from Dunaliella tertiolecta Reduce Cell Proliferation in Sheep Fed Flaxseed during Post Partum

    Directory of Open Access Journals (Sweden)

    Maria Giovanna Ciliberti

    2017-07-01

    Full Text Available The post partum period is characterized by immunosuppression and increased disease susceptibility. Both phytosterols from microalga Dunaniella tertiolecta and dietary supplementation with n-3 polyunsaturated fatty acids (PUFA influence cell proliferation and cytokine release during inflammation. The objective of this paper was the evaluation of the effects of physterols, extracted and purified from D. tertiolecta, on the in vitro immune responses of ewes supplemented with flaxseed during post partum. Twenty Comisana parturient ewes were divided in two balanced groups, and supplemented with flaxseed (FS, 250 g/day or fed with a conventional diet (CON. Blood samples (15 mL were collected for five weeks, starting from lambing, in order to isolate peripheral blood mononuclear cells (PBMC. Stimulated PBMC were treated with a total sterols fraction from D. tertiolecta (TS, a mix of ergosterol and 7-dehydroporiferasterol (purified extract, PE, and a mix of acetylated ergosterol and 7-dehydroporiferasterol (acetylated purified extract, AcPE, extracted and purified from D. tertiolecta at two concentrations (0.4 and 0.8 mg/mL. Results of the experiment demonstrated that n-3 PUFA from flaxseed induced an anti-inflammatory cytokine profile, with an increase of both IL-10, IL-6 and a decrease of IL-1β. TS, PE, and AcPE purified from D. tertiolecta showed an anti-proliferative effect on sheep PBMC regardless their chemical composition and concentration.

  20. Aromaterapi Lavender dapat Menurunkan Intensitas Nyeri Perineum pada Ibu Post Partum

    Directory of Open Access Journals (Sweden)

    Wiwin Widayani

    2017-01-01

    Full Text Available Perineals pain affects  woman ability to mobilize so that it can cause complications such as post-partum haemoragik. Trauma to the perineum also cause discomfort and dyspareunia, therefore, perineal pain management is important. Currently the handling used to relieve pain is complementary therapy aromatherapy with essential oils of lavender, because lavender has the properties of anticonvulsant, antidepressant, anxiolytic, and also soothing. Aromatherapy stimulates the hypothalamus to secrete chemical mediators that serve as pain relievers and give rise to feelings of happiness. The purpose of this study was to determine the effect of lavender aromatherapy to the perineal pain intensity in post partum women. This study is a quasy experiment pre and post non random control in postpartum women at Bidan Praktik Mandiri in Bandung. Sampling this study using consecutive sampling technique. The data taken using the instrument in the adaptation of a Visual Analog Scale (VAS and analyzed by using the wilcoxon signed rank test. The result is there was a decrease in pain intensity before and after the administration of inhaled lavender aromatherapy (Z=-3.77 with p-value 0.001. Lavender aromatherapy can be a complementary alternative therapy to reduce pain in postpartum women but more research necessary is needed with more respondents.

  1. Post partum occlusion of the hepatic artery

    International Nuclear Information System (INIS)

    Buecheler, E.; Hagemann, J.; Remmecke, J.; Hamburg Univ.

    1980-01-01

    A case of post partum acute thrombosis of the hepatic artery with infarction of the liver is reported. The prognosis depends on the areas of obstruction, on the early development of a collateral circulation and on the contribution to the blood supply from the portal vein. The diagnosis of liver infarction was made by computed tomography. This was characterised by sharply demarkated hypodense areas, which did not enhance with contrast. An important clue is the lack of increase in density in the liver after intravenous injection of contrast when compared with the increased contrast of the spleen. This finding provided the indication for angiography. This confirmed the diagnosis of acute occlusion and made appropriate treatment possible. (orig.) [de

  2. Early perinatal diagnosis of mothers at risk of developing post-partum depression--a concise guide for obstetricians, midwives, neonatologists and paediatricians.

    Science.gov (United States)

    Ambrosini, Alessandra; Donzelli, Gianpaolo; Stanghellini, Giovanni

    2012-07-01

    In this article, we tried to provide all those involved in perinatal medicine with a concise guide to detect mothers at risk of developing post-partum depression. Motherhood is a critical situation characterized by role conflicts because conflicts among the role of mother, worker and wife are the norm in the post-partum period and may jeopardize the mother's existence. We have described a kind of personality that is at great risk of developing post-partum depression because of the incapacity to creatively manage situations of role conflict. This personality structure is called typus melancholicus, and we operationally defined its main features: orderliness, conscientiousness, hypernomia/heteronomia and intolerance of ambiguity. We have shown how these mothers may typically behave during pregnancy and early motherhood: they cannot avoid behaving with feverish perfectionism, developing an exaggerated preoccupation towards the unborn child and hostility towards persons and events that are experienced as an obstacle to their search for perfection. They ultra-carefully follow all the steps concerning paediatric check-ups and feel all the responsibility relating to the care of the child, without being able to delegate to someone else or share their feelings. We hope to provide those clinicians who are engaged in the care of pregnant women and their children with a valuable and user-friendly instrument for understanding and making a timely diagnoses of at-risk psychopathological phenomena.

  3. The effects of social, cultural, economical and related factors on post partum psychosis

    Directory of Open Access Journals (Sweden)

    mitra Safa

    2006-11-01

    Results: Most of the subjects were in the range of 20-30 years old. They were housewives. In most case, they gave birth to a female newborn and the delivery was done in a normal way. Most of the patients declared that they had unplanned pregnancy. 29.6% of the patients had mental disease background. 9.1% had major depression, 5.6% had dysthymic disorder. 18.5% of the subjects had physical disease like UTI, hyper thyroid and seizure. Conclusion: There was a significant relationship between post partum psychosis and variables such as age, education, job, and disease background, number of delivery and lack of child acceptance. It is suggested that for prevention of post partum psychosis, there should be a very suitable situation for pregnant mothers. Moreover by planning and designing educational programs, we could provide the proper background for child birth in the family.

  4. Effectiveness of a facebook-delivered physical activity intervention for post-partum women: a randomized controlled trial protocol.

    Science.gov (United States)

    Kernot, Jocelyn; Olds, Tim; Lewis, Lucy K; Maher, Carol

    2013-05-29

    Physical activity is reduced during the post-partum period. Facebook is frequently used by Australian mothers, and offers flexibility, high levels of engagement and the ability to disseminate information and advice via social contacts. The Mums Step it Up Program is a newly developed 50 day team-based physical activity intervention delivered via a Facebook app. The program involves post-partum women working in teams of 4-8 friends aiming to achieve 10,000 steps per day measured by a pedometer. Women are encouraged to use the app to log their daily steps and undertake social and supportive interactions with their friends and other participants. This study aims to determine the effectiveness of the Mums Step it Up Program. A sample of 126 women up to 12 months post-partum will be recruited through community-based health and family services. Participants will be randomly allocated into one of three groups: control, pedometer only and the Mums Step it Up Program. Assessments will be completed at baseline, 6 weeks and 6 months. The primary outcome (objective physical activity) and the secondary outcomes (sleep quality and quantity, depressive symptoms, weight and quality of life) will be used to determine the effectiveness of the Mums Step it Up Program compared with the control and pedometer only groups. Analyses will be undertaken on an intention-to-treat-basis using random effects mixed modeling. The effect of theorized mediators (physical activity attitudes, subjective norms and perceived behavioral control) will also be examined. This study will provide information about the potential of a Facebook app for the delivery of health behavior interventions. If this intervention proves to be effective it will be released on a mass scale and promoted to the general public. Australia and New Zealand Clinical Trials Register: ACTRN12613000069752.

  5. Graviditetsudløst transient osteoporose som årsag til hoftesmerter post partum

    DEFF Research Database (Denmark)

    Svensson, Annemarie Lyng; Jensen, Jens-Erik Beck; Morsel-Carlsen, Lone

    2014-01-01

    Transient osteoporosis of the hip (TOH) affects pregnant women in the third trimester of pregnancy. Magnetic resonance imaging plays an important role in the diagnosis and shows a pattern of bone marrow oedema. We report a case of TOH post-partum with involvement of both hips in a 34-year-old woman...

  6. Becoming a parent: a model of parents' post-partum experience

    Directory of Open Access Journals (Sweden)

    Francine de Montigny

    2006-04-01

    Full Text Available Perceiving oneself as parent is a key challenge during the transition to parenthood. The importance of health professionals in determining perceived efficacy in parents upon the birth of their child is few explored. The objective of this study is to analayze the relations between the first time parents' perceived efficacy and their perceptions of nurses' help-giving and critical events during post-partum period. SAMPLE AND METHOD: One hundred sixty couples participated in a correlational study by completing questionaires after the birth of their first child. RESULTS: A model of parents' postpartum experience was established where nurses' collaboration and help-giving practices contribute directly and indirectly to the parents' perception of control and perceptions of events. They contribute indirectly to parent's perceived self-efficacy. IMPLICATIONS: The help given by health professionals, especially nurses, to parents following the birth of a child makes a major positive difference in the parents' experiences.

  7. Evaluation of the clinical effect of an on-line course for community nurses on post-partum emotional distress: a community-based longitudinal time-series quasi-experiment.

    Science.gov (United States)

    Thome, Marga; Orlygsdottir, Brynja; Elvarsson, Bjarki Thor

    2012-09-01

    About 14% of Icelandic women suffer post-partum from frequent depressive symptoms, and of those, 12% also report a high degree of parenting stress. Education of nurses and midwives on post-partum distress is crucial in reducing its degree. The purpose of the study is to evaluate the clinical effect of an on-line course for community nurses on post-partum emotional distress. A community-based, longitudinal, time-series quasi-experiment was conducted in four stages from 2001 to 2005. Mothers attending 16 health centres throughout Iceland and scoring ≥ 12 on the Edinburgh Postnatal Depression Scale (EPDS) at the 9th week post-partum were eligible to participate. Health centres were divided into experimental (EHC) and control centres (CHC), and control centres were crossed over to experimental centres the following year and new control centres recruited. Nurses at EHC attended an on-line course on post-partum emotional distress. Participating mothers answered the EPDS; the Parenting Stress Index/Short form and the Fatigue Scale. Nursing diagnoses and interventions were recorded at all study centres. Of the women who were eligible (n = 163), 57% (n = 93) participated. At baseline, 9 weeks post-partum, there were no significant differences between groups of women in the rate of depressive symptoms, fatigue or parenting stress. Women in all groups improved on all distress indicators over time; however, those from the EHC improved statistically and clinically significantly more on depressive symptoms than those from the CHC. Documentation of particular nursing diagnoses and interventions was significantly more frequent at the EHC, but referrals to specialists were significantly less frequent. On-line education for nurses on post-partum emotional distress is feasible and is related to improvement in post-partum depressive symptoms. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  8. Post-partum involution of the canine uterus - gross anatomical and histological features.

    Science.gov (United States)

    Orfanou, D C; Ververidis, H N; Pourlis, A; Fragkou, I A; Kokoli, A N; Boscos, C M; Taitzoglou, I A; Tzora, A; Nerou, C M; Athanasiou, L; Fthenakis, G C

    2009-07-01

    We aimed to study the normal puerperium in the bitch. Ovariohysterectomy was performed in nine bitches, each at a different day after normal whelping; their genital tract was subject to gross anatomical examination, as well as to histological examination and electron microscopy scanning. Corpora albicans were evenly distributed in the left and right ovaries and placental sites were evenly distributed among left and right uterine horns. Placental sites were initially of dark green to grey colour, later becoming dark brown; their length and height progressively decreased. Height of the myometrium and diameter of the uterine glands progressively decreased. Trophoblast-like cells were consistently observed at the placental sites and on the surface of the interplacental areas, at all time points where hysterectomy had been performed. It is suggested that involution of the canine genital tract can last up to 3 months and is slow. Continuous (up to D84 post-partum) presence of prominent placental sites should be considered a normal feature of canine uterine post-partum involution.

  9. Post-partum ovarian activity in adult and first-calf dual purpose cows in Guatemala

    International Nuclear Information System (INIS)

    Ordonez, H.; Gatica, A.; Miranda, J.; Matamoros, R.

    1990-01-01

    Progesterone (P 4 ) levels in skin milk were determined in two groups of dual purpose cows from farms in the Department of Escuintla on the south coast of Guatemala. Fifteen adult cows (crosses of Criollo with Zebu and Brown Swiss) were selected on the first farm and ten first-calf heifers (crosses of Criollo with Zebu and Holstein) on the second; both groups were considered to be representative of dual purpose livestock (milk and meat producers) in the country. To study the resumption of ovarian activity post-partum, milk samples were taken once a week from 10 days after calving until the first natural service; thereafter, sampling continued twice-weekly for 60 more days when the animals were rectally palpated for pregnancy diagnosis. On farm 1, the mean interval from calving to first rise in P 4 levels indicative of ovarian function was 42±16.7 days; all the study cows were at third calving and resumed cyclicity. On farm 2, only 30% of the study heifers resumed cyclicity and these had an interval from calving to first rise in P 4 of 80±28.9 days; all were at first calving. On farm 1, 73% of cows were served during first oestrus, 13% at second oestrus and 13% at the third. On farm 2, only 30% (3/10) of cows were served at first oestrus; the other 70% did not show signs of ovarian activity during the trial period which lasted until day 129 post-partum. Palpation of the cows 60 days post-service showed that all cows had conceived on farm 1 but only 20% on farm 2. (author). 9 refs, 3 figs

  10. Determination of the reproductive behavior of dairy cows, post-partum, by means of radio immunoassay (RIA) techniques

    International Nuclear Information System (INIS)

    Villalba, Patricio; Guerron, Edwin

    1992-01-01

    The main objective of this trial was to determine the post-partum ovaric activity in dairy cattle recently introduced in the Ecuadorian subtropic. On this trial, progesterone levels in milk of 114 post-partum cows from 6 different farms were determined. The progesterone level in milk was analyzed by RIA and the milk sampling was done according to established protocol. Additional data about management, nutritional condition and health of the animals were also taken in each farm. In the Santo Domingo valley, the ovaries of post-partum cows, with a good nutritious diet, start functioning after 54.21 days with a range of 10 to 161. The duration of the first oestral cycle was 24.07 with the range of 6 to 29 days. Fifty six cows (49.12 percent) remained pregnant up to the end of the trial and the average of interval calving was 409. 95 - 115. 69 days. In the area, there is high incidence of ovaric hypofunctions ( 30.70 percent) and return of anoestrus ( 14.03 percent). heats of the cows were observed ( 62.90 percent) by the farmers, but they were determined by progesterone levels, through RIA technique

  11. Health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and during the post-partum period: a systematic review of qualitative research

    Directory of Open Access Journals (Sweden)

    Kate Flemming

    2016-03-01

    Full Text Available Abstract Background Reducing smoking in pregnancy is a policy priority in many countries and as a result there has been a rise in the development of services to help pregnant women to quit. A wide range of professionals are involved in providing these services, with midwives playing a particularly pivotal role. Understanding professionals’ experiences of providing smoking cessation support in pregnancy can help to inform the design of interventions as well as to improve routine care. Methods A synthesis of qualitative research of health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and the post-partum period was conducted using meta-ethnography. Searches were undertaken from 1990 to January 2015 using terms for maternity health professionals and smoking cessation advisors, pregnancy, post-partum, smoking, and qualitative in seven electronic databases. The review was reported in accordance with the ‘Enhancing transparency in reporting the synthesis of qualitative research’ (ENTREQ statement. Results Eight studies reported in nine papers were included, reporting on the views of 190 health professionals/key informants, including 85 midwives and health visitors. The synthesis identified that both the professional role of participants and the organisational context in which they worked could act as either barriers or facilitators to an individual’s ability to provide smoking cessation support to pregnant or post-partum women. Underpinning these factors was an acknowledgment that the association between maternal smoking and social disadvantage was a considerable barrier to addressing and supporting smoking cessation Conclusions The review identifies a role for professional education, both pre-qualification and in continuing professional development that will enable individuals to provide smoking cessation support to pregnant women. Key to the success of this education

  12. Values of Prostaglandin during Pre and Post-Partum and at parturition in buffaloes

    Directory of Open Access Journals (Sweden)

    R.M. Khattab

    2010-02-01

    Full Text Available This study was carried out at Mehallet Mousa Animal production Research station, Animal production Research institute- ministry of agriculture, Egypt. This work was carried out on ten late pregnant buffaloes for studying prostaglandin (PG F2α during pre and post partum periods. Blood samples were collected five days prepartum and one week postpartum. Prostaglandin was determined by Elisa (Enzyme-Limked immunosorbant Assay. The results, showed that the plasma prostaglandin levels on day three, two and one prepartum was higher than on day five prepartum. On The day of delivery (0 day a sudden sharp increase in PGF2& con concentration occurred (180.83±4.23 pg/ml followed by a gradual decrease in the plasma concentration. Of PGF2α on day four, five, six and seven postpartum, small respectively.

  13. Elevated Thyroid Peroxidase Antibody Increases Risk of Post-partum Depression by Decreasing Prefrontal Cortex BDNF and 5-HT Levels in Mice.

    Science.gov (United States)

    Zhou, Yingying; Wang, Xinyi; Zhao, Yuhang; Liu, Aihua; Zhao, Tong; Zhang, Yuanyuan; Shan, Zhongyan; Teng, Weiping

    2016-01-01

    Post-partum depression (PPD) is a common mental disease in the perinatal period that profoundly affects mothers and their offspring. Some clinical studies have found that PPD is related to thyroid peroxidase antibodies (TPOAbs); however, the mechanism underlying this relationship is unclear. Female C57BL/6 mice immunized with adenovirus encoding the cDNA of the full-length mTPO (mTPO-Ad) were used to establish the isolated TPOAb-positive mouse model in the present study. Maternal depressive-like behaviors were assessed using the forced swimming test (FST), sucrose preference test (SPT), and tail suspension test (TST) post-partum. The serum TPOAb titer was measured by enzyme-linked immunosorbent assay (ELISA) before pregnancy and post-partum. Furthermore, in the prefrontal cortex, the mRNA and protein expression levels of brain-derived neurotrophic factor (BDNF) were measured, serotonin (5-HT) levels were measured by ultra-high-performance liquid chromatography-tandem mass-spectrometry (UHPLC-MS/MS), and total thyroxine (TT4) levels were determined by ELISA. Compared with the controls, the mice immunized with mTPO-Ad displayed depressive behaviors, with a significantly lower sucrose preference (SP) at the 12-h time point and a longer immobility time in the FST and TST, which were accompanied by a lower expression of BDNF and 5-HT but no change in the TT4 concentration in the prefrontal cortex. Together, these findings suggest that elevated TPOAb may increase the risk of subsequent PPD and decrease the concentration of BDNF and 5-HT in the prefrontal cortex.

  14. Post partum lymphocytic thyroiditis in North Indian population: a spectrum of thyroid dysfunction

    International Nuclear Information System (INIS)

    Sharma, Rajnish; Mondal, Anupam; Taneja, Vijay; Bansal, J.K.; Khanna, C.M.; Sharma, Manisha

    1999-01-01

    Two hundred and sixty one Indian women from Delhi and surrounding territory were prospectively evaluated to determine the frequency of post-partum thyroiditis upto 12 weeks of postpartum. Thirty one (11.8%) of the 261 cases included in our study developed thyroid disease. Twenty four (77%) of the patients who developed thyroiditis were found to have high titres of thyroid antibodies. Of these 24 patients, 21 (67.7%) tested positive for antimicrosomal antibodies and 17 (54.8%) tested positive for antithyroglobulin antibodies. Patients were found to have a spectrum of thyroid dysfunction. Transient hypothyroidism developed in 17 patients, I patient developed persistent hypothyroidism, 7 had transient thyrotoxicosis and 6 developed euthyroid goiters. Twenty two patients had goiters ranging from grade OB to grade II. Fine needle aspiration cytology showed chronic lymphocytic thyroiditis in 20 patients, while 2 had colloid goiter. It is concluded from our study that there is a significant incidence of post partum thyroid disease in the female population representative of North India, and most of the patients (93.5%) develop transient thyroid disorder. (author)

  15. Common symptoms during pregnancy to predict depression and health status 14 years post partum.

    Science.gov (United States)

    Khatun, Mohsina; Clavarino, Alexandra M; Callaway, Leonie; Alati, Rosa; Najman, Jake M; Williams, Gail; Al Mamun, Abdullah

    2009-03-01

    To examine the prospective association between symptoms commonly experienced during pregnancy and the mental and general health status of women 14 years post partum. Data used were from the Mater-University of Queensland Study of Pregnancy, a community-based prospective birth cohort study begun in Brisbane, Australia, in 1981. Logistic regression analyses were conducted. Data were available for 5118 women. Women who experienced a higher burden of symptoms during pregnancy were at greater risk of becoming depressed and reporting poorer health status 14 years post partum. Women who experienced major problems during pregnancy were 4 times more likely to be depressed and nearly 8 times more likely to report poorer health status 14 years after the index pregnancy compared with women who experienced few problems. Findings suggest that pregnant women who experience common symptoms during pregnancy are likely to experience poorer mental and self-reported general health 14 years after the pregnancy.

  16. Elevating serotonin pre-partum alters the Holstein dairy cow hepatic adaptation to lactation

    Science.gov (United States)

    Weaver, Samantha R.; Prichard, Allan S.; Maerz, Noah L.; Prichard, Austin P.; Endres, Elizabeth L.; Hernández-Castellano, Lorenzo E.; Akins, Matthew S.; Bruckmaier, Rupert M.

    2017-01-01

    Serotonin is known to regulate energy and calcium homeostasis in several mammalian species. The objective of this study was to determine if pre-partum infusions of 5-hydroxytryptophan (5-HTP), the immediate precursor to serotonin synthesis, could modulate energy homeostasis at the level of the hepatocyte in post-partum Holstein and Jersey dairy cows. Twelve multiparous Holstein cows and twelve multiparous Jersey cows were intravenously infused daily for approximately 7 d pre-partum with either saline or 1 mg/kg bodyweight of 5-HTP. Blood was collected for 14 d post-partum and on d30 post-partum. Liver biopsies were taken on d1 and d7 post-partum. There were no changes in the circulating concentrations of glucose, insulin, glucagon, non-esterified fatty acids, or urea nitrogen in response to treatment, although there were decreased beta-hydroxybutyrate concentrations with 5-HTP treatment around d6 to d10 post-partum, particularly in Jersey cows. Cows infused with 5-HTP had increased hepatic serotonin content and increased mRNA expression of the serotonin 2B receptor on d1 and d7 post-partum. Minimal changes were seen in the hepatic mRNA expression of various gluconeogenic enzymes. There were no changes in the mRNA expression profile of cell-cycle progression marker cyclin-dependent kinase 4 or apoptotic marker caspase 3, although proliferating cell nuclear antigen expression tended to be increased in Holstein cows infused with 5-HTP on d1 post-partum. Immunofluorescence assays showed an increased number of CASP3- and Ki67-positive cells in Holstein cows infused with 5-HTP on d1 post-partum. Given the elevated hepatic serotonin content and increased mRNA abundance of 5HTR2B, 5-HTP infusions may be stimulating an autocrine-paracrine adaptation to lactation in the Holstein cow liver. PMID:28922379

  17. Elevating serotonin pre-partum alters the Holstein dairy cow hepatic adaptation to lactation.

    Directory of Open Access Journals (Sweden)

    Samantha R Weaver

    Full Text Available Serotonin is known to regulate energy and calcium homeostasis in several mammalian species. The objective of this study was to determine if pre-partum infusions of 5-hydroxytryptophan (5-HTP, the immediate precursor to serotonin synthesis, could modulate energy homeostasis at the level of the hepatocyte in post-partum Holstein and Jersey dairy cows. Twelve multiparous Holstein cows and twelve multiparous Jersey cows were intravenously infused daily for approximately 7 d pre-partum with either saline or 1 mg/kg bodyweight of 5-HTP. Blood was collected for 14 d post-partum and on d30 post-partum. Liver biopsies were taken on d1 and d7 post-partum. There were no changes in the circulating concentrations of glucose, insulin, glucagon, non-esterified fatty acids, or urea nitrogen in response to treatment, although there were decreased beta-hydroxybutyrate concentrations with 5-HTP treatment around d6 to d10 post-partum, particularly in Jersey cows. Cows infused with 5-HTP had increased hepatic serotonin content and increased mRNA expression of the serotonin 2B receptor on d1 and d7 post-partum. Minimal changes were seen in the hepatic mRNA expression of various gluconeogenic enzymes. There were no changes in the mRNA expression profile of cell-cycle progression marker cyclin-dependent kinase 4 or apoptotic marker caspase 3, although proliferating cell nuclear antigen expression tended to be increased in Holstein cows infused with 5-HTP on d1 post-partum. Immunofluorescence assays showed an increased number of CASP3- and Ki67-positive cells in Holstein cows infused with 5-HTP on d1 post-partum. Given the elevated hepatic serotonin content and increased mRNA abundance of 5HTR2B, 5-HTP infusions may be stimulating an autocrine-paracrine adaptation to lactation in the Holstein cow liver.

  18. Use of radioimmunoassay technique for the determination of post-partum ovaric activity in high and low milk production in dairy cows

    International Nuclear Information System (INIS)

    Villalba, P.; Paneluisa, S.; Arcos, E.

    1993-01-01

    The principal objective of this study was to determinate the post-partum ovarian activity in milking cows of high and low production in one farm of ecuadorian highland. For this experiment was necessary to use 48 animals between second and sith calving, the milk samples were collected according one pre-stablished protocol and the same was: one sample 5th or 6th days, twice a week until the cows were pregnacy and 180 days after parturitium if the cow is open. Additional data were compiled in each farm and both the results of the progesterone by RIA were used to determinate the diferents reproductive parameters in the post-partum of the cows. The most of reproductives parameters in the post-partum of the cows in the both group didn't have significance but the conception rate, services per conception, number of pregnacy cows and percentaje of non visibles heats had one high significance between the treatments

  19. Studies on the post-partum ovarian activity of dairy cattle under different feeding regimes in Ecuador

    International Nuclear Information System (INIS)

    Jarrin, J.; Villalba, P.; Guerron, E.; Zurita, E.

    1990-01-01

    In order to monitor ovarian activity in post-partum dairy cows in the Cayambe Valley, Ecuador, 164 cows from three farms were studied. Milk progesterone concentrations (analysed by RIA) and additional data on livestock management, nutritional status and health were compiled. Farms were classified mainly according to nutritional and management status; the better the nutritional status of the cows the sooner they resumed oestrous activity (28.3-31.6 days post-partum). The duration of the first oestrous cycle was found to be variable, 18.0 to 20.4 days. Thirty-one per cent of the study cows did not conceive during the course of the trial and the mean calving interval of those that calved was 426 days. The high incidence of hypofunctional ovaries was a cause for concern on one farm. (author). 6 refs, 4 figs, 2 tabs

  20. Associations of maternal nutrition during pregnancy and post-partum with maternal cognition and caregiving.

    Science.gov (United States)

    Prado, Elizabeth L; Ashorn, Ulla; Phuka, John; Maleta, Kenneth; Sadalaki, John; Oaks, Brietta M; Haskell, Marjorie; Allen, Lindsay H; Vosti, Steve A; Ashorn, Per; Dewey, Kathryn G

    2018-04-01

    Pregnant and post-partum women require increased nutrient intake and optimal cognition, which depends on adequate nutrition, to enable reasoning and learning for caregiving. We aimed to assess (a) differences in maternal cognition and caregiving between women in Malawi who received different nutritional supplements, (b) 14 effect modifiers, and (c) associations of cognition and caregiving with biomarkers of iron, Vitamin A, B-vitamin, and fatty acid status. In a randomized controlled trial (n = 869), pregnant women daily received either multiple micronutrients (MMN), 20 g/day lipid-based nutrient supplements (LNS), or a control iron/folic acid (IFA) tablet. After delivery, supplementation continued in the MMN and LNS arms, and the IFA control group received placebo until 6 months post-partum, when cognition (n = 712), caregiving behaviour (n = 669), and biomarkers of nutritional status (n = 283) were assessed. In the full group, only one difference was significant: the IFA arm scored 0.22 SD (95% CI [0.01, 0.39], p = .03) higher than the LNS arm in mental rotation. Among subgroups of women with baseline low hemoglobin, poor iron status, or malaria, those who received LNS scored 0.4 to 0.7 SD higher than the IFA arm in verbal fluency. Breastmilk docosahexaenoic acid and Vitamin B12 concentrations were positively associated with verbal fluency and digit span forward (adjusting for covariates ps < .05). In this population in Malawi, maternal supplementation with MMN or LNS did not positively affect maternal cognition or caregiving. Maternal docosahexaenoic acid and B12 status may be important for post-partum attention and executive function. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

  1. Differences in total and allergen specific IgE during pregnancy compared with 1 month and 1 year post partum.

    Science.gov (United States)

    Perry, Lee M; Ownby, Dennis R; Wegienka, Ganesa R; Peterson, Edward L; Woodcroft, Kimberly J; Joseph, Christine L; Johnson, Christine C

    2009-10-01

    Pregnancy alters the function of many body systems, including the immune system. However, little is known regarding the effect of pregnancy on maternal IgE levels or atopy. To determine whether pregnancy consistently influences serum levels of total or allergen specific IgE. Blood samples were obtained from 764 women during the third trimester of pregnancy and 1 month post partum. A third sample was obtained from 106 of these women 1 year post partum. Samples were analyzed for total and specific IgE to 8 regionally common allergens using a commercially available system. Sensitization was defined as an allergen specific IgE level of 0.35 kU of allergen per liter or higher to any allergen. Total IgE increased significantly post partum, both at 1 month (40.36 vs 35.37 IU/mL intrapartum; P = .001) and at 1 year (44.97 vs 37.00 IU/mL intrapartum; P = .005). Allergen specific IgE decreased significantly at 1 month for cat, dog, ragweed, timothy grass, and egg (P = .001 to P = .02) but not for dust mite, cockroach, or Alternaria (P = .15 to P = .90). Similar patterns of change in total and specific IgE were seen at 1 year. However, on average, only 3.5% of participants changed sensitization status to the individual allergens studied during the 1 year of observation. Compared with intrapartum levels, total IgE levels increased significantly at 1 month and 1 year post partum. Conversely, at the same time points, IgE levels specific for common allergens significantly declined to most but not all allergens. Few women changed their sensitization status over 1 year.

  2. Lactobacillus-deficient vaginal microbiota dominate post-partum women in rural Malawi.

    Science.gov (United States)

    Doyle, Ronan; Gondwe, Austridia; Fan, Yue-Mei; Maleta, Kenneth; Ashorn, Per; Klein, Nigel; Harris, Kathryn

    2018-01-05

    The bacterial community found in the vagina is an important determinant of a woman's health and disease. A healthy vaginal microbiota is associated with a lower species richness and high proportions of one of a number of different Lactobacillus spp.. When disrupted the resulting abnormal vaginal microbiota is associated with a number of disease states and poor pregnancy outcomes. Studies up until now have concentrated on relatively small numbers of American and European populations which may not capture the full complexity of the community, nor adequately predict what constitutes a healthy microbiota in all populations. In this study we sampled and characterised the vaginal microbiota from a cohort of 1107 women in rural Malawi found on vaginal swabs taken post-partum. We found a population dominated by Gardnerella vaginalis and devoid of the most common vaginal Lactobacillus species, even if the vagina was sampled over a year post-partum. The Lactobacillus -deficient anaerobic community commonly labelled community state type (CST) 4 could be sub-divided into four further communities. A Lactobacillus iners dominated vaginal microbiota became more common the longer after delivery the vagina was sampled, but G. vaginalis remained the dominant organism. These results outline the difficulty in all-encompassing definitions of what a healthy or abnormal vaginal microbiota is post-partum. Previous identification of community state types and associations between bacterial species, bacterial vaginosis and adverse birth outcomes may not represent the complex heterogeneity of the microbiota present. Importance A bacterial community in the vaginal tract that is dominated by small number of bacterial Lactobacillus species and when they are not present, there is a greater incidence of inflammatory conditions and adverse birth outcomes. A switch to a vaginal bacterial community lacking in Lactobacillus species is common after pregnancy. In this study we characterised the vaginal

  3. An Overview of Risk Factors Associated to Post-partum Depression in Asia

    OpenAIRE

    Mehta, Shubham; Mehta, Nidhi

    2014-01-01

    Post partum depression (PPD) is an important complication of child-bearing. It requires urgent interventions as it can have long-term adverse consequences if ignored, for both mother and child. If PPD has to be prevented by a public health intervention, the recognition and timely identification of its risk factors is must. We in this review have tried to synthesize the results of Asian studies examining the risk factors of PPD. Some risk factors, which are unique to Asian culture, have also b...

  4. Maternal-foetal attachment independently predicts the quality of maternal-infant bonding and post-partum psychopathology.

    Science.gov (United States)

    Petri, Eleonora; Palagini, Laura; Bacci, Olivia; Borri, Chiara; Teristi, Valentina; Corezzi, Camilla; Faraoni, Sara; Antonelli, Paolo; Cargioli, Claudio; Banti, Susanna; Perugi, Giulio; Mauri, Mauro

    2017-08-21

    The aim of this study was to evaluate the association of maternal antenatal attachment and post-partum psychopathology, maternal-infant bonding, while checking for antenatal psychopathology, for lifetime psychiatric diagnosis and for the known risk factors for peripartum depression. One hundred and six women recruited at the first month of pregnancy (T0) were evaluated with the structured interview for DSM-IV TR (SCID-I) to assess the presence of lifetime psychiatric diagnosis and with the Perinatal Depression Predictor Inventory-Revised (PDPI-R), the Edinburgh Postnatal Depression Scale (EPDS), and the State-Trait Anxiety Inventory (STAI). At the sixth month of pregnancy (T1) and at the first month post-partum (T2), all patients were evaluated with the PDPI-R, the EPDS, the STAI, at T1, with the Maternal Antenatal Attachment Scale (MAAS), and at T2 with the Maternal Postnatal Attachment Scale (MPAS). Multivariate regression analyses showed that maternal-foetal attachment was the variable most significantly associated with postnatal symptoms of depression and anxiety and with quality of maternal-infant attachment. The logistic regression analyses showed that antenatal attachment may predict postnatal depressive and anxiety symptoms (respectively, OR: 0.83 - IC [0.74 - 0.95], p = .005, OR: 0.88 - IC [0.79 - 0.98], p = .02), and the quality of maternal postnatal attachment (OR: 1.17 - IC [1.08 - 1.27], p depression, the sociodemographic variables and lifetime psychiatric diagnosis. The quality of maternal-foetal bonding may independently predict the quality of maternal-infant attachment and post-partum depressive and anxiety symptoms. A comprehensive assessment of maternal risk factors for perinatal psychopathology during pregnancy should include the evaluation of antenatal attachment that could be modifiable by specific interventions promoting the quality of maternal bonding.

  5. Endocrine evaluation of puberty and post-partum ovarian function in indigenous and imported Brahman cattle

    International Nuclear Information System (INIS)

    Tan, H.S.; Ismaya, K.H.; Sulong, A.

    1990-01-01

    A study was conducted to monitor the reproductive performance of Kedah Kelantan (KK) and Brahman cattle maintained under similar environmental and management conditions on commercial farms in Malaysia. This allowed the physiological differences affecting reproductive efficiency to be identified in both pubertal and adult stock. The results revealed that the Brahman breed exhibited a better growth rate but poorer post-partum fertility than the KK. It appears that Brahman cattle require feed supplementation around the time of calving in order to reduce the duration of post-partum anoestrus. Both breeds exhibited late onset of puberty (on average at 25-36 months of age), although some animals initiated sexual activity at a much earlier age; this suggests that better selection as well as nutritional supplementation and possibly endocrine manipulation are necessary management inputs. Although the Brahman shows excellent potential in terms of performance per animal, the greater carrying capacity of the KK and its greater adaptiveness to local conditions indicate that this indigenous animal still has a major role to play in livestock production in Malaysia. (author). 20 refs, 1 fig., 6 tabs

  6. Spontaneous parasitic leiomyoma in a post-partum woman.

    Science.gov (United States)

    Iida, Mana; Ishikawa, Hiroshi; Shozu, Makio

    2016-12-01

    We report a case of spontaneous parasitic leiomyoma in a 30-year-old post-partum woman. A subserosal leiomyoma had been noted at the first trimester screening, and she had experienced persistent abdominal pain during her previous pregnancy. She was referred to hospital with severe abdominal pain at 7 months after delivery. We detected a homogenous solid tumor that resembled the subserosal leiomyoma but was completely detached from the uterus. On laparoscopy the vascularization of the tumor was supplied from the omentum, which was tightly adherent to the tumor. Histopathologically, the tumor was surrounded by a fibrous vascular capsule, and broadly hyalinized and partially calcified, consistent with a degenerated uterine leiomyoma. Detachment of a pedunculated subserosal leiomyoma from the uterus following adhesion to other pelvic structures throughout pregnancy may result in a parasitic leiomyoma, a rare subtype of uterine leiomyoma. © 2016 Japan Society of Obstetrics and Gynecology.

  7. Perbandingan Nilai Fleksibilitas Tubuh Ibu Post Partum Yang Melakukan Dan Tidak Melakukan Senam Pilates

    OpenAIRE

    Prabandani, Dyah Ayu; Laksono, Budi

    2016-01-01

    Latar Belakang : Mengukur nilai fleksibilitas tubuh adalah salah satu cara untuk mengetahui tingkat kelenturan tubuh seorang ibu, yang dapat berpengaruh terhadap ruang gerak sendi. Pada ibu post partum akan mengalami beberapa Perubahan seperti pengendoran otot dan bertambahnya berat badan yang dapat berpengaruh terhadap ruang gerak sendi. Senam pilates merupakan jenis senam yang populer di Indonesia yang menonjolkan stretching sehingga melatih kelenturan tubuh.Tujuan Penelitian : Membuktikan ...

  8. Psychological health of men with partners who have post-partum depression.

    Science.gov (United States)

    Roberts, Sarah L; Bushnell, John A; Collings, Sunny C; Purdie, Gordon L

    2006-08-01

    To compare the psychological health of men with partners who have post-partum depression (PPD; index group) with that of men with partners without PPD (comparison group). Using a cross-sectional survey, psychological symptoms and disturbances of index group men (n = 58) and comparison group men (n = 116) were compared. Validated self-report measures were used to assess five key areas of mental health: depression, anxiety, non-specific psychological impairment, aggression and alcohol use. Index group men had more symptoms of depression, aggression and non-specific psychological impairment, and had higher rates of depressive disorder, non-specific psychological problems and problem fatigue than comparison group men. Index group men were also more likely to have three or more comorbid psychological disturbances. There was no difference between the groups on measures of anxiety and alcohol use. Although many men in the postnatal period experience a variety of mental health problems, those who have a partner with PPD are themselves at increased risk for experiencing psychological symptoms and disturbances. Differentiation of psychological syndromes is important; higher rates of depressive disorder, non-specific psychological problems and problem fatigue were found, but rates of anxiety disorder and hazardous alcohol use did not differ between the groups. More attention from health professionals to men's mental health in the postnatal period may be beneficial to the entire family system.

  9. Color vision abnormality as the sole manifestation of posterior reversible encephalopathy due to post-partum HELLP syndrome.

    Science.gov (United States)

    Takahashi, Hironori; Matsubara, Teppei; Makino, Shinji; Horie, Kenji; Matsubara, Shigeki

    2017-03-01

    Posterior reversible encephalopathy syndrome (PRES) is associated with several symptoms; of those, visual acuity loss, light oversensitivity (photophobia), and light flashes (photopsia) are known as PRES-related eye symptoms. We report a post-partum woman with PRES associated with hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP), in whom color vision abnormality (achromatopsia) was the sole manifestation. Cesarean section was performed at 28 weeks due to headache, epigastralgia, and severe hypertension. HELLP became evident after delivery. On post-partum day 1, she complained of achromatopsia, stating: "all things look brownish-gray". Ophthalmologic examination was normal, but brain magnetic resonance imaging showed occipital lobe lesions, indicative of PRES, and, interestingly, also color vision center (area V4) lesions, suggesting that the achromatopsia had been caused by brain damage. It may be prudent to question HELLP patients concerning achromatopsia. © 2017 Japan Society of Obstetrics and Gynecology.

  10. [Post-partum: Guidelines for clinical practice--Short text].

    Science.gov (United States)

    Sénat, M-V; Sentilhes, L; Battut, A; Benhamou, D; Bydlowski, S; Chantry, A; Deffieux, X; Diers, F; Doret, M; Ducroux-Schouwey, C; Fuchs, F; Gascoin, G; Lebot, C; Marcellin, L; Plu-Bureau, G; Raccah-Tebeka, B; Simon, E; Bréart, G; Marpeau, L

    2015-12-01

    To determine the post-partum management of women and their newborn whatever the mode of delivery. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Because breastfeeding is associated with a decrease in neonatal morbidity (lower frequency of cardiovascular diseases, infectious, atopic or infantile obesity) (EL2) and an improvement in the cognitive development of children (EL2), exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (Professional consensus). In order to increase the rate of breastfeeding initiation and its duration, it is recommended that health professionals work closely with mothers in their project (grade A) and to promote breastfeeding on demand (grade B). There is no scientific evidence to recommend non-pharmacological measures of inhibition of lactation (Professional consensus). Pharmacological treatments for inhibition of lactation should not be given routinely to women who do not wish to breastfeed (Professional consensus). Because of potentially serious adverse effects, bromocriptin is contraindicated in inhibiting lactation (Professional consensus). For women aware of the risks of pharmacological treatment of inhibition of lactation, lisuride and cabergolin are the preferred drugs (Professional consensus). Whatever the mode of delivery, numeration blood count is not systematically recommended in a general population (Professional consensus). Anemia must be sought only in women with bleeding or symptoms of anemia (Professional consensus). The only treatment of post-dural puncture headache is the blood patch (EL2), it must not be carried out before 48 h (Professional consensus). Women vaccination status and their family is to be assessed in the early post-partum (Professional consensus). Immediate postoperative monitoring after caesarean delivery should be performed in the recovery room, but in exceptional

  11. Prediction of incidence and bio-psycho-socio-cultural risk factors of post-partum depression immediately after birth in an Iranian population.

    Science.gov (United States)

    Abdollahi, Fatemeh; Zarghami, Mehran; Sazlina, Shariff-Ghazali; Zain, Azhar Md; Mohammad, Asghari Jafarabadi; Lye, Munn-Sann

    2016-10-01

    Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. The purpose of the present study was to determine the incidence of early PPD and possible relevant risk factors among women attending primary health centers in Mazandaran province, Iran for the first time. A longitudinal cohort study was conducted among 2279 eligible women during weeks 32-42 of pregnancy to determine bio-psycho-socio-cultural risk factors of depression at 2 weeks post-partum using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). Univariate and hierarchical multiple logistic regression models were used for data analysis. Among 1,739 mothers whose EPDS scores were ≤ 12 during weeks 32-42 of gestation and at the follow-up study, the cumulative incidence rate of depression was 6.9% (120/1,739) at 2 weeks post-partum. In the multivariate model the factor that predicted depression symptomatology at 2 weeks post-partum was having psychiatric distress in pregnancy based on the General Health Questionnaire (GHQ) (OR = 1.06, (95% CI: 1.04-1.09), p = 0.001). The risk of PPD also lower in those with sufficient parenting skills (OR = 0.78 (95% CI: 0.69-0.88), p = 0.001), increased marital satisfaction (OR = 0.94 (95% CI: 0.9-0.99), p = 0.03), increased frequency of practicing rituals (OR = 0.94 (95% CI: 0.89-0.99), p = 0.004) and in those whose husbands had better education (OR = 0.03 (95% CI: 0.88-0.99), p = 0.04). The findings indicated that a combination of demographic, sociological, psychological and cultural risk factors can make mothers vulnerable to PPD.

  12. Graviditetsudløst transient osteoporose som årsag til hoftesmerter post partum

    DEFF Research Database (Denmark)

    Svensson, Annemarie Lyng; Jensen, Jens-Erik Beck; Morsel-Carlsen, Lone

    2014-01-01

    . She was known with undifferentiated spondyloartritis since 2004, which posed a diagnostic challenge. The reported patient was treated conservatively avoiding lactation, weight bearing activities, increased intake of calcium and vitamin D and recovered without further medical treatment.......Transient osteoporosis of the hip (TOH) affects pregnant women in the third trimester of pregnancy. Magnetic resonance imaging plays an important role in the diagnosis and shows a pattern of bone marrow oedema. We report a case of TOH post-partum with involvement of both hips in a 34-year-old woman...

  13. Low back pain post partum - A case report.

    LENUS (Irish Health Repository)

    2012-02-23

    Sacral stress fracture is an unusual source of low back pain and can be easily confused with a number of other clinical conditions seen in physiotherapy clinics. The purpose of this case report is to describe the case of a patient presenting with low back pain post partum illustrating pertinent aspects of differential diagnosis and issues of management. A 31 year old female presented complaining of low back pain since the birth of her second child 11 months earlier. Subjective and objective examination led the Therapist to consider a diagnosis of sacral stress fracture. This diagnosis was confirmed by MRI. Three months after presenting to physiotherapy the patient was pain free and had returned to all aspects of her daily life without any difficulties. Clinicians must be aware of the less common pathologies in any hypotheses development. A careful history and physical examination and broad hypotheses generation will ensure that patients are accurately diagnosed and receive appropriate and effective treatments.

  14. Luteinizing hormone-follicle stimulating hormone ratio as biological predictor of post-partum depression.

    Science.gov (United States)

    Ramachandran Pillai, R; Sharon, Leena; Premkumar, Nancy R; Kattimani, Shivanand; Sagili, Haritha; Rajendiran, Soundravally

    2017-01-01

    Post-partum depression (PPD) is the common adverse outcome of child bearing which affects the wellbeing of both mother and newborn and has long-term effects. Hence, reliable potential biological tests for early detection of PPD are essential. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) were associated with depressive disorders and the present study estimated the levels of serum FSH, LH in postpartum depression and explored them as predictive biomarkers in the development of PPD. In this nested case control study done at a tertiary care hospital in South India, 450 postpartum women were screened at 6th week post-delivery for PPD. Socio-demographic and clinical data were recorded and depressive symptoms were assessed using Edinburgh Postnatal Depression Scale (EPDS). Out of 450 subjects screened, 100 women with depressive symptoms were categorized as cases and 100 controls were selected from the remaining subjects matching for age and BMI with cases. Serum levels of FSH and LH were measured using direct competitive immunoassay by chemiluminescene technology. Serum LH/FSH ratio was found to be significantly (p=0.02) low in PPD women when compared to normal postpartum subjects. We also found a significant negative correlation between LH/FSH ratio and EPDS scores. Based on the receiver operating characteristic curve, the optimal cut-off value for serum of LH/FSH levels in predicting postpartum depression was estimated to be 0.22mlU/mL with an AUC of 0.598 (95%CI, 0.291-0.859). Our study demonstrated that low LH/FSH ratio after delivery was associated with increased risk for the development of PPD. Low LH/FSH ratio at six-week post delivery can be used as a robust biochemical predictor of post-partum depression. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. The impact of maternal post-partum depression on the language development of children at 12 months.

    Science.gov (United States)

    Quevedo, L A; Silva, R A; Godoy, R; Jansen, K; Matos, M B; Tavares Pinheiro, K A; Pinheiro, R T

    2012-05-01

    Language is one of the most important acquisitions made during childhood. Before verbal language, a child develops a range of skills and behaviours that allow the child to acquire all communication skills. Factors such as environmental factors, socio-economic status and interaction with parents can affect the acquisition of vocabulary in children. Post-partum depression can negatively affect the first interactions with the child and, consequently, the emotional, social and cognitive development of the child. To analyse the effect of the duration of the mother's depression on the language development of children at 12 months old. This was a longitudinal study. The participants of this study were mothers who had received prenatal care from the Brazilian National System of Public Health in Pelotas city, State of Rio Grande do Sul, Brazil. The mothers were interviewed at two different time points: from 30 to 90 days after delivery and at 12 months after delivery; the children were also evaluated at this later time point. To diagnose maternal depression, we used the Mini International Neuropsychiatric Interview, and to assess child development, we used the language scale of the Bayley Scales of Infant Development III. We followed 296 dyads. Maternal depression at both time points (post partum and at 12 months) was significantly associated with the language development of infants at 12 months of age. This impact was accentuated when related to the duration of the disorder. Older women and women with more than two children were more likely to have children with poorer language development, while women who were the primary caregiver had children with higher scores on the language test. The findings indicate that maternal age, parity, primary caregiver status and duration of post-partum depression are associated with the language development of the child. © 2011 Blackwell Publishing Ltd.

  16. Mother's postnatal stress: an investigation of links to various factors during pregnancy and post-partum.

    Science.gov (United States)

    Andersson, Ewa; Hildingsson, Ingegerd

    2016-12-01

    Higher levels of parental stress have long-term effects on children's health and could lead to dysfunction in the parent-child interaction. Different background factors can be predictors of high parental stress. The aim of this study was to examine parental stress among Swedish women and identify different factors linked to women's parental stress. About 702 women were recruited to a clinical study and followed up six months after birth. Data were collected by two questionnaires, and 279 women completed the Swedish Parental Stress Questionnaire (SPSQ). Less than very good mental health and depressive symptoms after birth were strongly associated with parental stress, and the strongest association was found between post-partum depressive symptoms and high levels of stress in the subscale Incompetence. Multiparity was associated with high stress in two subscales, and lower level of education was a protective factor for stress in nearly all subscales. Depressive symptoms and perceived poor mental health post-partum are the most important factors related to high parental stress. The results point to the importance of identifying and supporting mothers with depressive symptoms, since these women have both mental illness and increased stress. © 2015 Nordic College of Caring Science.

  17. The co-existence of depression, anxiety and post-traumatic stress symptoms in the perinatal period: A systematic review.

    Science.gov (United States)

    Agius, Andee; Xuereb, Rita Borg; Carrick-Sen, Debbie; Sultana, Roberta; Rankin, Judith

    2016-05-01

    to identify and appraise the current international evidence regarding the presence and prevalence of the co-existence of depression, anxiety and post-traumatic stress symptoms in the antenatal and post partum period. using a list of keywords, Medline, CINHAL, Cochrane Library, EMBASE, PsychINFO, Web of Science and the Index of Theses and Conference Proceedings (Jan 1960 - Jan 2015) were systematically searched. Experts in the field were contacted to locate papers that were in progress or in press. Reference lists from relevant review articles were searched. Inclusion criteria included full papers published in English reporting concurrent depression, anxiety and post-traumatic stress symptoms in pregnant and post partum women. A validated data extraction review tool was used. 3424 citations were identified. Three studies met the full inclusion criteria. All reported findings in the postnatal period. No antenatal studies were identified. The prevalence of triple co-morbidity was relatively low ranging from 2% to 3%. triple co-morbidity does occur, although the prevalence appears to be low. Due to the presentation of complex symptoms, women with triple co-morbidity are likely to be difficult to identify, diagnose and treat. Clinical staff should be aware of the potential of complex symptomatology. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Acute Lung Injury Complicating Blood Transfusion in Post-Partum Hemorrhage: Incidence and Risk Factors

    OpenAIRE

    Teofili, Luciana; Bianchi, Maria; Zanfini, Bruno A.; Catarci, Stefano; Sicuranza, Rossella; Spartano, Serena; Zini, Gina; Draisci, Gaetano

    2014-01-01

    Background. We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH).  Methods. We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without fresh frozen plasma (FFP) and platelet (PLT) transfusion. Clinical records were then retrieved and examined for respiratory distress events. Accor...

  19. Post-partum pituitary insufficiency and livedo reticularis presenting a diagnostic challenge in a resource limited setting in Tanzania: a case report, clinical discussion and brief review of existing literature

    Directory of Open Access Journals (Sweden)

    Sheriff Faheem G

    2012-07-01

    Full Text Available Abstract Background Pituitary disorders following pregnancy are an important yet under reported clinical entity in the developing world. Conversely, post partum panhypopituitarism has a more devastating impact on women in such settings due to high fertility rates, poor obstetric care and scarcity of diagnostic and therapeutic resources available. Case presentation A 37 year old African female presented ten years post partum with features of multiple endocrine deficiencies including hypothyroidism, hypoadrenalism, lactation failure and secondary amenorrhea. In addition she had clinical features of an underlying autoimmune condition. These included a history of post-partum thyroiditis, alopecia areata, livedo reticularis and deranged coagulation indices. A remarkable clinical response followed appropriate hormone replacement therapy including steroids. This constellation has never been reported before; we therefore present an interesting clinical discussion including a brief review of existing literature. Conclusion Post partum pituitary insufficiency is an under-reported condition of immense clinical importance especially in the developing world. A high clinical index of suspicion is vital to ensure an early and correct diagnosis which will have a direct bearing on management and patient outcome.

  20. Post partum depression and the psychosocial predictors in first-time fathers from northwestern China.

    Science.gov (United States)

    Zhang, Yin-Ping; Zhang, Lu-Lu; Wei, Huan-Huan; Zhang, Yao; Zhang, Chun-Li; Porr, Caroline

    2016-04-01

    there is growing evidence that fathers also experience post partum depression (PPD). However, paternal PPD has been less studied than maternal PPD. Very few studies have investigated PPD in first-time fathers from northwestern China. the purpose of this study was to investigate the occurrence and predictors of depressive symptoms in first-time fathers from northwestern China. a longitudinal study was conducted involving 180 couples who were assessed at three time periods: 3 days, 2 weeks and 6 weeks after childbirth. Self-reported questionnaires including Edinburgh Postnatal Depression Scale (EPDS), Parenting Sense of Competence Scale (PSOC), and Kansas Marital Satisfaction Scale (KMSS) were administered to all participants during each time period. after childbirth 35 (21.1%) of the fathers at 3 days, 32 (20.4%) at 2 weeks and 20 (13.6%) at 6 weeks, indicated that they suffered from PPD. Paternal parental sense of competence, paternal marital satisfaction, and maternal depressive symptoms were among the main predictors for paternal PPD. the study results suggest that paternal PPD is a significant public health concern. Health professionals should focus attention on the psychological health among new fathers during the postpartum period; and, the psychosocial predictors should be considered and incorporated into clinical assessment and intervention of paternal PPD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Glutamic acid decarboxylase autoantibody-positivity post-partum is associated with impaired β-cell function in women with gestational diabetes mellitus.

    Science.gov (United States)

    Lundberg, T P; Højlund, K; Snogdal, L S; Jensen, D M

    2015-02-01

    To investigate whether the presence of glutamic acid decarboxylase (GAD) autoantibodies post-partum in women with prior gestational diabetes mellitus was associated with changes in metabolic characteristics, including β-cell function and insulin sensitivity. During 1997-2010, 407 women with gestational diabetes mellitus were offered a 3-month post-partum follow-up including anthropometrics, serum lipid profile, HbA1c and GAD autoantibodies, as well as a 2-h oral glucose tolerance test (OGTT) with blood glucose, serum insulin and C-peptide at 0, 30 and 120 min. Indices of insulin sensitivity and insulin secretion were estimated to assess insulin secretion adjusted for insulin sensitivity, disposition index (DI). Twenty-two (5.4%) women were positive for GAD autoantibodies (GAD+ve) and the remainder (94.6%) were negative for GAD autoantibodies (GAD-ve). The two groups had similar age and prevalence of diabetes mellitus. Women who were GAD+ve had significantly higher 2-h OGTT glucose concentrations during their index-pregnancy (10.5 vs. 9.8 mmol/l, P = 0.001), higher fasting glucose (5.2 vs. 5.0 mmol/l, P = 0.02) and higher 2-h glucose (7.8 vs. 7.1 mmol/l, P = 0.05) post-partum. Fasting levels of C-peptide and insulin were lower in GAD+ve women compared with GAD-ve women (520 vs. 761 pmol/l, P = 0.02 and 33 vs. 53 pmol/l, P = 0.05) Indices of insulin sensitivity were similar in GAD+ve and GAD-ve women, whereas all estimates of DI were significantly reduced in GAD+ve women. GAD+ve women had higher glucose levels and impaired insulin secretion adjusted for insulin sensitivity (DI) compared with GAD-ve women. The combination of OGTT and GAD autoantibodies post-partum identify women with impaired β-cell function. These women should be followed with special focus on development of Type 1 diabetes. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  2. [Isolated severe neurologic disorders in post-partum: posterior reversible encephalopathy syndrome].

    Science.gov (United States)

    Wernet, A; Benayoun, L; Yver, C; Bruno, O; Mantz, J

    2007-01-01

    Just after Caesarean section for twin pregnancy and feto-pelvic dysproportion, a woman presented severe headaches and arterial hypertension, then blurred vision, then generalised seizures. There were no oedematous syndrome, proteinuria was negative, ASAT were 1.5 N and platelet count was 120,000/mm(3). Cerebral CT-scan was normal. Posterior reversible encephalopathy syndrome (PRES) was diagnosed on MRI. A second MRI performed at day 9 showed complete regression of cerebral lesions, while patient was taking anti-hypertensive and antiepileptic drugs. PRES has to be evoked in post-partum central neurological symptoms, even in absence of classical sign of pre-eclampsia, like proteinuria. PRES and eclampsia share probably common physiopathological pathways. There management and prognosis seems identical.

  3. Progesterone profiles and post-partum fertility in dairy cattle in southern Chile

    International Nuclear Information System (INIS)

    Correa, J.E.; Gatica, R.; Tapia, P.

    1990-01-01

    Milk samples were taken at weekly intervals from 77 dairy cows on days 23, 30, 37, 43 and 50 post-partum (pp) in order to monitor ovarian activity through progesterone concentration measurement. Skim milk samples were assayed for progesterone by radioimmunoassay using kits provided through the FAO and IAEA. Oestrus, clinical examinations, treatments, artificial insemination and pregnancy diagnosis were recorded. The profiles of progesterone concentration and oestrus occurrence combined with behavioural and clinical data indicated that the study cows were in the following reproductive states: I - normal, 38%; II - 'silent' oestrus, 12%; III - prolonged luteal activity, 13%; IV - irregular cyclic activity, 23%; and V - anoestrus, 13%. After artificial insemination, 89% (25/28) of normal, 77% (7/9) of silent oestrus, 50% (5/10) of prolonged luteal activity, 82% (14/17) of irregular cyclic activity and 80% (8/10) of anoestrous cows eventually became pregnant either with or without hormone treatment. With the exception of the anoestrous group, these results seem to support the idea that once a week sampling for progesterone over a seven week period pp is sufficient to monitor the ovarian activity and predict the fertility of a dairy herd. (author). 16 refs, 6 figs, 3 tabs

  4. Glutamic acid decarboxylase autoantibody-positivity post-partum is associated with impaired β-cell function in women with gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Lundberg, T. P.; Højlund, K.; Snogdal, L. S.

    2015-01-01

    AIMS: To investigate whether the presence of glutamic acid decarboxylase (GAD) autoantibodies post-partum in women with prior gestational diabetes mellitus was associated with changes in metabolic characteristics, including β-cell function and insulin sensitivity. METHODS: During 1997-2010, 407...... women with gestational diabetes mellitus were offered a 3-month post-partum follow-up including anthropometrics, serum lipid profile, HbA1c and GAD autoantibodies, as well as a 2-h oral glucose tolerance test (OGTT) with blood glucose, serum insulin and C-peptide at 0, 30 and 120 min. Indices of insulin...... similar age and prevalence of diabetes mellitus. Women who were GAD+ve had significantly higher 2-h OGTT glucose concentrations during their index-pregnancy (10.5 vs. 9.8 mmol/l, P = 0.001), higher fasting glucose (5.2 vs. 5.0 mmol/l, P = 0.02) and higher 2-h glucose (7.8 vs. 7.1 mmol/l, P = 0.05) post...

  5. Inadvertent intrathecal injection of labetalol in a patient undergoing post-partum tubal ligation.

    Science.gov (United States)

    Balestrieri, P J; Hamza, M S; Ting, P H; Blank, R S; Grubb, C T

    2005-10-01

    After receiving a continuous spinal anesthetic for labor following an inadvertent dural puncture with a 17-gauge epidural needle, a morbidly obese parturient underwent post-partum tubal ligation 12 h after vaginal delivery. The patient received a total of 2 mL of 0.75% hyperbaric bupivacaine for the surgery. In response to moderate hypertension the patient received intravenous labetalol hydrochloride 20 mg. She subsequently was inadvertently administered approximately 15 mg of labetalol through the spinal catheter. The spinal catheter was removed immediately after the procedure. She suffered no apparent adverse neurologic effects.

  6. Studies on post-partum reproductive performance of Hereford beef cows in Uruguay with the aid of progesterone assay

    International Nuclear Information System (INIS)

    Cavestany, D.; Cardozo, W.; Tagle, R.; Gama, S.; Lanzzeri, S.; Perdigon, F.

    1990-01-01

    A trial was undertaken on Hereford beef cows to determine the length of their post-partum (pp) anoestrous periods under traditional conditions of feeding and management in Uruguay. Three subsequent trials to shorten pp anoestrus involving early weaning (at 40 days pp), temporary weaning for 72 hours (at 45 days), and temporary weaning for 24 hours combined with GnRH, were run in different parts of Uruguay under different soil and pasture conditions. No treatment differences were found, but cows on improved pastures had shorter pp anoestrous periods (74, 99 and 102 days for the three trials respectively) and higher pregnancy rates (80%, 46% and 55% respectively). It was concluded that the main cause of low reproductive efficiency was poor nutrition and that, under such conditions, no treatment to shorten the pp anoestrus would ever be expected to be successful. (author). 14 refs, 2 figs, 2 tabs

  7. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Jahnavi Daru, MBBS

    2018-05-01

    Full Text Available Summary: Background: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. Methods: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia. Severe anaemia was defined as antenatal or postnatal haemoglobin concentrations of less than 70 g/L in a blood sample obtained before death. Maternal death was defined as death any time after admission until the seventh day post partum or discharge. In regression analyses, we adjusted for post-partum haemorrhage, general anaesthesia, admission to intensive care, sepsis, pre-eclampsia or eclampsia, thrombocytopenia, shock, massive transfusion, severe oliguria, failure to form clots, and severe acidosis as confounding variables. These variables were used to develop the propensity score. Findings: 312 281 women admitted in labour or with ectopic pregnancies were included in the adjusted multilevel logistic analysis, and 12 470 were included in the propensity score regression analysis. The adjusted odds ratio for maternal death in women with severe anaemia compared with those without severe anaemia was 2·36 (95% CI 1·60–3·48. In the propensity score analysis, severe anaemia was also associated with maternal death (adjusted odds ratio 1·86 [95% CI 1·39–2·49]. Interpretation: Prevention and treatment of anaemia during pregnancy and post partum should remain a global public health and research priority. Funding: Barts and the London Charity.

  8. Faktor-faktor yang Berhubungan Dengan Unmet Need KB Pasca-Salin IUD post-placenta di Kamar Rawat Pasca-bersalin RSUP DR. M. Djamil periode Januari-Maret 2013

    Directory of Open Access Journals (Sweden)

    Sari Handayani Utami

    2013-09-01

    Full Text Available AbstrakWanita pada periode post-partum memiliki angka unmet need terhadap kontrasepsi, padahal ini waktu yang tepat untuk mulai memakai kontrasepsi. Salah satu kontrasepsi pasca-salin terkini yang mulai disosialisasikan adalah IUD post-placenta. Namun demikian, masih belum banyak wanita pasangan usia subur yang menggunakan alat kontrasepsi ini bahkan mengetahuinya. Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan unmet need KB pasca-salin IUD post-placenta. Jenis penelitian survey dengan desain cross sectional study. Waktu pengambilan data dari 12 Januari sampai dengan 12 Maret 2013. Sampel adalah wanita pasangan usia subur yang melahirkan pervaginam dan dipilih secara accidental sampling. Penelitian dilakukan pada 88 orang responden dengan 50 orang bukan akseptor KB IUD post-placenta dan 38 orang akseptor KB IUD Post-placenta. Pengumpulan data dilakukan menggunakan kuesioner melalui wawancara terpimpin. Data dianalisis secara univariat dan bivariat. Hasil penelitian menunjukkan faktor yang memiliki hubungan signifikan dengan unmet need IUD post-placenta adalah faktor pengetahuan (p value = 0,001, sedangkan faktor lain yang tidak memiliki hubungan signifikan adalah faktor pendidikan (p value = 0,222, faktor status ekonomi (p value = 1,000, dan faktor konseling KB (p value = 0,583.Kata kunci: faktor yang berhubungan, unmet need, KB pasca-salin, IUD post-placentaAbstractThe women in post-partum period have unmet need rate to contraception, whereas it’s approriate time to start using contraception. One of recent post-partum contraception method is IUD post-placenta. But, only a few women of fertile age couple use this contraception even has known it. The purpose of this study was to determine the factors associated to unmet need of post-partum contraception IUD post-placenta. This survey study with cross sectional design study. The data was collected from January 12 until March 12 2013. The subject were

  9. Metabolic predictors of post-partum disease and culling risk in dairy cattle.

    Science.gov (United States)

    Seifi, Hesam A; Leblanc, Stephen J; Leslie, Ken E; Duffield, Todd F

    2011-05-01

    A retrospective study was conducted to determine the relationship between serum non-esterified fatty acids (NEFA), β-hydroxybutyrate (BHBA), glucose and calcium (Ca) with the occurrence of displaced abomasum (DA), clinical ketosis and culling in Holstein cows. Eight hundred and forty-nine cows from 16 farms were sampled weekly for the first 3 weeks post-partum. The cows were under clinical observation from calving until 60 days in milk (DIM) and during this time there were 22 cases of DA, 31 cases of clinical ketosis and 39 cows were culled. Elevated concentrations of BHBA were associated with DA, clinical ketosis and culling. In the first week after calving, cows with serum BHBA ≥1000μmol/L had 13.6 times greater odds of developing DA than cows with lower values. Serum NEFA and BHBA concentrations during week 1 were associated with the subsequent occurrence of clinical ketosis. The odds of clinical ketosis were 6.3 times greater in cows with serum NEFA ≥ 1.0mmol/L in the first week after calving. In addition, cows with BHB ≥1200μmol/L in the first week after calving, were at 4.7 times greater risk of developing clinical ketosis. In the first and second weeks after calving the serum Ca concentration was associated with subsequent culling. In addition, cows with NEFA concentration ≥ 1.0mmol/L were 3.6 times more likely to be culled within the following 2 months. The study indicated that early post-partum serum BHBA, NEFA and Ca concentrations have potential as indicators of disease and culling risk in dairy cows. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Post-partum depression, anxiety and marital satisfaction: A perspective from Southeastern Nigeria

    Directory of Open Access Journals (Sweden)

    Jaclyn I. Odinka

    2018-03-01

    Full Text Available Background: Many studies have noted the high prevalence of post-partum depression (PPD and anxiety associated with poor marital satisfaction, albeit amidst a dearth of literature on comorbid PPD and anxiety among women in Nigeria. Objective: The study was aimed to assess the prevalence of PPD and anxiety, and to investigate their relationship with marital satisfaction in low-risk women in Enugu, Southeastern Nigeria. Method: A cross-sectional study of 309 randomly selected nursing mothers at two tertiary health institutions. Socio-demographic Questionnaire, Hospital Anxiety and Depression Scale, and Index of Marital Satisfaction (IMS were used to collect data on demography, anxiety and depression and marital relationship respectively. All statistical tests were performed at a significant level of 0.05. Results: The age range of the respondents was 20–46 years; mean and s.d. was 29.65 and ± 4.87, respectively, and most of them were graduates of tertiary educational institutions (74.1%. The prevalence of post-partum anxiety was 31.1% and of PPD was 33.3%. Marital dissatisfaction was observed in 39.5% (122 of the respondents who were mothers. Those with co-morbid depression and anxiety (22.0% had worse marital dissatisfaction. The strongest correlation with depression and anxiety was item 12 of IMS (‘feel that my partner doesn’t confide in me’. Conclusion: There was a high prevalence of marital dissatisfaction, PPD and anxiety among nursing mothers in Enugu, but with low detection rate. The effects of PPD and anxiety on the mother, her marital relationship and her infant make them essential conditions for early diagnosis, prevention and treatments.

  11. Tranexamic acid for treatment of women with post-partum haemorrhage in Nigeria and Pakistan: a cost-effectiveness analysis of data from the WOMAN trial.

    Science.gov (United States)

    Li, Bernadette; Miners, Alec; Shakur, Haleema; Roberts, Ian

    2018-02-01

    Sub-Saharan Africa and southern Asia account for almost 85% of global maternal deaths from post-partum haemorrhage. Early administration of tranexamic acid, within 3 h of giving birth, was shown to reduce the risk of death due to bleeding in women with post-partum haemorrhage in the World Maternal Antifibrinolytic (WOMAN) trial. We aimed to assess the cost-effectiveness of early administration of tranexamic acid for treatment of post-partum haemorrhage. For this economic evaluation we developed a decision model to assess the cost-effectiveness of the addition of tranexamic acid to usual care for treatment of women with post-partum haemorrhage in Nigeria and Pakistan. We used data from the WOMAN trial to inform model parameters, supplemented by estimates from the literature. We estimated costs (calculated in 2016 US$), life-years, and quality-adjusted life-years (QALYs) with and without tranexamic acid, calculated incremental cost-effectiveness ratios (ICERs), and compared these to threshold values in each country. Costs were assessed from the health-care provider perspective and discounted at 3% per year in the base case analysis. We did a series of one-way sensitivity analyses and probabilistic sensitivity analysis to assess the robustness of the results to parameter uncertainty. Early treatment of post-partum haemorrhage with tranexamic acid generated an average gain of 0·18 QALYs at an additional cost of $37·12 per patient in Nigeria and an average gain of 0·08 QALYs at an additional cost of $6·55 per patient in Pakistan. The base case ICER results were $208 per QALY in Nigeria and $83 per QALY in Pakistan. These ICERs were below the lower bound of the cost-effectiveness threshold range in both countries. The ICERs were most sensitive to uncertainty in parameter inputs for the relative risk of death due to bleeding with tranexamic acid, the discount rate, the cost of the drug, and the baseline probability of death due to bleeding. Early treatment of post-partum

  12. Post-partum hemorrhage in women with rare bleeding disorders.

    Science.gov (United States)

    Peyvandi, Flora; Menegatti, Marzia; Siboni, Simona Maria

    2011-02-01

    Post-partum hemorrhage (PPH) accounts for a substantial fraction of maternal deaths in the general population. Among all women, however, those affected with rare bleeding disorders (RBDs) represent a particular group since to usual bleeding symptoms, they are likely to experience bleedings associated to obstetrical and gynaecological problems. Pregnancy and childbirth, two important stages in the life of a woman, pose a special clinical challenge in women with RBDs, since information about these issues are really scarce and limited to few case reports. These data show that all women with RBDs, except for FXI deficiency, have to be considered potentially at risk for developing PPH, therefore they should be monitored carefully during and immediately after pregnancy. The implication is that women with bleeding disorders may require prophylaxis and/or close observation for several weeks and should be followed by a multidisciplinary team including expertises such as laboratory haematologist, obstetrician-gynaecologist, anaesthesiologist, family physician, and laboratory technician. © 2011 Elsevier Ltd. All rights reserved.

  13. Post-partum depression, anxiety and marital satisfaction: A ...

    African Journals Online (AJOL)

    2018-03-22

    Mar 22, 2018 ... 1Department of Psychology, ... The first weeks and months postpartum may be associated with emotional upheaval.2 The nursing ... partum depressive symptoms,14,15,16,17 and marital problems ... reported a significant positive association ... satisfaction, and the importance of mental health promotion.

  14. The role of prenatal, obstetric, and post-partum factors in the parenting stress of mothers and fathers of 9-month old infants.

    Science.gov (United States)

    Matvienko-Sikar, Karen; Murphy, Gillian; Murphy, Mike

    2018-03-01

    The aim of this paper was to examine the role of perinatal, obstetric and post partum factors on maternal and paternal stress. It will present the first examination of the role of prenatal, obstetric, post-partum, and demographic variables in parenting stress for mothers and fathers at 9 months. Data from 6821 parental dyads of 9-month-old infants were extracted from the Growing Up in Ireland National Longitudinal Study of Children. Participants completed the Parental Stress Scale, the Dyadic Adjustment Scale, the Quality of Attachment Sub-scale from the Maternal and Paternal Postnatal Attachment Scales, and a single item health status question from the Short Form 12 Health Survey. Information on prenatal care, pregnancy complications, obstetric outcomes, infant health, and participant demographics were also collected. Separate hierarchical linear regressions were conducted for mothers and fathers Results: Mothers reported higher levels of parenting stress than fathers (p stress was predicted by attachment, own health status, average sleep, occupation, household income, and having a very rapid labor. Paternal parenting stress was predicted by attachment and own health status. A range of perinatal factors was associated with an increased risk of higher parenting stress at 9 months post-partum and the roles of these factors differ between mothers and fathers. These findings are important for predicting and reducing risk of parenting stress in both genders.

  15. Factors involved in the persistence of stress urinary incontinence from pregnancy to 2 years post partum.

    Science.gov (United States)

    Arrue, Miren; Diez-Itza, Irene; Ibañez, Larraitz; Paredes, Jone; Murgiondo, Arantzazu; Sarasqueta, Cristina

    2011-12-01

    To identify factors involved in the persistence of stress urinary incontinence (SUI) from pregnancy to 2 years post partum. In a longitudinal study at Donostia Hospital, San Sebastián, Spain, 458 primigravid women were recruited from April to October 2007. SUI was diagnosed via the 2002 International Continence Society definition. Severity was assessed via the Incontinence Severity Index, and impact on quality of life via the International Consultation on Incontinence Questionnaire. Means (Student t test and analysis of variance) and percentages (χ(2) and Fisher exact tests) were compared, and multiple logistic regression analysis was performed with variables that were significant or close to significant in a univariate analysis (Ppregnancy. Incontinence severity was slight or moderate in most cases and the impact on quality of life was low. A higher body mass index (BMI) in pregnant women at term was the only factor found to be associated with persistent SUI (odds ratio 1.19; 95% confidence interval 1.08-1.32). Higher BMI in pregnant women at term was an independent risk factor for the persistence of SUI from pregnancy to 2 years post partum. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Clinical study on the factors affecting the post-partum recovery of patients with hypertensive pregnancy disorders at a Chinese hospital.

    Science.gov (United States)

    Wei, Jun; Wang, Yan; Xu, Jiayuan; Zhang, Chunfang; Zhou, Helen; Liu, Guoli

    2017-03-01

    The aim of this study was to investigate the post-partum recovery of blood pressure (BP) in women with hypertensive disorders of pregnancy (HDP) and to evaluate HDP risk factors. A total of 124 patients with gestational hypertension (n = 63) or pre-eclampsia (n = 61) who gave birth at Peking University People's Hospital between January and December 2013 were included in this study. The recorded clinical and laboratory parameters included the patients' general information, maternal pre-pregnancy body mass index, gestational weight gain, gestational age at onset and delivery, delivery mode and time taken for BP to return to normal level. Logistic regression analysis was performed to evaluate the influence of various risk factors on post-partum BP recovery. The mean interval for BP normalization was 24.1 ± 22.8 days (median, 7 days). Forty-six percent of the patients recovered from hypertension within three days, and 75% recovered within six weeks of delivery. About 90% of the patients required 60 days for BP to normalize after delivery. After adjusting for confounding factors, post-partum recovery from hypertension was found to be influenced by hypertension severity, maternal serum albumin level, a family history of hypertension and gestational week at delivery. The BP of the majority of the patients with gestational hypertension or pre-eclampsia returned to normal within 60 days of delivery. Hypertension severity, maternal serum albumin level, a family history of family hypertension and gestational week at delivery influenced the time required for BP normalization. © 2016 Japan Society of Obstetrics and Gynecology.

  17. Swedish women's food habits during pregnancy up to six months post-partum: A longitudinal study.

    Science.gov (United States)

    Wennberg, Anna Lena; Isaksson, Ulf; Sandström, Herbert; Lundqvist, Anette; Hörnell, Agneta; Hamberg, Katarina

    2016-06-01

    Diet influences the health of the foetus and the woman during pregnancy and later in life. It is therefore important to investigate pregnant women's food habits. The aim of this study was to describe women's food habits during pregnancy and up to six months post-partum. A Food Frequency Questionnaire (VIP-FFQ) was distributed to 163 pregnant women on five occasions during and after pregnancy. Data were analysed using Friedman's ANOVA and a Bonferroni post-hoc test. Food habits in relation to the National Food Agency's (NFA) food index. The pregnant women's diets were inadequate according to the NFA food index. A tendency towards an even poorer diet after delivery was identified, something which was related to an increased intake of discretionary food, e.g. sweets, cakes, cookies, crisps, ice cream, and decreased intake of fruit and vegetable. The alcohol consumption was low throughout. The food habits during pregnancy were inadequate compared to recommendations and these habits became unhealthier after delivery. These suggest that dietary counselling needs to be more effective and continued into the lactating period. An increased focus should be given to healthy eating from the life course perspective, not just focus on effects on the foetus and pregnancy outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. [Maternal attachment patterns and personality in post partum depression].

    Science.gov (United States)

    Aceti, Franca; Baglioni, Valentina; Ciolli, Paola; De Bei, Francesco; Di Lorenzo, Flavia; Ferracuti, Stefano; Giacchetti, Nicoletta; Marini, Isabella; Meuti, Valentina; Motta, Paola; Roma, Paolo; Zaccagni, Michela; Williams, Riccardo

    2012-01-01

    This study investigates the prevalence of post partum depression (PPD) in a sample of Roman women, and the role of socio-demographic variables, personality structure and maternal attachment patterns, in order to identify primary and secondary prevention strategies. Data were collected in two phases. During the third trimester of pregnancy, a sample of 453 women completed a socio-demographic data sheet and the Edinburgh Postnatal Depression Scale (EPDS). Among the patients scoring 12 or more at EPDS, 15 entered the second phase of the study and completed SCID-II and Adult Attachment Interview. PPD diagnosis was confirmed by the SCID-I. The study group was compared with a control group. Among the 453 women who were evaluated, 92 (20.3%) scored ≥12 at EPDS, 39 has been enrolled and 15 entered the study. Presence of depressive symptoms was associated with: complications in pregnancy, previous psychiatric disorders, family and marital conflicts. 66.6% of depressed mothers showed more than one diagnosis on Axis II (particularly avoidant/dependent + borderline or histrionic + dependent). The AAI showed a prevalence of insecure (33.3%) and unresolved/disorganized (46.6%) attachment pattern in the clinical group. Our results suggest that psychological factors such as personality structure and attachment patterns are not only involved in post natal affective disorders, but have a key role in the onset and development of PPD.

  19. Depressão pós-parto: fatores de risco e repercussões no desenvolvimento infantil Post-partum depression: risk factors and repercussions in infant development

    Directory of Open Access Journals (Sweden)

    Eluisa Bordin Schmidt

    2005-06-01

    Full Text Available A depressão pós-parto é uma condição que afeta 10% a 15% das mulheres no pós-parto. Este quadro tem seu início em algum momento durante o primeiro ano do pós-parto, havendo maior incidência entre a quarta e oitava semana após o parto. Geralmente se manifesta por um conjunto de sintomas como irritabilidade, choro freqüente, sentimentos de desamparo e desesperança, falta de energia e motivação, desinteresse sexual, transtornos alimentares e do sono, ansiedade, sentimentos de incapacidade de lidar com novas solicitações. O objetivo deste artigo é apresentar uma revisão bibliográfica acerca da depressão pós-parto. São abordados aspectos conceituais, epidemiológicos, fatores de risco associados a sua ocorrência e algumas repercussões da depressão pós-parto na relação materno-infantil e no desenvolvimento da criança. O conhecimento destes aspectos reveste-se de grande importância considerando as conseqüências prejudiciais às mães bem como ao desenvolvimento cognitivo, social e emocional de suas crianças.The post-partum depression is a condition that affects 10 to 15% of the women in the post-partum period. These symptoms begin at some moment during the first year after delivery, occurring more frequently between the fourth and eighth week after parturition. It is generally expressed through a complexity of symptoms where there is a presence of irritability, frequent crying, feelings of abandonment and hopelessness, lack of energy and motivation, lack of sexual interest, disturbances in sleep and eating patterns, anxiety, and feelings of not being able to cope with new demands. The objective of this paper is to present a bibliographical revision regarding the post-partum depression. Conceptual and epidemiological aspects, risk factors associated with their occurrence as well as a few repercussions of the post-partum depression in the mother-child relation, and the development of the infant will be broached. The

  20. Beliefs and practices during pregnancy, post-partum and in the first days of an infant's life in rural Cambodia.

    Science.gov (United States)

    Turner, Claudia; Pol, Sreymom; Suon, Kamsan; Neou, Leakhena; Day, Nicholas P J; Parker, Michael; Kingori, Patricia

    2017-04-12

    The aim of this study was to record the beliefs, practices during pregnancy, post-partum and in the first few days of an infant's life, held by a cross section of the community in rural Cambodia to determine beneficial community interventions to improve early neonatal health. Qualitative study design with data generated from semi structured interviews (SSI) and focus group discussions (FGD). Data were analysed by thematic content analysis, with an a priori coding structure developed using available relevant literature. Further reading of the transcripts permitted additional coding to be performed in vivo. This study was conducted in two locations, firstly the Angkor Hospital for Children and secondarily in five villages in Sotnikum, Siem Reap Province, Cambodia. A total of 20 participants underwent a SSIs (15 in hospital and five in the community) and six (three in hospital and three in the community; a total of 58 participants) FGDs were conducted. Harmful practices that occurred in the past (for example: discarding colostrum and putting mud on the umbilical stump) were not described as being practiced. Village elders did not enforce traditional views. Parents could describe signs of illness and felt responsible to seek care for their child even if other family members disagreed, however participants were unaware of the signs or danger of neonatal jaundice. Cost of transportation was the major barrier to healthcare that was identified. In the population examined, traditional practices in late pregnancy and the post-partum period were no longer commonly performed. However, jaundice, a potentially serious neonatal condition, was not recognised. Community neonatal interventions should be tailored to the populations existing practice and knowledge.

  1. [The prevention of depression in pregnancy and the post-partum: when to intervene?].

    Science.gov (United States)

    Iapichino, Elena; Quartieri Bollani, Marta; Cauli, Gilla; Gala, Costanzo

    2012-06-01

    The aim of this paper is to describe the presence of anxious-depressive symptoms and risk factors and discuss the method of intervention used with women in pregnancy and post-partum. The mood of the woman was assessed by the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI), personality traits with the Vulnerable Personality Style Questionnaire (VPSQ) and social support through the Social Provisions Scale (PPS). 50 women have completed the evaluation. In line with the international literature, the presence of anxiety-depressive symptoms is accompanied by the presence of multiple risk factors, in particular the familiar seems to be a predisposing factor.

  2. Use of radioimmunoassay technique for the determination of post-partum ovaric activity in high and low milk production in dairy cows. Actividad ovarica post-parto en vacas de alta y baja produccion lechera usando la tecnica de radioimmunoanalisis (RIA)

    Energy Technology Data Exchange (ETDEWEB)

    Villalba, P [Comision Ecuatoriana de Energia Atomica, Quito (Ecuador); Paneluisa, S; Arcos, E [Facultad de Medicina Veterinaria y Zootecnia, Universidad Central del (Ecuador)

    1993-07-01

    The principal objective of this study was to determinate the post-partum ovarian activity in milking cows of high and low production in one farm of ecuadorian highland. For this experiment was necessary to use 48 animals between second and sith calving, the milk samples were collected according one pre-stablished protocol and the same was: one sample 5th or 6th days, twice a week until the cows were pregnacy and 180 days after parturitium if the cow is open. Additional data were compiled in each farm and both the results of the progesterone by RIA were used to determinate the diferents reproductive parameters in the post-partum of the cows. The most of reproductives parameters in the post-partum of the cows in the both group didn't have significance but the conception rate, services per conception, number of pregnacy cows and percentaje of non visibles heats had one high significance between the treatments.

  3. The effect of tranexamic acid on the risk of death and hysterectomy in women with post-partum haemorrhage: statistical analysis plan for the WOMAN trial.

    Science.gov (United States)

    Shakur, Haleema; Roberts, Ian; Edwards, Philip; Elbourne, Diana; Alfirevic, Zarko; Ronsmans, Carine

    2016-05-17

    Severe haemorrhage is a leading cause of maternal death worldwide. Most haemorrhage deaths occur soon after childbirth. Severe post-partum bleeding is sometimes managed by the surgical removal of the uterus (hysterectomy). Death and hysterectomy are important health consequences of post-partum haemorrhage, and clinical trials of interventions aimed at preventing these outcomes are needed. The World Maternal Antifibrinolytic trial aims to determine the effect of tranexamic acid on death, hysterectomy and other health outcomes in women with post-partum haemorrhage. It is an international, multicentre, randomised trial. Approximately 20,000 women with post-partum haemorrhage will be randomly allocated to receive an intravenous injection of either tranexamic acid or matching placebo in addition to usual care. The primary outcome measure is a composite of death in hospital or hysterectomy within 42 days of delivery. The cause of death will be described. Secondary outcomes include death, death due to bleeding, hysterectomy, thromboembolic events, blood transfusion, surgical and radiological interventions, complications, adverse events and quality of life. The health status and occurrence of thromboembolic events in breastfed babies will also be reported. We will conduct subgroup analyses for the primary outcome by time to treatment, type of delivery and cause of haemorrhage. We will conduct an analysis of treatment effect adjusted for baseline risk. The World Maternal Antifibrinolytic trial should provide reliable evidence for the efficacy of tranexamic acid in the prevention of death, hysterectomy and other outcomes that are important to patients. We present a protocol update and the statistical analysis plan for the trial. Current Controlled Trials ISRCTN76912190 (Registration date 08 December 2008), Clinicaltrials.gov NCT00872469 (Registration date 30 March 2009) and Pan African Clinical Trials Registry: PACTR201007000192283 (Registration date 02 September 2010).

  4. Towards 2015: post-partum haemorrhage in sub-Saharan Africa still on the rise.

    Science.gov (United States)

    Mpemba, Faraja; Kampo, Sylvanus; Zhang, Xinyu

    2014-03-01

    To review literature from 1996-2012 relating to factors associating with the persistent maternal mortality rate (MMR) caused by post-partum haemorrhage (PPH) in sub-Saharan Africa. One woman dies every seven minutes, at the same time, one-quarter of all maternal death worldwide is being caused by PPH. The aim of United Nations Fifth Millennium Development Goal 5 is to lower MMR by three quarters between 1990-2015. Narrative literature review. Study articles from 1996-2012 were searched in electronic databases MEDLINE, Cochrane, PubMED, Google's scholar and manual searches. Combinations of the following search words were used: post-partum haemorrhage/bleeding, sub-Saharan Africa/rural areas, antenatal/obstetric care/maternal mortality/skilled care at birth/maternity care/health survey. 125 article abstracts were read, and 50 full articles used in this review. Every day about 800 women died due to birth complications in 2010: of the 800 maternal deaths worldwide, 440 occurred in sub-Saharan Africa with PPH being the main cause. Common causes of PPH are related to failure of the healthcare system, inaccurate estimation of blood loss after delivery and lack of skills to prevent and manage PPH. Special attention is needed with emphasis on regular attendance of antenatal clinic, proper information concerning pregnancy and delivery, skills to accurate estimate blood loss, and prevention and management of PPH. PPH is the leading cause of MMR in areas where essential care and skilled health attendants are limited. Basic Emergency Obstetric Care and arrangements for timely referral to the big hospital with facilities must be practiced everywhere. This review may help to remind health workers and the government that maternal mortality due to PPH is still higher and more interventions are needed. © 2013 Blackwell Publishing Ltd.

  5. Exploratory analysis of textual data from the Mother and Child Handbook using the text-mining method: Relationships with maternal traits and post-partum depression.

    Science.gov (United States)

    Matsuda, Yoshio; Manaka, Tomoko; Kobayashi, Makiko; Sato, Shuhei; Ohwada, Michitaka

    2016-06-01

    The aim of the present study was to examine the possibility of screening apprehensive pregnant women and mothers at risk for post-partum depression from an analysis of the textual data in the Mother and Child Handbook by using the text-mining method. Uncomplicated pregnant women (n = 58) were divided into two groups according to State-Trait Anxiety Inventory grade (high trait [group I, n = 21] and low trait [group II, n = 37]) or Edinburgh Postnatal Depression Scale score (high score [group III, n = 15] and low score [group IV, n = 43]). An exploratory analysis of the textual data from the Maternal and Child Handbook was conducted using the text-mining method with the Word Miner software program. A comparison of the 'structure elements' was made between the two groups. The number of structure elements extracted by separated words from text data was 20 004 and the number of structure elements with a threshold of 2 or more as an initial value was 1168. Fifteen key words related to maternal anxiety, and six key words related to post-partum depression were extracted. The text-mining method is useful for the exploratory analysis of textual data obtained from pregnant woman, and this screening method has been suggested to be useful for apprehensive pregnant women and mothers at risk for post-partum depression. © 2016 Japan Society of Obstetrics and Gynecology.

  6. The benefits of paid maternity leave for mothers' post-partum health and wellbeing: Evidence from an Australian evaluation.

    Science.gov (United States)

    Hewitt, Belinda; Strazdins, Lyndall; Martin, Bill

    2017-06-01

    This paper investigates the health effects of the introduction of a near universal paid parental leave (PPL) scheme in Australia, representing a natural social policy experiment. Along with gender equity and workforce engagement, a goal of the scheme (18 weeks leave at the minimum wage rate) was to enhance the health and wellbeing of mothers and babies. Although there is evidence that leave, especially paid leave, can benefit mothers' health post-partum, the potential health benefits of implementing a nationwide scheme have rarely been investigated. The data come from two cross-sectional surveys of mothers (matched on their eligibility for paid parental leave), 2347 mother's surveyed pre-PPL and 3268 post-PPL. We investigated the scheme's health benefits for mothers, and the extent this varied by pre-birth employment conditions and job characteristics. Overall, we observed better mental and physical health among mothers after the introduction of PPL, although the effects were small. Post-PPL mothers on casual (insecure) contracts before birth had significantly better mental health than their pre-PPL counterparts, suggesting that the scheme delivered health benefits to mothers who were relatively disadvantaged. However, mothers on permanent contracts and in managerial or professional occupations also had significantly better mental and physical health in the post-PPL group. These mothers were more likely to combine the Government sponsored leave with additional, paid, employer benefits, enabling a longer paid leave package post-partum. Overall, the study provides evidence that introducing paid maternity leave universally delivers health benefits to mothers. However the modest 18 week PPL provision did little to redress health inequalities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Effect of system of lamb rearing and season on early post-partum fertility of ewes and growth performance of lambs in Katahdin sheep.

    Science.gov (United States)

    Rastle-Simpson, S; D'Souza, K; Redhead, A; Singh-Knights, D; Baptiste, Q; Knights, M

    2017-10-01

    The effect of season (S), lamb rearing system (RT) and grain supplementation (GS) on post-partum fertility in Katahdin ewes and growth in Katahdin lambs was evaluated. Katahdin ewes were bred to lamb in fall (n = 36) or spring (n = 56) and at approximately 2.5 months post-partum were randomly assigned to be permanently separated or to continue to suckle their lambs for an additional 3 months. All ewes were joined with rams following treatment to synchronize oestrus. Weaned (W, n = 84) and continuously suckled lambs (CSK, n = 88) were fed forage only (n = 84; hay and pasture for fall- and spring-born lambs respectively) or were supplemented (n = 88; 18% crude protein ration ad libitum) and all weighed biweekly. Ewes rebred in the fall had a shorter ram introduction to lambing interval (p ewes lambing was not affected by season. The first service lambing rate was lower in ewes continuously suckling lambs in the spring, but not in the fall breeding season (S × RT, p = 0.03). Lambs that continuously suckled their dams and were supplemented grew quicker and gained more (p ewes are capable of early rebreeding post-partum while suckling their lambs, which makes them suited for use in accelerated lambing programmes. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

  8. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis.

    Science.gov (United States)

    Daru, Jahnavi; Zamora, Javier; Fernández-Félix, Borja M; Vogel, Joshua; Oladapo, Olufemi T; Morisaki, Naho; Tunçalp, Özge; Torloni, Maria Regina; Mittal, Suneeta; Jayaratne, Kapila; Lumbiganon, Pisake; Togoobaatar, Ganchimeg; Thangaratinam, Shakila; Khan, Khalid S

    2018-05-01

    Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia. Severe anaemia was defined as antenatal or postnatal haemoglobin concentrations of less than 70 g/L in a blood sample obtained before death. Maternal death was defined as death any time after admission until the seventh day post partum or discharge. In regression analyses, we adjusted for post-partum haemorrhage, general anaesthesia, admission to intensive care, sepsis, pre-eclampsia or eclampsia, thrombocytopenia, shock, massive transfusion, severe oliguria, failure to form clots, and severe acidosis as confounding variables. These variables were used to develop the propensity score. 312 281 women admitted in labour or with ectopic pregnancies were included in the adjusted multilevel logistic analysis, and 12 470 were included in the propensity score regression analysis. The adjusted odds ratio for maternal death in women with severe anaemia compared with those without severe anaemia was 2·36 (95% CI 1·60-3·48). In the propensity score analysis, severe anaemia was also associated with maternal death (adjusted odds ratio 1·86 [95% CI 1·39-2·49]). Prevention and treatment of anaemia during pregnancy and post partum should remain a global public health and research priority. Barts and the London Charity. Copyright This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium

  9. Cavitating lung disease due to concomitant drug resistant tuberculosis and invasive pulmonary Aspergillosis in a post-partum patient: A case report.

    Science.gov (United States)

    Ray, Animesh; Suri, J C; Sen, M K; Chakrabarti, S; Gupta, Ayush; Capoor, Malini

    2015-01-01

    Many disorders can present as cavitating lesions in the lung. In this case report, a case of mixed infection with drug resistant tuberculosis and invasive pulmonary aspergillosis in a post-partum patient has been presented. Copyright © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  10. Untersuchungen zur Involution der Vagina and Zervix beim Rind post partum unter Berücksichtigung der Zervix als Geburtshindernis

    OpenAIRE

    Wehrend, Axel

    2002-01-01

    Ziel der vorliegenden Arbeit war es die physiologische Involution der Zervix im Vergleich zur Vagina beim Rind während der ersten zehn Tage post partum zu charakterisieren. Weiterhin sollte durch klinische Untersuchungen an Kühen nach Dystokie und einer retrospektiven Datenauswertung von Schwergeburten unterschiedlicher Tierarten der Anteil zervikal bedingter Geburtsstockungen im Interspeziesvergleich analysiert und Einflussfaktoren auf das Auftreten dieser Dystokieform sowie Störungen in der...

  11. Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks.

    Science.gov (United States)

    Lamarca, Gabriela A; Leal, Maria do C; Leao, Anna T T; Sheiham, Aubrey; Vettore, Mario V

    2012-01-13

    Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks. A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group--employed women with paid work, and, 2. home-based social network group--women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class. There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥ 4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥ 4 [OR 1.73 (95% CI: 1.23-2.42)]. Pregnant and post-partum Brazilian women in paid

  12. Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks

    Science.gov (United States)

    2012-01-01

    Background Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks. Methods A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group - employed women with paid work, and, 2. home-based social network group - women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class. Results There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥4 [OR 1.73 (95% CI: 1.23-2.42)]. Conclusions Pregnant and post-partum

  13. Supplemental fish oil does not alter immune competence or the pathophysiological response to an intramammary infusion of endotoxin in peri-partum multiparous Holstein cows.

    Science.gov (United States)

    Ballou, Michael A; Gomes, Rodrigo C; DePeters, Edward J

    2009-05-01

    The objective was to determine the effects of supplementing the diet with fish oil during the peri-partum period on the immune competence and the pathophysiological response to a lipopolysaccharide-induced mastitis challenge. Multiparous Holstein cows (n=30) were completely randomized to one of two treatments at 3 weeks pre-partum. Treatments differed only in the source of supplemental lipid and included either Energy Booster or fish oil. Treatment diets were fed from -21 d relative to expected date of parturition until 10 d post partum. Treatments were fed as a bolus prior to the a.m. feeding. The dose of lipid during the pre-partum period was 250 g/d, whereas the amount of lipid supplemented post partum was adjusted to the level of intake, approximately 0.92% of the previous day's dry matter intake. Ex-vivo analyses of immune competence were measured including the antimicrobial activity of whole blood against Escherichia coli, Salmonella typhimurium and Candida albicans as well as the production of interferon-gamma by peripheral blood mononuclear cultures. At 7 days in milk cows were infused with 100 microg of Esch. coli lipopolysaccharide into one rear quarter. Supplementing fish oil increased plasma concentrations of eicosapentaenoic and docosahexaenoic acids, but had no affect on the proportions of arachidonic acid at calving. Fish oil did not influence the production of interferon-gamma or the antimicrobial activity of whole blood against any of the microorganisms. Furthermore, fish oil had no ameliorative effect on either the local or the systemic acute phase response following an intramammary lipopolysaccharide challenge in early lactating Holstein cows. Supplementing fish oil in the diet of peri-partum cows will not protect them from deleterious effects of an excessive acute phase response.

  14. [Early post-partum discharges: benefits, disadvantages and implementation methodology].

    Science.gov (United States)

    Berkane, N

    2015-02-01

    Early post-partum discharges (EPD) are a hot topic. Already widely practised in many European countries this procedure, was promoted by the government for a decade, requested by representatives of Midwive organisations, desired by some patients, but also criticized by the Academy of Medicine. Well organized and with an obligatory control and follow-up, EPD could help with the management of the shortage of maternity beds and hence increase the satisfaction of the patients. The procedure could even be a way to effectively implement a town-hospital network, something, which has many other benefits. However this procedure is not without potential dangers: lower quality of care, financial risks for the department, and especially a significant increase of the workload of the hospital staff. The main objective of this paper is to detail the benefits and disadvantages of EPD for maternities and to propose an organizational basis if EPD is the procedure of choice. A participatory methodology is essential when using this procedure, due to the important participation of different categories of staff involved in hospital discharge (administrative, medical and paramedical staff) and to exclude complications when certain specifications are not followed or misunderstood. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  15. Distribution of causes of maternal mortality during delivery and post-partum: results of an African multicentre hospital-based study.

    Science.gov (United States)

    Thonneau, Patrick F; Matsudai, Tomohiro; Alihonou, Eusèbe; De Souza, Jose; Faye, Ousseynou; Moreau, Jean-Charles; Djanhan, Yao; Welffens-Ekra, Christiane; Goyaux, Nathalie

    2004-06-15

    To assess the maternal mortality ratio in maternity units of reference hospitals in large west African cities, and to describe the distribution of complications and causes of maternal deaths. Prospective descriptive study in twelve reference maternities located in three African countries (Benin, Ivory Coast, Senegal). Data (clinical findings at hospital entry, medical history, complications, type of surgery, vital status of the women at discharge) were collected from obstetrical and surgical files and from admission hospital registers. All cases of maternal deaths were systematically reviewed by African and European staff. Of a total of 10,515 women, 1495 presented a major obstetric complication with dystocia or inappropriate management of the labour phase as the leading cause. Eighty-five maternal deaths were reported, giving a global hospital-based maternal mortality ratio of 800/100,000. Hypertensive disorders were involved in 25/85 cases (29%) and post-partum haemorrhage in 13/85 cases (15%). Relatively few cases (14) of major sepsis were reported, leading to three maternal deaths. The results of this multicentre study confirm the high rates of maternal mortality in maternity units of reference hospitals in large African cities, and in addition to dystocia the contribution of hypertensive disorders and post-partum haemorrhage to maternal deaths.

  16. Prevalence and risk factors of childbirth-related post-traumatic stress symptoms.

    Science.gov (United States)

    Modarres, Maryam; Afrasiabi, Sedigheh; Rahnama, Parvin; Montazeri, Ali

    2012-09-03

    There is evidence that traumatic birth experiences are associated with psychological impairments. This study aimed to estimate the prevalence of childbirth-related post-traumatic stress symptoms and its obstetric and perinatal risk factors among a sample of Iranian women. This was a cross-sectional study carried out in Bushehr, Iran during a 3-months period from July to September 2009. Data were collected from all women attending eleven healthcare centers for postnatal care 6 to 8 weeks after childbirth. Those who had a traumatic delivery were identified and entered into the study. In order to assess childbirth-related post-traumatic stress, the Post-traumatic Symptom Scale-Interview (PSS-I) was administered. Data on demographic, obstetric and perinatal characteristics also were collected. Multivariate logistic regression was performed to examine the association between childbirth-related post-traumatic stress and demographic and obstetric and perinatal variables. In all, 400 women were initially evaluated. Of these, 218 women (54.5%) had a traumatic delivery and overall, 80 women (20%) were found to be suffering from post-partum post-traumatic stress disorder (PTSD). Multiple logistic regression analysis revealed that post-partum PTSD was associated with educational level, gestational age at delivery, number of prenatal care visits, pregnancy complications, pregnancy intervals, labor duration, and mode of delivery. The findings indicated that the prevalence of traumatic birth experiences and post-partum PTSD were relatively high among Iranian women. The findings also indicated that obstetric and perinatal variables were independently the most significant contributing factors to women's post-partum PTSD. It seems that a better perinatal care and supportive childbirth might help to reduce the burden of post-partum PTSD among this population.

  17. Myometrial cavernous hemangioma with pulmonary thromboembolism in a post-partum woman: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Bhavsar Tapan

    2012-11-01

    Full Text Available Abstract Introduction Cavernous hemangiomas of the uterus are rare benign vascular lesions. Nine cases of diffuse cavernous hemangioma of the gravid uterus have been reported, most of which diffusely involved the myometrium. These vascular malformations are clinically significant, and may cause pronounced bleeding resulting in maternal or fetal demise. Thrombosis of cavernous hemangiomas of the uterus has been previously reported. We here report the first case in which a thrombosed cavernous hemangioma of the myometrium resulted in a fatal pulmonary embolism in a post-partum woman. Case presentation A 25-year-old obese African-American woman who had one pregnancy and was delivered of twins by cesarean section was admitted 1 week after the successful delivery. The 12-day clinical course included ventilator-dependent respiratory failure, systemic hypertension, methicillin-resistant Staphylococcus aureus in the sputum, leukocytosis and asystole. A transabdominal ultrasound examination showed heterogeneous thickened and irregular products in the endometrial canal. The laboratory values were relevant for an increased prothrombin time, activated partial thromboplastin time, ferritin and a decrease in hemoglobin. The clinical cause of death was cited as acute respiratory distress syndrome. At autopsy, a 400g spongy, hemorrhagic uterus with multiple cystic spaces measuring approximately 0.5 × 0.4cm filled with thrombi within the myometrium was identified. Immunohistological examination with a CD31 stain for vascular endothelium associated antigen confirmed several endothelium-lined vessels, some of which contained thrombi. These histological features were consistent with cavernous hemangioma of the myometrium. A histological examination of the lungs revealed multiple fresh thromboemboli in small- and medium-sized pulmonary arteries in the right upper and lower lobes without organization, but with adjacent areas of fresh hemorrhagic infarction

  18. Myometrial cavernous hemangioma with pulmonary thromboembolism in a post-partum woman: a case report and review of the literature.

    Science.gov (United States)

    Bhavsar, Tapan; Wurzel, John; Duker, Nahum

    2012-11-23

    Cavernous hemangiomas of the uterus are rare benign vascular lesions. Nine cases of diffuse cavernous hemangioma of the gravid uterus have been reported, most of which diffusely involved the myometrium. These vascular malformations are clinically significant, and may cause pronounced bleeding resulting in maternal or fetal demise. Thrombosis of cavernous hemangiomas of the uterus has been previously reported. We here report the first case in which a thrombosed cavernous hemangioma of the myometrium resulted in a fatal pulmonary embolism in a post-partum woman. A 25-year-old obese African-American woman who had one pregnancy and was delivered of twins by cesarean section was admitted 1 week after the successful delivery. The 12-day clinical course included ventilator-dependent respiratory failure, systemic hypertension, methicillin-resistant Staphylococcus aureus in the sputum, leukocytosis and asystole. A transabdominal ultrasound examination showed heterogeneous thickened and irregular products in the endometrial canal. The laboratory values were relevant for an increased prothrombin time, activated partial thromboplastin time, ferritin and a decrease in hemoglobin. The clinical cause of death was cited as acute respiratory distress syndrome. At autopsy, a 400g spongy, hemorrhagic uterus with multiple cystic spaces measuring approximately 0.5 × 0.4cm filled with thrombi within the myometrium was identified. Immunohistological examination with a CD31 stain for vascular endothelium associated antigen confirmed several endothelium-lined vessels, some of which contained thrombi. These histological features were consistent with cavernous hemangioma of the myometrium. A histological examination of the lungs revealed multiple fresh thromboemboli in small- and medium-sized pulmonary arteries in the right upper and lower lobes without organization, but with adjacent areas of fresh hemorrhagic infarction. This case underscores the importance of a high index of suspicion in

  19. Post-partum depression in Kinshasa, Democratic Republic of Congo: validation of a concept using a mixed-methods cross-cultural approach.

    Science.gov (United States)

    Bass, Judith K; Ryder, Robert W; Lammers, Marie-Christine; Mukaba, Thibaut N; Bolton, Paul A

    2008-12-01

    To determine if a post-partum depression syndrome exists among mothers in Kinshasa, Democratic Republic of Congo, by adapting and validating standard screening instruments. Using qualitative interviewing techniques, we interviewed a convenience sample of 80 women living in a large peri-urban community to better understand local conceptions of mental illness. We used this information to adapt two standard depression screeners, the Edinburgh Post-partum Depression Scale and the Hopkins Symptom Checklist. In a subsequent quantitative study, we identified another 133 women with and without the local depression syndrome and used this information to validate the adapted screening instruments. Based on the qualitative data, we found a local syndrome that closely approximates the Western model of major depressive disorder. The women we interviewed, representative of the local populace, considered this an important syndrome among new mothers because it negatively affects women and their young children. Women (n = 41) identified as suffering from this syndrome had statistically significantly higher depression severity scores on both adapted screeners than women identified as not having this syndrome (n = 20; P depression and validated instruments to screen for this disorder. As the importance of compromised mental health in developing world populations becomes recognized, the methods described in this report will be useful more widely.

  20. Changes in lymphocyte subsets during pregnancy and post-partum in cases of beginning eclampsia.

    Science.gov (United States)

    Kühnert, M; Schmidt, S

    2000-01-01

    The goal of the present retrospective study was to examine the peripheral blood lymphocytes for expression of phenotypic and activation markers concerning the development of hypertension in pregnancy. 16 women (aged 25-43 years; mean 35.1) developing hypertension in the third trimester (week 25-34) have had blood samples taken in the first (post-partum, The control group consisted of 16 age-matched pregnant healthy women, who underwent the same regime. All blood samples were taken in the morning, stored at room temperature and stained within 6 hours and measured within 24 hours. Kruskal-Wallis analysis of variance between both groups was done with multiple comparison according to Dunn. Comparing both groups, the total white cell count was significantly increased in all pregnancies and post-partum. In case of hypertension in pregnancy the cell numbers of suppressor/cytotoxic (CD 8+) and CD 56(+)-activated T cells showed a significant increase in the first trimester (< 14 weeks) [p < 0.05] and decreased thereafter to normal values. In the second trimester (week 14-23) helper/inducer lymphocytes and CD 56+/CD 3+ lymphocytes decreased in case of pre-ecclampsia and cytotoxic lymphocytes elevated [p < 0.05]. In the third trimester (week 24-35) there was no difference in both study groups and in late pregnancy (week 36-termination) there were only small differences without statistical significance. Within 1 week postnatal the value of Il-2 receptor T lymphocytes decreased in the group of pre-eclampsia in comparison to normal pregnancies [p < 0.05]. Regarding the major changes in activated T cells in both study groups no specific pattern of lymphocyte subsets in case of pre-eclampsia could be found in comparison to healthy pregnant women. Further investigations should focus on functional activation and/or suppression of the cellular immune system. Perhaps this could lead to a screening test for pre-eclampsia in future, which is non-invasive for the patient and economic for

  1. Narrating Motherhood as Experience and Institution: Experimental Life-Writing in Mary Kelly’s Post-Partum Document (1973–79

    Directory of Open Access Journals (Sweden)

    Wierzchowska Justyna

    2015-12-01

    Full Text Available This article explores American visual artist Mary Kelly’s autobiographical work Post-partum document in reference to the politics of life writing. Resorting to Lacanian psychoanalysis, a pastiche of scientific narratives and other (auto-narrative strategies, in her work Kelly documented the first five years of her son’s life from his weaning from the breast until the day when he wrote his name. By documenting her child’s development, the artist also recorded the process of her own formation as a maternal subject, a formation gradually worked out through an evolving relationship with her son. In her work, the artist made vivid the incompatibility and limitations of various narrative frameworks in retelling a fundamentally relational experience that verges on the mental and bodily, and which is necessarily mediated by the patriarchal ideology. This article analyses Kelly’s conflicting narrative strategies that fail to successfully represent the mother-child formative relationship and which demonstrate the mother’s ideological alienation. It reads Kelly’s work politically, exploring the ways in which Post-partum document’s (auto-narrative voices address questions and dilemmas of the feminine/maternal subject, the subject’s formation, and the limits of its (self- representation within patriarchy. The article argues that Kelly challenges the traditional autobiographic genre by attending to her lived experience as a mother and the culturally repressed maternal desire.

  2. Panic disorder as a risk factor for post-partum depression: Results from the Perinatal Depression-Research & Screening Unit (PND-ReScU) study.

    Science.gov (United States)

    Rambelli, C; Montagnani, M S; Oppo, A; Banti, S; Borri, C; Cortopassi, C; Ramacciotti, D; Camilleri, V; Mula, M; Cassano, G B; Mauri, M

    2010-04-01

    Although the role of anxiety disorders on the development of Post-partum Depression (PPD) have already been studied in literature, that of individual anxiety disorders has not received specific attention. The aim of this study is to investigate the role of Panic Disorder (PD) and family history for PD as risk factors for PPD. Six hundred women were recruited in a prospective, observational study at the 3rd month of pregnancy and followed up until the 6th month after delivery. At baseline, risk factors for PPD, Axis-I disorders and family history for psychiatric disorders were assessed. We investigated minor and major depression (mMD) occurred at 1st, 3rd and 6th months post-partum. Logistic regression models were used to estimate the association between PD, family history for PD and PPD. Forty women had mMD in the post-partum. PD during pregnancy (RR=4.25; 95%CI:1.48-12.19), a history of PD (RR 2.47; 95%CI:1.11-5.49) and family history for PD (RR=2.1; 95%CI:1.06-4.4) predicted PPD after adjusting for lifetime depression and risk factors for PPD. The response rate is moderately low, but it is similar to other studies. The drop out rate is slightly high, however the 600 women who completed the 6th month follow-up did not differ from the presence of PD at baseline. PD is an independent risk factor for PPD, underscoring need to assess PD symptoms during pregnancy. Furthermore, PD represents an important risk factor for the development of PPD and should be routinely screened in order to develop specific preventive interventions. Copyright 2009 Elsevier B.V. All rights reserved.

  3. Case of a woman with acromegaly whose presenting complaint was prolonged post-partum amenorrhea.

    Science.gov (United States)

    Hara, Tomomi; Kanasaki, Haruhiko; Oride, Aki; Moriyama, Masayuki; Kyo, Satoru

    2016-10-01

    We report a case of a woman who was incidentally diagnosed with acromegaly after referral for prolonged post-partum amenorrhea. A 25-year-old woman, gravida 2 para 1, had a normal transvaginal delivery and breastfeeding had been discontinued more than a year after delivery. Thereafter, spontaneous menstruation did not restart and she underwent hormonal therapy. Subsequently, she was referred to our university hospital for prolonged amenorrhea. Hormonal examination revealed severe hypogonadotropic hypogonadism (luteinizing hormone 0.5 mIU/mL, follicle-stimulating hormone amenorrhea, which revealed mass lesions extending from the pituitary fossa to the suprasellar area with similar signal intensity as the gray matter. In addition, bitemporal hemianopsia was observed on campimetry. After further examination, the patient was diagnosed with acromegaly. © 2016 Japan Society of Obstetrics and Gynecology.

  4. Effect of restricted suckling upon post-partum reproductive activity in sheep

    International Nuclear Information System (INIS)

    Lopez Barbella, S.F.; Martinez Guillen, N.D.; Combellas, J.B. de; Rondon Morales, Z.

    1990-01-01

    The post-partum reproductive performance of adult West African ewes of proven fertility was studied to assess the beneficial effect of both 14 and 18 h restricted nursing or early weaning (35 days post-lambing) on the resumption of ovarian function and conception rate at first oestrus. Although the interval from lambing to first oestrus and/or conception in the 14 h nursing (55.13±11.03 days), 18 h nursing (65.00±15.65 days) and control (59.00±13.48 days) groups did not differ, the percentage of ewes that showed oestrus (90, 60 and 50% respectively) favoured the treatment with the shortest nursing time. When lambs were weaned early, the interval from lambing to oestrus (61.40±16.50 days) did not differ significantly from that for the 14 h nursing ewes (70.10±19.37 days) but tended to be lower than for the controls (94.25±62.38 days). Since differences in response were assumed to be dependent on body condition of the individual ewes at the time of lambing, and body weight changes of the dams after lambing were correlated with progesterone hormone, plasma proteins, glucose and free fatty acids, it was assumed that the beneficial effects of the treatments on the reproductive parameters were due to the partition of nutrients towards restoration of body reserves and subsequently to the secretion of progesterone. (author). 27 refs, 2 figs, 3 tabs

  5. Stratégie transfusionnelle des hémorragies graves du post-partum: étude rétrospective à propos de 47 cas

    Science.gov (United States)

    Khouadja, Hosni; Rouissi, Wissem; Mahjoub, Mohamed; Sakhri, Jaballah; Beletaifa, Dhafer; Jazia, Khaled Ben

    2016-01-01

    Introduction L’hémorragie du post-partum est la principale cause de morbi-mortalité maternelle dans le monde. La prise en charge est multidisciplinaire. La stratégie transfusionnelle est capitale jouant un rôle majeur dans le pronostic maternel. L’objectif de ce travail a été de déterminer le rapport PFC/CGR lors de la prise en charge des hémorragies graves du post-partum. Méthodes Une étude Etude rétrospective sur une période de 4 ans (2009-2012) a été réalisée dans un centre de maternité de référence de niveau III du centre-Est tunisien. Elle a inclut les parturientes admises pour une hémorragie sévère du post-partum définit par la nécessité d’une transfusion de plus de 04 CGR durant les 3 premières heures ou de plus de 10 CGR durant les 24 premières heures de prise en charge. Résultats Notre étude a inclut 47 parturientes. Le diagnostic de l’HPP a été fait devant un saignement vaginal dans 28 cas et suite à une césarienne dans 19 cas. En préopératoire le taux d’Hb a été de 6.3 g/dl. Le rapport transfusionnel (PFC/CGR) a été de 1/0.7. Conclusion Au cours de notre prise en charge, le rapport transfusionnel a été plus élevé que les recommandations récentes de la littérature stipulant une administration précoce et massive de PFC avec un ratio PFC/CGR compris entre 1/2 et 1/1. L’administration du fibrinogène (Fbg) et de l’acide tranexamique doit être précoce. L’emploi du facteur VII activé recombinant (rFVIIa) doit rester une solution ultime de prise en charge. PMID:28292131

  6. Dextromethorphan Reduces Postoperative Pain of Post Partum Tubal Ligation under General Anesthesia

    Directory of Open Access Journals (Sweden)

    N. Manochehrian

    2009-04-01

    Full Text Available Introduction & Objective: Postoperative pain has harmful effects in many systems. Dextromethorphan reduces postoperative pain in post partum tubal ligation under general anesthesia. Materials & Methods: In this research 40 patients with ASA class I and II in double blind randomized clinical trial were studied in two groups. 90 minutes before surgery the patients received 90 mg dextromethorphan or placebo (oral. The patients induced general anesthesia with thiopental (5mg/kg, fentanyl 1.5 g/kg and succinylcholin(1-1.5 mg/kg and maintenance with halothane and N2O 50%. Patients were observed studied for analgesic requirement, nausea, vomiting, urinary retention and respiratory depression in recovery and 2,4,8 and 24 hours after surgery. Results: There was no significant difference in age, education, . . . Pain in recovery, 2 and 4 hours after surgery in dextromethorphan was less than placebo group. The analgesic requirement (pethidine in dextromethophan was less than placebo group.Conclusion: Administration of 90 mg dextromethorphan 90 minutes before the surgery under GA reduces pain in recovery time , 2 and 4 hours after the surgery.

  7. Traditional Practices of Mothers in the Postpartum Period: Evidence ...

    African Journals Online (AJOL)

    USER

    In various cultures, the postpartum period is a sensitive time and various ... femmes au cours des huit premières semaines du post-partum qui se sont ..... For instance, in cultures such as those in India,. China ..... Asia Pacific Journal of Clinical.

  8. Antenatal dietary patterns and depressive symptoms during pregnancy and early post-partum.

    Science.gov (United States)

    Baskin, Rachel; Hill, Briony; Jacka, Felice N; O'Neil, Adrienne; Skouteris, Helen

    2017-01-01

    Perinatal depression is a debilitating disorder experienced during pregnancy and/or the first year post-partum. Recently, maternal dietary intake during pregnancy has emerged as a possible area of intervention for the prevention of mental disorders in women and their offspring. However, the relationship between antenatal diet quality and perinatal depressive symptoms remains poorly understood. The current study explored the predictive role of antenatal diet quality for antenatal and post-natal depressive symptoms. Pregnant women (n = 167) were recruited between February 2010 and December 2011. Women completed the Edinburgh Postnatal Depression Scale at time 1 [T1, mean weeks gestation = 16.70, standard deviation (SD) = 0.91], time 2 (T2, mean weeks gestation = 32.89, SD = 0.89) and time 3 (T3, mean weeks post-partum = 13.51, SD = 1.97) and a food frequency questionnaire at T1 and T2. Diet quality was determined by extracting dietary patterns via principal components analysis. Two dietary patterns were identified: 'healthy' (including fruit, vegetables, fish and whole grains) and 'unhealthy' (including sweets, refined grains, high-energy drinks and fast foods). Associations between dietary patterns and depressive symptoms were investigated by path analyses. While both 'healthy' and 'unhealthy' path models showed good fit, only one significant association consistent with study hypotheses was found, an 'unhealthy' diet was associated with increased depressive symptoms at 32 weeks gestation. Given that this association was cross-sectional, it was not possible to make any firm conclusions about the predictive nature of either dietary patterns or depressive symptoms. Dietary intervention studies or larger prospective studies are therefore recommended. © 2015 John Wiley & Sons Ltd.

  9. Identifying the support needs of fathers affected by post-partum depression: a pilot study.

    Science.gov (United States)

    Letourneau, N; Duffett-Leger, L; Dennis, C-L; Stewart, M; Tryphonopoulos, P D

    2011-02-01

    The purpose of this pilot study was to describe the experiences, support needs, resources, and barriers to support for fathers whose partners had post-partum depression (PPD) in preparation for a larger study. Qualitative methods and community-based research approaches were used in this exploratory/descriptive multi-site study, conducted in New Brunswick and Alberta. Telephone interviews were conducted with a total of 11 fathers in New Brunswick (n= 7) and Alberta (n= 4). Fathers experienced a number of depressive symptoms including: anxiety, lack of time and energy, irritability, feeling sad or down, changes in appetite, and thoughts of harm to self or baby. The most common barriers for fathers were lack of information regarding PPD resources and difficulty seeking support. This pilot study establishes the feasibility of the larger-scale exploration of fathers' experiences in supporting their spouses affected by PPD. © 2010 Blackwell Publishing.

  10. A rare case of peripartum cardiomyopathy posted for caesarean section

    Directory of Open Access Journals (Sweden)

    Nalini Kotekar

    2007-01-01

    Full Text Available Post Partum Cardiomyopathy (PPCM is a relatively rare form of heart failure associated with pregnancy. It was recognized first in the 19th century by Ritchie and is defined as the onset of acute heart failure in the last trimester or early post partum period in the absence of infections, metabolic, toxic, ischaemic or valvular causes of myocardial dysfunction. Prognosis depends on the degree of cardiomegaly at presentation and in the following 6 months. Initial high risk period carries a mortality of 25 to 50%. Keeping in mind the reduced contractility and ejection fraction with ventricular dilatation proceeding to cardiac failure, the anesthesiologist managing a case of PPCM faces the challenge of avoiding myocardial depression, hypovolemia and increased SVR, all of which may be hazardous

  11. Developing, implementing and evaluating a simulation learning package on post-partum haemorrhage for undergraduate midwifery students in KwaZulu-Natal*

    Directory of Open Access Journals (Sweden)

    Hafaza B. Amod

    2017-10-01

    Full Text Available Background: The training of undergraduate midwifery students to identify and manage post-partum haemorrhage, is an essential skill in midwifery. Aim: The aim of this study was to develop, implement and evaluate a simulation learning package (SLP on post-partum haemorrhage for undergraduate midwifery students using high fidelity simulation without risks to real-life patients. Methods: An exploratory sequential mixed methodology was used in this study. The study was made up of three phases namely; the development, implementation and evaluation of the learning package. The research participants were fourth year baccalaureate of nursing midwifery students and midwifery experts involved in teaching midwifery. Data was collected using an evaluation checklist for experts, a student satisfaction survey and focus group sessions. Quantitative data were analysed using SPSS Version 23.0 and the qualitative data was analysed using content analysis as described by Graneheim and Lundman(2004. Results: The evaluation checklist for experts revealed that the developed SLP was considered suitable for undergraduate students. It encouraged active learning, teamwork and accommodated diverse learning styles. The package was easy to use and offered opportunities for student feedback. The student satisfaction survey revealed that the pre-simulation support received was adequate and helpful, and the post simulation outcomes showed that using high fidelity simulation improved clinical skills, knowledge, critical thinking, self-confidence and satisfaction. The focus group sessions revealed that the SLP was an innovative and interactive method of learning; it improved the student's perception of their clinical competence, stimulated critical thinking and increased self-confidence. Conclusion: A simulation learning package, that uses high fidelity simulation, can be an innovative and interactive method to teach midwifery emergencies.

  12. A violência doméstica como indicador de risco no rastreamento da depressão pós-parto Domestic violence as a risk factor in the screening of for post-partum depression

    Directory of Open Access Journals (Sweden)

    Rosiane Mattar

    2007-09-01

    Full Text Available OBJETIVO: apurar a freqüência de risco para depressão pós-parto (DP em puérperas de hospital de São Paulo, região Sudeste do Brasil, e determinar fatores associados - entre eles a violência doméstica (VD. MÉTODOS: estudo descritivo, tipo corte transversal. Participaram 133 mulheres, que tiveram partos com idade gestacional de 20 semanas ou mais, no período de agosto a setembro de 2005, em maternidade terciária em São Paulo (Brasil. Foram entrevistadas empregando-se a versão em português do Abuse Assessment Screen para o diagnóstico de violência e responderam questionário de auto-avaliação do risco de DP (Edinburgh Postnatal Depression Scale. As variáveis foram representadas por freqüências absoluta e relativa. A associação entre as variáveis de interesse e DP foi avaliada pelo teste do chi2 ou exato de Fisher. Adotou-se o nível de significância de 5%. RESULTADOS: o risco de DP foi identificado em 24 puérperas (18%. Das mulheres entrevistadas, 38,3% referiram história de abusos. Observou-se associação entre a ocorrência de VD após os 15 anos de idade e o risco de depressão (p=0,03. A ocorrência de abusos no grupo de mulheres com probabilidade de apresentar DP foi de 58,3%, proporção significativamente maior do que a observada no grupo controle com 33,9%. CONCLUSÕES: a probabilidade de apresentar depressão foi alta entre as puérperas assistidas em maternidade terciária da região Sudeste do Brasil. A VD sofrida após os 15 anos de idade esteve estatisticamente associada ao risco de DP.PURPOSE: to assess the prevalence of the risk of post-partum depression in women in the post-natal ward of a hospital in São Paulo city, in the southeastern region of Brazil, and analyze the associated factors, including domestic violence (DV. METHODS: this was a descriptive, cross-sectional study. The participants were 133 women with at least 20 weeks of gestation age, who delivered their babies from August to September

  13. A field study of postpartum period of dairy cows by rectal palpation and progesterone profiles in the milk by radioimmunoassay

    International Nuclear Information System (INIS)

    Kozicki, Luis Ernandes; Silva, Marcelo Alves da; Woellner, Luis Carlos; Shibata, Flavia Kazumi

    1998-01-01

    This study was carried out on 18 calved dairy cows, near the town of Curitiba-PR-Brazil. The animals were submitted weekly to a rectal palpation of the genital tract and the uterine involution and ovarian activity were considered. The rectal palpations began from the 7 th day postpartum till the 49 th day. at the same milk samples the first morning milk were taken on the 9 th week. The progesterone (P 4 ) level determination of the milk was established by radioimmunoassay. The findings of the research showed: the postpartum oestrus was observed at the 28.5 th day and the corpus luteum was detected on the 34.5 th day. The period from oestrus to the first high progesterone level post partum was 5.5 days. The uterine involution period was carried on the 24.1 th day. The progesterone dominant period was shorter and had duration of 11.5 days on the first oestrus cycle post partum. The progesterone concentration from the first Corpus luteum post partum was low (1.9 ng/ml milk). The anoestrus rate until 49 th day postpartum was 33.3% and the silent heat rate reached 61.1%. (author)

  14. Diagnosis of post-partum ovarian vein thrombophlebitis by color Doppler ultrasonography: about 10 cases.

    Science.gov (United States)

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

    1997-09-01

    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.

  15. Social support and parenting self-efficacy among Chinese women in the perinatal period.

    Science.gov (United States)

    Gao, Ling-Ling; Sun, Ke; Chan, Sally Wai-Chi

    2014-05-01

    to examine the changes in and relationship between perceived social support and parenting self-efficacy in the perinatal period among pregnant women in mainland China. this was a secondary analysis with data from part of an experimental study of the effects of an interpersonal-psychotherapy-oriented childbirth psychoeducation programme on maternal adaptation. A longitudinal design was employed in the present study. The study was carried out from July 2008 to May 2009 in one general hospital in Guangzhou, China. a convenience sample of 68 first-time mothers in mainland China completed measurement of social support and parenting self-efficacy during pregnancy and at six weeks and three months post partum. perceived social support and parenting self-efficacy declined during early motherhood. Parenting self-efficacy increased from six weeks post partum to three months post partum. Perceived social support positively correlated with parenting self-efficacy. culturally competent health-care intervention should be developed during early motherhood to promote perceived social support and parenting self-efficacy for the new mothers. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Promoting male partner HIV testing and safer sexual decision making through secondary distribution of self-tests by HIV-negative female sex workers and women receiving antenatal and post-partum care in Kenya: a cohort study.

    Science.gov (United States)

    Thirumurthy, Harsha; Masters, Samuel H; Mavedzenge, Sue Napierala; Maman, Suzanne; Omanga, Eunice; Agot, Kawango

    2016-06-01

    Increased uptake of HIV testing by men in sub-Saharan Africa is essential for the success of combination prevention. Self-testing is an emerging approach with high acceptability, but little evidence exists on the best strategies for test distribution. We assessed an approach of providing multiple self-tests to women at high risk of HIV acquisition to promote partner HIV testing and to facilitate safer sexual decision making. In this cohort study, HIV-negative women aged 18-39 years were recruited at two sites in Kisumu, Kenya: a health facility with antenatal and post-partum clinics and a drop-in centre for female sex workers. Participants gave informed consent and were instructed on use of oral fluid based rapid HIV tests. Participants enrolled at the health facility received three self-tests and those at the drop-in centre received five self-tests. Structured interviews were conducted with participants at enrolment and over 3 months to determine how self-tests were used. Outcomes included the number of self-tests distributed by participants, the proportion of participants whose sexual partners used a self-test, couples testing, and sexual behaviour after self-testing. Between Jan 14, 2015, and March 13, 2015, 280 participants were enrolled (61 in antenatal care, 117 in post-partum care, and 102 female sex workers); follow-up interviews were completed for 265 (96%). Most participants with primary sexual partners distributed self-tests to partners: 53 (91%) of 58 participants in antenatal care, 91 (86%) of 106 in post-partum care, and 64 (75%) of 85 female sex workers. 82 (81%) of 101 female sex workers distributed more than one self-test to commercial sex clients. Among self-tests distributed to and used by primary sexual partners of participants, couples testing occurred in 27 (51%) of 53 in antenatal care, 62 (68%) of 91 from post-partum care, and 53 (83%) of 64 female sex workers. Among tests received by primary and non-primary sexual partners, two (4%) of 53

  17. [Risks factors associated with intra-partum foetal mortality in pre-term infants].

    Science.gov (United States)

    Zeballos Sarrato, Susana; Villar Castro, Sonia; Ramos Navarro, Cristina; Zeballos Sarrato, Gonzalo; Sánchez Luna, Manuel

    2017-03-01

    Pre-term delivery is one of the leading causes of foetal and perinatal mortality. However, perinatal risk factors associated with intra-partum foetal death in preterm deliveries have not been well studied. To analyse foetal mortality and perinatal risk factors associated with intra-partum foetal mortality in pregnancies of less than 32 weeks gestational age. The study included all preterm deliveries between 22 and 31 +1 weeks gestational age (WGA), born in a tertiary-referral hospital, over a period of 7 years (2008-2014). A logistic regression model was used to identify perinatal risk factors associated with intra-partum foetal mortality (foetal malformations and chromosomal abnormalities were excluded). During the study period, the overall foetal mortality was 63.1% (106/168) (≥22 weeks of gestation) occurred in pregnancies of less than 32 WGA. A total of 882 deliveries between 22 and 31+6 weeks of gestation were included for analysis. The rate of foetal mortality was 11.3% (100/882). The rate of intra-partum foetal death was 2.6% (23/882), with 78.2% (18/23) of these cases occurring in hospitalised pregnancies. It was found that Assisted Reproductive Techniques, abnormal foetal ultrasound, no administration of antenatal steroids, lower gestational age, and small for gestational age, were independent risk factors associated with intra-partum foetal mortality. This study showed that there is a significant percentage intra-partum foetal mortality in infants between 22 and 31+6 WGA. The analysis of intrapartum mortality and risk factors associated with this mortality is of clinical and epidemiological interest to optimise perinatal care and improve survival of preterm infants. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Post-Partum Depression, Personality, and Cognitive-Emotional Factors: A Longitudinal Study on Spanish Pregnant Women.

    Science.gov (United States)

    Peñacoba-Puente, Cecilia; Marín-Morales, Dolores; Carmona-Monge, Francisco Javier; Velasco Furlong, Lilian

    2016-01-01

    In this study, our purpose was to examine whether personality and cognitive factors could be related to post-partum depression (PPD), mediated by anxiety, in Spanish women. Women were evaluated for personality and cognitive factors after the first trimester, for anxiety in the third trimester, and for PPD 4 months after childbirth. A structural equation model revealed that personality and cognitive factors were associated with anxiety and PPD as predictors. Neuroticism and extroversion proved to be the most relevant factors. Conscientiousness was associated with pregnancy anxiety. Pregnancy anxiety appeared as an independent predictor of PPD. The model presented here includes personality and cognitive and emotional factors as predictors of PPD. Comprehensive care for pregnant women should contemplate assessment and intervention on all these aspects. Special focus should be on cognitive factors and emotional regulation strategies, so as to minimize the risk of later development of emotional disorders during puerperal phases.

  19. Re-conceptualising prenatal life stressors in predicting post-partum depression: cumulative-, specific-, and domain-specific approaches to calculating risk.

    Science.gov (United States)

    Liu, Cindy H; Tronick, Ed

    2013-09-01

    Prenatal life stress predicts post-partum depression (PPD); however, studies generally examine individual stressors (a specific approach) or the summation of such exposure (a cumulative approach) and their associations with PPD. Such approaches may oversimplify prenatal life stress as a risk factor for PPD. We evaluated approaches in assessing prenatal life stress as a predictor of PPD diagnosis, including a domain-specific approach that captures cumulative life stress while accounting for stress across different life stress domains: financial, relational, and physical health. The Pregnancy Risk Assessment Monitoring System, a population-based survey, was used to analyse the association of prenatal life stressors with PPD diagnoses among 3566 New York City post-partum women. Specific stressors were not associated with PPD diagnosis after controlling for sociodemographic variables. Exposure to a greater number of stressors was associated with PPD diagnosis, even after adjusting for both sociodemographic variables and specific stressors [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.5, 6.7]. Individuals reporting a moderate-to-high number of financial problems along with a moderate-to-high number of physical problems were at greater odds of PPD (OR = 4.2, 95% CI = 1.2, 15.3); those with a moderate-to-high number of problems in all three domains were at over fivefold increased odds of PPD (OR = 5.5, CI = 1.1, 28.5). In assessing prenatal stress, clinicians should consider the extent to which stressors occur across different life domains; this association appears stronger with PPD diagnosis than simple assessments of individual stressors, which typically overestimate risk or cumulative exposures. © 2013 John Wiley & Sons Ltd.

  20. Post-Partum Depression Effect on Child Health and Development.

    Science.gov (United States)

    Abdollahi, Fatemeh; Rezai Abhari, Farideh; Zarghami, Mehran

    2017-02-01

    While studies have shown the disastrous effects of post-partum depression (PPD) on children's behaviors, there is relatively lack of reliable data in Asian countries. This study examined the relative significance of maternal PPD in children's developmental disabilities at age four. In a longitudinal study design (2009), 1801 pregnant women attending in primary health centers of Mazandaran province in the north of Iran provided self-reports of depression from two to twelve postpartum weeks using Edinburgh Postnatal Depression Scale (EPDS). Approximately four years later, the women experiencing PPD and twice as the ones who did not experience this disorder were considered as case (N=204) and control (N=467) groups. The association between maternal depression at different times and childhood developmental disabilities based on Ages and Stages Questionnaire (ASQ) and other health problems reported by the child were analyzed using two-sample t-test, chi-square test, and logistic regression models. The presence of PPD only was not a predictor of child's developmental disabilities at age four. Childhood developmental disabilities in communication, gross motor and personal-social domains of ASQ were associated with the current and concurrent maternal depressive symptoms (OR=2.59, 95% CI=1.16-5.78; OR=4.34, 95% CI=2.10-8.96; OR=5.66, 95% CI=1.94-16.54 and OR=3.35, 95% CI=1.31-8.58; OR=4.15, 95% CI=2.72-13.87; OR=6.17, 95% CI=1.95-19.53 respectively). PPD, the current depressive symptoms, and depression at both occasions were associated with more health problems in children. Childhood developmental disabilities in some domains of ASQ were significantly related to the maternal depression chronicity or recurrence. Also, child's difficulties were more prevalent in association with maternal depression regardless of onset time.

  1. Post-Partum Depression Effect on Child Health and Development

    Directory of Open Access Journals (Sweden)

    Fatemeh Abdollahi

    2017-02-01

    Full Text Available While studies have shown the disastrous effects of post-partum depression (PPD on children's behaviors, there is relatively lack of reliable data in Asian countries. This study examined the relative significance of maternal PPD in children's developmental disabilities at age four. In a longitudinal study design (2009, 1801 pregnant women attending in primary health centers of Mazandaran province in the north of Iran provided self-reports of depression from two to twelve postpartum weeks using Edinburgh Postnatal Depression Scale (EPDS. Approximately four years later, the women experiencing PPD and twice as the ones who did not experience this disorder were considered as case (N=204 and control (N=467 groups. The association between maternal depression at different times and childhood developmental disabilities based on Ages and Stages Questionnaire (ASQ and other health problems reported by the child were analyzed using two-sample t-test, chi-square test, and logistic regression models. The presence of PPD only was not a predictor of child's developmental disabilities at age four. Childhood developmental disabilities in communication, gross motor and personal-social domains of ASQ were associated with the current and concurrent maternal depressive symptoms (OR=2.59, 95% CI=1.16-5.78; OR=4.34, 95% CI=2.10-8.96; OR=5.66, 95% CI=1.94-16.54 and OR=3.35, 95% CI=1.31-8.58; OR=4.15, 95% CI=2.72-13.87; OR=6.17, 95% CI=1.95-19.53 respectively. PPD, the current depressive symptoms, and depression at both occasions were associated with more health problems in children. Childhood developmental disabilities in some domains of ASQ were significantly related to the maternal depression chronicity or recurrence. Also, child's difficulties were more prevalent in association with maternal depression regardless of onset time.

  2. Alteração tireoidiana: um fator de risco associado à depressão pós-parto? Thyroid dysfunction: a risk factor associated with post-partum depression?

    Directory of Open Access Journals (Sweden)

    Gustavo Enrico Cabral Ruschi

    2009-06-01

    Full Text Available OBJETIVOS: estudar prevalência de depressão pósparto e sua correlação com alterações tireoidianas maternas. MÉTODOS: estudo observacional descritivo transversal realizado com 292 mulheres entre 31 e 180 dias após o parto, atendidas em unidades de saúde pública da Região Metroplitana de Vitória, Espírito Santo, Brasil. Analisou-se a amostra segundo características sociodemográficas e clínico-obstétricas. Definiu-se transtorno depressivo pelo escore igual ou superior a 12 na Escala de Depressão Pós-Parto de Edimburgo (EPDS. A avaliação tireoidiana foi realizada por dosagens séricas de hormônio tireo-estimulante (TSH, tiroxina livre (T4 livre e dos anticorpos anti-peroxidase (TPO. Para avaliação dos resultados utilizamos técnicas de análise descritiva e teste do χ2, adotando nível de significância de 5%. RESULTADOS: 115 mulheres (39,4% apresentaram escores iguais ou superiores a 12 na EPDS, sendo consideradas deprimidas; 117 (60,6%, com escores inferiores a 12, foram consideradas não deprimidas. A prevalência de depressão pós-parto no grupo com alterações tireoidianas foi de 36% e no grupo sem alterações tireoidianas foi de 40%. Não houve diferença estatisticamente significante na frequência de depressão entre as pacientes com e sem alterações tireoidianas (χ2=0,131;p=0,717. CONCLUSÕES: a frequência de DPP foi elevada, não sendo observada associação entre depressão pós-parto e alterações tireoidianas.OBJECTIVES: to investigate the prevalence of post partum depression and its correlation with thyroid dysfunction in mothers. METHODS: a descriptive, cross-cutting observational study carried out among 292 women between the 31st and 180th days post partum, attending public health units in the Metropolitan Region of Vitória, in the State of Espírito Santo, Brazil. The sample was analyzed for socio-demographic and clinical-obstetric characteristics. A depressive disorder was defined by a score

  3. THE EFFECT OF Anredera cordifolia (Ten. Steenis SUPPLEMENTATION ON UTERINE INVOLUTION PROCESS EVALUATED BY OESTRUS POST PARTUM BEHAVIOR AND FERNING

    Directory of Open Access Journals (Sweden)

    R. Purwasih

    2014-09-01

    Full Text Available The aim of this study was to determine the effect of Anrederacordifolia (Ten. Steenissupplementation on uterine involution process in rabbit. The research design applied was completelyrandomized design with 4 treatments and 3 replications (T0 = without Anredera cordifoliasupplementation; TI = Anredera cordifolia supplemented two days before parturition; T2 = Anrederacordifolia supplemented two days after parturition; T3 = Anredera cordifolia supplemented two daysbefore until two days after parturition. The results showed that Anredera cordifolia (Ten. Steenissupplementation could accelerate post partum oestrus in does that were characterized by post partumoestrus behavior, ferning of saliva and cervical mucus. The best treatment was T3, that was four daysAnredera cordifolia supplementation that was administered at 0.45 g/kg of body weight/day. Furtherresearch was needed to find an optimal dose of Anredera cordifolia (Ten. Steenis on uterine involution.

  4. High dietary ratio of omega-6 to omega-3 polyunsaturated acids during pregnancy and prevalence of post-partum depression.

    Science.gov (United States)

    da Rocha, Camilla M M; Kac, Gilberto

    2012-01-01

    Observational studies suggest association between low concentrations of omega-3 family fatty acids and greater risk for post-partum depression (PPD). The objective was to investigate the effect of unbalanced dietary intake of omega-6/omega-3 ratio >9:1 in the prevalence for PPD. The study comprises a prospective cohort with four waves of follow-up during pregnancy and one following delivery. PPD was evaluated according to the Edinburgh Post-partum Depression Scale (PPD ≥ 11) in 106 puerperae between 2005 and 2007, in Rio de Janeiro, Brazil. Independent variables included socio-demographic, obstetric, pre-pregnancy body mass index (BMI) and dietary intake data, which were obtained by means of a food frequency questionnaire in the first trimester of pregnancy. Statistical analysis involved calculation of PPD prevalence and multivariate Poisson regression with robust variance. PPD prevalence amounted to 26.4% [n = 28; confidence interval (CI) 95%: 18.0-34.8], and higher prevalences of PPD were observed in women who consumed an omega-6/omega-3 ratio >9:1 (60.0%) and in those with pre-pregnancy BMI <18.5 kg/m(2) (66.7%). These variables held as factors associated to PPD in the multivariate model, elevating the chances of occurrence of the outcome in 2.50 (CI 95%: 1.21-5.14) and 4.01 times (CI 95%: 1.96-8.20), respectively. Analyses were adjusted for age, schooling, pre-pregnancy BMI, lipids consumption and time elapsed since delivery. It verified an association between omega-6/omega-3 ratio above 9:1, the levels recommended by the Institute of Medicine, and the prevalence of PPD. These results add to the evidence regarding the importance of omega-6 and omega-3 fatty acids in the regulation of mental health mechanisms. © 2010 Blackwell Publishing Ltd.

  5. Effectiveness of rectal misoprostol in cessation of Post Partum Haemorrhage

    International Nuclear Information System (INIS)

    Nasreen, S.; Baqai, S.; Iftikhar, S.

    2018-01-01

    Objective: To determine the efficacy of rectal misoprostol in management of Post Partum Haemorrhage in third stage of labour. Study Design: Interventional study. Place and Duration of Study: Gynaecology and obstetrics department at PNS Shifa Hospital Karachi, from Sep 2012 to Mar 2013. Material and Methods: All singleton and multiple pregnancies of gestation 37-42 weeks, who presented in labour room to deliver and had prolonged second stage of labour (n=112) were enrolled in the study. Patients, who were having coagulopathy, abruption, placenta previa, and allergy to prostaglandins were excluded from the study. Third stage was managed actively according to hospital standard routine. Hemoglobin was measured at the time of admission and repeated after delivery in patients having PPH. Blood was estimated by weighing all gauzes and packs. If blood loss more than 500ml one hour after delivery and all traumatic causes and retained placenta were excluded, 600 mu g (3 tablets) of misoprostol were given per rectally, which were inserted up to a digit depth. After one hour total amount of blood loss was calculated. The data were then entered in a proforma and analyzed. Results: Majority (44.6%) of the women were 26-33 years of age, 8.9% had PPH with fall in hemoglobin by 1.5-2 gms/dl. Ninety percent of the patients responded to rectal misoprostol. Conclusion: Active management of third stage of labour has a definite role in the preventive of PPH. Rectal administration of misoprostol should be considered for control of PPH in low resource settings like ours as it was found effective in the study. (author)

  6. Determinantes nutricionais e sóciodemográficos da variação de peso no pós-parto: uma revisão da literatura Nutritional and socio-demographic determinants of post-partum weight change: a literature review

    Directory of Open Access Journals (Sweden)

    Maria Beatriz Trindade de Castro

    2009-06-01

    note and two books considered relevant to the subject and published prior to 1997 are also cited in the review. The review prioritized studies involving randomized clinical trials and follow-up carried out among pregnant and post-partum women. The results show that the following are the main factors associated with post-partum weight variation: gestational weight gain above the recommendations of the Institute of Medicine, Pregestational Body Mass > 25 kg/m2, diet, duration and intensity of breast-feeding and socio-demographic factors, such as being black, having given birth only once, the age of the mother, low income and low schooling. Regular physical activity is recommended as a strategy for avoiding excessive weight gain and improving weight loss during post partum. In Brazil, there is no national strategy for preventing excessive weight gain and ensuring adequate weight loss during this period. During post-partum, most health service actions are restricted to ensuring that mothers breastfeed.

  7. Conhecimentos maternos sobre amamentação entre puérperas inscritas em programa de pré-natal Breastfeeding knowledge among post-partum women previously enrolled in a prenatal program

    Directory of Open Access Journals (Sweden)

    Gilza Sandre-Pereira

    2000-06-01

    .4% identified it as immediately after delivery. Some 47.4% said breastfeeding protects the child from diseases. Thus, although the mothers demonstrated basic knowledge about breastfeeding, issues like the best moment for the first feeding, the importance of colostrum, and nutritional aspects for nursing mothers require further clarification during prenatal care and the immediate post-partum period.

  8. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    2017-05-27

    Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10

  9. Analysis of ante-partum maternal morbidity in rural Bangladesh.

    Science.gov (United States)

    Chakraborty, Nitai; Islam, M Ataharul; Chowdhury, Rafiqul Islam; Bari, Wasimul

    2003-01-01

    This paper presents the results of a prospective study of maternal morbidity during the ante-partum period in rural areas of Bangladesh. The data came from a survey of Maternal Morbidity in Bangladesh, conducted by the Bangladesh Institute of Research for Promotion of Essential and Reproductive Health and Technologies (BIRPERHT) during the period from November 1992 to December 1993. Since then no such national level survey has been conducted in Bangladesh. This paper employs multiple-decrement life table technique, a convenient way of analysing the risks of different types of disease conditions that women experience during the antenatal period for different age categories. The high-risk complications such as ante-partum haemorrhage, excessive vomiting, fits/convulsion and oedema were considered in this study. In this study a cause specific model was applied to explore the differences in the risks exerted at different ages of reproductive life attributable to some selected complications of pregnancy. The results of this study indicate that women of age 25-29 years are less susceptible to most of the selected life-threatening and high-risk complications during pregnancy such as haemorrhage, fits/convulsion and oedema. However, younger women (age or = 30 years) are at greater risk of haemorrhage, fits/convulsion and oedema.

  10. Emotional impact of severe post-partum haemorrhage on women and their partners: an observational, case-matched, prospective, single-centre pilot study.

    Science.gov (United States)

    Ricbourg, Aude; Gosme, Christelle; Gayat, Etienne; Ventre, Chloé; Barranger, Emmanuel; Mebazaa, Alexandre

    2015-10-01

    This observational, matched-control, prospective, single-centre study sought to estimate the emotional impact of post-partum haemorrhage (PPH) on women and their partners, including its influences on post-traumatic stress disorder (PTSD), postpartum depression and the mother/child relationship. All consecutive women who were admitted for PPH from December 2010 through December 2011 and their partners were screened for eligibility. Emotional impact was assessed using three self-reported questionnaires (Impact of Event Scale-Revised to assess PTSD, Edinburgh Post Natal Depression Scale to assess post-natal depression and Mother-Infant Bonding Scale to assess the relationship between mother and child). Each PPH patient was matched with a control woman for whom the delivery was not complicated by PPH. The results showed (a) that women with PPH and their partners were more likely to report symptoms related to PTSD compared with controls, (b) that women with PPH were less likely to suffer from postnatal depression and (c) that there was no difference in the mother/child relationship between women with PPH and controls. PPH is associated with a high incidence of PTSD-related symptoms in both women and their partners. PTSD in the context of PPH is likely an under-recognised phenomenon by health care professionals. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Comparison between the Health Belief Model and Subjective Expected Utility Theory: predicting incontinence prevention behaviour in post-partum women.

    Science.gov (United States)

    Dolman, M; Chase, J

    1996-08-01

    A small-scale study was undertaken to test the relative predictive power of the Health Belief Model and Subjective Expected Utility Theory for the uptake of a behaviour (pelvic floor exercises) to reduce post-partum urinary incontinence in primigravida females. A structured questionnaire was used to gather data relevant to both models from a sample antenatal and postnatal primigravida women. Questions examined the perceived probability of becoming incontinent, the perceived (dis)utility of incontinence, the perceived probability of pelvic floor exercises preventing future urinary incontinence, the costs and benefits of performing pelvic floor exercises and sources of information and knowledge about incontinence. Multiple regression analysis focused on whether or not respondents intended to perform pelvic floor exercises and the factors influencing their decisions. Aggregated data were analysed to compare the Health Belief Model and Subjective Expected Utility Theory directly.

  12. “ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhage

    Directory of Open Access Journals (Sweden)

    Navkiran Singh Gill

    2017-05-01

    Full Text Available A case of massive post-partum hemorrhage in East-Malaysia, associated with 3-4 methylene-dioxy-methamphetamine (MDMA abuse otherwise known as Ecstasy or locally as “ICE”, injected by the patient as a means to suppress labor pains prior to hospital presentation. We report a rare case of substance abuse that lead to life threatening hemorrhage in a maternal patient of productive age group. Presenting to the labor suite in second stage of labor in breech presentation, exhibiting active neuropsychiatric symptoms of intoxication like euphoria, drowsiness, mydriasis but able to obey commands. A rapid response by the Obstetric on-call team proceeded with an assisted-breech delivery. Post-delivery, a baby girl with poor Apgar score was born and intubated. The mother was then posted for an Examination Under Anesthesia as she was noted to have slow blood oozing per-vaginally using a single shot spinal as she exhibited features of difficult intubation and high risk of aspiration. During the procedure, she tipped into massive PPH complicated with DIVC, and was rushed into the intensive care unit for stabilization and back into the operation theatre, needing a total abdominal hysterectomy (TAH as definitive bleeding control. She required large scale resuscitative efforts peri-operatively including continuous veno-venous hemofiltration (CVVH as well as regional intensive care consultation. We describe, chronologically the anesthetic challenges faced in managing a patient in acute substance intoxication at presentation to our district hospital during twilight hours. We then explain the pharmacodynamics of MDMA in provoking coagulopathy. No reports of similar cases in the South-East Asia region.

  13. Development and Validation of a Questionnaire for the Assessment of Pelvic Floor Disorders and Their Risk Factors During Pregnancy and Post Partum.

    Science.gov (United States)

    Metz, Melanie; Junginger, Bärbel; Henrich, Wolfgang; Baeßler, Kaven

    2017-04-01

    Introduction The aim of this study was to develop and validate a questionnaire for the assessment of pelvic floor disorders, their symptoms and risk factors in pregnancy and after birth including symptom course, severity and impact on quality of life. Methods The validated German pelvic floor questionnaire was modified and a new risk factor domain developed. The questionnaire was initially completed by 233 nulliparous women in the third trimester of pregnancy and at six weeks (n = 148) and one year (n = 120) post partum. Full pyschometric testing was performed. The clinical course of symptoms and the influence of risk factors were analysed. Results Study participants had a median age of 31 (19-46) years. 63 % had spontaneous vaginal deliveries, 15 % operative vaginal deliveries and 22 % were delivered by caesarean section. Content validity: Missing answers never exceeded 4 %. Construct validity: The questionnaire distinguished significantly between women who reported bothersome symptoms and those who did not. Reliability: Cronbach's alpha values exceeded 0.7 for bladder, bowel and support function, and 0.65 for sexual function. The test-retest analysis showed moderate to almost complete concordance. The intraclass coefficients for domain scores (between 0.732 and 0.818) were in acceptable to optimal range. Reactivity: The questionnaire was able to track changes significantly with good effect size for each domain. Risk factors for pelvic floor symptoms included familial predisposition, maternal age over 35 years, BMI above 25, nicotine abuse, subjective inability to voluntarily contract the pelvic floor musculature and postpartum wound pain. Conclusion This pelvic floor questionnaire proved to be valid, reliable and reactive for the assessment of pelvic floor disorders, their risk factors, incidence and impact on quality of life during pregnancy and post partum. The questionnaire can be utilised to assess the course of symptoms and treatment effects

  14. [Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods].

    Science.gov (United States)

    Núñez-Urquiza, Rosa María; Hernández-Prado, Bernardo; García-Barrios, Cecilia; González, Dolores; Walker, Dylis

    2003-01-01

    To describe the proportion of unwanted pregnancies among all pregnant adolescents, its association with sociodemographic characteristics, and the use of post-partum contraceptive methods. A cross-sectional study was conducted among 220 women between 13 and 19 years of age, in two semi-urban municipalities of the State of Morelos, Mexico, interviewed between 1992 and 1994. Women were interviewed at home, six to twelve weeks after their delivery date. Women were asked whether they had wanted their last pregnancy, and about knowledge and use of contraceptive methods after delivery. Adolescent pregnancies accounted for 17% of all births registered in these two municipalities. Among all adolescent mother 22.73% reported that their pregnancy had not been wanted. A positive association was found between the lack of access to health services provided by public medical insurance systems (Instituto Mexicano del Seguro Social IMSS and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado ISSSTE) and unwanted pregnancy (adjusted OR = 3.03, 95% CI (1.31, 7.) An association was also found between living in an urban community (adjusted OR = 2.16, 95% CI (1.08, 4.33) and an unwanted pregnancy. Among all adolescent mothers, 91.3% were familiar with "the pill" as a contraceptive method; 84.72% knew about the IUD, and 63.68% knew about the condom. However, only 35% of them were actually using an effective contraceptive method six weeks after delivery. No difference in frequency of contraceptive use was found among the adolescent mothers, according to whether they wanted their last pregnancy. Only 43.39% of mothers who delivered at hospitals or health centers were using an effective contraceptive method. These findings suggest that there is a great potential for family planning programs to target adolescents, and that the use of contraceptive methods after delivery should be promoted among adolescent mothers, especially those lacking access to public medical

  15. Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial

    NARCIS (Netherlands)

    Uegaki, K.; Stomp-van den Berg, S.G.; de Bruijne, M.C.; van Poppel, M.N.M.; Heymans, M.W.; van Mechelen, W.; van Tulder, M.W.

    2011-01-01

    Background: Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum

  16. Translation and validation of the German version of the Mother-Generated Index and its application during the postnatal period.

    Science.gov (United States)

    Grylka-Baeschlin, Susanne; van Teijlingen, Edwin; Stoll, Kathrin; Gross, Mechthild M

    2015-01-01

    the Mother-Generated Index (MGI) is a validated tool to assess postnatal quality of life. It is usually administered several weeks or months after birth and correlates with indices of post partum mood states and physical complaints. The instrument had not been translated into German before or validated for use among German-speaking women, nor have the results of the tool been assessed specifically for the administration directly after birth. This paper aims to describe the systematic translation process of the MGI into German and to assess the convergent validity of the German version of the instrument directly after birth and seven weeks post partum. prospective two-stage survey. two rural hospitals in the south of Germany and in the north of Switzerland. all women giving birth between 1st October and 15th December 2012 with sufficient knowledge of German and whose babies were not referred to a neonatal care unit; 226 women were eligible to participate. two questionnaires including questions relating to socio-demographic factors and perinatal care, and incorporating the MGI, the Hospital Anxiety and Depression Scale (HADS) and the Postnatal Morbidity Index (PMI). All instruments were subjected to forward and back translation and pilot-tested; the first questionnaire was then administered in the first two days after birth and the second six weeks post partum. Parametric and non-parametric tests were computed using SPSS. 129 surveys were returned an average of three days after birth and 83 after seven weeks. Higher postnatal quality of life showed a significant correlation with a lower anxiety and depression score (pGerman version of the MGI is a valid indicator of physical and emotional post partum well-being. the German version of the MGI can be used in the post partum period to identify women whose quality of life is impaired during the first days after birth, in order to initiate extended midwifery care and referral if necessary. Copyright © 2014 The Authors

  17. Prevalence and factors associated with recent intimate partner violence and relationships between disability and depression in post-partum women in one clinic in eThekwini Municipality, South Africa.

    Science.gov (United States)

    Gibbs, Andrew; Carpenter, Bradley; Crankshaw, Tamaryn; Hannass-Hancock, Jill; Smit, Jennifer; Tomlinson, Mark; Butler, Lisa

    2017-01-01

    Intimate partner violence (IPV) experienced by pregnant and post-partum women has negative health effects for women, as well as the foetus, and the new-born child. In this study we sought to assess the prevalence and factors associated with recent IPV amongst post-partum women in one clinic in eThekwini Municipality, South Africa, and explore the relationship between IPV, depression and functional limitations/disabilities. Past 12 month IPV-victimisation was 10.55%. Logistic regression modelled relationships between IPV, functional limitations, depressive symptoms, socio-economic measures, and sexual relationship power. In logistic regression models, overall severity of functional limitations were not associated with IPV-victimisation when treated as a continuous overall score. In this model relationship power (aOR0.22, p = 0.001) and depressive symptoms (aOR1.26, p = 0.001) were significant. When the different functional limitations were separated out in a second model, significant factors were relationship power (aOR0.20, p = 0.001), depressive symptoms (aOR1.20, p = 0.011) and mobility limitations (aOR2.96, p = 0.024). The study emphasises that not all functional limitations are associated with IPV-experience, that depression and disability while overlapping can also be considered different drivers of vulnerability, and that women's experience of IPV is not dependent on pregnancy specific factors, but rather wider social factors that all women experience.

  18. Pregnancy Intention and Post-partum Depressive Affect in Louisiana Pregnancy Risk Assessment Monitoring System.

    Science.gov (United States)

    Suh, Elizabeth Y; Ma, Ping; Dunaway, Lauren Futrell; Theall, Katherine P

    2016-05-01

    Postpartum depression is associated with negative physical and mental health outcomes for both the mother and infant. This study examines the relationship between a mother and/or her partner's pregnancy intentions and reported post-partum depressive symptoms (PPDs). Using Louisiana pregnancy risk assessment monitoring system, 2000-2003, a secondary cross-sectional analysis was conducted on 5549 mothers, stratified by race, who delivered a singleton, live birth and whose infant was still alive at the time of the survey. Bivariate and multivariable logistic regressions were conducted, taking into account the complex survey design. In multivariable models, unwanted pregnancies were associated with severe PPDs (aOR 1.76, 95 % CI 1.23-2.53). Furthermore, the association between husbands/partners' who did not want or care about the pregnancy and mild PPDs remained for White women (aOR 1.32, 95 % CI 1.02-1.69); while among Black women, neither parent's pregnancy intention were associated with mild or severe PPDs. This study supports existing research demonstrating the association between pregnancy intention and PPDs. This study contributes to the limited information on the role that partner pregnancy intention plays on maternal mental health outcomes, however further discussion is needed on the impact of this role across races. Findings can be used in programs aiming to reduce adverse mental health outcomes among high-risk mothers.

  19. Emotional Freedom Technique (EFT) Tapping for Post Sectio Caesaria Patient: Decrease Anxiety and Increase Early Mobilization

    OpenAIRE

    Rusmini, Rusmini; Suparmi, Suparmi; Musdalifah, Ulfah

    2013-01-01

    The objective of the study is to evaluate the level of anxiety and early mobilization using the Emotional Freedom Technique (EFT): Tapping on patients post partum post secsio Caesaria before and after intervention period both control and experimental group. Design Quasi-experimental two group design was applied in the study. Forty two mothers with primipara post secsio Caesaria were recruited. Data analysis in the study included correlation, paird t-test, and independent t-test. The findings ...

  20. Falling caesarean section rate and improving intra-partum outcomes: a prospective cohort study.

    Science.gov (United States)

    Amin, Pina; Zaher, Summia; Penketh, Richard; Cherian, Sobha; Collis, Rachel E; Sanders, Julia; Bhal, Kiron

    2018-02-19

    To evaluate caesarean section (CS) rates and moderate to severe hypoxaemic ischaemic encephalopathy (HIE) rates with other core intra-partum outcomes following reconfiguration of maternity services in Cardiff, South Wales, UK. Cohort study of births from 2006 to 2015. A University tertiary referral centre for foetal and maternal medicine with 6000 births/year, University Hospital of Wales, United Kingdom. Data relating to births from 1 January 2006 to 31 December 2015 were extracted from the computerized maternity database on a yearly basis. Case notes of all mothers and babies for the same duration were hand searched for documentation of HIE. HIE data was also collected prospectively by neonatologist (SC) and obstetrician (PA). Incidence of caesarean section births, babies with moderate to severe HIE, instrumental vaginal births, obstetric anal sphincter injuries (OASIS) associated with instrumental delivery, and major post-partum haemorrhage (MPPH) of 2500 mL or more. During this 10-year period, a downward trend in emergency CS rate was seen from 15.6% in 2006 to 10.5% in 2015, reducing total CS rate from 25.5% in 2006 to 21.2% in 2015. A downward trend in the incidence of moderate and severe HIE was seen over the same period. There was an increase in operative vaginal births (OVB) from 12.8% to 15%. The rate of spontaneous vaginal births (SVB) remained stable. The incidence of OASIS remained constant and MPPH rate has fallen. Following amalgamation of two medium sized obstetric units and the opening of a Midwifery Led Unit (MLU), core intrapartum outcomes have improved. Contributing factors are the introduction of regular multidisciplinary training with enhanced team working, compulsory education for obstetricians and midwives on cardiotocograph (CTG) interpretation, increased consultant presence on delivery suite, robust risk management systems and broad multidisciplinary agreement on clinical guidelines promoting vaginal birth.

  1. Influence of energy balance on the antimicrobial peptides S100A8 and S100A9 in the endometrium of the post-partum dairy cow

    Science.gov (United States)

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

    2013-01-01

    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

  2. [Is the cognitive-behavioural therapy an effective strategy also in the prevention of post partum depression? a critical review].

    Science.gov (United States)

    Nardi, Bernardo; Laurenzi, Sabrina; Di Nicolò, Marzia; Bellantuono, Cesario

    2012-01-01

    The aim of this study was to evaluate the efficacy of cognitive-behavioural therapy (CBT) in the prevention of post partum depression (PPD) in pregnant women at risk. PubMed, Medline, PsychInfo, Embase, and the Cochrane Library databases were searched from January 1991 to June 2011 to review studies on the efficacy of CBT in the prevention of PD. The literature analyzed recommends that depression in pregnancy requires an efficient management to provide mother's symptoms relief as well as to prevent PD. While several studies demonstrated the efficacy of CBT in the treatment of PD, only a few controlled studies focused on its efficacy in the prevention of PD in women identified at risk during pregnancy. The efficacy of CBT in preventing PD in pregnant women at risk is supported by only a few studies, presenting some methodological flaws. Better designed trials are needed to strongly support the efficacy of such psychotherapeutic preventive strategy in women at risk for PD.

  3. [THE ADDED VALUE OF ART THERAPY FOR MOTHERS WITH POST-PARTUM DEPRESSION IN ARABIC SOCIETY IN ISRAEL].

    Science.gov (United States)

    Afnan Hamed-Agbariah; Rosenfeld, Yaakov

    2015-09-01

    Post-partum depression (PPD) is a neurotic condition, which appears usually within two months after the delivery. This is the most common complication of pregnancy and puerperium, affecting about 15 to 20% of the mothers. In Israel, with some 150,000 deliveries annually, this relates to about 20,000 women each year. Routine treatment with psychotherapy (PT), helps about two thirds of these women. Continuation of the maternal symptoms affects the baby's development, and the rest of the family as well. The purpose of this study was to evaluate the additional value of art therapy (AT), compared to standard therapy, with PT alone, to eradicate symptoms of depression. A prospective, randomized controlled study was conducted. During the period 2011-2013, a total of 141 Arab mothers with symptoms of PPD, from the Um-El-Fahem region, were included in the study. A comparison was made between two groups: The control group receiving routine treatment with PT and the intervention group which received, in addition, AT. Both groups demonstrated a reduction in the level of depressive symptoms. In the intervention group, however, the reduction in the level of depressive symptoms was statistically more significant (p depressive state. In a health care system with chronic budgetary constraints, the addition of some cardboard and plasticine to the "Health Basket", coupled with a few hours with a trained therapist, is probably a worthy alternative, considering the scope of the problem and its influence on the mother, the baby, and the family as a whole. The appearance of PPD symptoms is a common and significant medical condition. These attributes make this phenomenon a significant problem from the public health perspective. Routine treatment with PT, helps a lot of women. Many, however, remain symptomatic. The addition of AT enables most of them to resume a normal and healthy course of life.

  4. Factors associated with unintended pregnancy, poor birth outcomes and post-partum contraceptive use among HIV-positive female adolescents in Kenya.

    Science.gov (United States)

    Obare, Francis; van der Kwaak, Anke; Birungi, Harriet

    2012-10-06

    Although the experiences of unintended pregnancies and poor birth outcomes among adolescents aged 15-19 years in the general population are well documented, there is limited understanding of the same among those who are living with HIV. This paper examines the factors associated with experiencing unintended pregnancies, poor birth outcomes, and post-partum contraceptive use among HIV-positive female adolescents in Kenya. Data are from a cross-sectional study that captured information on pregnancy histories of HIV-positive female adolescents in four regions of Kenya: Coast, Nairobi, Nyanza and Rift Valley provinces. Study participants were identified through HIV and AIDS programs in the four regions. Out of a total of 797 female participants, 394 had ever been pregnant with 24% of them experiencing multiple pregnancies. Analysis entails the estimation of random-effects logit models. Higher order pregnancies were just as likely to be unintended as lower order ones (odds ratios [OR]: 1.2; 95% confidence interval [CI]: 0.8-2.0) while pregnancies occurring within marital unions were significantly less likely to be unintended compared to those occurring outside such unions (OR: 0.1; 95% CI: 0.1-0.2). Higher order pregnancies were significantly more likely to result in poor outcomes compared to lower order ones (OR: 2.5; 95% CI: 1.6-4.0). In addition, pregnancies occurring within marital unions were significantly less likely to result in poor outcomes compared to those occurring outside such unions (OR: 0.3; 95% CI: 0.1-0.9). However, experiencing unintended pregnancy was not significantly associated with adverse birth outcomes (OR: 1.3; 95% CI: 0.5-3.3). There was also no significant difference in the likelihood of post-partum contraceptive use by whether the pregnancy was unintended (OR: 0.9; 95% CI: 0.5-1.5). The experience of repeat unintended pregnancies among HIV-positive female adolescents in the sample is partly due to inconsistent use of contraception to prevent

  5. Prevalence and factors associated with recent intimate partner violence and relationships between disability and depression in post-partum women in one clinic in eThekwini Municipality, South Africa.

    Directory of Open Access Journals (Sweden)

    Andrew Gibbs

    Full Text Available Intimate partner violence (IPV experienced by pregnant and post-partum women has negative health effects for women, as well as the foetus, and the new-born child. In this study we sought to assess the prevalence and factors associated with recent IPV amongst post-partum women in one clinic in eThekwini Municipality, South Africa, and explore the relationship between IPV, depression and functional limitations/disabilities. Past 12 month IPV-victimisation was 10.55%. Logistic regression modelled relationships between IPV, functional limitations, depressive symptoms, socio-economic measures, and sexual relationship power. In logistic regression models, overall severity of functional limitations were not associated with IPV-victimisation when treated as a continuous overall score. In this model relationship power (aOR0.22, p = 0.001 and depressive symptoms (aOR1.26, p = 0.001 were significant. When the different functional limitations were separated out in a second model, significant factors were relationship power (aOR0.20, p = 0.001, depressive symptoms (aOR1.20, p = 0.011 and mobility limitations (aOR2.96, p = 0.024. The study emphasises that not all functional limitations are associated with IPV-experience, that depression and disability while overlapping can also be considered different drivers of vulnerability, and that women's experience of IPV is not dependent on pregnancy specific factors, but rather wider social factors that all women experience.

  6. A field study of postpartum period of dairy cows by rectal palpation and progesterone profiles in the milk by radioimmunoassay; Contribuicao ao estudo do puerperio de vacas leiteiras atraves de acompanhamento clinico-reprodutivo e determinacao de progesterona por radioimunoensaio

    Energy Technology Data Exchange (ETDEWEB)

    Kozicki, Luis Ernandes; Silva, Marcelo Alves da [Parana Univ., Curitiba, PR (Brazil). Setor de Ciencias Agrarias. Dept. de Medicina Veterinaria]. E-mail: lkozicki@agrarias.ufpr.br; Woellner, Luis Carlos; Shibata, Flavia Kazumi [Parana Univ., Curitiba, PR (Brazil). Centro de Medicina Nuclear

    1998-07-01

    This study was carried out on 18 calved dairy cows, near the town of Curitiba-PR-Brazil. The animals were submitted weekly to a rectal palpation of the genital tract and the uterine involution and ovarian activity were considered. The rectal palpations began from the 7{sup th} day postpartum till the 49{sup th} day. at the same milk samples the first morning milk were taken on the 9{sup th} week. The progesterone (P{sub 4}) level determination of the milk was established by radioimmunoassay. The findings of the research showed: the postpartum oestrus was observed at the 28.5{sup th} day and the corpus luteum was detected on the 34.5{sup th} day. The period from oestrus to the first high progesterone level post partum was 5.5 days. The uterine involution period was carried on the 24.1{sup th} day. The progesterone dominant period was shorter and had duration of 11.5 days on the first oestrus cycle post partum. The progesterone concentration from the first Corpus luteum post partum was low (1.9 ng/ml milk). The anoestrus rate until 49{sup th} day postpartum was 33.3% and the silent heat rate reached 61.1%. (author)

  7. SERUM ELECTROLYTES IN BUFFALOES DURING LATE PREGNANCY, PARTURITION AND POST PARTUM PERIODS

    Directory of Open Access Journals (Sweden)

    Shahzad Hussain, Muhammad Amir Saeed and Isma Nazli Bashir

    2001-09-01

    Full Text Available This study was executed on 30 pregnant Nili-Ravi buffaloes. Serum was harvested for the estimation of calcium, magnesium, phosphorus, sodium, potassium and iron in the late pregnancy (at 8th and 9th month of gestation, at parturition and in the postpartum periods (at Ist and 2 month postpartum. The concentrations of Ca and P were significantly (P< 0.05 lower and Mg was significantly (P<0.05 higher at the time of parturition. The concentrations of Na and K did not show much variation. The values of Fe also decreased significantly (P<0.05 near parturition (at 9th month of gestation and at parturition. No puerperal disorder was observed in any of the experimental animals.

  8. Efficacy of selective arterial embolisation for the treatment of life-threatening post-partum haemorrhage in a large population.

    Directory of Open Access Journals (Sweden)

    Cyril Touboul

    Full Text Available BACKGROUND: The objective of this study was to assess efficacy and determine the optimal indication of selective arterial embolisation (SAE in patients with life-threatening post-partum haemorrhage (PPH. METHODOLOGY/PRINCIPAL FINDINGS: One hundred and two patients with PPH underwent SAE and were included from January 1998 to January 2002 in our university care center. Embolisation was considered effective when no other surgical procedure was required. Univariate and multivariate statistical analysis were performed. SAE was effective for 73 patients (71.5%, while 29 required surgical procedures. SAE was effective in 88.6% of women with uterine atony that was associated with positive outcome (OR 4.13, 1.35-12.60, whereas caesarean deliveries (OR 0.16, 0.04-0.5 and haemodynamic shock (OR 0.21, 0.07-0.60 were associated with high failure rates, 47.6% and 39.1%, respectively. CONCLUSIONS/SIGNIFICANCE: Success rate for SAE observed in a large population is lower than previously reported. It is most likely to succeed for uterine atony but not recommended in case of haemodynamic shock or after caesarean section.

  9. Pengaruh Senam Nifas terhadap Penurunan Tinggi Fundus Uteri pada Ibu Post Partum di RSUP DR. M. Djamil Padang

    Directory of Open Access Journals (Sweden)

    Nurniati Tianastia Rullynil

    2014-09-01

    Full Text Available AbstrakPerdarahan merupakan penyebab utama kesakitan dan kematian ibu pada masa nifas, dimana 50%-60% karena kegagalan miometrium berkontraksi secara sempurna. Salah satu asuhan untuk memaksimalkan kontraksi uterus pada masa nifas adalah dengan melaksanakan senam nifas, guna mempercepat proses involusi uteri. Tujuan penelitian ini adalah untuk mengetahui pengaruh senam nifas terhadap penurunan tinggi fundus uteri (TFU pada ibu post partum. Penelitian ini merupakan studi eksperimental dengan Post Test Only Control Group Design. Alat yang digunakan dalam penelitian berupa kaliper pelvimetri. Diberikan perlakuan senam nifas pada kelompok intervensi dan tidak senam nifas pada kelompok kontrol, kemudian dilakukan pengukuran tinggi fundus uteri hari ke-1, hari ke-3 dan hari ke-6. Data dianalisa menggunakan Uji General Linier Model (GLM. Rerata TFU hari ke-1 pada kelompok intervensi 12,37±0,72 dan 12,42±0,54 pada kelompok kontrol. Rerata TFU hari ke-3 pada kelompok intervensi 9,00±0,94 dan 9,87±0,75 pada kelompok kontrol. Sedangkan rerata TFU hari ke-6 pada kelompok intervensi 5,72±0,88 dan 7,37±0,68 pada kelompok kontrol. Terdapat perbedaan yang signifikan penurunan tinggi fundus uteri antara kedua kelompok pada hari ke-3 (p=0,00 dan hari ke 6 (p=0,00. Dari hasil penelitian dapat disimpulkan bahwa senam nifas berpengaruh terhadap penurunan tinggi fundus uteri. Penurunan tinggi fundus uteri pada kelompok intervensi lebih turun dibanding kelompok kontrol.Kata kunci: senam nifas, tinggi fundus uteri, post partumAbstractHemorrhage is a major cause of maternal morbidity and mortality in the puerperium, about 50%-60% of hemorrhage occurs due to failure of myometrium to contract completely. One care to maximaze uterine contraction during the puerperium is by implementing parturition gymnastics in order to accelarate the process of uterine involution. The purpose of this study was to determine the effect of parturition gymnastics on a decreasing of

  10. Safety and Efficacy of Intravenous Ferric Carboxy Maltose in Iron Deficiency Anaemia During Post-partum Period.

    Science.gov (United States)

    Mishra, Vineet; Roy, Priyankar; Gandhi, Khushali; Choudhary, Sumesh; Aggarwal, Rohina; Sokabaj, Shaheen

    2018-01-01

    Iron deficiency is the commonest treatable cause of postpartum anaemia. Parenteral iron therapy results in faster and higher replenishment of iron stores and correction of haemoglobin levels with better compliance. Ferric Carboxy Maltose is an effective and a safe option which can be administered intravenously in single total correction dose without any serious adverse effects.The study was done to evaluate the efficacy and safety of Ferric Carboxy Maltose in the treatment of iron deficiency anaemia in post-natal patients. It was an open, single arm study including 615 women with diagnosis of Iron deficiency anaemia and haemoglobin (Hb) levels between 4gm% and 11gm% from January 2013 to December 2016. Intravenous Ferric Carboxy Maltose(500-1500mg) was administered and the improvement in haemoglobin levels and iron stores were assessed after three weeks of total dose infusion. Out of the 615 women, 595 women were included in the analysis. Most of the women were in the age group of 27-30 years. Most of the women had mild anaemia as per World Health Organisation guidelines. Mean hemoglobin levels significantly increased over a period of three weeks after Ferric Carboxy Maltose administration. Other parameters like total iron binding capacity, Ferritin and Iron also had a significant improvement after Ferric Carboxy Maltose administration. No serious adverse events were observed after Ferric Carboxy Maltose. Intravenous Ferric Carboxy Maltose was an effective and a safe treatment option for iron deficiency anaemia and has an advantage of single administration of high doses without serious adverse effects.

  11. Atividade ovariana de vacas leiteiras em dietas com propilenoglicol ou monensina no período de transição Ovarian activity of dairy cows receiving diets with propylene glycol or monensin during the transition period

    Directory of Open Access Journals (Sweden)

    M.A.T. Artunduaga

    2008-04-01

    transition period. Ovaries were evaluated by ultrasonography between days 4 and 46 post-partum. On days 10, 20, 25, 30, 35, 40, and 45 post-partum, blood samples were taken to assay progesterone. The addition of propylene glycol showed to be more efficient in accelerate the return to cyclic ovarian activity. Cows that received propylene glycol just during pre-partum, post-partum or during the hole transition period showed intervals from parturition to first ovulation of 29.0, 44.0 and 27.2 days, respectively. The intervals from parturition to conception for the same groups were 98.3, 90.8, and 100.0 days, respectively. The addition of monensin to diets did not show positive effects on post-partum return to ovarian cyclicity. Cows that received monensin just during pre-partum, post-partum or during the hole transition period showed intervals from parturition to first ovulation of 43.6, 39.3, and 42.8 days, respectively. The interval from parturition to conception for cows that received monensin pre and post-partum were 173.2 and 126.1 days, respectively.

  12. The impact of early outcome events on the effect of tranexamic acid in post-partum haemorrhage: an exploratory subgroup analysis of the WOMAN trial.

    Science.gov (United States)

    Brenner, Amy; Shakur-Still, Haleema; Chaudhri, Rizwana; Fawole, Bukola; Arulkumaran, Sabaratnam; Roberts, Ian

    2018-06-07

    In severe post-partum haemorrhage, death can occur within hours of bleeding onset so interventions to control the bleeding must be given immediately. In clinical trials of treatments for life-threatening bleeding, established treatments are given priority and the trial treatment is usually given last. However, enrolling patients in whom severe maternal morbidity or death is imminent or inevitable at the time of randomisation may dilute the effects of a trial treatment. We conducted an exploratory analysis of data from the WOMAN trial, an international, randomised placebo-controlled trial of the effects of tranexamic acid on death and surgical intervention in 20,060 women with post-partum haemorrhage. We assessed the impact of early maternal death or hysterectomy due to exsanguination on the effect of tranexamic acid on each of these respective outcomes. We conducted repeated analyses excluding patients with these outcomes at increasing intervals from the time of randomisation. We quantified treatment effects using risk ratios (RR) and 99% confidence intervals (CI) and prepared cumulative failure plots. Among 14,923 women randomised within 3 h of delivery (7518 tranexamic acid and 7405 placebo), there were 216 bleeding deaths (1.5%) and 383 hysterectomies due to bleeding (2.8%). After excluding deaths from exsanguination at increasing time intervals following randomization, there was a significant reduction in the risk of death due to bleeding with tranexamic acid (RR = 0.41; 99% CI 0.19-0.89). However, after excluding hysterectomies at increasing time intervals post-randomization, there was no reduction in the risk of hysterectomy due to bleeding with tranexamic acid (RR = 0.79; 99% CI 0.33-1.86). Findings from this analysis provide further evidence that tranexamic acid reduces the risk of death from exsanguination in women who experience postpartum haemorrhage. It is uncertain whether tranexamic acid reduces the risk of hysterectomy for bleeding after

  13. Acute lung injury complicating blood transfusion in post-partum hemorrhage: incidence and risk factors.

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    Teofili, Luciana; Bianchi, Maria; Zanfini, Bruno A; Catarci, Stefano; Sicuranza, Rossella; Spartano, Serena; Zini, Gina; Draisci, Gaetano

    2014-01-01

    We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH). We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without transfusion of fresh frozen plasma (FFP) and/or platelets (PLT). Clinical records were then retrieved and examined for respiratory distress events. According to the 2004 consensus definition, cases of new-onset hypoxemia, within 6 hours after transfusion, with bilateral pulmonary changes, in the absence of cardiogenic pulmonary edema were identified as TRALI. If an alternative risk factor for acute lung injury was present, possible TRALI was diagnosed. Thirteen cases of TRALI and 1 case of possible TRALI were identified (overall incidence 19.7%). At univariate analysis, patients with TRALI received higher number of RBC, PLT and FFP units and had a longer postpartum hospitalization. Among the diseases occurring in pregnancy- and various pre-existing comorbidities, only gestational hypertension and pre-eclampsia, significantly increased the risk to develop TRALI (p = 0.006). At multivariate analysis including both transfusion- and patient-related risk factors, pregnancy-related, hypertensive disorders were confirmed to be the only predictors for TRALI, with an odds ratio of 27.7 ( 95% CI 1.27-604.3, p=0.034). Patients suffering from PPH represent a high-risk population for TRALI. The patients with gestational hypertension and pre-eclampsia, not receiving anti-hypertensive therapy, have the highest risk. Therefore, a careful monitoring of these patients after transfusions is recommended.

  14. Severe maternal morbidity and breastfeeding outcomes in the early post-natal period: a prospective cohort study from one English maternity unit.

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    Furuta, Marie; Sandall, Jane; Cooper, Derek; Bick, Debra

    2016-10-01

    Previous research has identified potential issues of establishing and maintaining breastfeeding among women who experience severe maternal morbidity associated with pregnancy and birth, but evidence in the UK maternity population was scarce. We explored the association between severe maternal morbidity and breastfeeding outcomes (uptake and prevalence of partial and exclusive breastfeeding) at 6 to 8 weeks post-partum in a UK sample. Data on breastfeeding outcomes were obtained from a large cohort study of women who gave birth in one maternity unit in England to assess the impact of women's experiences of severe maternal morbidity (defined as major obstetric haemorrhage, severe hypertensive disorder or high dependency unit/intensive care unit admission) on their post-natal health and other important outcomes including infant feeding. Results indicated that among women who responded (n = 1824, response rate = 53%), there were no statistically significant differences in breastfeeding outcomes between women who did or did not experience severe morbidity, except for women with severe hypertensive disorder who were less likely to breastfeed either partially or exclusively at 6 to 8 weeks post-partum. Rather, breastfeeding outcomes were related to multi-dimensional factors including sociodemographic (age, ethnicity, living arrangement), other pregnancy outcomes (neonatal intensive care unit admission, mode of birth, women's perceived control during birth) and post-natal psychological factors (depressive symptoms). Women who experience severe maternal morbidity can be reassured that establishing successful breastfeeding can be achieved. More studies are required to understand what support is best for women who have complex health/social needs to establish breastfeeding. © 2015 John Wiley & Sons Ltd.

  15. Reproductive responses and productive characteristics in ewes supplemented with detoxified castor meal for a long period

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    Liliane Moreira Silva

    2014-08-01

    Full Text Available The objective of the present study was to evaluate the effects of supplementation with detoxified castor meal (DCM in the diet of ewes during pregnancy, partum, and post-partum on the weight development of their offspring and at slaughter. The study included 56 ewes with synchronized estrus that were naturally mated. At the beginning of pregnancy and in post-partum, hepatic and renal function-related parameters and progesterone levels were measured. At slaughter, the proximate composition and fatty acid profile were determined in the loin of ewes. There was no effect of diet on reproductive response after estrus synchronization. At the beginning of pregnancy, albumin and creatinine levels were lower in the DCM group. Supplementation with DCM did not alter the weight or body condition of ewes at partum. However, at weaning, the DCM group showed a higher loin-eye area (LEA in relation to the group fed diets without detoxified castor meal (WDCM. At partum, as well as at weaning, the offspring of the ewes supplemented with DCM had a larger LEA than the WDCM group. In post-partum, levels of glucose, urea, protein, and cholesterol were lower in the DCM group. The return to cyclicity was similar in both groups, with an average of 47 days after partum. At slaughter, neither anatomical and carcass components nor the results of the proximate analysis were affected by the type of diet, except for an increase in heptadecanoic acid in the DCM group. Supplementation with detoxified castor meal in the diet of ewes does not affect lambing, pregnancy, prolificacy, return to cyclicity, milk production, blood biochemical parameters, or carcass characteristics.

  16. Factors associated with unintended pregnancy, poor birth outcomes and post-partum contraceptive use among HIV-positive female adolescents in Kenya

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    Obare Francis

    2012-10-01

    Full Text Available Abstract Background Although the experiences of unintended pregnancies and poor birth outcomes among adolescents aged 15–19 years in the general population are well documented, there is limited understanding of the same among those who are living with HIV. This paper examines the factors associated with experiencing unintended pregnancies, poor birth outcomes, and post-partum contraceptive use among HIV-positive female adolescents in Kenya. Methods Data are from a cross-sectional study that captured information on pregnancy histories of HIV-positive female adolescents in four regions of Kenya: Coast, Nairobi, Nyanza and Rift Valley provinces. Study participants were identified through HIV and AIDS programs in the four regions. Out of a total of 797 female participants, 394 had ever been pregnant with 24% of them experiencing multiple pregnancies. Analysis entails the estimation of random-effects logit models. Results Higher order pregnancies were just as likely to be unintended as lower order ones (odds ratios [OR]: 1.2; 95% confidence interval [CI]: 0.8–2.0 while pregnancies occurring within marital unions were significantly less likely to be unintended compared to those occurring outside such unions (OR: 0.1; 95% CI: 0.1–0.2. Higher order pregnancies were significantly more likely to result in poor outcomes compared to lower order ones (OR: 2.5; 95% CI: 1.6–4.0. In addition, pregnancies occurring within marital unions were significantly less likely to result in poor outcomes compared to those occurring outside such unions (OR: 0.3; 95% CI: 0.1–0.9. However, experiencing unintended pregnancy was not significantly associated with adverse birth outcomes (OR: 1.3; 95% CI: 0.5–3.3. There was also no significant difference in the likelihood of post-partum contraceptive use by whether the pregnancy was unintended (OR: 0.9; 95% CI: 0.5–1.5. Conclusions The experience of repeat unintended pregnancies among HIV-positive female adolescents

  17. Pregnancy and post-partum depression and anxiety in a longitudinal general population cohort: the effect of eating disorders and past depression.

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    Micali, Nadia; Simonoff, Emily; Treasure, Janet

    2011-06-01

    This study investigated the effect of past depression, past and current eating disorders (ED) on perinatal anxiety and depression in a large general population cohort of pregnant women, the Avon Longitudinal Study of Parents and Children (ALSPAC). Anxiety and depression were measured during and after pregnancy in 10,887 women using the Crown-Crisp Experiential Inventory and Edinburgh Postnatal Depression Scale. Women were grouped according to depression and ED history: past ED with (n = 123) and without past depression (n = 50), pregnancy ED symptoms with (n = 77) and without past depression (n = 159), past depression only (n = 818) and controls (n = 9,660). We compared the course of depression and anxiety with linear mixed-effect regression models; and probable depressive and anxiety disorders using logistic regression. Women with both past depression and past/current ED had high anxiety and depression across time perinatally; this was most marked in the group with pregnancy ED symptoms and past depression (b coefficient:5.1 (95% CI: 4.1-6.1), p depressive and anxiety disorder compared to controls. At 8 months post-partum pregnancy ED symptoms and/or past depression conferred the highest risk for a probable depressive and anxiety disorder. Data were based on self-report. There was some selective attrition. Pregnancy ED symptoms and past depression have an additive effect in increasing the risk for depression and anxiety perinatally. Screening at risk women for anxiety and depression in the perinatal period might be beneficial. Copyright © 2010 Elsevier B.V. All rights reserved.

  18. Broiler adaptation to post-hatching period

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    Maiorka Alex

    2006-01-01

    Full Text Available In the latest years more attention has been given to mechanisms for bird adaptation at post-hatching period by management of environmental conditions and formulations of diets offered during this period when digestive, immune, and thermo-regulating systems suffer slight changes. In post-hatching period, digestive system is anatomically complete, but its functionality is still immature in relation to adult birds. The chick immunity depends on maternal antibodies transferred to egg just before laying. In addition, variations within thermal comfort zone might affect initial development of chick. For example, high temperatures may induce hyperthermia with dehydration, while low temperatures may lead to hypothermia responsible by pulmonary hypertension syndrome. In conclusion, productivity might be enhanced when good conditions are offered to chicks during the period from last embryo development to first days after hatching.

  19. Measuring Post-Partum Haemorrhage in Low-Resource Settings: The Diagnostic Validity of Weighed Blood Loss versus Quantitative Changes in Hemoglobin.

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    Esther Cathyln Atukunda

    Full Text Available Accurate estimation of blood loss is central to prompt diagnosis and management of post-partum hemorrhage (PPH, which remains a leading cause of maternal mortality in low-resource countries. In such settings, blood loss is often estimated visually and subjectively by attending health workers, due to inconsistent availability of laboratory infrastructure. We evaluated the diagnostic accuracy of weighed blood loss (WBL versus changes in peri-partum hemoglobin to detect PPH.Data from this analysis were collected as part of a randomized controlled trial comparing oxytocin with misoprostol for PPH (NCT01866241. Blood samples for complete blood count were drawn on admission and again prior to hospital discharge or before blood transfusion. During delivery, women were placed on drapes and had pre-weighed sanitary towels placed around their perineum. Blood was then drained into a calibrated container and the sanitary towels were added to estimate WBL, where each gram of blood was estimated as a milliliter. Sensitivity, specificity, negative and positive predictive values (PPVs were calculated at various blood volume loss and time combinations, and we fit receiver-operator curves using blood loss at 1, 2, and 24 hours compared to a reference standard of haemoglobin decrease of >10%.A total of 1,140 women were enrolled in the study, of whom 258 (22.6% developed PPH, defined as a haemoglobin drop >10%, and 262 (23.0% had WBL ≥500mL. WBL generally had a poor sensitivity for detection of PPH (85% in high prevalence settings when WBL exceeds 750mL.WBL has poor sensitivity but high specificity compared to laboratory-based methods of PPH diagnosis. These characteristics correspond to a high PPV in areas with high PPH prevalence. Although WBL is not useful for excluding PPH, this low-cost, simple and reproducible method is promising as a reasonable method to identify significant PPH in such settings where quantifiable red cell indices are unavailable.

  20. The relational dimension of care for maternity blues and its relation to decompensation of a psychiatric disorder during the intermediate postpartum period in Cameroon.

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    Mboua, C P; Nkoum, B A; Abessouguié, S P

    2016-08-01

    In a setting such as Cameroon, where perinatal care offers few services for women with psychiatric problems during pregnancy, delivery, and the immediate postpartum period, the development of the relational dimension of care may help prevent severe psychiatric disorders . This study evaluates the role of the relational dimension of perinatal and early postpartum care (providing perinatal counseling and a space to speak) on women with blues on the intermediate-term outcomes of decompensation, in view of the importance of the emotional issues occurring in the perinatal period. Data collection used both diagnostic and clinical methods on a sample of 50 women from three hospitals in Cameroon who gave birth during the study period and agreed to participate. Of the 38 diagnosed with blues, 10 were available for observation during the intermediate post-partum: they were sorted into an experimental group that received perinatal counseling (n=5) and a control group that did not. The results suggest the importance to women with blues of a space for talking during the post-partum period. In particular, the quality of this counseling, in terms of the emotional responses of the nursing staff, determines the outcome of this management and can help to reduce the outset of depression and decompensation.

  1. Magnitude da depressão pós-parto no Brasil: uma revisão sistemática The extent of post-partum depression in Brazil: a systematic review

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    Gustavo Lobato

    2011-12-01

    Full Text Available OBJETIVOS: realizar uma revisão sistemática dos estudos sobre a magnitude da depressão pós-parto (DPP no Brasil. MÉTODOS: a busca e seleção da literatura baseouse em artigos publicados em periódicos nacionais e internacionais, nas bases de dados eletrônicas Lilacs, SciELO e Medline. RESULTADOS: foram selecionados 14 estudos, sendo que 13 deles reportavam a prevalência de DPP e apenas um estudo de seguimento com limitada casuística (n=21 trazia estimativa da incidência do agravo (42,8%. A grande heterogeneidade em relação à população de estudo, método diagnóstico utilizado e período pós-parto focalizado dificultou a obtenção de uma estimativa agregada da prevalência de DPP no Brasil. Contudo, estudos conduzidos em unidades básicas de saúde, no âmbito da Estratégia de Saúde da Família ou em populações carentes apontaram uma prevalência entre 30 e 40% de DPP, enquanto pesquisas que incluíram amostras de base populacional e populações de unidades hospitalares terciárias revelaram uma prevalência de cerca de 20%. CONCLUSÕES: embora novos estudos sejam necessários para melhor caracterizar as peculiaridades que envolvem a magnitude da DPP no Brasil, as evidências disponíveis justificam uma atenção prioritária para os agravos à saúde mental materna no âmbito da saúde pública no país.OBJECTIVES: to carry out a systematic review of studies of the extent of post-partum depression (PPD in Brazil. METHODS: articles were searched for and selected from national and international periodicals included in the Lilacs, SciELO and Medline electronic databases. RESULTS: fourteen studies were selected, thirteen of which reported the prevalence of PPD and one, which followed up a limited number of cases (n=21 estimated the incidence of the disorder at 42.8%. The wide range of different populations studied, diagnostic methods used, and post-partum period monitored made it difficult to obtain an aggregate estimate for

  2. Cardiovascular System during the Post Partum State in Women with a History of Preeclampsia

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    Evans, Caroline S.; Gooch, Linda; Flotta, Deborah; Lykins, David; Powers, Robert W.; Landsittel, Douglas; Roberts, James M.; Shroff, Sanjeev G.

    2011-01-01

    Hypothesis In subjects with previous preeclampsia, differences in cardiovascular and/or blood biochemical parameters are present in the non-pregnant state and that a simultaneous assessment of multiple derived indices better differentiates between women with or without prior preeclampsia. We examined 18 prior preeclamptic and 50 prior uncomplicated pregnancies, ~16 months post partum. Cardiovascular assessment included: (1) systemic hemodynamics and mechanics (Doppler echocardiography, tonometry, oscillometric sphygmomanometry) (2) endothelial function (plethysmography) (3) left ventricular properties (echocardiography), and (4) blood biochemical analyses. Compared to women with prior uncomplicated pregnancies, prior preeclamptics had higher mean (80±1 vs. 86±3 mmHg, P=0.04) and diastolic (64±1 vs. 68±2 mmHg; P=0.04) pressures and total vascular resistance (1562±37 vs. 1784±114 dyne•s/cm5; P=0.03). Systolic blood pressure, arterial compliance, and left ventricular properties were not different. While heart-to-femoral pulse wave velocity was not different, heart-to-brachial pulse wave velocity tended to be faster in prior preeclamptics (374±8 vs. 404±20 cm/s; P=0.06). Stress-induced increase in forearm blood flow was less in prior preeclamptics (245±21% vs. 136±22%; P=0.01), indicating impaired endothelial function. No significant differences were observed in markers of endothelial activation, dyslipidemia, or oxidative stress; prior preeclamptics tended to have higher glucose level (58.7±1.9 vs. 95±5.2 mg/dl; P=0.06). Logistic regression analysis indicated that a simultaneous evaluation of multiple derived indices better discriminated between the two groups. The differences in the prior preeclamptic group are in directions known to be associated with greater cardiovascular disease risk later in life. PMID:21606389

  3. Effect of Dietary Palm oil Fatty Acids and Buffer on Physiological Performance of Cows During The Transition Period

    International Nuclear Information System (INIS)

    Teama, F.E.I.; Osman, S.F.; El-Tarabany, A.A.

    2013-01-01

    The aim of the present study is to examine the physiological effect of supplemental palm oil fatty acids- Ca salt and buffer on some biochemical and hormonal levels, milk yield and composition for high yielding Holstein Friesian cows during transition period. Thirty six Holstein Friesian cows, aged 53±1.4 months and 739±19.86 kg body weight, were used. The cows were randomly divided into three groups; 12 cows each, control group, the second group received 4% calcium salt palm oil fatty acid (Ca-POFA) and the third group received Ca-POFA + buffer ( 0.5% sodium bicarbonate) for three weeks before and after parturition (transition period). Blood samples were collected at 21, 14, 7 and 2 days before and 2, 7, 14 and 21 days after parturition to assess total protein, albumin, globulin, glucose, cholesterol, creatinine, total lipids and total cholesterol in addition to cortisol and progesterone hormones. Milk yield were recorded for each animal and samples were taken after parturition at different intervals (7, 14 and 21 days) to assess milk composition. Significant decreases in total protein, globulin, total lipids, cortisol and progesterone levels in post-partum cows compared to pre-partum were improved after Ca-POFA + buffer supplementation. On the other hand, increased levels of serum albumin, cholesterol and creatinine were recorded in post-partum period which returned to the normal level as shown in albumin only after treatment with Ca-POFA + buffer. A continuous increase in cholesterol and creatinine levels was observed as a result of supplementation of Ca-POFA + buffer (0.5% sodium bicarbonate). Significant improvements in milk yield, 4% FCM and GE were determined after Ca-POFA + buffer supplementation whereas non-significant changes were recorded in total solids, fat, protein and ash content of milk. In the present study, supplementation of cows in transition period with Ca-POFA + buffer (0.5% sodium bicarbonate) can improve the levels of some blood components

  4. Prise en charge des plaies du périnée en post partum: faut-il prescrire systématiquement un antibiotique?

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    Fouelifack, Florent Ymele; Eko, Filbert Eko; Ko’A, Claude Odile Vanessa Ebode; Fouedjio, Jeanne Hortence; Mbu, Robinson Enow

    2017-01-01

    Résumé Introduction L'intégrité des voies génitales n'est pas toujours respectée au cours de l'accouchement. Aucun protocole de prise en charge des plaies périnéales du post-partum (déchirures et épisiotomies) n'existant dans nos services, la prise en charge reste praticien dépendant. Nous avons entrepris cette étude dans le but d'établir l'intérêt de l'antibiotique dans le traitement des plaies périnéales du post-partum. Notre objectif était d'évaluer l'impact de l'antibioprophylaxie sur le processus de cicatrisation et dans la prévention des complications infectieuses après réparation. Méthodes Il s'agissait d'une étude de cohorte prospective sur une durée de 6 mois, soit du 1er janvier au 31 mai 2016, menée dans l'Unité de Gynécologie et Obstétriques de l'Hôpital Central de Yaoundé. Deux groupes A et B d'accouchées avec déchirure périnéale et/ou épisiotomie étaient suivies. Le groupe A était composé de 85 accouchées à qui on avait prescrit le protocole compresse imbibée de Bétadine® (placebo). Le groupe B (ou groupe test) était composé d'accouchées qui en plus du placebo, avaient la prescription d'un antibiotique (association 1000mg d'amoxicilline et 125mg d'acide clavulanique à raison de 1000mg 2fois par jour par voie orale pendant 05 jours). Les 2 groupes étaient suivis à J0, J2 et J9. Nos critères d'évaluation de la prise en charge étaient: la douleur, l'infection, la tuméfaction, la propreté de la plaies et le delai de cicatrisation complete. Les données étaient saisies et analysées à l'aide des logiciels Epidata analysis version 3.2 et STATA version 12.0 (Texas USA 2001). Les corrélations entre les variables étaient recherchées selon le cas par le chi carré, l'Odds ratio et avec la valeur de P (significatif pour toute valeur ≤ 0.05). Résultats La moyenne d'âge était de 26.32 ± 6.5 ans avec des extrêmes de 15 et 43 ans. Les primipares représentaient 55.9% de la population d'étude. La

  5. Identification of risk factors and demographic features of patients with peri partum cardiomyopathy

    International Nuclear Information System (INIS)

    Sharieff, S.; Khan, Shah-e-Zaman

    2002-01-01

    Objective: To describe and identify the demographic features and risk factors for peri partum cardiomyopathy (PPCM). Design: A prospective study: The study was conducted at the department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan from December 1999 to August 2001. Subjects and Methods: A total of 35 consecutive patients diagnosed to have peri partum cardiomyopathy (PPCM) on echocardiogram were enrolled. Proforma containing demographic characteristics and established risk factors for PPCM was established and filled carefully. The data gathered was analyzed statistically. Results: The mean age at the time of diagnosis was 30.8-6.74 years. Urdu speaking (Mohajir) population was found to be more affected ethnic group (42.9%) Majority of the patients was from lower socio-economic group with poor nutritional status (77%) and multiparous (77.14%). 25.7% had past history of PPCM and 71.4% presented during postpartum period. Mortality at six months was 22.8% while 42.9% had persistent disease and only 34.3% recovered completely. Conclusion: Advanced age, lower economic group with poor nutritional status, multi parity and past history of peri partum cardiomyopathy were identified as risk factors for the development of PPCM, especially among Mohajir population. There was no statistically significant difference between the clinical features and outcome of patients presented first time or with recurrent PPCM. We identified advanced age (>30 years), high LVEDD, and low ejection fraction (EF) at initial presentation as poor prognostic factors. (author)

  6. Separation anxiety, attachment and inter-personal representations: disentangling the role of oxytocin in the perinatal period.

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    Valsamma Eapen

    Full Text Available In this paper, we aimed to assess cross-sectionally and longitudinally associations between disturbances in maternal early attachment experiences, symptoms of separation anxiety and depression and oxytocin plasma levels. We examined a mediational model that tested the hypothesis that anxious attachment style arising from the mothers' early bonding experiences with her own parents was associated with high levels of separation anxiety which, via its impact on depression, was associated with reduced levels of oxytocin in the postnatal period. Data is reported on a structured sample of 127 women recruited during pregnancy from a general hospital antenatal clinic and an initial follow up cohort of 57 women who were re-assessed at 3-months post-partum. We found an association between lower oxytocin level in the post partum period and symptoms of separation anxiety and depression during pregnancy, as well as maternal negative interpersonal representations, upbringing attributes and anxious attachment style. Further meditational analysis revealed that the unique association between anxious attachment and depression is mediated by separation anxiety and that depressed mood mediated the relationship between separation anxiety and oxytocin. In conjunction with evidence from the literature suggesting that lower oxytocin level is associated with bonding difficulties, our findings have significant implications for understanding the biological processes underpinning adverse attachment experiences, negative affect state, and mother-to-infant bonding difficulties.

  7. Management of Recurrent Post-partum Pregnancy Tumor with Localized Chronic Periodontitis.

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    Reddy, N Raghavendra; Kumar, P Mohan; Selvi, Tamil; Nalini, H Esther

    2014-05-01

    Pregnancy tumor is a benign, hyperplastic lesion of the gingiva, considered to be reactive or traumatic rather than neoplastic in nature. The term pyogenic granuloma is a misnomer as it is not filled with pus or granulomatous tissue histologically. It is multi factorial in nature, which shows an exaggerated response to stimuli such as low grade or chronic irritation, trauma or hormonal variations. Higher levels of sex hormones during pregnancy produce effects on sub gingival microflora, the immune system, the vasculature and specific cells of periodontium which in turn in the presence of local irritants exaggerate the lesion. Since the lesion is clinically indistinguishable from other type of hyperplastic conditions, histological findings are required for proper diagnosis. We present a case report of recurrent pyogenic tumor which showed the evidence of pre-existing localized periodontitis with extensive horizontal bone destruction. The lesion was excised by electrocautery combined with conventional flap procedure after parturition period. During 3 and 6 months follow-up period post-operative healing showed satisfactory results without recurrence.

  8. Management of Recurrent Post-partum Pregnancy Tumor with Localized Chronic Periodontitis

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    N. Raghavendra Reddy

    2014-01-01

    Full Text Available Pregnancy tumor is a benign, hyperplastic lesion of the gingiva, considered to be reactive or traumatic rather than neoplastic in nature. The term pyogenic granuloma is a misnomer as it is not filled with pus or granulomatous tissue histologically. It is multi factorial in nature, which shows an exaggerated response to stimuli such as low grade or chronic irritation, trauma or hormonal variations. Higher levels of sex hormones during pregnancy produce effects on sub gingival microflora, the immune system, the vasculature and specific cells of periodontium which in turn in the presence of local irritants exaggerate the lesion. Since the lesion is clinically indistinguishable from other type of hyperplastic conditions, histological findings are required for proper diagnosis. We present a case report of recurrent pyogenic tumor which showed the evidence of pre-existing localized periodontitis with extensive horizontal bone destruction. The lesion was excised by electrocautery combined with conventional flap procedure after parturition period. During 3 and 6 months follow-up period post-operative healing showed satisfactory results without recurrence.

  9. Reversible posterior leucoencephalopathy syndrome in a peripartum patient.

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    Prout, R E; Tuckey, J P; Giffen, N J

    2007-01-01

    We present the case of a multiparous parturient who developed hypertension associated with a severe headache in the immediate post-partum period. She subsequently suffered a generalised tonic clonic seizure on the fifth post-partum day. Following recovery of consciousness, she developed a left homonymous hemianopia. Apart from hypertension, headache and convulsion, she had no symptoms and no proteinuria or other biochemical or haematological changes associated with eclampsia. The magnetic resonance imaging findings were consistent with vasogenic oedema in the right posterior parieto-occipital white matter and these in turn are consistent with reversible posterior leucoencephalopathy syndrome. The differential diagnosis of convulsions in the post-partum period is discussed and the clinical and radiological features of reversible posterior leucoencephalopathy syndrome are described.

  10. Effects of a single administration of prostaglandin F2alpha, or a combination of prostaglandin F2alpha and prostaglandin E2, or placebo on fertility variables in dairy cows 3-5 weeks post partum, a randomized, double-blind clinical trial.

    Science.gov (United States)

    Hirsbrunner, Gaby; Burkhardt, Heinz W; Steiner, Adrian

    2006-12-21

    Delayed uterine involution has negative effects on the fertility of cows; use of prostaglandin F2alpha alone as a single treatment has not been shown to consistently improve fertility. Combined administration of PGF2alpha and PGE2 increased uterine pressure in healthy cows. We hypothesized, that the combination of both prostaglandins would accelerate uterine involution and have, therefore, a positive effect on fertility variables. In commercial dairy farming, the benefit of a single post partum combined prostaglandin treatment should be demonstrated. 383 cows from commercial dairy farms were included in this study. Uterine size and secretion were evaluated at treatment 21-35 days post partum and 14 days later. Cows were randomly allocated to one of three treatment groups: PGF2alpha and PGE2, PGF2alpha or placebo. For every animal participating in the study, the following reproduction variables were recorded: Interval from calving to first insemination, days open, number of artificial inseminations (AI) to conception; subsequent treatment of uterus, subsequent treatment of ovaries. Plasma progesterone level at time of treatment was used as a covariable. For continuous measurements, analysis of variance was performed. Fisher's exact test for categorical non-ordered data and exact Kruskal-Wallis test for ordered data were used; pairwise group comparisons with Bonferroni adjustment of significance level were performed. There was no significant difference among treatment groups in uterine size. Furthermore, there was no significant difference among treatments concerning days open, number of AI, and subsequent treatment of uterus and ovaries. Days from calving to first insemination tended to be shorter for cows with low progesterone level given PGF2alpha and PGE2 in combination than for the placebo-group (P = 0.024). The results of this study indicate that the administration of PGF2alpha or a combination of PGF2alpha and PGE2 21 to 35 days post partum had no beneficial

  11. Socio-demographic characteristics and risk factors of ante-partum fetal death in a tertiary care hospital in Dhaka City.

    Science.gov (United States)

    Azim, A K; Sultana, N; Chowdhury, S; Azim, E

    2013-10-01

    The objectives of this study were to assess the socio-demographic profile and to identify the risk factors of ante-partum fetal death which occurs after the age of viability of fetus. This prospective observational study was conducted in the Obstetrics and Gynaecology department of Ad-din Women Medical College Hospital from June 2009 to July 2010. A total of 14,015 pregnant patients were admitted in the study place after the age of viability, which was taken as 28 weeks of gestation for our facilities. Eighty-three (0.59%) of them were identified as intrauterine fetal death. Assessment of maternal socio-demographic characteristics and maternal-fetal risk factors were evaluated with a semi structured questionnaire which was pre-tested before executing in this study. Majority (81.92%, n=68) of the patients were below 30 years of age, 78.31% belonged to middle socioeconomic group. Almost 58% women had education below secondary school certificate (SSC) level and 28.91% took regular antenatal checkup. About 61.45% patients were multi-gravida. Most (59.04%) ante-partum deaths were identified below 32 weeks of pregnancy. Out of 83 patients, maternal risk factors were identified in 41(49.59%) cases where fetal risk factors were found in 16(19.27%) cases; no risk factors could be determined in rests. Hypertension (48.78%), diabetes (21.95%), hyperpyrexia (17.3%), abruptio placentae (4.88%) and UTI (7.36%) were identified as maternal factors; and congenital anomaly (37.5%), Rh incompatibility (37.5%), multiple pregnancy (12.5%) and post-maturity (12.5%) were the fetal risk factors. Here, proximal biological risk factors are most important in ante-partum fetal deaths. More investigations and facilities are needed to explain the causes of ante-partum deaths.

  12. Ultrasonographic visualization of bleeding sites can help control postpartum hemorrhage using intrauterine balloon tamponade.

    Science.gov (United States)

    Kondoh, Eiji; Konishi, Mitsunaga; Kariya, Yoshitaka; Konishi, Ikuo

    2015-01-01

    Identification of precise bleeding sites is generally important to control hemorrhage. Nevertheless, the optimal technique to detect the bleeding sites has not yet been fully defined for patients with life-threatening post partum hemorrhage. We describe that ultrasonographic visualization of bleeding sites can help control post partum hemorrhage using intrauterine balloon tamponade. © 2014 Wiley Periodicals, Inc.

  13. Effect of diet supplementation on growth and reproduction in camels under arid range conditions

    Directory of Open Access Journals (Sweden)

    Abdouli H.

    2001-01-01

    Full Text Available Eighteen pregnant dromedary females (Camelus dromedarius were used to determine the effect of concentrate supplement on growth and reproductive performances in peri-partum period. The females were divided into supplemented (n = 9; S and unsupplemented (n = 9; C experimental groups. All animals grazed, with one mature male, 7 to 8 hours per day on salty pasture rangelands. During night, they were kept in pen, where each female of group S received 4 kg per day of concentrate supplement during the last 3 months of gestation and 5 kg per day during the first 3 months post-partum. During the last 90 days of gestation daily body weight gain (DBG was at least tenfold more important in group S than in group C (775 g vs. 72 g respectively. Supplementation affected birth weight of offspring (30.3 kg vs. 23.4 kg and its DBG (806 g vs. 430 g in group S and group C respectively. During the post-partum period, females in group S gained in weight (116 g per day whereas females in group C lost more than 200 g per day. The mean post-partum interval to the first heat and the percentage of females in heat were 29.5 day and 44.4/ vs. 41.2 day and 71.4/ for the C and S groups, respectively. We conclude that under range conditions, dietary supplementation of dromedary during late pregnancy stage and post-partum period improves productive and reproductive parameters.

  14. Carbetocin versus oxytocin in the management of atonic post partum haemorrhage (PPH) after vaginal delivery: a randomised controlled trial.

    Science.gov (United States)

    Maged, Ahmed Mohamed; Hassan, AbdelGany M A; Shehata, Nesreen A A

    2016-05-01

    The objective of this study is to compare the effectiveness and safety of carbetocin vs. oxytocin in the management of atonic post partum haemorrhage (PPH) after vaginal delivery. A prospective randomised study was conducted in which 100 pregnant women were randomised into 2 equal groups: group 1 received Carbetocin 100 µgm (Pabal(®) Ferring, UK) and group 2 received oxytocin 5 IU (Syntocinon(®), Novartis, Switzerland). The amount of blood loss and the need for other uterotonics were significantly lower in the carbetocin group (811 ± 389.17 vs. 1010 ± 525.66 and 10/50 vs. 21/50). There was no significant difference between the carbetocin and oxytocin groups regarding occurrence of major PPH (6 vs. 11), the need for blood transfusion (6 vs. 9), the difference between blood haemoglobin levels before delivery and 24 h after delivery (0.6 ± 0.28 vs. 0.56 ± 0.25), respectively. There was no significant difference between the 2 study groups regarding both systolic and diastolic blood pressure measured immediately after the drug administration and at 30 and 60 min later. Regarding the drugs side effects, there was no significant difference between the 2 groups in the occurrence of nausea, vomiting, tachycardia, flushing, dizziness, headache, shivering, metallic taste, dyspnea, palpitations and itching. Carbetocin is a better alternative to oxytocin in management of atonic PPH with non-significant hemodynamic changes or side effects .

  15. Sheehan’s Syndrome: A Case Report and Literature Review

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    S Errarhay

    2009-01-01

    Full Text Available Post-partum pituitary necrosis (Sheehan’s syndrome is a rare complication of post-partumhemorrhage. The diagnosis can be erratic and often delayed. In this case report of Sheehan’ssyndrome in the post-partum period, the signs were characterized by agalactia, severe hypoglycemia,and low serum levels of thyroid hormones, cortico-adrenal hormones, and gonadotrophin (FSH, LH.The hypophyseal magnetic resonance imaging confirmed the diagnosis of hypopituitarism secondaryto pituitary necrosis.

  16. Influence Of Summer Season On Some Biochemical And Hormonal Changes In Crossbred Cows During Suckling Period

    International Nuclear Information System (INIS)

    Teama, F.E.I.; Gad, A.E.

    2012-01-01

    According to the seasonal variations in environmental conditions in post-partum cows, some biochemical and physiological changes which affect the productive efficiency of farm animals may occur. This study was conducted in the bovine farm of Experimental Farms Project of Nuclear Research Centre, Atomic Energy Authority, Inshas, Egypt, to evaluate some blood biochemical and some hormonal changes during the suckling period in crossbred cows under winter and summer conditions. Alterations in metabolites and metabolic hormones during the first 10 weeks post-partum in both winter and summer during a period of suckling were analyzed on a total of 13 crossbred (Brown Swiss X Balady) cows (winter, n=7; summer, n=6). The blood samples were taken at 2 weeks intervals, 5 times in each season to determine the concentrations and changes in glucose, urea, total cholesterol, total proteins and some hormones including leptin, T4 and progesterone (P4) under winter and summer conditions. The data indicated that total protein (P<0.01), glucose (P<0.05), leptin (P<0.01), total cholesterol (P<0.01), and T4 (P<0.01) had significant seasonal differences between the two calving groups. A positive correlation coefficient was observed between leptin and T4 hormone. From the obtained data, it could be concluded that in summer season, certain biochemical and hormonal levels of calving cows may enhanced but not enough to affect the levels of urea and progesterone. The positive correlation between leptin and T4 may indicate association in the rate of metabolism.

  17. [Excrement of the meconium and the intra-partum cardiotocogram].

    Science.gov (United States)

    Santeler, P; Hochuli, E

    1976-01-01

    Of 2233 parturients, 170 cases with evidence of meconium during delivery were examined. We tried to establish the correlation between the appearance of meconium and the occurance of contraction induced FHR-decelerations in continuous intra partum monitoring. In addition we purposed to determine, whether the appearing of meconium during labor can be used as a clinical prognosite sign for fetal outcome. Our data support the assumption that the passage of meconium during any stage of labor only represents a sign of potential fetal distress showing the intra partum records pathology FHF-patterns. The appearance of meconium alone -- diagnosed at the time of the entrance of parturients or in an advanced stage of labor -- demands supplemented diagnostic methods for a better interpreting of an actual or compensated fetal distress.

  18. Effect of changes in dietary sodium on active electrolyte transport by erythrocytes at different stages of human pregnancy.

    Science.gov (United States)

    Gallery, E D; Rowe, J; Brown, M A; Ross, M

    1988-02-01

    1. Active electrolyte transport was examined in erythrocytes from women in the second and third trimesters of pregnancy and post partum, and compared with that in ovulating women. 2. There was a significant reduction in intracellular sodium ([Na]i) and increase in intracellular potassium ([K]i) in pregnancy with a return towards normal values in the post-partum period. 3. Maximum specific ouabain binding [number of Na+,K+-adenosine triphosphatase (Na+, K+-ATPase) units] was increased by 70% in pregnancy and returned slowly towards normal values post partum. 4. Na+,K+-ATPase activity as determined by ouabain-sensitive 86Rb influx in artificial media was also increased in pregnancy by 13%. It returned towards normal post partum. 5. The increases in Na+,K+-ATPase in pregnancy were not closely related to the concomitant increases in aldosterone or cholesterol nor to reticulocytosis and were not affected by 7 days of high (greater than 250 mmol/day) or low (less than 50 mmol/day) sodium intake.

  19. Effects of a single administration of prostaglandin F2alpha, or a combination of prostaglandin F2alpha and prostaglandin E2, or placebo on fertility variables in dairy cows 3–5 weeks post partum, a randomized, double-blind clinical trial

    Directory of Open Access Journals (Sweden)

    Steiner Adrian

    2006-12-01

    Full Text Available Abstract Background Delayed uterine involution has negative effects on the fertility of cows; use of prostaglandin F2alpha alone as a single treatment has not been shown to consistently improve fertility. Combined administration of PGF2alpha and PGE2 increased uterine pressure in healthy cows. We hypothesized, that the combination of both prostaglandins would accelerate uterine involution and have, therefore, a positive effect on fertility variables. In commercial dairy farming, the benefit of a single post partum combined prostaglandin treatment should be demonstrated. Methods 383 cows from commercial dairy farms were included in this study. Uterine size and secretion were evaluated at treatment 21–35 days post partum and 14 days later. Cows were randomly allocated to one of three treatment groups: PGF2alpha and PGE2, PGF2alpha or placebo. For every animal participating in the study, the following reproduction variables were recorded: Interval from calving to first insemination, days open, number of artificial inseminations (AI to conception; subsequent treatment of uterus, subsequent treatment of ovaries. Plasma progesterone level at time of treatment was used as a covariable. For continuous measurements, analysis of variance was performed. Fisher's exact test for categorical non-ordered data and exact Kruskal-Wallis test for ordered data were used; pairwise group comparisons with Bonferroni adjustment of significance level were performed. Results There was no significant difference among treatment groups in uterine size. Furthermore, there was no significant difference among treatments concerning days open, number of AI, and subsequent treatment of uterus and ovaries. Days from calving to first insemination tended to be shorter for cows with low progesterone level given PGF2alpha and PGE2 in combination than for the placebo-group (P = 0.024. Conclusion The results of this study indicate that the administration of PGF2alpha or a combination

  20. Effects of a single administration of prostaglandin F2alpha, or a combination of prostaglandin F2alpha and prostaglandin E2, or placebo on fertility variables in dairy cows 3–5 weeks post partum, a randomized, double-blind clinical trial

    Science.gov (United States)

    Hirsbrunner, Gaby; Burkhardt, Heinz W; Steiner, Adrian

    2006-01-01

    Background Delayed uterine involution has negative effects on the fertility of cows; use of prostaglandin F2alpha alone as a single treatment has not been shown to consistently improve fertility. Combined administration of PGF2alpha and PGE2 increased uterine pressure in healthy cows. We hypothesized, that the combination of both prostaglandins would accelerate uterine involution and have, therefore, a positive effect on fertility variables. In commercial dairy farming, the benefit of a single post partum combined prostaglandin treatment should be demonstrated. Methods 383 cows from commercial dairy farms were included in this study. Uterine size and secretion were evaluated at treatment 21–35 days post partum and 14 days later. Cows were randomly allocated to one of three treatment groups: PGF2alpha and PGE2, PGF2alpha or placebo. For every animal participating in the study, the following reproduction variables were recorded: Interval from calving to first insemination, days open, number of artificial inseminations (AI) to conception; subsequent treatment of uterus, subsequent treatment of ovaries. Plasma progesterone level at time of treatment was used as a covariable. For continuous measurements, analysis of variance was performed. Fisher's exact test for categorical non-ordered data and exact Kruskal-Wallis test for ordered data were used; pairwise group comparisons with Bonferroni adjustment of significance level were performed. Results There was no significant difference among treatment groups in uterine size. Furthermore, there was no significant difference among treatments concerning days open, number of AI, and subsequent treatment of uterus and ovaries. Days from calving to first insemination tended to be shorter for cows with low progesterone level given PGF2alpha and PGE2 in combination than for the placebo-group (P = 0.024). Conclusion The results of this study indicate that the administration of PGF2alpha or a combination of PGF2alpha and PGE2 21 to

  1. Accident vasculaire cérébral hémorragique du tronc cérébral suite à une éclampsie du post partum: à propos d’un cas et revue de la littérature

    OpenAIRE

    Ennaqui, Khadija; Makayssi, Assia; Boufettal, Houssine; Samouh, Naima

    2017-01-01

    Les accidents vasculaires cérébraux sont des accidents rares mais graves durant la grossesse et le post-partum, ils sont responsable d'une mortalité et d'une morbidité élevée, la pré éclampsie, l'éclampsie et les accidents vasculaires cérébraux sont significativement liés. Le dysfonctionnement endothélial, l'altération de l'autorégulation cérébrale, et l'hypertension sévère sont, probablement, la cause de nombreux accidents vasculaires cérébraux chez la femme enceinte et durant la période du ...

  2. Clinical features and risk factors for post-partum depression in a large cohort of Chinese women with recurrent major depressive disorder.

    Science.gov (United States)

    Tian, Tian; Li, Yihan; Xie, Dong; Shen, Yifeng; Ren, Jianer; Wu, Wenyuan; Guan, Chengbin; Zhang, Zhen; Zhang, Danning; Gao, Chengge; Zhang, Xiaoming; Wu, Jinbo; Deng, Hong; Wang, Gang; Zhang, Yunshu; Shao, Yun; Rong, Han; Gan, Zhaoyu; Sun, Yan; Hu, Bin; Pan, Jiyang; Li, Yi; Sun, Shufan; Song, Libo; Fan, Xuesheng; Li, Yi; Zhao, Xiaochuan; Yang, Bin; Lv, Luxian; Chen, Yunchun; Wang, Xiaoli; Ning, Yuping; Shi, Shenxun; Chen, Yiping; Kendler, Kenneth S; Flint, Jonathan; Tian, Hongjun

    2012-02-01

    Post partum depression (PPD) is relatively common in China but its clinical characteristics and risk factors have not been studied. We set out to investigate whether known risk factors for PPD could be found in Chinese women. A case control design was used to determine the impact of known risk factors for PPD in a cohort of 1970 Chinese women with recurrent DSM-IV major depressive disorder (MDD). In a within-case design we examined the risk factors for PPD in patients with recurrent MDD. We compared the clinical features of MDD in cases with PPD to those without MDD. Odds ratios were calculated using logistic and ordinal regression. Lower occupational and educational statuses increased the risk of PPD, as did a history of pre-menstrual symptoms, stressful life events and elevated levels of the personality trait of neuroticism. Patients with PPD and MDD were more likely to experience a comorbid anxiety disorder, had a younger age of onset of MDD, have higher levels of neuroticism and dysthymia. Results obtained in this clinical sample may not be applicable to PPD within the community. Data were obtained retrospectively and we do not know whether the correlations we observe have the same causes as those operating in other populations. Our results are consistent with the hypothesis that the despite cultural differences between Chinese and Western women, the phenomenology and risk factors for PPD are very similar. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Short communication. Melatonin improves the reproductive performance of seasonal anoestrus goats exposed to buck effect during early post-partum

    Directory of Open Access Journals (Sweden)

    L. A. Zarazaga

    2013-10-01

    Full Text Available The aim of the present study was to determine whether any combination of buck effect and melatonin treatment could improve reproductive performance in Payoya female goats during early postpartum. Forty-four pregnant female goats were used. After birth in spring, they were distributed into two major groups: females submitted to the buck effect (BE, N=22 or not such effect (NBE, N=22. In turn, the BE animals were subdivided into: 1 no further treatment (CBE, N=11 and 2 implanted with melatonin (MELBE, N=11. And the NBE animals were subdivided into: 3 no further treatment (CNBE, N=12 and 4 implanted with melatonin (MELNBE, N=10. Melatonin was implanted 10 days after birth. Oestrus activity was tested daily using entire males from day of birth (D0 in the groups NBE and from D55 after birth in the BE groups. Transrectal ultrasonography was performed 10 days after the detection of oestrus and 45 days after mounting to determine pregnancy. Fecundity, fertility and productivity were higher in MELBE animals compared to CNBE animals (fecundity and fertility: 66.7% vs. 0.0%, and productivity: 0.73 vs. 0.00 kids/female for MELBE and CNBE respectively, p<0.05, and CBE animals (fecundity and fertility: 66.7% vs. 14.3%, and productivity: 0.73 vs. 0.09 kids/female for MELBE and CBE respectively; p<0.05. No significant differences were recorded between the subgroups of the NBE animals. The present results show that exogenous melatonin improves the reproductive performances of early post-partum Payoya does exposed to male effect during the seasonal anoestrus.

  4. The role of maternal thyroid hormones on the development of the brushtail possum, Trichosurus vulpecula.

    Science.gov (United States)

    Gemmell, R T; Buaboocha, W

    1998-01-01

    Thyroxine (T4) is a vital hormone for the development of mammals. To determine the role of maternal thyroid hormones on organ development, methimazole, an inhibitor of T4, was first administered via a minipump to 13 mothers with pouch young between days 10 and 80 post partum for 28 days. Three young survived and 10 of the young died at 104.0 +/- 10.8 days post partum (mean, SEM). Methimazole was then administered for 28 days to 6 lactating adult possums with pouch young at day 20 post partum. The effects of this treatment on the maternal plasma concentrations of T4 were monitored and the development of the lung, kidney and brain of the young were examined at day 90 post partum. There was no difference in the morphology of the lung, kidney and brain of pouch young at day 90 post partum whose mothers were treated with methimazole or saline. Thus methimazole administered to lactating possums for a short period early in lactation can cause the demise of the young about day 100 post partum although the cause of death is unknown. It is possible that the development of the central nervous system or some other vital organ has been inhibited, this altered state not being apparent morphologically. Nevertheless the marsupial appears to be similar to the eutherian in its requirement for thyroxine for normal development. However whereas this requirement is apparent during fetal development and around the time of birth in eutherians thyroxine is of importance during pouch development in marsupials.

  5. Post partum anxiety and depression in peri-urban communities of Karachi, Pakistan: a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Azam Iqbal S

    2009-10-01

    Full Text Available Abstract Background Postpartum anxiety and depression is a major public health concern because of its adverse effects on the cognitive and social development of the infant. Globally postpartum depression has been widely investigated but as anxiety is a more prominent feature of postpartum depression we assessed the prevalence of anxiety and depression and their associated factors in post partum women. Methods A quasi-experimental study investigating the impact of postpartum anxiety and depression on child growth and development was conducted in two peri-urban, multiethnic, communities of Karachi, a mega city of Pakistan. A house to house questionnaire based survey was done by trained field workers; 420 consenting pregnant women were identified and data for socio-demographic, home environment and family relationship variables was collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother's levels of anxiety and depression were assessed after one month, two months, six months and twelve months of childbirth; this was two step process: initially an indigenous, validated screening instrument Aga Khan University Anxiety and Depression Scale was used and diagnostic confirmation was done through a psychologist's interview based on DSM IV criteria. Women found to be anxious and depressed at least once out of four assessments were considered for the computation of overall prevalence of postpartum anxiety and depression as well as its risk factors. However, point prevalence's of postpartum anxiety and depression were also reported at each assessment time. Two sixty seven women could be followed for one year. Data was analyzed using SPSS. Chi-square test, simple and multiple logistic regression were used to see the association of different factors. Results The overall prevalence of postpartum anxiety and depression was found to be 28.8 percent. Domestic violence, difficulty in breast feeding at birth and unplanned current pregnancy

  6. Milk progesterone in evaluation of reproductive performance of dairy cattle in Costa Rica

    International Nuclear Information System (INIS)

    Taylor, R.T.; Hueckmann, F.; Estrada, S.; Padilla, M.; Robert, O.; Madriz, C.; Alfaro, R.; Gonzales, V.; Colmenares, A.

    1990-01-01

    Post-partum ovarian activity was studied by means of rectal palpation, and progesterone (P 4 ) concentration measured by radioimmunoassay in defatted milk samples in Jersey, Holstein, Criollo and Criollo x Jersey cows. The accuracy with which farm personnel detected oestrus was monitored from measurements of P 4 on the day of AI and 23 days later. P 4 profiles during the oestrous cycle and early pregnancy were determined in Jersey cows through the analysis of daily milk samples. Accuracy of pregnancy diagnosis as indicated by P 4 levels was 79% and 88% in Jersey and Holstein cows respectively. Diagnosis of non-pregnancy from P 4 levels was found to be 100% accurate. Only 62% of the Jerseys and 82.5% of the Holsteins which returned to oestrus after first AI post-partum were identified by staff on the different farms. Studies carried out in Jersey and Holstein cows during the early post-partum period revealed significant discrepancies between P 4 levels and palpable corpora lutea. P 4 profiles showed the presence of short (< 14 days) oestrous cycles in 53.9% and 47.4% of the Jersey and Holstein cows respectively during the first six weeks post-partum. Cows which developed milk fever at or before calving but which were treated promptly took no longer than healthy cows to resume ovarian activity. However, compared with healthy cows, those which had dystocia, retention of placenta or severe metritis took significantly longer (P < 0.01) to resume ovarian activity. Studies in the humid tropics during the post-partum period in Criollo, Criollo x Jersey and Jersey cows showed that 57% of the animals exhibited pre-ovulatory short cycles. Analysis of the monthly AI percentages in the different genetic groups indicated a seasonal distribution in sexual receptivity in both Criollo and Jersey dairy cows under these conditions; Criollo cows also resumed post-partum ovarian activity sooner than the other breeds. (author). 23 refs, 8 figs, 5 tabs

  7. Retinol sérico en mujeres mexicanas urbanas durante el periodo perinatal Serum retinol in urban Mexican women during the perinatal period

    Directory of Open Access Journals (Sweden)

    Esther Casanueva

    1999-07-01

    Full Text Available OBJETIVO. Establecer la prevalencia de deficiencia de vitamina A durante el embarazo y la lactancia en un grupo de mujeres mexicanas urbanas. MATERIAL Y MÉTODOS. Se invitó a participar a un grupo de gestantes que acudían a control prenatal, que carecían de patología agregada y contaban con menos de 20 semanas de embarazo. Fueron evaluadas tres veces durante el embarazo y hasta la semana 24 del posparto. La determinación de vitamina A en suero se realizó por cromatografía de líquidos de alta presión. Se consideró como punto de corte para riesgo de deficiencia una concentración de retinol OBJECTIVE. To establish the prevalence of vitamin A deficiency during pregnancy and lactation in a group of urban Mexican women. MATERIAL AND METHODS. A group of pregnant women who attended a prenatal care program were invited to participate. Subjects had no added pathologies and were less than 20 weeks pregnant. Evaluations were performed 3 times during pregnancy until 24 weeks post-partum. Vitamin A levels were determined in serum by high performance liquid chromatography (HPLC. The cut-off point to consider retinol deficiency was < 1.05 µmol/L. RESULTS. During the 3 gestational evaluations, vitamin A levels were 2.34±0.70, 2.41±1.03 and 1.86±0.66 µmol/L, respectively, which shows a significant decrease. However, only 1/30 was situated below the accepted cut-off point to consider risk of deficiency, and none for deficiency. During post-partum , concentrations remained relatively constant, approximately 2.10 µmol/L. Lactation had no impact on serum retinol levels, while weight loss did. CONCLUSIONS. No cases of vitamin A deficiency were found in the studied population during the perinatal period. Maternal weight loss affects post-partum retinol levels.

  8. Personal Care Product Use in Pregnancy and the Postpartum Period: Implications for Exposure Assessment

    Directory of Open Access Journals (Sweden)

    Carly Lang

    2016-01-01

    Full Text Available Concern regarding the potential for developmental health risks associated with certain chemicals (e.g., phthalates, antibacterials used in personal care products is well documented; however, current exposure data for pregnant women are limited. The objective of this study was to describe the pattern of personal care product use in pregnancy and the post-partum period. Usage patterns of personal care products were collected at six different time points during pregnancy and once in the postpartum period for a cohort of 80 pregnant women in Ottawa, Canada. The pattern of use was then described and groups of personal care product groups commonly used together were identified using hierarchical cluster analysis. The results showed that product use varied by income and country of birth. General hygiene products were the most commonly used products and were consistently used over time while cosmetic product use declined with advancing pregnancy and post-delivery. Hand soaps and baby products were reported as used more frequently after birth. This study is the first to track personal care product use across pregnancy and into the postpartum period, and suggests that pregnant populations may be a unique group of personal care product users. This information will be useful for exposure assessments.

  9. STUDI KASUS HUBUNGAN SENAM NIFAS DENGAN STATUS KESEHATAN IBU NIFAS

    Directory of Open Access Journals (Sweden)

    Gurendro Putro

    2012-11-01

    Full Text Available Background: During pregnancy and birth period there are physical changes, some of muscle experiencing lengthening, especially uterus muscle and stomach muscle. After bearing, uterus was not back quickly like before, but through a process. Health recover process at post-partum was important thing for mother after birth period. Therefore, for turning back at early condition or recover period better so that body always health needed a exercise which popular as post-partum exercise. Methods: This research executed was prospective cohort design with quantitative approach. Interview was executed at 30 respondents post-partum mother. Subject got from population with simple random sampling. Depth interview was executed to get depth information about research which observed. Independent variables at this research were participation postparfum exercise and dependent variables are complication, narrow of uterus, swell oedema, treatment of stitching hurt loctation, early ambulation, urinate, defecate, drink and eat pattern. Results: Chi square result indicated difference health status between does exercise and neither was only early ambulation and defecates from other some variable. Variables early ambulation (p = 0.001 and deficate (p = 0.001 significant with exercise. But variables involution utery, oedema treatment of stitching hurt and drink and eat pattern not significant with exercise.Key words: post-parfum exercise, health status

  10. [Acute pulmonary edema and pregnancy: a descriptive study of 15 cases and review of the literature].

    Science.gov (United States)

    Dolley, P; Lebon, A; Beucher, G; Simonet, T; Herlicoviez, M; Dreyfus, M

    2012-11-01

    To describe the incidence and the etiologies of acute pulmonary edema (APE) and the diagnostic procedure used during pregnancy and immediate post-partum. We analyzed records from a search of codes of heart failure and APE as well as from the term "pulmonary edema" in computerized obstetric records from 2002 to 2010 in a university center of level 3. We identified maternal characteristics, the term of appearance and route of delivery, the time between symptoms and diagnosis, additional tests performed, and data from echocardiography. Fifteen patients had an APE during pregnancy or in the immediate post-partum period during the study period (0.05%). The mean age was 28.6 years and the mean term of appearance was 31.2±3.1 weeks of amenorrhea. The diagnosis was made in 11 cases (73.3%) before delivery and in four during post-partum. The main etiology was preeclampsia (46.6%) followed by heart disease (26.7%), then tocolysis and overfilling (13.3%). In 55% of cases, we found a diagnostic wander characterized by carrying out further unnecessary tests. The echocardiography has led to a change in management in 27.3% of cases. The APE is a rare event during pregnancy and the post-partum period and its main etiology is preeclampsia. Some other etiologies are avoidable like the use of beta-agonists by intravenous route. The diagnosis is sometimes difficult, but the realization of a chest X-ray, a simple and inexpensive test, is enough to confirm it. Copyright © 2012. Published by Elsevier Masson SAS.

  11. Energy balance in transition cows and its association with health, reproduction and milk production.

    Science.gov (United States)

    Furken, C; Nakao, T; Hoedemaker, M

    2015-01-01

    It was the purpose of this study to determine the effects of non-esterified fatty acids (NEFA) concentrations at different time periods of the transition period as well as lactation number on metabolism, health, reproduction and milk production in dairy cows. This trial was conducted in a single dairy herd located in Northern Germany. Of the herd, which comprised 330 lactating Holstein cows housed in a free stall barn and fed a total mixed ration (TMR), 83 primiparous and multiparous cows were randomly selected. Animals were checked for body condition score (BCS), locomotion score, calving data, quality of colostrum, reproductive measures, daily rectal temperature of the first 10 days post-partum (p. p.), health data and culling rates up to 200 days in milk (DIM) as well as milk production until 305 DIM. Three different time periods were considered: 3 and 1 week ante partum (a. p.); partus and 1 week p. p.; 3 weeks p. p. Animals with NEFA concentrations ≥ 0.4 mmol/l ante partum had a higher risk of no ovarian activity in week 5 p. p. and of subclinical ketosis post partum than cows with lower NEFA concentrations (p reproduction of dairy cows.

  12. Post-traumatic stress disorder after childbirth: the phenomenon of traumatic birth

    OpenAIRE

    Reynolds, J L

    1997-01-01

    CHILDBIRTH CAN BE A VERY PAINFUL EXPERIENCE, often associated with feelings of being out of control. It should not, therefore, be surprising that childbirth may be traumatic for some women. Most women recover quickly post partum; others appear to have a more difficult time. The author asserts that post-traumatic stress disorder (PTSD) may occur after childbirth. He calls this variant of PTSD a "traumatic birth experience." There is very little literature on this topic. The evidence available ...

  13. Revisiting the Yummy Mummy

    DEFF Research Database (Denmark)

    Prinds, Christina; Folmann, Birgitte; Nikolajsen, Helene

    To explore Danish new fathers’ perceptions of their partners’ post partum body and how fathers’ perspective influence the post partum body identity and body image of the new mother.......To explore Danish new fathers’ perceptions of their partners’ post partum body and how fathers’ perspective influence the post partum body identity and body image of the new mother....

  14. Determinants of post-partum anaemia – a cross sectional study ...

    African Journals Online (AJOL)

    Prevention and treatment of anaemia in post-natal women is essential in reducing maternal ... (WHO) criteria had further investigations done to determine the cause. ... Intermittent Preventive Therapy (IPT) administration during pregnancy were ...

  15. Parents' anxiety and depression symptoms after successful infertility treatment and spontaneous conception: does singleton/twin pregnancy matter?

    Science.gov (United States)

    Tendais, I; Figueiredo, B

    2016-10-01

    Does mode of conception [spontaneous/after infertility treatment (IT)], type of pregnancy (singleton/twin) and parent gender have an effect on anxiety and depression levels and trajectories during pregnancy and the post-partum period? Conception after IT was associated with a transitory increase in anxiety during the perinatal period for parents of singletons, while for IT parents of twins higher levels of psychopathological symptoms tended to persist during pregnancy and the post-partum period. Most previous studies have shown that successful IT is not associated with poor psychological well-being during pregnancy and the post-partum period, but there is also some evidence for heightened pregnancy-related anxiety, lower self-esteem and lower self-efficacy. Parents of twins experience increased postnatal anxiety and depression. This prospective longitudinal study assessed 267 couples (N = 534) at each trimester of pregnancy, after childbirth and at 3 months post-partum. The sample comprised 36 couples who had conceived after IT (19 twin pairs and 17 singletons) and 231 couples who had conceived spontaneously (SC; 28 twin pairs and 203 singletons). Couples were recruited at four public hospitals in Portugal, and self-report measures of anxiety and depression symptoms were administered. IT parents reported higher anxiety after childbirth than parents who SC, regardless of pregnancy type. IT parents of twins showed higher anxiety at mid-pregnancy, as well as higher anxiety and depression at 3 months post-partum than IT parents of singletons. Among IT mothers, those who had twins exhibited higher depression after childbirth than those who had singletons. Differences according to mode of conception, pregnancy type and parents gender over time were also noted. During pregnancy, IT parents of twins showed no significant change in depression scores, while the other groups depression scores statistically significantly decreased over time. From pregnancy to the post-partum

  16. Antenatal depression in Anuradhapura, Sri Lanka and the factor structure of the Sinhalese version of Edinburgh post partum depression scale among pregnant women.

    Science.gov (United States)

    Agampodi, Suneth Buddhika; Agampodi, Thilini Chanchala

    2013-01-01

    Mental health problems among women of reproductive age group contribute to 7% of Global Burden of Diseases of women of all ages. Purpose of this study was to determine the prevalence and correlates of antenatal depression among pregnant women in Anuradhapura, Sri Lanka, and to explore the factor structure of EPDS. Pregnant women with gestational age of 24-36 weeks and residing in Anuradhapura district, Sri Lanka were recruited to the study using a two stage cluster sampling procedure. Sinhalese version of Edinburgh Post Partum Depression Scale (EPDS) and an interviewer administered questionnaire was use to collect data. A cut off value of 9 was used for the Sinhalese version of EPDS. A total of 376 pregnant women were studied. Median EPDS score among pregnant women was 5 (IQR 2-8). Prevalence of antenatal depression in this study sample was 16.2% (n = 61). Thought of self harming (item number 10) was reported by 26 pregnant women (6.9%). None of the socio-demographic factors were associated with depression in this study sample. Having heart burn was significantly associated with depressive symptoms (p = 0.041). Sri Lankan version of EPDS showed a two factor solution. Anxiety was not emerged as a separate factor in this analysis. Prevalence of antenatal depression in Anuradhapura, Sri Lanka was relatively low. Anxiety was not emerged as a separate factor in the Sinhalese version of the EPDS.

  17. Antenatal depression in Anuradhapura, Sri Lanka and the factor structure of the Sinhalese version of Edinburgh post partum depression scale among pregnant women.

    Directory of Open Access Journals (Sweden)

    Suneth Buddhika Agampodi

    Full Text Available BACKGROUND: Mental health problems among women of reproductive age group contribute to 7% of Global Burden of Diseases of women of all ages. Purpose of this study was to determine the prevalence and correlates of antenatal depression among pregnant women in Anuradhapura, Sri Lanka, and to explore the factor structure of EPDS. METHODS: Pregnant women with gestational age of 24-36 weeks and residing in Anuradhapura district, Sri Lanka were recruited to the study using a two stage cluster sampling procedure. Sinhalese version of Edinburgh Post Partum Depression Scale (EPDS and an interviewer administered questionnaire was use to collect data. A cut off value of 9 was used for the Sinhalese version of EPDS. RESULTS: A total of 376 pregnant women were studied. Median EPDS score among pregnant women was 5 (IQR 2-8. Prevalence of antenatal depression in this study sample was 16.2% (n = 61. Thought of self harming (item number 10 was reported by 26 pregnant women (6.9%. None of the socio-demographic factors were associated with depression in this study sample. Having heart burn was significantly associated with depressive symptoms (p = 0.041. Sri Lankan version of EPDS showed a two factor solution. Anxiety was not emerged as a separate factor in this analysis. CONCLUSIONS: Prevalence of antenatal depression in Anuradhapura, Sri Lanka was relatively low. Anxiety was not emerged as a separate factor in the Sinhalese version of the EPDS.

  18. Clinical decision-making: midwifery students' recognition of, and response to, post partum haemorrhage in the simulation environment.

    Science.gov (United States)

    Scholes, Julie; Endacott, Ruth; Biro, MaryAnne; Bulle, Bree; Cooper, Simon; Miles, Maureen; Gilmour, Carole; Buykx, Penny; Kinsman, Leigh; Boland, Rosemarie; Jones, Jan; Zaidi, Fawzia

    2012-03-23

    This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. The students' clinical management of the situation varied considerably. Students struggled to prioritize their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their interventions to illuminate what else could

  19. Clinical decision-making: midwifery students' recognition of, and response to, post partum haemorrhage in the simulation environment

    Directory of Open Access Journals (Sweden)

    Scholes Julie

    2012-03-01

    Full Text Available Abstract Background This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH. Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Methods Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. Results The students' clinical management of the situation varied considerably. Students struggled to prioritise their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. Conclusions The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the

  20. Longitudinal study of perinatal maternal stress, depressive symptoms and anxiety.

    Science.gov (United States)

    Liou, Shwu-Ru; Wang, Panchalli; Cheng, Ching-Yu

    2014-06-01

    to understand the trends in, and relationships between, maternal stress, depressive symptoms and anxiety in pregnancy and post partum. a prospective longitudinal survey study was undertaken to explore maternal psychological distress throughout the perinatal period. The participants were recruited after 24 completed weeks of gestation, and were followed-up monthly until one month post partum (four surveys in total). participants were recruited from a single hospital in southern Taiwan, and asked to complete questionnaires in the hospital waiting area. inclusion criteria were: age ≥18 years, able to read and write Chinese, ≥24 weeks of gestation, singleton pregnancy and no pregnancy complications (including a diagnosis of antenatal depression or anxiety disorder). In total, 197 women completed all four surveys (response rate 74.62%). stress was measured with the 10-item Perceived Stress Scale, depressive symptoms were measured with the Center for Epidemiologic Studies' Depression scale, and anxiety was measured with the Zung Self-reported Anxiety Scale. Participants were followed-up at four time points: T1 (25-29 gestational weeks), T2 (30-34 gestational weeks), T3 (>34 gestational weeks) and T4 (4-6 weeks post partum). Appointments for data collection were made in accordance with the participants' antenatal and postnatal check-ups. The three types of maternal distress had different courses of change throughout the perinatal period, as levels of depressive symptoms remained unchanged, anxiety levels increased as gestation advanced but declined after birth, and stress decreased gradually during pregnancy but returned to the T1 level after birth. There was a low to high degree of correlation in maternal stress, depressive symptoms and anxiety in pregnancy and post partum. around one-quarter of the study participants had depressive symptoms during pregnancy and post partum. Stress and anxiety showed opposing courses during the perinatal period. Regardless of the

  1. Uterine involution in colombian fine pace mares, measured by ultrasonography and endometrial cytology

    Directory of Open Access Journals (Sweden)

    Germán Ramírez

    2006-06-01

    Full Text Available Today, there still exists a controversial issue, as to the high incidence of early embryonic death in mares, mated on the first post partum oestrus. The purpose of this study was first, to determine the post partum period of uterine involution in fine pace Colombian mares using endometrial cytology and ultra sonograph. Secondly, to determine the relation between the neutrophil percentages found in cytology and the echogenicity of accumulated intrauterine fluid during the first 30 post partum days. Twenty (n=20 mares were examined beginning on the 6th post partum day and on alternate days, up to the 30th day. All subjects were grazing Kikuyo grass (Pennisetum clandestinum at la Sabana de Bogotá, 2.600 meters over sea level, 4 º north latitude and with an average temperature of 13 º C. From the 3rd postpartum day, all 20 mares were exposed to 2 healthy stallions, to establish their heat behaviour. Ten of them, following complete randomization, were inseminated on the first postpartum heat, while the others were inseminated on the second post partum heat. Genital examination was carried out by a technician, who did not know the reproductive history of any of the experimental mares. Examinations included rectal palpation, ultra sonograph (Pie Medical 480, linear array, 5 MHz, vaginal swabs and endometrial cytology. Uterine dimension was recorded by rectal palpation and ultra sonograph, it was included the uterine horn dimensions (tip, middle, and corporo-cornual junction of previously gravid and non gravid uterus. Intrauterine fluid detection was performed by the use of an echogenicity scale. Ovaric structures were recorded (preovulatory follicles and ovulation. Pregnancy diagnosis was performed on day 15 post ovulation and then confirmed on day 40. Endometrial cytology samples were taken from uterus after the perineal area was disinfected using non covered isopos with a Pollanski speculum. Smears specimens were fixed with metil alcohol for 15

  2. Precursors for liver gluconeogenesis in periparturient dairy cows

    DEFF Research Database (Denmark)

    Larsen, Mogens; Kristensen, Niels Bastian

    2013-01-01

    -organ transfer of nitrogen from catabolised AA. AAs seem to be prioritised for anabolic purposes, indicating the relevance of investigating effects of supplying additional protein to post partum dairy cows. Combining data from quantitative and qualitative experimental techniques on L-lactate metabolism point...... to the conclusion that the quantitatively most important adaptation of metabolism to support the increased glucose demand in the immediate post partum period is endogenous recycling of glucogenic carbon through lactate. This is mediated by a dual site of adaptation of metabolism in the liver and in the peripheral...

  3. Stress indicators in the post-partum period and their relation with women’s mood in the puerperium

    Directory of Open Access Journals (Sweden)

    Dolores Marín Morales

    2013-01-01

    Full Text Available The aim of this research project is to study the relationships among physiological indicators of stress, maternal hormone levels and mood in the early postpartum, and their possible association with psychological problems during the puerperium. This observational, longitudinal and correlational study will be carried in a sample of voluntary women belonging to area 9 of health services of the Community of Madrid, the participants will be recruited during their childbirth hospitalization. To evaluate the target variables structured and validated questionnaires would be applied and analysis of biological indicators taken at two time points:-In the early postpartum: anxiety, depression and childbirth satisfaction, physiological indicators of the stress response (cortisol in saliva, plasma norepinephrine and epinephrine, and seric oxytocin and gonadotropin hormone levels. -During the puerperal period up to three months after delivery: perceived stress,anxiety and depression. Socio-demographic information as well as clinical data on the progress of labor, and status of maternal and neonatal health condition will be also obtained and included in the study.

  4. Estimation of the intercalving period in Italian Mediterranean buffalo

    Directory of Open Access Journals (Sweden)

    G. Campanile

    2010-02-01

    Full Text Available Aim of this study was to estimate the average intercalving period of a buffalo herd/population, by using the percentage of subjects that are able to conceive within 90 days post-partum, and that, consequently, have an intercalving period lower than 400 days, in order to give a precocious judgment on its fertility. A total number of 8,845 intercalving periods were recorded in 4 farms and 4 Provinces of Campania and Lazio Regions. In all the farms the out of breeding season mating technique was adopted and a constant diet was administered throughout the year. Values were grouped for primiparous and pluriparous buffaloes and were divided in four calving periods: January-March; April-June; July-September; October-December. Within each group/farm ANOVA was performed and the means were analysed by t Student test. In each group the mean value and the percentage of subjects with an intercalving period lower than 400 days (% < 400 days were calculated and the regression analysis was carried out between the values of the intercalving periods and the % < 400 days. Finally, an all-in regression analysis was performed by using the data of 55 groups, excluding those with less than 25 values. The regression analysis between % < 400 days and the mean value of the intercalving period was always significant, except in one case. The comparison between the real values and those calculated allows to affirm that, if the percentage of subjects with an intercalving period lower than 400 days is higher than 50%, an intercalving period lower than 450 days will be probably recorded.

  5. The tip of the iceberg: Post caesarean wound dehiscence presenting as abdominal wound sepsis

    Directory of Open Access Journals (Sweden)

    Kaundinya Kiran Bharatam

    2015-01-01

    Conclusion: Uterine scar dehiscence with infection requires high index of suspicion as rare cause for post partum localized/generalized peritonitis with sepsis. Severe abdominal wound infection after caesarean section may be associated with uterine wound dehiscence, which poses a grave risk to the mother in a future pregnancy.

  6. Exposure to Photoperiod-Melatonin-Induced, Sexually-Activated Rams after Weaning Advances the Resumption of Sexual Activity in Post-Partum Mediterranean Ewes Lambing in January.

    Science.gov (United States)

    Abecia, José A; Chemineau, Philippe; Gómez, Andrea; Palacios, Carlos; Keller, Matthieu; Delgadillo, José A

    2017-01-21

    This study was aimed to determine whether the presence of sexually stimulated rams by photoperiodic and melatonin treatments can advance the resumption of post-partum sexual activity in Mediterranean ewes lambing in January and weaned at the end of the breeding season at 41°N, in March. Rams were exposed to two months of long days (16 h light/day) and given three melatonin implants at the end of the long days (sexually-activated rams; SAR). Control rams (CR) were exposed to the natural photoperiod. Thirty-six ewes weaned on 25 February were assigned to one of two groups. From 1 March to 30 June, one group was housed with four SAR males (SAR-treated; n = 18), and the other group (CR-treated; n = 18) was housed with four unstimulated rams. Ovulation was assessed once per week based on plasma progesterone concentrations. Estrus was monitored daily by marks left on ewes by rams' harnesses. SAR-treated ewes had a shorter ( p ewes (61 ± 17 days vs. 102 ± 47 days; mean date of first estrus after weaning on April 26 and June 6, respectively). The proportion of the ewes ovulating in April or May was higher ( p ewes resumed estrous activity sooner than CR-treated ewes such that, in April, May, and June, the proportion of females that exhibited estrus was higher ( p ewes in spring. The practical implications of this work could be important in ewes adapted for intensive production and accelerated lambing systems.

  7. Radioimmunoassay determination of the effect on animal reproduction of alternative of feeding suplementation in dairy cows. Alternativas de alimentacion en vacas lecheras y sus efectos en la reproduccion animal, determinados por radioinmunoanalisis, RIA

    Energy Technology Data Exchange (ETDEWEB)

    Villalba, Patricio [Comision Ecuatoriana de Energia Atomica, Quito (Ecuador); Ambuludi, Eduardo [Facultad de Medicina Veterinaria y Zootecnia, Universidad Central del (Ecuador)

    1993-07-01

    The principal object of this trial was to evaluate the influence of three alternatives of feeding suplementation in dairy cows in the post-partum period in ecuadorian highlands. Thirty sic animals in fist lactation were used in this experiment and were divided in three groups according to the feed intake: Group A diet was 5 Kg. of a commercial concentrate mixture with 12 per cent of crude protein plus pasture ad libitum; Group B diet was green banans (Musa paradisiaca) and pasture and Group C diet was the control only pasture. Using Radioimmunoassay technique (RIA), progesterone values were determinated in milk from each cow. the sampling was sequential, two samples a week, starting 6 days after parturition, until the animal was pregnant or until the study was finished, 150 days after post-partum for each cow. This research allowed us to evaluate the ovaric post-partum activity of each group: Frequency and length of the oestrus cycles; efficiency of oestrus detection, calving-first, oestrus period, calving-conception length, conception rate, and services per conception. Additional datas were used in this study such as: milk production, palpations and treatments.

  8. Radioimmunoassay determination of the effect on animal reproduction of alternative of feeding suplementation in dairy cows

    International Nuclear Information System (INIS)

    Villalba, Patricio; Ambuludi, Eduardo

    1993-01-01

    The principal object of this trial was to evaluate the influence of three alternatives of feeding suplementation in dairy cows in the post-partum period in ecuadorian highlands. Thirty sic animals in fist lactation were used in this experiment and were divided in three groups according to the feed intake: Group A diet was 5 Kg. of a commercial concentrate mixture with 12 per cent of crude protein plus pasture ad libitum; Group B diet was green banans (Musa paradisiaca) and pasture and Group C diet was the control only pasture. Using Radioimmunoassay technique (RIA), progesterone values were determinated in milk from each cow. the sampling was sequential, two samples a week, starting 6 days after parturition, until the animal was pregnant or until the study was finished, 150 days after post-partum for each cow. This research allowed us to evaluate the ovaric post-partum activity of each group: Frequency and length of the oestrus cycles; efficiency of oestrus detection, calving-first, oestrus period, calving-conception length, conception rate, and services per conception. Additional datas were used in this study such as: milk production, palpations and treatments

  9. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy

    DEFF Research Database (Denmark)

    Behrens, Ida; Basit, Saima; Melbye, Mads

    2017-01-01

    with prescription drugs, and hazard ratios estimated using Cox regression.Results Of women with a hypertensive disorder of pregnancy in a first pregnancy in their 20s, 14% developed hypertension in the first decade post partum, compared with 4% of women with normotensive first pregnancies in their 20s...

  10. Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial.

    Science.gov (United States)

    Uegaki, Kimi; Stomp-van den Berg, Suzanne G M; de Bruijne, Martine C; van Poppel, Mireille N M; Heymans, Martijn W; van Mechelen, Willem; van Tulder, Maurits W

    2011-01-27

    Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP). We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses. 541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention. STC was not cost-effective compared to common practice for a healthy population of working mothers; therefore, implementation is not indicated. The cost

  11. Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Poppel Mireille NM

    2011-01-01

    Full Text Available Abstract Background Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs compared to common practice (CP. Methods We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses. Results 541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951. Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention. Conclusions STC was not cost-effective compared to common practice for a healthy population of working

  12. Effect of eugenol-based endodontic sealer on the adhesion of intraradicular posts cemented after different periods.

    Science.gov (United States)

    Dias, Larissa Lustosa Lima; Giovani, Alessandro Rogério; Silva Sousa, Yara Teresinha Corrêa; Vansan, Luiz Pascoal; Alfredo, Edson; Sousa-Neto, Manoel Damião; Paulino, Silvana Maria

    2009-01-01

    This study evaluated in vitro the influence of an eugenol-based sealer (EndoFill) on the retention of stainless steel prefabricated posts cemented with zinc phosphate and resin-based (Panavia F) cements after different periods of root canal obturation, using the pull-out test. Sixty upper canines were decoronated and the roots were embedded in resin blocks. The specimens were distributed into 3 groups, according to the period elapsed between canal obturation and post cementation: Group I - immediately; Group II - 72 h and Group III - 4 months. The groups were subdivided according to the type of cement used for post cementation: A - zinc phosphate and B - Panavia F. Following the experimental periods, specimens were subjected to pullout test in an Instron machine with application of tensile force at a crosshead speed of 0.5 mm/min until post dislodgement. The maximum forces required for post removal were recorded (kN) and means were subjected to statistical analysis by 2-way ANOVA and Tukey-Kramer test (alpha=0.001) There were statistically significant differences (pcemented with zinc phosphate cement (0.2112 kN) and Panavia F (0.0501 kN). However, no statistically significant differences (p>0.05) were found between the three post cementation periods, regardless of the cement. It was concluded that the eugenol-based sealer influenced the tensile strength of the posts cemented with the resin cement, but had no influence on the time waited between root canal obturation and post space preparation/post cementation.

  13. Quasi-periodic oscillations from post-shock accretion column of polars

    Science.gov (United States)

    Bera, Prasanta; Bhattacharya, Dipankar

    2018-02-01

    A set of strongly magnetized accreting white dwarfs (polars) shows quasi-periodic oscillations (QPOs) with frequency about a Hz in their optical luminosity. These Hz-frequency QPOs are thought to be generated by intensity variations of the emitted radiation originating at the post-shock accretion column. Thermal instability in the post-shock region, triggered by efficient cooling process at the base, is believed to be the primary reason behind the temporal variability. Here, we study the structure and the dynamical properties of the post-shock accretion column including the effects of bremsstrahlung and cyclotron radiation. We find that the presence of significant cyclotron emission in optical band reduces the overall variability of the post-shock region. In the case of a larger post-shock region above the stellar surface, the effects of stratification due to stellar gravity become important. An accretion column, influenced by the strong gravity, has a smaller variability as the strength of the thermal instability at the base of the column is reduced. On the other hand, the cool, dense plasma, accumulated just above the stellar surface, may enhance the post-shock variability due to the propagation of magnetic perturbations. These characteristics of the post-shock region are consistent with the observed properties of V834 Cen and in general with cataclysmic variable sources that exhibit QPO frequency of about a Hz.

  14. Affective disorders among women during post partum

    Directory of Open Access Journals (Sweden)

    Silvia Juliana Orejarena Serrano

    2004-08-01

    Full Text Available Women, in general, present a high rate of prevalence of affective disorders, mainly depressive ones, during their lives. This is even more evident during their puerperal time, were depression is quite common. This is, probably, due to the fact of a highest physical and emotional needs during this difficult period, for both the mother and the family,as well. This clinical condition will increase both the mobility and mortality rates among puerperal women and will increase the risk for new episodes of depression on future pregnancies. Since we all know that during puerperium, both mother and child are usually attended by the Health System, this is a good time to detect these disorders. Therefore, we will try to review the pertinent medical literature regarding this probem, in order to provide the psychiatrist and another physicians with new, effective tools, that will allow them to recognize earlier, patients with this disorder, handle them properly to avoid all negative consequences.

  15. Yummy Mummy Constructions of Postpartum Body Identity Among Danish First Time Mothers

    DEFF Research Database (Denmark)

    Prinds, Christina

    to low bodily self-esteem. One group of women that might be particularly at risk for decreases in satisfaction of their body image are first time mothers, as their bodies go through immense changes during pregnancy and the postpartum period. Aim The aim is to explore first time mothers’ experiences...... of their body post partum, thus qualifying maternity services and contributing to midwifery care of interpretations of the post partum body. Methods Data collection was initiated in spring 2016 and is on-going. Danish first time mothers with children approximately aged 4-8 month are interviewed. Qualitative...

  16. Changes in the blood indicators and body condition of high yielding Holstein cows with retained placenta and ketosis

    Directory of Open Access Journals (Sweden)

    Zenon Nogalski

    2012-01-01

    Full Text Available The aim of this study was to determine the effect of changes in body condition in the dry period and the early lactation period on the incidence of retained placenta and ketosis in 94 high-yielding Holstein-Friesian cows. Body condition scoring was performed every two weeks from the beginning of the dry period until week 18 of lactation. Blood for the measuring of indicators of metabolism was sampled in weeks 1 and 2 ante partum and in weeks 1, 2, 3, 7 and 15 post partum. Retained placenta was reported in 11 cows, and ketosis was diagnosed in 18 animals. One week ante partum, the serum profile of cows diagnosed with ketosis during lactation revealed 0.52 mmol/l β-hydroxybutyric acid and 0.29 mmol/l non-esterified fatty acids on average. One week post partum, the serum profile of cows with ketosis revealed 1.59 mmol/l β-hydroxybutyric acid and 1.09 mmol/l non-esterified fatty acids and cows with retained placenta 1.65 and 1.41, respectively. From the week 5 ante partum to the point of lowest body condition the average body condition loss reached 1.4 points in cows with retained placenta, 1.1 points in cows with ketosis, and 0.8 points in healthy cows. Retained placenta and ketosis increased significantly conception rates by 0.47 and 0.50, respectively. Our results show that monitoring changes in the body condition and non-esterified fatty acids and β-hydroxybutyric acid blood levels in high-yielding cows in the transition period, followed by taking relevant disease-control measures, may be effective in reducing the incidence of retained placenta and ketosis in dairy cattle herds.

  17. The effects of two out-wintering pad systems compared with free-stalls on dairy cow hoof and limb health.

    Science.gov (United States)

    O'Driscoll, Keelin Km; Hanlon, Alison; French, Padraig; Boyle, Laura A

    2009-02-01

    Lameness is one of the most serious health and welfare problems for dairy cows. This study compared hoof health, limb health and locomotion of dairy cows in three over-winter management systems. Treatments were: (1) an indoor free-stall system (FS), (2) outdoors on an uncovered woodchip pad (UP) and (3) outdoors on a covered woodchip pad (CP). Animals were assigned to treatments at drying off, remained on treatment until parturition, then turned out to pasture. Sole lesions were scored on assignment to treatment, at calving, and 6 weeks and 12 weeks post partum. Locomotion and skin lesions were scored on assignment to treatment, and every 2 weeks until parturition. Post-partum locomotion was scored weekly for 13 weeks. More FS cows were affected by limb lesions than CP cows, and these animals had the worst locomotion scores post calving. There was an effect of inspection, and interactive effect of inspection and treatment on sole lesion scores. UP cows had the highest sole lesion scores 12 weeks post partum probably due to softening of the hooves arising from exposure to moisture while on the woodchip pad. However, post partum, UP cows had better locomotion scores, and CP cows tended to have better scores than cows in FS. Both of these treatments were less likely to have a high tracking-up score than cows in FS. It is possible that cows in this treatment were able to exercise more, owing to the secure underfoot surface and lack of barriers, and this promoted limb flexibility. Although woodchip pads provided benefits for limb health and locomotion, the wood chip surface in both outdoor systems did not offer protective benefits to the hooves relative to housing on concrete. However, the provision of shelter on the pad somewhat overcame the problem of high sole lesion scores in the post-partum period.

  18. Successful Obstetric Outcome in Dextrocardia with Situs Inversus and Moderate Pulmonary Hypertension- Rare Case.

    Science.gov (United States)

    Deepika; Wadhwa, Leena; Shekhar, Chandna; Saini, Jyoti; Chetani, Monica

    2016-10-01

    Situs inversus is a rare congenital anomaly, which is characterized by right sided heart (Dextrocardia) and inversely rotated visceral organs of abdomen. In present case, the patient reported with G3p2l2, 34 weeks of gestational period along with breathlessness accompanied and labour pains. On further investigation, she was diagnosed as dextrocardia with situs inversus and moderate pulmonary artery hypertension along with severe iron deficiency anaemia. Patient had normal vaginal delivery with intra-partum and post-partum period. Normally, any patient having situs inversus has a normal life expectancy and is not associated with any significant morbidity or mortality.

  19. Pilot Study of an Individualised Early Postpartum Intervention to Increase Physical Activity in Women with Previous Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Harold David McIntyre

    2012-01-01

    Full Text Available Optimal strategies to prevent progression towards overt diabetes in women with recent gestational diabetes remain ill defined. We report a pilot study of a convenient, home based exercise program with telephone support, suited to the early post-partum period. Twenty eight women with recent gestational diabetes were enrolled at six weeks post-partum into a 12 week randomised controlled trial of Usual Care (n=13 versus Supported Care (individualised exercise program with regular telephone support; n=15. Baseline characteristics (Mean ± SD were: Age  33±4  years; Weight 80 ± 20 kg and Body Mass Index (BMI 30.0±9.7 kg/m2. The primary outcome, planned physical activity {Median (Range}, increased by 60 (0–540 mins/week in the SC group versus 0 (0–580 mins/week in the UC group (P=0.234. Walking was the predominant physical activity. Body weight, BMI, waist circumference, % body fat, fasting glucose and insulin did not change significantly over time in either group. This intervention designed to increase physical activity in post-partum women with previous gestational diabetes proved feasible. However, no measurable improvement in metabolic or biometric parameters was observed over a three month period.

  20. Corporate governance and performance of Turkish banks in the pre- and post-crisis periods

    Directory of Open Access Journals (Sweden)

    F. Dilvin Taşkin

    2012-11-01

    Full Text Available This paper aims to analyze the relationship between corporate governance and bank performance. Return on asset (ROA, return on equity (ROE and net interest margin (NIM is considered as the measures of bank performance. Corporate governance is determined through the measures of internal governance mechanism which is measured by CEO duality and external governance mechanisms which are proxied by discipline exerted by shareholders, creditors and educated personnel and bank ownership. The analysis covers the period 1990-2000 and 2002-2011 which are the pre and post periods of the severe 2001 banking crisis. The results show that different governance characteristics are important in the pre and post crisis periods.

  1. Feeding behavior and performance of dairy cows during the transition period seven days before and after calvingComportamento e desempenho de vacas leiteiras no período de transição de sete dias antes e após o parto

    Directory of Open Access Journals (Sweden)

    Douglas Veira

    2011-10-01

    Full Text Available Dairy cows experience challenges during the transition period, which may put them at risk of diseases such as rumen acidosis and laminitis. The traditional recommendations during the transition period is to feed dairy cows on moderate level of concentrates in the pre-partum and switch it to high grain diet just after calving. However, there are some evidences that this management may cause a bump effect on the feeding intake in the post-partum period. The aim of this work was to study the effect of a constant diet during all transition period on the behaviour; feeding intake and milk yield of dairy cows. Thirty primiparous and multiparous Holstein dairy cows were at random allocated in one group fed on higher fibre diet in the pre-partum followed by a higher concentrate diet in the post-partum (traditional management and in a second group fed constantly on a higher fibre diet during all transition period. The behaviour and the feeding intake were monitored by an electronic feeding system and data loggers and milk yield data obtained in the milking parlour computer. The animals fed on the constant diet spent more time eating ration in second day post-partum, 142 minutes/day and cows in traditional recommendations 105minutes/day, while cows fed on lactation diet just after calving had higher dry matter intake in day 1 averaging 2.2 kg/day/100 kg LW but not in the following days, longer for cows receiving the constant diet the DMI was 1.7 kg/day/100 kg LW. There were no significant differences between the two diets related to milk yield (P>0.05. Cows fed diets constant throughout the transition period produced an average of 29.0 ± 8.2 liters of milk/day, while those who received traditional treatment ration with the highest concentrate after birth, produced an average of 29.1 ± 7.5 liters of milk/day. These results do not allow to a final conclusion about the recommendation to delay or not to switch diet after post-partum to avoid the bump in dry

  2. Managerial ownership and corporate performance in Slovenian post-privatisation period

    Directory of Open Access Journals (Sweden)

    Marko Simoneti

    2004-12-01

    Full Text Available The Slovenian post-privatisation period has been characterised by a decline in the ownership by non-managerial owners (employees and state-controlled funds. On the other hand, domestic and foreign non-financial firms, Privatisation Investment Funds and managers have been increasing their holdings. The latter, namely the growing managerial ownership, is likely to feature in future ownership dynamics in Slovenia. In fact, in 2002 the desired (optimal ownership stakes estimated by Slovenian managers were 10.8 percentage points higher than their actual stakes. The aim of our paper is to describe the main trends in the ownership of Slovenian corporations in the post-privatisation period and to provide an answer to the basic economic question: what is the influence of the ongoing consolidation of managerial ownership on the performance of Slovenian firms. The empirical analysis testing this relationship is based on a panel of 182 Slovenian firms in the 1995-99 period and does not provide relevant evidence of any positive effects of the increasing managerial control on Slovenian firms’ performance. If any, a positive incentive effect is only observed in those firms whose managers’ holdings exceed 10-percent, only with regards to firms’ financial performance (but not total factor productivity and only in firms that are not listed on the capital market. Further, the negative effect of the current gap between the desired and actual managerial ownership seems to exceed any positive incentive effect arising out of managerial ownership

  3. Cardiomyopathie du péri-partum prise en charge en milieu ...

    African Journals Online (AJOL)

    Cardiomyopathie du péri-partum prise en charge en milieu Hospitalier Universitaire de Bobo-Dioulasso : aspects thérapeutiques et évolutifs. S. J-B. Tougouma, A.A. Yaméogo, A. Dembélé, G. Kinda, N.V. Yaméogo, G.R.C. Millogo, J.K. Kologo, A. Héma, Y. Kambiré, L. Savadogo, M.S. Ouédraogo, P. Zabsonré ...

  4. Postnatal changes in electromyographic signals during piglet growth, and in relation to muscle fibre types

    DEFF Research Database (Denmark)

    Andersen, Ninette Kieme; Ravn, L.S.; Guy, J.H.

    2008-01-01

    This study uses non-invasive evoked surface electromyography (SEMG) to investigate postnatal muscle development in pigs, and to assess any correlation between recorded signal parameters and muscle fibre types in two different skeletal muscles. Four litters (n=43) of Large White x Landrace pigs were...... used. Evoked SEMG mesurements were taken on days 2, 5, 14, 26, 60 and 151 post partum from m. Longissimus dorsi (LD) and on days 14, 26, 60 and 151 post partum from m. Biceps femoris (BF). A third of each litter was slaughtered at days 27, 61 and 153 post partum. Biopsy samples for LD and BF were taken...... to categorize day 5 post partum, whilst for BF significant increases occurred from days 14 to 26 post partum. Fibre type development in both muscles showed a significant decrease in type IIA fibre number (Ptype IIB fibre number (P

  5. Late eclampsie post partum

    NARCIS (Netherlands)

    van Weert, J. M.; Hajenius, P. J.; Richard, E.; Wolf, H.; Bleker, O. P.

    2007-01-01

    A 36-year-old woman, who had given birth once before, had an eclamptic epileptic seizure eight days after caesarean delivery of healthy premature twins. Severe headache and loss of vision, leading to blindness, had not been recognised as prodromal signs by the healthcare professionals involved.

  6. Viraemia before, during and after pregnancy in HIV-infected women on antiretroviral therapy in rural KwaZulu-Natal, South Africa, 2010-2015.

    Science.gov (United States)

    Chetty, Terusha; Newell, Marie-Louise; Thorne, Claire; Coutsoudis, Anna

    2018-01-01

    Pregnancy and post-partum viral load suppression is critical to prevent mother-to-child HIV transmission and ensure maternal health. We measured viraemia risk before, during and after pregnancy in HIV-infected women. Between 2010 and 2015, 1425 HIV-infected pregnant women on lifelong antiretroviral therapy (ART) for at least six months pre-pregnancy were enrolled in a cohort study in rural KwaZulu-Natal, South Africa. Odds ratios were estimated in multilevel logistic regression, with pregnancy period time-varying. Over half of 1425 women received tenofovir-based regimens (n = 791). Median pre-pregnancy ART duration was 2.1 years. Of 988 women (69.3%) with pre-pregnancy viral loads, 82.0%, 6.8% and 11.2% had VL pregnancy and at six, 12 and 24 months, viral load was ≥1000 copies/ml in 15.2%, 15.7%, 17.8% and 16.6% respectively; viral load pregnancy factors, viraemia risk (viral load ≥50 copies/ml) was not significantly associated with pregnancy [adjusted OR (aOR) 1.31; 95% CI 0.90-1.92], six months (aOR 1.30; 95% CI 0.83-2.04), 12 months (aOR 0.96; 95% CI 0.58-1.58) and 24 months (aOR 1.40; 95% CI 0.89-2.22) post-partum. Adjusting for ART duration-pregnancy period interaction, viraemia risk was 1.8 during pregnancy and twofold higher post-partum. While undetectable viral load before pregnancy through post-partum was common, the UNAIDS goal to suppress viraemia in 90% of women was not met. Women on preconception ART remain vulnerable to viraemia; additional support is required to prevent mother-to-child HIV transmission and maintain maternal health. © 2017 John Wiley & Sons Ltd.

  7. Labour productivity and economic growth in the EU in post-crisis period

    OpenAIRE

    Auzina-Emsina, Astra

    2014-01-01

    Labour productivity and economic growth are the major factors to sustain and improve the performance and competitiveness of countries. The paper is devoted to the analysis of recent trends of labour productivity and economic growth in the European Union (EU) countries in post-crisis period in comparison with the trends in pre-crisis and crisis periods. The paper analyses the impact of changes in labour productivity and the effect on the macroeconomic indicators. The research focuses on the Eu...

  8. A serotonin transporter gene polymorphism predicts peripartum depressive symptoms in an at-risk psychiatric cohort.

    Science.gov (United States)

    Binder, Elisabeth B; Newport, D Jeffrey; Zach, Elizabeth B; Smith, Alicia K; Deveau, Todd C; Altshuler, Lori L; Cohen, Lee S; Stowe, Zachary N; Cubells, Joseph F

    2010-07-01

    Peripartum major depressive disorder (MDD) is a prevalent psychiatric disorder with potential detrimental consequences for both mother and child. Despite its enormous health care relevance, data regarding genetic predictors of peripartum depression are sparse. The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population. Two hundred and seventy four women with a prior history of MDD were genotyped for 5-HTTLPR and serially evaluated in late pregnancy (gestational weeks 31-40), early post-partum (week 1-8) and late post-partum (week 9-24) for diagnosis of a current major depressive episode (MDE) and depressive symptom severity. 5-HTTLPR S-allele carrier status predicted the occurrence of a MDE in the early post-partum period only (OR=5.13, p=0.017). This association persisted despite continued antidepressant treatment. The 5-HTTLPR genotype may be a clinically relevant predictor of early post-partum depression in an at-risk population. Peripartum major depressive disorder is a prevalent psychiatric disorder with potential detrimental consequences for both mother and child. Despite its enormous health care relevance, data regarding genetic predictors of peripartum depression are sparse. The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population. Copyright 2009 Elsevier Ltd. All rights reserved.

  9. Efeitos do manejo pós-parto de vacas primíparas no desempenho de bezerros de corte até um ano de idade Effects of post-partum management of primiparous cows on growth of beef calves up to one year of age

    Directory of Open Access Journals (Sweden)

    Bernardo Augusto Albornoz Pötter

    2004-04-01

    Full Text Available Os efeitos no desenvolvimento de bezerros submetidos a: a três tratamentos, consitindo de cargas animais pós-parto (CA de 240 kg de peso vivo (PV/ha (tratamento 1, T1, de 320 kg de PV/ha (T2, ambas em campo nativo, e de 400 kg de PV/ha em pastagem melhorada de azevém (Lolium multiflorum L. por 80 dias pós-parto e, posteriormente, em CA igual à do T2 em campo nativo (T3; b duas idades de desmame, consistindo de desmame aos 100 (DP ou 180 (DC dias de idade, foram avaliados utilizando 92 bezerros filhos de vacas primíparas Hereford e Braford. O sexo dos bezerros influenciou significativamente o peso ao nascer, não sendo observado efeito da raça da vaca. Os tratamentos e a raça da vaca não influenciaram o ganho médio diário (GMD dos bezerros do nascimento ao desmame precoce. Bezerros filhos de vacas Braford tiveram maiores pesos no DP (PDP que os filhos de vacas Hereford, enquanto os tratamentos não influenciaram o PDP. Os bezerros filhos de vacas Braford no T2 tiveram GMD até os 180 dias (GMD180 e PV aos 180 dias (PAJ180 superiores aos bezerros filhos de vacas Braford no T1 e Hereford no T2. Os bezerros do DP tiveram GMD180 e PAJ180 significativamente inferiores aos bezerros do DC. Entretanto, não se verificaram efeitos de tratamentos e idade de desmame sobre o GMD até os 365 dias e o peso ajustado aos 365 dias de idade. Portanto, os três manejos pós-parto das vacas e as duas idades de desmame dos bezerros avaliados não influenciaram o desenvolvimento dos bezerros a um ano de idade.The effects on the performance of calves submitted to: a three treatments, consisted of post-partum stocking rates (CA of 240 kg of live weight (LW/ha (treatment 1, T1, of 320 kg of LW/ha (T2, both on natural pastures, and of 400 kg of LW/ha on improved pasture of Italian ryegrass (Lolium multiflorum L. during the first 80 days post-partum, and after on natural pasture at the same stocking rate as T2 afterwards (T3; b two weaning ages, consisted of

  10. Post partum emotional distress in mothers of preterm infants: a ...

    African Journals Online (AJOL)

    Objectives: To investigate whether mothers of preterm infants experience more psychological distress than mothers of normal full term infants in the immediate postpartum period. Design: Cross sectional prospective study of postpartal women using the Beck Depression Inventory(BDI) and the GHQ-30. Setting: Neonatal ...

  11. Colonial Figures: Memories of Street Traders in the Colonial and Early Post-colonial Periods

    Directory of Open Access Journals (Sweden)

    Sheri Lynn Gibbings

    2012-12-01

    Full Text Available This article explores post-colonial memories about street traders among individuals who lived in the former colony of the Dutch East Indies. It argues that these narratives romanticize the relationship between Europeans and indigenous peoples. Street vendors are also used to differentiate between periods within colonial and post-colonial history. The nostalgic representation of interracial contact between Europeans and traders is contrasted with representations of other figures such as the Japanese and the nationalist. A recurring feature of these representations is the ability of Europeans to speak with street traders and imagine what they wanted and needed. The traders are remembered as a social type that transgressed politics and represented the neutrality of the economic sphere as a place for shared communication. The article concludes that the figure of the street vendor contributes to the nostalgic reinvention of the colony but is also used in narratives to differentiate between and mark changes across the colonial and post-colonial periods.

  12. Peripartum haemodynamic status of bitches with normal birth or dystocia.

    Science.gov (United States)

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

    2009-07-01

    There has been limited investigation of parturition in the bitch and there is little information published on clinical and obstetrical examination other than opinion and anecdote. While there are substantial data on haemodynamic and vascular changes during normal parturition in humans, little is known about the physiological events in the dog. This study was aimed at maternal haemodynamic changes occurring during normal parturition and to investigate how these were modified in bitches with dystocia (DYST) treated either medically or via assisted delivery and caesarean operation. Three groups of 10 bitches were investigated; those with normal parturition, those with DYST corrected by manipulative assistance or caesarean operation and those with uterine inertia treated by oxytocin administration. Heart rate, systolic and diastolic blood pressure, electrocardiogram and blood glucose concentration were measured pre-partum, intra-partum, immediately after parturition and 1 h later. Heart rate was high at all times throughout the study and the majority of bitches had normal sinus rhythm. Blood pressure was generally within the normal range, and although systolic and diastolic blood pressure was highest during the intra-partum period and sometimes during the immediate post-partum period, there were no significant differences between groups. All bitches had blood glucose concentrations within the normal range throughout the study although pre-partum concentrations were statistically lower than many of the other time periods. The study provides useful physiological data that will facilitate monitoring and clinical management of bitches throughout normal parturition and DYST.

  13. Les différentes modalités d'accompagnement au retour à domicile permettent-elles de répondre aux attentes des patientes en Post-partum ?

    OpenAIRE

    Arsac, Lucie

    2015-01-01

    Mothers, newborns and couples are in an important vulnerability during the post-natal period. They have a multitudes of needs. A relay at home is frequently setting up in order to complete the post-natal support. Do the accompaniement at home return succeed in answering the patient expectations and needs ? Patients with a post-natal home support organized were recruited in the maternity ward. A survey was sent a month later by e-mail. They were asked about their life conditions, the course of...

  14. Pregnancy and the risk of torsades de pointes in congenital long-QT syndrome

    NARCIS (Netherlands)

    Meregalli, P. G.; Westendorp, I. C. D.; Tan, H. L.; Elsman, P.; Kok, W. E. M.; Wilde, A. A. M.

    2008-01-01

    Patients with congenital long-QT syndrome (LQTS) are at increased risk of ventricular arrhythmias during stressful situations. Large-scale studies have pointed out that affected individuals are particularly at risk in the period following pregnancy (post-partum). This is recognised especially for

  15. 42 CFR 405.2448 - Preventive primary services.

    Science.gov (United States)

    2010-10-01

    ... centers are the following: (1) Medical social services. (2) Nutritional assessment and referral. (3) Preventive health education. (4) Children's eye and ear examinations. (5) Prenatal and post-partum care. (6) Perinatal services. (7) Well child care, including periodic screening. (8) Immunizations, including tetanus...

  16. Effects of feed in the dry period on fertility of dairy cows post partum

    NARCIS (Netherlands)

    Kruip, T.A.M.; Meijer, G.A.L.; Rukkwamsuk, T.; Wensing, T.

    1998-01-01

    It has been hypothesized that the decrease in fertility of dairy cows is related to the increase in milk yield and associated with fatty liver and increased vulnerability for both infection and metabolic diseases. To elucidate the mechanisms behind this complex of health and reproductive problems an

  17. Matrix Metalloproteinase Activities And Some Hormones Levels During Gestation Period In Cows

    International Nuclear Information System (INIS)

    TEAMA, F.E.

    2010-01-01

    Many factors including proteases, growth factors and hormones play important role in implantation and tissue remodelling of endometrium during different stages of gestation.Matrix metalloproteinases (MMP) such as gelatinases mainly MMP-2 and MMP-9 are implicated in the degradation of extracellular matrix for tissue remodelling.The aim of the present study is to evaluate the role of matrix metalloproteinases (MMP-2 and MMP-9) and hormones including progesterone (P4) and estradiol (E2) in the gestation process. The enzyme activities of MMP-2 and MMP-9 in serum collected from 8 Brown Swiss cows during different periods of gestation using zymography technique were examined. Hormonal levels for both P4 and E2 were determined using radioimmunoassay and also total proteins were estimated. A significant increase in MMP-2 activity by about 98%, 115% and 110% in the 1 st , 2 nd and 3 rd trimester of gestation were recorded, respectively, whereas it increased to be 185% in the pre-partum period as compared to non-pregnant cows (P nd trimester was recorded where the activity elevated by about 85% of non-pregnant controls (P st and 3 rd trimesters, the enzyme activity was not detectable. P4 level was increased gradually until its maximum at the 2 nd trimester then decreased until pre-partum.E2 level recorded too little increase at the beginning of the 1 st and 2 nd trimesters then sharply increased at the 3 rd one reached its maximum at pre-partum. There were significant decreases in total protein concentrations in the 2 nd and 3 rd trimesters then reached the lowest level before parturition .It could be concluded that the high activity of MMP-2 but not MMP-9 enzyme has important role throughout the gestation period in cows and P4 has important role in the fetal growth and E2 in the placental loss.

  18. Pregnancy-specific anxiety, ART conception and infant temperament at 4 months post-partum.

    Science.gov (United States)

    McMahon, C A; Boivin, J; Gibson, F L; Hammarberg, K; Wynter, K; Saunders, D; Fisher, J

    2013-04-01

    Is anxiety focused on the pregnancy outcome, known to be particularly salient in women conceiving through assisted reproductive technology (ART), related to difficult infant temperament? While trait anxiety predicts infant temperament, pregnancy-focused anxiety is not associated with more difficult infant temperament. A large body of research has provided convincing evidence that fetal exposure to maternal anxiety and stress in pregnancy has adverse consequences for child neurodevelopmental, behavioural and cognitive development, and that pregnancy-specific anxiety (concerns related to the pregnancy outcome and birth) may be of particular significance. Women conceiving through ART are of particular interest in this regard. Research over more than 20 years has consistently demonstrated that while they do not differ from spontaneously conceiving (SC) women with respect to general (state and trait) anxiety, they typically report higher pregnancy-specific anxiety. While research suggests normal behavioural and developmental outcomes for children conceived through ART, there is some evidence of more unsettled infant behaviour during the first post-natal year. The longitudinal cohort design followed 562 nulliparous women over a 7-month period, during the third trimester of pregnancy and at 4 months after birth. Approximately equal numbers of nulliparous women conceiving through ART (n = 250) and spontaneously (SC: n = 262) were recruited through ART clinics and nearby hospitals in Melbourne and Sydney, Australia. Participants completed three anxiety measures (state, trait, pregnancy specific) at time 1 in the third trimester of pregnancy and a measure of infant temperament at time 2, 4 months after birth. At time 1, relevant socio-demographic, pregnancy (maternal age, smoking, alcohol, medications, medical complications) information was recorded and at time 2, information regarding childbirth (gestation, infant birthweight, mode of delivery) and post-natal (concurrent

  19. Studies on levels of luteinuzing hormone and prolactin In serum of ...

    African Journals Online (AJOL)

    Vlakke van luteiniserings hormoon (LH) in serum gedurende die estrus-siklus en die post partum periode is deur middel van radio immunologiese bepaling in 14 Brangus en 5 Fries koeie bepaal. Met die uitsondering van die periodes tydens die pre-ovulasie golf, het die basale vlakke van LH tussen 0,2 en 5,0 ng LH/ml ...

  20. The Need for Conflict Management in the Post-Crisis Period

    Directory of Open Access Journals (Sweden)

    Gheorghe Popovici

    2014-06-01

    Full Text Available The paper presents the results of the study regarding the need for conflict management in the post-crisis period for the Romanian organisations. The 2008-2013 economic crisis placed the organisations on new coordinates by which a new approach is needed for the management activity. On the one hand, managers should adapt to the new requirements of the market and behaviour of customers, and on the other hand we also need a redefinition and practical solving of conflicts within an organisation.

  1. Minimal Residual Disease Diagnostics and Chimerism in the Post-Transplant Period in Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Ulrike Bacher

    2011-01-01

    Full Text Available In acute myeloid leukemia (AML, the selection of poor-risk patients for allogeneic hematopoietic stem cell transplantation (HSCT is associated with rather high post-transplant relapse rates. As immunotherapeutic intervention is considered to be more effective before the cytomorphologic manifestation of relapse, post-transplant monitoring gains increasing attention in stem cell recipients with a previous diagnosis of AML. Different methods for detection of chimerism (e.g., microsatellite analysis or quantitative real-time PCR are available to quantify the ratio of donor and recipient cells in the post-transplant period. Various studies demonstrated the potential use of mixed chimerism kinetics to predict relapse of the AML. CD34+-specific chimerism is associated with a higher specificity of chimerism analysis. Nevertheless, a decrease of donor cells can have other causes as well. Therefore, efforts continue to introduce minimal residual disease (MRD monitoring based on molecular mutations in the post-transplant period. The NPM1 (nucleophosmin mutations can be monitored by sensitive quantitative real-time PCR in subsets of stem cell recipients with AML, but for approximately 20% of patients, suitable molecular mutations for post-transplant MRD monitoring are not available so far. This emphasizes the need for an expansion of the panel of MRD markers in the transplant setting.

  2. Improving access to interventions among mothers screened positive for post-partum depression (PPD) at National Programme on Immunization (NPI) clinics in south-western and south-eastern Nigeria - A service development report.

    Science.gov (United States)

    Bakare, Muideen O; Bello-Mojeed, Mashudat A; Munir, Kerim M; Duduyemi, Olaniyi O; Orovwigho, Andrew O; Odetunde, Odutola I; Taiwo, Olufemi G; Olofinlade, Jushua A; Omotoso, Olakunle N; Famurewa, Olayinka H; Omolabi, Oladipupo O; Jejeloye, Adebayo O

    2017-01-01

    We investigate the possibility of improving access to interventions among mothers screened positive for post-partum depression (PPD) at National Programme on Immunization (NPI) clinics randomly selected from Lagos and Enugu States in south-western and south-eastern Nigeria respectively. The principle of human centred design was employed by engaging the mothers screened positive for PPD to be part of the decision making regarding their further assessment and intervention services. The study brought intervention services to primary healthcare centre at the NPI clinics. Improvement in willingness to seek interventions was observed among the mothers screened positive for PPD in this study when compared to our observation in a previous report, where mothers diagnosed with PPD were referred and requested to visit a mental health facility closer to their NPI clinics for further assessment and interventions (95.2% versus 33.7%). Interventional services for the mothers diagnosed with PPD also impact positively on the growth parameters of their infants on follow-up. Principle of human centred design improved access to intervention services among the mothers and infants studied. NPI clinics at primary healthcare level would provide appropriate forum for early screening of mothers for PPD and interventions in low-resource setting like Nigeria. There would be improvement in maternal and child health coverage if the Nigerian Government can adapt human centred design principles employed in this study nationwide.

  3. Predictors of breast feeding self-efficacy in the immediate postpartum period: A cross-sectional study.

    Science.gov (United States)

    Yang, Xiao; Gao, Ling-Ling; Ip, Wan-Yim; Sally Chan, Wai Chi

    2016-10-01

    to examine breast feeding self-efficacy and identify its predictors among mainland Chinese mothers in the early postpartum period. a cross-sectional descriptive questionnaire survey was conducted in a regional teaching hospital with childbirth rate over 3000 per year at Guangzhou, China from April 1 to July 14, 2014. a total of 571 Chinese mothers who were within 72-96hours post partum were recruited consecutively to the study. data were collected by the Chinese version of the Breastfeeding Self-efficacy Scale-Short Form (BSES-SF), the Network Support for Breastfeeding Scale (NSBS) and a socio-demographic data sheet. a total of 640 eligible women was approached and 571 mothers completed the study with the response rate of 89%. Mothers reported moderate level of breast feeding self-efficacy in the immediate postpartum period. The best-fit regression analysis revealed six variables that explained 43.9% of the variance in breast feeding self-efficacy in the immediate postpartum period. They were intention of breast feeding, support from husband, support from nurses/midwives, attending antenatal breast feeding classes, time from childbirth to initiate breast feeding and previous breast feeding experience. this study found six predictors of breast feeding self-efficacy in the immediate postpartum period. In order to increase maternal breast feeding self-efficacy level, a more women-centred approach is recommended. Mothers and fathers should be facilitated to attend antenatal classes on breast feeding. New mother' husband could be encouraged in supporting breast feeding. Nurses and midwives could encourage new mothers to initiate breast feeding as soon as possible. Further work to promote early mother-infant contact post birth, such as via skin to skin contact should also be facilitated where possible. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Perinatal nutrition interventions and post-partum depressive symptoms.

    Science.gov (United States)

    Gould, Jacqueline F; Best, Karen; Makrides, Maria

    2017-12-15

    Postpartum depression (PPD) is the most prevalent mood disorder associated with childbirth. No single cause of PPD has been identified, however the increased risk of nutritional deficiencies incurred through the high nutritional requirements of pregnancy may play a role in the pathology of depressive symptoms. Three nutritional interventions have drawn particular interest as possible non-invasive and cost-effective prevention and/or treatment strategies for PPD; omega-3 (n-3) long chain polyunsaturated fatty acids (LCPUFA), vitamin D and overall diet. We searched for meta-analyses of randomised controlled trials (RCT's) of nutritional interventions during the perinatal period with PPD as an outcome, and checked for any trials published subsequently to the meta-analyses. Fish oil: Eleven RCT's of prenatal fish oil supplementation RCT's show null and positive effects on PPD symptoms. Vitamin D: no relevant RCT's were identified, however seven observational studies of maternal vitamin D levels with PPD outcomes showed inconsistent associations. Diet: Two Australian RCT's with dietary advice interventions in pregnancy had a positive and null result on PPD. With the exception of fish oil, few RCT's with nutritional interventions during pregnancy assess PPD. Further research is needed to determine whether nutritional intervention strategies during pregnancy can protect against symptoms of PPD. Given the prevalence of PPD and ease of administering PPD measures, we recommend future prenatal nutritional RCT's include PPD as an outcome. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. The control of short-term feed intake by metabolic oxidation in late-pregnant and early lactating dairy cows exposed to high ambient temperatures.

    Science.gov (United States)

    Eslamizad, Mehdi; Lamp, Ole; Derno, Michael; Kuhla, Björn

    2015-06-01

    The objective of the present study was to integrate the dynamics of feed intake and metabolic oxidation in late pregnant and early lactating Holstein cows under heat stress conditions. On day 21 before parturition and again on day 20 after parturition, seven Holstein cows were kept for 7days at thermoneutral (TN) conditions (15°C; temperature-humidity-index (THI)=60) followed by a 7day heat stress (HS) period at 28°C (THI=76). On the last day of each temperature condition, gas exchange, feed intake and water intake were recorded every 6min in a respiration chamber. Pre- and post-partum cows responded to HS by decreasing feed intake. The reduction in feed intake in pre-partum cows was achieved through decreased meal size, meal duration, eating rate and daily eating time with no change in meal frequency, while post-partum cows kept under HS conditions showed variable responses in feeding behavior. In both pre- and post-partum cows exposed to heat stress, daily and resting metabolic heat production decreased while the periprandial respiratory quotient (RQ) increased. The prolonged time between meal and the postprandial minimum in fat oxidation and the postprandial RQ maximum, respectively, revealed that HS as compared to TN early-lactating cows have slower postprandial fat oxidation, longer feed digestion, and thereby showing a shift from fat to glucose utilization. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. [Symphysiotomy to relieve shoulder dystocia

    NARCIS (Netherlands)

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

    2014-01-01

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

  7. Integrative Analyses of Hepatic Differentially Expressed Genes and Blood Biomarkers during the Peripartal Period between Dairy Cows Overfed or Restricted-Fed Energy Prepartum

    Science.gov (United States)

    Shahzad, Khuram; Bionaz, Massimo; Trevisi, Erminio; Bertoni, Giuseppe; Rodriguez-Zas, Sandra L.; Loor, Juan J.

    2014-01-01

    Using published dairy cattle liver transcriptomics dataset along with novel blood biomarkers of liver function, metabolism, and inflammation we have attempted an integrative systems biology approach applying the classical functional enrichment analysis using DAVID, a newly-developed Dynamic Impact Approach (DIA), and an upstream gene network analysis using Ingenuity Pathway Analysis (IPA). Transcriptome data was generated from experiments evaluating the impact of prepartal plane of energy intake [overfed (OF) or restricted (RE)] on liver of dairy cows during the peripartal period. Blood biomarkers uncovered that RE vs. OF led to greater prepartal liver distress accompanied by a low-grade inflammation and larger proteolysis (i.e., higher haptoglobin, bilirubin, and creatinine). Post-partum the greater bilirubinaemia and lipid accumulation in OF vs. RE indicated a large degree of liver distress. The re-analysis of microarray data revealed that expression of >4,000 genes was affected by diet × time. The bioinformatics analysis indicated that RE vs. OF cows had a liver with a greater lipid and amino acid catabolic capacity both pre- and post-partum while OF vs. RE cows had a greater activation of pathways/functions related to triglyceride synthesis. Furthermore, RE vs. OF cows had a larger (or higher capacity to cope with) ER stress likely associated with greater protein synthesis/processing, and a higher activation of inflammatory-related functions. Liver in OF vs. RE cows had a larger cell proliferation and cell-to-cell communication likely as a response to the greater lipid accumulation. Analysis of upstream regulators indicated a pivotal role of several lipid-related transcription factors (e.g., PPARs, SREBPs, and NFE2L2) in priming the liver of RE cows to better face the early postpartal metabolic and inflammatory challenges. An all-encompassing dynamic model was proposed based on the findings. PMID:24914544

  8. Applied biotechnology for improving fertility of herds in Argentina

    International Nuclear Information System (INIS)

    Mongiardino, M.E.; Dick, A.R.; Murray, R.; Ramos, G.; Balbiani, G.; Maciel, M.

    1990-01-01

    In an attempt to find methods to shorten the calving to conception interval of dairy cattle in Argentina, three research projects were carried out: (1) use of hormonal treatments in the early post-partum period to increase fertility in non-cycling cows; (2) treatments to increase the fertility of cycling cows; and (3) management systems to improve the efficiency of oestrus detection. In non-cycling cows, fewer services per conception and earlier pregnancies were obtained when a progesterone suppository was placed intravaginally (PRID treatment) 24-31 days post-partum. No statistical reduction in days open was observed, however, because of the great variability in response within groups. GnRH injection given 24 and 25 days post-partum did not improve reproductive indices. In cycling cows, clitoral massage after AI did not enhance fertility, while GnRH 14 days post-service resulted in pregnancy rates of 68.4% compared with 25% in the control group. In an attempt to improve the efficiency of oestrus detection successive periods of either 10 or 14 days of 'heat' observation followed by similar periods of no observation, combined with the systematic use of an oestrus synchronizer (cloprostenol), resulted in the same reproductive performance as in control cows observed continuously but with a saving of 50% in time spent in oestrus detection. In a seasonally bred herd, a reduction of 12 days in interval to conception and subsequent improvement in milk produced in the following season were obtained by synchronizing oestrus at the start of the breeding season with a norgestomet implant followed by a prostaglandin injection one day before implant removal. In repeat breeders, a second implant 9 days and 21 days later was found to be effective. (author). 24 refs, 2 figs, 4 tabs

  9. Falsiporphyromonas endometrii gen. nov., sp. nov., isolated from the post-partum bovine uterus, and emended description of the genus Porphyromonas Shah and Collins 1988.

    Science.gov (United States)

    Wagener, K; Drillich, M; Baumgardt, S; Kämpfer, P; Busse, H-J; Ehling-Schulz, M

    2014-02-01

    Two black-pigmented, anaerobic bacterial strains, designated LMM 40(T) and LMM 41, were isolated from the bovine post-partum endometrium of two Holstein cows. The 16S rRNA gene sequences of the two strains were identical and showed the highest similarity to the 16S rRNA gene sequence of the type strain of Porphyromonas crevioricanis (90.2%) but only 85.1% 16S rRNA gene sequence similarity to the type strain of the type species of the genus Porphyromonas, Porphyromonas asaccharolytica. The major fatty acid profiles of the two strains were similar to those of species of the genus Porphyromonas, containing iso-C(15 : 0) as the major component and moderate amounts of anteiso-C(15 : 0), iso-C(13 : 0), C(15 : 0) and C(16 : 0). Hydroxylated fatty acids, such as iso-C(14 : 0) 3-OH, iso-C(16 : 0) 3-OH and iso-C(17 : 0) 3-OH, were also detected. The quinone profiles were dominated by the menaquinones MK-8 and MK-9, while spermidine was the major polyamine. The polar lipid profiles contained major amounts of phosphatidylethanolamine, an unidentified phospholipid, an unidentified aminophospholipid and two unidentified lipids and minor amounts of phosphatidylglycerol, an unidentified aminolipid, a second unidentified aminophospholipid and an unidentified glycolipid. The cell-wall peptidoglycan contained meso-diaminopimelic acid. The genomic DNA G+C contents of LMM 40(T) and LMM 41 were 40.7 and 41.3 mol%, respectively. Based on a polyphasic approach, including phylogenetic analysis, physiological and biochemical tests as well as metabolic fingerprinting, it is proposed that the two strains are members of a novel genus and species, for which the name Falsiporphyromonas endometrii gen. nov., sp. nov. is proposed. The type strain of Falsiporphyromonas endometrii is LMM 40(T) ( = DSM 27210(T) = CCUG 64267(T)). An emended description of the genus Porphyromonas is also presented.

  10. EMPIRICAL ASSESSMENT OF THE GROWTH RATE OF MAIZE PRODUCTION IN THE PRE - SAP, SAP AND POST - SAP PERIODS IN NIGERIA

    Directory of Open Access Journals (Sweden)

    Oyinbo Oyakhilomen

    2012-05-01

    Full Text Available This study was carried out to provide empirical evidence on the growth rates of maize production in three sub - periods in Nigeria namely pre - Structural Adjustment Programme period, Structural Adjustment Program period and post - Structural Adjustment Programme period. Secondary data on maize production in Nigeria during the Pre - Structural Adjustment Programme period (1970 to 1985, Structural Adjustment period (1986 to 1994 and post - Structural Adjustment Programme period (1995 to 2007 were employed in this study. A growth rate model was used to estimate the growth rates of maize in the three sub - periods. The results of the analysis showed that the instantaneous growth rates of maize production are - 0.1%, 5.7% and 2.4% and the compound rates of growth of maize production are - 0.001%, 0.059% and 0.024% for the pre - Structural Adjustment Programme, Structural Adjustment Programme and post - Structural Adjustment Programme periods respectively. The higher compound growth rate of maize production in the Structural Adjustment Programme period implies that the policy reforms in the period was more effective in ensuring increased growth of maize production over that of other periods in Nigeria. Therefore, despite the myriads of problems associated with the programme in Nigeria, it was beneficial to maize production in Nigeria.

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

    Science.gov (United States)

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

    2015-05-01

    The objectives of this study were to determine the effect of mineral/energy supplementation of dairy cows with dystocia on blood mineral concentrations, energetic and inflammatory profiles, and milk yield. Multiparous Holstein cows with dystocia were randomly assigned into two groups, (1) treated with a mineral/energy supplement (DME, n= 18) and (2) not treated (DNT, n= 22). A group of cows with normal parturition were randomly selected and were left untreated (NNT, n= 25). Cows in DME received an oral drench of 110 g of calcium and 400 g of propionate as calcium propionate plus 110 g potassium chloride and 150 g of magnesium sulfate administered within 6 h of calving and again 3 days post-partum. Compared to cows with a normal parturition, dystocic cows had decreased plasma calcium concentrations, increased plasma haptoglobin, decreased milk yield at 1 day post-partum, and tended to have increased rectal temperatures from 1 to 12 days post-partum. Compared with cows in DNT, those in DME had decreased plasma calcium concentrations and increased plasma magnesium concentrations 2 and 3 days post-partum, and a tendency for an increase in rectal temperature from 1 to 12 days post-partum. Dystocia is detrimental to calcium homeostasis post-partum, but mineral/energy supplementation as undertaken in this study is not recommended for use in cows with dystocia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. [Ischemic stroke in young women

    NARCIS (Netherlands)

    Ekker, M.S.; Wermer, M.J.; Riksen, N.P.; Klijn, C.J.; Leeuw, F.E. de

    2016-01-01

    - In virtually all age groups, the incidence of ischemic stroke is higher in men. However, in women aged between 25-49 years the prevalence is higher than in men. Female-specific risk factors and disorders may explain this peak.- Pregnancy and the post-partum period are associated with physiological

  13. [Urinary incontinence and pregnancy].

    Science.gov (United States)

    Deffieux, X

    2009-12-01

    The goal of the current study was to systematically review the literature concerning urinary incontinence and pregnancy, in order to develop recommendations for clinical practice. The prevalence of urinary stress incontinence and overactive bladder symptoms increase with gestational age during pregnancy (from the first to the third trimester), and decrease during the third months following delivery. Obstetrics factors (position during delivery, length of the second part of the labour, forceps, episiotomy, epidural or pudendal anaesthesia) do not modify the risk of post-partum or long term urinary incontinence. At short term follow-up, caesarean delivery is associated with a lower rate of post-partum urinary incontinence. At long term follow-up, data are lacking. Non elective caesarean section is not associated with a decrease in the rate of post-partum or long-term urinary incontinence. Elective caesarean section and systematic episiotomy are not recommended methods for the prevention of post-partum urinary incontinence (grade B), even in "high risk" women. Pelvic floor muscle therapy is the first line treatment for prenatal or post-partum urinary incontinence (grade A). Copyright © 2009 Elsevier Masson SAS. All rights reserved.

  14. External foam and the post-mortem period in freshwater drowning; results from a retrospective study in Amsterdam, the Netherlands.

    Science.gov (United States)

    Reijnen, G; Buster, M C; Vos, P J E; Reijnders, U J L

    2017-11-01

    Determining the time of death of bodies recovered from water can be difficult. A feature of drowning is the presence of external foam. This study describes the presence of external foam in relation to the post-mortem period. The study utilizes a database of death reports dated between January 2011 and July 2016. For bodies recovered from fresh water, the presence or absence of external foam was noted. In this study, 112 death reports are included. Of these reports, 18 mentioned external foam, which account for 16.1% of the entire study population. In the population with a post-mortem period of less than 24 h, external foam was detected in 27.7% of cases. All 18 incidents with external foam had an estimated post-mortem period of less than 24 h. In our study, external foam was only present in freshwater drowning cases with a post-mortem period of less than 24 h. Based on this finding, the presence of external foam may be useful as an additional indicator when estimating the time of death in freshwater drowning. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  15. Research on Probability for Failures in VW Cars During Warranty and Post-Warranty Periods

    Directory of Open Access Journals (Sweden)

    Dainius Luneckas

    2014-12-01

    Full Text Available The present paper examines the distribution of failures in „Volkswagen“ car during warranty and post-warranty periods. A statistical mathematical model has been developed upon collecting distribution data on car failures. Considering mileage rates, probabilities for a failure in the systems, including suspension and transmission, cooling, electrical, etc., have been determined during warranty and expiration periods. The obtained results of the conducted research have been compared. The reached conclusions have been formulated and summarized.

  16. USO DA PGF2? NO PUERPÉRIO PARA REDUZIR O ANESTRO PÓS-PARTO DE CABRAS EM ALEITAMENTO CONTÍNUO E CONTROLADO USE OF PGF2? ON THE PUERPERIO TO REDUCE THE POS-PARTUM ANESTROUS OF CONTINUOS OR CONTROLLED SUCKLING GOATS

    Directory of Open Access Journals (Sweden)

    Paulo Fernandes Lima

    2008-07-01

    study the effect of PGF2α administration on anestrous post-partum period in 80 goats, with continuos or controlled suckled, rised in semi-extensive system with water and mineral salt ad libitum. The females, with age between two and six years, were randomly distributed in three groups (GI, GII, GIII. The females of GI (n = 30 received 250µg of PGF2α in vulvar muscle on days 6th and 12th after delivery. The females of GII (n = 30 received the same treatment of Group I, but every day from days 6th to 10th after delivery. The GIII (n = 20 was the control group. The estrous detection was made by using teasers and the mating with bucks with confirmed fertility. The obtained data were analyzed by ANOVA and by analysis of standard errors of difference among proportions. Difference in the occurrence of estrous among the three experimental groups was not observed (P > 0.05, however the average time of post partum anestrous was significantly reduced (P < 0.05 in animals treated with PGF2α. It was also detected a relevant reduction (P < 0.05 of post-partum anestrous in females with controlled suckled. Difference was not registered (P > 0.05 on pregnant percentages among the different groups. It may be concluded that the administration of PGF in the beginning of puerperium in caprine is efficient to reduce the anestrous pos-partum period, specially in females controlled suckled; however do not influence the fertility in meat goats.

    KEY WORDS: Caprine, estrus, puerperium, prostaglandine.

  17. The experience of women with an eating disorder in the perinatal period: a meta-ethnographic study.

    Science.gov (United States)

    Fogarty, Sarah; Elmir, Rakime; Hay, Phillipa; Schmied, Virginia

    2018-05-02

    Pregnancy is a time of enormous body transformation. For those with an eating disorder during pregnancy this time of transformation can be distressing and damaging to both the mother and the child. In this meta-ethnographic study, we aimed to examine the experiences of women with an Eating Disorder in the perinatal period; that is during pregnancy and two years following birth. A meta-ethnographic framework was used in this review. After a systematic online search of the literature using the keywords such as pregnancy, eating disorders, anorexia, bulimia, binge eating disorder, perinatal, postnatal and post-partum, 11 papers, involving 94 women, were included in the review. A qualitative synthesis of the papers identified 2 key themes. The key theme that emerged during pregnancy was: navigating a 'new' eating disorder. The key that emerged in the perinatal period was return to the 'old' eating disorder. Following a tumultuous pregnancy experience, many described returning to their pre-pregnancy eating behaviors and thoughts. These experiences highlight the emotional difficulty experienced having an eating disorder whilst pregnant but they also point to opportunities for intervention and a continued acceptance of body image changes. More research is needed on the experiences of targeted treatment interventions specific for pregnant and postpartum women with an eating disorder and the effectiveness of putative treatment interventions during this period.

  18. Timing of transcriptomic and proteomic changes in the bovine placentome after parturition

    Science.gov (United States)

    Proper post-partum reproductive performance is important for reproductive efficiency in beef cows, and dystocia decreases post-partum fertility. Crossbred beef cows (n = 1676) were evaluated for lifetime performance based on degree of dystocia at presentation of the first calf. Cows that experience...

  19. Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review.

    Science.gov (United States)

    Lee, Eleanor W; Denison, Fiona C; Hor, Kahyee; Reynolds, Rebecca M

    2016-02-29

    Perinatal depression is strikingly common with a prevalence of 10-15%. The adverse effects of perinatal depression on maternal and child health are profound with considerable costs. Despite this, few women seek medical attention. E-health, providing healthcare via the Internet is an accessible and effective solution for the treatment of depression in the general population. We aimed to conduct a systematic review of web-based interventions for the prevention and treatment of mood disorders in the perinatal period, defined as the start of pregnancy to 1 year post-partum. Six databases were searched until 26(th) March 2015. Two researchers independently screened articles for eligibility. Of the 547 screened articles, four met the inclusion criteria. These included three randomised-controlled trials and one feasibility trial, with total data from 1274 participants. MOOSE and PRISMA guidelines were adhered to for the conduct and reporting of the systematic review. All studies were conducted in the post-partum period. All reported an improvement in maternal mood following intervention. A significant improvement in depressive symptoms was measured using validated rating scales, such as the Edinburgh Postnatal Depression Scale (EPDS), either at post-treatment or follow-up which ranged from 3 to 12 months post study completion. For the two RCTs utilising the EPDS, the EPDS score reductions were (mean ± SEM) 8.52 ± 0.22 (Range 19.46 to10.94) and 9.19 ± 0.63 (Range, 20.24 to 11.05) for treatment groups and 5.16 ± 0.25 (Range 19.44 to 14.28) and 6.81 ± 0.71 (Range 21.07 to 14.26) for comparator groups. However attrition within studies ranged from 13 to 61%. One study was rated as 'good' quality. Preliminary data suggests web-based therapies for perinatal depression delivered in the post-partum period may play a role in improving maternalmood but more studies are needed, particularly with interventions delivered antenatally. Further research is needed

  20. Recognising and managing increased HIV transmission risk in newborns

    Directory of Open Access Journals (Sweden)

    Max Kroon

    2015-05-01

    Full Text Available Prevention of mother-to-child transmission (PMTCT programmes have improved maternalhealth outcomes and reduced the incidence of paediatric HIV, resulting in improved childhealth and survival. Nevertheless, high-risk vertical exposures remain common and areresponsible for a high proportion of transmissions. In the absence of antiretrovirals (ARVs,an 8- to 12-hour labour has approximately the same 15% risk of transmission as 18 monthsof mixed feeding. The intensity of transmission risk is highest during labour and delivery;however, the brevity of this intra-partum period lends itself to post-exposure interventions toreduce such risk. There is good evidence that infant post-exposure prophylaxis (PEP reducesintra-partum transmission even in the absence of maternal prophylaxis. Recent reports suggestthat infant combination ARV prophylaxis (cARP is more efficient at reducing intra-partumtransmission than a single agent in situations of minimal pre-labour prophylaxis. Guidelinesfrom the developed world have incorporated infant cARP for increased-risk scenarios. Incontrast, recent guidelines for low-resource settings have rightfully focused on reducingpostnatal transmission to preserve the benefits of breastfeeding, but have largely ignored thepotential of augmented infant PEP for reducing intra-partum transmissions. Minimal prelabourprophylaxis, poor adherence in the month prior to delivery, elevated maternal viralload at delivery, spontaneous preterm labour with prolonged rupture of membranes andchorioamnionitis are simple clinical criteria that identify increased intra-partum transmissionrisk. In these increased-risk scenarios, transmission frequency may be halved by combiningnevirapine and zidovudine as a form of boosted infant PEP. This strategy may be important toreduce intra-partum transmissions when PMTCT is suboptimal.

  1. STUDY OF GIVING FEED SUPPLEMENT ON PRODUCTIVITY PO CATTLE IN SUBANG DISTRICT

    Directory of Open Access Journals (Sweden)

    Erni Gustiani

    2014-02-01

    Full Text Available Decreasing of population and productivity of beef cattle due to low of post partus reproduction capability. Feeding at the last of pregnancy and early lactation period has not appropriate with the needs of cattle that caused this condition. Need the right strategy and technology to support that condition. Improvement of feed quality intake at the period is one attempt to increase of productivition capability. Assessment aims to determine the performance of beef cattle productivity capability through the improvement of feed quality. Research was conducted at Family Jaya livestock farmers group in Ponggang Village, Serangpanjang District, Subang Regency, and carried out from June to November 2013. Feed quality improvement by introduction feed supplementation (concentrates and UMB that is given at the last of pregnancy period and the early lactation period during 2 months before partus and 2 months after partus(flushing. While animal control / comparison fed in accordance with the habits of farmers is only given forage and agricultural waste which is not given every day. Provision of drinking water is done ad-libitum. Livestock productivity parameters measured were body weight calf; daily weight gain of cattle calf and post-partum estrus parent. Data collected were tabulated and analyzed by t-test. The study showed that cattle treated with additional feed gives a better effect on birth weight, weight gain of cattle and post-partum estrus.

  2. Effects of propylene glycol supplementation on blood indicators of hepatic function, body condition score, milk fat-protein concentration and reproductive performance of dairy cows

    Directory of Open Access Journals (Sweden)

    Silviu Ionuţ Borş

    2014-01-01

    Full Text Available The aim of the present study was to determine the effects of propylene glycol on metabolic variables of hepatic function, body condition score, milk fat-protein concentration and reproductive performance of dairy cows after ending administration. Postparturient dairy cows (n = 200 of Holstein Friesian breed were divided into two groups of 100 individuals. The experimental group received during days 0-7 post partum an oral daily dose of 600 ml of propylene glycol; the control group was without any supplement. The hepatic enzymes, glucose, cholesterol and serum albumin were measured on days 10-15, 45-50 and 70 post partum. Reproduction indicators of dairy cows were calculated from the farm recording data and the milk data record from a regular dairy control (days 10, 20, 30, and 50 post partum. Animals that received propylene glycol in the first 7 days post partum had reduced activities of aspartate transaminase and gamma-glutamyl transferase, elevated cholesterol concentration (P 0.05 and low milk fat percentage (P P 0.05. Our results suggest that some blood indicators of hepatic function, milk fat concentration and calving to first oestrus interval can be improved for 70 days post partum by the use of propylene glycol drenching in the first 7 days post partum. The beneficial effect of this treatment could be evaluated by easily available data, which can be used by practitioners in the field to analyze fertility problems in dairy herds and more exactly to examine whether metabolic stress, among other factors, is involved in the fertility problem.

  3. Elective caesarean operation in the bitch using aglepristone before the pre-partum decline in peripheral progesterone concentration.

    Science.gov (United States)

    Levy, X; Fontaine, E; Segalini, V; Fontbonne, A

    2009-07-01

    The aim of this study was to investigate caesarean operation (CO) undertaken before the pre-partum decrease of progesterone but following administration of a progesterone receptor antagonist and to evaluate the innocuity of this procedure for the dam and pups. Thirty seven bitches of 15 different breeds, received an injection of 15 mg/kg aglepristone 59 or 60 days after the estimated day of ovulation, determined by progesterone quantitative assays, and caesarean section (CS) was performed between 20 and 24 h after administration. Progesterone remained above 6 nmol/l at the time of CS (mean = 15.75, SD = 3.84). No post-operative clinical complications were reported in any of the bitches. All bitches were able to nurse and feed their puppies in the first 24 h following surgery. No pups showed any signs of prematurity and 5 out of 188 pups (2.6) died in the first 2 weeks after delivery. This small study demonstrates that a CS may be safely and successfully performed an average of 2 days before the expected date of parturition following the administration of aglepristone, without any harmful consequence for the dam and her neonates.

  4. Depression evaluation in an attendance group for high-risk pregnant women

    OpenAIRE

    Adriana Said Daher Baptista; Makilim Nunes Baptista

    2005-01-01

    The goal of this study was to verify the variation of depression symptomatology in an informative high-risk post-partum group of pregnant (GAGER). Six high-risk pregnant women, from a University Hospital participated in this research, and they were evaluated four times: first, before forming the group; second, after two participations in this group; third, 24 to 36 hours after partum; and, four weeks post-partum. The instruments used were a Psychological Clinic Interview and, the Edinburgh Po...

  5. Obstetric vesico-vaginal fistula is preventable by timely recognition ...

    African Journals Online (AJOL)

    Prevention of obstetric fistula should include universal access to maternity care, recognition and timely correction of abnormal progress of labour and punctilious attention to bladder care to avoid post-partum urinary retention. Key words: Obstetric fistula, Risk factors, Pathophysiology, Post-partum urinary retention ...

  6. Critical periods of brain growth and cognitive function in children.

    Science.gov (United States)

    Gale, Catharine R; O'Callaghan, Finbar J; Godfrey, Keith M; Law, Catherine M; Martyn, Christopher N

    2004-02-01

    There is evidence that IQ tends to be higher in those who were heavier at birth or who grew taller in childhood and adolescence. Although these findings imply that growth in both foetal and postnatal life influences cognitive performance, little is known about the relative importance of brain growth during different periods of development. We investigated the relationship between brain growth in different periods of pre- and postnatal life and cognitive function in 221 9-year-old children whose mothers had taken part in a study of nutrition in pregnancy and whose head circumference had been measured at 18 weeks gestation, birth and 9 months of age. Cognitive function of the children and their mothers was assessed with the Wechsler Abbreviated Scale of Intelligence. Full-scale IQ at age 9 years rose by 1.98 points [95% confidence interval (CI) 0.34 to 3.62] for each SD increase in head circumference at 9 months and by 2.87 points (95% CI 1.05 to 4.69) for each SD increase in head circumference at 9 years of age, after adjustment for sex, number of older siblings, maternal IQ, age, education, social class, duration of breastfeeding and history of low mood in the post-partum period. Postnatal head growth was significantly greater in children whose mothers were educated to degree level or of higher socio-economic status. There was no relation between IQ and measurements of head size at 18 weeks gestation or at birth. These results suggest that brain growth during infancy and early childhood is more important than growth during foetal life in determining cognitive function.

  7. Maternal immunity against rabies in raccoon dogs.

    Science.gov (United States)

    Vos, A; Müller, T; Schuster, P; Selhorst, T; Wenzel, U

    2001-01-01

    The objective of the study was to examine possible maternally transferred antibodies (maAb) against rabies in raccoon dogs. Ten cubs born from a rabies-immune animal were bled on days 31, 36, 43, 50, 57 and 64 post partum. The geometric mean titres of the cubs were 1.19, 1.18, 0.45, 0.25, 0.25 and 0.16 IU/ml, respectively. Up to 36 days post partum maAb were detected in all cubs at levels > or = 0.5 IU/ml and at day 56 post partum all animals had maAb levels dogs as well.

  8. Child Abuse: Abused all the way but determined not to abuse ...

    African Journals Online (AJOL)

    The case of a 14-year old girl who was abused right from infancy through childhood, pregnancy labour and immediate post-partum period, and management of both the child mother and her baby is presented. Information was obtained both retrospectively and prospectively. Tender loving care to the child mother and her ...

  9. Developing, implementing and evaluating a simulation learning ...

    African Journals Online (AJOL)

    Background: The training of undergraduate midwifery students to identify and manage post-partum haemorrhage, is an essential skill in midwifery. Aim: The aim of this study was to develop, implement and evaluate a simulation learning package (SLP) on post-partum haemorrhage for undergraduate midwifery students ...

  10. The Indonesian Economy from the Colonial Extraction Period until the Post-New Order Period: A Review of Thee Kian Wie’s Major Works

    Directory of Open Access Journals (Sweden)

    Maria Monica Wihardja

    2015-04-01

    Full Text Available This paper reviews some major works of Thee Kian Wie, one of Indonesia’s most distinguished economic historians, that spans from the Colonial period until the post-New Order period. His works emphasize that economic history can guide future economic policy. Current problems in Indonesia were resulted from past policy failures. Indonesia needs to consistently embark on open economic policies, free itself from "colonial period mentality". Investment should be made in rebuilding crumbling infrastructure, improving the quality of health and education services, and addressing poor law enforcement. If current corruption persists, Indonesia could not hope to become a dynamic and prosperous country.

  11. The life course model as a framework for post-conflict health analysis: reflections on the Gulf War critical period.

    Science.gov (United States)

    Cange, Charles W

    2016-01-01

    In the Kuwait context, from January 1991 to December 1991, there were a series of chemical and psychological Gulf War-era exposures that left persistent, long-term damage. Extreme stress from a critical event speeds up the usual disease latency period, and may be part of a synergistic effect that leads to higher disease rates over a shorter period of time. I am interested in the impact of armed conflict on health outcomes over the life course in Kuwait, and particularly the pathways through which armed conflict causes changes in health on a population level. In this paper, I propose a culturally sensitive, post-conflict socio-ecological model that informs a three-pronged health study. I propose a macro-micro mix that includes an ecological study, a case-control study and a qualitative study to investigate Kuwait's post-conflict health concerns. Thus, I revise the concept of 'post-conflict health' as a trajectory that is mediated through different, complex social levels and develops over time during the latency period. The main advantage of a macro-micro mix approach for post-conflict health is that it contextualizes the Gulf War as an environmental health issue.

  12. Neonatal mortality of pigs in Nsukka, Southeast Nigeria | Abonyi ...

    African Journals Online (AJOL)

    This study was conducted to investigate the causes of neonatal mortality among pig farms in Nsukka Local Government area of Enugu State, Nigeria. Forty (40) pig farms in the study area were randomly selected and used for the 20 weeks study duration. One week post partum was considered as the neonatal period. A total ...

  13. Etat de Stress Post-traumatique lié à l'accouchement et Algies pelviennes chroniques

    OpenAIRE

    GEFFROY- GRECO , Gisele

    2005-01-01

    Objectif : Rechercher un lien entre un accouchement objectivement stressant (césarienne ou forceps pour anomalies du rythme cardiaque fœtal, hémorragie de la délivrance) et des algies pelviennes chroniques (dysménorrhées, douleurs pelviennes non cycliques, dyspareunies) dans le post-partum tardif (au-delà d'un an).Méthode : auto-questionnnaire ; enquête exposés/non-exposés ; comparaison entre accouchement stressant et accouchement normal. Résultats : taux de réponse 58,3%. 253 patientes dans ...

  14. Family planning knowledge, attitudes and practices in refugee and migrant pregnant and post-partum women on the Thailand-Myanmar border - a mixed methods study.

    Science.gov (United States)

    Salisbury, Patricia; Hall, Layla; Kulkus, Sibylla; Paw, Moo Kho; Tun, Nay Win; Min, Aung Myat; Chotivanich, Kesinee; Srikanok, Somjet; Ontuwong, Pranee; Sirinonthachai, Supachai; Nosten, François; Somerset, Shawn; McGready, Rose

    2016-08-19

    Lack of data in marginalized populations on knowledge, attitudes and practices (KAP) hampers efforts to improve modern contraceptive practice. A mixed methods study to better understand family planning KAP amongst refugee and migrant women on the Thailand-Myanmar border was conducted as part of an ongoing effort to improve reproductive health, particularly maternal mortality, through Shoklo Malaria Research Unit (SMRU) antenatal and birthing services. Cross-sectional surveys and focus group discussions (FGDs) in currently pregnant women; and in-depth interviews (IDIs) in selected post-partum women with three children or more; were conducted. Quantitative data were described with medians and proportions and compared using standard statistical tests. Risk factors associated with high parity (>3) were identified using logistic regression analysis. Qualitative data were coded and grouped and discussed using identified themes. In January-March 2015, 978 women participated in cross-sectional studies, 120 in FGD and 21 in IDI. Major positive findings were: > 90 % of women knew about contraceptives for birth spacing, >60 % of women in the FGD and IDI reported use of family planning (FP) in the past and nearly all women knew where they could obtain FP supplies. Major gaps identified included: low uptake of long acting contraception (LAC), lack of awareness of emergency contraception (>90 % of women), unreliable estimates of when child bearing years end, and misconceptions surrounding female sterilization. Three was identified as the ideal number of children in the cross-sectional survey but less than half of the women with this parity or higher in the IDI actually adopted LAC leaving them at risk for unintended pregnancy. Discussing basic female anatomy using a simple diagram was well received in FGD and IDIs. LAC uptake has increased particularly the IUD from 2013-2015. Definitive contextual issues were identified during this study and a significant range of action

  15. Free radical generation in post-irradiation period: an evidence from the conversion of xanthine dehydrogenase into xanthine oxidase

    International Nuclear Information System (INIS)

    Kale, R.K.

    2003-01-01

    Xanthine oxidoreductase (XOR) system which consists of xanthine dehydrogenase (XDH) and xathine oxidase (XO), is one of the major sources of free radicals in biological systems. XOR system is pre-dominantly present as XDH in the normal tissue and converts into free radical generating XO-Form in the damaged tissue. Therefore, XO-Form of XOR system, is expected to be mainly found in the radiolytically damaged tissue. In such an event, XO may catalyze the generation of free radicals and potentiate the radiation effects in post-irradiation period. Recent findings on the effect of ionizing radiation on XOR system in the liver of mice, peroxidative damage and lactate dehydrogenase support this possibility. From these results it has been hypothized that free radical generating systems could be activated in the radiolytically damaged cell and in turn contribute to the cause and complications of late effects and their persistence in post-irradiation period. This aspect may have great significance in understanding the radiation - induced damages. It may also have serious implication in various fields like radiation therapy, health physics, carcinogenesis, space travelling radiation exposures and post nuclear accident care. Further, it is suggested that efforts need to be made to search more system(s) which could be activated particularly at lower doses of radiation and generate free radicals in post-irradiation period

  16. Safety and effectiveness of minimally invasive sacroiliac joint fusion in women with persistent post-partum posterior pelvic girdle pain: 12-month outcomes from a prospective, multi-center trial.

    Science.gov (United States)

    Capobianco, Robyn; Cher, Daniel

    2015-01-01

    Postpartum posterior pelvic girdle pain (PPGP) affects nearly 20 % of women who experience back pain in the peripartum period. The sacroiliac joint is a source of this pain in 75 % of women with persistent PPGP. A subset of women will fail to obtain acceptable pain relief from the current array of non-surgical treatment options. The purpose of this study is to assess the safety and effectiveness of minimally invasive sacroiliac (SI) joint fusion in women with chronic SI joint dysfunction whose pain began in the peri-partum period whose symptoms were recalcitrant to non-surgical management. A sub-group analysis of subjects with sacroiliac joint disruption and/or degenerative sacroiliitis enrolled in a prospective, multi-center trial of SI joint fusion was performed. Subjects with PPGP were identified and compared with women without PPGP and with men. Of 172 enrolled subjects, 52 were male, 100 were females without PPGP and 20 females had PPGP. PPGP subjects were significantly younger (43.3 years, vs. 52.8 for females without PPGP and 50.5 for men, p = 0.002). There were no differences in any other demographic or baseline clinical measure. Women with PPGP experienced a significant improvement in pain (-51 mm on VAS), function (-20.6 pts on ODI) and quality of life (SF-36 PCS +10.4, MCS +7.2, EQ-5D +0.31) at 12 months after surgery. These improvements were characteristic of the overall study results; no difference was detected between sub-groups. The sacroiliac joint can be a source of pain in women with persistent PPGP and should be investigated as a pain generator. In this study, women with carefully diagnosed chronic SI joint pain from PPGP recalcitrant to conservative therapies experienced clinically beneficially improvements in pain, disability and quality of life after minimally invasive SI joint fusion using a series of triangular porous plasma spray coated implants.

  17. Progesterone up-regulates vasodilator effects of calcitonin gene-related peptide in N(G)-nitro-L-arginine methyl ester-induced hypertension.

    Science.gov (United States)

    Gangula, P R; Wimalawansa, S J; Yallampalli, C

    1997-04-01

    We recently reported that calcitonin gene-related peptide can reverse the hypertension produced by N(G)-nitro-L-arginine methyl ester in pregnant rats. In the current study we investigated whether these vasodilator effects of calcitonin gene-related peptide were progesterone dependent. Calcitonin gene-related peptide or N(G)-nitro-L-arginine methyl ester was infused through osmotic minipumps, either separately or in combination, to groups of five pregnant rats from day 17 of gestation until day 8 post partum or to nonpregnant ovariectomized rats for 8 days. Progesterone was injected during days 1 to 6 post partum and for 6 days after ovariectomy. Systolic blood pressure was measured daily. Animals receiving N(G)-nitro-L-arginine methyl ester exhibited significant elevations of blood pressure during pregnancy and post partum. Coadministration of calcitonin gene-related peptide to these rats reversed the hypertension during pregnancy but not during the postpartum period. At the dose used in this study calcitonin gene-related peptide administered alone was without significant effects on blood pressure. However, it reduced both the mortality and growth restriction of the fetus associated with N(G)-nitro-L-arginine methyl ester in these animals. Calcitonin gene-related peptide reversed the hypertension in N(G)-nitro-L-arginine methyl ester-infused postpartum rats during the periods of progesterone treatment only, and these effects were lost when progesterone treatment was stopped. Neither progesterone nor calcitonin gene-related peptide alone were effective. To further confirm these observations, progesterone effects were tested in ovariectomized adult rats. Similar to the findings in postpartum rats, calcitonin gene-related peptide completely reversed the elevation in blood pressure in N(G)-nitro-L-arginine methyl ester-treated rats receiving progesterone injections. The effects of calcitonin gene-related peptide were apparent only during the progesterone treatment

  18. Prevalence and determinants of tobacco consumption among ...

    African Journals Online (AJOL)

    background: About 6.8% of Indian women consume tobacco and only 21.0% receive 'full' antenatal .... either home or higher facility) facility to the mother and her new-born.[15] The time of participant recruitment and data collection was the period of post-partum stay at the ... The mean age of the women who did and did not.

  19. Subarachnoid hemorrhage caused by pregnancy induced hypertension: A rare occurrence

    OpenAIRE

    Chandrashekhar Anil Sohoni

    2013-01-01

    This article presents the case of a young primigravida with pregnancy induced hypertension (PIH) presenting with seizure in the post-partum period. Magnetic resonance imaging revealed the presence of isolated convexal subarachnoid hemorrhage (cSAH). The absence of any other demonstrable vascular anomaly or coagulopathy on further investigation suggested PIH as the cause of cSAH.

  20. Subarachnoid hemorrhage caused by pregnancy induced hypertension: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Chandrashekhar Anil Sohoni

    2013-01-01

    Full Text Available This article presents the case of a young primigravida with pregnancy induced hypertension (PIH presenting with seizure in the post-partum period. Magnetic resonance imaging revealed the presence of isolated convexal subarachnoid hemorrhage (cSAH. The absence of any other demonstrable vascular anomaly or coagulopathy on further investigation suggested PIH as the cause of cSAH.

  1. The Conservation of Early Post-Medieval Period Coins Found in Estonia

    Directory of Open Access Journals (Sweden)

    Aive Viljus

    2013-02-01

    Full Text Available This article deals with archaeological find material with a low silver content and the problems of conserving such material. The aim of the research was to find the most suitable method for the conservation of poorly preserved early post-medieval period coins with varying composition. For this, first, the composition of both the metal and the corrosion products of the archaeological coins were analysed, after which comparative experiments of different cleaning methods were carried out in order to find out the least harmful and most efficient method. A test was also performed to determine the necessity and efficiency of stabilizing the surface of the coins after cleaning.

  2. Anaesthesia Management of Caesarean Section in Two Patients with Eisenmenger's Syndrome

    Directory of Open Access Journals (Sweden)

    G. Fang

    2011-01-01

    Full Text Available Recently two parturients with Eisenmenger's syndrome underwent caesarean section at our hospital. They were managed by a multidisciplinary team during their perioperative period. The caesarean sections were uneventfully performed, one under general anaesthesia and one with epidural anaesthesia, with delivery of two newborns with satisfactory Apgar scores. One patient died in the post-partum period, and the other did well. We discuss the anaesthetic considerations in managing these high-risk patients.

  3. Deliveries in maternity homes in Norway: results from a 2-year prospective study.

    Science.gov (United States)

    Schmidt, Nina; Abelsen, Birgit; Øian, Pål

    2002-08-01

    The study aims to report the short-term outcome for the mothers and newborns for all pregnancies accepted for birth at maternity homes in Norway. A 2-year prospective study of all mothers in labor in maternity homes, i.e. all births including women and newborns transferred to hospital intra partum or the first week post partum. The study included 1275 women who started labor in the maternity homes in Norway; 1% of all births in Norway during this period. Of those who started labor in a maternity home, 1217 (95.5%) also delivered there while 58 (4.5%) women were transferred to hospital during labor. In the post partum period there were 57 (4.7%) transferrals of mother and baby. Nine women had a vacuum extraction, one had a forceps and three had a vaginal breech (1.1% operative vaginal births in the maternity homes). Five babies (0.4%) had an Apgar score below 7 at 5 min. There were two (0.2%) neonatal deaths; both babies were born with a serious group B streptococcal infection. Midwives and general practitioners working in the districts can identify a low-risk population (estimated at 35%) of all pregnant women in the catchment areas who can deliver safely at the maternity homes in Norway. Only 4.5% of those who started labor in the maternity homes had to be transferred to hospital during labor.

  4. The management of pregnancy in maple syrup urine disease: experience with two patients.

    Science.gov (United States)

    Tchan, Michel; Westbrook, M; Wilcox, G; Cutler, R; Smith, N; Penman, R; Strauss, B J G; Wilcken, B

    2013-01-01

    We describe the management and outcomes of pregnancy in two women affected with Maple syrup urine disease (MSUD). Both patients had classical disease diagnosed in the newborn period and were managed with low-protein diets and supplements, although compliance was moderately poor throughout life. Both pregnancies were complicated by poor compliance and one patient had a metabolic decompensation, which included seizures and profound encephalopathy, at the end of the first trimester. Peri-partum management required a coordinated team approach including a high-calorie and low-protein diet. Both patients had elevated leucine levels in the post-partum period - one due to mastitis and the other due to poor dietary and supplement compliance combined with uterine involution. On later review, leucine had returned to pre-pregnancy levels. Both infants were unaffected and have made normal developmental progress in the subsequent 1 to 2 years.

  5. Carotid and vertebral arterial fibromuscular dysplasia masquerading as severe preeclampsia: a case report.

    Science.gov (United States)

    Dawley, Brenda; Ritchie, Adam

    2011-01-01

    Fibromuscular dysplasia is a non-atherosclerotic noninflammatory vascular disease that can affect any vascular bed. Dysplasia of the intima, media, or adventitia layer of the affected arteries causes stenosis and hypertension. Pregnant or post-partum patients may present with hypertension and be mistakenly diagnosed with preeclampsia. A 26 year old Gravida 1 Para 1 female 20 days post partum from a spontaneous vaginal delivery was transported from an outlying facility due to severely elevated blood pressure and transient left arm numbness and left sided facial droop. Upon arrival the patient was begun on intravenous magnesium sulfate and labetalol for a presumptive diagnosis of severe post partum preeclampsia. Her blood pressure and symptoms responded promptly. Due to her neurologic symptoms a magnetic resonance angiogram was ordered revealing 90% stenosis of her bilateral carotid and vertebral arteries. Severe hypertension and minimal neurologic symptoms may be the presenting symptoms for fibromuscular dysplasia. Cranial imaging is warranted in any pregnant or post partum patient who presents with these symptoms to allow appropriate treatment.

  6. Diagnosis and therapy of the subinvolution of placental sites in the bitch.

    Science.gov (United States)

    Dickie, M B; Arbeiter, K

    1993-01-01

    Within the last 19 years, 20 cases of placentitis post partum have been studied at the clinic. On 14 occasions the condition took the form of excessive uterine bleeding (metrorrhagia) post partum and, on five occasions, of prolonged vaginal discharge lasting 8-13 weeks post partum. One bitch with a clinically undetectable form of this disorder was diagnosed at ovariohysterectomy. The average age of the bitches was 4.5 years (range 2-6 years). Examinations included abdominal palpation, vaginoscopy, vaginal smear examination and, if necessary, radiography and ultrasonography. The presence of decidua-like cells in the smear was confirmed as evidence of abnormal uterine involution. Six dogs were subjected to ovariohysterectomy; histological examination revealed inflamed and degenerated areas of the uterine surface. Decidualike cells were seen for up to 10 weeks post partum. Fourteen bitches were treated successfully with an injection of the progestagen Niagestin (25-50 mg per bitch) and both intrauterine and parenteral antibiotics were administered. The discharge stopped within a few days in all dogs treated. A subsequent normal pregnancy occurred in four cases.

  7. Comportamento ingestivo de vacas Jersey confinadas durante a fase inicial da lactação Ingestive behavior of Jersey cows in free stall at the beginning of lactation

    Directory of Open Access Journals (Sweden)

    Cintia Oliveira da Costa

    2003-04-01

    Full Text Available Este trabalho foi desenvolvido com o objetivo de caracterizar o comportamento ingestivo de vacas da raça Jersey durante duas épocas do ano (estações fria e quente e aos 30, 60 e 90 dias pós-parto. Os tempos diários gastos com ingestão, ruminação e descanso foram estimados a partir de observações visuais realizadas por um único observador bem treinado. Os registros das atividades comportamentais foram realizados a intervalos de 10 minutos, durante 24 horas por dia, cinco dias por período, totalizando 30 dias de observações. Os animais foram observados individualmente. Os tempos médios de ingestão e ruminação foram maiores na estação quente, comparados à estação fria e aos 30 dias pós-parto comparados aos 90 dias pós-parto, e associados com os efeitos positivos de temperatura, fotoperíodo e teor de fibra da silagem. O peso vivo decresceu até 30 dias pós-parto, apresentando recuperação aos 90 dias pós-parto. A produção de leite apresentou interação significativa entre época e período, com menor produção de leite aos 60 dias pós-parto em relação aos 30 e 90 dias pós-parto, principalmente na estação quente, fato parcialmente atribuído às mudanças na composição química da silagem. Concluiu-se que as vacas leiteiras modificaram seu comportamento ingestivo para se adaptarem às mudanças nutricionais, ambientais (efeito de época e anatômicas e fisiológicas (efeito do número de dias após o parto.This trial aimed to characterize the ingestive behavior of Jersey dairy cows during cool and warm seasons, and at 30, 60 and 90 days post-partum. Daily time spent eating, ruminating and idling was estimated through visual observations recorded by a well trained observer. Records were made intermittently, using 10 minutes interval during 24 hours, five days per period, totalizing 30 days of observations. Ingestive behavior was recorded for each individual animal. Daily eating and rumination times were larger

  8. Studies on hepatic lipidosis and coinciding health and fertility problems of high-producing dairy cows using the "Utrecht fatty liver model of dairy cows". A review.

    Science.gov (United States)

    Geelen, M J H; Wensing, T

    2006-09-01

    Fatty liver or hepatic lipidosis is a major metabolic disorder of high-producing dairy cows that occurs rather frequently in early lactation and is associated with decreased health, production and fertility. A background section of the review explores reasons why high-producing dairy cows are prone to develop fatty liver post partum. Hepatic lipidosis and coinciding health and fertility problems seriously endanger profitability and longevity of the dairy cow. Results from a great number of earlier epidemiological and clinical studies made it clear that a different approach was needed for elucidation of pathogenesis and etiology of this complex of health problems. There was a need for an adequate animal model in which hepatic lipidosis and production, health and fertility problems could be provoked under controlled conditions. It was hypothesized that overconditioning ante partum and feed restriction post partum might induce lipolysis in adipose tissue and triacylglycerol accumulation in the liver following calving. This consideration formed the basis for the experiments, which resulted in the "Utrecht fatty liver model of dairy cows". In this model, post partum triacylglycerol-lipidosis as well as the whole complex of health and fertility problems are induced under well-controlled conditions. The experimental protocol based on this hypothesis produced in all cases (10 feeding trials with over 150 dairy cattle) the intended result, i.e. all experimental cows developed post partum higher hepatic triacylglycerol concentrations than did control cows. The model was evaluated in biochemical, clinical pathology, immunological, clinical and fertility terms. It turned out that in this model, post partum triacylglycerol-lipidosis as well as the whole complex of health and fertility problems were induced under well-controlled conditions.

  9. Protection of ewes against Teladorsagia circumcincta infection in the periparturient period by vaccination with recombinant antigens.

    Science.gov (United States)

    Nisbet, Alasdair J; McNeilly, Tom N; Greer, Andrew W; Bartley, Yvonne; Oliver, E Margaret; Smith, Stephen; Palarea-Albaladejo, Javier; Matthews, Jacqueline B

    2016-09-15

    Teladorsagiosis is a major production-limiting disease in ruminants in temperate regions throughout the world and one of the key interventions in the management of the disease is the prevention of pasture contamination with Teladorsagia circumcincta eggs by ewes during the periparturient relaxation in immunity which occurs in the period around lambing. Here, we describe the immunisation of twin-bearing ewes with a T. circumcincta recombinant subunit vaccine and the impact that vaccination has on their immune responses and shedding of parasite eggs during a continuous T. circumcincta challenge period spanning late gestation and lactation. In ewes which displayed a clear periparturient relaxation in immunity, vaccination resulted in a 45% reduction in mean cumulative faecal egg count (cFEC, p=0.027) compared to control (immunised with adjuvant only) ewes. Recombinant antigen-specific IgG and IgA, which bound each of the vaccine antigens, were detected in the serum of vaccinated ewes following each immunisation and in colostrum taken from vaccinated ewes post-partum whereas low levels of antigen-specific IgG were detected in serum and colostrum from control ewes. Antigen-specific IgG and IgA levels in blood collected within 48h of birth from lambs largely reflected those in the colostrum of their ewes. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  10. The reliability of welfare assessment according to the WelFur-protocol in the nursing period of mink (Neovison vison) is challenged by increasing welfare problems prior to weaning

    DEFF Research Database (Denmark)

    Henriksen, Britt I. F.; Møller, Steen Henrik

    2015-01-01

    The objective of this study was to test the hypothesis that the body condition of the mink dam, the frequency of dirty nests, frequency of injuries and diarrhoea change significantly with the day of assessment, post-partum, within the data collection period from parturition to weaning, influencing...... feeding', but not by enough to affect the estimated welfare classification. The score for the three other measures also varied with date of assessment but not enough to affect the classification. However, the observed change in the four measures we focused on indicates that a change in the overall Wel......Fur classification can occur if these or other measures change a little more for the better or worse. Possible solutions to this could be reducing the time window for assessment, development of a valid correction factor or to stratify the visits into an early, middle and late visit on a farm within the three...

  11. Ante partum depression and husband’s mental problem increased risk maternity blues

    Directory of Open Access Journals (Sweden)

    R. I. Ismail

    2006-06-01

    Full Text Available Maternity blues disorder (MB is common, and it is usually undiagnosed. This study to identify several risk factors related to MB. Subjects were pregnant women who had antenatal and delivery at the Persahabatan Hospital (RSP Jakarta from 1 November 1999 to 15 August 2001. Consecutive sampling and was followed-up until two-week postpartum. Those who ever had psychiatric disorders (schizophrenia or other psychotic disorders were excluded. MB and ante partum depression (APD detected by using Edinburgh Postnatal Depression Scale (EPDS. Husband’s mental status based on Symptom Check List-90 (SCL-90 respectively. Among 580 subjects, 25% suffering from MB. Compared with those who did not have APD, those who experienced it had more than three-fold increased risk to be MB [adjusted hazard ratio (aHR = 3.57; 95% confidence interval (CI = 2.54;5.03]. Those who had not healthy baby on the first 5 days afterbirth than who had healthy baby had twice increased risk to be MB (aHR = 2.21; 95% CI = 1.34 ; 3.66. Who had husband with problem in mental health had 1.9 increased risk to be MB (aHR = 1.91; 95% CI = 1.36 ; 2.68. Stress during pregnancy had 1.6 increased risk to be MB (aHR = 1.59; 95% CI = 1.14 ; 2.25. To control MB, special attention should be paid to women who had APD history, who had unhealthy baby on 5 first days afterbirth, who had husbands’ mental health problems, and who had stress during pregnancy. (Med J Indones 2006; 15:74-80Keywords: ante partum, maternity blues, depression, mental problem

  12. High parity predicts use of long-acting reversible contraceptives in the extended postpartum period among women in rural Uganda.

    Science.gov (United States)

    Anguzu, Ronald; Sempeera, Hassard; Sekandi, Juliet N

    2018-01-01

    The use of implants and Intra-uterine devices (IUD) during the post-partum period is very low in Uganda especially in rural settings. Long-acting reversible contraceptives (LARC) are known to be the most cost-effective for prevention of unintended pregnancy and unsafe abortions. This study aimed at determining the factors associated with long-acting reversible contraceptive use among women in the extended postpartum period in rural Uganda. We conducted a household-based, cross-sectional study among 400 women in two rural communities in Mityana district, central Uganda. Eligible women were aged 15 to 45 years who had childbirth within 12 months of study enrollment in September 2014. The outcome variable was self-reported use of a LARC method, either IUD or implants in the extended postpartum period. The main independent variables were previous childbirths (parity), fertility desire, willingness to use modern contraception, duration of postpartum period and previous pregnancies (gravidity). A logistic regression model was run in STATA v12.0 to compute adjusted odds ratios (AOR) for factors that predicted LARC use statistically significant at p  postpartum period (AOR = 4.07, 95%CI 1.08-15.4). Willingness to use modern contraception, desire for more children and postpartum duration had no significant association with LARC use in the extended postpartum period. This study revealed low use of LARC within twelve months of child birth despite women's willingness to use them. High parity (≥5 childbirths) predicted LARC use. The next logical step is to identify barriers to using LARC in the extended postpartum period and design appropriate interventions to increase access and use especially in multi-parous women.

  13. Unmet need for modern contraceptives and associated factors among women in the extended postpartum period in Dessie town, Ethiopia.

    Science.gov (United States)

    Tegegn, Masresha; Arefaynie, Mastewal; Tiruye, Tenaw Yimer

    2017-01-01

    The contraceptive use of women in the extended postpartum period is usually different from other times in a woman's life cycle due to the additional roles and presence of emotional changes. However, there is lack of evidence regarding women contraceptive need during this period and the extent they met their need. Therefore, the objective of this study was to assess unmet need for modern contraceptives and associated factors among women during the extended postpartum period in Dessie Town, North east Ethiopia in December 2014. A community-based cross-sectional study was conducted among women who gave birth one year before the study period. Systematic random sampling technique was employed to recruit a total of 383 study participants. For data collection, a structured and pretested standard questionnaire was used. Descriptive statistics were done to characterize the study population using different variables. Bivariate and multiple logistic regression models were fitted to control confounding factors. Odds ratios with 95% confidence intervals were computed to identify factors associated with unmet need. This study revealed that 44% of the extended post-partum women had unmet need of modern contraceptives of which 57% unmet need for spacing and 43% for limiting. Education of women (being illiterate) (AOR (adjusted odds ratio) =3.37, 95% CI (confidence interval) 1.22-7.57), antenatal care service (no) (AOR = 2.41, 95% CI 1.11-5.79), Post-natal care service (no) (AOR = 3.63, CI 2.13-6.19) and knowledge of lactational amenorrhea method (AOR = 7.84 95% CI 4.10-15.02) were the factors positively associated with unmet need modern contraceptives in the extended postpartum period. The unmet need for modern contraception is high in the study area. There is need to improve the quality of maternal health service, girls education, information on postpartum risk of pregnancy on the recommended postpartum contraceptives to enable mothers make informed choices of

  14. Postnatal Depression Prevention Through Prenatal Intervention: A Literature Review

    Science.gov (United States)

    2006-03-17

    Healthy People 2010 is to reduce the rate of post - partum depression . One method to reach this goal is to prevent post -partun depression (PPD) by providing...20060505147 04/17/2006 06:59 13036779673 BUCKLEY AFB ITT PAGE 07 Introduction Depression during pregnancy is associated with "higher incidence of post ... partum depression , maternal psychosocial and lifestyle risks, death by suicide, and adverse fetal outcomes" (Jesse and Graham, 2005). According to

  15. Bekymringer og fødselsangst under svangerskapet – hvordan påvirkes fødselen?

    OpenAIRE

    Balendra, Sri Ramya

    2017-01-01

    ABSTRACT Background: Pregnancy is an important period with many transitions in a woman’s life. This period is characterized by great expectations and joy, but also by worries, anxiety and depression both during pregnancy and post partum. Many studies have investigated these factors using different methods and scores, and our aim was to look at the context between worries, anxieties, depression and the outcome and delivery method. Methods: We conducted a literature study consisting of 37 studi...

  16. Prediction of acute renal allograft rejection in early post-transplantation period by soluble CD30.

    Science.gov (United States)

    Dong, Wang; Shunliang, Yang; Weizhen, Wu; Qinghua, Wang; Zhangxin, Zeng; Jianming, Tan; He, Wang

    2006-06-01

    To evaluate the feasibility of serum sCD30 for prediction of acute graft rejection, we analyzed clinical data of 231 patients, whose serum levels of sCD30 were detected by ELISA before and after transplantation. They were divided into three groups: acute rejection group (AR, n = 49), uncomplicated course group (UC, n = 171) and delayed graft function group (DGF, n = 11). Preoperative sCD30 levels of three groups were 183 +/- 74, 177 +/- 82 and 168 +/- 53 U/ml, respectively (P = 0.82). Significant decrease of sCD30 was detected in three groups on day 5 and 10 post-transplantation respectively (52 +/- 30 and 9 +/- 5 U/ml respectively, P sCD30 values on day 5 post-transplantation (92 +/- 27 U/ml vs. 41 +/- 20 U/ml and 48 +/- 18 U/ml, P sCD30 levels on day 10 post-transplantation were virtually similar in patients of three groups (P = 0.43). Receiver operating characteristic (ROC) curve demonstrated that sCD30 level on day 5 post-transplantation could differentiate patients who subsequently suffered acute allograft rejection from others (area under ROC curve 0.95). According to ROC curve, 65 U/ml may be the optimal operational cut-off level to predict impending graft rejection (specificity 91.8%, sensitivity 87.1%). Measurement of soluble CD30 on day 5 post-transplantation might offer a noninvasive means to recognize patients at risk of impending acute graft rejection during early post-transplantation period.

  17. [Comparison of clinical and histological diagnosis in kidney post-transplantation period].

    Science.gov (United States)

    de Castro, M C; Chocair, P R; Saldanha, L B; Nahas, W; Arap, S; Sabbaga, E; Ianhez, L E

    1998-01-01

    To assess the agreement between clinical and histopathological diagnosis in a renal transplantation center, 40 episodes of acute renal failure were studied. Kidney biopsies were performed at the moment that a clinical diagnosis was made by the staff. Nineteen episodes of acute tubular necrosis (ATN), eighteen episodes of acute cellular rejection (ACR), 2 humoral rejections and 1 acute cyclosporin nephrotoxicity episodes were diagnosed. ATN episodes were confirmed by renal biopsy in 84.21%, ACR episodes in 83.33%, humoral rejections in 100%. Renal biopsy showed ATN in the occurrence of clinical cyclosporin nephrotoxicity. Total agreement was 82.5%. There is a good relationship between clinical and histopathological diagnosis in the post-transplantation period. Diagnostic mistakes occurred mainly when oliguria was present.

  18. The role of GABAA receptor activity in post-ictal depression period in a rat kindling model of epilepsy

    Directory of Open Access Journals (Sweden)

    Javad Mirnajafi-Zadeh

    2009-02-01

    Full Text Available Introduction: Following the seizure there is an inhibitory period named “post-ictal depressionperiod” which has a depressing effect on the following seizure. In this study, the role of GABAAreceptors on post-ictal depression period was investigated in amygdala kindling model of epilepsy inrat.Materials and Methods: Animals were kindled by electrical stimulation of amygdala. Then, theywere divided into four groups. Different groups of kindled animals were received a second stimulationat 10, 30, 60 and 90 min after the first stimulation and the percentage of suppression of seizureparameters after the second stimulation was calculated. In another four groups, bicucullin, a selectiveGABAA receptor antagonist (100 nM, was intra-cerebroventricularly microinjected 10 min before thesecond stimulation and its effect on the percentage of suppression induced by the first stimulation wasinvestigated. Six animals were used in each group.Results: When the second stimulation was applied at 10 and 30 min after the first stimulation asignificant reduction was observed in the seizure severity and seizure parameters were depressed afterthe second stimulation. Bicucullin microinjection significantly decreased the percentage of depressionin seizure parameters following the second stimulation compared to the animals received the solventalone (P<0.05. This decrease was significant when the second stimulation was applied at 10 and 30min after the first stimulation.Conclusion: Obtained results showed that activity of GABAA receptors by endogenous GABA isone of the mechanisms involved in post-ictal depressing period. However, the blocking of thesereceptors could not completely prevent this period. Thus, other factors have also role in its induction.

  19. Factors affecting the reproductive performance of Bunaji cattle under different pastoral management systems in the Guinea savanna zone of Nigeria

    International Nuclear Information System (INIS)

    Eduvie, L.O.; Bawa, E.K.; Dawuda, P.M.; Oyedipe, E.O.; Olorunju, S.A.S.; Bales, J.O.; Sekoni, V.O.

    1993-01-01

    The effects of management on the productivity of Bunaji cattle were investigated on 6 farms using 38 post-partum cows and 8 heifers. General information obtained on management of the farms indicated differences in managements practices between farms. The screening of the animals in the various farms for blood and endo-parasites showed that some of the farms had problems of helminthiasis and fascioliasis. Uterine involution was complete within 25 days of calving in all post-partum cows. Intervals from calving to ovulation and conception were different between farms. The conception rates for all farms over a period of 730 days ranged from 60 to 100%. A higher percentage of heifers on farm A reached puberty at an earlier age than those in farm B. It was concluded that management affects reproductive performance and thus productivity of Bunaji cattle, with nutrition and disease being the major contributing factors. (author). 10 refs, 7 tabs

  20. PARAVAGINAL AND RETROPERITONEAL HAEMATOMA POST PARTUM

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    Boštjan Lovšin

    2018-02-01

    Full Text Available Background. Postpartum haemorrhage from ruptured tissues can usually be diagnosed and managed properly. A problem exists with the occult haemorrhage without evident tissue trauma in which case a haematoma develops. Methods. After a normal delivery of the 41 years old secundipara after a previous caesarean in epidural analgesia a boy was born. Placenta was delivered spontaneously and perineal rupure sutured properly. About an hour after the delivery heavy pain was noted in the lower abdomen. Pelvic exam revealed a paravaginal haematoma and ultrasound scan coagulated and fresh blood behind the uterus. Rupture of the uterus was suspected and laparotomy revision performed. During the laparotomy there was no haemorrhage in the pelvic cavity, no uterine rupture but a large retroperitoneal haematoma extending to mesosigmoidal part of intestinum. Paravaginal heamatoma was evacuated vaginally and after half an hour the retroperitoneal haematoma diminished by 50 %. The patient received two blood transfusions. The blood loss was estimated as about 500 grams. The pulse and blood pressure were normal all the time. The laboratory values of haemoglobin was 96 g/l, haematocrit 0.30 before the operation and 93 g/l and 0.28 respectively 6 hours after. Beside anaemia the postoperative course was uneventful and the patient was dismissed from the hospital the 6th day postpartum. Conclusions. Although the laparotomy seems an excessive treatment it was the only way to exclude uterus rupture after a previous caesarean, heavy pain in the lower abdomen and blood behind the uterus noted on the ultrasound scan. In the non-urgent situation a CT scan could be performed to locate the blood accumulation and possibly exclude uterine rupture.

  1. [Risk factors for post partum depression].

    Science.gov (United States)

    Dois, Angelina; Uribe, Claudia; Villarroel, Luis; Contreras, Aixa

    2012-06-01

    Postpartum depression (PPD) is a public health problem with high prevalence in Chile. Many factors are associated with PPD. To analyze the factors associated with the incidence of depressive symptoms (SD) in women with low obstetric risk. Cross-sectional analytical study on a sample of 105 postpartum women with low obstetric risk assessed by the Edinburgh Depression Scale at the eighth week postpartum. A 37% prevalence of depressive symptoms was found. Univariate analysis showed that the perception of family functioning, overcrowding and number of siblings, were significantly associated with postpartum depressive symptoms. A multiple regression model only accepted family functioning as a predictor of depression. Perception of family functioning was the only variable that explained in part the presence of depressive symptoms in women with low obstetric risk.

  2. Control of the reproductive performance of Chios sheep and Damascus goats: Studies using hormone radioimmuoassays

    International Nuclear Information System (INIS)

    Mavrogenis, A.P.

    1988-01-01

    The effects of environment on conception rate and litter size, and of the goat status and age in the preceding season on the time of oestrus appearance were studied. Furthermore, the effect of season of kidding and daily milk production at the occurrence of oestrus on 'days open' was examined. Environmental factors such as temperature, humidity, age of goat or management and feeding could not account for the variation in reproductive behaviour. Ovarian activity monitored for 53 weeks showed that: there was a short period of anoestrus from late March to early July; conventional methods of heat detection are inadequate; there was an irregular heat wave in July which was not followed by repeated cycles; and the regular breeding season for the Damascus goat is in autumn (September to December) and the average length of the cycle is 21 days. The duration of oestrus was studied in parous and non-parous goats following oestrus synchronization with progesterone analogue and PMSG. Overt oestrus appeared 31.1 h (range 24-48 h) after the removal of sponges, and continued for 36-44 h. Its duration was somewhat longer in parous compared to non-parous goats. Serum progesterone levels correlated with oestrus detection by vasectomized males. Milk and blood samples were collected at regular intervals starting three days post-partum to study post-partum anoestrus in Chios sheep. Progesterone assays, carried out using skimmed milk and blood serum, showed that first ovulation occurred approximately within 30 days post-partum. Progesterone levels were much higher in serum than in skimmed milk. It is suggested that Chios sheep have ovulations during the suckling period although overt oestrus could not always be detected by vasectomized males. 50 refs, 8 figs, 7 tabs

  3. EL POSPARTO EN LA VACA POST-PARTUM IN THE CATTLE

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    Hernández Vásquez Aureliano

    2007-11-01

    Full Text Available El posparto es un periodo crítico del ciclo reproductivo del bovino. Para que se reasuma la función reproductiva después del parto, es necesario que haya involución uterina, cese la inhibición de la función del hipotálamo y la hipófisis para que se restablezcan el patrón de secreción de la hormona luteinizante y la ovulación. En el presente artículo se discuten sucintamente los aspectos más relevantes que influyen en la restauración de la función reproductiva, a saber: el amamantamiento y cercanía del ternero a la madre, presencia del toro en el hato, la nutrición, las reservas energéticas de la madre y el efecto del suministro de algunas hormonas.The postpartum is a critical period during the reproductive life of a cow. In a general approach, the return to reproductive function after parturition, depends on uterine involution and cessation of the inhibition of hypothalamic and hypophyseal functions. In the present revision, known relevant factors aspects which influence postpartum reproductive physiology, are briefly discussed, including suckling, nutrition and energy status of the cow, contact with the calf and presence of a bull, and the effect of time of the year at parturition, as well as the use of hormonal therapies.

  4. Bone metabolism dynamics in the early post-transplant period following kidney and liver transplantation.

    Science.gov (United States)

    Schreiber, Peter W; Bischoff-Ferrari, Heike A; Boggian, Katia; Bonani, Marco; van Delden, Christian; Enriquez, Natalia; Fehr, Thomas; Garzoni, Christian; Hirsch, Hans H; Hirzel, Cédric; Manuel, Oriol; Meylan, Pascal; Saleh, Lanja; Weisser, Maja; Mueller, Nicolas J

    2018-01-01

    Bone disease contributes to relevant morbidity after solid organ transplantation. Vitamin D has a crucial role for bone metabolism. Activation of vitamin D depends on the endocrine function of both, liver and kidney. Our study assessed key markers of bone metabolism at time of transplantation and 6 months after transplantation among 70 kidney and 70 liver recipients. In 70 kidney recipients 25-OH vitamin D levels did not differ significantly between peri-transplant (median 32.5nmol/l) and 6 months post-transplant (median 41.9nmol/l; P = 0.272). Six months post-transplant median 1, 25-(OH)2 vitamin D levels increased by >300% (from 9.1 to 36.5ng/l; Ptransplantation and of intact parathyroid hormone 6 months post-transplant. Among 70 liver recipients, 25-OH vitamin D, 1, 25-(OH)2 vitamin D and intact parathyroid hormone levels were not significantly altered between peri-transplant and 6 months post-transplant. Contrary to kidney recipients, median CTx increased by 60.0% (from 0.45 to 0.72 ng/ml; P = 0.002) and P1NP by 49.3% (from 84.0 to 125.4ng/ml; P = 0.001) in the longitudinal course. Assessed biomarkers didn't differ between liver recipients with and without fractures. To conclude, the assessed panel of biomarkers proved highly dynamic after liver as well as kidney transplantation in the early post-transplant period. After kidney transplantation a significant gain in 1, 25-(OH)2 vitamin D combined with a decline in iPTH, CTx and P1NP, whereas after liver transplantation an increase in CTx and P1NP were characteristic.

  5. Fathers make a difference: positive relationships with mother and baby in relation to infant colic.

    Science.gov (United States)

    Alexander, C P; Zhu, J; Paul, I M; Kjerulff, K H

    2017-09-01

    Maternal psychological factors like depression, anxiety and stress have been associated with infant fussiness or colic. However, little research exists on whether positive factors such as social support and the happiness of the mother-partner relationship are associated with lower rates of infant fussiness or colic. We investigated the association between infant colic and three types of maternal support: general maternal social support (during pregnancy and post partum), the happiness of the mother-partner relationship (during pregnancy and post partum) and partner involvement in caring for the newborn. Participants were 3006 women in the First Baby Study, a prospective study of the effect of mode of first delivery on subsequent childbearing. Women were interviewed by telephone during pregnancy and 1 month after first childbirth and asked about social support and if their baby had a variety of problems since birth, including 'Colic - crying or fussiness three or more hours a day'. Multivariable logistic regression models were used to model the association between maternal support and infant colic, controlling for confounders, including maternal race or ethnicity, insurance, marital status, smoking, mode of delivery, maternal post-partum depression, breastfeeding, other neonatal illnesses and newborn gestational age. Infant colic was reported by 11.6% of new mothers. High general maternal social support (in comparison with low), measured during pregnancy, was associated with lower reported infant colic (adjusted odds ratio (AOR), 0.55, 95% confidence interval (CI), 0.40-0.75) and measured post partum (AOR, 0.51, 95% CI, 0.39-0.67); high relationship happiness (in comparison with low), measured during pregnancy (AOR, 0.71, 95% CI, 0.54-0.93), and measured post partum (AOR, 0.22, 95% CI, 0.12-0.40); and high partner involvement with newborn care (in comparison with low) (AOR, 0.60, 95% CI, 0.44-0.81). Higher levels of maternal social support during pregnancy and post

  6. Clinical phenotypes of perinatal depression and time of symptom onset: analysis of data from an international consortium

    Science.gov (United States)

    Putnam, Karen T; Wilcox, Marsha; Robertson-Blackmore, Emma; Sharkey, Katherine; Bergink, Veerle; Munk-Olsen, Trine; Deligiannidis, Kristina M; Payne, Jennifer; Altemus, Margaret; Newport, Jeffrey; Apter, Gisele; Devouche, Emmanuel; Viktorin, Alexander; Magnusson, Patrik; Penninx, Brenda; Buist, Anne; Bilszta, Justin; O’Hara, Michael; Stuart, Scott; Brock, Rebecca; Roza, Sabine; Tiemeier, Henning; Guille, Constance; Epperson, C Neill; Kim, Deborah; Schmidt, Peter; Martinez, Pedro; Di Florio, Arianna; Wisner, Katherine L; Stowe, Zachary; Jones, Ian; Sullivan, Patrick F; Rubinow, David; Wildenhaus, Kevin; Meltzer-Brody, Samantha

    2018-01-01

    Summary Background The perinatal period is a time of high risk for onset of depressive disorders and is associated with substantial morbidity and mortality, including maternal suicide. Perinatal depression comprises a heterogeneous group of clinical subtypes, and further refinement is needed to improve treatment outcomes. We sought to empirically identify and describe clinically relevant phenotypic subtypes of perinatal depression, and further characterise subtypes by time of symptom onset within pregnancy and three post-partum periods. Methods Data were assembled from a subset of seven of 19 international sites in the Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. In this analysis, the cohort was restricted to women aged 19–40 years with information about onset of depressive symptoms in the perinatal period and complete prospective data for the ten-item Edinburgh postnatal depression scale (EPDS). Principal components and common factor analysis were used to identify symptom dimensions in the EPDS. The National Institute of Mental Health research domain criteria functional constructs of negative valence and arousal were applied to the EPDS dimensions that reflect states of depressed mood, anhedonia, and anxiety. We used k-means clustering to identify subtypes of women sharing symptom patterns. Univariate and bivariate statistics were used to describe the subtypes. Findings Data for 663 women were included in these analyses. We found evidence for three underlying dimensions measured by the EPDS: depressed mood, anxiety, and anhedonia. On the basis of these dimensions, we identified five distinct subtypes of perinatal depression: severe anxious depression, moderate anxious depression, anxious anhedonia, pure anhedonia, and resolved depression. These subtypes have clear differences in symptom quality and time of onset. Anxiety and anhedonia emerged as prominent symptom dimensions with post-partum onset and were notably severe

  7. Terapi Kognitif Perilaku dan Depresi Pasca Melahirkan

    OpenAIRE

    Haeba, Haerani Nur; Moordiningsih, Moordiningsih

    2009-01-01

    This study is aimed to discover the effectiveness of cognitive behavior therapy towards post-partum depression. The reseach question of this study is whether or not cognitive behavior therapy can decrease post-partum depression The participants of this study are three mothers who are in the state of seven days to one month of post labour dan obtains a BDt pretest score between 16-23 which indicates moderate depression. Depression is measured with the Beck Depression Inventory. The result of t...

  8. Estimation of efficiency of new local rehabilitation method at the early post-operative period after dental implantation

    Directory of Open Access Journals (Sweden)

    A. V. Pasechnik

    2017-01-01

      Summary Despite of success of dental implantation, there are often complications at the early post-operative period of implant placing associated with wound damage and aseptic inflammation. Purpose of the work is studying clinical efficiency of combined local application of new mucosal gel “Apior” and magnetotherapy at the early post-operative period after dental implantation. Combined local application of the mucosal gel “Apior” and pulsating low-frequency electromagnetic field in the complex medical treatment of patients after conducting an operation of setting dental implants favourably affects the common state of patients and clinical symptoms of inflammation in the area of operating wound. As compared with patients who had traditional anti-inflammatory therapy, the patients treated with local application of apigel and magnetoterapy had decline of edema incidence, of gingival mucosa hyperemia, of discomfort in the area of conducted operation. There occurred more rapid improvement of inflammation painfulness, which correlated with the improvement of hygienic state of oral cavity and promoted to prevention of bacterial content of damaged mucous surfaces. Estimation of microvasculatory blood stream by the method of ultrasonic doppler flowmetry revealed more rapid normalization of volume and linear high systole speed of blood stream in the periimplant tissues in case of use of new complex local rehabilitation method, that testified to the less pronounced inflammation of oral mucosa after the operation. The authors came to conclusion that the local application of the offered method of medical treatment of early post-operative complications of dental implantation reduces terms of renewal of structural-functional integrity of oral mucosa, helps in preventing development of inflammatory complications and strengthening endosseus implant. The inclusion in the treatment management of a new combined method of application of mucosal gel “Apior” and

  9. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study.

    Science.gov (United States)

    Behrens, Ida; Basit, Saima; Melbye, Mads; Lykke, Jacob A; Wohlfahrt, Jan; Bundgaard, Henning; Thilaganathan, Baskaran; Boyd, Heather A

    2017-07-12

    Objectives  To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time. Design  Nationwide register based cohort study. Setting  Denmark. Populations  482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses). Main outcome measures  10 year cumulative incidences of post-pregnancy hypertension requiring treatment with prescription drugs, and hazard ratios estimated using Cox regression. Results  Of women with a hypertensive disorder of pregnancy in a first pregnancy in their 20s, 14% developed hypertension in the first decade post partum, compared with 4% of women with normotensive first pregnancies in their 20s. The corresponding percentages for women with a first pregnancy in their 40s were 32% and 11%, respectively. In the year after delivery, women with a hypertensive disorder of pregnancy had 12-fold to 25-fold higher rates of hypertension than did women with a normotensive pregnancy. Rates in women with a hypertensive disorder of pregnancy were threefold to 10-fold higher 1-10 years post partum and remained twice as high even 20 or more years later. Conclusions  The risk of hypertension associated with hypertensive disorders of pregnancy is high immediately after an affected pregnancy and persists for more than 20 years. Up to one third of women with a hypertensive disorder of pregnancy may develop hypertension within a decade of an affected pregnancy, indicating that cardiovascular disease prevention in these women should include blood pressure monitoring initiated soon after pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Effect of ultraviolet light irradiation period on bond strengths between fiber-reinforced composite post and core build-up composite resin.

    Science.gov (United States)

    Asakawa, Yuya; Takahashi, Hidekazu; Iwasaki, Naohiko; Kobayashi, Masahiro

    2014-01-01

    The aim of the present study was to characterize the effects of the ultraviolet light (UV) irradiation period on the bond strength of fiber-reinforced composite (FRC) posts to core build-up resin. Three types of FRC posts were prepared using polymethyl methacrylate, urethane dimethacrylate, and epoxy resin. The surfaces of these posts were treated using UV irradiation at a distance of 15 mm for 0 to 600 s. The pull-out bond strength was measured and analyzed with the Dunnett's comparison test (α=0.05). The bond strengths of the post surfaces without irradiation were 6.9 to 7.4 MPa; those after irradiation were 4.2 to 26.1 MPa. The bond strengths significantly increased after 15 to 120-s irradiation. UV irradiation on the FRC posts improved the bond strengths between the FRC posts and core build-up resin regardless of the type of matrix resin.

  11. Temperament, post-partum depression, hopelessness, and suicide risk among women soon after delivering.

    Science.gov (United States)

    Girardi, Paolo; Pompili, Maurizio; Innamorati, Marco; Serafini, Gianluca; Berrettoni, Claudia; Angeletti, Gloria; Koukopoulos, Alexia; Tatarelli, Roberto; Lester, David; Roselli, Domenico; Primiero, Francesco M

    2011-07-22

    The aim of the authors in this study was to assess the prevalence of postpartum depression and evaluate the association of affective temperaments with emotional disorders in a sample of 92 pregnant women consecutively admitted for delivery between March and December 2009. In the first few days postpartum, women completed the Suicidal History Self-rating Screening Scale, the Beck Hopelessness Scale, the Edinburgh Postnatal Depression Scale, the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire, and the Gotland Male Depression Scale. Fifty percent of the women reported an Edinburgh Postnatal Depression Scale score of 9 or higher, and 23% a score of 13 or higher. Women with a dysphoric-dysregulated temperament had higher mean scores on the Beck Hopelessness Scale (p Depression Scale (p Depression Scale (p Depression Scale was significantly associated with temperament when controlling for the presence of other variables. Women with a dysphoric-dysregulated temperament were 1.23 times as likely to have higher depressive symptom scores. Future studies should evaluate the effectiveness of psychiatric screening programs in the postpartum period as well as factors associated with depression and suicidality during the same period.

  12. Adjustment of interbank lending in pre- and post-regulation periods: Empirical analysis of Vietnamese commercial banks

    Directory of Open Access Journals (Sweden)

    Ho Thanh Tung

    2017-10-01

    Full Text Available This article aims to analyze the interbank lending adjustment during the period when Vietnamese commercial banks are compliant with some parts of the Basel regulation framework. A pilot regulation period has started in 2011 and full application will be effective by the end of 2018. Partial adjustment models and variance decomposition are used for the analyses. In the analysis of the quarterly released financial statements of Vietnamese commercial banks in the period from 2008/Q1 to 2015/Q4, the empirical evidence showed that throughout the period, lending to non-bank and high liquidity assets contributed to the adjustment in both long run and short run with a negative association. In addition, the loan loss allowance contributed to the adjustment in the post-regulation period only with a positive association. These highly contributing factors also show a potential shock after the adjustment of the interbank lending. The results imply there is a need for interbank lending portfolio report and an efficient control over the IRB of Vietnamese commercial banks.

  13. A Rare case of Guillain-Barré syndrome in pregnancy treated with plasma exchange

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    Rahul Vasudev

    2014-01-01

    Full Text Available Guillain-Barre syndromé (GBS is an autoimmune disorder. It is rare in pregnancy as there is a decrease in cell-mediated immunity. A case of 28-year-old pregnant woman who presented with acute flaccid quadriplegia suffering from GBS is discussed in this study. She was treated with plasma exchange in her immediate post-partum period. The management of GBS in pregnancy has been discussed.

  14. Les conséquences obstétricales de l'endométriose pendant la grossesse, l'accouchement et ses suitesA partir d'une revue de la littérature

    OpenAIRE

    Lauriol, Manon

    2017-01-01

    Background: endometriosis affects 10% of the general population. It’s a gynaecologic benign, estrogen-dependent disease of the woman of childbearing age. Endometriosis may have adverse effects on pregnancy.Objectif: to investigate obstetric complications of endometriosis during pregnancy, delivery and post-partum period.Methods: a literature review was conducted. 15 articles, published between 2005 and 2016, were selected from the PubMed database using the following keywords : endometriosis, ...

  15. Peripartum dynamics of Coxiella burnetii infections in intensively managed dairy goats associated with a Q fever outbreak in Australia.

    Science.gov (United States)

    Muleme, Michael; Stenos, John; Vincent, Gemma; Wilks, Colin R; Devlin, Joanne M; Campbell, Angus; Cameron, Alexander; Stevenson, Mark A; Graves, Stephen; Firestone, Simon M

    2017-04-01

    Coxiella burnetii may cause reproduction disorders in pregnant animals but subclinical infection in other animals. Unrecognised disease may delay implementation of control interventions, resulting in transmission of infection to other livestock and to humans. Seroreactivity to C. burnetii phase-specific antigens, is routinely used to interpret the course of human Q fever. This approach could be similarly useful in identifying new and existing infections in livestock herds to help describe risk factors or production losses associated with the infections and the implementation of disease-control interventions. This study aimed to elucidate the dynamics of C. burnetii infections using seroreactivity to phase-specific antigens and to examine the impact of infection on milk yield in goats in an endemically-infected farm that was associated with a Q fever outbreak in Australia. Seroreactivity pre- and post-partum and milk yield were studied in 164 goats (86 nulliparous and 78 parous). Post-partum, the seroprevalence of antibodies to C. burnetti increased from 4.7% to 31.4% throughout goats' first kiddings and from 47.4% to 55.1% in goats kidding for the second or greater time. Of 123 goats that were seronegative pre-partum, 26.8% seroconverted over the three-month peri-partum period, highlighting the importance of controlling infection throughout this time. The risk of seroconversion was comparable in first or later kidders, suggesting constant risk irrespective of parity. No loss in milk production associated with seroconversion to phase 2 was observed within the first nine weeks of lactation. However, seroconversion to only phase 1 was associated with extra 0.276L of milk per day (95% Confidence Interval: 0.010, 0.543; P=0.042), which warrants further investigation to ascertain whether or not the association is causal. Further studies on seroreactivity and milk production over longer periods are required, as milk production loss caused by C. burnetti may be an

  16. Parenting Stress, Mental Health, Dyadic Adjustment: A Structural Equation Model

    Directory of Open Access Journals (Sweden)

    Luca Rollè

    2017-05-01

    Full Text Available Objective: In the 1st year of the post-partum period, parenting stress, mental health, and dyadic adjustment are important for the wellbeing of both parents and the child. However, there are few studies that analyze the relationship among these three dimensions. The aim of this study is to investigate the relationships between parenting stress, mental health (depressive and anxiety symptoms, and dyadic adjustment among first-time parents.Method: We studied 268 parents (134 couples of healthy babies. At 12 months post-partum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Post-natal Depression Scale, the State-Trait Anxiety Inventory, and the Dyadic Adjustment Scale. Structural equation modeling was used to analyze the potential mediating effects of mental health on the relationship between parenting stress and dyadic adjustment.Results: Results showed the full mediation effect of mental health between parenting stress and dyadic adjustment. A multi-group analysis further found that the paths did not differ across mothers and fathers.Discussion: The results suggest that mental health is an important dimension that mediates the relationship between parenting stress and dyadic adjustment in the transition to parenthood.

  17. Investigation of hormone profiles in dairy cattle with a view to controlling fertility and increasing reproductive efficiency

    International Nuclear Information System (INIS)

    Kovacevic, R.; Krsmanovic, L.; Maric, D.; Perkucin, R.; Veselinovic, S.

    1988-01-01

    The investigation was carried out on 677 Holstein-Friesian dairy cows from one big commercial farm in Voivodina. The accuracy of the application of serum progesterone RIA for the early diagnosis of non-pregnancy was 98% (and 97% for milk progesterone samples). The figures were 49% and 60%, respectively, for positive diagnosis. The high percentage of false positive results was probably due to a high incidence of disturbances in the oestrous cycle and problems of heat detection. Investigation of progesterone profiles in post-partum dairy cows showed that the duration of post-partum anoestrous was strongly influenced by the level of nutrition. Treatment with GnRH suggested that two injections of GnRH given 15 d and 23 d post-partum could induce the onset of the first ovulation. (author). 15 refs, 9 figs, 4 tabs

  18. Subscales measuring symptoms of non-specific depression, anhedonia, and anxiety in the Edinburgh Postnatal Depression Scale.

    Science.gov (United States)

    Tuohy, Alan; McVey, Cynthia

    2008-06-01

    There has been considerable research and clinical interest in the comorbidity of anxiety and depression in the post-partum period, and specifically in the possibility that the commonly used Edinburgh Postnatal Depression Scale (EPDS) incorporates an anxiety component. We hypothesized that the recommended version of factor analysis (Fabrigar, Wegener, MacCallum, & Strahan, 1999) would identify such covert dimensions more reliably than the commonly used principal components analysis with varimax rotation and eigenvalues greater than 1. Principal axis factor extraction with parallel analysis and oblique (direct quartimin) factor rotation was applied to the 10 EPDS items. The study used a sample of recent mothers recruited and assessed via e-mail and the Internet (N=440). In addition to the EPDS, the Hospital Anxiety and Depression Scale (HADS) and the Positive and Negative Affect Scales (PANAS) were also administered. Three factors were found, which were identified as 'non-specific depressive symptoms', 'anhedonia', and 'anxietal symptoms' subscales, respectively. These subscales were regressed on the HADS anxiety and depression and the PANAS positive and negative affectivity scales, with results substantially consistent with current structural models of the taxonomy of the emotional disorders. The data were obtained from a self-selected non-clinical sample. In addition, it is known that the use of computer-based assessment may tend to inflate self-report scores. It was concluded that there is now sufficient evidence that clinicians should not assume the EPDS to be unidimensional, but should assess all three subscales when screening for susceptibility to post-partum depression and/or post-partum anxiety.

  19. Pregnancy and Parenthood in the Navy: Results of the 2008 Survey

    Science.gov (United States)

    2009-06-01

    officers. Women use annual leave to supplement post - partum convalescent leave. N134W receives continued requests to increase duration of maternity...was horrible! Almost got out of the Navy. • I feel that the military can show more support by offering a mandatory " Post - Partum ” awareness class and...postpartum depression 9292At postpartum visit, discussed birth control methods 60 92 Officer 77At postpartum visit, discussed Shaken Baby Syndrome prevention

  20. The protective role of maternal post-traumatic growth and cognitive trauma processing in Palestinian mothers and infants: a longitudinal study.

    Science.gov (United States)

    Diab, Safwat Y; Isosävi, Sanna; Qouta, Samir R; Kuittinen, Saija; Punamäki, Raija-Leena

    2018-02-21

    Women at pre partum and post partum are especially susceptible to war trauma because they struggle to protect their infants from danger. Trauma research suggests increased problems in maternal mental health and infant development. Yet many cognitive-emotional processes affect the trauma survivors' mental health, such as post-traumatic growth and post-traumatic cognition. The aim of this study was to examine whether a mother's high post-traumatic growth and optimal post-traumatic cognition could protect their own mental health and their infant's stress regulation from the effects of traumatic war experiences. This three-wave prospective study involved Palestinian women living in the Gaza Strip who were at the second trimester of pregnancy (T1), women with infants aged 4 months (T2), and women with children aged 12 months (T3) months. The participants reported their war experiences in a 30-item checklist of losses, destruction, and atrocities in the 2008-09, 2012, and 2014 military offensives. Post-traumatic growth was assessed by a 21-item scale and post-traumatic cognition by a 36-item scale. Maternal mental health was assessed by post-traumatic stress disorder (PTSD), depressive, anxiety, and dissociation symptoms at T1 and T3, and infants' stress regulation was assessed with the Infant Behaviour Questionnaire at T2 and T3. We included 511 women at T1, 481 women at T2, and 454 women at T3. High maternal post-traumatic growth and post-traumatic cognition had protective roles. Post-traumatic growth had a protective effect on maternal mental health since severe exposure to traumatic war experiences was not associated with maternal PTSD, depression, and dissociation if women showed high post-traumatic growth, as indicated by the significant interaction effect between post-traumatic growth and war trauma on each of the three symptoms. Post-traumatic cognition had a protective effect on infant development since severe exposure was not associated with dysfunctional

  1. The environmental radioactivity data analysis at the inr platform in the post-chernobyl period

    International Nuclear Information System (INIS)

    Tudor, G.; Valeca, M.; Iordache, R.

    2016-01-01

    As a result of the Chernobyl accident, large quantities of radioactive substances were released into the atmosphere and were transported long distances, covering virtually the whole Europe, including Romania. This paper presents the analysis of the environment radioactivity data around the INR site, in the post-Chernobyl period in different types of samples. The purpose of this study was to evaluate the evolution of Chernobyl originated radionuclides concentration in Mioveni-Pitesti area. The selected indicator was Cs-137, which was monitored on a regular basis. From the post-Chernobyl annual reports, were collected the average values for Cs-137 activity in environmental samples. The concentration was determined for eleven sampling locations (soil and vegetation samples) distributed on 10 km distance around INR site, and the determination was made using gamma spectrometry. The data reveals significant variations of the Cs-137 activity. These variations may be generated by various disturbances that detach material from the soil and air, therefore allowing the substance to travel long distances from its origin. (authors)

  2. Reproduction in female copperhead snakes (Agkistrodon contortrix): plasma steroid profiles during gestation and post-birth periods.

    Science.gov (United States)

    Smith, Charles F; Schuett, Gordon W; Hoss, Shannon K

    2012-04-01

    We investigated levels of plasma progesterone (P4), 17β-estradiol (E2), testosterone (T), and corticosterone (CORT) during gestation and post-birth periods in wild-collected female copperhead snakes (Viperidae; Agkistrodon contortrix). We also sought to determine whether CORT levels at (or near) birth dramatically increase and were correlated with duration of labor and litter size. Specifically, pregnant subjects (N = 14) were collected during early- to mid-gestation, held in the laboratory, and repeatedly bled to obtain plasma for steroid analyses. Progesterone showed significant changes during gestation, with the highest levels at the onset of sampling (circa 50 days prior to birth); P4 progressively declined up to parturition, and basal levels were observed thereafter. At the onset of sampling, E2 was at peak levels and fell sharply at circa 30 days prior to birth, a trend observed throughout the post-birth sampling period. Throughout the entire sampling period, T was undetectable. Although CORT showed no significant changes during gestation and several days following parturition, there was a highly significant peak at the time of birth. Our findings mirror the results of previous studies on pregnancy and steroid hormones of other live-bearing snakes, lizards, and mammals. As expected, there was a significant relationship between duration of labor and litter size; however, although levels of CORT did not achieve significance, there was a positive trend with litter size. We suggest that elevation of CORT at birth is involved in the mobilization and regulation of energy stores necessary for the physiological process of parturition and as a possible mechanism to trigger birth.

  3. The plankton community on Sukkertop and Fylla Banks off West Greenland during a spring bloom and post-bloom period: Hydrography, phytoplankton and protozooplankton

    DEFF Research Database (Denmark)

    Poulsen, Louise K.; Reuss, N.

    2002-01-01

    The plankton community structure was investigated on Sukkertop and Fylla Banks off West Greenland during the spring bloom in May 2000 and the post-bloom period in June 1999. In May a small change in density, clearly illustrated by the profile of potential energy, was sufficient to support a spring...... the phytoplankton community. Heterotrophic biomass was low (5 +/- 1 mg C m(-3)) and an important part was comprised by heterotrophic nanoflagellates (24 +/- 1%). Protozooplankters (heterotrophic dinoflagellates and ciliates) were important grazers of the phytoplankton community in the post-bloom period (estimated...

  4. Anatomy in Cologne--Institutional development and body supply from the Weimar Republic to the early post-war period.

    Science.gov (United States)

    Kaiser, Stephanie; Gross, Dominik

    2015-07-01

    The Anatomical Institute of the University of Cologne was founded in 1925. This paper highlights its institutional development and the sources from which it procured bodies for dissection. A comparison is drawn between the first years of the institute's existence during the Weimar Republic (1925-1932) and its rebuilding after war damage in the early post-war period (1947-1954). The institute and its procurement of bodies have not previously been investigated for these two time periods. The Third Reich, for which a detailed study already exists, will be mentioned as well to allow better evaluation of the periods before and after National Socialism. Based on newly evaluated archival material and body journals which will be examined both quantitatively and qualitatively, it becomes apparent that the Cologne institute experienced a chronic shortage of bodies both during the Weimar Republic and the first post-war decade (even though the delivery facilities were mostly the same). However, the situation of the institute in terms of structure, organization and personnel as well as body supply in the aftermath of World War II proved much more challenging than during the time of the Weimar Republic. Copyright © 2015 Elsevier GmbH. All rights reserved.

  5. Parturition effects on reproductive health in the gilt and sow

    OpenAIRE

    Peltoniemi, Olli Aarno Tapio; Björkman, Stefan; Oliviero, Claudio

    2016-01-01

    In this review, we address significant characteristics of parturition in the pig and their connection to post-partum reproductive health and fertility. We discuss the normal physiology and behaviour around parturition and the effect of the second phase (expulsion of foetuses) on the third phase of parturition (expulsion of foetal membranes). In addition, we intend to cover retained placenta, and the connection to post-partum uterine health and fertility in the contemporary prolific sow. We al...

  6. Sexual risk during pregnancy and postpartum periods among HIV-infected and -uninfected South African women: Implications for primary and secondary HIV prevention interventions.

    Science.gov (United States)

    Joseph Davey, Dvora; Farley, Elise; Gomba, Yolanda; Coates, Thomas; Myer, Landon

    2018-01-01

    HIV acquisition in pregnancy and breastfeeding contributes significantly toward pediatric HIV infection. However, little is known about how sexual behavior changes during pregnancy and postpartum periods which will help develop targeted HIV prevention and transmission interventions, including pre-exposure prophylaxis (PrEP). Cross-sectional study in HIV-infected and uninfected pregnant and postpartum women in Cape Town, South Africa. Interviewers collected survey data on demographic, sexual behaviors, and alcohol use among pregnant and post-partum women. We report descriptive results of sexual behavior by trimester and postpartum period, and results of multivariable logistic regression stratified by pregnancy status. We enrolled 377 pregnant and postpartum women (56% pregnant, 40% HIV-infected). During pregnancy, 98% of women reported vaginal sex (8% anal sex, 44% oral sex) vs. 35% and 88% during the periods 0-6 and 7-12 months postpartum, respectively (p1 partner in the past 12-months compared to postpartum women (18% vs. 13%, respectively, p6-months postpartum (13 mean sex acts in first trimester; 17 mean sex acts >6-months postpartum). Pregnant women had increased odds of reporting condomless sex at last sex (aOR = 2.96;95%CI = 1.84-4.78) and ever having condomless sex in past 3-months (aOR = 2.65;95%CI = 1.30-5.44) adjusting for age, HIV status, and sex frequency compared to postpartum women. We identified that sexual behaviors and risk behaviors were high and changing during pregnancy and postpartum periods, presenting challenges to primary and secondary HIV prevention efforts, including PrEP delivery to pregnant and breastfeeding women.

  7. The effect of a self-efficacy-based educational programme on maternal breast feeding self-efficacy, breast feeding duration and exclusive breast feeding rates: A longitudinal study.

    Science.gov (United States)

    Chan, Man Yi; Ip, Wan Yim; Choi, Kai Chow

    2016-05-01

    breast feeding has a number of well-documented benefits. Numerous studies have been conducted to investigate an effective approach to increase the breast feeding rate, duration and exclusive breast feeding rate, in which maternal breast feeding self-efficacy was determined as one of the major contributors. Although numerous breast feeding educational programmes have been developed to enhance maternal breastfeeding self-efficacy, results on the effectiveness of these programmes remain inconclusive. this study aims to investigate the effectiveness of a self-efficacy-based breast feeding educational programme (SEBEP) in enhancing breast feeding self-efficacy, breast feeding duration and exclusive breast feeding rates among mothers in Hong Kong. eligible pregnant women were randomized to attend a 2.5-hour breast feeding workshop at 28-38 weeks of gestation and receive 30-60minutes of telephone counselling at two weeks post partum, whereas both intervention and control groups received usual care. At two weeks postpartum, the Breast feeding Self-Efficacy Scale-Short Form (BSES-SF) and a self-developed post partum questionnaire were completed via telephone interviews. The breast feeding duration, pattern of breast feeding and exclusive breast feeding rates were recorded at two weeks, four weeks, eight weeks and six months post partum. results of analyses based on an intention-to-treat (ITT) assumption showed a significant difference (p<0.01) in the change in BSES-SF mean scores between the mothers who received SEBEP and those who did not receive SEBEP at two weeks post partum. The exclusive breast feeding rate was 11.4% for the intervention group and 5.6% for the control group at six months post partum. the findings of this study highlight the feasibility of a major trial to implement breast feeding education targeted at increasing breast feeding self-efficacy and exclusive breast feeding rates in Hong Kong. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Symptoms associated with the DSM IV diagnosis of depression in pregnancy and post partum.

    Science.gov (United States)

    Kammerer, Martin; Marks, Maureen N; Pinard, Claudia; Taylor, Alyx; von Castelberg, Brida; Künzli, Hansjörg; Glover, Vivette

    2009-06-01

    Pregnancy and the postpartum may affect symptoms of depression. However it has not yet been tested how the symptoms used for the DSM IV diagnosis of depression discriminate depressed from non depressed women perinatally. A modified version of the Structured Clinical Interview for DSM IV (SCID interview) was used that allowed assessment of all associated DSM IV symptoms of depression with depressed and non depressed women in pregnancy and the postpartum period. Loss of appetite was not associated with depression either ante or postnatally. The antenatal symptom pattern was different from the postnatal. The sensitivity of the symptoms ranged from 0.7% to 51.6%, and specificity from 61.3% to 99.1%. The best discriminating symptoms were motor retardation/agitation and concentration antenatally, and motor retardation/agitation, concentration and fatigue postnatally. Depression in pregnancy and postpartum depression show significantly different symptom profiles. Appetite is not suitable for the diagnosis of depression in the perinatal period.

  9. The relationship between social capital, social support and the adequate use of prenatal care A relação entre capital social e suporte social com a adequação da utilização da atenção pré-natal

    OpenAIRE

    Maria do Carmo Leal; Ana Paula Esteves Pereira; Gabriela de Almeida Lamarca; Mario Vianna Vettore

    2011-01-01

    This study investigated the relationship between social capital and social support and the adequate use of prenatal care. A follow-up study involving 1,485 pregnant women was conducted in two cities in the Rio de Janeiro State, Brazil. Demographic and socioeconomic characteristics, social support and social capital data were collected during the first trimester of pregnancy. The post-partum period included information on levels of prenatal care utilization, social networks, parity, obstetric ...

  10. Les kystes ovariens dans l'espèce bovine. 2. Rappels physiologiques et étio-pathogénie

    OpenAIRE

    Hanzen, Christian; Bascon, F.; Theron, Léonard; Lopez-Gatius, F.

    2008-01-01

    A large number of publications have been devoted to the ultrasonography and hormonal follow-up of the follicular growth. This alteration of the normal follicular growth may concern the recruited, growing or preovulatory follicles mainly during the puberty and post-partum periods. Cyst development results (i) in an endocrine inbalance of the hypothalamo-hypophysial axis: the positive feedback of oestradiol on LH is altered because of a lack in progesterone impregnation of hypothalamic receptor...

  11. A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers

    OpenAIRE

    Vaziri, Farideh; Nasiri, Samira; Tavana, Zohreh; Dabbaghmanesh, Mohammad Hossein; Sharif, Farkhondeh; Jafari, Peyman

    2016-01-01

    Background Mood disorders in pregnancy and post-partum period are common and considered as a public health issue. Researchers have studied the relationship between low serum vitamin D concentration and perinatal depression, although no clinical trial has been conducted on vitamin D?s effects on depression related to childbirth. This study evaluated the effect of vitamin D3 supplementation on perinatal depression scores. Methods This randomized clinical trial was done in pregnant women who wer...

  12. Access to Finance of the Macedonian Companies in the Post-Crisis period

    Directory of Open Access Journals (Sweden)

    Meri Boshkoska

    2016-08-01

    Full Text Available In this paper we analyzed the liquidity of the companies, the plans for the future cash flows and questions related to the new law regarding the financial discipline. Main questions addressed here are the number of difficulties related to the sources of financing the current and the developing activities of the companies in Macedonia. The analysis is undertaken by using statistical techniques and models. The results suggest that in the post-crisis period the companies are facing with number of difficulties of providing financial resources for the current and the developing activities where the most significant source of finance are the bank credits. Also, the results suggest that delayed payment of claims, the legislative and the high level of interest rate are the most common factors that restrict the access to finance of the Macedonian companies.

  13. Temporal variability of benzene concentration in the ambient air of Delhi: a comparative assessment of pre- and post-CNG periods.

    Science.gov (United States)

    Khillare, P S; Hoque, Raza Rafiqul; Shridhar, Vijay; Agarwal, Tripti; Balachandran, S

    2008-06-15

    CNG (compressed natural gas) was fully implemented in public transport system in Delhi in December 2002. The study assesses the benzene concentration trends at two busy traffic intersections and a background site in Delhi, India. Monitoring was done for two different time periods viz; in the year 2001-2002 (pre-CNG) and two winter months (January and February) of the year 2007 (post-CNG) to assess the impact of various policy measures adopted by the government of Delhi to improve the air quality in the city. Annual average benzene concentration for the pre-CNG period was found to be 86.47+/-53.24 microg m(-3). Average benzene concentrations for the winter months (January-February) of pre- and post-CNG periods were 116.32+/-51.65 microg m(-3) and 187.49+/-22.50 microg m(-3), respectively. Enhanced values could be solely attributed to the increase in the vehicular population from 3.5 million in the year 2001-2002 to approximately 5.1 millions in the year 2007.

  14. Induction of fertile estrus in bitches using a sustained-release formulation of a GnRH agonist (leuprolide acetate).

    Science.gov (United States)

    Inaba, T; Tani, H; Gonda, M; Nakagawa, A; Ohmura, M; Mori, J; Torii, R; Tamada, H; Sawada, T

    1998-04-01

    A single subcutaneous injection of a sustained-release formulation of a potent GnRH agonist, leuprolide acetate (LA; [D-Leu6, Pro9NEt]-GnRH), was evaluated as a method of inducing fertile estrus in 12 mature anestrous and 6 prepubertal beagle bitches. The bitches were treated with microencapsulated LA (100 micrograms/kg, s.c.) at 120 or 150 d post partum, or at 1 yr of age, followed by a GnRH-analogue (fertirelin; [Pro9NEt]-GnRH, 3 micrograms/kg, i.m.) on the first day of induced estrus. Signs of estrus were seen within 10.3 +/- 0.9 d after LA administration in all bitches. The interestrous interval in 120- and 150-d post-partum bitches was shortened (P bitches. All LA treated dogs demonstrated behavioral estrus and mated. Three of 6 (50%) at 120 d post partum, 6 of 6 (100%) at 150 d post partum and 5 of 6 (83%) of prepubertal (1-yr old) bitches then became pregnant and produced a mean litter size of 4.1 +/- 0.8 pups. A normal circulating estrogen and progesterone response pattern was observed in mature anestrous bitches. A prepubertal bitch that failed to become pregnant had a similar estrogen response pattern but an insufficient progesterone profile. The results suggest that microencapsulated LA can be useful in inducing fertile estrus in the domestic dogs.

  15. Comparison of Various Indices of Energy Metabolism in Recumbent and Healthy Dairy Cows.

    Science.gov (United States)

    Guyot, Hugues; Detilleux, Johann; Lebreton, Pascal; Garnier, Catherine; Bonvoisin, Marie; Rollin, Frederic; Sandersen, Charlotte

    2017-01-01

    Downer cow syndrome (DCS) is often diagnosed in dairy cattle during the early post-partum period. The etiology of this condition is not completely understood, as it can be related to the energetic or electrolyte metabolism, as well as to infectious diseases or to trauma. The aim of this study is to compare energy metabolism and insulin sensitivity indices and various biochemical parameters between recumbent and healthy dairy cows. A prospective study has been undertaken on 361 recumbent and 80 healthy Holstein cows. Plasmatic glucose, insulin, non-esterified fatty acid (NEFA) and β-hydroxybutyrate (BHB) were assayed in all cows in order to calculate the insulin sensitivity indices but also minerals (Calcium, Phosphorous and Magnesium), thyroxin and creatine kinase. Body Condition Scores (BCS) was assessed. Significant differences in NEFA, and the glucose and insulin sensitivity indices ("Homeostasis Model Assessment" HOMA, "Revised Quantitative Insulin Sensitivity Check Index" RQUICKI, RQUICKI-BHB) were observed between healthy and recumbent cows in the early post-parturient period indicating disturbances of glucose and insulin homeostasis in the recumbent cows. In the same manner, mineral concentrations were significantly different between healthy and recumbent cows. Glucose, insulin NEFA, and HOMA, were different between early post-partum downer cows and the DCS-affected cows later in lactation. Results indicate disturbances in energy homeostasis in DCS-affected dairy cows. Further research should determine a prognostic value of the indices in cows suffering from recumbency of metabolic origin.

  16. Comparison of Various Indices of Energy Metabolism in Recumbent and Healthy Dairy Cows.

    Directory of Open Access Journals (Sweden)

    Hugues Guyot

    Full Text Available Downer cow syndrome (DCS is often diagnosed in dairy cattle during the early post-partum period. The etiology of this condition is not completely understood, as it can be related to the energetic or electrolyte metabolism, as well as to infectious diseases or to trauma.The aim of this study is to compare energy metabolism and insulin sensitivity indices and various biochemical parameters between recumbent and healthy dairy cows.A prospective study has been undertaken on 361 recumbent and 80 healthy Holstein cows.Plasmatic glucose, insulin, non-esterified fatty acid (NEFA and β-hydroxybutyrate (BHB were assayed in all cows in order to calculate the insulin sensitivity indices but also minerals (Calcium, Phosphorous and Magnesium, thyroxin and creatine kinase. Body Condition Scores (BCS was assessed.Significant differences in NEFA, and the glucose and insulin sensitivity indices ("Homeostasis Model Assessment" HOMA, "Revised Quantitative Insulin Sensitivity Check Index" RQUICKI, RQUICKI-BHB were observed between healthy and recumbent cows in the early post-parturient period indicating disturbances of glucose and insulin homeostasis in the recumbent cows. In the same manner, mineral concentrations were significantly different between healthy and recumbent cows. Glucose, insulin NEFA, and HOMA, were different between early post-partum downer cows and the DCS-affected cows later in lactation.Results indicate disturbances in energy homeostasis in DCS-affected dairy cows. Further research should determine a prognostic value of the indices in cows suffering from recumbency of metabolic origin.

  17. Inequality of Income Distribution and Economics Growth in the Regions of Russia in the Post-Crisis Period

    Directory of Open Access Journals (Sweden)

    Ruslan Arkadyevich Grigoryev

    2015-09-01

    Full Text Available Income distribution is one of the factors influencing economic growth. At present time, the regional aspect of such influence is an important sphere of research. The present article is intended to view the aspects of the influence of income distribution differentiation on economic growth on the example of the Russian regions in post-crisis period. The research results are presented in the form of regression model, estimating the differences in the growth rates of gross regional products in Russia in post-crisis 2010. The explanatory variables are Gini coefficients as an indicator of income inequality, and a number of other indicators characterizing the regional development in 2006 — 2010. Special attention is paid to the influence of 2008 crisis on the differences of regions by the level of dependent variable. Cross-sectional regression model based on the Russian Federation regions data shows the positive influence of changes in income distribution on the rate of economic growth. The general result of the research is confirmation of the hypothesis of the influence of income inequality on economic growth at the regional level in Russia. The observed effect is positive and statistically significant. The effect is relatively short-term, both from the point of view of the dependent variable (the yearly growth rate of GRP is used in the model, and from the point of view of the time lag between the year of dependent variable observation, 2010, and the period of observation, for which the Gini coefficient is significant in regression equation (2006-2007. Pre-crisis value of the Gini coefficient does not determined the differences in economic growth in the regions of Russia in 2011-2012. The results can be used in predicting the pace of regional development in Russia in the post-crisis period, as well as in the implementation of regional economic policy in times of crisis in order to maximize regional economic growth after the crisis

  18. Benefits of PEGylation in the early post-transplant period of intraportal islet transplantation as assessed by magnetic resonance imaging of labeled islets.

    Science.gov (United States)

    Jin, Sang-Man; Oh, Seung-Hoon; Oh, Bae Jun; Suh, Sunghwan; Bae, Ji Cheol; Lee, Jung Hee; Lee, Myung-Shik; Lee, Moon-Kyu; Kim, Kwang-Won; Kim, Jae Hyeon

    2014-01-01

    While a few studies have demonstrated the benefit of PEGylation in islet transplantation, most have employed renal subcapsular models and none have performed direct comparisons of islet mass in intraportal islet transplantation using islet magnetic resonance imaging (MRI). In this study, our aim was to demonstrate the benefit of PEGylation in the early post-transplant period of intraportal islet transplantation with a novel algorithm for islet MRI. Islets were PEGylated after ferucarbotran labeling in a rat syngeneic intraportal islet transplantation model followed by comparisons of post-transplant glycemic levels in recipient rats infused with PEGylated (n = 12) and non-PEGylated (n = 13) islets. The total area of hypointense spots and the number of hypointense spots larger than 1.758 mm(2) of PEGylated and non-PEGylated islets were quantitatively compared. The total area of hypointense spots (P islet group 7 and 14 days post translation (DPT). These results translated into better post-transplant outcomes in the PEGylated islet group 28 DPT. In validation experiments, MRI parameters obtained 1, 7, and 14 DPT predicted normoglycemia 4 wk post-transplantation. We directly demonstrated the benefit of islet PEGylation in protection against nonspecific islet destruction in the early post-transplant period of intraportal islet transplantation using a novel algorithm for islet MRI. This novel algorithm could serve as a useful tool to demonstrate such benefit in future clinical trials of islet transplantation using PEGylated islets.

  19. A journey to zero: reduction of post-operative cesarean surgical site infections over a five-year period.

    Science.gov (United States)

    Hickson, Evelyn; Harris, Jeanette; Brett, David

    2015-04-01

    Surgical site infections (SSI) are a substantial concern for cesarean deliveries in which a surgical site complication is most unwelcome for a mother with a new infant. Steps taken pre- and post-operatively to reduce the number of complications may be of substantial benefit clinically, economically, and psychologically. A risk-based approach to incision management was developed and implemented for all cesarean deliveries at our institution. A number of incremental interventions for low-risk and high-risk patients including pre-operative skin preparations, standardized pre- and post-operative protocols, post-operative nanocrystalline silver anti-microbial barrier dressings, and incisional negative pressure wound therapy (NPWT) were implemented sequentially over a 5-y period. A systematic clinical chart review of 4,942 patients spanning all cesarean deliveries between 2007-2012 was performed to determine what effects the interventions had on the rate of SSI for cesarean deliveries. The percentage of SSI was reduced from 2.13% (2007) to 0.10% (2012) (poperative SSIs were avoided: A total cost saving of nearly $5,000,000. Applying a clinical algorithm for assessing the risk of surgical site complication and making recommendations on pre-operative and post-operative incision management can result in a substantial and sustainable reduction in cesarean SSI.

  20. Immediate post-partum haemorrhage: Epidemiological aspects and ...

    African Journals Online (AJOL)

    have more because after this dose, undesirable effects can occur. For these patients .... and 24,600 cases of liver cancer – and also found strong evidence that: ... and economic vulnerabilities, making it easier for them to eat unhealthy foods.

  1. Research of nitroxynil residues in bovine milk following a single administration in the dry period by ultra-performance liquid chromatography tandem mass spectrometry

    Directory of Open Access Journals (Sweden)

    Claudia Chirollo

    2013-10-01

    Full Text Available Nitroxynil (NIT is a halogenated phenol used to control fascioliasis in cattle and sheep. The Commission Regulation EU No 37/2010 has established maximum residue limits for NIT in bovine and ovine muscle (400 μg kg−1, fat (200 μg kg−1, liver (20 μg kg−1 and kidney (400 μg kg−1, and more recently in bovine and ovine milk (20 μg kg−1. Thirty-five pregnant dairy cows were treated in this study with nitroxynil (340 mg/mL solution for injection at the recommended dose of 10 mg/kg body weight at the start of the dry period, i.e. 53 to 74 days before the expected calving. Calving occurred between 43 days and 79 days after treatment. The concentrations of NIT in the milk were monitored for up to 120 days after calving. NIT residues were extracted using acetonitrile; magnesium sulfate and sodium chloride were added to induce liquid-liquid partitioning and purified by dispersive solid phase extraction for clean-up. NIT was detected by ultra high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS in negative ionization mode. The highest concentrations of this drug were found in two animals at the first milking, 48 and 53 day post treatment with levels of 362 and 657 μg kg–1, respectively. NIT residues were below the limit of detection of the method (0.24 μg/kg–1 between 67 and 106 day post-treatment. Following calving, residues rapidly depleted in animals and were non-detectable from 10 to 38 days post-calving. In particular, in all animals milk resulted compliant (<20 μg/kg−1 three days post partum.

  2. Comparison of Various Indices of Energy Metabolism in Recumbent and Healthy Dairy Cows

    OpenAIRE

    Guyot, Hugues; Detilleux, Johann; Lebreton, Pascal; Garnier, Catherine; Bonvoisin, Marie; Rollin, Frederic; Sandersen, Charlotte

    2017-01-01

    Background Downer cow syndrome (DCS) is often diagnosed in dairy cattle during the early post-partum period. The etiology of this condition is not completely understood, as it can be related to the energetic or electrolyte metabolism, as well as to infectious diseases or to trauma. Hypothesis/Objectives The aim of this study is to compare energy metabolism and insulin sensitivity indices and various biochemical parameters between recumbent and healthy dairy cows. Animals A prospective study h...

  3. Predictors of Safe Delivery Service Utilization in Arsi Zone, South-East Ethiopia

    OpenAIRE

    Abera, Mulumebet; Gebremariam, Abebe; Belachew, Tefera

    2011-01-01

    Background Evidence show that lack of access to and use of, essential obstetric care services to be a crucial factor that contributes to the high maternal morbidity and mortality. Skilled attendance during labor, delivery and early post-partum period could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. There is limited information on the mothers' use of skilled delivery services in the study area. This study assessed the predictors of safe delivery service utilizatio...

  4. Post-traumatic stress disorder in the perinatal period: A concept analysis.

    Science.gov (United States)

    Vignato, Julie; Georges, Jane M; Bush, Ruth A; Connelly, Cynthia D

    2017-12-01

    To report an analysis of the concept of perinatal post-traumatic stress disorder. Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal-child outcomes result in increased morbidity, mortality and healthcare costs. Concept analysis via Walker and Avant's approach. The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006-2015, containing the terms perinatal and post-traumatic stress disorder. Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal-infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal-infant outcomes. Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder. Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal-infant outcomes. © 2017 John Wiley

  5. Hypertension 6 weeks post partum in apparently normal women. A reappraisal and challenge.

    Science.gov (United States)

    Piver, M S; Corson, S L; Bolognese, R J

    1967-08-01

    Hypertensive blood pressure readings were recorded in 282 women from a group of 1025 consecutive patients returning for their sixth-week postpartum visit. Of the 282 women, 120 were classified as toxemic; however, 162 (58%) had had no elevation of blood pressure antepartum, intrapartum, or during the immediate postpartum period. In addition, 100 women with normal sixth-week postpartum blood pressures were randomly selected as controls. A retrospective analysis of their records showed sixth-week postpartum hypertension to occur much less frequently (13%) in nulliparous women, as compared to the preeclamptic nulliparous patients (31%). With the exception of proteinuria, all of the other data studied failed to reveal any significant abnormalities in the late postpartum hypertensive group of patients.

  6. Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH) - a prospective follow-up study.

    Science.gov (United States)

    Jeevaratnam, Kamalan; Nadarajah, Vishna Devi; Judson, John Paul; Nalliah, Sivalingam; Abdullah, Mohd Farouk

    2010-09-28

    Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry. Venous blood samples (antepartum, intrapartum and post partum periods) were drawn to estimate for sFlt-1 and PlGF levels while placental tissue samples were examined for placental morphometry. PlGF levels were lower in gestational hypertension (GH) compared to normotensive during antepartum and intrapartum period, whereas sFlt-1 levels were elevated in GH at antepartum, intrapartum and postpartum intervals during pregnancy. An inverse relationship between these two biomarkers was observed through correlation analysis. PlGF levels were inversely correlated with total villous surface area of the placental periphery (TCsa-C) and villous capillarization (VC-C) of the placental periphery. We established periodic values of for sFlt-1 and PlGF levels for the first time in an ethnically diverse Malaysian setting. We suggest the development of GH in women is related to defective capillarization. In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1. The correlation between PlGF levels and morphometric findings also support possible capillarization defect.

  7. Rates and determinants of early initiation of breastfeeding and exclusive breast feeding at 42 days postnatal in six low and middle-income countries: A prospective cohort study.

    Science.gov (United States)

    Patel, Archana; Bucher, Sherri; Pusdekar, Yamini; Esamai, Fabian; Krebs, Nancy F; Goudar, Shivaprasad S; Chomba, Elwyn; Garces, Ana; Pasha, Omrana; Saleem, Sarah; Kodkany, Bhalachandra S; Liechty, Edward A; Kodkany, Bhala; Derman, Richard J; Carlo, Waldemar A; Hambidge, K; Goldenberg, Robert L; Althabe, Fernando; Berrueta, Mabel; Moore, Janet L; McClure, Elizabeth M; Koso-Thomas, Marion; Hibberd, Patricia L

    2015-01-01

    Early initiation of breastfeeding after birth and exclusive breastfeeding through six months of age confers many health benefits for infants; both are crucial high impact, low-cost interventions. However, determining accurate global rates of these crucial activities has been challenging. We use population-based data to describe: (1) rates of early initiation of breastfeeding (defined as within 1 hour of birth) and of exclusive breastfeeding at 42 days post-partum; and (2) factors associated with failure to initiate early breastfeeding and exclusive breastfeeding at 42 days post-partum. Prospectively collected data from women and their live-born infants enrolled in the Global Network's Maternal and Newborn Health Registry between January 1, 2010-December 31, 2013 included women-infant dyads in 106 geographic areas (clusters) at 7 research sites in 6 countries (Kenya, Zambia, India [2 sites], Pakistan, Argentina and Guatemala). Rates and risk factors for failure to initiate early breastfeeding were investigated for the entire cohort and rates and risk factors for failure to maintain exclusive breastfeeding was assessed in a sub-sample studied at 42 days post-partum. A total of 255,495 live-born women-infant dyads were included in the study. Rates and determinants for the exclusive breastfeeding sub-study at 42 days post-partum were assessed from among a sub-sample of 105,563 subjects. Although there was heterogeneity by site, and early initiation of breastfeeding after delivery was high, the Pakistan site had the lowest rates of early initiation of breastfeeding. The Pakistan site also had the highest rate of lack of exclusive breastfeeding at 42 days post-partum. Across all regions, factors associated with failure to initiate early breastfeeding included nulliparity, caesarean section, low birth weight, resuscitation with bag and mask, and failure to place baby on the mother's chest after delivery. Factors associated with failure to achieve exclusive breastfeeding

  8. Patterns of body condition use and its impact on fertility

    Directory of Open Access Journals (Sweden)

    D. Savietto

    2016-03-01

    Full Text Available A total of 60 nulliparous crossbred rabbit females were, a posteriori, divided into 2 experimental groups according to their natural “decision” to conceive or not at day 11 post first parturition (L: solely-lactating or LP: lactating-pregnant. This design allowed us to study the evolution of body reserves around first parturition and its influence on the future reproductive success of rabbit females. Primiparous rabbit females that failed to conceive when inseminated at day 11 post-partum (L seemed to have a higher perirenal fat thickness (PFT 12 d pre-partum (+0.25 mm; P=0.079 than females that conceived (LP. In the subsequent days, L females showed a significantly higher mobilisation rate than LP females (on av.–0.12 and –0.07 mm of PFT per day, respectively; P=0.007, reaching a lower PFT at partum (5.17 mm vs. 5.62 mm, respectively; P = 0.002. However, due to a greater recovery rate observed in L females (+0.15 vs. +0.08 mm of PFT per day for L and LP females, respectively; P=0.007, PFT at 10 d post-partum was similar (on av. 5.86 mm. These different patterns showed that PFT level at 12 d pre-partum and PFT mobilisation rate onwards seems to drive the start of a new pregnancy. It also seems to modify the energy metabolism of rabbit females, allowing does to recover perirenal fat tissue without compromising the production of milk necessary for the current litter.

  9. Silage alcohols in dairy cow nutrition

    DEFF Research Database (Denmark)

    Raun, Birgitte Marie Løvendahl

    Corn silages with high propanol concentrations has been suspected to cause reduced feed intake and health problems for dairy cows in the post-pattum transition period. With the increasing use of hetero fermentative inoculants to support corn silage fermentation it is likely that silage concentrat......Corn silages with high propanol concentrations has been suspected to cause reduced feed intake and health problems for dairy cows in the post-pattum transition period. With the increasing use of hetero fermentative inoculants to support corn silage fermentation it is likely that silage...... of alcohols will lead to high alcohol concentrations in peripheral bood for a considerable period. Increased hepatic NEFA uptake in the postpartum transition period may result in even further decreased hepatic capacity for alcohol metabolism making post-partum transition cows especially vulnerable to high...... alcohol intakes. In order to evaluate the impact of alcohol fermentation in corn silages on dairy cow performance, the main purpose of this thesis was first to investigate the concentrations and composition of alcohols in typical field corn silages, and second to study how transition and lactating dairy...

  10. Post-Traumatic Stress Disorder after childbirth and the influence of maternity team care during labour and birth: A cohort study.

    Science.gov (United States)

    De Schepper, Sarah; Vercauteren, Tinne; Tersago, Jolein; Jacquemyn, Yves; Raes, Filip; Franck, Erik

    2016-01-01

    we examined the prevalence of Post-Traumatic Stress Disorder (PTSD) and the role of personal and obstetric risk factors, as well as the role of midwifery team care factors in a cohort of Flemish women. prospective cohort study. Data collection was performed at two times post partum: During the first week, socio-demographic and obstetric data as well as information related to midwifery team care factors were assessed using self-report measures. To asses PTSD symptomatology, the Impact of Event Scale-Revised (IES-R) and the Traumatic Event Scale (TES) were used. At six weeks post partum, PTSD symptoms were reassessed either by telephone interviews or e-mail. Results were calculated in frequencies, means and standard deviations. Differences between week one and six were analysed using parametrical and non-parametrical statistics. Multiple and logistic regression was performed to determine risk factors for PTSD symptomatology. P-value was set at 0.05. maternity wards in Flanders, Belgium. the first (week 1) and follow-up (week 6) sample of the data collection consisted of 340 and 229 women respectively. the prevalence of PTSD symptoms after childbirth ranged from 22% to 24% in the first week and from 13% to 20% at six weeks follow-up. Multiple regression analysis showed that Islamic belief, a traumatic childbirth experience, family income <€2500, a history of psychological or psychiatric consults and labour/birth with complications significantly predicted PTSD symptomatology at six weeks post-birth. Midwifery team care and the opportunity to ask questions, as well as experiencing a normal physiological birth were significantly associated with less postnatal PTSD symptoms. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTISE: the results of this study suggest that contextual factors such as religion, socio-economic status, and childbirth experience might be important factors to address by the midwifery team. Midwifery team care factors such as 'providing the opportunity to

  11. Mammary gland leptin in relation to lactogenesis in the periparturient dairy goat

    DEFF Research Database (Denmark)

    Rasmussen, Alice Neess; Nielsen, Mette Olaf; Tauson, Anne-Helene

    2008-01-01

    The role of leptin in development of mammary gland secretory function was studied during the periparturient period in dairy goats. Changes in mammary leptin and leptin receptor (short cytoplasmic form) expression were evaluated by real-time RT-PCR and related to changes in milk and plasma leptin...... peak in milk leptin 2 days post-partum needs to be understood. We did not find evidence that milk leptin can be absorbed, and thus play a role in systemic regulation, of the neonatal goat....

  12. Practices of traditional birth attendants in Machakos District, kenya.

    Science.gov (United States)

    Kaingu, Catherine Kaluwa; Oduma, Jemimah Achieng; Kanui, Titus I

    2011-09-01

    The aim of the study was to document TBAs practices as well as the indigenous herbal remedies they use to manage pre, intra and post partum complications in a rural Kenyan community. A cross sectional study was conducted on practicing TBAs and their clients living in the study area. Data was collected using structured questionnaires and interviews. Focused group discussions were held with the TBAs to supplement the interviews and questionnaire survey. Two hundred TBAs and 20 clients were interviewed. The majority of the TBAs were females 75% of them having attended to over 200 pregnant women over a period of 5 years and above compared to only 6% of the males. A total of 10 pregnancy related complications and symptoms including threatened abortion, labor complications, post partum hemorrhage and retained after birth were recorded. Fifty five plant species most of them belonging to Euphorbiaceae family were identified for the management of the complications. Traditional Birth Attendants still have a role to play in assisting pregnant women in rural communities. Their knowledge on herbal medicines is equally important and should be preserved for posterity. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. The use of iloprost in early pregnancy in patients with pulmonary arterial hypertension.

    Science.gov (United States)

    Elliot, C A; Stewart, P; Webster, V J; Mills, G H; Hutchinson, S P; Howarth, E S; Bu'lock, F A; Lawson, R A; Armstrong, I J; Kiely, D G

    2005-07-01

    In patients with pulmonary hypertension, pregnancy is associated with a high risk of maternal death. Such patients are counselled to avoid pregnancy, or if it occurs, are offered early interruption. Some patients, however, decide to continue with their pregnancy and others may present with symptoms for the first time whilst pregnant. Pulmonary vasodilator therapy provides a treatment option for these high-risk patients. The present study describes three patients with pulmonary arterial hypertension of various aetiologies who were treated with the prostacyclin analogue iloprost during pregnancy, and the post-partum period. Nebulised iloprost commenced as early as 8 weeks of gestation and patients were admitted to hospital between 24-36 weeks of gestation. All pregnancies were completed with a duration of between 25-36 weeks and all deliveries were by caesarean section under local anaesthetic. All patients delivered children free from congenital abnormalities, and there was no post-partum maternal or infant mortality. In conclusion, although pregnancy is strongly advised against in those with pulmonary hypertension, the current authors have achieved a successful outcome for mother and foetus with a multidisciplinary approach and targeted pulmonary vascular therapy.

  14. Blood parameters in Swedish dairy herds with high or low incidence of displaced abomasum or ketosis.

    Science.gov (United States)

    Stengärde, Lena; Holtenius, Kjell; Emanuelson, Ulf; Hultgren, Jan; Niskanen, Rauni; Tråvén, Madeleine

    2011-10-01

    Sixty dairy herds were studied to investigate the association between long-term incidence of displaced abomasum and clinical ketosis and body condition score and blood profiles, including parameters estimating energy metabolism and hepatic lipidosis in the periparturient period and early lactation. Blood samples were taken around parturition and in early lactation from cows without apparent clinical symptoms of metabolic disorders. A difference in metabolism between high and low incidence herds was shown post-partum by a lower metabolic index (the revised Quantitative Insulin Sensitivity Check Index, RQUICKI), and tendencies for higher concentrations of glucose, insulin and non-esterified fatty acids in the high incidence herds. High incidence herds had more cows and produced on average 1400kg energy-corrected milk per cow per year more than the low incidence herds. No differences were found in parameters reflecting liver cell damage. In the first 3weeks post-partum the RQUICKI was a more sensitive marker of herds with a high incidence of displaced abomasum and clinical ketosis than any of the individual parameters, but further research is needed before practical applications of the RQUICKI can be foreseen. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. The proximate determinants of fertility and birth intervals in Egypt: An application of calendar data

    Directory of Open Access Journals (Sweden)

    Andrew Hinde

    2007-01-01

    Full Text Available In this paper we use calendar data from the 2000 Egyptian Demographic and Health Survey (DHS to assess the determinants of birth interval length among women who are in union. We make use of the well-known model of the proximate determinants of fertility, and take advantage of the fact that the DHS calendar data provide month-by-month data on contraceptive use, breastfeeding and post-partum amenorrhoea, which are the most important proximate determinants among women in union. One aim of the analysis is to see whether the calendar data are sufficiently detailed to account for all variation among individual women in birth interval duration, in that once they are controlled, the effect of background social, economic and cultural variables is not statistically significant. The results suggest that this is indeed the case, especially after a random effect term to account for the unobserved proximate determinants is included in the model. Birth intervals are determined mainly by the use of modern methods of contraception (the IUD being more effective than the pill. Breastfeeding and post-partum amenorrhoea both inhibit conception, and the effect of breastfeeding remains even after the period of amenorrhoea has ended.

  16. Efficiency of Calatonia on clinical parameters in the immediate post-surgery period: a clinical study

    Directory of Open Access Journals (Sweden)

    Elaine Ferreira Lasaponari

    2013-09-01

    Full Text Available OBJECTIVE: to assess the efficiency of the Calatonia technique about clinical parameters and pain in the immediate post-surgical phase. METHOD: a randomised study was carried out with 116 patients subjected to a cholecystectomy, by laparoscopy, divided into an experimental group (58 patients and a placebo group (58 patients. The experimental group received the Calatonia technique, while the placebo was only subjected to non-intentional touches. RESULTS: The placebo group and the experimental group were considered homogeneous in terms of the variables: sex, age, physical status classification, duration of surgical procedures and also the time spent recovering in the Post-Anaesthetic Recovery Room. The only variable to show a statistically significant difference was the axillary temperature of the body. In relation to pain, the experimental group showed significant results, and hence it is possible to deduce that the relaxation caused by the Calatonia technique brought some relief of the general situation of pain. CONCLUSION: The application of Calatonia can take up the function of a resource complementary to assistance in the period immediately after surgery. Brazilian Register of Clinical Trials, UTN U1111-1129-9629.

  17. Maternal Identity Formation in a Military Sample: A Longitudinal Perspective

    Science.gov (United States)

    2006-06-08

    Correlates of pre- partum depressive symptomatology: A multivariate analysis. Journal of Reproductive & Infant Psychology, 16, 45-56. Bloom, K. C. (1995...presented at the National NAACOG Conference, Minneapolis, MN. Lederman, R. P., & Lederman, E. (1987). Dimensions of post - partum adaptation: Comparisons of...validation for the changes the pregnant woman experiences prenatally (Liese, Snowden, & Ford, 1989; Sorenson, 1990), decreases depressed mood both

  18. Is being resolute better than being pragmatic when it comes to breastfeeding? Longitudinal qualitative study investigating experiences of women intending to breastfeed using the Theoretical Domains Framework.

    Science.gov (United States)

    Jardine, E E; McLellan, J; Dombrowski, S U

    2017-09-01

    In the UK, initiating then discontinuing breastfeeding before two weeks post-partum is common. The aim of this longitudinal qualitative study was to explore which psychosocial factors may influence discontinuation. A sample of 10 pregnant women intending to breastfeed were recruited. A longitudinal qualitative design was used to capture views prior to and two weeks following birth. Semi-structured interviews were conducted underpinned by the Theoretical Domains Framework to explore a comprehensive list of psychosocial factors. Four women discontinued breastfeeding at the time of the second interview. Pre-partum differences were identified between maintainers and discontinuers; discontinuers appeared to have stronger intentions to breastfeed based on their self-determination, self-confidence and perception of fewer barriers to breastfeeding. Post-partum, discontinuers highlighted how they felt physically unable to carry on; their feeding experiences elicited negative emotions and pain. Negative emotions appeared to be exacerbated by original breastfeeding beliefs and advice given by healthcare professionals. The women in this study who discontinued breastfeeding showed less cognitive flexibility, which appeared to exacerbate post-partum emotional distress, when they encountered difficulties. Women with strong intentions and self-determination might benefit from support in anticipating potential barriers and identifying ways of overcoming them. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Parturition effects on reproductive health in the gilt and sow.

    Science.gov (United States)

    Peltoniemi, Oat; Björkman, S; Oliviero, C

    2016-10-01

    In this review, we address significant characteristics of parturition in the pig and their connection to post-partum reproductive health and fertility. We discuss the normal physiology and behaviour around parturition and the effect of the second phase (expulsion of foetuses) on the third phase of parturition (expulsion of foetal membranes). In addition, we intend to cover retained placenta, and the connection to post-partum uterine health and fertility in the contemporary prolific sow. We also explore factors that support successful parturition or can cause potential problems. Successful parturition in the pig includes the possibility to express adequate maternal behaviour, rapid expulsion of the piglets, complete expulsion of the placenta, neonatal activity and colostrum intake. Abnormal incidents during any phase of parturition can cause subsequent problems. Duration of the expulsion phase of foetuses can be used as a simple measure of whether parturition is considered successful. Prolonged parturition can impair health of the sow and piglet and fertility after weaning. New insights, such as adding more fibre to sow diets during pregnancy, and especially during the period prior to farrowing, may prevent constipation, increase water intake of the sow around parturition and increase milk intake and performance of piglets. Maternal characteristics, including maternal behaviour, ease of parturition, colostrum production and piglet quality parameters, may be utilized to improve success rate of reproductive management during farrowing and early lactation. Additionally, we share some of the recent developments in methods, including ultrasonography in evaluation of post-partum uterine health. In conclusion, successful farrowing is of the greatest importance for reproductive health of the sow and survival of the piglets. We suggest connections exist among prolonged farrowing and yield of colostrum, retained placenta, development of PDS, and impaired involution of the

  20. A randomised controlled trial to compare opt-in and opt-out parental consent for childhood vaccine safety surveillance using data linkage: study protocol

    Directory of Open Access Journals (Sweden)

    Duszynski Katherine M

    2011-01-01

    Full Text Available Abstract Background The Vaccine Assessment using Linked Data (VALiD trial compared opt-in and opt-out parental consent for a population-based childhood vaccine safety surveillance program using data linkage. A subsequent telephone interview of all households enrolled in the trial elicited parental intent regarding the return or non-return of reply forms for opt-in and opt-out consent. This paper describes the rationale for the trial and provides an overview of the design and methods. Methods/Design Single-centre, single-blind, randomised controlled trial (RCT stratified by firstborn status. Mothers who gave birth at one tertiary South Australian hospital were randomised at six weeks post-partum to receive an opt-in or opt-out reply form, along with information explaining data linkage. The primary outcome at 10 weeks post-partum was parental participation in each arm, as indicated by the respective return or non-return of a reply form (or via telephone or email response. A subsequent telephone interview at 10 weeks post-partum elicited parental intent regarding the return or non-return of the reply form, and attitudes and knowledge about data linkage, vaccine safety, consent preferences and vaccination practices. Enrolment began in July 2009 and 1,129 households were recruited in a three-month period. Analysis has not yet been undertaken. The participation rate and selection bias for each method of consent will be compared when the data are analysed. Discussion The VALiD RCT represents the first trial of opt-in versus opt-out consent for a data linkage study that assesses consent preferences and intent compared with actual opting in or opting out behaviour, and socioeconomic factors. The limitations to generalisability are discussed. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12610000332022

  1. A randomised controlled trial to compare opt-in and opt-out parental consent for childhood vaccine safety surveillance using data linkage: study protocol.

    Science.gov (United States)

    Berry, Jesia G; Ryan, Philip; Braunack-Mayer, Annette J; Duszynski, Katherine M; Xafis, Vicki; Gold, Michael S

    2011-01-04

    The Vaccine Assessment using Linked Data (VALiD) trial compared opt-in and opt-out parental consent for a population-based childhood vaccine safety surveillance program using data linkage. A subsequent telephone interview of all households enrolled in the trial elicited parental intent regarding the return or non-return of reply forms for opt-in and opt-out consent. This paper describes the rationale for the trial and provides an overview of the design and methods. Single-centre, single-blind, randomised controlled trial (RCT) stratified by firstborn status. Mothers who gave birth at one tertiary South Australian hospital were randomised at six weeks post-partum to receive an opt-in or opt-out reply form, along with information explaining data linkage. The primary outcome at 10 weeks post-partum was parental participation in each arm, as indicated by the respective return or non-return of a reply form (or via telephone or email response). A subsequent telephone interview at 10 weeks post-partum elicited parental intent regarding the return or non-return of the reply form, and attitudes and knowledge about data linkage, vaccine safety, consent preferences and vaccination practices. Enrolment began in July 2009 and 1,129 households were recruited in a three-month period. Analysis has not yet been undertaken. The participation rate and selection bias for each method of consent will be compared when the data are analysed. The VALiD RCT represents the first trial of opt-in versus opt-out consent for a data linkage study that assesses consent preferences and intent compared with actual opting in or opting out behaviour, and socioeconomic factors. The limitations to generalisability are discussed. Australian New Zealand Clinical Trials Registry ACTRN12610000332022.

  2. Mês de parição, condição corporal e resposta ao protocolo de inseminação artificial em tempo fixo em vacas de corte primíparas Calving date, body condition score, and response to a timed artificial insemination protocol in first-calving beef cows

    Directory of Open Access Journals (Sweden)

    M. Meneghetti

    2008-08-01

    Full Text Available No experimento I, foi avaliada a alteração da condição corporal (CC pré e pós-parto em 155 novilhas inseminadas para parir de setembro a dezembro. A CC foi avaliada mensalmente no pré e pós-parto, de junho a fevereiro. No experimento II, 538 vacas primíparas foram sincronizadas com o protocolo de inseminação artificial em tempo fixo (IATF que usou estradiol junto ao dispositivo intravaginal de progesterona (CIDR®. As taxas de ciclicidade, sincronização e concepção foram avaliadas por ultra-som. No experimento I, os animais que pariram primeiro tiveram maior (PIn experiment I, it was evaluated the body condition score (BCS change during pre and post-partum in 155 heifers, inseminated to calve from September to December. The BCS was monthly evaluated from June to February, during the pre and post-partum periods. In experiment II, 538 primiparous cows were synchronized with a timed artificial insemination (TAI protocol which used estradiol associated with an intravaginal progesterone device (CIDR®. The cyclicity, synchronization, and conception rates were evaluated by ultrasound. In experiment I, the animals that calved earlier had higher (P<0.001 reduction on BCS. In experiment II, it was observed higher BCS (P<0.0001 in cows with lower days in post-partum, higher (P<0.05 synchronization rate in cows with a better BCS, and also an increase (P<0.0001 in conception rate as BCS got better (increase in six percentual points in conception for each increase of 0.25 in BCS. Beef heifers should not calve earlier when is planned to submitt these animals to TAI at the beginning of the next breeding season.

  3. Effects of ovarian steroids upon responses mediated by adrenoceptors in separated layers of the myometrium and in the costo-uterine muscle of the guinea-pig

    Science.gov (United States)

    Hartley, Margaret L.; Pennefather, Jocelyn N.; Story, Margot E.

    1983-01-01

    1 This study describes the effects of ovarian steroid hormones upon the responses to adrenoceptor agonists of isolated myometrium, separated into its longitudinal and circular layers, and of costo-uterine muscle from guinea-pigs. The preparations were field-stimulated at 100 s intervals, and the adrenoceptor agonists phenylephrine and isoprenaline produced enhancement or inhibition of the evoked contractions. 2 Isoprenaline produced propranolol-sensitive inhibitory effects in longitudinal and circular myometrium and costo-uterine muscle preparations from animals from all experimental groups: i.e. from nonsteroid-treated animals (ovariectomized and intact); intact animals treated with either oestrogen or progesterone alone; ovariectomized animals treated with oestrogen; ovariectomized and intact animals treated with progesterone following oestrogen priming; and from animals 1-4 days post-partum. Longitudinal myometrial preparations from progesterone-treated oestrogen-primed and from post-partum animals were most sensitive to this agonist. 3 Phenylephrine produced phentolamine-sensitive excitatory effects in circular myometrial and costo-uterine muscle preparations from animals from all the experimental groups. In contrast, propranolol-sensitive inhibitory responses to phenylephrine occurred in longitudinal myometrial preparations taken from animals treated with progesterone following oestrogen priming, and from post-partum animals. Longitudinal myometrium from animals from the remaining experimental groups exhibited phentolamine-sensitive excitatory responses to phenylephrine. 4 The basis for the selective effect upon the longitudinal myometrium of exposure to progesterone following a period of oestrogen priming, is discussed. The results described are consistent with the possibility that in the longitudinal layer of guinea-pig uterus exposed to progesterone following oestrogen priming there is an increase in the proportion of β-adrenoceptors in this layer. This

  4. Non-thyroid cancer in Northern Ukraine in the post-Chernobyl period: Short report.

    Science.gov (United States)

    Hatch, M; Ostroumova, E; Brenner, A; Federenko, Z; Gorokh, Y; Zvinchuk, O; Shpak, V; Tereschenko, V; Tronko, M; Mabuchi, K

    2015-06-01

    The Chernobyl nuclear power plant accident in Ukraine in 1986 led to widespread radioactive releases into the environment - primarily of radioiodines and cesium - heavily affecting the northern portions of the country, with settlement-averaged thyroid doses estimated to range from 10 mGy to more than 10 Gy. The increased risk of thyroid cancer among exposed children and adolescents is well established but the impact of radioactive contamination on the risk of other types of cancer is much less certain. To provide data on a public health issue of major importance, we have analyzed the incidence of non-thyroid cancers during the post-Chernobyl period in a well-defined cohort of 13,203 individuals who were <18 years of age at the time of the accident. The report is based on standardized incidence ratio (SIR) analysis of 43 non-thyroid cancers identified through linkage with the National Cancer Registry of Ukraine for the period 1998 through 2009. We compared the observed and expected number of cases in three cancer groupings: all solid cancers excluding thyroid, leukemia, and lymphoma. Our analyses found no evidence of a statistically significant elevation in cancer risks in this cohort exposed at radiosensitive ages, although the cancer trends, particularly for leukemia (SIR=1.92, 95% confidence interval: 0.69; 4.13), should continue to be monitored. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Risk factors associated with postpartum haemorrhage at Juba Teaching Hospital, South Sudan, 2011

    Directory of Open Access Journals (Sweden)

    Thomas Tako Akim Ujjiga

    2014-08-01

    Full Text Available Objective: To study risk factors associated with post partum haemorrhage (PPH in Juba Teaching Hospital, South Sudan. Method: An unmatched case control study was conducted in which 44 cases and 88 Controls were involved, from September to December 2011. Data was collected using a structured questionnaire in face to face interviews, and analyzed using Epi-info 3.5.3 statistical programme to determine if there was a correlation. Results: Maternal demographic and obstetric characteristics were found to be associated with the risk of bleeding during Bivariate analysis. However, age was found to confound emergency admission, uterotonic use (Oxytocin and Misoprostol use and delivery type, the latter being modified, in the development of post partum haemorrhage. Conclusion: These results indicate that active management of the third stage of labour (AMTSL and prompt intervention reduced the risk of developing PPH. Understanding the factors that cause PPH will allow us to better strengthen and effect pre delivery and emergency obstetric care which may help us reduce maternal mortality due to post partum haemorrhage.

  6. Reproductive Disorder Studies Using Radioimmunoassay (RIA) Progesterone Technique

    International Nuclear Information System (INIS)

    Tuasikal, Boky Jeanne; Totti Tjiptosumirat; Ratnawati Kukuh

    2004-01-01

    Five dairy cattle, cattle A: 6 th parity; cattle B: 7 th parity; cattle C: 2 nd parity; cattle D and F: 3 rd parity, were used in this study. According to Health Extension and Artificial Insemination Technicians anamneses and according to farmers who own the animals, these cattle were showing reproductive failure, and RIA technique was used to study the symptoms. For this purpose, milk progesterone sample were collected twice a week for five weeks to follow the biological reproductive status of every animal. Result from the analysis were plotted for each individual animal and shows that cattle A and B were acyclic, which indicated that no reproductive activity post partum have occurred in both animals; cattle C in the status of prolonged oestrus cycle post partum; and cattle D and F were in the status of recovery of oestrus cycle post partum. With the availability of historical record of the cattle and confirmation of biological status by Health Technicians, the reproductive disorder, which leads to the failure of AI in dairy cattle, can be monitored by RIA Progesterone technique. (author)

  7. Treatment of post-partum depression: a review of clinical, psychological and pharmacological options

    Directory of Open Access Journals (Sweden)

    Elizabeth Fitelson

    2010-12-01

    Full Text Available Elizabeth Fitelson1, Sarah Kim4, Allison Scott Baker3, Kristin Leight21Director, 2Attending Psychiatrist, TheWomen's Program, 3Child and Adolescent Psychiatry Fellow, Division of Child Psychiatry, 4PGY-I Resident in Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY, USAAbstract: Postpartum depression (PPD is a common complication of childbearing, and has increasingly been identified as a major public health problem. Untreated maternal depression has multiple potential negative effects on maternal-infant attachment and child development. Screening for depression in the perinatal period is feasible in multiple primary care or obstetric settings, and can help identify depressed mothers earlier. However, there are multiple barriers to appropriate treatment, including concerns about medication effects in breastfeeding infants. This article reviews the literature and recommendations for the treatment of postpartum depression, with a focus on the range of pharmacological, psychotherapeutic, and other non-pharmacologic interventions. Keywords: postpartum depression, postnatal depression, lactation, antidepressant, hormone therapy, psychotherapy, bright light therapy, omega-3

  8. Measles epidemic in Brazil in the post-elimination period: Coordinated response and containment strategies.

    Science.gov (United States)

    Lemos, Daniele Rocha Queiroz; Franco, Aidée Ramirez; de Sá Roriz, Maria Lúcia Feitosa; Carneiro, Ana Karine Borges; de Oliveira Garcia, Márcio Henrique; de Souza, Fábia Lidiana; Duron Andino, Regina; de Góes Cavalcanti, Luciano Pamplona

    2017-03-23

    The measles virus circulation was halted in Brazil in 2001 and the country has a routine vaccination coverage against measles, mumps and rubella higher than 95%. In Ceará, the last confirmed case was in 1999. This article describes the strategies adopted and the effectiveness of surveillance and control measures implemented during a measles epidemic in the post-elimination period. The epidemic started in December 2013 and lasted 20 months, reaching 38 cities and 1,052 confirmed cases. The D8 genotype was identified. More than 50,000 samples were tested for measles and 86.4% of the confirmed cases had a laboratory diagnosis. The beginning of an campaign vaccination was delayed in part by the availability of vaccine. The classic control measures were not enough to control the epidemic. The creation of a committee of experts, the agreement signed between managers of the three spheres of government, the conducting of an institutional active search of suspected cases, vaccination door to door at alternative times, the use of micro planning, a broad advertising campaign at local media and technical operative support contributed to containing the epidemic. It is important to recognize the possibility of epidemics at this stage of post-elimination and prepare a sensitive surveillance system for timely response. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Maternal colonization or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in Africa: A systematic review and meta-analysis.

    Science.gov (United States)

    Bulabula, Andre N H; Dramowski, Angela; Mehtar, Shaheen

    2017-11-01

    To summarize published studies on the prevalence of and risk factors for maternal bacterial colonization and/or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in pregnant and/or post-partum women in Africa. A systematic review was conducted using the PubMed, Scopus, and Google Scholar databases. Bibliographies of included eligible studies were manually searched to identify additional relevant articles. No language restriction was applied. The timeframe of the search included all records from electronic database inception to July 15, 2017. A random-effects meta-analysis was performed to summarize the prevalence and the 95% confidence intervals (CI) of ESBL-E colonization or infection in pregnant or post-partum women in Africa. The meta-analysis was conducted using STATA IC 13.1 software and the metaprop function/plugin. Ten studies (seven on pregnant women and three on post-partum women) were included, documenting a 17% prevalence of maternal colonization with ESBL-E in Africa (95% CI 10-23%). The prevalence of ESBL-E in community isolates exceeded that in isolates from the hospital setting (22% vs. 14%). The most frequently reported ESBL-encoding gene was CTX-M (cefotaxime hydrolyzing capabilities). Data on risk factors for maternal ESBL-E colonization and infection are very limited. The prevalence of colonization and/or infection with ESBL-E in pregnant and post-partum women in Africa exceeds that reported from high- and middle-income settings, representing a risk for subsequent neonatal colonization and/or infection with ESBL-E. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  10. Protease and protease inhibitory activity in pregnant and postpartum involuting uterus

    International Nuclear Information System (INIS)

    Milwidsky, A.; Beller, U.; Palti, Z.; Mayer, M.

    1982-01-01

    The presence of two distinct proteolytic activities in the rat uterus was confirmed with 14 C-labeled globin used as a sensitive protein substrate and following release of label into the trichloroacetic acid-soluble supernatant fraction. Protease I is a cytoplasmic acid protease while protease II is associated with the pellet fraction, can be extracted by 0.6 M sodium chloride, and is active at pH 7.0. Protease I activity is low during pregnancy and markedly increases at term achieving maximal activity at day 3 post partum with a subsequent decline to preterm activity values. Lactation did not affect the uterine protease I activity. Protease II activity is not significantly different during pregnancy, at term, and post partum. The presence of an inhibitor of protease I was suggested by a decrease in enzyme activity with an increased cytosolic protein concentration. The inhibitor also lessened bovine trypsin activity but had no effect on protease II. Although its inhibitory potency on trypsin fluctuated during the various uterine physiologic stages, these changes appeared to be statistically insignificant. Human uterine samples were also found to contain the two protease activities with similar changes in protease I post partum. It is suggested that, both in the rat and in man, uterine involution post partum is associated with a marked increase in activity of acid cytosolic protease, while a particulate neutral protease and a soluble inhibitor of trypsin, which are also present in uterine cells, do not appear to play a significant role in the dissolution of uterine tissues after parturition

  11. Cardiac diastolic function after recovery from pre-eclampsia.

    Science.gov (United States)

    Soma-Pillay, P; Louw, M C; Adeyemo, A O; Makin, J; Pattinson, R C

    Pre-eclampsia is associated with significant changes to the cardiovascular system during pregnancy. Eccentric and concentric remodelling of the left ventricle occurs, resulting in impaired contractility and diastolic dysfunction. It is unclear whether these structural and functional changes resolve completely after delivery. The objective of the study was to determine cardiac diastolic function at delivery and one year post-partum in women with severe pre-eclampsia, and to determine possible future cardiovascular risk. This was a descriptive study performed at Steve Biko Academic Hospital, a tertiary referral hospital in Pretoria, South Africa. Ninety-six women with severe preeclampsia and 45 normotensive women with uncomplicated pregnancies were recruited during the delivery admission. Seventy-four (77.1%) women in the pre-eclamptic group were classified as a maternal near miss. Transthoracic Doppler echocardiography was performed at delivery and one year post-partum. At one year post-partum, women with pre-eclampsia had a higher diastolic blood pressure (p = 0.001) and body mass index (p = 0.02) than women in the normotensive control group. Women with early onset pre-eclampsia requiring delivery prior to 34 weeks' gestation had an increased risk of diastolic dysfunction at one year post-partum (RR 3.41, 95% CI: 1.11-10.5, p = 0.04) and this was irrespective of whether the patient had chronic hypertension or not. Women who develop early-onset pre-eclampsia requiring delivery before 34 weeks are at a significant risk of developing cardiac diastolic dysfunction one year after delivery compared to normotensive women with a history of a low-risk pregnancy.

  12. Specific features of cytological and colposcopical pattern in pregnant women with benign cervix uteri pathology in anamnesis.

    Science.gov (United States)

    Bysaha, Nataliya Yu

    2016-01-01

    a tendency of increasing incidence of the cervix uteri precancer and cancer in women of reproductive age is noticed recently being related to the growth of number of the sexually-transmitted infections. The cervix uteri pathology incidence in women of fertile age is 20-25%. to study the specific features of the cytological and colposcopical pattern in pregnant patients with benign cervix uteri pathology in the anamnesis and the character of its change post partum. we have examined 195 women during their pregnancy and 3-5 months post partum. All pregnant women, alongside with generally accepted clinical and laboratory examinations, were subjected to the simple and extended colposcopy, cytology of the targeted smears and, according to indications, the histological studies of bioptate. according to the results of the colcoscopical studies and the signs of the cervix uteri pathology found, the patients were divided into several groups. A control group included 49 pregnant women. The clinical and instrumental examination of 146 women with cervix uteri pathology has been carried out both during pregnancy and post partum. the structure of the clinical forms of benign and premalignant changes in the cervix uteri epithelium in pregnant patients has been found. Specific features of the cytological and colposcopical pattern in pregnant patients with benign cervix uteri pathology in anamnesis have been studied. The relationship between the parity of pregnancy, delivery, route of delivery and regress of both benign and premalignant changes in the cervix uteri epithelium 3-5 months post partum has been determined.

  13. Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH - a prospective follow-up study

    Directory of Open Access Journals (Sweden)

    Nalliah Sivalingam

    2010-09-01

    Full Text Available Abstract Background Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry. Methods Venous blood samples (antepartum, intrapartum and post partum periods were drawn to estimate for sFlt-1 and PlGF levels while placental tissue samples were examined for placental morphometry. Results PlGF levels were lower in gestational hypertension (GH compared to normotensive during antepartum and intrapartum period, whereas sFlt-1 levels were elevated in GH at antepartum, intrapartum and postpartum intervals during pregnancy. An inverse relationship between these two biomarkers was observed through correlation analysis. PlGF levels were inversely correlated with total villous surface area of the placental periphery (TCsa-C and villous capillarization (VC-C of the placental periphery. Conclusion We established periodic values of for sFlt-1 and PlGF levels for the first time in an ethnically diverse Malaysian setting. We suggest the development of GH in women is related to defective capillarization. In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1. The correlation between PlGF levels and morphometric findings also support possible capillarization defect.

  14. Relative Effects of the Dollar and Yen on East Asian Currency Values: Focusing on the Post-Crisis Period

    OpenAIRE

    Bonghan Kim; Seeun Jeong

    2007-01-01

    This paper empirically analyzes the relative effects of the dollar and yen on the value of East Asian currencies. We focus especially on countries that have chosen to adopt floating regimes in the post-financial crisis period, such as South Korea, Taiwan, Indonesia, the Philippines and Thailand. First, we calculate a exchange rate flexibility index and carry out a regression using Frankel and Wei's (1994) methodology. The results confirm an increase in the coupling of East Asian currencies vi...

  15. Companionship in labour: Do the personality characteristics of labour supporters influence their effectiveness

    Directory of Open Access Journals (Sweden)

    B. Chalmers

    1995-03-01

    Full Text Available Recent research has revealed beneficial post-partum, psychosocial effects on the mother following labour which was accompanied by supportive companions. Whether these effects are obtained as a result of having companionship during labour or because of specific personality characteristics of the companions provided is important and is explored in this paper. Although findings revealed few differences in adjustment between women who were supported by different companions, some variability in the post-partum state anxiety and depression scores were noted which suggest that selection of an appropriate supporter is an important aspect of such programmes.

  16. [The midwife-child health nurse collaboration, a link between the maternity unit and neonatology].

    Science.gov (United States)

    Pallaro, Audrey; Polzin, Karine

    2016-01-01

    Collaborative work forms part of the well-treatment and improvement of quality of care approach. It is also of benefit to the medical and paramedical teams. Within the parent-child unit of Libourne hospital, the midwife and child health nurse collaborate throughout the pregnancy, and especially during the post-partum period. The teams work together notably around the care of "high-risk" births and in particular when the newborn is hospitalised in a kangaroo care unit. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Depression in Mongolian women over the first 2 months after childbirth: prevalence and risk factors.

    Science.gov (United States)

    Pollock, J I; Manaseki-Holland, S; Patel, V

    2009-07-01

    Social, political and economic changes in Mongolia have followed post-Soviet style government policies and contributed to both increased liberalisation and reduced security in employment and family finances. This is the first study to attempt to assess the prevalence of depression in a population of Mongolian women in the post-partum period and assess risk factors, including financial position, associated with the condition. A total of 1044 women who had delivered healthy babies in Ulaanbaatar between October and December 2002 were screened for depression using the WHO Self Reporting Questionnaire between 5 and 9 weeks post-partum. Further details on the mother, her family and social and economic circumstances were simultaneously collected. Analysis of risk factors for probable depression was undertaken using multiple logistic regression techniques. The prevalence of depression was 9.1% (95% CLs 7.5%-11.1%). Variables significantly and independently associated with risk of probable maternal depression included economic factors, mother being subject to physical abuse, dissatisfied with the pregnancy, concerned about her baby's behaviour, and her own health problems. The sample was drawn from a population of mothers all of whom had healthy, full-term babies of normal birth weight. Clinical confirmation of diagnosis was not established. Mongolian women with young infants in Ulaanbaatar probably experience depression at rates comparable with other cultures. Factors associated with probable depression were dominated by health, relationships and financial position.

  18. Low-frequency rTMS with language therapy over a 3-month period for sensory-dominant aphasia: case series of two post-stroke Japanese patients.

    Science.gov (United States)

    Kakuda, Wataru; Abo, Masahiro; Uruma, Go; Kaito, Nobuyoshi; Watanabe, Motoi

    2010-01-01

    To examine the safety and feasibility of therapeutic application of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with language therapy for post-stroke patients with sensory-dominant aphasia. Two post-stroke Japanese patients with sensory-dominant aphasia were studied. In both patients, 10 sessions of 20-minute low-frequency rTMS with 1 Hz to the Wernicke's area were provided throughout 6-day hospitalization, followed by weekly outpatient rTMS treatment for 3 months. The language therapy was also provided through the period of in- and out-patient treatment. Language function was evaluated using the Token test and the Standard Language Test of Aphasia (SLTA) at the start and end of the in-patient treatment and the end of the outpatient treatment. The therapeutic protocol was well tolerated throughout the in- and out-patient treatments, without any adverse effects. The scores of the Token test and certain sub-categories of SLTA increased in both patients after the in-patient rTMS treatment. Persistent improvement of the score was noted over the 3-month post-discharge period. The proposed protocol of long-term application of low-frequency rTMS to the Wernicke's area and language therapy is considered a safe and feasible therapeutic approach for post-stroke patients with sensory-dominant aphasia.

  19. Blood Selenium Associated with Health and Fertility in Norwegian Dairy Herds

    Directory of Open Access Journals (Sweden)

    Kommisrud E

    2006-12-01

    Full Text Available A survey of blood selenium (Se concentrations in Norwegian Red heifers and dry period cows was conducted to reveal possible association to management, feeding, health and fertility. Selenium contents were determined in 254 herd blood samples consisting of pooled samples from individual non-lactating animals from herds in 5 counties. The Se concentrations showed a normal distribution with mean 0.09 μg Se/g blood, with a standard deviation (SD of 0.05, and ranged from 0.02 to 0.23 μg/g, with 50 % of the samples being between 0.06 and 0.11 μg/g. The herds with Se concentrations below 0.06 μg/g were smaller (21.4 ± 8.7 cow-years than those with Se levels above 0.11 μg/g (27.5 ± 14.1 cow-years (P pre partum and decreased incidence of mastitis, ovarian cysts and anoestrus/silent oestrus post partum.

  20. National Identity of High-School Adolescents in an Era of Socio-Economic Change: Russia and Ukraine in the Post-Perestroika Period

    Science.gov (United States)

    Tartakovsky, Eugene

    2011-01-01

    This study focuses on the national identity of high-school adolescents in Russia and Ukraine in the post-perestroika period. Adolescents studying in public high schools in 12 medium-size and large cities completed questionnaires in 1999 (n = 468) and 2007 (n = 646). Russian adolescents consistently reported a more positive attitude towards their…

  1. How safe is GP obstetrics? An assessment of antenatal risk factors and perinatal outcomes in one rural practice.

    Science.gov (United States)

    Kirke, Andrew B

    2010-01-01

    Approximately one-fifth of Western Australian women deliver their babies in rural and remote regions of the state. The medical workforce caring for these women is predominantly non-specialist GP obstetricians. This article explores how safe is rural GP obstetrics. It reviews one rural obstetric practice in detail. In particular it asks these questions: What are the antenatal risk factors? What are the obstetric outcomes for the mother? What are the obstetric outcomes for the baby? This study is an audit of the author's obstetric practice over a two-year period from July 2007 to June 2009. The audit criteria included all obstetric patients managed by the author through to delivery and immediate post-partum care. Hospital and practice notes for 195 singleton pregnancies were reviewed. Antenatal risk factors, intrapartum events and immediate post-partum events for all patients cared for by the author through to delivery were recorded and compared with averages for Western Australia from published 2007 figures. The maternal population had mean age of 28.5 years, 2.1% were Aboriginal. Body mass index (BMI) at booking was a mean of 27.1 (range 18-40). Those with a BMI > 40 were referred elsewhere. Significant antenatal risks included smoking (14.9%), previous caesarean section (14.4%), hypertension (13.3%), pre-eclampsia (5.1%) and gestational diabetes (8.2%). Intrapartum there were high rates of induction (33.5%), epidural/spinal (34.7%) and shoulder dystocia (3.6%). Type of delivery was predominantly spontaneous vaginal (65.6%), vacuum (14.9%), forceps (2.6%), elective caesarean (9.7%) and non-elective caesarean (8.7%). Post-partum events included post-partum haemorrhage (10.3%), transfusion (1.5%), retained placenta (2.1%), neonatal jaundice (21.1%), neonatal seizures (1.5%) neonatal sepsis (1.5%) and neonatal special care or intensive care (SCU/NICU) admission (9.8%). The audit population was a group of relatively low risk pregnant women. Despite referral of more

  2. Population prevalence, attributable risk, and attributable risk percentage for high methylmalonic acid concentrations in the post-folic acid fortification period in the US

    Directory of Open Access Journals (Sweden)

    Ganji Vijay

    2012-01-01

    Full Text Available Abstract Background Serum methylmalonic acid (MMA is regarded as a sensitive marker of vitamin B-12 status. Elevated circulating MMA is linked to neurological abnormalities. Contribution of age, supplement use, kidney dysfunction, and vitamin B-12 deficiency to high serum MMA in post-folic acid fortification period is unknown. Methods We investigated prevalence, population attributable risk (PAR, and PAR% for high MMA concentrations in the US. Data from 3 cross-sectional National Health and Nutrition Examination Surveys conducted in post-folic acid fortification period were used (n = 18569. Results Likelihood of having high serum MMA for white relative to black was 2.5 (P P P P P Conclusions Old age is the strongest determinant of PAR for high MMA. About 5 cases of high serum MMA/1000 people would be reduced if vitamin B-12 deficiency (

  3. Maternal care practices among the ultra poor households in rural Bangladesh: a qualitative exploratory study

    Directory of Open Access Journals (Sweden)

    Choudhury Nuzhat

    2011-03-01

    Full Text Available Abstract Background Although many studies have been carried out to learn about maternal care practices in rural areas and urban-slums of Bangladesh, none have focused on ultra poor women. Understanding the context in which women would be willing to accept new practices is essential for developing realistic and relevant behaviour change messages. This study sought to fill in this knowledge gap by exploring maternal care practices among women who participated in a grant-based livelihood programme for the ultra poor. This is expected to assist the designing of the health education messages programme in an effort to improve maternal morbidity and survival towards achieving the UN millennium Development Goal 5. Methods Qualitative method was used to collect data on maternal care practices during pregnancy, delivery, and post-partum period from women in ultra poor households. The sample included both currently pregnant women who have had a previous childbirth, and lactating women, participating in a grant-based livelihood development programme. Rangpur and Kurigram districts in northern Bangladesh were selected for data collection. Results Women usually considered pregnancy as a normal event unless complications arose, and most of them refrained from seeking antenatal care (ANC except for confirmation of pregnancy, and no prior preparation for childbirth was taken. Financial constraints, coupled with traditional beliefs and rituals, delayed care-seeking in cases where complications arose. Delivery usually took place on the floor in the squatting posture and the attendants did not always follow antiseptic measures such as washing hands before conducting delivery. Following the birth of the baby, attention was mainly focused on the expulsion of the placenta and various maneuvres were adapted to hasten the process, which were sometimes harmful. There were multiple food-related taboos and restrictions, which decreased the consumption of protein during

  4. Comparing standard office-based follow-up with text-based remote monitoring in the management of postpartum hypertension: a randomised clinical trial.

    Science.gov (United States)

    Hirshberg, Adi; Downes, Katheryne; Srinivas, Sindhu

    2018-04-27

    Monitoring blood pressure at 72 hours and 7-10 days post partum in women with hypertensive disorders is recommended to decrease morbidity. However, there are no recommendations as to how to achieve this. To compare the effectiveness of text-based blood pressure monitoring to in-person visits for women with hypertensive disorders of pregnancy in the immediate postpartum period. Randomised clinical trial among 206 postpartum women with pregnancy-related hypertension diagnosed during the delivery admission between August 2016 and January 2017. Women were randomised to 2 weeks of text-based surveillance using a home blood pressure cuff and previously tested automated platform or usual care blood pressure check at their prenatal clinic 4-6 days following discharge. The primary study outcome was a single recorded blood pressure in the first 10 days post partum. The ability to meet American Congress of Obstetricians and Gynecologists (ACOG) guidelines, defined as having a blood pressure recorded on postpartum days 3-4 and 7-10 was evaluated in the text message group. The study was powered to detect a 1.4-fold increase in a single recorded blood pressure using text messaging. All outcomes were analysed as intention to treat. 206 women were randomised (103 in each arm). Baseline characteristics were similar. There was a statistically significant increase in a single blood pressure obtained in the texting group in the first 10 days post partum as compared with the office group (92.2% vs 43.7%; adjusted OR 58.2 (16.2-208.1), p<0.001). Eighty-four per cent of patients undergoing text-based surveillance met ACOG criteria for blood pressures at both recommended points. Text-based monitoring is more effective in obtaining blood pressures and meeting current clinical guidelines in the immediate postdischarge period in women with pregnancy-related hypertension compared with traditional office-based follow-up. NCT03185455, Remote Surveillance of Postpartum Hypertension (Text

  5. AN UNUSUAL PRESENTATION OF DIC

    Directory of Open Access Journals (Sweden)

    Manish

    2015-10-01

    Full Text Available Placenta Praevia is a common obstetric problem which presents with antepartum H aemorrhage and is treated by the obstetrician. It is very rare to see a patient with placenta praevia treated in medical ward for post - partum H aemorrhage due to disseminated intravascular coagulation defect with the added complication of acute kidney injury, P ost - partum H ypertension and PRES (posterior reversible encephalopathy syndrome, hence the presentation

  6. Timor-Leste’s Foreign Policy: Securing State Identity in the Post-Independence Period

    Directory of Open Access Journals (Sweden)

    Selver B. Sahin

    2014-01-01

    Full Text Available This paper examines some of the major ideational aspects of Timor-Leste’s foreign policy orientation in the post-independence period. Drawing upon the constructivist accounts of state behaviour, the paper situates Timorese leaders’ foreign policy decisions in the broader context of their search to position the fledging nation in the global political order. It argues that Timor-Leste’s insecure state identity has shaped its leaders’ foreign policy preferences in the post-independence period. This identity can be examined by separating it into two parts: the construction of spatial boundaries and the creation of a temporal “other”. The former is evidenced by the leadership’s rhetorical emphasis on the country’s Portuguese heritage and their prioritisation of ASEAN membership, both of which are closely related to the consolidation of the young nation’s political and cultural identity. The creation of a temporal other, as illustrated by the rise of political discourse emphasising sovereignty, reflects a wider transitional process that is embedded in the country’s transformation from colony to independent state under international supervision as well as the state’s transformation from “fragile” or “failing” to “stable”. A detailed analysis of the basic aspects of Timor-Leste’s insecurities as a constitutive element of its foreign policy becomes instrumental to understanding the country’s nation-state-building experience since its separation from Indonesia in 1999, as it enters a new phase of socio-political structuring following the withdrawal of the international security presence in 2012.

  7. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain

    Science.gov (United States)

    Tennfjord, Merete Kolberg; Hilde, Gunvor; Ellström-Engh, Marie; Bø, Kari

    2016-01-01

    Background/aim Diastasis recti abdominis (DRA) is defined as a separation of the 2 muscle bellies of rectus abdominis. To date there is scant knowledge on prevalence, risk factors, and consequences of the condition. The present study aimed to investigate the prevalence of DRA during pregnancy and post partum, presence of possible risk factors, and the occurrence of lumbopelvic pain among women with and without DRA. Methods This prospective cohort study followed 300 first-time pregnant women from pregnancy till 12 months post partum. Data were collected by electronic questionnaire and clinical examinations. DRA was defined as a palpated separation of ≥2 fingerbreadths either 4.5 cm above, at or 4.5 cm below the umbilicus. Women with and without DRA were compared with independent samples Student's t-test and χ2/Fisher exact test, and OR with significance level >0.05. Results Prevalence of DRA was 33.1%, 60.0%, 45.4%, and 32.6% at gestation week 21, 6 weeks, 6 months and 12 months post partum, respectively. No difference in risk factors was found when comparing women with and without DRA. OR showed a greater likelihood for DRA among women reporting heavy lifting ≥20 times weekly (OR 2.18 95% CI 1.05 to 4.52). There was no difference in reported lumbopelvic pain (p=0.10) in women with and without DRA. Conclusions Prevalence of mild DRA was high both during pregnancy and after childbirth. Women with and without DRA reported the same amount of lumbopelvic pain 12 months post partum. PMID:27324871

  8. ONSET PENGELUARAN KOLOSTRUM PERSALINAN NORMAL LEBIH CEPAT DARIPADA PERSALINAN SECTIO CAESARIA

    Directory of Open Access Journals (Sweden)

    Maria NSW Kause

    2016-12-01

    Full Text Available Background: Lactation onset is a term of multiplying breast milk until the release of breast milk for the first time. It is also perceived by mothers as a bit hard breast, inflammed, and full of breast milk or the release of colostrum. Colostrum is the first liquid secreted by breast milk gland since the first day until the fourth day of labour. One of the factors that influences lactation onset is labour methods. Mothers who undergo sectio caesaria surgery will experience pain and prolonged effects of anesthesia compared to mothers with normal labors. Objective: To investigate the difference of colostrum releasing onset in post partum mothers with normal labors and sectio caesaria in Panembahan Senopati General Hospital, Bantul. Method: This study was quantitative with cross sectional design. The number of samples were 80 respondents selected with purposive sampling technique. Study instrument was observational sheets. Data analysis applied Mann-Whitney test. Result: The majority of respondents who had normal labors and sectio caesaria experienced different colostrum onset. In normal labors, the time of colostrum release was 1 day. In sectio caesaria labors, the time of colostrum release was 2 days. The average duration of post partum mothers with normal labors was 13,6 hours and post partum mothers with sectio caesaria was 22,6 hours. The result of Mann-Whitney test was that there was a difference between colostrum release onset of post partum mothers with normal labors and sectio caesaria with p-value of 0,001 (p<0,05. Conclusion: Colostrum onsets were different in normal labors and sectio caesaria labors.

  9. The effect of colostral immunoglobulin supplement on the passive immunity, growth and health of neonatal calves

    Directory of Open Access Journals (Sweden)

    Juha Nousiainen

    1994-09-01

    Full Text Available Neonatal dairy calves were randomly allotted to three colostrum feeding regimens with increasing intakes of immunoglobulins (Ig on the first day of life. The control group was fed one litre of pooled colostrum (Ig intake 19.5 g. In two experimental groups, the pooled colostrum was supplemented with 0.5 or 1.5 litres of commercial Ig-concentrate, giving a total Ig intake of 52.7 and 119.0 g, respectively. Serum IgG, IgM and IgA levels increased linearly (p < 0.001 on day 2 post partum with the increasing Ig intake. The calculated mean Ig-absorption rate was 61% and decreased linearly for IgM (p = 0.051 and IgG (p = 0.078 with increasing Ig intake. At the highest Ig intake, serum IgG remained above 10 g/l during 30 days post partum. In the experimental groups, serum IgM and IgA decreased sharply during the first week of life and were relatively constant thereafter. In the control group, however, there was an increase in serum IgM after one week post partum, perhaps due to the in situ production of Ig. With the increasing Ig intake there was a small and non-significant tendency for better live weight gain (p = 0.286 and a lower incidence of diarrhoea (p = 0.421 during the first four weeks of life. It is concluded that the Ig-product tested is well absorbed during 24 hours post partum and it can be used either as a supplement to maternal colostrum when its quality is poor, or as a substitute when colostrum is not available.

  10. [Why women consult sexologists: an approach for practicing physicians].

    Science.gov (United States)

    Buffat, Juliette

    2005-03-16

    Female sexual dysfunctions are less known than male ones because women are more discrete and introverted. Female genitals are mostly internal and women live sex more cerebrally and sentimentally than men. Still half the patients my current sexological consultation are women. They seek help due for lack of desire, frigidity, coital or clitoridal anorgasmy, dyspareuny, vaginism and problems related to pregnancy or the post-partum period. This article describes how to construct a precise clinical etiology following a "5 circles" scheme, which will help to determine the most adequate therapeutic approach.

  11. Effect of single and repeated injections of selective D2-antagonist clebopride on maternal behavior of albino rats.

    Science.gov (United States)

    Tanaeva, K K; Dobryakova, Yu V; Dubynin, V A; Kamensky, A A

    2012-06-01

    This study examined the effect of clebopride at low concentration that did not modify the motor activity on the parental care in female albino rats. Single injection of the drug attenuated the parental care reactions on postinjection minute 20, but not one day thereafter. The daily injection of the drug during the post partum period (1-6 days) resulted in significantly more pronounced and stable effects. The data obtained substantiated the views on the major contribution of D(2)-receptors in the development of behavioral manifestations of puerperal depression.

  12. Pulmonary capillary haemangiomatosis: a rare cause of pulmonary hypertension.

    Science.gov (United States)

    Babu, K Anand; Supraja, K; Singh, Raj B

    2014-01-01

    Pulmonary capillary haemangiomatosis (PCH) is a rare disorder of unknown aetiology, characterised by proliferating capillaries that invade the pulmonary interstitium, alveolar septae and the pulmonary vasculature. It is often mis-diagnosed as primary pulmonary hypertension and pulmonary veno-occlusive disease. Pulmonary capillary haemangiomatosis is a locally aggressive benign vascular neoplasm of the lung. We report the case of a 19-year-old female who was referred to us in the early post-partum period with severe pulmonary artery hypertension, which was diagnosed as PCH by open lung biopsy.

  13. Longitudinal associations between maternal disrupted representations, maternal interactive behavior and infant attachment: a comparison between full-term and preterm dyads.

    Science.gov (United States)

    Hall, R A S; Hoffenkamp, H N; Tooten, A; Braeken, J; Vingerhoets, A J J M; van Bakel, H J A

    2015-04-01

    This prospective study examined whether or not a mother's representations of her infant were more often disrupted after premature childbirth. Furthermore, the study examined if different components of maternal interactive behavior mediated the relation between maternal disrupted representations and infant attachment. The participants were mothers of full-term (n = 75), moderately preterm (n = 68) and very preterm infants (n = 67). Maternal representations were assessed by the Working Model of the Child Interview at 6 months post-partum. Maternal interactive behavior was evaluated at 6 and 24 months post-partum, using the National Institute of Child Health and Human Development Early Care Research Network mother-infant observation scales. Infant attachment was observed at 24 months post-partum and was coded by the Attachment Q-Set. The results reveal that a premature childbirth does not necessarily generate disrupted maternal representations of the infant. Furthermore, maternal interactive behavior appears to be an important mechanism through which maternal representations influence the development of infant attachment in full-term and preterm infants. Early assessment of maternal representations can identify mother-infant dyads at risk, in full-term and preterm samples.

  14. Manual lymphatic drainage and therapeutic ultrasound in liposuction and lipoabdominoplasty post-operative period

    Directory of Open Access Journals (Sweden)

    Igor F. B. Masson

    2014-01-01

    Full Text Available Background: Physiotherapy in the plastic surgery post-operative (PO is essential to provide means for an adequate and fast recovery as it restores function through the use of physiotherapeutic procedures. Aim: The aim of the following study is to verify the effects of the association between the manual lymphatic drainage and the therapeutic ultrasound on pain, oedema and the tissue fibrosis in liposuction and lipoabdominoplasty PO. Design: This is a clinical trial prospective. Materials and Methods: Eighteen women aged between 18 and 60 years participated in this study, in the late PO period following lipoabdominoplasty or liposuction in the abdomen, flanks and lower trunk, which showed tissue fibrosis of the flanks and abdomen regions. They were divided into two groups: Liposuction group and lipoabdominoplasty group. A total of twelve sessions of therapeutic ultrasound followed by the manual lymphatic drainage were performed. The patients were assessed with regard to pain, oedema and tissue fibrosis in different moments: Initial assessment, during assessment and final assessment through the application of the protocol of evaluation of cysts fibrosis levels. Statistical Analysis: The test of equality for two proportions and the confidence interval test for mean to evaluate the distribution of variables. The significance level adopted for statistical tests was 5% (P < 0.05. Results: There was a statistically significant reduction of pain, swelling and tissue fibrosis in both groups. Conclusion: the association between manual lymphatic drainage and the therapeutic ultrasound reduced the swelling and the tissue fibrosis and made pain disappear in liposuction and lipoabdominoplasty PO period.

  15. Tranexamic acid reduces blood loss during and after cesarean section: A double blinded, randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Amr H. Yehia

    2014-03-01

    Conclusions: Tranexamic acid can be used safely to reduce blood loss during cesarean section. Reduced blood loss after tranexamic acid was associated with improvement of post-operative hemoglobin, hematocrit and with reduction of post-partum need for iron replacement.

  16. Risk factors of maternal mortality in Sistan region: 10-year report

    Directory of Open Access Journals (Sweden)

    Mohammad Sarani

    2014-12-01

    Conclusion: Based on our findings, some factors including multiparity, pregnancy his-tory more than 4 times, short interval between pregnancies lower than 2 years and ma-ternal age more than 35 years were some risk factors for maternal death. Maternal mortality in the postpartum period was more than pre-delivery period. Bleeding was the main cause of maternal mortality. Therefore monitoring of vital signs in the post-partum period and the proper management of bleeding are very important. It is sug-gested that risk assessment should be done for pregnant women in delivery ward for detecting high risk pregnant women. Suitable management for these women especially for patients with postpartum hemorrhage plays an important role to decrease the ma-ternal mortality.

  17. 39 CFR 121.2 - Periodicals.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Periodicals. 121.2 Section 121.2 Postal Service UNITED STATES POSTAL SERVICE POST OFFICE SERVICES [DOMESTIC MAIL] SERVICE STANDARDS FOR MARKET-DOMINANT MAIL PRODUCTS § 121.2 Periodicals. (a) End-to-End. (1) For all SCF turnaround Periodicals properly...

  18. Some effects of partial suckling on milk yield, reproduction and calf growth in crossbred dairy cattle in north east coastal Tanzania

    International Nuclear Information System (INIS)

    Bryant, M.J.; Msanga, Y.N.

    1999-01-01

    Two experiments are described where a progeny of Bos taurus x Bos indicus crossbred cows were reared by partial suckling or bucket rearing (Experiment I), and partially suckled calves were weaned at 12 or 24 weeks of age (Experiment II). The results of Experiment I suggest that calf rearing method had no significant effect in the yield of milk extracted from the cows by hand milking although there were effects on the shape of the lactation curve. Cows showed similar patterns of live weight and body condition losses and gains and there were no significant effects on the length of the post partum interval. Suckled calves were lighter at weaning (P <0.01) but there were no differences in live weight between treatments at 52 weeks of age. The main advantage of partial suckling was that the calves took advantage of residual milk which was estimated as 28-29% of the total yield. The results from Experiment II suggest that there were no advantages in terms of milk yield or calf growth by extending the suckling period to 24 weeks. The post partum intervals observed in Experiment II were substantially longer than those in Experiment I, possibly because of greater live weight/body condition losses experienced by cows in the second experiment. (author)

  19. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.

    Science.gov (United States)

    Gelaye, Bizu; Rondon, Marta B; Araya, Ricardo; Williams, Michelle A

    2016-10-01

    Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Vertebral artery dissection in hypertensive disorders of pregnancy: a case series and literature review.

    Science.gov (United States)

    Shanmugalingam, Renuka; Reza Pour, Nina; Chuah, Siang Chye; Vo, Thi Mong; Beran, Roy; Hennessy, Annemarie; Makris, Angela

    2016-07-16

    Arterial dissection is a rare complication of pregnancy and puerperium. There have been reports of aortic, coronary and cervical artery dissection in association with preeclampsia, however, vertebral artery dissection is rarely reported particularly in the antenatal setting in the presence of a Hypertensive Disorder of Pregnancy (HDP).The general annual incidence of symptomatic spontaneous cervicocephalic arterial dissection is 0.0026 % and a data registry reported that 2.4 % of these occurred in the post-partum period. The actual incidence of vertebral artery dissection in HDP is unknown as the current literature consists of case series and reports only with most documenting adverse outcomes. Given the presence of collateral circulation, unilateral vertebral artery dissections may go unrecognised and may be more common than suspected. We present a case series of four patients with vertebral artery dissection in association with HDP, two of which occurred in the antenatal setting and two in the post-partum setting. All our patients had favourable outcome with no maternal neurological deficit and live infants. Our discussion covers the proposed pathophysiology of vertebral artery dissection in HDP and the management of it. Our case series highlights the need to consider VAD an important differential diagnosis when assessing pregnant women with headache and neck pain particularly in the context of HDP.