WorldWideScience

Sample records for prolonged postpartum anestrus

  1. Body condition and suckling as factors influencing the duration of postpartum anestrus in cattle: a review.

    Science.gov (United States)

    Montiel, F; Ahuja, C

    2005-01-01

    Prolonged postpartum anestrus is a main factor limiting reproductive efficiency in cattle, particularly in Bos indicus and Bos taurus/Bos indicus cows from tropical regions, because it prevents achievement of a 12 month calving interval. During anestrus, ovulation does not occur despite ovarian follicular development, because growing follicles do not mature. Although many factors affect postpartum anestrus, nutrition and suckling are the major factors influencing the resumption of postpartum ovarian cycles, as they affect hypothalamic, pituitary and ovarian activity and thus inhibit follicular development. Under-nutrition contributes to prolonged postpartum anestrus, particularly among cows dependent upon forages to meet their feed requirements and it apparently interacts with genetic, environmental or management factors to influence the duration of anestrus. The nutritional status or balance of an animal is evaluated through body condition score (BCS), as it reflects the body energy reserves available for metabolism, growth, lactation and activity. There is a converse relationship between energy balance and time to resumption of postpartum ovarian activity; inadequate nutrient intake results in loss of weight and BCS and finally cessation of estrous cycles. Suckling interferes with hypothalamic release of GnRH, provoking a marked suppression in pulsatile LH release, resulting in extended postpartum anestrus. The effects of suckling on regulation of tonic LH release are determined by the ability of the cow to identify a calf as her own or as unrelated. Vision and olfaction play critical roles in the development of the maternal-offspring bond, allowing the cow to identify her own calf, and abolition of both senses attenuates the negative effects of suckling on LH secretion. Thus, the maternal-offspring bond is essential for prolonged postpartum suckling-induced anovulation, and the suppressive influence of suckling is independent of neurosensory pathways within the

  2. Risk factors for postpartum anestrus in crossbred cows in Bangladesh

    International Nuclear Information System (INIS)

    Kamal, M.M.; Uddin Bhuiyan, M.M.; Parveen, N.; Momont, H.W.; Shamsuddin, M.

    2016-01-01

    Full text: Ultrasonography and a structured questionnaire were used in a cross-sectional study to gather data on the prevalence and risk factors for anestrus in crossbred cows at ≥60 days postpartum in 273 smallholder farms. The prevalence of anestruc was 18%. The odds ratio (OR) for true anestrus was 17.52 and 2.81 times higher (P < 0.05) in cows with poor (≤2.0) and excessive (>3.5) body condition score (BCS), respectively, compared to those with optimal BCS (2.5-3.5), 2.82 times higher in suckled than in nonsuckled cows (P = 0.03), and 2.53 times higher in cows that calved during the cold season than in those that calved during the hot season (P = 0.03). The OR for anestrus was 1.62 times higher (P = 0.017) in cows managed by an employee than in those managed by the farmers themselves (P = 0.001), and 2.66 times higher (P = 0.003) in small farms (≤5 cows) than in large farms (≥11 cows). The OR was 0.71 to 0.46 times lower in farms having a guaranteed market to sell milk than those with an uncertain traditional milk market (P < 0.05). Maintaining optimal BCS of cows, farmers' training on management of cattle reproduction, and development of a market linkage to sell milk would improve the number of cows for breeding by 60 days postpartum. (author)

  3. Certain hormonal profiles of postpartum anestrus jersey crossbred cows treated with controlled internal drug release and ovsynch protocol

    Directory of Open Access Journals (Sweden)

    Dayanidhi Jena

    2016-10-01

    Full Text Available Aim: The study was conducted to determine the serum levels of certain hormones in post-partum anestrus cows following treatment with controlled internal drug release (CIDR and Ovsynch protocol. Materials and Methods: A total of 30 postpartum anestrus cows were divided into three equal groups after thorough gynecoclinical examination. The Group 1 animals received an intravaginal progesterone device on day 0 and 2 ml of prostaglandin F2α (PGF2α on day of CIDR removal (7th day, Group 2 cows were treated with ovsynch protocol (gonadotropinreleasing hormone [GnRH]-PGF2α-GnRH on day 0, 7 and 9, respectively, and Group 3 cows were supplemented with mineral mixture and treated as control. The serum estrogen, progesterone, triiodothyronine, and thyroxine concentration were estimated using enzyme-linked immunosorbent assay kit and absorbance was read at 450 nm with Perkin Elmer Wallac 1420 Microplate Reader. Results: There was a significant increase in progesterone level in Group 1 after withdrawal of CIDR as compared to other two groups. However, the estrogen assay revealed a greater concentration in Group 2 against Group 1 on day 7 of sampling. However, there was no significant difference for serum triiodothyronine (T3 and thyroxine (T4 irrespective of treatment protocols and days of sampling. Conclusion: Treatment with CIDR based progesterone therapy and drug combinations may affect the reproductive hormonal balance like estrogen and progesterone, which is inevitable for successful return to cyclicity and subsequent fertilization and conception. However, as far as serum T3 and T4 concentration concerned it may not give an astounding result.

  4. Prolonged postpartum urinary retention: A case report and review of ...

    African Journals Online (AJOL)

    Postpartum urinary retention (PUR), which is defined as difficulty in emptying the bladder completely after ... Although many risk factors for this disturbance are identified in ... Despite incontinence related to pregnancy or labour having been.

  5. Prolonged postpartum urinary retention: A case report and review of ...

    African Journals Online (AJOL)

    Postpartum urinary retention (PUR), which is defined as difficulty in emptying the bladder completely after delivery, may be clinically pronounced or silent. The incidence differs according to the definition. Although many risk factors for this disturbance are identified in the literature, every patient at risk does not necessarily ...

  6. 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.

  7. Effects of exogenous melatonin on in vivo embryo viability and oocyte competence of undernourished ewes after weaning during the seasonal anestrus.

    Science.gov (United States)

    Vázquez, M I; Abecia, J A; Forcada, F; Casao, A

    2010-09-01

    This study investigated the effects of exogenous melatonin on embryo viability and oocyte competence in post-partum undernourished ewes during the seasonal anestrus. At parturition (mid-Feb), 36 adult Rasa Aragonesa ewes were assigned to one of two groups: treated (+MEL) or not treated (-MEL) with a subcutaneous implant of melatonin (Melovine(R), CEVA) on the day of lambing. After 45 d of suckling, lambs were weaned, ewes were synchronized using intravaginal pessaries, and fed to provide 1.5x (Control, C) or 0.5x (Low, L) times daily maintenance requirements. Thus, ewes were divided into four groups: C-MEL, C+MEL, L-MEL, and L+MEL. At estrus (Day=0), ewes were mated. At Day 5 after estrus, embryos were recovered by mid-ventral laparotomy and classified based on their developmental stage and morphology. After embryo collection, ovaries were recovered and oocytes were classified and selected for use in in vitro fertilization (IVF). Neither diet nor melatonin treatment had a significant effect on ovulation rate and on the number of ova recovered per ewe. Melatonin treatment significantly improved the number of fertilized embryos/corpus luteum (CL) (-MEL: 0.35 +/- 0.1, +MEL: 0.62 +/- 0.1; P = 0.08), number of viable embryos/CL (-MEL: 0.23 +/- 0.1, +MEL: 0.62 +/- 0.1; P competence of oocytes during IVF. Treatment groups did not differ significantly in the number of healthy oocytes used for IVF, number of cleaved embryos, or number of blastocysts and, consequently, the groups had similar cleavage and blastocyst rates. In conclusion, melatonin treatments improved ovine embryo viability during anestrus, particularly in undernourished post-partum ewes, although the effects of melatonin did not appear to be mediated at the oocyte competence level. Copyright 2010 Elsevier Inc. All rights reserved.

  8. Postpartum Sterilization

    Science.gov (United States)

    f AQ FREQUENTLY ASKED QUESTIONS FAQ052 CONTRACEPTION Postpartum Sterilization • What is sterilization? • What is postpartum sterilization? • How is postpartum sterilization performed? • What kind of anesthesia is used for postpartum sterilization? • How ...

  9. Postpartum Depression

    Science.gov (United States)

    ... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...

  10. Maternity Care Update: Postpartum Care.

    Science.gov (United States)

    Smith, Andrew; Barr, Wendy B; Bassett-Novoa, Erin; LeFevre, Nicholas

    2018-04-01

    Family physicians are uniquely situated to play a major role in postpartum care. Postpartum issues that should be monitored and addressed include reproductive and contraceptive planning, breastfeeding counseling and support, and maternal mental health. All women should be screened for postpartum depression using a validated tool at the postpartum visit and/or at well-child visits. Patients with positive screening results should be offered support and treatment. Women are more likely to breastfeed if they are provided with breastfeeding support and counseling routinely during the prenatal and postpartum periods. All women should be asked about their reproductive life plans, counseled about potential risks associated with short and prolonged interpregnancy intervals, and offered contraception. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  11. Postpartum Thyroiditis

    Science.gov (United States)

    American Thyroid Association ® Postpartum Thyroiditis www.thyroid.org What is the thyroid gland? The thyroid gland is a butterfly-shaped endocrine gland that ... as they should. What are the symptoms of postpartum thyroiditis? Thyroiditis is a general term that refers ...

  12. Ultrasonographic reproductive tract measures and pelvis measures as predictors of pregnancy failure and anestrus in restricted bred beef heifers.

    Science.gov (United States)

    Holm, Dietmar E; Nielen, Mirjam; Jorritsma, Ruurd; Irons, Peter C; Thompson, Peter N

    2016-02-01

    Previous reports have shown that reproductive tract score (RTS) can predict reproduction outcomes in seasonally bred beef heifers, although the accuracy can vary. Some ultrasonographic measures of the female reproductive tract and pelvis area have also been associated with reproductive outcome in young heifers. The objectives of this study were to determine which transrectal ultrasound or pelvis measures taken at a single examination are independent predictors of reproductive failure and whether the RTS system can be optimized with this information. In this observational study, year-old beef heifers (n = 488) in 2 birth cohorts were followed from just before the first breeding until confirmation of pregnancy. A single pre-breeding examination included body condition score, RTS, ultrasound measures of the reproductive tract (length and diameter of the left and right ovaries, presence and diameter of a CL, largest follicle diameter and left uterus horn diameter) and transverse and vertical diameters of the pelvis. Additional farm records including dam parity, sire, birth weight and birth date, weaning weight, weaning date, prebreeding body weight, AI dates, and semen used were available. Breeding consisted of 50 days of AI, followed 5 to 7 days later by a 42-day bull breeding period. Pregnancy failure was defined as the failure to become pregnant after the AI and bull breeding periods, while anestrus was defined as the failure to be detected in estrus during the 50-day AI period. From the prebreeding data and farm records, independent predictors of pregnancy failure and anestrus were identified using stepwise reduction in multiple logistic regression models. Age at the onset of breeding was the only consistent independent predictor of pregnancy failure and anestrus in both cohorts of this study (P score, uterus horn diameter, absence of a CL, largest follicle of less than 13 mm, and pelvis area (PA) were the prebreeding examination variables that remained in

  13. Postpartum complications

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  14. Body condition and stage of seasonal anestrus interact to determine the ovulatory response after male biostimulation in anovulatory Criollo × Nubian goats.

    Science.gov (United States)

    Vera-Avila, Hector R; Urrutia-Morales, Jorge; Espinosa-Martinez, Mario A; Gamez-Vazquez, Hector G; Jimenez-Severiano, Hector; Villagomez-Amezcua, Eugenio

    2017-06-01

    The effect of goat nutritional condition on the response to biostimulation with sexually active males during different stages of anestrus was determined. Fifty-eight Criollo × Nubian females on high and low body mass index (BMI) diets were used. Each BMI group was divided into two for biostimulation with sexually active males during May (mid-anestrus) or July (transition period). Ovulatory responses to biostimulation were characterized from serum progesterone, as well as the delay for response (first and second ovulations followed by a normal length luteal phase, O-WNLP). The percentage of goats showing one O-WNLP was greater in the high BMI group than in the low BMI group and greater during the transition period than in the mid-anestrus. However, the interaction between factors revealed that the difference between BMI groups was only significant in the transition period and the difference between stages was only significant in goats with high BMI. Occurrence of a second O-WNLP tended to be greater in the high BMI group than in the low BMI group. Response delay was shorter in the transition period than in mid-anestrus. In conclusion, female nutritional status interacting with the stage of anestrus determined the ovulatory response to male biostimulation in crossbred Criollo goats. © 2016 Japanese Society of Animal Science.

  15. Postpartum Psychosis

    Science.gov (United States)

    ... survivors of postpartum psychosis never had delusions containing violent commands. Delusions take many forms, and not all ... and families PP Psychosis Books Resources and Creative Media Help in an Emergency Emergency Hotlines are available ...

  16. Postpartum choriocarcinoma

    International Nuclear Information System (INIS)

    Sirichand, P.; Das, C.M.; Hassan, N.

    2006-01-01

    Choriocarcinoma, following term pregnancy, is a rare form of gestational trophoblastic disease. The usual presentation is with persistent primary or secondary postpartum hemorrhage, the diagnosis is often delayed because of failure to recognize this mode of presentation of the disease. Early diagnosis is important because this rare condition is potentially curable with appropriate chemotherapy. A case of postpartum choriocarcinoma, following a term pregnancy is reported that was successfully treated with methotrexate therapy and surgery. (author)

  17. Postpartum Blood Clots

    Science.gov (United States)

    ... Video) Fetal Ultrasound Scanning Additional Content Medical News Postpartum Blood Clots By Julie S. Moldenhauer, MD, Associate Professor ... Professional Version Postdelivery Period Overview of the Postdelivery (Postpartum) Period Postpartum Infections Postpartum Infections of the Uterus ...

  18. Postpartum haemorrhage: prevention

    OpenAIRE

    Chelmow, David

    2008-01-01

    Loss of more than 500 mL of blood is usually caused by failure of the uterus to contract fully after delivery of the placenta, and occurs in over 10% of deliveries with a 1% mortality rate worldwide. Other causes of postpartum haemorrhage include retained placental tissue, lacerations to the genital tract and coagulation disorders.Uterine atony is more likely in women who have had a general anaesthetic or oxytocin, an over-distended uterus, a prolonged or precipitous labour, or who are of ...

  19. Postpartum haemorrhage: prevention

    OpenAIRE

    Chelmow, David

    2011-01-01

    Loss of more than 500 mL of blood is usually caused by failure of the uterus to contract fully after delivery of the placenta, and occurs in over 10% of deliveries, with a 1% mortality worldwide. Other causes of postpartum haemorrhage include retained placental tissue, lacerations to the genital tract, and coagulation disorders.Uterine atony is more likely in women who have had a general anaesthetic or oxytocin, an over-distended uterus, a prolonged or precipitous labour, or who are of hig...

  20. Postpartum Preeclampsia

    Science.gov (United States)

    ... are one of the most common methods of treatment.Screening in PregnancyRead Article >>Pregnancy and ChildbirthScreening in PregnancyWhen you are pregnant, genetic screenings can determine your baby’s risk for having Down syndrome, trisomy 18, and spina…Recovering from Delivery (Postpartum ...

  1. Postpartum Depression

    DEFF Research Database (Denmark)

    Smith-Nielsen, Johanne

    Background: In three academic articles, this PhD thesis investigates maternal postpartum depression (PPD) as a risk factor for the infant-mother attachment and infant development. Previous studies have been contradictory with respect to the question of whether PPD can have long term effects...... on offspring. This may be due to not differing between when PPD is only occurring in the postpartum period and when effects are also due to ongoing or recurrent depression. However, it may also be due to viewing maternal depression as a unitary construct, and not considering underlying maternal psychological...... difficulties which may moderate potential adverse effects. The present thesis investigates two potential maternal moderators of risk:. Comorbid personality disorder and adult attachment insecurity. Moreover, the question of early environmental effects of PPD versus effects of later or ongoing depression...

  2. Postpartum Depression - Multiple Languages

    Science.gov (United States)

    ... Русский (Russian) Bilingual PDF Health Information Translations Postpartum Depression - English PDF Postpartum Depression - Русский (Russian) PDF Postpartum Depression - English MP3 ...

  3. Postpartum Depression Facts

    Science.gov (United States)

    ... Where can I find more information? Share Postpartum Depression Facts Download PDF Download ePub Download Mobi Order ... for herself or her family. What is postpartum depression? Postpartum depression is a mood disorder that can ...

  4. Risk factors associated with postpartum haemorrhage at Juba ...

    African Journals Online (AJOL)

    2010-05-01

    May 1, 2010 ... No 3. August 2014. oRIgINAL RESEARCH. 52. Risk factors associated with postpartum ... analyzed using Epi-info 3.5.3 statistical programme to determine if there was a correlation. .... Traumatic episiotomy, prolonged third.

  5. Postpartum haemorrhage: prevention.

    Science.gov (United States)

    Chelmow, David

    2011-04-04

    Loss of more than 500 mL of blood following childbirth is usually caused by failure of the uterus to contract fully after delivery of the placenta, and occurs in over 10% of deliveries, with a 1% mortality rate worldwide. Other causes of postpartum haemorrhage include retained placental tissue, lacerations to the genital tract, and coagulation disorders. Uterine atony is more likely in women who have had a general anaesthetic or oxytocin, an over-distended uterus, a prolonged or precipitous labour, or who are of high parity. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug interventions and of drug interventions to prevent primary postpartum haemorrhage? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 40 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: active management of the third stage of labour, carboprost injection, controlled cord traction, ergot compounds (ergometrine/methylergotamine), immediate breastfeeding, misoprostol (oral, rectal, sublingual, or vaginal), oxytocin, oxytocin plus ergometrine combinations, prostaglandin E2 compounds, and uterine massage.

  6. A Counselor's Primer on Postpartum Depression.

    Science.gov (United States)

    Pfost, Karen S.; And Others

    1990-01-01

    Notes that women are particularly vulnerable to depression during the postpartum period. Distinguishes postpartum depression from normal postpartum adjustment, postpartum blues, and postpartum psychosis. Describes biological, psychodynamic, and diathesis-stress perspectives on postpartum depression. Encourages counselors to fashion individualized…

  7. Postpartum hysterectomy

    Directory of Open Access Journals (Sweden)

    Katja Juvan-Kramer

    2006-01-01

    Full Text Available Background: Emergency postpartum hysterectomy (PH is generally performed in the situation of lifethreatening haemorrhage. Incidence according to the literature is between 1/300 and 1/5000 labours. The leading cause in developed world is placenta accreta. Besides standard methods (aplication of drugs, revision of uterus, bimanual compression of uterus etc., conservative surgical methods and embolization of vessels are increasingly used. We wanted to establish the incidence of PH in the Ljubljana Maternity Hospital, use of conservative surgical methods and matching of histological and operative diagnosis. We wanted to check the possibilities for embolization of vessels.Methods: Retrospective analysis of PH in the years 1992–2002 in the Ljubljana Maternity Hospital was done and the incidence of PH was calculated. We analysed patients regarding indications for PH, sort of operation and matching of histological and operative diagnose. We checked the possibilities for embolization of uterine vessels.Results: In the mentioned period 20 labours ended with PH (incidence 1/3124 labours. 17 patients were multiparas, PH was done after caesarean section in 9 cases. The most common indication was rupture of the uterus (6 cases, followed by inflammation of the uterus (5 cases and atony (4 cases. Among conservative methods, application of 15-metil PGF2alpha and oxytocin were most commonly used, the next two were manual exploration of uterine cavity and uterine packing. None of conservative surgical methods were used. Histological and operative diagnosis matched in 16 cases. There were no maternal and neonatal deaths.Conclusions: The incidence of PH in the Ljubljana Maternity Hospital is low. The leading two causes are uterine rupture and inflammation of uterus. None of conservative surgical methods were used. There are good possibilities for embolization of uterine vessels.

  8. Postpartum Depression: An Overview.

    Science.gov (United States)

    Albright, Angela

    1993-01-01

    Occurring in about 12 percent of postpartum women, postpartum depression has been focus of considerable research. Variables that have been correlated with postpartum depression range from biological causes, to lack of social support, to relationship with husband, to attributional styles, to psychodynamic explanations. There is need for more…

  9. The effect of estrus synchronization treatments on somatic cell count of transitional-anestrus Awassi ewes' milk.

    Science.gov (United States)

    Talafha, A Q; Lafi, S Q; Ababneh, M M

    2009-02-01

    Fifty-three transitional-anestrus Awassi ewes, randomly assigned to three groups: fluorogestone acetate (FGA, n = 18), FGA-Prostaglandin (FGA-PGF, n = 18) and control (n = 17), were used to examine the effect of estrus synchronization protocols and steroid hormones concentrations on milk somatic cell count (SCC). Intravaginal FGA sponge was inserted for 13 days and 600 IU equine chorionic gonadotropin was administered for ewes of FGA and FGA-PGF groups at the time of sponge removal (day 0). In addition, 10 mg was administered to ewes of FGA-PGF group on day 0. Blood and milk samples were collected from all ewes on days -13, -6, 0, 1, 2, 7 and 14. Estradiol had significant positive correlation with the SCC during the periods of sponge insertion (P = 0.015, r = 0.235) and within two days (P = 0.063 r = 0.23) after sponge removal with no correlation with SCC of both udder halves during the luteal phase. Progesterone concentrations, on the other hand, had a significant positive correlation (P progesterone on days 7 and 14 to pre-synchronization values. In conclusion, sheep milk SCC is affected significantly with induction of estrus and steroid hormones concentrations. However, peak SCC recorded during estrus was far below the upper limit of the current standard for normal milk. With the current standards for SCC of 1,000,000/ml as legal limit for abnormal milk control programs in sheep, estrus synchronization programs and the estrus status should not be considered when bulk-tank milk SCC is being investigated, but should be considered during the process of setting new standards.

  10. Effect of Doublesynch and Estradoublesynch protocols on estrus induction, conception rate, plasma progesterone, protein, and cholesterol profile in anestrus Gir heifers

    Directory of Open Access Journals (Sweden)

    N. J. Chaudhary

    2018-04-01

    Full Text Available Aim: This study aimed to evaluate the efficacy of Doublesynch and Estradoublesynch protocols on estrus induction, conception rates, plasma progesterone, protein, and cholesterol profile in anestrus Gir heifers. Materials and Methods: In this study, 50 pubertal anestrus Gir heifers were selected from the field and farm conditions. The heifers were dewormed (injection ivermectin, 100 mg, s/c and supplemented with minerals and vitamins (injection organic phosphorus 800 mg and injection Vitamin AD3E and Biotin 10 ml i/m and multi-mineral bolus at 1 bolus daily for 7 days. The heifers were randomly divided into three groups: Doublesynch (n=20, Estradoublesynch (n=20, and control (n=10. The animals were monitored for estrus response, estrus interval, behavioral signs, and conception rates after induced/first, second, and third cycle post-treatment. Blood samples were obtained on day 0, day 9, day 12, and on day 12 post-artificial insemination (AI for determination of plasma progesterone, protein, and cholesterol profile. Results: The estrus response rate between Doublesynch and Estradoublesynch protocols was similar between treated heifers (85% and 95%. The interval from the second prostaglandin F2α (PGF2α injection to estrus induction did not differ between the groups (63.87±4.19 vs. 58.27±3.83 h. The conception rates following induced estrus (20% vs. 30%, at the second cycle (23.07% vs. 16.66%, at the third cycle (22.22% vs. 30.00%, and the overall conception rate (45% and 55% within 27.89±5.75 and 26.45±5.48 days were the same across the treatment groups. The mean plasma progesterone concentrations were significantly (p<0.01 higher on day 9 (second PGF2α injection and day 12 post-AI compared to day 0 (first PGF2α injection and the day of fixed-timed artificial insemination. The concentrations were also significantly (p<0.05 higher in conceived than non-conceived heifers on day 9 of treatment and day 12 post-AI in both the protocols. The

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

    Science.gov (United States)

    Chaidate, Inchaisri; Somchai, Chanpongsang; Jos, Noordhuizen; Henk, Hogeveen

    2014-09-01

    Subacute ruminal acidosis in dairy cows occurs when ruminal pH is below about 5.5. However, the exact threshold level of ruminal pH affecting cow health is still in debate. This investigation was carried out in 505 cows within 31 farms. The postpartum disorders, including dystocia, retained placenta, anestrus, cystic ovary, metritis, clinical mastitis and lameness, were analyzed. Ruminal pH, serum beta-hydroxy butyrate (SBHB), serum urea nitrogen and body condition score (BCS) were measured once during the 3 to 6 weeks postpartum, while BCS was determined once more at 1 week before calving. Ruminal pH was determined by ruminocentesis technique. The ruminal pH was evaluated to study the association with BCS, SBHB and postpartum disorders using linear regression in a generalized linear mixed model with farm as a random effect. The results show that low ruminal pH was associated with dystocia, metritis and lameness. Moreover, a low ruminal pH can be found in cows with a high loss of BCS after calving and also in cows with low SBHB postpartum. These findings confirmed the feasibility of the ruminocentesis technique and the association of low ruminal pH on various postpartum disorders at the individual cow level. However, the consequences of low ruminal pH on dairy cow health still needs more exploration for a better understanding of the physiological mechanisms. © 2014 Japanese Society of Animal Science.

  12. Therapeutics of postpartum depression.

    Science.gov (United States)

    Thomson, Michael; Sharma, Verinder

    2017-05-01

    Postpartum depression is a prevalent disorder affecting many women of reproductive age. Despite increasing public awareness, it is frequently underdiagnosed and undertreated leading to significant maternal morbidity and adverse child outcomes. When identified, postpartum depression is usually treated as major depressive disorder. Many studies have identified the postpartum as a period of high risk for first presentations and relapses of bipolar disorder. Areas covered: This article reviews the acute and prophylactic treatment of postpartum major depressive disorder, bipolar depression and major depressive disorder with mixed features. The safety of antidepressant and mood stabilizing medications in pregnancy and breastfeeding will also be reviewed. Expert commentary: Differentiating postpartum major depressive disorder and postpartum bipolar depression can be difficult given their clinical similarities but accurate identification is vital for initiating proper treatment. Antidepressants are the mainstay of drug treatment for postpartum major depressive disorder, yet randomized controlled trials have shown conflicting results. A paucity of evidence exists for the effectiveness of antidepressant prophylaxis in the prevention of recurrences of major depressive disorder. Mood stabilizing medications reduce the risk of postpartum bipolar depression relapse but no randomized controlled trials have examined their use in the acute or prophylactic treatment of postpartum bipolar depression.

  13. Postpartum Depression and Child Development.

    Science.gov (United States)

    Murray, Lynne, Ed.; Cooper, Peter J., Ed.

    Only recently has the research on postpartum depression dealt with the disorder's effects on child development. This book explores the impact of postpartum depression on mother-infant interaction and child development, its treatment, and postpartum psychosis. The chapters are: (1) "The Nature of Postpartum Depressive Disorders" (Michael…

  14. Review of Primary Postpartum Haemorrhage in Sagamu, Nigeria ...

    African Journals Online (AJOL)

    Out of these deliveries, 76 had primary postpartum haemorrhage (PPH), giving a prevalence of 3.1%. Uterine atony and genital tract trauma were the main causes of the primary PPH. Associated factors were prolonged second and third stages of labour, induction and augmentation of labour with oxytocin and instrumental ...

  15. [Post-partum thyroiditis].

    Science.gov (United States)

    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.

  16. Maternal Postpartum Role Collapse as a Theory of Postpartum Depression

    Science.gov (United States)

    Amankwaa, Linda Clark

    2005-01-01

    The purpose of this paper is to discuss the development of a theory of maternal postpartum role collapse. The influences of traditional role theory and symbolic interactionism are presented. The development of the maternal postpartum role collapse theory emerged from the study of postpartum depression among African-American women (Amankwaa, 2000).…

  17. Imaging of postpartum complications

    International Nuclear Information System (INIS)

    Rooholamini, S.A.; Au, A.H.; Hansen, G.C.; Kioumehr, F.; Yaghmai, I.

    1991-01-01

    The purpose of this paper is to evaluate the efficacy of various imaging modalities in the detection of postpartum complications. Nineteen cases of postpartum complications, studied radiologically, form the basis of this exhibit. Plain abdominal radiography, US, CT, and MR imaging were performed alone or in combination. The abnormalities detected included uterine rupture, intramural uterine hematoma, hematomas of the broad ligaments and the abdominal rectus muscles, ovarian vein thrombosis, HELLP syndrome, pyometrium, retained placenta and blood clots, periappendiceal abscess, superior sagittal sinus thrombosis, and cerebral edema. Representative cases will be illustrated; and the effective value of each technique will be stressed

  18. Appetitive and Consummatory Sexual Behaviors of Rams Treated with Exogenous Testosterone and Exposed to Anestrus Dorper Ewes: Efficacy of the Male Effect.

    Science.gov (United States)

    Tejada, Luz M; Meza-Herrera, Cesar A; Rivas-Muñoz, Raymundo; Rodríguez-Martínez, Rafael; Carrillo, Evaristo; Mellado, Miguel; Véliz-Deras, Francisco G

    2017-04-01

    We determine whether Dorper rams treated with testosterone in the sexual resting season trigger both appetitive and consummatory sexual behaviors and sexual and reproductive outcomes in anestrous ewes at 26° North during March-April. Dorper rams (n = 12, 2.5 years) were randomly divided prior to mating in two groups: GT (treated group; n = 6), treated with testosterone propionate (25 mg i.m. every 3 days × 3 weeks) and GC (control group; n = 6), treated with saline. Thereafter, adult anovulatory Dorper ewes (n = 61) were exposed to the GT-rams while the other group (n = 60) was exposed to the GC-rams. Ram's appetitive sexual behavior was similar (50 %) in both groups, yet the GT-rams exerted 100 % of the consummatory sexual behavior. Sexual and reproductive outcomes of the anestrus females exposed to both male groups considered two phases: 0-15 and 16-25 days from exposure to males. Involved variables were: ewes in estrus, ewes ovulating, duration of estrus, pregnant ewes, and lambed ewes. All the average variables favored those ewes exposed to GT-males: ewes in estrus: 85 versus 40 %; ewes ovulating: 80 versus 53 %; duration of estrus: 37 versus 25 h; pregnant ewes: 60 versus 31 %, and lambed ewes: 57 versus 31 %. Results confirm that adult Dorper rams treated with exogenous testosterone had improved consummatory sexual behavior and induced increased ovulation and pregnancy rates when exposed to anestrus ewes. This feasible and inexpensive testosterone-based protocol through the male effect also enhanced both sexual and reproductive outcomes in previously anestrous Dorper ewes during the natural out-of-season. Results are important to speed up reproductive performance of sheep during the natural anestrous season at this latitude, while also they embrace interesting outcomes from a comparative sexual behavior stand point.

  19. Hormones and postpartum cardiomyopathy.

    NARCIS (Netherlands)

    Clapp, C.; Thebault, S.C.; Martinez de la Escalera, G.M.

    2007-01-01

    Prolactin, a hormone fundamental for lactation, was recently shown to mediate postpartum cardiomyopathy, a life-threatening disease in late-term and lactating mothers. The detrimental effect of prolactin results from myocardial upregulation of cathepsin-D, which in turn cleaves prolactin to a 16 kDa

  20. Causes of postpartum anoestrus in cattle in the tropics

    International Nuclear Information System (INIS)

    Hansel, W.; Alila, H.W.

    1984-01-01

    Prolonged postpartum anoestrus is a major cause of economic losses in cattle in most tropical countries. The length of the period from parturition to first oestrus varies greatly in cattle in the tropics and is influenced by many factors, including endocrine events, management, nutrition, heat and humidity, genetic-environmental interactions, diseases and internal and external parasites. Results of recent research on endocrinology of the postpartum cow are particularly relevant to the problem in tropical cattle. Development of a pulsatile pattern of pituitary luteinizing hormone (LH) secretion is necessary for induction of the first postpartum oestrus, and many cows undergo a short episode of elevated plasma progesterone levels immediately before the first oestrus. Adrenal corticosteroids inhibit development of the pulsatile pattern of LH secretion. The concept is developed that elevated levels of cortisol, resulting from the stresses of heat, high humidity, malnutrition, parasites and diseases to which tropical cattle are often exposed, contribute to anoestrus. Techniques developed for oestrous cycle synchronization of cyclic cattle have been found to induce first oestrus and a fertile ovulation in a significant percentage of anoestrous lactating beef cattle. These treatments involve short-term (6-7 day) progesterone treatments, followed by single injections of prostaglandin Fsub(2α) and insemination 80 hours later. Some success has also been achieved in shortening the postpartum interval by pulsatile administration of gonadotropin-releasing hormone which, in turn, causes pulsatile release of LH, and by administering progestational compounds for short periods of time. Improved management, particularly oestrus detection and insemination at the optimum time, could contribute greatly to reducing the postpartum interval in tropical cattle. Nutritional factors that result in reduced haemoglobin levels (trace mineral deficiencies and parasite infestations) also cause

  1. Postpartum Mood Disorders: Recognizing the symptoms

    OpenAIRE

    Misri, Shaila; Burgmann, Allan J.F.

    1992-01-01

    Adjusting to the role of mother, a creative and joyous change for most women, combines with simultaneous physiological and psychological changes to develop into psychiatric problems in some women. Three common syndromes during the postpartum period are postpartum blues, postpartum depression, and postpartum psychosis. Any postpartum condition should be diagnosed rapidly to prevent short- and long-term disorders.

  2. Predictors of postpartum depression.

    Science.gov (United States)

    Katon, Wayne; Russo, Joan; Gavin, Amelia

    2014-09-01

    To examine sociodemographic factors, pregnancy-associated psychosocial stress and depression, health risk behaviors, prepregnancy medical and psychiatric illness, pregnancy-related illnesses, and birth outcomes as risk factors for post-partum depression (PPD). A prospective cohort study screened women at 4 and 8 months of pregnancy and used hierarchical logistic regression analyses to examine predictors of PPD. The study sample include 1,423 pregnant women at a university-based high risk obstetrics clinic. A score of ≥10 on the Patient Health Questionnaire-9 (PHQ-9) indicated clinically significant depressive symptoms. Compared with women without significant postpartum depressive symptoms, women with PPD were significantly younger (pdepressive symptoms (pdepression case finding for pregnant women.

  3. PSYCHOLOGICAL CORRELATES OF POSTPARTUM DEPRESSION

    Directory of Open Access Journals (Sweden)

    Anida Fazlagić

    2011-12-01

    Full Text Available Manual of Mental Disorders (DSM-IV, postpartum depression may include any nonpsychotic depressive disorder during the first four weeks of postpartum, according to research criteria during the first year after birth. The exact cause of postpartum depression is not yet known, and most researchers believe that postpartum depression is a bio-psycho-social problem. So far, the biological aspect of the disease is explained by changing the levels of estrogen and progesterone during pregnancy, and by decrease of hormone levels after birth. Psychological correlates are often associated with low selfesteem, pessimism as a personality trait, bad strategies of coping with stress, mood swings and emotional reactions. The social aspect of the disease is associated with the existential conditions of pregnant woman, support of partners and education level. This paper will include issues like hereditary causes and possible psychological factors of postpartum depression prevention. Nowadays, it is estimated that on average 15% of women, regardless of the pregnancy outcome, are suffering from postpartum depression. However, this information includes only those women who were diagnosed with postpartum depression and who themselves reported about it. Almost every woman receives basic care during pregnancy to prevent complications in the physiological level. This paper has shown possible psychological factors of postpartum depression prevention, the impact of optimism, self-esteem and coping skills.

  4. Postpartum depression in older women.

    Science.gov (United States)

    Strelow, Brittany; Fellows, Nicole; Fink, Stephanie R; OʼLaughlin, Danielle J; Radke, Gladys; Stevens, Joy; Tweedy, Johanna M

    2018-03-01

    Postpartum depression, which affects 10% to 20% of women in the United States, can significantly harm the health and quality of life for mother, child, and family. This article reviews the risk factors, pathophysiology, clinical manifestations, diagnosis, and treatment of postpartum depression with specific focus on women of advanced maternal age.

  5. Aetiology and treatment of severe postpartum haemorrhage

    DEFF Research Database (Denmark)

    Edwards, Hellen

    2017-01-01

    This thesis is comprised of three studies focusing on severe postpartum haemorrhage (PPH). PPH is a major cause of maternal morbidity and mortality worldwide. Risk factors include retained placenta, prolonged duration of the third stage of labour, previous caesarean section, and operative vaginal...... delivery. Occurrence and development of PPH are, however, unpredictable and can sometimes give rise to massive haemorrhage or even hysterectomy and maternal death. Severe haemorrhage can lead to coagulopathy causing further haemorrhage and requiring substitution with blood transfusions. The aim...... had a cardiac arrest, and a total of 128 women (52%) required a hysterectomy. Hysterectomy was associated with increased blood loss, increased number of blood transfusions, a higher fresh frozen plasma to red blood cell ratio (p=0.010), and an increased number of red blood cells before first platelet...

  6. [Postpartum thyroiditis. A review].

    Science.gov (United States)

    Hurtado-Hernández, Z; Segura-Domínguez, A

    2013-01-01

    Postpartum thyroiditis (PPT) is a transient thyroid dysfunction of autoimmune origin that can occur in the first year postpartum in women who have not been previously diagnosed with thyroid disease. It may start with clinical thyrotoxicosis followed by hypothyroidism and the subsequent recovery of thyroid function, or may just appear as isolated thyrotoxicosis or hypothyroidism. PPT recurs in high percentage of patients after subsequent pregnancies. Many women develop permanent hypothyroidism sometime during the 3 to 10 year period after an episode of PPT. It is important for family physicians to be familiar with this disease, due to its high prevalence in order to make a correct diagnosis and therapeutic intervention. Family doctors also play a crucial role in the monitoring of these patients, given the negative implications of established hypothyroidism on reproduction in the female population during their reproductive years. This article reviews the principle characteristics of PPT along with its diagnosis and treatment. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  7. Postpartum behaviour as predictor of weight change from before pregnancy to one year postpartum

    NARCIS (Netherlands)

    Althuizen, E.; Poppel, M.N.M.; Vries, de J.H.M.; Seidell, J.C.; Mechelen, van W.

    2011-01-01

    Background - Postpartum weight retention affects many women and increases the risk of becoming overweight. The research objective was to study modifiable factors contributing to weight change at one year postpartum. Methods - In this prospective cohort, postpartum behavior, such as physical

  8. Breastfeeding reduces postpartum weight retention

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Gamborg, Michael; Heitmann, Berit L

    2008-01-01

    BACKGROUND: Weight gained during pregnancy and not lost postpartum may contribute to obesity in women of childbearing age. OBJECTIVE: We aimed to determine whether breastfeeding reduces postpartum weight retention (PPWR) in a population among which full breastfeeding is common and breastfeeding...... duration is long. DESIGN: We selected women from the Danish National Birth Cohort who ever breastfed (>98%), and we conducted the interviews at 6 (n = 36 030) and 18 (n = 26 846) mo postpartum. We used regression analyses to investigate whether breastfeeding (scored to account for duration and intensity......) reduced PPWR at 6 and 18 mo after adjustment for maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG). RESULTS: GWG was positively (P postpartum. Breastfeeding was negatively associated with PPWR in all women but those...

  9. Postpartum Depression: An Interactional View.

    Science.gov (United States)

    Kraus, Mary Ann; Redman, E. Scott

    1986-01-01

    Postpartum depression is conceptualized as a predictable developmental, family crisis, which occurs when the natural difficulties of childbirth are benignly mishandled. Tactics are illustrated for interdicting maladaptive interpersonal spirals, including normalizing conflicting complaints; reframing depression as positive but costly; regulating…

  10. Postpartum management of diabetes pregnancy.

    Science.gov (United States)

    Hossain, Nazli

    2016-09-01

    Diabetes mellitus has assumed the role of an epidemic. Previously considered a disease of affluent developed countries, it has become more common in developing countries. Pakistan is included among the countries with a high prevalence of diabetes. In this scenario, postpartum management of a woman with diabetes mellitus becomes more important as in this period counseling and educating a woman is essential. Counselling includes life style modifications to prevent future risks involving all the systems of the body. This review article discusses management of diabetes mellitus in postpartum period, guidelines for postpartum screening of women with gestational diabetes mellitus, risks involved in future life and stresses upon the need of local population based studies. Primary care providers and gynaecologists must realize the importance of postpartum screening for diabetes mellitus and provide relevant information to women as well.

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

    Science.gov (United States)

    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.

  12. Immediate Postpartum Mood Assessment and Postpartum Depressive Symptoms

    Science.gov (United States)

    Miller, Michelle L.; Kroska, Emily B.; Grekin, Rebecca

    2016-01-01

    Background Negative affect (NA) and positive affect (PA) in the early postpartum period have been associated with postpartum depressive symptoms, but the exact relationship is not well understood. This study aimed to determine if NA and PA in the immediate postpartum period predicted postpartum depressive symptoms over and above well-established predictors (previous trauma, history of depression). Methods Participants were prospectively recruited from a Mother-Baby Unit at a large Midwestern academic medical center in the United States from April 2011 to April 2014. Participants (N = 526) completed the Daily Experiences Questionnaire (DEQ), a self-report measure which assessed NA and PA, within three days post-delivery. Participants then reported their depressive symptoms at two weeks (n = 364) and twelve weeks postpartum (n = 271). Results Hierarchical regression analyses indicated that low PA and high NA after birth significantly predicted depressive symptoms early (at 2 weeks) and later (at 12 weeks) in the postpartum period, over and above previous traumatic experiences and history of depression. Limitations The sample was relatively homogenous, and data were from self-report instruments. Conclusions The current study found NA and PA in the days immediately after birth predicted depressive symptoms at multiple time points in the postpartum period. Because the perinatal period places women at a higher risk for depressive symptomatology, prevention and early intervention are critical. Measuring affect in hospitals immediately after birth may provide a more normalized set of items that is predictive of later depression, which will allow physicians to identify those at highest risk for developing depressive symptoms. PMID:27716540

  13. Immediate postpartum mood assessment and postpartum depressive symptoms.

    Science.gov (United States)

    Miller, Michelle L; Kroska, Emily B; Grekin, Rebecca

    2017-01-01

    Negative affect (NA) and positive affect (PA) in the early postpartum period have been associated with postpartum depressive symptoms, but the exact relationship is not well understood. This study aimed to determine if NA and PA in the immediate postpartum period predicted postpartum depressive symptoms over and above well-established predictors (previous trauma, history of depression). Participants were prospectively recruited from a Mother-Baby Unit at a large Midwestern academic medical center in the United States from April 2011 to April 2014. Participants (N=526) completed the Daily Experiences Questionnaire (DEQ), a self-report measure which assessed NA and PA, within three days post-delivery. Participants then reported their depressive symptoms at two weeks (n=364) and twelve weeks postpartum (n=271). Hierarchical regression analyses indicated that low PA and high NA after birth significantly predicted depressive symptoms early (at 2 weeks) and later (at 12 weeks) in the postpartum period, over and above previous traumatic experiences and history of depression. The sample was relatively homogenous, and data were from self-report instruments. The current study found NA and PA in the days immediately after birth predicted depressive symptoms at multiple time points in the postpartum period. Because the perinatal period places women at a higher risk for depressive symptomatology, prevention and early intervention are critical. Measuring affect in hospitals immediately after birth may provide a more normalized set of items that is predictive of later depression, which will allow physicians to identify those at highest risk for developing depressive symptoms. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Exhaustion from prolonged gambling

    Directory of Open Access Journals (Sweden)

    Fatimah Lateef

    2013-01-01

    Full Text Available Complaints of fatigue and physical exhaustion are frequently seen in the acute medical setting, especially amongst athletes, army recruits and persons involved in strenuous and exertional physical activities. Stress-induced exhaustion, on the other hand, is less often seen, but can present with very similar symptoms to physical exhaustion. Recently, three patients were seen at the Department of Emergency Medicine, presenting with exhaustion from prolonged involvement in gambling activities. The cases serve to highlight some of the physical consequences of prolonged gambling.

  15. Tips for Postpartum Dads and Partners

    Science.gov (United States)

    ... Blues: Partners Interview with Wade Bowen Coping with Suicide & Loss Tips for Postpartum Dads and Partners Pregnancy and postpartum mood and anxiety disorders affect the whole family. Here are some tips ...

  16. Depression in pregnancy and postpartum period.

    Science.gov (United States)

    Sood, Mamta; Sood, A K

    2003-01-01

    This prospective study was carried out in a service hospital, with the aim to study the prevalence and incidence of depression in pregnancy and postpartum period. Eighty Four consecutive patients attending the antenatal outpatient in the Obstetrics & Gynaecology department in their last trimester of pregnancy were recruited for the study. They were assessed on Beck Depression Inventory thrice viz. during third trimester of pregnancy, within 3 days of delivery (early postpartum period) & within 4-8 weeks of delivery (late postpartum period).The prevalence of depression was 8.3%, 20% and 12.8% respectively at three ratings. The incidence was 16% and 10% in the early & late postpartum period respectively. Further analysis revealed that depression in pregnancy correlated significantly with depression in early postpartum period, but not with late postpartum period. Depression in early postpartum period correlated with depression in late postpartum period.These findings have implications for early detection and care of women at risk for developing depression.

  17. Postpartum Depression After Mild and Severe Preeclampsia

    NARCIS (Netherlands)

    Hoedjes, Meeke; Berks, Durk; Vogel, Ineke; Franx, Arie; Bangma, Meike; Darlington, Anne-Sophie E.; Visser, Willy; Duvekot, Johannes J.; Habbema, J. Dik F.; Steegers, Eric A. P.; Raat, Hein

    2011-01-01

    Objective: To describe the prevalence of postpartum depressive symptoms after preeclampsia, to assess the extent to which the prevalence of postpartum depressive symptoms differs after mild and severe preeclampsia, and to investigate which factors contribute to such differences. Methods: Women

  18. Maternal postpartum distress and childhood overweight

    DEFF Research Database (Denmark)

    Adeltoft, Teresa Ajslev; Andersen, Camilla S; Ingstrup, Katja Glejsted

    2010-01-01

    We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight.......We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight....

  19. [Pathophysiology of prolonged hypokinesia].

    Science.gov (United States)

    Kovalenko, E A

    1976-01-01

    Hypokinesia is an important problem in modern medicine. In the pathogenetic effect of prolonged hypokinesia the main etiological factor is diminished motor activity; of major importance are disorders in the energy and plastic metabolism which affect the muscle system; the contributing factors are cardiovascular deconditioning and orthostatic intolerance. This is attributed to a decreased oxygen supply and eliminated hydrostatic influences during a prolonged recumbency. Blood redistribution in the vascular bed is related to the Gauer-Henry reflex and subsequent changes in the fluid-electrolyte balance. Decreased load on the bone system induces changes in the protein-phosphate-calcium metabolism, diminished bone density and increased calcium content in the blood and urine. Changes in the calcium metabolism are systemic. The activity of the higher nervous system and reflex functions is lowered. Changes in the function of the autonomic nervous system which include a noticeable decline of its adaptive-trophic role as a result of the decrease of afferent and efferent impulsation are of great importance. Changes in the hormonal function involve a peculiar stress-reaction which develops at an early stage of hypokinesia as a response to an unusual situation. Prolonged hypokinesia may result in a disturbed function of the pituitary-adrenal system. It is assumed that prolonged hypokinesia may induce a specific disease of hypokinesia during which man cannot lead a normal mode of life and work.

  20. Counseling postpartum women about contraception.

    Science.gov (United States)

    Kennedy, K

    1992-10-01

    Only 5 studies have examines resumption of intercourse after childbirth and coital frequency. These studies conducted in Chile, England, the Philippines, Scotland, and Thailand found that 4 to almost 8 weeks is the average duration between childbirth and resumption of intercourse. Yet, they also showed sizable variation in this duration. In Thailand, the first postpartum intercourse occurred between 3 and 21 weeks. Further, during this study, one mother had not yet resumed intercourse. A study in metropolitan Cebu, in the Philippines, included 3080 women. The mean intercourse resumption interval was 4-6 weeks, yet at 2 years 80 women still had not had postpartum intercourse. This study found 10 factors predicting resumption of intercourse: husband present, not breast feeding, resumption of menstruation, young age, some education, children younger than 7 years old, uncrowded home, nuclear family, urba residence, and trained health worker delivering baby. Mean coital frequency among the Thai women was once per week, but this does not indicate typical frequency. In fact, one woman averaged intercourse 3 times/week, while another had her first postpartum intercourse 6 weeks after delivery and not gain until 8 weeks later. Family planning counselors can use coital frequency studies to guide them when advising postpartum women. For example, a women who does not have intercourse frequently and is at 6-12 months postpartum could use the lactational amenorrhea method and condoms. More frequent intercourse and resumption of menstruation requires a more reliable family planning method. A 1988 study found that for the first 6 months postpartum women who breast feed have a lower coital frequency, longer delay before intercourse resumption, reduced sexual interest and enjoyment, more pain during intercourse, and are somewhat more depressed than those who bottle feed.

  1. Microbiological diagnosis of postpartum endometritis

    Directory of Open Access Journals (Sweden)

    N. A. Korobkov

    2013-01-01

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

  2. The relationship between serum adiponectin and postpartum luteal activity in high-producing dairy cows.

    Science.gov (United States)

    Kafi, Mojtaba; Tamadon, Amin; Saeb, Mehdi

    2015-05-01

    The aims of the present study were to initially determine the pattern of serum adiponectin concentrations during a normal estrous cycle in high-producing postpartum dairy cows and then evaluate the relationship between the serum concentrations of adiponectin and insulin with the commencement of postpartum luteal activity and ovarian activities in clinically healthy high-producing Holstein dairy cows. During a normal estrous cycle of cows (n = 6), serum adiponectin concentrations gradually decreased (P Cows with higher peak of milk yield had lower serum adiponectin concentrations by week 7 postpartum (P = 0.01). Serum adiponectin and insulin concentrations in cows with different postpartum luteal activity (based on the progesterone profile) were evaluated using the following class of cows: normal (≤45 days, n = 11) and delayed (>45 days, n = 11) commencement of luteal activity (C-LA) and four different profiles of normal luteal activity (NLA, n = 5), prolonged luteal phase (n = 6), delayed first ovulation (n = 6), and anovulation (AOV, n = 5). Serum adiponectin concentrations decreased gradually by week 3 postpartum in NLA and then increased; whereas in AOV and delayed first ovulation, they were decreased after week 3 postpartum (P cows was more than that of NLA cows. Insulin concentrations were almost maintained at a stable level in NLA cows (P > 0.05), whereas they increased in the other groups (P cows with C-LA greater than 45 days decreased more than those with C-LA 45 days or less after week 3 postpartum (P = 0.002). Serum adiponectin concentrations at week 7 postpartum were lower in delayed C-LA (P = 0.01). Milk yield in cows with C-LA greater than 45 days increased more than cows with C-LA 45 days or less postpartum (P = 0.002). Insulin concentrations increased relatively in parallel from weeks 1 to 7 postpartum in cows either with C-LA greater than 45 or with C-LA 45 days or less. We showed for the first time the profile of serum adiponectin concentrations

  3. Reducing postpartum hemorrhage in Africa

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Lalonde, A

    2005-01-01

    Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in sub-Saharan Africa. This is being addressed by leading professional organizations, which point to the importance of a skilled attendant at birth. But they also emphasize that the active management of the third stage of labor...

  4. Adolescent Motherhood and Postpartum Depression

    Science.gov (United States)

    Birkeland, Robyn; Thompson, J. Kevin; Phares, Vicky

    2005-01-01

    Adolescent mothers undergo unique personal and social challenges that may contribute to postpartum functioning. In this exploratory investigation completed within a risk and resilience framework, 149 adolescent mothers, ages 15 to 19, who participated in school-based teen parents' programs, completed measures of parental stress (social isolation…

  5. Management of prolonged pregnancy

    International Nuclear Information System (INIS)

    Iqbal, S.

    2004-01-01

    Objective: To compare two strategies for management of prolonged pregnancy (= or >294 days) i.e. induction (intervention) versus expectant management (non-intervention) and evaluate the associated feto-maternal risks. Subjects and Methods: One hundred cases of uncomplicated prolonged gestation were selected. The gestational age was confirmed by ultrasound in first trimester. One group (50 patients) was managed by intervention i.e. induction of labour (group A) and other group (50 patients) by non-intervention i.e. expectant management (group B). In group A intervention was done at 42 weeks. In expectant group, the methods of monitoring were fetal kick charting recorded daily by the patient, and ultrasound for amniotic fluid index. The biophysical profile score and NST (non stress test) were performed once a week till 42 weeks and then twice weekly. Results: The frequency of prolonged pregnancy was found to be 10.9%. There was no significant difference in the number of spontaneous vaginal deliveries between the two groups. The rate of LSCS (lower segment caesarean section) was higher in intervention group ( 30% versus 18% ). The neonatal depression at birth was more in group B ( 10% versus 4%) and at 5 minutes almost same between two groups (4% versus 2%). There were 11 cases of meconium aspiration syndrome, leading to one neonatal death. Among nine perinatal deaths two were neonatal deaths. Seven cases of intrauterine deaths in which antepartum deaths occurred because of non compliance of patients. No cause could be detected for the other three fetuses. Conclusion: There was increased LSCS rate in group A. However in expectant group B perinatal mortality was about twice more as compared to intervention group. Active early intervention at 42 weeks is warranted to reduce perinatal morbidity and mortality. (author)

  6. Pengobatan Perilaku Kognitif untuk Depresi Postpartum

    Directory of Open Access Journals (Sweden)

    Bina Melvia Girsang

    2013-08-01

    Full Text Available Sebagian besar wanita mengalami gangguan emosional setelah melahirkan seperti depresi, mudah marah, terutama mudah frustasi serta emosional. Gangguan mood selama periode postpartum paling sering terjadi pada wanita primipara dan multipara. Penelitian ini bertujuan menilai pengaruh penerapan pengobatan perilaku kognitif (cognitive behavior therapy untuk mengatasi depresi postpartum di ruang kebidanan Rumah Sakit Bhayangkara Palembang. Penelitian ini menggunakan desain studi kuasi eksperimen dengan non equivalent control group. Sampel yang diambil dengan metode purposive sampling berjumlah 30 ibu postpartum yang terdiri dari 15 orang kelompok perlakuan dan 15 orang kelompok kontrol. Penelitian ini menemukan rata-rata perbedaan depresi pada ibu postpartum yang diintervensi dengan ibu postpartum yang tidak diintervensi adalah 0,15, standar deviasi adalah 0,724, dan pada nilai t sebesar 3,56, dan nilai p = 0,003. Ada perbedaan depresi postpartum pada ibu yang dilakukan intervensi terapi pengobatan perilaku kognitif dan yang tidak. Temuan ini memerlukan penerapan penyuluhan kesehatan khususnya melalui terapi cognitive behavior dengan memberikan informasi tentang pencegahan depresi postpartum pada saat pemeriksaan kehamilan trimester I, II, dan III dan setelah tiga hari melahirkan untuk mencegah dan mengatasi depresi postpartum. In general, most women experience postpartum emotional disturbances, depression, irritable, easily frustrated and emotional especially. Mood disorders during the postpartum period is one of the most common disorders in both primiparous and multiparous women. This study aimed to analyze the effect of the application of cognitive behavioral intervention therapy (CBT in overcoming postpartum depression in Space Obstetrics Hospital Bhayangkara, Palembang. This study was conducted with a quasi experiment (quasi-experimental, using the draft non equivalent control group. The sample study of postpartum mothers 30 respectively 15

  7. Depression During Pregnancy and Postpartum.

    Science.gov (United States)

    Becker, Madeleine; Weinberger, Tal; Chandy, Ann; Schmukler, Sarah

    2016-03-01

    Depression is a common complication of pregnancy and the postpartum period. There are multiple risk factors for peripartum mood disorders, most important of which is a prior history of depression. Both depression and antidepressant medications confer risk upon the infant. Maternal depression has been associated with preterm birth, low birth weight, fetal growth restriction, and postnatal cognitive and emotional complications. Antidepressant exposure has been associated with preterm birth, reductions in birth weight, persistent pulmonary hypertension, and postnatal adaptation syndrome (PNAS) as well as a possible connection with autism spectrum disorder. Paroxetine has been associated with cardiac malformations. Most antidepressant medications are excreted in low levels in breast milk and are generally compatible with breastfeeding. The use of antidepressants during pregnancy and postpartum must be weighed against the risk of untreated depression in the mother.

  8. The comparison of postpartum with non-postpartum depression: a rose by any other name.

    OpenAIRE

    Whiffen, V E

    1991-01-01

    A strong tradition exists in the psychiatric literature to consider postpartum depression a distinct diagnosis. However, the empirical evidence indicates that, in terms of etiology and relapse rates, postpartum depression is indistinguishable from non-postpartum depression. Symptomatically, postpartum depression seems to involve a milder disturbance, suggesting that it is best seen as an adjustment disorder. This paper summarizes the empirical evidence relevant to the distinct diagnosis quest...

  9. Heterogeneity of postpartum depression: a latent class analysis

    NARCIS (Netherlands)

    Putnam, K.; Robertson-Blackmore, E.; Sharkey, K.; Payne, J.; Bergink, V.; Munk-Olsen, T.; Deligiannidis, K.; Altemus, M.; Newport, J.; Apter, G.; Devouche, E.; Vikorin, A.; Magnusson, P.; Lichtenstein, P.; Penninx, B.W.J.H.; Buist, A.; Bilszta, J.; O'Hara, M.; Stuart, S.; Brock, R.; Roza, S.; Tiemeier, H.; Guille, C.; Epperson, C.N.; Kim, D.; Schmidt, P.; Martinez, P.; Wisner, K.L.; Stowe, Z.; Jones, I.; Rubinow, D.; Sullivan, P.; Meltzer-Brody, S.

    2015-01-01

    Background: Maternal depression in the postpartum period confers substantial morbidity and mortality, but the definition of postpartum depression remains controversial. We investigated the heterogeneity of symptoms with the aim of identifying clinical subtypes of postpartum depression. Methods: Data

  10. Relationship Between Postpartum Depression and Psychological and Biological Variables in the Initial Postpartum Period.

    Science.gov (United States)

    Marín-Morales, Dolores; Toro-Molina, Susana; Peñacoba-Puente, Cecilia; Losa-Iglesias, Marta; Carmona-Monge, Francisco Javier

    2018-06-01

    Objectives The aims of this study were to evaluate the predictive relationship between psychological symptomatology 24 h postpartum and depression 4 months postpartum, and analyze the relationship between estradiol and postpartum mood. Methods Two hundred women participated in an assessment 24 h postpartum and gave a blood sample for estradiol analysis. One hundred eleven of these women completed the second assessment 4 months postpartum. The Beck Depression Inventory II and the Scale of State-Trait Anxiety were used to assess psychological symptoms. Results At 24 h postpartum, symptoms of depression, trait anxiety, and state anxiety were all significantly correlated with each other. Depression at 24 h postpartum was the only significant independent predictor of depression at 4 months postpartum, explaining 28.7% of the variance. No statistically significant relationship was found between levels of estradiol and mood. Symptoms of depression immediately postpartum thus appear to be a predictor of postpartum depression. Conclusions for Practice These results suggest that early postpartum psychological evaluation of the mother, and intervention as warranted, might prevent or lessen postpartum depression.

  11. Obstetric Emergencies: Shoulder Dystocia and Postpartum Hemorrhage.

    Science.gov (United States)

    Dahlke, Joshua D; Bhalwal, Asha; Chauhan, Suneet P

    2017-06-01

    Shoulder dystocia and postpartum hemorrhage represent two of the most common emergencies faced in obstetric clinical practice, both requiring prompt recognition and management to avoid significant morbidity or mortality. Shoulder dystocia is an uncommon, unpredictable, and unpreventable obstetric emergency and can be managed with appropriate intervention. Postpartum hemorrhage occurs more commonly and carries significant risk of maternal morbidity. Institutional protocols and algorithms for the prevention and management of shoulder dystocia and postpartum hemorrhage have become mainstays for clinicians. The goal of this review is to summarize the diagnosis, incidence, risk factors, and management of shoulder dystocia and postpartum hemorrhage. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Inside a Postpartum Nursing Center: Tradition and Change

    Directory of Open Access Journals (Sweden)

    Yueh-Chen Yeh, RN, MSN, PhD

    2016-06-01

    Conclusions: Social changes have an influence on traditional postpartum ritual practices so a postpartum nursing center becomes a choice for postpartum women. Thus, health care professionals should value their own functions and roles at the postpartum nursing center since the new mothers regard them as the primary support resource to help them recover from giving birth. Therefore, they need to re-examine their practices from the postpartum women's perspective to provide better support and sensitive care to postpartum women and their families.

  13. Traditional Postpartum Practices Among Malaysian Mothers: A Review.

    Science.gov (United States)

    Fadzil, Fariza; Shamsuddin, Khadijah; Wan Puteh, Sharifa Ezat

    2016-07-01

    To briefly describe the postpartum practices among the three major ethnic groups in Malaysia and to identify commonalities in their traditional postpartum beliefs and practices. This narrative review collated information on traditional postpartum practices among Malaysian mothers through a literature search for published research papers on traditional postpartum practices in Malaysia. This review shows that Malaysian mothers have certain postpartum practices that they considered to be important for preventing future ill health. Despite the perceived differences in intra-ethnic postpartum practices, most Malaysian mothers, although from different ethnicities, share similarities in their postpartum regimens and practices in terms of beliefs and adherence to food taboos, use of traditional postpartum massage and traditional herbs, and acknowledgment of the role of older female family members in postpartum care. Health care providers should be aware of multiethnic traditional postpartum practices and use the commonalities in these practices as part of their postpartum care regimen.

  14. Measurement of illumination exposure in postpartum women

    Directory of Open Access Journals (Sweden)

    Stein Martin T

    2003-05-01

    Full Text Available Abstract Background Low levels of light exposure at critical times are thought to cause seasonal affective disorder. Investigators, in studies demonstrating the usefulness of bright light therapy, also have implicated light's role in non-seasonal depression. The precise cause of postpartum depression has not been delineated, but it seemed possible that new mothers would spend reduced time in daylight. The goal of this study was to examine the levels of illumination experienced by postpartum mothers and to discover any relationship between light exposure and mood levels experienced during the postpartum period. Methods Fifteen postpartum women, who did not have any baseline indication of depression, wore a wrist device (Actillume for 72 hours to measure their exposure to light. At the end of the recording period, they completed a self-reported measure of mood. The mean light exposure of these postpartum women (expressed as the 24-hour average logarithm of illumination in lux was compared with that of a representative sample of women of comparable age, residence, and seasonal months of recording. Mood levels were then rank-ordered and tested for correlation with light exposure levels. Results There was no significant difference between the amount of light [log10lux] experienced by postpartum (1.01 SD 0.236 and control women (1.06 SD 0.285. Mood was not correlated with illumination in the postpartum sample. Conclusions Postpartum women in San Diego did not receive reduced light, nor was low mood related to low illumination.

  15. Use of Postpartum Care: Predictors and Barriers

    Directory of Open Access Journals (Sweden)

    Jessica N. DiBari

    2014-01-01

    Full Text Available This study aimed to identify actual and perceived barriers to postpartum care among a probability sample of women who gave birth in Los Angeles County, California in 2007. Survey data from the 2007 Los Angeles Mommy and Baby (LAMB study (N = 4,075 were used to identify predictors and barriers to postpartum care use. The LAMB study was a cross-sectional, population-based study that examined maternal and child health outcomes during the preconception, prenatal, and postpartum periods. Multivariable analyses identified low income, being separated/divorced and never married, trying hard to get pregnant or trying to prevent pregnancy, Medi-Cal insurance holders, and lack of prenatal care to be risk factors of postpartum care nonuse, while Hispanic ethnicity was protective. The most commonly reported barriers to postpartum care use were feeling fine, being too busy with the baby, having other things going on, and a lack of need. Findings from this study can inform the development of interventions targeting subgroups at risk for not obtaining postpartum care. Community education and improved access to care can further increase the acceptability of postpartum visits and contribute to improvements in women’s health. Postpartum care can serve as a gateway to engage underserved populations in the continuum of women’s health care.

  16. Sigmoid Volvulus Complicating Postpartum Period

    Directory of Open Access Journals (Sweden)

    Kelsey E. Ward

    2017-01-01

    Full Text Available Background. Sigmoid volvulus is a rare complication of pregnancy and the puerperium. Case. A 19-year-old patient, gravida 1 para 0 at 41 0/7 weeks of gestation, admitted for late-term induction of labor underwent an uncomplicated primary low transverse cesarean delivery for arrest of descent. Her postoperative period was complicated by sudden onset of abdominal pain and the ultimate diagnosis of sigmoid volvulus. Conclusion. Prompt surgical evaluation of an acute abdomen in the postpartum period is essential; delayed diagnosis and treatment can lead to significant maternal morbidity and mortality.

  17. Sheehan's Syndrome Presenting with Early Postpartum Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Shu-Yi Wang

    2005-08-01

    Full Text Available We report the case of a young woman with Sheehan's syndrome who presented with ventricular arrhythmia and congestive heart failure. The patient was admitted because of postpartum hemorrhage and hypovolemic shock; a massive blood transfusion was required to restore blood volume. After initial stabilization, the patient developed acute respiratory distress and congestive heart failure accompanied by hemodynamic instability 2 weeks after delivery. Episodes of ventricular tachycardia of the torsade de pointes type and a prolonged QT interval were noted on baseline electrocardiogram. A low cortisol level was found incidentally, which led to the suspicion of hypopituitarism. The diagnosis was later supported by laboratory findings of multiple pituitary hormone deficiencies. After administration of corticosteroids and thyroxine, the patient's clinical condition improved dramatically. A pituitary magnetic resonance imaging scan 32 days after delivery revealed a diminished and flattened pituitary gland with prominent intrasellar cerebrospinal fluid loculation, which was compatible with the clinical diagnosis of empty sella with panhypopituitarism. The syndrome of acute anterior pituitary necrosis secondary to postpartum hemorrhage and shock was first described by Sheehan in 1939. Although the occurrence of Sheehan's syndrome is now rare, it should still be considered in any woman with a history of peripartum hemorrhage who develops manifestations of pituitary hormone deficiency. Appropriate hormone replacement therapy is essential and always results in dramatic clinical improvement.

  18. Preventing urinary incontinence during pregnancy and postpartum

    DEFF Research Database (Denmark)

    Wesnes, Stian Langeland; Lose, Gunnar

    2013-01-01

    focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized...... (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations......: women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy...

  19. Best Practices in Management of Postpartum Pain.

    Science.gov (United States)

    Fahey, Jenifer O

    Pain has been documented as a major concern for women in the postpartum period. Management of postpartum pain, however, is a relatively neglected area of clinical research. As a result, evidence to support interventions to alleviate the discomforts associated with childbirth is sparse. This paucity of research on postpartum pain management is particularly surprising given that in the United States alone nearly 4 million women give birth each year. Inadequate pain relief in the hours to months following childbirth can interfere with maternal-newborn bonding and feeding and, by impeding mobility, can increase the risk of postpartum complications. In addition, pain that is not adequately managed may increase the risk of chronic pain that lasts beyond the postpartum period. In this article, the more common causes of pain following childbirth are reviewed and recommendations for pain management based on available evidence are outlined. Considerations for pain management in lactating women and for hospital discharge are discussed.

  20. Thoughts on the Postpartum Situation

    Directory of Open Access Journals (Sweden)

    Jennifer Scuro

    2018-06-01

    Full Text Available The event of childbirth carries with it a dominant narrative: that a pregnant woman happily gives birth to a baby. This appears to be quite a simple formulation—as if a natural fact, as if plain and common sense. Yet, the complexities masked by the mythological and whitewashed quality of this narrative, as I have already argued recently in The Pregnancy ≠ Childbearing Project: A Phenomenology of Miscarriage (Feb 2017, harms and even kills women. In this paper, I expand on the problem of what I term “dismemberment after birth” as it operates invisibly in the “postpartum situation.” The dominant narrative, combined with a pervasive cultural misogynoir— manifesting specifically as an antagonism toward black women and women of color—as medicalized and ableist establishment of care, renders women without resource if they cannot maintain the desires and embodiments required of a contented and successful maternity. The naturalized assumptions about the narrative move from the birth event to “having a baby” are disrupted here with hope of opening up an opportunity to validate and diversify the more non-linear narratives. As an afterthought to these disruptions, I offer an additional challenge to anti-natalist thinking in its limited insight into the postpartum situation.

  1. Bangladesh women report postpartum health problems.

    Science.gov (United States)

    Goodburn, L

    1994-02-01

    The Bangladesh Rural Advancement Committee conducted operational research in Bangladesh to examine postpartum health problems. Researchers conducted focus groups, indepth interviews, and observation. More than 40% of the postpartum women had a delivery-related health problem by 2 weeks after delivery. 52% had signs or symptoms of anemia. Body needs after pregnancy, lactation, and blood loss during delivery exacerbate the nutritional anemia common to Bangladeshi women. 17% of the postpartum women had signs of infections. More than 50% had severe malnutrition, worsened by food taboos during the postpartum period. 60% of infant deaths occur in the neonatal period. The mortality risk is elevated in low birth weight (LBW) infants. In this study, more than 50% of the newborns were LBW infants. Many Bangladeshi mothers discard the colostrum and begin breast feeding several days after delivery. 11% of the postpartum women had breast problem (e.g., cracked nipples). Women believed that susceptibility to evil spirits accounted for their being more vulnerable to health problems during the postpartum. They feared leaving the household. These findings show a need for home visits to provide valuable postpartum care.

  2. Postpartum Depression Among Asian Indian Mothers.

    Science.gov (United States)

    Goyal, Deepika; Park, Van Ta; McNiesh, Susan

    2015-01-01

    To explore Asian Indian mothers' perspectives of postpartum depression (PPD) and mental health help-seeking behavior. Qualitative exploratory design. Using convenience sampling, postpartum mothers were recruited through flyers posted in public places and on social media sites. Postpartum depression risk was assessed with the Edinburgh Postnatal Depression Scale (EPDS) prior to qualitative interviews. Content analysis methods were used to extract themes from participant narratives. Twelve self-identified, married, Asian Indian mothers, aged between 29 and 40 years, living in Northern California, who gave birth to a healthy infant within the last 12 months, took part in this study. Scores on the EPDS indicated two participants were at an increased risk for developing PPD. Content analysis revealed two emerging themes: (1) Culture-specific postpartum practices and ceremonies and their role in maternal-infant postpartum recovery; and (2) Maternal mental health help-seeking behavior. Nurses taking care of women during the extended prenatal and postpartum period have the unique opportunity to build rapport with their patients which can offer a window of opportunity to educate and help dispel myths about PPD symptoms and treatment. To promote successful maternal-infant outcomes, PPD education should be initiated at the first prenatal appointment, continue during the pregnancy, and be incorporated into well-baby visits through the first postpartum year. Education should include signs and symptoms of PPD as well as importance of timely mental-health help-seeking.

  3. Massive postpartum right renal hemorrhage.

    Science.gov (United States)

    Kiracofe, H L; Peterson, N

    1975-06-01

    All reported cases of massive postpartum right renal hemorrhage have involved healthy young primigravidas and blacks have predominated (4 of 7 women). Coagulopathies and underlying renal disease have been absent. Hematuria was painless in 5 of 8 cases. Hemorrhage began within 24 hours in 1 case, within 48 hours in 4 cases and 4 days post partum in 3 cases. Our first case is the only report in which hemorrhage has occurred in a primipara. Failure of closure or reopening of pyelovenous channels is suggested as the pathogenesis. The hemorrhage has been self-limiting, requiring no more than 1,500 cc whole blood replacement. Bleeding should stop spontaneously, and rapid renal pelvic clot lysis should follow with maintenance of adequate urine output and Foley catheter bladder decompression. To date surgical intervention has not been necessary.

  4. Physiotherapy in the postpartum problems

    Directory of Open Access Journals (Sweden)

    Witold Słomko

    2017-04-01

    Full Text Available Female after childbirth recovering at different rates, in theory, it is assumed that the confinement takes from 6 to 8 weeks. At this time maternal should return of the condition before pregnancy and childbirth. Sometimes that the return to full fitness is difficult, because of the problems typical for the postpartum. This article presents physiotherapeutic methods are effective in treating: diastasis of the rectus muscle of abdomen, stretch marks, difficult  healing scars after a cesarean section, lactating problems, incontinence. Appropriate treatment results prevention of these symptoms, although if they appear, it helps to fight them down. Kinesitherapy and physical therapy are used in the treatment. Also can be used massage and kinesiotaping.

  5. Prolongation of islet allograft survival

    International Nuclear Information System (INIS)

    Lacy, P.E.; Davie, J.M.; Finke, E.H.; Scharp, D.W.

    1979-01-01

    Pretreatment of donor rats with irradiation and silica followed by in vitro culture of the islets for 1 to 2 days prolonged survival of allografts across a minor histocompatibility barrier if hand-picked, clean islets were used for transplantation. Pretreatment of donor rats with irradiation and silica in conjunction with a single injection of antilymphocyte serum (ALS) into the recipient produced a prolongation of survival of hand-picked islets transplanted across a major histocompatibility barrier

  6. Genetic influence on prolonged gestation

    DEFF Research Database (Denmark)

    Laursen, Maja; Bille, Camilla; Olesen, Annette Wind

    2004-01-01

    OBJECTIVE: The purpose of this study was to test a possible genetic component to prolonged gestation. STUDY DESIGN: The gestational duration of single, first pregnancies by both female and male twins was obtained by linking the Danish Twin Registry, The Danish Civil Registration System, and the D...... factors. CONCLUSION: Maternal genes influence prolonged gestation. However, a substantial paternal genetic influence through the fetus was not found....

  7. Changes in bone mineral density and body composition during pregnancy and postpartum. A controlled cohort study

    DEFF Research Database (Denmark)

    Liendgaard, Ulla Kristine Møller; við Streym, Susanna; Mosekilde, Leif

    2012-01-01

    In a controlled cohort study, bone mineral density (BMD) was measured in 153 women pre-pregnancy; during pregnancy; and 0.5, 4, 9, and 19 months postpartum. Seventy-five age-matched controls, without pregnancy plans, were followed in parallel. Pregnancy and breastfeeding cause a reversible bone...... in fat mass differed according to breastfeeding status with a slower decline in women who continued breastfeeding. Calcium and vitamin D intake was not associated with BMD changes. CONCLUSION: Pregnancy and breastfeeding cause a reversible bone loss. At 19 months postpartum, BMD has returned to pre-pregnancy...... loss, which, initially, is most pronounced at trabecular sites but also involves cortical sites during prolonged breastfeeding. INTRODUCTION: Conflicting results have been reported on effects of pregnancy and breastfeeding on BMD and body composition (BC). In a controlled cohort study, we elucidate...

  8. Breastfeeding, retinoids, and postpartum depression: a new theory.

    Science.gov (United States)

    Mawson, Anthony R; Xueyuan, Wang

    2013-09-25

    Postpartum depression (PPD) is an international public health problem affecting at least 1 in 8 mothers. Known risk factors include: giving birth to a preterm or low birth weight infant, babies with greater symptoms of illness at age 4-6 weeks, formula feeding, younger maternal age, smoking, and fatigue. Prolonged breastfeeding is associated with a reduced risk of PPD but the mechanisms are not well understood. Interventions for PPD focusing on psychosocial risk factors have been largely unsuccessful, suggesting that the condition has a mainly biological basis. The hypothesis proposed for consideration is that breastfeeding protects against PPD by maintaining endogenous retinoids (vitamin A-related compounds) below a threshold concentration. In fact, breast milk is rich in retinoids; pregnant women accumulate retinoids in liver and breast in preparation for lactation; there is increasing evidence that retinoids in higher concentration are associated with cognitive disturbances and mood disorders, including depression and suicide; and prolonged lactation reduces maternal stores of retinoids. Consistent with this hypothesis, it is estimated that an amount of vitamin A is transferred from mother to infant during the first six months of exclusive breastfeeding equivalent to 76% of a dose known to cause acute vitamin A poisoning in an adult. Breastfeeding may thus have evolutionary-adaptive functions for both mother and infant, transferring vital nutrients to an infant unable to feed itself, yet at the same time providing a natural means of reducing potentially toxic concentrations of retinoids in the mother. © 2013 Elsevier B.V. All rights reserved.

  9. [Endocrinopathies during the postpartum period. Management].

    Science.gov (United States)

    Gallo-Vallejo, J L; Gallo-Vallejo, F J

    2015-03-01

    The various endocrinopathies that may occur during the postpartum period are described. The most important and common is gestational and pre-gestational diabetes, but other less common, and also very important ones, are mentioned such as hypopituitarism (Sheehan's syndrome and lymphocytic hypophysitis) and thyroid disorders, pre-existing (hyperthyroidism and hypothyroidism), or postpartum onset (postpartum thyroiditis and Graves' disease). After describing their characteristics, the emphasis is placed on the proper management of these endocrine diseases, some of them which exclusively appear during the postpartum period. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  10. Support of USARIEM Postpartum Soldier Research Study

    National Research Council Canada - National Science Library

    Dettori, Joseph

    1996-01-01

    It is estimated approximately 9% of Army women are pregnant at any one time. Shortly after delivery, postpartum soldiers are expected to return to full duty, meet body fat standards and pass the APFT...

  11. Fear of childbirth predicts postpartum depression

    DEFF Research Database (Denmark)

    Räisänen, Sari; Lehto, Soili M; Nielsen, Henriette Svarre

    2013-01-01

    To study how reproductive risks and perinatal outcomes are associated with postpartum depression treated in specialised healthcare defined according to the International Classification of Diseases (ICD)-10 codes, separately among women with and without a history of depression....

  12. Enhanced myometrial autophagy in postpartum uterine involution

    Directory of Open Access Journals (Sweden)

    Keng-Fu Hsu

    2014-09-01

    Conclusion: Autophagy of myocytes may play an important role in uterine involution. These results have implications for our understanding of myometrial functional adaptations during pregnancy and the physiological role of autophagy in the uterine remodeling events in the postpartum period.

  13. Postpartum Inflammatory Sacroiliitis-A Case Report

    Directory of Open Access Journals (Sweden)

    Seniz Akcay Yalbuzdag

    2013-08-01

    Full Text Available During the pregnancy several changes occur in sacroiliac joint and pelvis which may predispose for sacroiliac joint strain and septic sacroiliitis. We describe a case of acute inflammatory sacroiliitis in a patient with HLA B27 positivity during postpartum period, and diagnosed psoriatic arthritis during the follow up period. We aimed to emphasize that inflammatory sacroiliitis should take place whithin differantial diagnose of postpartum low back pain.

  14. Risk factors for postpartum urinary incontinence

    OpenAIRE

    Lígia da Silva Leroy; Adélia Lúcio; Maria Helena Baena de Moraes Lopes

    2016-01-01

    Abstract OBJECTIVE: To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. METHOD: This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. RESULTS: Stress UI was present in 45.5% of the women, incidents of urine...

  15. Periodontal status during pregnancy and postpartum.

    Science.gov (United States)

    González-Jaranay, Maximino; Téllez, Luís; Roa-López, Antonio; Gómez-Moreno, Gerardo; Moreu, Gerardo

    2017-01-01

    Different studies have documented an association between periodontal disease and low birth-weight delivery. Hence, knowledge of periodontal status during pregnancy and postpartum is important in order to reduce the risks of both diseases. This study aimed to analyze periodontal status at successive stages of pregnancy and 3-6 weeks postpartum in women with initial periodontal alterations. Ninety-six pregnant women were examined at 8-10 weeks (pregnancy diagnosis, baseline), 21-23 weeks and 34-36 weeks of gestation and at 40 days postpartum to record plaque scores, clinically assessed gingival inflammation and probing depth (mean depth and % sites with depth >3 mm). Bivariate and multivariate analyses were performed. Type 1 (α) error was established at 0.05. Plaque Index increased (p = 0.043) throughout pregnancy (baseline, 42%±0.18); 21-23 weeks, 42.6%±0.14; 34-36 weeks, 45.6%±0.13 and decreased postpartum (44.8%±0-13). Gingival Index increased (ppregnancy (baseline, 56.7%±0.20; 21-23 weeks, 66.36%±0.17; 34-36 weeks, 74.5%±0.18) and decreased postpartum (59.3%±0.21). Probing Depth increased (ppregnancy (baseline, 2.51±0.05; 21-23 weeks, 2.63±0.053; 34-36 weeks 2.81±0.055) and decreased postpartum (2.54±0.049). Percentage of sites with Probing Depth >3 mm increased (ppregnancy (baseline, 17.6%±0.16; 21-23 weeks, 23.9%±0.17; 34-36 weeks, 31.1%±0.17) and decreased postpartum (21.2%±0.17) but remained significantly (pPeriodontal status deteriorates during gestation but improves postpartum.

  16. Advanced Maternal Age Worsens Postpartum Vascular Function

    Directory of Open Access Journals (Sweden)

    Jude S. Morton

    2017-06-01

    Full Text Available The age at which women experience their first pregnancy has increased throughout the decades. Pregnancy has an important influence on maternal short- and long-term cardiovascular outcomes. Pregnancy at an advanced maternal age increases maternal risk of gestational diabetes, preeclampsia, placenta previa and caesarian delivery; complications which predict worsened cardiovascular health in later years. Aging also independently increases the risk of cardiovascular disease; therefore, combined risk in women of advanced maternal age may lead to detrimental cardiovascular outcomes later in life. We hypothesized that pregnancy at an advanced maternal age would lead to postpartum vascular dysfunction. We used a reproductively aged rat model to investigate vascular function in never pregnant (virgin, previously pregnant (postpartum and previously mated but never delivered (nulliparous rats at approximately 13.5 months of age (3 months postpartum or equivalent. Nulliparous rats, in which pregnancy was spontaneously lost, demonstrated significantly reduced aortic relaxation responses (methylcholine [MCh] Emax: 54.2 ± 12.6% vs. virgin and postpartum rats (MCh Emax: 84.8 ± 3.5% and 84.7 ± 3.2% respectively; suggesting pregnancy loss causes a worsened vascular pathology. Oxidized LDL reduced relaxation to MCh in aorta from virgin and postpartum, but not nulliparous rats, with an increased contribution of the LOX-1 receptor in the postpartum group. Further, in mesenteric arteries from postpartum rats, endothelium-derived hyperpolarization (EDH-mediated vasodilation was reduced and a constrictive prostaglandin effect was apparent. In conclusion, aged postpartum rats exhibited vascular dysfunction, while rats which had pregnancy loss demonstrated a distinct vascular pathology. These data demonstrate mechanisms which may lead to worsened outcomes at an advanced maternal age; including early pregnancy loss and later life cardiovascular dysfunction.

  17. Tryptophan pathway alterations in the postpartum period and in acute postpartum psychosis and depression.

    Science.gov (United States)

    Veen, Cato; Myint, Aye Mu; Burgerhout, Karin M; Schwarz, Markus J; Schütze, Gregor; Kushner, Steven A; Hoogendijk, Witte J; Drexhage, Hemmo A; Bergink, Veerle

    2016-01-01

    Women are at very high risk for the first onset of acute and severe mood disorders the first weeks after delivery. Tryptophan breakdown is increased as a physiological phenomenon of the postpartum period and might lead to vulnerability for affective psychosis (PP) and severe depression (PD). The aim of the current study was to investigate alterations in tryptophan breakdown in the physiological postpartum period compared to patients with severe postpartum mood disorders. We included 52 patients (29 with PP, 23 with PD), 52 matched healthy postpartum women and 29 healthy non-postpartum women. Analyzes of serum tryptophan metabolites were performed using LC-MS/MS system for tryptophan, kynurenine, 3-hydroxykynurenine, kynurenic acid and 5-hydroxyindoleacetic acid. The first two months of the physiological postpartum period were characterized by low tryptophan levels, increased breakdown towards kynurenine and a downstream shift toward the 3-OH-kynurenine arm, away from the kynurenic acid arm. Kynurenine was significantly lower in patients with PP and PD as compared to healthy postpartum women (p=0.011 and p=0.001); the remaining tryptophan metabolites demonstrated few differences between patients and healthy postpartum women. Low prevalence of the investigated disorders and strict exclusion criteria to obtain homogenous groups, resulted in relatively small sample sizes. The high kynurenine levels and increased tryptophan breakdown as a phenomenon of the physiological postpartum period was not present in patients with severe postpartum mood disorders. No differences were observed in the levels of the 'neurotoxic' 3-OH-kynurenine and the 'neuroprotective' kynurenic acid arms between patients and healthy postpartum women. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Contribution of placenta accreta to the incidence of postpartum hemorrhage and severe postpartum hemorrhage.

    Science.gov (United States)

    Mehrabadi, Azar; Hutcheon, Jennifer A; Liu, Shiliang; Bartholomew, Sharon; Kramer, Michael S; Liston, Robert M; Joseph, K S

    2015-04-01

    To quantify the contribution of placenta accreta to the rate of postpartum hemorrhage and severe postpartum hemorrhage. All hospital deliveries in Canada (excluding Quebec) for the years 2009 and 2010 (N=570,637) were included in a retrospective cohort study using data from the Canadian Institute for Health Information. Placenta accreta included placental adhesion to the uterine wall, musculature, and surrounding organs (accreta, increta, or percreta). Severe postpartum hemorrhage included postpartum hemorrhage with blood transfusion, hysterectomy, or other procedures to control bleeding (including uterine suturing and ligation or embolization of pelvic arteries). Rates, rate ratios, population-attributable fractions (ie, incidence of postpartum hemorrhage attributable to placenta accreta), and 95% confidence intervals (CIs) were estimated. Logistic regression was used to quantify associations between placenta accreta and risk factors. The incidence of placenta accreta was 14.4 (95% CI 13.4-15.4) per 10,000 deliveries (819 cases among 570,637 deliveries), whereas the incidence of placenta accreta with postpartum hemorrhage was 7.2 (95% CI 6.5-8.0) per 10,000 deliveries. Postpartum hemorrhage among women with placenta accreta was predominantly third-stage hemorrhage (41% of all cases). Although placenta accreta was strongly associated with postpartum hemorrhage (rate ratio 8.3, 95% CI 7.7-8.9), its low frequency resulted in a small population-attributable fraction (1.0%, 95% CI 0.93-1.16). However, the strong association between placenta accreta and postpartum hemorrhage with hysterectomy (rate ratio 286, 95% CI 226-361) resulted in a population-attributable fraction of 29.0% (95% CI 24.3-34.3). Placenta accreta is too infrequent to account for the recent temporal increase in postpartum hemorrhage but contributes substantially to the proportion of postpartum hemorrhage with hysterectomy.

  19. Postpartum illness in Fiji: a sociosomatic perspective.

    Science.gov (United States)

    Becker, A E

    1998-01-01

    The purpose of this study is to explore the apparent social mediation of a postpartum somatic illness, na tadoka ni vasucu, occurring among ethnic Fijian women. During their first two postpartum days, 85 consecutive newly delivered ethnic Fijian women were recruited for a prospective study on na tadoka ni vasucu at the Sigatoka District Hospital in Nadroga, Fiji. Subjects underwent translated structured interviews and responded to the Kellner Symptom Questionnaire and to visual analog scales to assess social supports and occurrence of mood symptoms or an episode of na tadoka ni vasucu in the postpartum period. Semistructured ethnographic interviews were also conducted with subjects who reported an episode of na tadoka ni vasucu. Data were collected in the initial postpartum days and again at 2 to 5 months postpartum; 82 women completed the study. Na tadoka ni vasucu is a somatic syndrome occurring in 9% (N = 7) of this sample. Both quantitative and narrative data demonstrate that this syndrome is associated with perceived inferior social supports. Despite its relatively infrequent occurrence and benign clinical course, the disorder is a subject of serious social concern within the Fijian community. Although na tadoka ni vasucu seems to be clinically trivial, because of its cultural salience it is nonetheless able to mobilize intensive social surveillance and care for the postpartum mother. The moral concern generated by this culturally marked disorder, as well as its association with perceived inferior social supports, suggest a dialectical relationship between somatic idiom and its social context.

  20. Periodontal status during pregnancy and postpartum.

    Directory of Open Access Journals (Sweden)

    Maximino González-Jaranay

    Full Text Available Different studies have documented an association between periodontal disease and low birth-weight delivery. Hence, knowledge of periodontal status during pregnancy and postpartum is important in order to reduce the risks of both diseases. This study aimed to analyze periodontal status at successive stages of pregnancy and 3-6 weeks postpartum in women with initial periodontal alterations.Ninety-six pregnant women were examined at 8-10 weeks (pregnancy diagnosis, baseline, 21-23 weeks and 34-36 weeks of gestation and at 40 days postpartum to record plaque scores, clinically assessed gingival inflammation and probing depth (mean depth and % sites with depth >3 mm. Bivariate and multivariate analyses were performed. Type 1 (α error was established at 0.05.Plaque Index increased (p = 0.043 throughout pregnancy (baseline, 42%±0.18; 21-23 weeks, 42.6%±0.14; 34-36 weeks, 45.6%±0.13 and decreased postpartum (44.8%±0-13. Gingival Index increased (p3 mm increased (p<0.001 throughout pregnancy (baseline, 17.6%±0.16; 21-23 weeks, 23.9%±0.17; 34-36 weeks, 31.1%±0.17 and decreased postpartum (21.2%±0.17 but remained significantly (p<0.02 higher than at baseline.Periodontal status deteriorates during gestation but improves postpartum.

  1. Postpartum education for contraception: a systematic review.

    Science.gov (United States)

    Lopez, Laureen M; Hiller, Janet E; Grimes, David A

    2010-05-01

    Contraceptive education is generally considered a standard component of postpartum care, but the effectiveness is seldom examined. Two-thirds of postpartum women may have unmet needs for contraception, and many adolescents become pregnant again within a year of giving birth. Women may prefer to discuss contraception prenatally or after hospital discharge. The objective of this systematic review was to assess the effects of educational interventions for postpartum mothers about contraceptive use. We searched computerized databases for randomized controlled trials that evaluated the effectiveness of postpartum contraceptive education. The intervention must have started within 1 month after delivery. The Mantel-Haenszel odds ratio was calculated with 95% confidence interval for the dichotomous outcomes. Eight trials met the inclusion criteria. Of 4 short-term interventions, 1 did not have sufficient data and 1 was statistically underpowered. The remaining 2 showed a positive effect on contraceptive use. Of 4 multifaceted programs, 2 showed fewer pregnancies or births among adolescents in the experimental group that had enhanced services, and 1 structured home-visiting program showed more contraceptive use. The effective interventions were conducted in Australia, Nepal, Pakistan, and the United States. Postpartum education about contraception led to more contraception use and fewer unplanned pregnancies. Short-term interventions were limited by self-reported outcomes or showing no effect for many comparisons. The longer-term programs were promising and not necessarily more costly than usual care. Health care providers can determine if 1 of these interventions suits their setting and level of resources. Obstetricians & Gynecologist, Family Physicians. After completing this educational activity, the participant should be better able to assess the importance of assessing delivery methods when examining intervention quality, evaluate the evidence from randomized trials on

  2. Physical activity patterns during pregnancy through postpartum

    Directory of Open Access Journals (Sweden)

    Evenson Kelly R

    2009-11-01

    Full Text Available Abstract Background Realizing the importance of regular physical activity, particularly in the prevention of chronic diseases and unhealthy weight gain, it is important to study how physical activity changes during and after pregnancy using prospective study designs. The aim of this study was to describe the mode, duration, intensity, and changes in physical activity during pregnancy through one year postpartum among a cohort of women. Methods This study was part of the third Pregnancy, Infection and Nutrition Postpartum Study at the University of North Carolina Hospitals. A cohort of 471 women was followed at 17-22 and 27-30 weeks' gestation and at 3 and 12 months postpartum. The participants reported the mode, frequency, duration, and intensity of all physical activities that increased their breathing and heart rate in the past week. Results Overall physical activity for the cohort decreased from 17-22 weeks to 27-30 weeks of gestation, but rebounded up at 3 months postpartum and remained stable at 12 months postpartum. The mean MET h/wk values for each time point were 24.7 (standard deviation, SD 26.8, 19.1 (SD 18.9, 25.7 (SD 29.3, and 26.7 (SD 31.5. In postpartum, women reported more care-giving and recreational activity and less indoor household activity, as compared to their activity level during pregnancy. Conclusion For health benefits and weight management, health care professionals are encouraged to provide pregnant and postpartum women with information on recommendations of physical activity, particularly regarding the minimum duration and intensity level.

  3. Postpartum haemorrhage: prevention and treatment.

    Science.gov (United States)

    Sentilhes, Loïc; Merlot, Benjamin; Madar, Hugo; Sztark, François; Brun, Stéphanie; Deneux-Tharaux, Catherine

    2016-11-01

    Postpartum hemorrhage (PPH) is one of the leading causes of maternal death and severe maternal morbidity worldwide and strategies to prevent and treat PPH vary among international authorities. Areas covered: This review seeks to provide a global overview of PPH (incidence, causes, risk factors), prevention (active management of the third stage of labor and prohemostatic agents), treatment (first, second and third-line measures to control PPH), by also underlining recommendations elaborated by international authorities and using algorithms. Expert commentary: When available, oxytocin is considered the drug of first choice for both prevention and treatment of PPH, while peripartum hysterectomy remains the ultimate life-saving procedure if pharmacological and resuscitation measures fail. Nevertheless, the level of evidence for preventing and treating PPH is globally low. The emergency nature of PPH makes randomized controlled trials (RCT) logistically difficult. Population-based observational studies should be encouraged as they can usefully strengthen the evidence base, particularly for components of PPH treatment that are difficult or impossible to assess through RCT.

  4. ROLE OF HYSTEROSCOPY IN THE MANAGEMENT OF SECONDARY POSTPARTUM HAEMORRHAGE

    Directory of Open Access Journals (Sweden)

    Krupa Patalay

    2016-03-01

    Full Text Available INTRODUCTION Secondary postpartum haemorrhage [PPH] or puerperal haemorrhage, though rare can sometimes cause severe morbidity needing prolonged hospitalisation. Majority of the cases can be managed medically, a few of them requiring surgical interventions. With retained placental tissue being a common cause, emptying the uterus in the puerperium can be difficult and dangerous too as the wall is soft and perforation chances are high. Hysteroscopic evaluation of the puerperal uterus gives us a better picture of the retained bits of placental tissue, and helps in complete evacuation of the tissue without causing much trauma to the fragile uterine wall. It is also more specific than ultrasonogram [USG] to rule out the presence of retained tissue. MATERIAL AND METHODS 17 patients who had secondary PPH and did not respond to the initial medical management were included in the study. Hysteroscopy was done in these cases. Definitive pathology was found in 12 cases; 7 cases had polypoidal tissue [retained bits of placenta], 3 cases had placental tissue adherent to the caesarean scar [placenta accreta] and 2 cases had submucous fibroids. RESULTS In cases which had retained placental bits, the tissue could be visualised, its exact location noted and the entire tissue could be removed without inciting much trauma to the uterine wall. In cases with placenta accreta, gentle extraction of the adherent tissue could be done without traumatising the scar. In one case which had multiple fibroids with irregular uterine cavity, hysteroscopy helped in localising the retained tissue. CONCLUSION Hysteroscopy is a useful modality in managing cases of secondary PPH, who have persistent bleeding in the postpartum period.

  5. Prolonged unexplained fatigue in paediatrics

    NARCIS (Netherlands)

    Bakker, R.J.

    2010-01-01

    Prolonged Unexplained Fatigue in Paediatrics. Fatigue, as the result of mental or physical exertion, will disappear after rest, drinks and food. Fatigue as a symptom of illness will recover with the recovering of the illness. But when fatigue is ongoing for a long time, and not the result of

  6. Physiology Of Prolonged Bed Rest

    Science.gov (United States)

    Greenleaf, John E.

    1991-01-01

    Report describes physiological effects of prolonged bed rest. Rest for periods of 24 hours or longer deconditions body to some extent; healing proceeds simultaneously with deconditioning. Report provides details on shifts in fluid electrolytes and loss of lean body mass, which comprises everything in body besides fat - that is, water, muscle, and bone. Based on published research.

  7. Post-partum acute kidney injury

    Directory of Open Access Journals (Sweden)

    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.

  8. Postpartum care and breast-feeding.

    Science.gov (United States)

    Acheson, L S; Danner, S C

    1993-09-01

    Scientific studies investigating the postpartum period are scarce, and observational studies greatly outnumber controlled trials. Many studies are biased in their assumptions about the social roles of women and men and in the interpretation of observations and treatment strategies. The published literature is fragmentary; few researchers have attempted a comprehensive, biopsychosocial system-oriented view of postpartum health. More research is needed on the occurrence and treatment of such common postpartum problems as urinary incontinence, sexual dysfunction, and back pain. Widespread application of what is already known about support for breast-feeding, prevention of fatigue and depression, contraception, and maintenance of healthy lifestyles will require innovations in healthcare delivery, professional practices, and social policy, particularly in the occupational arena. Many postpartum problems have been found to be iatrogenic and responsive to changes in the routine care of mothers and newborns. Finally, it is clear that women of lower education and socioeconomic status and those with less social support are consistently at higher risk for postpartum and parenting problems; great benefits are likely from interventions that enhance the well-being of these mothers and infants.

  9. Familiality of Psychiatric Disorders and Risk of Postpartum Psychiatric Episodes

    DEFF Research Database (Denmark)

    Bauer, Anna E; Maegbaek, Merete L; Liu, Xiaoqin

    2018-01-01

    OBJECTIVE: Postpartum psychiatric disorders are common and morbid complications of pregnancy. The authors sought to evaluate how family history of psychiatric disorders is associated with postpartum psychiatric disorders in proband mothers with and without a prior psychiatric history by assessing...

  10. Prevalence of autoimmune thyroid dysfunction in postpartum psychosis

    NARCIS (Netherlands)

    Bergink, Veerle; Kushner, Steven A.; Pop, Victor; Kuijpens, Hans; Lambregtse-van den Berg, Mijke P.; Drexhage, Roos C.; Wiersinga, Wilmar; Nolen, Willem A.; Drexhage, Hemmo A.

    Background Postpartum psychosis is a life-threatening psychiatric emergency, which often occurs without significant premorbid symptoms. Although many studies have postulated an involvement of the immune and endocrine systems in the onset of postpartum psychosis, the specific aetiological factors

  11. Ischemic neuropathy and rhabdomyolysis as presenting symptoms of postpartum cardiomyopathy

    NARCIS (Netherlands)

    Helmich, Rick C. G.; van Laarhoven, Hanneke W. M.; Schoonderwaldt, Hennie C.; Janssen, Mirian C. H.

    2009-01-01

    Rhabdomyolysis and peripheral neuropathy are two distinct disease entities which are rarely encountered in combination. We present a woman with rhabdomyolysis and peripheral neuropathy 3 weeks postpartum. Her symptoms were caused by bilateral femoral artery thrombosis due to postpartum

  12. Postpartum mental health in relation to sociocultural practices

    Directory of Open Access Journals (Sweden)

    Fatemeh Abdollahi

    2016-02-01

    Conclusions: Cultural practices could not be perceived as protective mechanisms that protect women from PPD in this traditional society. However, health professionals should be familiar with postpartum beliefs and practices that could support mothers in the postpartum period.

  13. Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms.

    Science.gov (United States)

    Jobst, Andrea; Krause, Daniela; Maiwald, Carina; Härtl, Kristin; Myint, Aye-Mu; Kästner, Ralph; Obermeier, Michael; Padberg, Frank; Brücklmeier, Benedikt; Weidinger, Elif; Kieper, Susann; Schwarz, Markus; Zill, Peter; Müller, Norbert

    2016-08-01

    During the postpartum period, women are at higher risk of developing a mental disorder such as postpartum depression (PPD), a disorder that associates with mother-infant bonding and child development. Oxytocin is considered to play a key role in mother-infant bonding and social interactions and altered oxytocin plasma concentrations were found to be associated with PPD. In the present study, we evaluated oxytocin plasma levels and depressive symptoms during pregnancy and the postpartum period in healthy women. We evaluated 100 women twice during pregnancy (weeks 35 and 38) and three times in the postpartum period (within 2 days and 7 weeks and 6 months after delivery) by measuring oxytocin plasma levels with enzyme-linked immunosorbent assay (ELISA) and assessing depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Oxytocin plasma levels significantly increased from the 35th week of gestation to 6 months postpartum in all women. However, levels decreased from the 38th week of gestation to 2 days after delivery in participants with postpartum depressive symptoms, whereas they continuously increased in the group without postpartum depressive symptoms; the difference between the course of oxytocin levels in the two groups was significant (Δt2-t3: t = 2.14; p = 0.036*). Previous depressive episodes and breastfeeding problems predicted postpartum depressive symptoms. Our results indicate that alterations in the oxytocin system during pregnancy might be specific for women who develop postpartum depressive symptoms. Future studies should investigate whether oxytocin plasma levels might have predictive value in women at high risk for PPD.

  14. Bladder rupture caused by postpartum urinary retention.

    Science.gov (United States)

    Dueñas-García, Omar Felipe; Rico, Hugo; Gorbea-Sanchez, Viridiana; Herrerias-Canedo, Tomas

    2008-08-01

    Postpartum bladder rupture is an uncommon surgical emergency and a diagnostic challenge. A primigravida delivered a healthy newborn without complications at 39.4 weeks of gestation. The patient was admitted 80 hours postpartum with abdominal pain, oliguria, hematuria, and pain that worsened during the previous 4 hours. An inserted Foley catheter drained only a small amount of urine, and serum creatinine was elevated (3.5 mg/dL). A laparotomy was performed and revealed a 10-cm hole in the urinary bladder. The bladder was repaired and the patient was discharged 15 days after surgery. The follow-up cystoscopy revealed adequate healing of the bladder. Urinary retention can lead to serious complications, including bladder rupture. Postpartum bladder rupture due to urinary retention should be ruled out if there is a history of abdominal pain, oliguria, and elevated of serum creatinine.

  15. Social energy exchange theory for postpartum depression.

    Science.gov (United States)

    Posmontier, Bobbie; Waite, Roberta

    2011-01-01

    Postpartum depression (PPD), a significant health problem affecting about 19.4% of postpartum women worldwide, may result in long-term cognitive and behavior problems in children, spousal depression, widespread family dysfunction, and chronic and increasingly severe maternal depression. Although current theoretical frameworks provide a rich context for studying PPD,none provides a framework that specifically addresses the dynamic relationship of the inner personal experience with the social and cultural context of PPD. The authors propose the social energy exchange theory for postpartum depression to understand how PPD impedes this dynamic relationship and suggest it as a theoretical framework for the study of interventions that would target intra- and interpersonal disturbance within the social and cultural context.

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

    Science.gov (United States)

    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.

  17. Antioxidant status and endocannabinoid concentration in postpartum depressive women

    Directory of Open Access Journals (Sweden)

    Mina Ranjbaran

    2015-02-01

    Conclusion: Women’s Job, husband’s job, wanted or unwanted pregnancy from husbands and marital period are associated to postpartum depression. In postpartum depression, TAC, AEA and 2-AG are reduced. So it can be concluded that both antioxidant system and endocannabinoid concentration involved in the development of postpartum depression.

  18. Bipolar Spectrum Disorder During Pregnancy and the Postpartum Period

    NARCIS (Netherlands)

    R. Wesseloo (Richard)

    2018-01-01

    markdownabstractDuring the postpartum period, women are at high risk for both first-onset and recurrent mood disorder episodes. This thesis focuses on the treatment and course of mood disorders during pregnancy and the postpartum period, with a main focus on bipolar disorder and postpartum

  19. Postpartum care attendance at a rural district hospital in Zambia

    NARCIS (Netherlands)

    J. Lagro (Joep); A. Liche (Agnes); J. Mumba (John); R. Ntebeka (Ruth); J. van Roosmalen (Jos)

    2006-01-01

    textabstractPostpartum care is an important tool in both preventive and promotive maternal health care. We studied the postpartum care attendance rate in 540 women who delivered at a district hospital in Zambia. Forty-two percent of the women attended postpartum care within six weeks of delivery.

  20. Postpartum anoestrus in the suckled swamp buffalo

    International Nuclear Information System (INIS)

    Jainudeen, M.R.; Sharifuddin, W.; Yap, K.C.; Bakar Dahari, A.

    1984-01-01

    Postpartum anoestrus is a serious cause of infertility in the swamp buffalo. Our studies have revealed that it is due to a failure in the resumption of ovarian cyclicity. Parity was inversely related to the calving interval being longer in primiparous than multiparous suckled buffaloes. This effect may be partly due to the higher nutrient demands for growth as well as for lactation in the primiparous animal. The effects of suckling on ovarian and pituitary function of postpartum buffaloes were investigated with the aid of radioimmunoassays for progesterone and luteinizing hormone (LH) as well as rectal palpation and laparoscopic inspection of the ovaries. The incidence of postpartum anoestrus was higher in suckled than non-suckled buffaloes. Weaning buffalo calves at 30 d postpartum resulted in the resumption of normal ovarian cycles within 60 d postpartum. LH release in response to a single injection of a synthetic gonadotropin-releasing hormone (GnRH) indicated that pituitary responsiveness to GnRH was restored by Day 30 postpartum in suckled buffaloes whereas anoestrous buffaloes were able to release levels of LH comparable to that of the preovulatory surge. A progesterone-releasing intra-vaginal device (PRID) induced an anovulatory oestrus in the anoestrous suckled buffalo which was partially overcome by human chorionic gonadotropin (HCG) administered at the induced oestrus. However, a 72 h separation of the calf from its dam combined with PRID was the most effective substitute to weaning in initiating ovarian cycles in the suckled buffalo. Our data suggest that suckling inhibits ovarian function not by an effect on the pituitary gland but rather on GnRH release by the hypothalamus. (author)

  1. Effects of prolonged second stage, method of birth, timing of caesarean section and other obstetric risk factors on postnatal urinary incontinence: an Australian nulliparous cohort study.

    Science.gov (United States)

    Brown, S J; Gartland, D; Donath, S; MacArthur, C

    2011-07-01

    To investigate the contribution of prolonged labour, method of birth, timing of caesarean section and other obstetric risk factors to postpartum urinary incontinence. Prospective pregnancy cohort. Six metropolitan public hospitals in Victoria, Australia. A total of 1507 nulliparous women recruited to the maternal health study in early pregnancy (≤24 weeks). Data from hospital medical records and self-administered questionnaires/telephone interviews at ≤24 and 30-32 weeks of gestation and 3 months postpartum analysed using univariable and multivariable logistic regression. Urinary incontinence 3 months postpartum in women continent before the index pregnancy. Of the women continent before pregnancy, 26% reported new incontinence at 3 months postpartum. Compared with women who had a spontaneous vaginal birth, women who had a caesarean section before labour (adjusted odds ratio [OR] 0.2, 95% CI 0.1-0.5) or in the first stage of labour (adjusted OR 0.2, 95% CI 0.1-0.4) were less likely to be incontinent 3 months postpartum. Adjusted OR for incontinence after caesarean section in the second stage of labour compared with spontaneous vaginal birth was 0.5 (95% CI 0.2-1.0). Prolonged second stage labour was associated with increased likelihood of postpartum incontinence in women who had a spontaneous vaginal birth (adjusted OR 1.9, 95% CI 1.1-3.4) or operative vaginal birth (adjusted OR 1.7, 95% CI 1.0-2.8). In addition to pregnancy itself, physiological changes associated with the second stage of labour appear to play a role in postpartum urinary incontinence. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  2. An Integrative Psychotherapy of Postpartum Adjustment

    Directory of Open Access Journals (Sweden)

    Carol Merle-Fishman

    2010-12-01

    Full Text Available Becoming a mother is a time of transition, transformation and sometimes trauma. The immediacy of meeting the needs of an infant, combined with the immediacy of becoming a mother, often collide to produce depression, anxiety and stress. Shame, confusion, isolation and cultural expectations often prevent women from seeking the postpartum support they need, which may result in long lasting depression, anxiety and unresolved trauma. Integrative Psychotherapy, Transactional Analysis and Attachment Theory offer ways to understand postpartum adjustment as well as methodologies for addressing this unique developmental event in the life of women.

  3. Postpartum perineal repair performed by midwives

    DEFF Research Database (Denmark)

    Kindberg, S; Stehouwer, M; Hvidman, L

    2008-01-01

    OBJECTIVE: To compare a continuous suture technique with interrupted stitches using inverted knots for postpartum perineal repair of second-degree lacerations and episiotomies. DESIGN: A double-blind randomised controlled trial. SETTING: A Danish university hospital with more than 4800 deliveries...... months postpartum. Pain was evaluated using a visual analogue scale and the McGill Pain Questionnaire. Wound healing was evaluated using the REEDA scale and by assessment of gaping wounds >0.5 cm. Analysis complied with the intention-to-treat principle. MAIN OUTCOME MEASURES: The primary outcome...

  4. [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.

  5. Patient Satisfaction With Postpartum Teaching Methods.

    Science.gov (United States)

    Wagner, Debra L; Washington, Cynthia

    2016-01-01

    Postpartum discharge instructions are a crucial part of a mother's birth experience. Finding the method to provide those discharge instructions in a manner that increases the mother's satisfaction with her hospital experience is important. This quasi-experimental study examined the relationship between new mothers' interaction with nurses providing postpartum instructions by the traditional and class methods and their satisfaction with discharge teaching. The results indicated new mothers were satisfied with both methods of discharge teaching; however, they were more likely to report stronger agreement with overall satisfaction with the traditional method of discharge teaching than with attending the discharge class.

  6. RD50 Prolongation Request 2018

    CERN Document Server

    Casse, Gianluigi

    2018-01-01

    With this document, we request the prolongation of the CERN RD50 research program for 5 years. A very brief historical review of the RD50 research program since the RD50 project approval by the Research Board in the year 2002 is presented and the biggest RD50 achievements are highlighted. The present composition of the collaboration, its organizational structure, and the research methodology are described. The role of RD50 in the present various upgrade and research programs of the LHC Experiments community is given and the overall work plan explained. Finally, a detailed 5-years work program with precise milestones and deliverables for the various research activities is presented. We conclude with our prolongation request towards the LHCC.

  7. Risk of postpartum relapse in bipolar disorder and postpartum psychosis : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Wesseloo, R.; Kamperman, A.M.; Munk-Olsen, T.; Pop, V.J.M.; Kushner, S.A.; Bergink, V.

    2016-01-01

    Objective: Women with a history of bipolar disorder, postpartum psychosis, or both are at high risk for postpartum relapse. The aim of this meta-analysis was to estimate the risk of postpartum relapse in these three patient groups. Method: A systematic literature search was conducted in all public

  8. Recurrent Silent Thyroiditis as a Sequela of Postpartum Thyroiditis

    Science.gov (United States)

    Kim, Paul

    2014-01-01

    Thyroiditis encompasses a group of disorders characterized by thyroid inflammation. Though clinically indistinguishable from silent thyroiditis, postpartum thyroiditis occurs in women within 12 months after delivery. Recurrent postpartum thyroiditis in subsequent pregnancies is common, but recurrent silent thyroiditis is rare. We reported a case of patient with recurrent episodes of thyroiditis, unrelated to pregnancy, after an episode of postpartum thyroiditis. It is of interest that postpartum thyroiditis and silent thyroiditis could occur closely to each other; however, the link between these disorders is not well established. This report is to remind physicians of the possibility of recurrent silent thyroiditis in women with a history of postpartum thyroiditis. PMID:24987536

  9. Postpartum Substance Use and Depressive Symptoms: A Review

    Science.gov (United States)

    Chapman, Shawna L. Carroll; Wu, Li-Tzy

    2013-01-01

    National survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression (PPD) may be at high risk for substance use. Understanding postpartum substance use and its relationship to PPD can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999–2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%−49%) and drug use (4.5%–8.5%) were lower than use among not pregnant, not postpartum women (41.5%–57.5%; 7.6%–10.6%, respectively) but higher than use among pregnant women (5.4%–11.6%; 3.7%–4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by Blacks and Hispanics, but Black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%–46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use. PMID:23879459

  10. Mother's perceptions of postpartum stress and satisfaction.

    Science.gov (United States)

    Horowitz, J A; Damato, E G

    1999-01-01

    To examine mothers' postpartum perceptions of stress and satisfaction. Methodologic triangulation with quantitative and qualitative data in a nonexperimental design. A convenience sample of 95 women was obtained during normally scheduled postpartum appointments at a health maintenance organization. The self-administered questionnaire included the Mothers' Information Tool (MIT), What Being the Parent of a Baby Is Like (WPL-R), and the Brief Symptom Inventory (BSI). Open-ended MIT items revealed mothers' perceptions of stress and satisfaction. The WPL-R provided maternal satisfaction scores, and the BSI yielded Global Stress Index scores. Content analysis identified the following categories: Roles, Tasks, Resources, and Relationships. Subcategories identified as areas of stress were Work/School, Sleep/Rest, Adjustment/Own Needs, Health/Body Image, Organization of Life, Child Care, Day Care, Housework, Future Challenges, Finances, Housing, Time, Partner, and Family. Subcategories identified as areas of satisfaction were Participating in Relationships, Sharing the Future, Being Proud to Be a Mother, Enjoying a Healthy Baby, and Caring for a Child. Levels of stress and satisfaction of mothers who scored high and low on quantitative measures were compared. The outcomes contribute to the knowledge concerning postpartum women's perceptions of the mothering experience and suggest approaches to nursing assessment and intervention to prevent postpartum adjustment difficulties.

  11. Pleural effusions in the postpartum period

    International Nuclear Information System (INIS)

    Stark, P.; Pollack, M.S.

    1986-01-01

    We report on the high frequency of pleural effusions in the immediate postpartum period. Forty-four out of 45 women who examined within 24-48 h after delivery showed evidence of pleural fluid. Under these circumstances, this pleural abnormality should not be considered an indicator of serious cardiopulmonary disease. (orig.) [de

  12. A Shortened versus Standard Matched Postpartum Magnesium ...

    African Journals Online (AJOL)

    Magnesium sulphate is currently the most ideal drug for the treatment of eclampsia but its use in Nigeria is still limited due its cost and clinicians inexperience with the drug. The purpose of this study was to determine whether a shortened postpartum course of magnesium sulphate is as effective as the standard Pritchard ...

  13. Maternal postpartum distress and childhood overweight.

    Directory of Open Access Journals (Sweden)

    Teresa A Ajslev

    Full Text Available OBJECTIVE: We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight. METHODS: We performed a prospective cohort study, including 21,121 mother-child-dyads from the Danish National Birth Cohort (DNBC. Maternal distress was measured 6 months postpartum by 9 items covering anxiety, depression and stress. Outcome was childhood overweight at 7-years-of age. Multiple logistic regression analyses were performed and information on maternal age, socioeconomic status, pre-pregnancy BMI, gestational weight gain, parity, smoking during pregnancy, paternal BMI, birth weight, gestational age at birth, sex, breastfeeding and finally infant weight at 5 and 12 month were included in the analyses. RESULTS: We found, that postpartum distress was not associated with childhood risk of overweight, OR 1.00, 95%CI [0.98-1.02]. Neither was anxiety, depression, or stress exposure, separately. There were no significant differences between the genders. Adjustment for potential confounders did not alter the results. CONCLUSION: Maternal postpartum distress is apparently not an independent risk factor for childhood overweight at 7-years-of-age. However, we can confirm previous findings of perinatal determinants as high maternal pre-pregnancy BMI, and smoking during pregnancy being risk factors for childhood overweight.

  14. POSTPARTUM CONTRACEPTIVE USE IN RURAL BAREILLY

    Directory of Open Access Journals (Sweden)

    Syed Esam Mahmood

    2011-12-01

    Full Text Available Background: Contraception is an important intervention to reduce burden of unwanted pregnancy and promote healthy living among women. Objectives: To find out the postpartum contraceptive usage and identify the different variables which affect the postpartum contraception among the rural females of Bareilly district. Methods: The cross sectional study was carried out in randomly selected villages of Bhojipura Block of Bareilly district, Uttar Pradesh. All women who had delivered within last one year were interviewed by house to house survey to collect data regarding socio-demographic characteristics and contraceptive use by structured questionnaire. A total of 123 women participated in the study. Chi- square test was used to analyze data. Results: Only 13.8% mothers adopted postpartum contraception. Lack of knowledge (32.5% and young infant being breastfed (28.5% were the common reasons of not using any contraceptive method. Contraceptive use was higher amongst females aged less than 30 years and those belonging to middle socioeconomic class and nuclear families. The significant influence of the women’ educational status on utilization of family planning methods was observed (p<0.05. Conclusions: Low percent of postpartum contraceptive use indicates the need for improving awareness among the study population.

  15. Postpartum consultation: Occurrence, requirements and expectations

    Directory of Open Access Journals (Sweden)

    Carlgren Ingrid

    2008-07-01

    Full Text Available Abstract Background As a matter of routine, midwives in Sweden have spoken with women about their experiences of labour in a so-called 'postpartum consultation'. However, the possibility of offering women this kind of consultation today is reduced due to shortage of both time and resources. The aim of this study was to explore the occurrence, women's requirements of, and experiences of a postpartum consultation, and to identify expectations from women who wanted but did not have a consultation with the midwife assisting during labour. Methods All Swedish speaking women who gave birth to a live born child at a University Hospital in western Sweden were consecutively included for a phone interview over a three-week period. An additional phone interview was conducted with the women who did not have a postpartum consultation, but who wanted to talk with the midwife assisting during labour. Data from the interviews were analysed using qualitative content analysis. Results Of the 150 interviewed women, 56% (n = 84 had a postpartum consultation of which 61.9% (n = 52 had this with the midwife assisting during labour. Twenty of the 28 women who did not have a consultation with anyone still desired to talk with the midwife assisting during labour. Of these, 19 were interviewed. The content the women wanted to talk about was summarized in four categories: to understand the course of events during labour; to put into words, feelings about undignified management; to describe own behaviour and feelings, and to describe own fear. Conclusion The survey shows that the frequency of postpartum consultation is decreasing, that the majority of women who give birth today still require it, but only about half of them receive it. It is crucial to develop a plan for these consultations that meets both the women's needs and the organization within current maternity care.

  16. Possible Rivaroxaban Failure during the Postpartum Period.

    Science.gov (United States)

    Rudd, Kelly M; Winans, Amanda R McFee; Panneerselvam, Narmadha

    2015-11-01

    Rivaroxaban, a factor Xa inhibitor, is a direct-acting oral anticoagulant (DOAC) indicated for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and for reducing the risk of DVT and PE recurrence. To our knowledge, no data are presently available to guide DOAC dosing in the postpartum period when pharmacokinetic and pharmacodynamic changes induced by pregnancy have an impact on drug clearance and increase hypercoagulability for a period of 6-8 weeks after delivery. We describe the case of a 35-year-old postpartum woman who presented to the emergency department with a diagnosis of a new multiple segmental PE 5 days after starting rivaroxaban therapy for a diagnosis of DVT. No precipitating cause, including noncompliance, was identified as a source of thrombosis embolization or extension. The patient was admitted, a heparin infusion was started for the management of PE, and rivaroxaban was discontinued. She was transitioned to enoxaparin 1 mg/kg (90 mg) subcutaneously every 12 hours the next day, bridged to warfarin, and discharged home on the overlapping regimen with close follow-up by the pharmacist-managed outpatient Anticoagulation Management Service. To our knowledge, this is the first case report of potential failure associated with rivaroxaban therapy in the postpartum period, possibly due to pharmacokinetic alterations seen in the postpartum period contributing to decreased drug exposure, yielding reduced anticoagulant efficacy. Clinicians should carefully weigh the risks and benefits of DOAC therapy in postpartum patients or other special populations requiring anticoagulation therapy. This report also highlights the need for further research identifying the impact of pharmacokinetic changes induced by special populations and the need to develop monitoring assays for such clinical situations. © 2015 Pharmacotherapy Publications, Inc.

  17. Postpartum deaths: piglet, placental, and umbilical characteristics.

    Science.gov (United States)

    Rootwelt, V; Reksen, O; Farstad, W; Framstad, T

    2013-06-01

    The fetal growth of the piglet is highly dependent on its placenta, and the newborn piglet birth weight is highly associated with postpartum death. However, there is little information available in the literature on the assessment of the placenta in relation to postpartum death in piglets. The aim of this study was to evaluate the impact of the placental area and placental weight, status of the umbilical cord, and piglet birth characteristics, such as blood parameters, vitality score, and birth weight on postpartum death. All live born piglets in litters from 26 Landrace-Yorkshire sows were monitored during farrowing and the status of each was recorded, including placental area and placental weight and blood variables obtained from the piglets and umbilical veins. Out of the 386 live-born piglets, 16.8% died before weaning at 5 wk. Among these, 78.5% died within the first 3 d of life. Mean blood concentration of lactate was increased in piglets that did not survive to weaning (P = 0.003). Concentrations of hemoglobin and hematocrit were decreased (P vitality score vs. piglets born with an intact umbilical cord (P = 0.021), and they had an increased probability of dying before weaning (P = 0.050). Mean birth weight, body mass index, placental area (P live litter size. Blood concentrations of IgG and albumin recorded at d 1 were decreased in piglets that died before weaning (P < 0.01), and blood concentration of albumin was positively associated with placental area (P < 0.001). We conclude that placental area and placental weight, status of the umbilical cord, birth weight, body mass index, blood concentrations of lactate, hemoglobin, and hematocrit recorded at birth, and blood concentrations of IgG and albumin recorded at d 1 were associated with postpartum death in this study. These results may indicate that there is an upper uterine limitation of litter size and that placental area and placental weight influence postpartum survival.

  18. Does Coordinated Postpartum Care Influence Costs?

    Directory of Open Access Journals (Sweden)

    Elisabeth Zemp

    2017-03-01

    Full Text Available Questions under study: To investigate changes to health insurance costs for post-discharge postpartum care after the introduction of a midwife-led coordinated care model. Methods: The study included mothers and their newborns insured by the Helsana health insurance group in Switzerland and who delivered between January 2012 and May 2013 in the canton of Basel Stadt (BS (intervention canton. We compared monthly post-discharge costs before the launch of a coordinated postpartum care model (control phase, n = 144 to those after its introduction (intervention phase, n = 92. Costs in the intervention canton were also compared to those in five control cantons without a coordinated postpartum care model (cross-sectional control group: n = 7, 767. Results: The average monthly post-discharge costs for mothers remained unchanged in the seven months following the introduction of a coordinated postpartum care model, despite a higher use of midwife services (increasing from 72% to 80%. Likewise, monthly costs did not differ between the intervention canton and five control cantons. In multivariate analyses, the ambulatory costs for mothers were not associated with the post-intervention phase. Cross-sectionally, however, they were positively associated with midwifery use. For children, costs in the post-intervention phase were lower in the first month after hospital discharge compared to the pre-intervention phase (difference of –114 CHF [95%CI –202 CHF to –27 CHF], yet no differences were seen in the cross-sectional comparison. Conclusions: The introduction of a coordinated postpartum care model was associated with decreased costs for neonates in the first month after hospital discharge. Despite increased midwifery use, costs for mothers remained unchanged.

  19. Health after childbirth: patterns of reported postpartum morbidity from Lebanon.

    Science.gov (United States)

    Kabakian-Khasholian, Tamar; Shayboub, Rawan; Ataya, Alexandra

    2014-03-01

    The postpartum period is under-researched in low and middle income countries. The scarce literature reveals heavy burden of ill health experienced in that period and under utilisation of health services. Understanding the postpartum morbidity burden and identifying the care-seeking behaviours is essential to improve service delivery. This paper examines reported postpartum morbidity, care seeking behaviour and whether postpartum morbidity is associated with method of birth. A cross sectional study of women delivering in 18 private hospitals from two regions in Lebanon was undertaken. Women in their second or third trimester of pregnancy, visiting private obstetric clinics affiliated with participating hospitals were interviewed for baseline information. Reported postpartum morbidity was assessed in an interview conducted at women's homes from 40 days up to six months postpartum. Of the 269 women recruited, physical postpartum health problems were reported by 93.6% and psychological health problems by 84.4% of women, with more health problems being reported beyond two months postpartum. Women were less likely to seek professional care for psychological health problems. Reporting postpartum health problems was not associated with method of birth. A heavy burden of postpartum morbidity is experienced by women with gaps in utilisation of relevant health services. Efforts should be directed towards the organisation and delivery of comprehensive maternity care services. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  20. Women's experiences with postpartum anxiety disorders: a narrative literature review.

    Science.gov (United States)

    Ali, Elena

    2018-01-01

    Postpartum anxiety disorders are common and may have significant consequences for mothers and their children. This review examines the literature on women's experiences with postpartum generalized anxiety disorder (GAD), postpartum panic disorder (PD), obsessive compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). MEDLINE (Ovid), CINAHL, PsycINFO, and reference lists were searched. Qualitative and quantitative studies assessing women's experiences with GAD, postpartum PD, OCD, and PTSD were included. Narrative approach to literature synthesis was used. Fourteen studies (among 44 articles) met the criteria for review to identify descriptions of women's cognitive, affective, and somatic experiences related to postpartum anxiety disorders. Loss, frustration, and guilt, accompanied by physical symptoms of tension, were some of the experiences identified across studies. Most women suffered from more than one anxiety disorder, in addition to postpartum depression. To date, research has focused on prevalence rates of postpartum anxiety disorders, and evidence about clinical and subclinical symptoms of postpartum anxiety disorders and outcomes on mother and child is lacking. Postpartum anxiety disorders may have negative effects on parenting and child development; however, the nature of the underlying mechanisms is unclear. More robust longitudinal studies are needed to examine the impact of postpartum GAD, PD, OCD, and PTSD symptoms on the mother and the mother-child relationship to develop targets for therapeutic preventative interventions.

  1. Preventing urinary incontinence during pregnancy and postpartum: a review.

    Science.gov (United States)

    Wesnes, Stian Langeland; Lose, Gunnar

    2013-06-01

    Urinary incontinence (UI) is a common condition in association with pregnancy. Incident UI in pregnancy or postpartum are significant risk factors for UI later in life. Epidemiological studies on UI during pregnancy and postpartum list numerous variables associated with UI. For women, the main focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized controlled trials on prevention of UI in association with pregnancy. Systematic searches for publications until September 2012 on prevention of UI during pregnancy and postpartum were performed. Based on available evidence, the following recommendations to prevent UI during pregnancy and postpartum were made: women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations are addressed in association with pregnancy, incidence of UI during pregnancy and postpartum is likely to decrease.

  2. Limited Uptake of Planned Intrauterine Devices During the Postpartum Period.

    Science.gov (United States)

    Salcedo, Jennifer; Moniaga, Natalie; Harken, Tabetha

    2015-08-01

    The primary objective of this study was to determine the percentage of women with a documented plan for postpartum intrauterine device (IUD) insertion who had a device inserted within 8 weeks of delivery. The secondary objective was to determine factors associated with successful initiation of postpartum IUDs as planned. We conducted a retrospective chart review of women who had at least one prenatal visit and delivered a viable pregnancy at our academic medical center. Methods of planned and established postpartum contraceptive methods were recorded, as well as demographic information and documented reasons for failure to initiate planned intrauterine contraception. A total of 110 women planned postpartum IUD placement. Of these women, 84 (76%) presented for at least one postpartum appointment. Only 22.6% (95% confidence interval 13.7-31.5) of those presenting for postpartum follow-up underwent IUD placement within 8 weeks of delivery. Women planning postpartum IUD insertion were just as likely as women with no planned postpartum contraceptive method to fail to establish contraception within 8 weeks (P = 0.55). Failure to establish planned postpartum intrauterine contraception occurs frequently, even in a setting with a high rate of postpartum follow-up.

  3. Stigma and Postpartum Depression Treatment Acceptability Among Black and White Women in the First Six-Months Postpartum.

    Science.gov (United States)

    Bodnar-Deren, Susan; Benn, E K T; Balbierz, Amy; Howell, E A

    2017-07-01

    Objective To measure stigma associated with four types of postpartum depression therapies and to estimate the association between stigma and the acceptance of these therapies for black and white postpartum mothers. Methods Using data from two postpartum depression randomized trials, this study included 481 black and white women who gave birth in a large urban hospital and answered a series of questions at 6-months postpartum. Survey items included socio demographic and clinical factors, attitudes about postpartum depression therapies and stigma. The associations between race, stigma, and treatment acceptability were examined using bivariate and multivariate analyses. Results Black postpartum mothers were less likely than whites to accept prescription medication (64 vs. 81%, p = 0.0001) and mental health counseling (87 vs. 93%, p = 0.001) and more likely to accept spiritual counseling (70 vs. 52%, p = 0.0002). Women who endorsed stigma about receipt of postpartum depression therapies versus those who did not were less likely to accept prescription medication, mental health and spiritual counseling for postpartum depression. Overall black mothers were less likely to report stigma associated with postpartum depression therapies. In adjusted models, black women versus white women remained less likely to accept prescription medication for postpartum depression (OR = 0.42, 95% CI 0.24-0.72) and stigma did not explain this difference. Conclusions Although treatment stigma is associated with lower postpartum depression treatment acceptance, stigma does not explain the lower levels of postpartum depression treatment acceptance among black women. More research is needed to understand treatment barriers for postpartum depression, especially among black women.

  4. Prolonged Intermittent Renal Replacement Therapy.

    Science.gov (United States)

    Edrees, Fahad; Li, Tingting; Vijayan, Anitha

    2016-05-01

    Prolonged intermittent renal replacement therapy (PIRRT) is becoming an increasingly popular alternative to continuous renal replacement therapy in critically ill patients with acute kidney injury. There are significant practice variations in the provision of PIRRT across institutions, with respect to prescription, technology, and delivery of therapy. Clinical trials have generally demonstrated that PIRRT is non-inferior to continuous renal replacement therapy regarding patient outcomes. PIRRT offers cost-effective renal replacement therapy along with other advantages such as early patient mobilization and decreased nursing time. However, due to lack of standardization of the procedure, PIRRT still poses significant challenges, especially pertaining to appropriate drug dosing. Future guidelines and clinical trials should work toward developing consensus definitions for PIRRT and ensure optimal delivery of therapy. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. Prevention of mother-to-child transmission of HIV: Postpartum adherence to Option B+ until 18 months in Western Uganda.

    Science.gov (United States)

    Decker, Sarah; Rempis, Eva; Schnack, Alexandra; Braun, Vera; Rubaihayo, John; Busingye, Priscilla; Tumwesigye, Nazarius Mbona; Harms, Gundel; Theuring, Stefanie

    2017-01-01

    Since 2012, the WHO recommends Option B+ for the prevention of mother-to-child transmission of HIV. This approach entails the initiation of lifelong antiretroviral therapy in all HIV-positive pregnant women, also implying protection during breastfeeding for 12 months or longer. Research on long-term adherence to Option B+ throughout breastfeeding is scarce to date. Therefore, we conducted a prospective observational cohort study in Fort Portal, Western Uganda, to assess adherence to Option B+ until 18 months postpartum. In 2013, we recruited 67 HIV-positive, Option B+ enrolled women six weeks after giving birth and scheduled them for follow-up study visits after six, twelve and 18 months. Two adherence measures, self-reported drug intake and amount of drug refill visits, were combined to define adherence, and were assessed together with feeding information at all study visits. At six months postpartum, 51% of the enrolled women were considered to be adherent. Until twelve and 18 months postpartum, adherence for the respective follow-up interval decreased to 19% and 20.5% respectively. No woman was completely adherent until 18 months. At the same time, 76.5% of the women breastfed for ≥12 months. Drug adherence was associated with younger age (ptravel costs (p = 0.02), and lower number of previous deliveries (p = 0.04). Long-term adherence to Option B+ seems to be challenging. Considering that in our cohort, prolonged breastfeeding until ≥12 months was widely applied while postpartum adherence until the end of breastfeeding was poor, a potential risk of postpartum vertical transmission needs to be taken seriously into account for Option B+ implementation.

  6. Prevention of mother-to-child transmission of HIV: Postpartum adherence to Option B+ until 18 months in Western Uganda.

    Directory of Open Access Journals (Sweden)

    Sarah Decker

    Full Text Available Since 2012, the WHO recommends Option B+ for the prevention of mother-to-child transmission of HIV. This approach entails the initiation of lifelong antiretroviral therapy in all HIV-positive pregnant women, also implying protection during breastfeeding for 12 months or longer. Research on long-term adherence to Option B+ throughout breastfeeding is scarce to date. Therefore, we conducted a prospective observational cohort study in Fort Portal, Western Uganda, to assess adherence to Option B+ until 18 months postpartum. In 2013, we recruited 67 HIV-positive, Option B+ enrolled women six weeks after giving birth and scheduled them for follow-up study visits after six, twelve and 18 months. Two adherence measures, self-reported drug intake and amount of drug refill visits, were combined to define adherence, and were assessed together with feeding information at all study visits. At six months postpartum, 51% of the enrolled women were considered to be adherent. Until twelve and 18 months postpartum, adherence for the respective follow-up interval decreased to 19% and 20.5% respectively. No woman was completely adherent until 18 months. At the same time, 76.5% of the women breastfed for ≥12 months. Drug adherence was associated with younger age (p<0.01, lower travel costs (p = 0.02, and lower number of previous deliveries (p = 0.04. Long-term adherence to Option B+ seems to be challenging. Considering that in our cohort, prolonged breastfeeding until ≥12 months was widely applied while postpartum adherence until the end of breastfeeding was poor, a potential risk of postpartum vertical transmission needs to be taken seriously into account for Option B+ implementation.

  7. Ultrasonography and radiography of the canine postpartum uterus

    International Nuclear Information System (INIS)

    Pharr, J.W.; Post, K.

    1992-01-01

    A vulvovaginal discharge following parturition in a bitch is often a cause of concern to owners and clinicians, especially if whelping was complicated in any way. Ultrasonography could potentially distinguish between normal and abnormal postpartum uterine states because the uterine wall and luminal contents can be imaged in detail. Five normal bitches were examined to determine the normal ultrasonographic appearance of the postpartum uterus and the sensitivity of ultrasonography in detecting the involuting uterus, comparing this sensitivity with that of radiography. Ultrasonography was done at 1, 4, 8, 12, 18 and 24 days postpartum, radiography at 1, 4, 8, 12 and 18 days postpartum. By 12 days postpartum, the uterus could not be seen on radiographs, while at 24 days postpartum the uterus was still sonographically identifiable. The ultrasonographic characteristics of the involuting uterus are described

  8. Risk factors for postpartum urinary incontinence

    Directory of Open Access Journals (Sweden)

    Lígia da Silva Leroy

    2016-04-01

    Full Text Available Abstract OBJECTIVE: To investigate the risk factors for postpartum urinary incontinence (UI and its characteristics. METHOD: This was a case-control study with 344 puerperal women (77 cases and 267 controls with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. RESULTS: Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, p<0.0001, multiparity (OR 2.26, CI 95% 1.22 - 4.19, p=0.009, gestational age at birth greater or equal to 37 weeks (OR 2.52, CI 95% 1.16 - 5.46, p=0.02 and constipation (OR 1.94, CI 95% 1.05 - 5.46, p=0.035. CONCLUSION: Most often, UI first appeared during pregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent.

  9. Nutrition and the psychoneuroimmunology of postpartum depression

    OpenAIRE

    Ellsworth-Bowers, E. R.; Corwin, E. J.

    2012-01-01

    Postpartum depression (PPD) is a relatively common and often severe mood disorder that develops in women after childbirth. The aetiology of PPD is unclear, although there is emerging evidence to suggest a psychoneuroimmune connection. Additionally, deficiencies in n-3 PUFA, B vitamins, vitamin D and trace minerals have been implicated. This paper reviews evidence for a link between micronutrient status and PPD, analysing the potential contribution of each micronutrient to psychoneuroimmunolog...

  10. Brain Abscess Presenting as Postpartum Diabetes Insipidus

    Directory of Open Access Journals (Sweden)

    Silvia So-Haei Liu

    2004-03-01

    Conclusion: The diagnosis of brain abscess in this patient was masked by postpartum diabetes insipidus, which is an unusual manifestation. Symptoms and signs of brain abscess are nonspecific in the early stage and missed diagnosis is not uncommon. In conclusion, we reaffirm the importance of remarking on any past relevant information, and one should always be aware of any unresolved symptoms even though they may be nonspecific.

  11. Birth order and postpartum psychiatric disorders.

    Science.gov (United States)

    Munk-Olsen, Trine; Jones, Ian; Laursen, Thomas Munk

    2014-05-01

    Primiparity is a well-established and significant risk factor for postpartum psychosis and especially bipolar affective disorders. However, no studies have, to our knowledge, quantified the risk of psychiatric disorders after the first, second, or subsequent births. The overall aim of the present study was to study the risk of first-time psychiatric episodes requiring inpatient treatment after the birth of the first, second, or third child. A cohort comprising 750,127 women was defined using information from Danish population registries. Women were followed individually from the date of birth of their first, second, or third child through the following 12 months over the period 1970-2011. The outcome of interest was defined as first-time admissions to a psychiatric hospital with any type of psychiatric disorder. Women who had a first psychiatric episode which required inpatient treatment after their first (n = 1,327), second (n = 735), or third (n = 238) delivery were included. The highest risk was found in primiparous mothers 10-19 days postpartum [relative risk (RR) = 8.65; 95% confidence interval (CI): 6.89-10.85]. After the second birth, the highest risk was at 60-89 days postpartum (RR = 2.01; 95% CI: 1.52-2.65), and there was no increased risk after the third birth. The effect of primiparity was strongest for bipolar disorders. Primiparity is a significant risk factor for experiencing a first-time episode with a psychiatric disorder, especially bipolar disorders. A second birth was associated with a smaller risk, and there was no increased risk after the third birth. The risk of postpartum episodes after the second delivery increased with increasing inter-pregnancy intervals, a result which warrants further investigation. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Postpartum depression and the male partner

    Directory of Open Access Journals (Sweden)

    Anna de Magistris

    2013-04-01

    Full Text Available Background: Numerous studies have shown that postpartum depression is a phenomenon that develops in a family, social and economic context capable of influencing its course. A predominant role in the onset of the pathology is played by the relationship of the couple, but up to now few studies have been carried out on the role of the partner of the depressed mother and on the interactions between the two partners, that is, on how maternal depression influences the behaviour of the male partner and is in turn influenced, and how the depression of both parents, and not only that of the mother, influences the neuropsychic development of the child and the interactions between the child and the outside world. Objectives: The objectives are to examine the literature to arrive at an understanding of how the father figure develops during the pregnancy and how postpartum depression impacts on the couple’s relationship and the care of the children by both partners. Materials and methods: This article presents a review of recent literature on the subject through a search for articles in Pubmed and Sciencedirect (keywords: men, postpartum depression, fathers, couple, prediction, detection, and by referring to classic texts in the fields of psychiatry and psychotherapy on the development of the parental figures. Conclusions: Although up to now the literature on the consequences of postpartum depression on the couple is scanty, the data collected allow us to affirm that it is not a problem that concerns only the mother, but one that has an impact on the entire family, on the child and the partner, triggering a chain reaction of maladjustment and distress that may lead to separation and destruction of the family unit with important repercussions on society as a whole.

  13. Bipolar postpartum depression: An update and recommendations.

    Science.gov (United States)

    Sharma, Verinder; Doobay, Minakshi; Baczynski, Christine

    2017-09-01

    Over the past few years there has been a surge of interest in the study of bipolar postpartum depression (PPD); however, questions remain about its prevalence, screening, clinical features, and treatment. Three electronic databases, MEDLINE/PubMed (1966-2016), PsycINFO (1806-2016), and the Cochrane Database of Systematic Reviews, were searched using a combination of the keywords bipolar, depression, postpartum, peripartum, prevalence, screening, diagnosis, treatment, drugs, and psychotherapy. The reference lists of articles identified were also searched. All relevant articles published in English were included. Depending on the population studied, 21.4-54% of women with PPD have a diagnosis of bipolar disorder (BD). Characteristic clinical features include younger age at illness onset, first onset of depression after childbirth, onset immediately after delivery, atypical depressive symptoms, psychotic features, mixed features, and history of BD in first-degree family members. Treatment should be guided by symptom acuity, safety concerns, the patient's response to past treatments, drug tolerability, and breastfeeding preference. In the absence of controlled treatment data, preference should be given to drugs normally indicated for bipolar depression including lithium, quetiapine and lamotrigine. Although antidepressants have been studied in combination with mood stabilizers in bipolar depression, these drugs should be avoided due to likelihood of elevated risk of induction of manic symptoms in the postpartum period. In the postpartum period, bipolar PPD is common, can be differentiated from unipolar PPD, and needs to be identified promptly in order to expedite appropriate treatment. Future studies on pharmacotherapy and psychotherapy should focus on the acute and preventative treatment of bipolar PPD. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Conservative management of primary postpartum haemorrhage

    International Nuclear Information System (INIS)

    Naqvi, S.; Makhdoom, T.

    2004-01-01

    Severe postpartum haemorrhage (PPH) is a serious obstetrical emergency. Two cases of severe PPH due to uterine atony are described which were managed by uterine packing with sterile ribbon gauze by vaginal route under general anesthesia. Along with supportive measures, it resulted in marked improvement in controlling haemorrhage and infectious morbidity. This is an effective treatment for severe PPH and should be practiced at tertiary care level in woman who wishes to preserve fertility. (author)

  15. Autoimmune Abnormalities of Postpartum Thyroid Diseases

    Directory of Open Access Journals (Sweden)

    Flavia Di Bari

    2017-07-01

    Full Text Available The year following parturition is a critical time for the de novo appearance or exacerbation of autoimmune diseases, including autoimmune thyroid disease. The vast majority of postpartum thyroid disease consists of postpartum thyroiditis (PPT and the minority by Graves’ disease and non-autoimmune thyroiditis. PPT has a worldwide prevalence ranging from 1 to 22% and averaging 5% based on a review published in 2012. Several factors confer risk for the development of PPT. Typically, the clinical course of PPT is characterized by three phases: thyrotoxic, hypothyroid, and euthyroid phase. Approximately half of PPT women will have permanent hypothyroidism. The best humoral marker for predictivity, already during the first trimester of gestation, is considered positivity for thyroperoxidase autoantibodies (TPOAb, though only one-third to half of such TPOAb-positive pregnant women will develop PPT. Nutraceuticals (such as selenium or omega-3-fatty acid supplements seem to have a role in prevention of PPT. In a recent study on pregnant women with stable dietary habits, we found that the fish consumers had lower rates of positivity (and lower serum levels of both TPOAb and thyroglobulin Ab compared to meat eaters. Finally, we remind the reader of other diseases that can be observed in the postpartum period, either autoimmune or non-autoimmune, thyroid or non-thyroid.

  16. Postpartum bleeding: efficacy of endovascular management

    International Nuclear Information System (INIS)

    Lee, Sun Young; Ko, Gi Young; Song, Ho Young; Gwon, Dong Il; Sung, Kyu Bo; Yoon, Hyun Ki

    2003-01-01

    To assess the effectiveness and safety of transcatheter arterial embolization for the treatment of massive postpartum bleeding. Transcatheter arterial embolization was attempted in 25 patients with massive postpartum bleeding. After identification at bilateral internal iliac arteriography, the bleeding artery was embolized using gelfoam, polyvinyl alcohol particles or microcoils, and to prevent rebleeding through collateral pathways, the contralateral uterine artery or anterior division of the internal iliac artery was also embolized. Clinical success and complications were retrospectively assessed and documented. Active bleeding foci were detected in 13 patients (52%), and involved the unilateral (n=10) or bilateral (n=2) uterine artery and unilateral vaginal artery (n=1). Twelve (92%) of the 13 patients recovered completely following embolization, but one underwent hysterectomy due to persistent bleeding. The focus of bleeding was not detected in 12 patients (48%), but 11 (92%) of these also recovered following embolization of the bilateral uterine or internal iliac arteries. One patient, however, died due to sepsis. Two of the 12 patients underwent hysterectomy due ro rebleeding on the 12 th and 13 th day, respectively, after embolization. Transcatheter arterial embolization is relatively safe and effective for the treatment massive postpartum bleeding

  17. Postpartum bleeding: efficacy of endovascular management

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young; Ko, Gi Young; Song, Ho Young; Gwon, Dong Il; Sung, Kyu Bo; Yoon, Hyun Ki [Asan Medical Center, Seoul (Korea, Republic of)

    2003-06-01

    To assess the effectiveness and safety of transcatheter arterial embolization for the treatment of massive postpartum bleeding. Transcatheter arterial embolization was attempted in 25 patients with massive postpartum bleeding. After identification at bilateral internal iliac arteriography, the bleeding artery was embolized using gelfoam, polyvinyl alcohol particles or microcoils, and to prevent rebleeding through collateral pathways, the contralateral uterine artery or anterior division of the internal iliac artery was also embolized. Clinical success and complications were retrospectively assessed and documented. Active bleeding foci were detected in 13 patients (52%), and involved the unilateral (n=10) or bilateral (n=2) uterine artery and unilateral vaginal artery (n=1). Twelve (92%) of the 13 patients recovered completely following embolization, but one underwent hysterectomy due to persistent bleeding. The focus of bleeding was not detected in 12 patients (48%), but 11 (92%) of these also recovered following embolization of the bilateral uterine or internal iliac arteries. One patient, however, died due to sepsis. Two of the 12 patients underwent hysterectomy due ro rebleeding on the 12{sup th} and 13{sup th} day, respectively, after embolization. Transcatheter arterial embolization is relatively safe and effective for the treatment massive postpartum bleeding.

  18. Women's challenges with postpartum weight loss.

    Science.gov (United States)

    Montgomery, Kristen S; Bushee, Tracy D; Phillips, Jennifer D; Kirkpatrick, Terrie; Catledge, Courtney; Braveboy, Kristin; O'Rourke, Carol; Patel, Neema; Prophet, Malshundria; Cooper, Anita; Mosley, Lori; Parker, Christie; Douglas, Gaye M

    2011-11-01

    This study was designed to examine women's experiences of weight loss during the postpartum period. Understanding women's positive and negative experiences can assist health care providers to successfully intervene in helping women lose weight following pregnancy and avoid long-term weight gain and obesity development. Phenomenology, according to Husserl's perspective. Private location of the women's choosing. Twenty-six women, who ranged in age from 25 to 35 years, and had given birth within the last 5 years, were interviewed regarding their experiences with postpartum weight loss. The majority of the sample was Caucasian. Interviews were transcribed and themes were identified from each of the interviews. Comparisons were made between interviews to identify common experiences between women. Data were analyzed according to the Giorgi method. The women in the study had a wide range of experiences. Themes that emerged from the interviews related to women's challenges with return to prepregnancy weight. These included: time and motivation issues, the need for support, and weight and other struggles. This study provides a look inside the lives of women faced with the reality of losing weight after childbirth. Losing weight after delivery is multi-faceted and influenced by many factors. Interventions to assist women with weight loss should target the challenges described in this paper. When effective strategies are developed, education can be done during pregnancy to prepare for the postpartum period. Ultimately, future research efforts can help us to eliminate pregnancy as a risk factor for obesity in women.

  19. Recurrent post-partum coronary artery dissection

    Directory of Open Access Journals (Sweden)

    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. Women's postpartum maternity benefits and work experience.

    Science.gov (United States)

    Gjerdingen, D K; McGovern, P M; Chaloner, K M; Street, H B

    1995-10-01

    This study was conducted to describe women's perceptions of their maternity leave policy and its implementation, maternity leave benefits, postpartum work experience, and factors that relate to returning to work. Surveys were mailed to 436 married, recently employed, first-time mothers at 1, 3, 6, 9 and 12 months postpartum. Most respondents said they had written maternity leave policies they could understand, but they were not completely satisfied with their policies. The average 11.1-week maternity leave was considerably shorter than their 8-month ideal, and only 25.5% had the option of working part-time. A minority (35.8%) were allowed to use personal days to care for a sick infant. Most women were distressed about making child care arrangements. Compared with women who remained at home, those who returned to work complained of more respiratory, gynecologic, and breast symptoms. Relatively little is known about women's postpartum work experience. In this study, return to work after delivery was related to several demographic, occupational, and social factors and was associated with health problems and concerns about child care. With a majority of new mothers now returning to work, attention has recently been directed to factors that facilitate the merger of work and parenting roles. One such important factor is women's parental or maternity leave benefits, the focus of this study.

  1. Sleep disturbance and neurobehavioral performance among postpartum women.

    Science.gov (United States)

    Insana, Salvatore P; Williams, Kayla B; Montgomery-Downs, Hawley E

    2013-01-01

    Sleep disturbances cause neurobehavioral performance and daytime functioning impairments. Postpartum women experience high levels of sleep disturbance. Thus, the study objective was to describe and explore the relation between neurobehavioral performance and sleep among women during the early postpartum period. Longitudinal field-based study. There were 70 primiparous women and nine nulliparous women in a control group. None. During their first 12 postpartum weeks, 70 primiparous women wore continuous wrist actigraphy to objectively monitor their sleep. Each morning they self-administered the psychomotor vigilance test (PVT) to index their neurobehavioral performance. Nine nulliparous women in a control group underwent the same protocol for 12 continuous weeks. Postpartum PVT mean reciprocal (1/RT) reaction time did not differ from that of women in the control group at postpartum week 2, but then worsened over time. Postpartum slowest 10% 1/RT PVT reaction time was significantly worse than that of women in the control group at all weeks. Despite improvements in postpartum sleep, neurobehavioral performance continued to worsen from week 2 through the end of the study. Across the first 12 postpartum weeks, PVT measures were more frequently associated with percent sleep compared with total sleep time, highlighting the deleterious consequences of sleep disruption on maternal daytime functioning throughout the early postpartum period. Worsened maternal neurobehavioral performance across the first 12 postpartum weeks may have been influenced by the cumulative effects of sleep disturbance. These results can inform future work to identify the particular sleep profiles that could be primary intervention targets to improve daytime functioning among postpartum women, and indicate need for further research on the effectiveness of family leave policies. The time when postpartum women return to control-level daytime functioning is unknown.

  2. Recurrent Silent Thyroiditis as a Sequela of Postpartum Thyroiditis

    OpenAIRE

    Hanseree, Preaw; Salvador, Vincent Bryan; Sachmechi, Issac; Kim, Paul

    2014-01-01

    Thyroiditis encompasses a group of disorders characterized by thyroid inflammation. Though clinically indistinguishable from silent thyroiditis, postpartum thyroiditis occurs in women within 12 months after delivery. Recurrent postpartum thyroiditis in subsequent pregnancies is common, but recurrent silent thyroiditis is rare. We reported a case of patient with recurrent episodes of thyroiditis, unrelated to pregnancy, after an episode of postpartum thyroiditis. It is of interest that postpar...

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

    OpenAIRE

    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...

  4. Preventing postpartum depression: A meta-analytic review

    Science.gov (United States)

    Sockol, Laura E.; Epperson, C. Neill; Barber, Jacques P.

    2014-01-01

    This meta-analysis assessed the efficacy of a wide range of preventive interventions designed to reduce the severity of postpartum depressive symptoms or decrease the prevalence of postpartum depressive episodes. A systematic review identified 37 randomized or quasi-randomized controlled trials in which an intervention was compared to a control condition. Differences between treatment and control conditions in the level of depressive symptoms and prevalence of depressive episodes by 6 months postpartum were assessed in separate analyses. Depressive symptoms were significantly lower at post-treatment in intervention conditions, with an overall effect size in the small range after exclusion of outliers (Hedges' g = 0.18). There was a 27% reduction in the prevalence of depressive episodes in intervention conditions by 6 months postpartum after removal of outliers and correction for publication bias. Later timing of the postpartum assessment was associated with smaller differences between intervention and control conditions in both analyses. Among studies that assessed depressive symptoms using the EPDS, higher levels of depressive symptoms at pre-treatment were associated with smaller differences in depressive symptoms by 6 months postpartum. These findings suggest that interventions designed to prevent postpartum depression effectively reduce levels of postpartum depressive symptoms and decrease risk for postpartum depressive episodes. PMID:24211712

  5. Postpartum Maternal Weight Changes: Implications for Military Women

    National Research Council Canada - National Science Library

    Abrams, Barbara

    2002-01-01

    .... Multivariate analysis suggested that high level of maternal weight gain during pregnancy, history of weight cycling, postpartum depression, and financial insecurity were associated with increased weight after birth...

  6. Personality and risk for postpartum depressive symptoms.

    Science.gov (United States)

    Iliadis, S I; Koulouris, P; Gingnell, M; Sylvén, S M; Sundström-Poromaa, I; Ekselius, L; Papadopoulos, F C; Skalkidou, A

    2015-06-01

    Postpartum depression (PPD) is a common childbirth complication, affecting 10-15 % of newly delivered mothers. This study aims to assess the association between personality factors and PPD. All pregnant women during the period September 2009 to September 2010, undergoing a routine ultrasound at Uppsala University Hospital, were invited to participate in the BASIC study, a prospective study designed to investigate maternal well-being. Depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) while the Depression Self-Rating Scale (DSRS) was used as a diagnostic tool for major depression. Personality traits were evaluated using the Swedish Universities Scale of Personality (SSP). One thousand thirty-seven non-depressed pregnant women were included in the study. Non-depressed women reporting high levels of neuroticism in late pregnancy were at high risk of developing postpartum depressive symptoms (PPDSs) at 6 weeks and 6 months after delivery, even after adjustment for confounders (adjusted odds ratio (aOR) = 3.4, 95 % confidence interval (CI) 1.8-6.5 and adjusted odds ratio (aOR) = 3.9, 95 % CI 1.9-7.9). The same was true for a DSRS-based diagnosis of major depression at 6 months postpartum. Somatic trait anxiety and psychic trait anxiety were associated with increased risk for PPDS at 6 weeks (aOR = 2.1, 95 % CI 1.2-3.5 and aOR = 1.9, 95 % CI 1.1-3.1), while high scores of mistrust were associated with a twofold increased risk for PPDS at 6 months postpartum (aOR 1.9, 95 % CI 1.1-3.4). Non-depressed pregnant women with high neuroticism scores have an almost fourfold increased risk to develop depressive symptoms postpartum, and the association remains robust even after controlling for most known confounders. Clinically, this could be of importance for health care professionals working with pregnant and newly delivered women.

  7. Prolonged pregnancy: Methods, Causal Determinants and Outcome

    DEFF Research Database (Denmark)

    Olesen, Annette Wind

    Summary Prolonged pregnancy, defined as a pregnancy with a gestational length of 294 days or more, is a frequent condition. It is associated with an increased risk of fetal and maternal complications. Little is known about the aetiology of prolonged pregnancy. The aims of the thesis were 1......) to study the incidence of prolonged pregnancy as a function of methods for determining gestational age; 2) to determine the risk of obstetrical and fetal complications in prolonged pregnancy; 3) to validate the self-reported gestational age in the National Birth Cohort; 4) to determine whether...... the risk of recurrence of prolonged pregnancy as a function of change in male partner and social conditions (IV). The National Birth Cohort provided data for the study on prenatal risk indicators of prolonged pregnancy in a follow-up design (V). The self-reported gestational ages from this database...

  8. Preventing Postpartum Smoking Relapse: A Randomized Clinical Trial.

    Science.gov (United States)

    Levine, Michele D; Cheng, Yu; Marcus, Marsha D; Kalarchian, Melissa A; Emery, Rebecca L

    2016-04-01

    Most women who quit smoking during pregnancy will relapse postpartum. Previous efforts to prevent postpartum relapse have been unsuccessful at increasing rates of sustained abstinence. To evaluate the relative efficacy of 2 different approaches to prevent postpartum smoking relapse. Pregnant women who recently had quit smoking were recruited before the end of pregnancy. Intervention sessions were conducted through a combination of telephone calls and in-person visits beginning at delivery and continuing through 24 weeks postpartum. Participants completed assessments at the prenatal baseline and at 12, 24, and 52 weeks postpartum. Participants were recruited between March 2008 and December 2012. The dates of the analysis were April 2014 to February 2015. Women received postpartum-adapted, behavioral smoking relapse prevention intervention and were randomly assigned to an enhanced cognitive behavioral intervention that included additional specialized strategies and content focused on women's postpartum concerns about mood, stress, and weight (Strategies to Avoid Returning to Smoking [STARTS]) or a supportive, time and attention-controlled comparison (SUPPORT). Intervention began before delivery and continued through 24 weeks postpartum. The primary outcome was biochemically confirmed sustained tobacco abstinence at 52 weeks postpartum. Secondary outcomes were self-reported mood, levels of perceived stress, and degree of concern about smoking-related weight gain. The study cohort comprised 300 participants (150 randomly assigned to each group). Their mean (SD) age was 24.99 (5.65) years. Overall, 38.0% (114 of 300), 33.7% (101 of 300), and 24.0% (72 of 300) of the sample maintained abstinence at 12, 24, and 52 weeks' postpartum, respectively. There were no differences between the intervention groups in abstinence or time to relapse. Self-reported depressive symptoms and perceived stress significantly improved over time, and improvements were similar for both

  9. Meta-analysis of the predictive factors of postpartum fatigue.

    Science.gov (United States)

    Badr, Hanan A; Zauszniewski, Jaclene A

    2017-08-01

    Nearly 64% of new mothers are affected by fatigue during the postpartum period, making it the most common problem that a woman faces as she adapts to motherhood. Postpartum fatigue can lead to serious negative effects on the mother's health and the newborn's development and interfere with mother-infant interaction. The aim of this meta-analysis was to identify predictive factors of postpartum fatigue and to document the magnitude of their effects using effect sizes. We used two search engines, PubMed and Google Scholar, to identify studies that met three inclusion criteria: (a) the article was written in English, (b) the article studied the predictive factors of postpartum fatigue, and (c) the article included information about the validity and reliability of the instruments used in the research. Nine articles met these inclusion criteria. The direction and strength of correlation coefficients between predictive factors and postpartum fatigue were examined across the studies to determine their effect sizes. Measurement of predictor variables occurred from 3days to 6months postpartum. Correlations reported between predictive factors and postpartum fatigue were as follows: small effect size (r range =0.10 to 0.29) for education level, age, postpartum hemorrhage, infection, and child care difficulties; medium effect size (r range =0.30 to 0.49) for physiological illness, low ferritin level, low hemoglobin level, sleeping problems, stress and anxiety, and breastfeeding problems; and large effect size (r range =0.50+) for depression. Postpartum fatigue is a common condition that can lead to serious health problems for a new mother and her newborn. Therefore, increased knowledge concerning factors that influence the onset of postpartum fatigue is needed for early identification of new mothers who may be at risk. Appropriate treatments, interventions, information, and support can then be initiated to prevent or minimize the postpartum fatigue. Copyright © 2017 Elsevier

  10. [A postpartum woman with toxic shock syndrome: group A streptococcal infection, a much feared postpartum complication.

    NARCIS (Netherlands)

    Abbink, K.; Kortekaas, J.C.; Buise, M.P.; Dokter, J.; Kuppens, S.M.; Hasaart, T.H.M.

    2016-01-01

    BACKGROUND: The development of toxic shock syndrome (TSS) after an invasive group A streptococcal (GAS) infection in the postpartum period is a much feared complication. The mortality rate of TSS with necrotizing fasciitis is 30 to 50%. CASE DESCRIPTION: We present the case of a woman with atypical

  11. Psychometric properties of the postpartum depression screening scale beyond the postpartum period.

    Science.gov (United States)

    Vogeli, Jo M; Hooker, Stephanie A; Everhart, Kevin D; Kaplan, Peter S

    2018-04-01

    Accurate postpartum depression screening measures are needed to identify mothers with depressive symptoms both in the postpartum period and beyond. Because it had not been tested beyond the immediate postpartum period, the reliability and validity of the Postpartum Depression Screening Scale (PDSS) and its sensitivity, specificity, and predictive value for diagnoses of major depressive disorder (MDD) were assessed in a diverse community sample of 238 mothers of 4- to 15-month-old infants. Mothers (N = 238; M age = 30.2, SD = 5.3) attended a lab session and completed the PDSS, the Beck Depression Inventory-II (BDI-II), and a structured clinical interview (SCID) to diagnose MDD. The reliability, validity, specificity, sensitivity, and predictive value of the PDSS to identify maternal depression were assessed. Confirmatory factor analysis supported the construct validity of five but not seven content subscales. The PDSS total and subscale scores demonstrated acceptable to high reliability (α = 0.68-0.95). Discriminant function analysis showed the scale correctly provided diagnostic classification at a rate higher than chance alone. Sensitivity and specificity for major depressive disorder (MDD) diagnosis were good and comparable to those of the BDI-II. Even in mothers who were somewhat more diverse and had older infants than those in the original normative study, the PDSS appears to be a psychometrically sound screener for identifying depressed mothers in the 15 months after childbirth. © 2018 Wiley Periodicals, Inc.

  12. Safety information on QT-interval prolongation

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Holtkamp, Frank A; Rutten, Frans H

    2014-01-01

    Prolongation of the QT interval can predispose to fatal ventricular arrhythmias. Differences in QT-labeling language can result in miscommunication and suboptimal risk mitigation. We systematically compared the phraseology used to communicate on QT-prolonging properties of 144 drugs newly approve...

  13. Risk factors for QTc interval prolongation

    NARCIS (Netherlands)

    Heemskerk, Charlotte P.M.; Pereboom, Marieke; van Stralen, Karlijn; Berger, Florine A.; van den Bemt, Patricia M.L.A.; Kuijper, Aaf F.M.; van der Hoeven, Ruud T M; Mantel-Teeuwisse, Aukje K.; Becker, Matthijs L

    2018-01-01

    Purpose: Prolongation of the QTc interval may result in Torsade de Pointes, a ventricular arrhythmia. Numerous risk factors for QTc interval prolongation have been described, including the use of certain drugs. In clinical practice, there is much debate about the management of the risks involved. In

  14. Prenatal risk indicators of a prolonged pregnancy

    DEFF Research Database (Denmark)

    Olesen, Annette Wind; Westergaard, Jes Grabow; Olsen, Jørn

    2006-01-01

    BACKGROUND: Few prenatal risk factors of prolonged pregnancy, a pregnancy of 42 weeks or more, are known. The objective was to examine whether sociodemographic, reproductive, toxicologic, or medical health conditions were associated with the risk of prolonged pregnancy. METHODS: Data from...

  15. The association between breastfeeding, the stress response, inflammation, and postpartum depression during the postpartum period: Prospective cohort study.

    Science.gov (United States)

    Ahn, Sukhee; Corwin, Elizabeth J

    2015-10-01

    Research suggests that exclusive breastfeeding may have a stress-protective role in postpartum depression; however, less is known about the underlying mechanisms by which this protection may occur or whether the protective relationship holds for women who mix breast and bottle feeding. To examine patterns of the stress response, inflammation, and depressive symptoms among women predominantly breastfeeding or bottle feeding their infants at 6 months postpartum. A part of a larger longitudinal study across 6 months postpartum investigating the psychoneuroimmunology (PNI) of postpartum depression. Prenatal clinics and community. One hundred nineteen postpartum women who met inclusion/exclusion criteria and followed up from the prenatal period to postpartum 6 months. Data were collected during seven home visits occurring during the 3rd trimester (weeks 32-36) and on postpartum days 7 and 14, months 1, 2, 3, and 6. Women completed stress and depression surveys and provided blood for pro- (IL-1β, IL-6, IL-8, TNF-a, IFN-γ) and anti-inflammatory (IL-10) cytokines, and collected saliva for diurnal cortisol. Self-report of predominant breastfeeding during 6 months postpartum ranged from 91.9% at day 7 to 70.6% at month 6 postpartum. There were no associations between the pattern of feeding and depressive symptoms. Biological differences, however, existed between the groups, with levels of salivary cortisol at 8 AM and 8:30 AM at month 6 higher and levels of IL-6 at month 6 lower in women who primarily breastfed compared to those who primarily bottle fed their infants after controlling for confounding variables. Breastfeeding was not related to postpartum depression however differences in stress and inflammatory markers are apparent at month 6 postpartum. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. 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.

  17. Inside a Postpartum Nursing Center: Tradition and Change.

    Science.gov (United States)

    Yeh, Yueh-Chen; St John, Winsome; Venturato, Lorraine

    2016-06-01

    The purpose of this study was to explore how traditional ritual practices are incorporated into the context of contemporary healthcare. An ethnographic study was conducted, using observations and interviews with 27 first-time mothers and 3 nurses at a postpartum nursing center in Taipei, Taiwan. Nursing routines, policies and care provision at the center affected the way traditional ritual practices were conducted. New mothers in this study constructed their everyday activities at the center by incorporating and modifying the ritual practices inside and outside the postpartum nursing center setting. Social changes have an influence on traditional postpartum ritual practices so a postpartum nursing center becomes a choice for postpartum women. Thus, health care professionals should value their own functions and roles at the postpartum nursing center since the new mothers regard them as the primary support resource to help them recover from giving birth. Therefore, they need to re-examine their practices from the postpartum women's perspective to provide better support and sensitive care to postpartum women and their families. Copyright © 2016. Published by Elsevier B.V.

  18. Short term effect of breastfeeding on postpartum maternal ...

    African Journals Online (AJOL)

    Background: Pregnancy related weight gain and retention of gained weight during the postpartum period has remained a challenge to African women. Studies have revealed that breastfeeding has various benefits on both mother and child, however studies on the ability to cause reduction in postpartum maternal weight ...

  19. Sequential serotonin and noradrenalin associated processes involved in postpartum blues

    NARCIS (Netherlands)

    Doornbos, B.; Fekkes, D.; Tanke, M.A.; de Jonge, P.; Korf, J.

    2008-01-01

    Objective: We investigated whether postpartum blues was related to changes in parameters of noradrenergic and serotonergic functioning. Methods: From 26 healthy pregnant women blood was collected at the End of pregnancy and 5 days and 6 weeks postpartum. Serotonergic parameters were: platelet

  20. Factors Influencing Physical Activity among Postpartum Iranian Women

    Science.gov (United States)

    Roozbahani, Nasrin; Ghofranipour, Fazlollah; Eftekhar Ardabili, Hassan; Hajizadeh, Ebrahim

    2014-01-01

    Background: Postpartum women are a population at risk for sedentary living. Physical activity (PA) prior to pregnancy may be effective in predicting similar behaviour in the postpartum period. Objective: To test a composite version of the extended transtheoretical model (TTM) by adding "past behaviour" in order to predict PA behaviour…

  1. The epidemiology of postpartum malaria: a systematic review

    NARCIS (Netherlands)

    Boel, Machteld E.; Rijken, Marcus J.; Brabin, Bernard J.; Nosten, François; McGready, Rose

    2012-01-01

    Pregnant women are more susceptible to malaria than their non-pregnant counterparts. Less is known about the risk of malaria in the postpartum period. The epidemiology of postpartum malaria was systematically reviewed. Eleven articles fitted the inclusion criteria. Of the 10 studies that compared

  2. Prevalence of autoimmune thyroid dysfunction in postpartum psychosis

    NARCIS (Netherlands)

    Bergink, Veerle; Kushner, Steven A.; Pop, Victor; Kuijpens, Hans; Lambregtse-van den Berg, Mijke P.; Drexhage, Roos C.; Wiersinga, Wilmar; Nolen, Willem A.; Drexhage, Hemmo A.

    2011-01-01

    Postpartum psychosis is a life-threatening psychiatric emergency, which often occurs without significant premorbid symptoms. Although many studies have postulated an involvement of the immune and endocrine systems in the onset of postpartum psychosis, the specific aetiological factors have remained

  3. Women's Experiences with Postpartum Anxiety: Expectations, Relationships, and Sociocultural Influences

    Science.gov (United States)

    Wardrop, Andrea A.; Popadiuk, Natalee E.

    2013-01-01

    Evidence about anxiety in the postpartum is sparse and contradictory. Our research expands this knowledge by using a qualitative methodology, the Feminist Biographical Method, to explore first time mothers' experiences of postpartum anxiety. Data collection included 1.5 to 2.0 hour interviews with six women about their experiences of anxiety in…

  4. Challenges in Diagnosing and Treating Postpartum Blues, Depression and Psychosis

    Science.gov (United States)

    Lewis, Carol A.; Byers, Alison Daly; Malard, Sarah Deann; Dawson, Gregory A.

    2010-01-01

    With recent media attention and a growing awareness in popular culture, the appropriate treatment for postpartum depression has taken center stage as a prevalent women's health issue. There is little agreement on the definition, existence and treatment of postpartum depression. Contributing to this factor is the lack of research that exists to…

  5. Serum cholesterol decline and depression in the postpartum period

    NARCIS (Netherlands)

    Dam, van R.M.; Schuit, A.J.; Schouten, E.G.; Vader, H.L.; Pop, V.J.M.

    1999-01-01

    We examined the relation between total serum cholesterol decline and depression in the postpartum period in a prospective study of 266 Dutch women, who were followed until 34 weeks after delivery. The decline in serum cholesterol between week 32 of pregnancy and week 10 postpartum was similar for

  6. Serum cholesterol decline and depression in the postpartum period

    NARCIS (Netherlands)

    van Dam, R M; Schuit, A.J.; Schouten, E G; Vader, H L; Pop, V.J.

    We examined the relation between total serum cholesterol decline and depression in the postpartum period in a prospective study of 266 Dutch women, who were followed until 34 weeks after delivery. The decline in serum cholesterol between week 32 of pregnancy and week 10 postpartum was similar for

  7. 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.

  8. Clinical and Biomarkers Difference in Prepartum and Postpartum Eclampsia.

    Science.gov (United States)

    Berhan, Yifru; Endeshaw, Gezahegn

    2015-07-01

    There is a large body of literature which assessed the incidence and risk factors of eclampsia, but little was done in assessing the association of clinical features and biological markers with prepartum and postpartum eclampsia. A total of 361 eclamptic women admitted to three teaching hospitals between 2008 and 2013 were included in this analysis. A comparative analysis was done for several clinical and biological variables to assess their association with prepartum and postpartum eclampsia. The overall incidence of eclampsia was 1.2% (prepartum 71% and postpartum 29%). The majority of women with prepartum eclampsia were young, primigravida, more hypertensive, symptomatic and proteinuric. Conversely, the majorities of the women with post-partum eclampsia were adult, multiparous, carrying pregnancy to term, anemic, thrombocytopenic, and with hepatic dysfunction. The commonest severity symptom (headache) was less common in postpartum eclamptic women. The incidence of eclampsia was among the highest in the world. And, the analysis has shown that the clinical and biochemical spectrum of prepartum and postpartum eclampsia were apparently different. The majority of the women who developed postpartum eclampsia were multiparous and adult. Derangement of biomarkers was also more common in women with postpartum eclampsia.

  9. Prevalence of pre- and postpartum depression in Jamaican women

    Directory of Open Access Journals (Sweden)

    Kulkarni Santosh

    2005-11-01

    Full Text Available Abstract Background Maternal depression during pregnancy has been studied less than depression in postpartum period. The aims of this study were to find out the prevalence of prepartum and postpartum depression and the risk factors associated in a cohort of Afro-Jamaican pregnant women in Jamaica. Methods The Zung self-rating depression scale instrument was administered to 73 healthy pregnant women at 28 weeks gestation and at 6 weeks postpartum for quantitative measurement of depression. Blood samples were collected at 8, 28, 35 weeks gestation and at day 1 and 6 weeks postpartum to study the thyroid status. Results Study demonstrated depression prevalence rates of 56% and 34% during prepartum and postpartum period, respectively. 94% women suffering depression in both periods were single. There were significant variations in both FT3 and TT4 concentrations which increased from week 8 to week 28 prepartum (p th week (p 3, TT4 and TSH there were no significant between group differences in concentrations. The major determinants of postpartum depression were moderate and severe prepartum depression and change in TT4 hormone concentrations. Conclusion High prevalence of depression was found during pre- and postpartum periods. Single mothers, prepartum depression and changes in TT4 were factors found to be significantly associated with postpartum depression.

  10. Primary postpartum haemorrhage at the university of Port Harcourt ...

    African Journals Online (AJOL)

    Background: Postpartum haemorrhage (PPH) is a leading global cause of severe maternal morbidity and mortality. Approximately 14 million women suffer postpartum haemorrhage annually and at least 128,000 of these women bleed to death. Most of these deaths, which occur within four hours of delivery and are as a ...

  11. Prevalence and correlates of postpartum depression in a teaching ...

    African Journals Online (AJOL)

    Background: Postpartum depression is a common and disabling disorder seen in new mothers having many deleterious effects on the new mother, the new infant, the father, the family and the society at large. This study determined the prevalence and socio-demographic correlates of postpartum depression among new ...

  12. Postpartum depression among mothers as seen in hospitals in ...

    African Journals Online (AJOL)

    Introduction: Postpartum depression is an uncommon and frequently undocumented issue that impacts negatively on maternal and child health. Methods: The study was carried out among mothers who attended postpartum clinics from two teaching hospitals and three private hospitals all in Enugu metropolis.

  13. Postpartum Depression Among Igbo Women In An Urban Mission ...

    African Journals Online (AJOL)

    Context: Postpartum depression adversely affects mothers, their newborn infants, their partners and the society. Its timely diagnosis is highly desirable. Objective: To assess the prevalence and associated sociodemographic variables of Postpartum depression among women of Igbo Ethnic origin attending an urban mission ...

  14. [Brain function recovery after prolonged posttraumatic coma].

    Science.gov (United States)

    Klimash, A V; Zhanaidarov, Z S

    2016-01-01

    To explore the characteristics of brain function recovery in patients after prolonged posttraumatic coma and with long-unconscious states. Eighty-seven patients after prolonged posttraumatic coma were followed-up for two years. An analysis of a clinical/neurological picture after a prolonged episode of coma was based on the dynamics of vital functions, neurological status and patient's reactions to external stimuli. Based on the dynamics of the clinical/neurological picture that shows the recovery of functions of the certain brain areas, three stages of brain function recovery after a prolonged episode of coma were singled out: brain stem areas, diencephalic areas and telencephalic areas. These functional/anatomic areas of brain function recovery after prolonged coma were compared to the present classifications.

  15. 9. Nuclear power plant service life prolongation

    International Nuclear Information System (INIS)

    Evropin, S.V.

    1998-01-01

    The problem of prolongation of nuclear power plant service life duration is discussed. A schematic diagram of the program developed in the course of activities dealing with NPP service time prolongation is shown and analyzed in details. It is shown that the basic moment when determining the strategy for NPP service time prolongation is the positive confirmation of the agreement between the NPP safety provisions and modern safety requirements. The other very important aspect of the problem is engineering substantiation of the measures assuring the reactor operation prolongation. The conclusion is made that available methods of recovering reactor materials properties, main components repair and replacement, the modern techniques for nondestructive testing of metals and NPP pipelines, as well as the developed approaches to reactor facility safety improvements make the prolongation of the Russian NPP service lifetimes possible from engineering viewpoint and economically desirable

  16. 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...

  17. Vitamin A supplementation for postpartum women.

    Science.gov (United States)

    Oliveira-Menegozzo, Julicristie M; Bergamaschi, Denise P; Middleton, Philippa; East, Christine E

    2010-10-06

    In vitamin A deficient populations, the amount of vitamin A may be insufficient for maintenance of maternal health and levels in breast milk may be insufficient for breastfeeding infants' needs. To assess the effects of postpartum maternal vitamin A supplementation on maternal and infant health. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2010), LILACS (1982 to July 2010), Web of Science (1945 to July 2010) and Biological Abstracts (1998 to July 2010). Randomised controlled trials evaluating the effects of postpartum maternal vitamin A supplementation. Two review authors assessed the studies independently. We included 12 trials at moderate risk of bias, enrolling 25,465 mother-baby pairs and comparing several postpartum doses (200,000-400,000 IU) of vitamin A or 7.8 mg daily beta-carotene, with placebo, iron or no supplement; or higher (400,000 IU) versus lower dose (200,000 IU). The majority of infants in all studies were at least partially breastfed for six months.Maternal: we observed no impact of vitamin A on maternal mortality (two trials of 9,126 women), morbidity (one trial of 50 women) or adverse effects (subset of 786 women in one trial). Vitamin A enhanced serum and breast milk retinol at three months in five trials, but these improvements were generally not sustained.Infant: we observed no significant differences for infant mortality RR 1.14 95% CI 0.84 to 1.57 (five trials (6,170 infants) or morbidity (three trials) except for fewer episodes of fever with vitamin A in one small trial. No significant differences in infant vitamin A status were seen with maternal vitamin A supplementation (five trials).No beneficial effects for maternal or infant health were associated with higher compared to lower doses of vitamin A in two trials. The lack of effect on maternal and infant mortality and morbidity, with exception of some improved infant morbidity in one small study, and the improvement in maternal vitamin A status

  18. 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...

  19. [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.

  20. Locomotor inhibition in adults horses faced to stressors: a single postpartum experience may be enough!

    Directory of Open Access Journals (Sweden)

    Virginie eDurier

    2012-10-01

    Full Text Available Despite the number of postpartum handling that a newborn experiences, few studies focus on their long-term consequences. In rats, regular long separations from the mother, during the early life, led to modifications of the locomotor activity when the animal is confronted to a stressor. In horses, one component of the behavioural response to stressful situation is active locomotion. We wondered if the routine postpartum handling undergone by foals, would affect their level of reactivity or the way they express their stress, when older. One single prolonged bout of handling just after birth clearly affected later adult expression of stress reactivity. In social separation associated with novelty, handled and unhandled horses produced an equal amount of whinnies, showing a similar vocal response to stress. However, both groups differed in their locomotor response to the situations. Early-handled foals expressed less of the active forms of locomotion than the control group. Our findings highlight the need of further reflections on long-term effects of routine handlings procedures close to birth.

  1. Contraceptive efficacy and clinical performance of Nestorone implants in postpartum women.

    Science.gov (United States)

    Massai, M R; Díaz, S; Quinteros, E; Reyes, M V; Herreros, C; Zepeda, A; Croxatto, H B; Moo-Young, A J

    2001-12-01

    The objective of this study was to evaluate the contraceptive efficacy and clinical performance of a Nestorone subdermal implant (NES) in the postpartum period. NES (n = 100) and Copper T intrauterine device (T-Cu; n = 100) acceptors initiated contraception at 8 weeks postpartum and were followed at monthly intervals during the first year and at 3-month intervals thereafter. Pregnancy rates, breastfeeding performance, infant growth, bleeding pattern, and side effects were assessed. Blood and milk NES concentration were measured. No pregnancy occurred in 2195 and 2145 woman-months of NES implant and T-Cu use, respectively. No effect of NES on lactation and infant growth and no serious adverse events were observed. Lactational amenorrhea was significantly longer in NES users (353 +/- 20 days) than in T-Cu users (201 +/- 11 days). More NES users (55.8%) experienced prolonged bleedings than did T-Cu users (36.2%). Concentrations of NES in breast milk ranged between 54-135 pmol/liter. The Nestorone implant is a highly effective contraceptive, safe for breastfed infants because the steroid is inactive by the oral route.

  2. Postpartum Depression: How Childbirth Educators Can Help Break the Silence

    Science.gov (United States)

    Zauderer, Cheryl

    2009-01-01

    The voices of women suffering from postpartum depression are often silent. Women are reluctant to reveal to others that they are unhappy after the birth of their babies. Much has been written on possible causes, risk factors, and treatments for postpartum depression, but little has been done to investigate why women take so long to seek help. Early detection and treatment are key to a full recovery. Childbirth educators are in the position to offer anticipatory guidance on possible complications of the postpartum period, including postpartum depression. This article explores why women with postpartum depression choose to suffer in silence and suggests how childbirth educators can help new mothers find their voices. PMID:20190853

  3. Educational needs of women in relation to postpartum religious orders

    Directory of Open Access Journals (Sweden)

    Marjan Beigi

    2017-01-01

    Full Text Available Introduction: Religious orders are one of the educational needs of the postpartum period. This study was conducted to determine the educational needs of postpartum religious orders.Materials and Methods: This cross-sectional study was conducted among 421 postpartum women and 15 specialists. Quota random sampling was conducted from January to March 2014 in Isfahan, Iran. Data analysis was performed using the Statistical Package for the Social Sciences software and statistical methods.Results: From the perspective of women and specialists, the results showed that the educational needs of women in postpartum religious orders is high.Conclusion: Considering the high educational need in the field of postpartum religious orders, it is necessary to integrate education in prenatal and postnatal health education programs.

  4. 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.

  5. Postpartum MR diagnosis of retained placenta accreta

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Yumiko Oishi; Itai, Yuji [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan); Shigemitsu, Sadahiko [Department of Obstetrics and Gynecology, Ryugasaki Saiseikai General Hospital, Ryagasaki (Japan); Ichikawa, Yoshihito; Sohda, Satoshi; Yoshikawa, Hiroyuki [Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan)

    2004-06-01

    Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta. (orig.)

  6. Postpartum hemorrhage: Clinical and radiologic aspects

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Kyung [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, 1-10, Ami-Dong, Seo-Gu, Busan 602-739 (Korea, Republic of); Kim, Suk [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, 1-10, Ami-Dong, Seo-Gu, Busan 602-739 (Korea, Republic of)], E-mail: kimsuk@medimail.co.kr; Lee, Jun Woo; Sol, Yu Li; Kim, Chang Won [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, 1-10, Ami-Dong, Seo-Gu, Busan 602-739 (Korea, Republic of); Hyun Sung, Kim [Department of Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Jang, Ho Jin; Suh, Dong Soo [Department of Obstetrics and Gynecology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of)

    2010-04-15

    Postpartum hemorrhage (PPH) is a potentially life threatening condition, and it remains the leading cause of maternal morbidity. Uterine atony, lower genital tract lacerations, uterine rupture or inversion, retained products of conception and underlying coagulopathy are some of the common causes of PPH. Most conditions can be diagnosed based on clinical and laboratory evaluation supplemented by ultrasound information. Computed tomography (CT) or magnetic resonance (MR) imaging can provide information for the detection, localization and characterization of PPH in some difficult cases. CT can accurately demonstrate the anatomic location of significant arterial hemorrhage as sites of intravenous contrast material extravasation, which can be as a guide for angiographic intervention. The presence of focal or diffuse intravenous contrast extravasation or a hematoma within the enlarged postpartum uterine cavity on CT can help the diagnosis of uterine atony when the clinical diagnosis of uterine atony is unclear. CT can also provide the information of other alternative conditions such as a puerperal genital hematoma, uterine rupture and concealed hematoma in other sites. MR imaging may be considered as a valuable complement to ultrasound where the ultrasound findings are inconclusive in the diagnosis and differential diagnosis of retained products of conception. Knowledge of the various radiologic appearances of PPH and the correlation with clinical information can ensure correct diagnosis and appropriate and prompt treatment planning in the patients with PPH.

  7. Postpartum MR diagnosis of retained placenta accreta

    International Nuclear Information System (INIS)

    Tanaka, Yumiko Oishi; Itai, Yuji; Shigemitsu, Sadahiko; Ichikawa, Yoshihito; Sohda, Satoshi; Yoshikawa, Hiroyuki

    2004-01-01

    Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta. (orig.)

  8. Postpartum hemorrhage: Clinical and radiologic aspects

    International Nuclear Information System (INIS)

    Lee, Nam Kyung; Kim, Suk; Lee, Jun Woo; Sol, Yu Li; Kim, Chang Won; Hyun Sung, Kim; Jang, Ho Jin; Suh, Dong Soo

    2010-01-01

    Postpartum hemorrhage (PPH) is a potentially life threatening condition, and it remains the leading cause of maternal morbidity. Uterine atony, lower genital tract lacerations, uterine rupture or inversion, retained products of conception and underlying coagulopathy are some of the common causes of PPH. Most conditions can be diagnosed based on clinical and laboratory evaluation supplemented by ultrasound information. Computed tomography (CT) or magnetic resonance (MR) imaging can provide information for the detection, localization and characterization of PPH in some difficult cases. CT can accurately demonstrate the anatomic location of significant arterial hemorrhage as sites of intravenous contrast material extravasation, which can be as a guide for angiographic intervention. The presence of focal or diffuse intravenous contrast extravasation or a hematoma within the enlarged postpartum uterine cavity on CT can help the diagnosis of uterine atony when the clinical diagnosis of uterine atony is unclear. CT can also provide the information of other alternative conditions such as a puerperal genital hematoma, uterine rupture and concealed hematoma in other sites. MR imaging may be considered as a valuable complement to ultrasound where the ultrasound findings are inconclusive in the diagnosis and differential diagnosis of retained products of conception. Knowledge of the various radiologic appearances of PPH and the correlation with clinical information can ensure correct diagnosis and appropriate and prompt treatment planning in the patients with PPH.

  9. Prolonged CT urography in duplex kidney.

    Science.gov (United States)

    Gong, Honghan; Gao, Lei; Dai, Xi-Jian; Zhou, Fuqing; Zhang, Ning; Zeng, Xianjun; Jiang, Jian; He, Laichang

    2016-05-13

    Duplex kidney is a common anomaly that is frequently associated with multiple complications. Typical computed tomography urography (CTU) includes four phases (unenhanced, arterial, parenchymal and excretory) and has been suggested to considerably aid in the duplex kidney diagnosi. Unfortunately, regarding duplex kidney with prolonged dilatation, the affected parenchyma and tortuous ureters demonstrate a lack of or delayed excretory opacification. We used prolonged-delay CTU, which consists of another prolonged-delay phase (1- to 72-h delay; mean delay: 24 h) to opacify the duplicated ureters and affected parenchyma. Seventeen patients (9 males and 8 females; age range: 2.5-56 y; mean age: 40.4 y) with duplex kidney were included in this study. Unenhanced scans did not find typical characteristics of duplex kidney, except for irregular perirenal morphology. Duplex kidney could not be confirmed on typical four-phase CTU, whereas it could be easily diagnosed in axial and CT-3D reconstruction using prolonged CTU (prolonged-delay phase). Between January 2005 and October 2010, in this review board-approved study (with waived informed consent), 17 patients (9 males and 8 females; age range: 2.5 ~ 56 y; mean age: 40.4 y) with suspicious duplex kidney underwent prolonged CTU to opacify the duplicated ureters and confirm the diagnosis. Our results suggest the validity of prolonged CTU to aid in the evaluation of the function of the affected parenchyma and in the demonstration of urinary tract malformations.

  10. Licence prolongations of US nuclear power plants

    International Nuclear Information System (INIS)

    2004-04-01

    Licences of US nuclear reactors were initially attributed for a 40 years duration. However, the vast majority of the reactors can benefit of a licence prolongation for a period of 20 years maximum. This article recalls first the procedure to follow for the licence prolongation demands (safety analysis, components aging, environmental impact statement), and then it makes a status of the accepted prolongations, of the demands under examination, and of the demands that should be presented in the next 5 years. (J.S.)

  11. Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women.

    Science.gov (United States)

    Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri

    2016-01-01

    The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.

  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. Correlates of First-Time Mothers' Postpartum Stress

    Directory of Open Access Journals (Sweden)

    Chich-Hsiu Hung

    2006-10-01

    Full Text Available The purpose of this study was to examine first-time mothers' postpartum stress and its correlates following discharge from the hospital or clinic after vaginal delivery. One hundred and eightythree first-time mothers were enrolled from hospitals and clinics in Kaohsiung City. All first-time mothers reported normal pregnancies and vaginal deliveries, delivered healthy infants at term, and were surveyed during their postpartum periods after discharge from hospitals or clinics. The Hung Postpartum Stress Scale was used to examine first-time mothers' postpartum stress and stressors during their postpartum periods. The top ten postpartum stressors perceived by the women were: “the baby getting sick suddenly”, “the flabby flesh of my belly”, “the unpredictability of the baby's schedule”, “interrupted sleep”, “the shape of the baby's head due to the sleeping position”, “not sleeping enough”, “lack of information regarding infant's growth and development”, “the baby's crying”, “my life is restricted”, and “the baby choking during feeding”. There were no significant differences between the first-time mothers' demographic characteristics and their postpartum stress and its three components (negative body changes, maternal role attainment, lack of social support, respectively. Insight into the study results of first-time mothers' post- partum stress and stressors provides a reference for health professionals that the development of programs and resources addressing primiparous women's unique needs are required.

  14. Prolonged delirium misdiagnosed as a mood disorder.

    Science.gov (United States)

    Cao, Fei; Salem, Haitham; Nagpal, Caesa; Teixeira, Antonio L

    2017-01-01

    Delirium can be conceptualized as an acute decline in cognitive function that typically lasts from hours to a few days. Prolonged delirium can also affect patients with multiple predisposing and/or precipitating factors. In clinical practice, prolonged delirium is often unrecognized, and can be misdiagnosed as other psychiatric disorders. We describe a case of a 59-year-old male presenting with behavioral and cognitive symptoms that was first misdiagnosed as a mood disorder in a general hospital setting. After prolonged delirium due to multiple factors was confirmed, the patient was treated accordingly with symptomatic management. He evolved with progressive improvement of his clinical status. Early diagnosis and management of prolonged delirium are important to improve patient prognosis and avoid iatrogenic measures.

  15. QT Prolongation due to Graves’ Disease

    Directory of Open Access Journals (Sweden)

    Zain Kulairi

    2017-01-01

    Full Text Available Hyperthyroidism is a highly prevalent disease affecting over 4 million people in the US. The disease is associated with many cardiac complications including atrial fibrillation and also less commonly with ventricular tachycardia and fibrillation. Many cardiac pathologies have been extensively studied; however, the relationship between hyperthyroidism and rate of ventricular repolarization manifesting as a prolonged QTc interval is not well known. Prolonged QTc interval regardless of thyroid status is a risk factor for cardiovascular mortality and life-threatening ventricular arrhythmia. The mechanism regarding the prolongation of the QT interval in a hyperthyroid patient has not been extensively investigated although its clinical implications are relevant. Herein, we describe a case of prolonged QTc in a patient who presented with signs of hyperthyroidism that was corrected with return to euthyroid status.

  16. Prolonged parenteral nutrition after neonatal gastrointestinal surgery

    DEFF Research Database (Denmark)

    Estmann, Anne; Qvist, Niels; Husby, Steffen

    2002-01-01

    to diagnosis and clinical course. METHODOLOGY: This study reviews the clinical course of infants with gastrointestinal disease (gastroschisis, intestinal atresia, omphalocele, volvulus, Hirschsprung's disease and necrotizing enterocolitis) with a prolonged need for parenteral nutrition in the Western part...

  17. Prolonged Pregnancy: Methods, Causal Determinants and Outcome

    DEFF Research Database (Denmark)

    Olesen, Annette Wind

    ) to study the incidence of prolonged pregnancy as a function of methods for determining gestational age; 2) to determine the risk of obstetrical and fetal complications in prolonged pregnancy; 3) to validate the self-reported gestational age in the National Birth Cohort; 4) to determine whether...... an ultrasound scan in the first or second trimester, or menstrual history was best at predicting the day of delivery; 5) to study the risk of recurrence of prolonged pregnancy as a function of change in male partner, social status and municipality; and 6) to detect prenatal risk indicators of prolonged...... of perinatal and obstetrical complications was high in post-term delivery compared to term delivery (OR between 1.2 and 3.1). The risk of perinatal death (OR=1.36 (1.08-1.72)) was also higher in the post-term group (I). The self-reported gestational ages in the National Birth Cohort correlated well with data...

  18. Dream-associated Behaviors Affecting Pregnant and Postpartum Women

    Science.gov (United States)

    Nielsen, Tore; Paquette, Tyna

    2007-01-01

    Study objectives: Evaluate the prevalence and phenomenology of dream-associated behaviors affecting pregnant and postpartum mothers. Episodes consist of anxious dreams and nightmares about the new infant that are accompanied by complex behaviors (motor activity, speaking, expressing emotion). Design: Three-group design (postpartum, pregnant, null gravida), self-report, and repeated measures. Setting: Pregnancy and postpartum groups: completion of questionnaires in hospital room within 48 hours of giving birth and home telephone interviews; null gravida group: completion of questionnaires and interview in person or by telephone. Participants: Two hundred seventy-three women in 3 groups: postpartum: n = 202 (mean age = 29.7 ± 4.94 years; 95 primiparas, 107 multiparas); pregnant: n = 50 (mean age = 31.1 ± 5.44 years); null gravida: n = 21 (mean age = 28.5 ± 6.34 years). Interventions: Subjects completed questionnaires about pregnancy and birth factors, personality, and sleep and participated in interviews concerning the prevalence of recent infant dreams and nightmares, associated behaviors, anxiety, depression, and other psychopathologic factors. Measurements and Results: Most women in all groups recalled dreams (88%-91%). Postpartum and pregnant women recalled infant dreams and nightmares with equal prevalence, but more postpartum women reported they contained anxiety (75%) and the infant in peril (73%) than did pregnant women (59%, P dream-associated behaviors (P dream anxiety and, among postpartum women, post-awakening anxiety (41%), confusion (51%), and a need to check on the infant (60%). Primiparas and multiparas differed in dream and nightmare recall but not in prevalence of dream-associated behaviors. Conclusion: The prevalent occurrence of pregnancy and postpartum infant dreams and associated behaviors may reflect the pervasive emotional influence of maternal concerns or changes instigated by severe sleep disruption, rapid eye movement sleep deprivation

  19. Heterogeneity of postpartum depression: a latent class analysis

    Science.gov (United States)

    2016-01-01

    Summary Background Maternal depression in the postpartum period confers substantial morbidity and mortality, but the definition of postpartum depression remains controversial. We investigated the heterogeneity of symptoms with the aim of identifying clinical subtypes of postpartum depression. Methods Data were aggregated from the international perinatal psychiatry consortium Postpartum Depression: Action Towards Causes and Treatment, which represents 19 institutions in seven countries. 17 912 unique subject records with phenotypic data were submitted. We applied latent class analyses in a two-tiered approach to assess the validity of empirically defined subtypes of postpartum depression. Tier one assessed heterogeneity in women with complete data on the Edinburgh postnatal depression scale (EPDS) and tier two in those with postpartum depression case status. Findings 6556 individuals were assessed in tier one and 4245 in tier two. A final model with three latent classes was optimum for both tiers. The most striking characteristics associated with postpartum depression were severity, timing of onset, comorbid anxiety, and suicidal ideation. Women in class 1 had the least severe symptoms (mean EPDS score 10·5), followed by those in class 2 (mean EPDS score 14·8) and those in class 3 (mean EPDS score 20·1). The most severe symptoms of postpartum depression were significantly associated with poor mood (mean EPDS score 20·1), increased anxiety, onset of symptoms during pregnancy, obstetric complications, and suicidal ideation. In class 2, most women (62%) reported symptom onset within 4 weeks postpartum and had more pregnancy complications than in other two classes (69% vs 67% in class 1 and 29% in class 3). Interpretation PPD seems to have several distinct phenotypes. Further assessment of PPD heterogeneity to identify more precise phenotypes will be important for future biological and genetic investigations. Funding Sources of funding are listed at the end of the

  20. Prolonged transition time between colostrum and mature milk in a bear, the giant panda, Ailuropoda melanoleuca

    Science.gov (United States)

    Griffiths, Kate; Hou, Rong; Wang, Hairui; Zhang, Zhihe; Zhang, Liang; Zhang, Tong; Watson, David G.; Burchmore, Richard J. S.; Loeffler, I. Kati; Kennedy, Malcolm W.

    2015-01-01

    Bears produce the most altricial neonates of any placental mammal. We hypothesized that the transition from colostrum to mature milk in bears reflects a temporal and biochemical adaptation for altricial development and immune protection. Comparison of bear milks with milks of other eutherians yielded distinctive protein profiles. Proteomic and metabolomic analysis of serial milk samples collected from six giant pandas showed a prolonged transition from colostrum to main-phase lactation over approximately 30 days. Particularly striking are the persistence or sequential appearance of adaptive and innate immune factors. The endurance of immunoglobulin G suggests an unusual duration of trans-intestinal absorption of maternal antibodies, and is potentially relevant to the underdeveloped lymphoid system of giant panda neonates. Levels of certain milk oligosaccharides known to exert anti-microbial activities and/or that are conducive to the development of neonatal gut microbiomes underwent an almost complete changeover around days 20–30 postpartum, coincident with the maturation of the protein profile. A potential metabolic marker of starvation was detected, the prominence of which may reflect the natural postpartum period of anorexia in giant panda mothers. Early lactation in giant pandas, and possibly in other ursids, appears to be adapted for the unique requirements of unusually altricial eutherian neonates. PMID:26587250

  1. Prolonged transition time between colostrum and mature milk in a bear, the giant panda, Ailuropoda melanoleuca.

    Science.gov (United States)

    Griffiths, Kate; Hou, Rong; Wang, Hairui; Zhang, Zhihe; Zhang, Liang; Zhang, Tong; Watson, David G; Burchmore, Richard J S; Loeffler, I Kati; Kennedy, Malcolm W

    2015-10-01

    Bears produce the most altricial neonates of any placental mammal. We hypothesized that the transition from colostrum to mature milk in bears reflects a temporal and biochemical adaptation for altricial development and immune protection. Comparison of bear milks with milks of other eutherians yielded distinctive protein profiles. Proteomic and metabolomic analysis of serial milk samples collected from six giant pandas showed a prolonged transition from colostrum to main-phase lactation over approximately 30 days. Particularly striking are the persistence or sequential appearance of adaptive and innate immune factors. The endurance of immunoglobulin G suggests an unusual duration of trans-intestinal absorption of maternal antibodies, and is potentially relevant to the underdeveloped lymphoid system of giant panda neonates. Levels of certain milk oligosaccharides known to exert anti-microbial activities and/or that are conducive to the development of neonatal gut microbiomes underwent an almost complete changeover around days 20-30 postpartum, coincident with the maturation of the protein profile. A potential metabolic marker of starvation was detected, the prominence of which may reflect the natural postpartum period of anorexia in giant panda mothers. Early lactation in giant pandas, and possibly in other ursids, appears to be adapted for the unique requirements of unusually altricial eutherian neonates.

  2. The role of filaggrin mutations during pregnancy and postpartum

    DEFF Research Database (Denmark)

    Bager, P; Wohlfahrt, J; Boyd, H

    2016-01-01

    suppression, mechanical stress), we studied the possible role of FLG mutations on the risk of AD flares, genital infections, and postpartum problems related to perineal trauma. FLG-genotyping was performed in a population-based sample of 1837 women interviewed in the 12th and 30th weeks of pregnancy and 6...... months postpartum as part of the Danish National Birth Cohort study 1996-2002. We found that FLG mutations also influence pregnancy-related skin disease; thus, women with FLG mutations had an increased risk of AD flares during pregnancy (OR 10.5, 95% CI 3.6-30.5) and of enduring postpartum physical...

  3. Preventing Excessive Gestational Weight Gain and Postpartum Weight Retention.

    LENUS (Irish Health Repository)

    O’Dwyer, V

    2017-10-01

    regnancy and the postpartum period are unique opportunities to promote healthy lifestyle choices including a healthy diet and regular exercise. This is especially important for those who are overweight or obese. Women are weighed at their first antenatal visit and body mass index (BMI) calculated, but not all hospitals routinely weigh women throughout pregnancy. A qualitative Dublin study examined experiences of routine weighing during antenatal care. This study found that women expected to be weighed during pregnancy and postpartum. The benefits of this included providing reassurance and minimising postpartum weight retention. Furthermore, women were eager to receive more information about healthy lifestyle interventions and gestational weight gain (GWG) from healthcare professionals

  4. High serum testosterone levels during postpartum period are associated with postpartum depression.

    Science.gov (United States)

    Aswathi, A; Rajendiren, Soundravally; Nimesh, Archana; Philip, R Ravi; Kattimani, Shivanand; Jayalakshmi, D; Ananthanarayanan, P H; Dhiman, Pooja

    2015-10-01

    In view of the reported cases of mood disorders that occur in mothers following childbirth and believing that sex steroid hormones contribute to mood and behavioral changes, this study has been aimed to explore the role of sex steroid hormones as an etiological factor for postpartum depression (PPD). This study was conducted at JIPMER, Puducherry, India between January 2010 and 2011. 103 women were recruited in the study after childbirth, out of which 62 women who were believed to be suffering from PPD were categorized as cases and the remaining 41 with no mood changes as controls, using Edinburgh Postpartum Depression Scale (EPDS) (cases had EPDS score ≥10 at 24-28h, controls had score postpartum). The hormones estimated in these two groups included estradiol, progesterone and testosterone, and their levels were compared between these two groups. A significantly high testosterone levels were observed in cases with PPD at 24-28h when compared to controls. Estradiol and progesterone levels did not show significant difference between cases and controls. ROC analysis done at 24-28h showed that testosterone levels beyond 42.71ng/mL predict the development of PPD with 79% sensitivity, 63% specificity, 68% positive predictive value, 74% negative predictive value with AUC being 0.708. This study shows that there is an association between persistent high serum testosterone level in women following childbirth and PPD. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. [Effects of Foot-Reflexology Massage on Fatigue, Stress and Postpartum Depression in Postpartum Women].

    Science.gov (United States)

    Choi, Mi Son; Lee, Eun Ja

    2015-08-01

    To identify the effects of foot reflexology massage on fatigue, stress and depression of postpartum women. A nonequivalent control group pre-post design was used. A total of 70 women in a postpartum care center were recruited and were assigned to the experimental group (35) or control group (35). Foot reflexology massage was provided to the experimental group once a day for three days. Data were collected before and after the intervention program which was carried out from December, 2013 to February, 2014. Data were analyzed using Chi-square test, Fisher's exact test, and t-test. The level of fatigue in the experimental group was significantly lower than the control group (t=-2.74, p=.008). The level of cortisol in the urine of women in the experimental group was significantly lower than the control group (t=-2.19, p=.032). The level of depression in the experimental group was significantly lower than the control group (t=-3.00, p=.004). The results show that the foot reflexology massage is an effective nursing intervention to relieve fatigue, stress, and depression for postpartum women.

  6. QT interval prolongation associated with sibutramine treatment

    Science.gov (United States)

    Harrison-Woolrych, Mira; Clark, David W J; Hill, Geraldine R; Rees, Mark I; Skinner, Jonathan R

    2006-01-01

    Aims To investigate a possible association of sibutramine with QT interval prolongation. Methods Post-marketing surveillance using prescription event monitoring in the New Zealand Intensive Medicines Monitoring Programme (IMMP) identified a case of QT prolongation and associated cardiac arrest in a patient taking sibutramine for 25 days. This patient was further investigated, including genotyping for long QT syndrome. Other IMMP case reports suggesting arrhythmias associated with sibutramine were assessed and further reports were obtained from the World Health Organisation (WHO) adverse drug reactions database. Results The index case displayed a novel mutation in a cardiac potassium channel subunit gene, KCNQ1, which is likely to prolong cardiac membrane depolarization and increase susceptibility to long QT intervals. Assessment of further IMMP reports identified five additional patients who experienced palpitations associated with syncope or presyncopal symptoms, one of whom had a QTc at the upper limit of normal. Assessment of reports from the WHO database identified three reports of QT prolongation and one fatal case of torsade de pointes in a patient also taking cisapride. Conclusions This case series suggests that sibutramine may be associated with QT prolongation and related dysrhythmias. Further studies are required, but in the meantime we would recommend that sibutramine should be avoided in patients with long QT syndrome and in patients taking other medicines that may prolong the QT interval. PMID:16542208

  7. Rapunzel syndrome: a rare postpartum case.

    Science.gov (United States)

    Tegene, Teshome; Foda, Yahia; Hussain, Omar; Oloniyo, Kolawole; Ha, Ngoc-Tram; Manikonda, Geeta

    2013-01-01

    The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman.

  8. Rapunzel Syndrome: A Rare Postpartum Case

    Directory of Open Access Journals (Sweden)

    Teshome Tegene

    2013-01-01

    Full Text Available The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman.

  9. Risk factors for postpartum urinary incontinence.

    Science.gov (United States)

    Leroy, Lígia da Silva; Lúcio, Adélia; Lopes, Maria Helena Baena de Moraes

    2016-04-01

    To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, ppregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent. Investigar os fatores de risco para a incontinência urinária (IU) no puerpério e as suas características. Trata-se de estudo caso-controle com 344 puérperas (77 casos e 267 controles), com até 90 dias pós-parto. Foi aplicado, em um único momento, um questionário para os dados sociodemográficos e clínicos, e dois outros para avaliar a perda urinária, situações de perda e o tipo de IU. Apresentaram IU de esforço 45,5%, perda urinária diversas vezes ao dia 44,2%, sendo 71,4% em pequena quantidade e 57,1% ao tossir ou espirrar. Em 70,1% dos casos a IU iniciou-se na gestação e permaneceu no puerpério. Ao ajustar-se um modelo de regressão logística binária, apenas IU na gestação (OR 12,82, IC 95% 6,94 - 23,81, p<0,0001), multiparidade (OR 2,26, IC 95% 1,22 - 4,19, p=0,009), idade gestacional no parto maior ou igual a 37 semanas (OR 2,52, IC 95% 1,16 - 5,46, p=0,02) e constipação (OR 1,94, IC

  10. Postpartum depression among African-American women.

    Science.gov (United States)

    Amankwaa, Linda Clark

    2003-01-01

    The purpose of this qualitative study was to describe the nature of postpartum depression (PPD) among African-American women. Twelve women, who had experienced PPD within the last three years, were interviewed for approximately one hour at two intervals. Nudist-4 software and the constant comparative method were used to analyze the data. Five themes "Stressing Out," "Feeling Down," "Losing It," "Seeking Help," and "Feeling Better" represented aspects of PPD as experienced by the participants. The last theme, "Dealing with It," represented the cultural ways in which African-American mothers managed their depression. These included Keeping the Faith, Trying to Be a Strong Black Woman, Living with Myths, and Keeping Secrets. Suggestions for future directions in nursing research are included.

  11. Physical activity of pregnant and postpartum women

    Directory of Open Access Journals (Sweden)

    Tomasz Łosień

    2017-10-01

    Full Text Available Introduction: One of the basic elements of a healthy lifestyle is regular physical activity. Nowadays, more and more women during pregnancy take up the topic of the impact of physical activity and diet on the child developing in the womb. The existence of birth schools allows you to prepare for delivery, obtain information on acceptable safe activity adapted to the health of the future mother and ways of rational nutrition. The silhouette of women during pregnancyis constantly changing. Literature often shows the subject of a decrease in self-esteem during this period, associated with hormonal changes, appearance, fatigue and limitation of time for self-development. In the literature, we find two different positions of women about the subject of physical activity during pregnancy. The first position speaks of virtually complete limitation of activity, the second is about taking minimal activity such as before pregnancy. The aim of the study: 1 What impact on physical well-being in pregnant women and postpartum is having, 2 Is there a relationship between physical activity and pregnancy? 3 Is there a relationship between physical activity and postpartum period?, 4 What is the most common motivation to undertake physical activity after delivery? Material and methods:57 women aged 18 to 47 participated in the study. The study used an original anonymous survey of 28 questions. The questions concerned, among others: pregnancy, postnatal period, physical activity during pregnancy and after delivery. Conclusions: Taking physical activity during pregnancy and after childbirth influences the increase of self-esteem and well-being of women. About 25% of women surveyed did not return to physical activity a year after delivery. The basic factors influencing the activity after childbirth are the desire to improve the appearance, well-being and return to fitness which they presented before delivery.

  12. Postpartum Tuberculosis: A Diagnostic and Therapeutic Challenge

    Directory of Open Access Journals (Sweden)

    Vijay Kodadhala

    2016-01-01

    Full Text Available Tuberculosis (TB infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother’s TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department. Current guidelines recommend primary Isoniazid prophylaxis in TB exposed pregnant women who are immune-suppressed and have chronic medical conditions or obstetric risk factors and close and sustained contact with a patient with infectious TB. Treatment during pregnancy is the same as for the general adult population. Infants born to mothers with active TB at delivery should undergo a complete diagnostic evaluation. Primary Isoniazid prophylaxis for at least twelve weeks is recommended for those with negative diagnostic tests and no evidence of disease. Repeated negative diagnostic tests are mandatory before interrupting prophylaxis. Separation of mother and infant is only necessary when the mother has received treatment for less than 2 weeks, is sputum smear-positive, or has drug-resistant TB. This case highlights important aspects for management of TB during the postpartum period which has a higher morbidity. We present a case of a young mother migrating from a developing nation to the USA, who was found to have a positive quantiFERON test associated with multiple cavitary lung lesions and gave birth to a healthy baby.

  13. Postpartum Depression Among Somali Women in Norway.

    Science.gov (United States)

    Løvlie, Astrid Louise; Madar, Ahmed Ali

    2017-06-01

    Postpartum depression (PPD) has been described as the most common complication experienced postpartum, affecting about 10-15 % of all new mothers. Factors like a history of mental illness, and experienced recent adverse life events has been associated with an increased risk for developing PPD. Immigrant women in Western countries have been found to have a marked higher prevalence of PPD compared to the general population. In Norway the prevalence of PPD in the general population has been found to be around 8-10 %, and among Pakistani immigrants a rate of 7.6 % was found. Somali people in Norway are the second largest immigrant group in Norway with a non-Western background. No study on PPD and associated factors among Somali women has been found in the literature. The aim of the study was to assess PPD and associated factors among Somali women in greater Oslo region, Norway. A cross-sectional survey was conducted; recruiting new mothers through all maternity wards in the Oslo region. Data was collected with interview-administrated questionnaires. PPD was assessed using Edinburgh Postnatal Depression Scale (EPDS), defining those scoring ≥10 to have a possible PPD. Of the 80 eligible women identified, 39 (49 %) consented to participate, and completed the study. Of the 39 respondents 3 (7.7 %) were assessed to have a possible PPD. Most important associated factors found were history of mental illness, having experienced technical assistance during delivery, self-rated health and experienced economical problems last 12 months. A low prevalence of PPD was found, and both the prevalence and its associated factors should be interpreted with caution. The associated factors do not have enough power to give any strength to the associations. However, some of the results can be used in develop new hypotheses with regard to PPD among Somali women as immigrants in a Western society.

  14. Quality of drug label information on QT interval prolongation

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Holtkamp, Frank A; Rutten, Frans H

    2014-01-01

    BACKGROUND: Information regarding QT-prolongation in the drug label may vary between products. This could lead to suboptimal risk minimization strategies. OBJECTIVE: To systematically assess the variation in the extent and content of information on QT prolongation in the summary of product......-prolongation'/'QT-prolongation') and the advice on cautionary measures pertaining to QT-prolongation in the label were examined, as well as their association. RESULTS: Of the 175 screened products, 44 contained information on QT in the SPC ('no QT-prolongation': 23%, 'unclear drug-QT association': 43%, 'possibly QT-prolongation': 16%, 'QT......-prolongation': 18%). 62% contained advices to act with caution in patients with additional risk factors for QT-prolongation. Products that more likely to have QT-prolonging properties according to the SPC provided more information on QT-prolongation in the SPC ('no prolongation': 10% and for the category 'QT...

  15. 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

  16. Review of the Aetiology and Complications of Primary Postpartum ...

    African Journals Online (AJOL)

    Review of the Aetiology and Complications of Primary Postpartum Haemorrhage following vaginal delivery at University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria: A 5-year Review. CI Emechebe, CO Njoku, AN Njoku, JT Ukaga, EM Eyong ...

  17. Maternal weight change from prepregnancy to 7 years postpartum

    DEFF Research Database (Denmark)

    Kirkegaard, Helene; Stovring, Henrik; Rasmussen, Kathleen M

    2015-01-01

    OBJECTIVE: We studied the influence of maternal behavior on weight change from prepregnancy to 7 years postpartum. METHODS: We used linear regression to study the independent and combined associations between self-reported behavior in pregnancy (dietary intake, leisure-time exercise, sedentary...... activity, smoking) and postpartum (breastfeeding duration and smoking) on weights at 6 months, 18 months, and 7 years postpartum. RESULTS: Women's average 7-year weight gain was 2.07 kg, with 23% gaining >5 kg. Multivariable analyses suggested that women with healthier dietary intake, more leisure......-time exercise, less sedentary behavior, and longer duration of breastfeeding on average gained 1.66 kg [95% confidence interval (CI): 1.40; 1.91] with a significantly reduced odds [OR 0.56 (95% CI: 0.49; 0.64)] of gaining >5 kg from prepregnancy to 7 years postpartum compared to women with none or one...

  18. Condom Tamponade in the Management of Primary Postpartum ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Keywords: condom temponade, postpartum haemorrhage, management. Résumé. L'hémorragie du ..... and affordable strategies to help overcome some of the challenges .... Prendiville WJ, Elbourne D, McDonald S. Active versus expectant ...

  19. Postpartum osteoporosis associated with proximal tibial stress fracture

    Energy Technology Data Exchange (ETDEWEB)

    Clemetson, I.A.; Anderson, S.E. [Department of Radiology, University Hospital of Bern, Inselspital, 3010, Bern (Switzerland); Popp, A.; Lippuner, K. [Department of Osteology, University Hospital of Bern, Inselspital, 3010, Bern (Switzerland); Ballmer, F. [Knee and Sports Medicine Unit, Lindenhofspital Bern, 3012, Bern (Switzerland)

    2004-02-01

    A 33-year-old woman presented with acute nonspecific knee pain, 6 months postpartum. MR imaging, computed tomography and radiography were performed and a proximal tibia plateau insufficiency fracture was detected. Bone densitometry demonstrated mild postpartum osteoporosis. To our knowledge these findings have not been described in this location and in this clinical setting. The etiology of the atraumatic fracture of the tibia is presumed to be due to a low bone mineral density. The bone loss was probably due to pregnancy, lactation and postpartum hormonal changes. There were no other inciting causes and the patient was normocalcemic. We discuss the presence of a postpartum stress fracture in a hitherto undescribed site in a patient who had lactated following an uncomplicated pregnancy and had no other identifiable cause for a stress fracture. (orig.)

  20. Knowledge of Postpartum Depression and its Associated Risk ...

    African Journals Online (AJOL)

    Knowledge of Postpartum Depression and its Associated Risk Factors ... affects many women and if ignored can have long-term adverse consequences, for both ... who are the first point of contact during antenatal, labour and post natal period.

  1. Postpartum urinary tract infection by mode of delivery

    DEFF Research Database (Denmark)

    Gundersen, Tina Djernis; Krebs, Lone; Loekkegaard, Ellen Christine Leth

    2018-01-01

    OBJECTIVES: To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified...... was postpartum urinary tract infection (n=16 295) within 30 days post partum, defined as either a diagnosis of urinary tract infection in the National Patient Registry or redemption of urinary tract infection-specific antibiotics recorded in the Register of Medicinal Product Statistics. RESULTS: We found that 4.......6% of women with intended caesarean delivery and 3.5% of women with intended vaginal delivery were treated for postpartum urinary tract infection.Women with intended caesarean delivery had a significantly increased risk of postpartum urinary tract infection compared with women with intended vaginal delivery...

  2. Postpartum Sterilization Choices Made by HIV-Infected Women

    Directory of Open Access Journals (Sweden)

    Gretchen S. Stuart

    2005-01-01

    Full Text Available Objective. To assess if HIV-infected women made different choices for postpartum sterilization after implementation of the Pediatric AIDS Clinical Trials Group protocol 076 (November 1, 1994 compared to before implementation.

  3. The Postpartum Tradition of Sawa Mahina in Rural Punjab, Pakistan

    Directory of Open Access Journals (Sweden)

    Azher Hameed Qamar

    2017-06-01

    Full Text Available The Punjabi postpartum tradition is called sawa mahina (‘five weeks’. This study investigates infant health care belief practices in rural Punjab and looks at the social significance of infant care beliefs practiced during sawa mahina. During six months of fieldwork, using participant observation and unstructured interviews as primary research methods, the study explored the prevalent postpartum tradition from a childcare perspective. A Punjabi child holds a social value regarding familial, religious, and emotional values. The five-week traditional postpartum period provides an insight into mother–child attachment, related child care belief practices, and the social construction of infancy. A child’s agency is recognised in the embodied mother–child relationship, and a child is seen in a sympathetic connection with the mother. Establishing an early foundation of ascribed identities is another important part of postpartum belief practices.

  4. Postpartum osteoporosis associated with proximal tibial stress fracture

    International Nuclear Information System (INIS)

    Clemetson, I.A.; Anderson, S.E.; Popp, A.; Lippuner, K.; Ballmer, F.

    2004-01-01

    A 33-year-old woman presented with acute nonspecific knee pain, 6 months postpartum. MR imaging, computed tomography and radiography were performed and a proximal tibia plateau insufficiency fracture was detected. Bone densitometry demonstrated mild postpartum osteoporosis. To our knowledge these findings have not been described in this location and in this clinical setting. The etiology of the atraumatic fracture of the tibia is presumed to be due to a low bone mineral density. The bone loss was probably due to pregnancy, lactation and postpartum hormonal changes. There were no other inciting causes and the patient was normocalcemic. We discuss the presence of a postpartum stress fracture in a hitherto undescribed site in a patient who had lactated following an uncomplicated pregnancy and had no other identifiable cause for a stress fracture. (orig.)

  5. Impact of forced separation policy on incarcerated postpartum mothers.

    Science.gov (United States)

    Chambers, Angelina N

    2009-08-01

    The number of incarcerated women in the United States is steadily increasing with 9% giving birth while serving time. Mothers and babies are routinely separated immediately and during most of the postpartum period. This qualitative study examines the impact of this policy by exploring the nature and meaning of the mother-infant bonding experience when the mothers know separation is coming. Twelve incarcerated postpartum mothers were interviewed during the early postpartum period about their antepartum and postpartum relationships with their babies. Qualitative data analysis produced four relational themes: (a) "a love connection," (b) "everything was great until I birthed," (c) "feeling empty and missing a part of me," and (d) "I don't try to think too far in advance." Results of this qualitative study provide information to professionals exploring gender-sensitive prison policies for the growing female population.

  6. [Assessment of Urinary Incontinence in Pregnancy and Postpartum: Observational Study].

    Science.gov (United States)

    Rocha, Juliana; Brandão, Pedro; Melo, Anabela; Torres, Silvia; Mota, Lurdes; Costa, Fernanda

    2017-08-31

    The urinary incontinence can affect up to 50% of women at some stage of their lives, particularly during pregnancy and postpartum. This study was designed in order to identify and assess the prevalence and risk factors for urinary incontinence during the third trimester of pregnancy and three months postpartum. Observational and cross-sectional study. The population of the study was composed of 268 women who delivered and were admitted to the Centro Hospitalar Tâmega e Sousa in the years 2013 and 2014, and who agreed to participate in this study. Postpartum women were asked to fill out a questionnaire adapted from the International Consultation on Incontinence Questionnaire - Short Form, for urinary incontinence research in the third trimester of pregnancy. Three months after delivery, they were contacted by telephone and asked to answer the same questions about the urinary incontinence postpartum. Of the 268 women interviewed, 31 were excluded from the study, taking into account the defined inclusion and exclusion criteria. In total (n = 237), 51.89% of women included in the study, reported the occurrence of urinary incontinence during pregnancy. The prevalence of urinary incontinence in pregnancy by parity (primiparous versus multiparous) was statistically significant (p = 0.006). At postpartum (n = 237), 28.69% of women with urinary incontinence had vaginal delivery and 5.91% of women underwent cesarean delivery (p = 0.001). In these group of women with postpartum urinary incontinence (n = 82), 31.69% have had urinary incontinence only in the postpartum and 68.31% of women have had symptoms during pregnancy (p urinary incontinence in pregnancy and the respective decrease in postpartum. Multiparity and occurrence of urinary incontinence in pregnancy appear as potential risk factors in the emergence of the urinary incontinence.

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

    DEFF Research Database (Denmark)

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

    2000-01-01

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

  8. Efficacy of b-lynch brace suture in postpartum haemorrhage

    International Nuclear Information System (INIS)

    Tarique, S.; Wazir, S.; Moeen, G.

    2011-01-01

    Massive uncontrolled haemorrhage after childbirth is the leading cause of maternal death in developing countries. Postpartum haemorrhage is traditionally defined as blood loss of more than 500 ml after vaginal delivery and more than 1000 ml after caesarean section, but intraoperative estimation of blood loss is inaccurate. Uterine atony alone accounts for 75 - 90% of PPH. To estimate the effectiveness and safety of B-Lynch brace Suture in the management of primary postpartum haemorrhage (PPH). (author)

  9. An unusual presentation of postpartum ovarian vein thrombosis

    International Nuclear Information System (INIS)

    Hakim, Fayaz A.; Khan, Nadra N.; Qushmaq, Khalid A.; Al-Shami, Sadiq Y.

    2007-01-01

    Ovarian vein thrombosis is a rare but potentially serious complication following childbirth. The majority of patients present during the first week postpartum, with fever and right lower quadrant abdominal pain. We report an unusual case of postpartum ovarian vein thrombosis who presented with fever, low backache, and painful thighs. A high index of suspicion is crucial to diagnose and treat this condition in order to avoid serious consequences. (author)

  10. Exploring the Link between Maternity Leave and Postpartum Depression.

    Science.gov (United States)

    Kornfeind, Katelin R; Sipsma, Heather L

    2018-05-02

    Postpartum depression affects a substantial proportion of new mothers in the United States. Although most employed women return to paid work after birth, the association between duration of maternity leave and postpartum depression is unclear. We therefore aimed to explore this relationship among mothers in the United States. Data included 177 mothers from a national survey who had returned to work full time after having a baby. Multivariable logistic regression was used to explore the independent association between duration of maternity leave and experiencing of postpartum depressive symptoms in the 2 weeks preceding the postpartum survey completion. Overall, duration of maternity leave was not significantly associated with experiencing postpartum depression symptoms (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.80-1.01). This effect, however, varied by duration of maternity leave. Among women who took maternity leaves of 12 weeks or less, every additional week of leave was associated with a lesser odds of experiencing postpartum depressive symptoms (OR, 0.58; 95% CI, 0.40-0.84). Among women who took maternity leaves longer than 12 weeks, leave duration was not associated with postpartum depression symptoms (OR, 0.97; 95% CI, 0.73-1.29). Maternity leaves equaling 12 weeks or less may contribute additional risk for postpartum depressive symptoms, possibly because mothers are juggling employment alongside of important physical and emotional changes during this period. This association underscores the importance of ensuring that mothers have at least 12 weeks of leave from full-time employment after the birth of a baby. Copyright © 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  11. Babinski-Nageotte Syndrome Diagnosed in Postpartum Period

    Directory of Open Access Journals (Sweden)

    Serdar Oruç

    2016-01-01

    Full Text Available Babinski-Nageotte Syndrome (BNS is one of the brainstem syndromes characterized by muscle weakness in the opposite half of the body with classic Wallenberg findings. According to our literature survey, only a few cases have been reported and none of them was in the postpartum period. We report a case of a typical BNS in a postpartum woman with an ischemic lesion in the medulla oblongata shown on magnetic resonance imaging.

  12. Barriers to adopting a healthy lifestyle: insight from postpartum women

    Directory of Open Access Journals (Sweden)

    Krause Katrina M

    2009-08-01

    Full Text Available Abstract Background Postpartum weight retention can contribute to obesity. There may be unique barriers to weight loss in this period. Findings Cases are presented for three postpartum women who declined to participate in a postpartum weight loss intervention. Despite their desire to engage in healthier behaviors, or partake in an intervention uniquely designed to promote healthy lifestyles for postpartum women, some find it too difficult to make such commitments. Barriers women face in adopting a healthier lifestyle in this period include 1 time availability; 2 prioritizing other competing life responsibilities above their own health; 3 support from family members, friends, and/or co-workers; and 4 lack of flexibility in the intervention structure. These illustrations describe their perspectives in the context of life balance, perceived health, and support, and reflect the multi-dimensional nature of their lives during the life cycle change of the postpartum period. Conclusion Postpartum women face difficult and complex challenges to prioritizing their health and their weight management.

  13. Creating New Strategies to Enhance Postpartum Health and Wellness.

    Science.gov (United States)

    Cornell, Andria; McCoy, Carolyn; Stampfel, Caroline; Bonzon, Erin; Verbiest, Sarah

    2016-11-01

    Over the past 5 years there have been a number of new initiatives focused on improving birth outcomes and reducing infant mortality, including a renewed focus on the complex interactions between motherhood and infancy that influence lifelong health trajectories. Beginning in 2012, the Association of Maternal & Child Health Programs (AMCHP) facilitated a series of meetings to enhance coordination across initiatives. Emerging from these conversations was a shared desire across stakeholders to reimagine the postpartum visit and improve postpartum care and wellness. AMCHP convened a Postpartum Think-Tank Meeting in 2014 to map the system of postpartum care and identify levers for its transformation. The meeting findings are presented in an infographic which frames the challenges and proposed solutions from the woman's perspective. The infographic describes maternal issues and concerns along with a concise summary of the recommended solutions. Strategies include creating integrated services and seamless care transitions from preconception through postpartum and well-baby; business, community, and government support, including paid parental leave, health insurance and spaces for new parents to meet each other; and mother-centered care, including quality visits on her schedule with complete and culturally appropriate information. These solutions catalyze a postpartum system of care that supports women, children, and families by infusing new ideas and capitalizing on existing opportunities and resources.

  14. Magnetic Resonance Imaging Studies of Postpartum Depression: An Overview

    Directory of Open Access Journals (Sweden)

    Marco Fiorelli

    2015-01-01

    Full Text Available Postpartum depression is a frequent and disabling condition whose pathophysiology is still unclear. In recent years, the study of the neural correlates of mental disorders has been increasingly approached using magnetic resonance techniques. In this review we synthesize the results from studies on postpartum depression in the context of structural, functional, and spectroscopic magnetic resonance studies of major depression as a whole. Compared to the relative wealth of data available for major depression, magnetic resonance studies of postpartum depression are limited in number and design. A systematic literature search yielded only eleven studies conducted on about one hundred mothers with postpartum depression overall. Brain magnetic resonance findings in postpartum depression appear to replicate those obtained in major depression, with minor deviations that are not sufficient to delineate a distinct neurobiological profile for this condition, due to the small samples used and the lack of direct comparisons with subjects with major depression. However, it seems reasonable to expect that studies conducted in larger populations, and using a larger variety of brain magnetic resonance techniques than has been done so far, might allow for the identification of neuroimaging signatures for postpartum depression.

  15. Depression and anxiety among postpartum and adoptive mothers

    Science.gov (United States)

    Schiller, Crystal Edler; Richards, Jenny Gringer; O’Hara, Michael W.; Stuart, Scott

    2012-01-01

    Similar to biological mothers during the postpartum period, women who adopt children experience increased stress and life changes that may put them at risk for developing depression and anxiety. The purpose of the current study was to compare levels of depression and anxiety symptoms between postpartum and adoptive women and, among adoptive women, to examine associations between specific stressors and depressive symptoms. Data from adoptive mothers (n=147), recruited from Holt International, were compared to existing data from postpartum women (n=147). Differences in the level of depression and anxiety symptoms as measured by the Inventory of Depression and Anxiety Symptoms among postpartum and adoptive women were examined. Associations between specific stressors and depressive symptoms were examined among adoptive mothers. Postpartum and adoptive women had comparable levels of depressive symptoms, but adoptive women reported greater well-being and less anxiety than postpartum women. Stressors (e.g., sleep deprivation, history of infertility, past psychological disorder, and less marital satisfaction) were all significantly associated with depressive symptoms among adoptive women. The level of depressive symptoms was not significantly different between the two groups. In contrast, adoptive women experienced significantly fewer symptoms of anxiety and experienced greater well-being. Additionally, adoptive mothers experienced more depressive symptoms during the year following adoption when the stressors were present. Thus, women with these characteristics should be routinely screened for depression and anxiety. PMID:21725836

  16. The prevalence and screening methods of postpartum depression

    Directory of Open Access Journals (Sweden)

    Özgür Erdem

    2012-09-01

    Full Text Available Postpartum Depression is the most common complicationof the delivery and affects approximately 10%-15% ofwomen who had just gave birth. During a period in whichwomen believe that they should be happy, the depressivemood experienced by most women leads to feelings ofguilt, hiding the symptoms, and postpartum depressionto be overlooked. Although the incidence of serious psychiatricdisorders during pregnancy is low, it is reportedthat the incidence shows a dramatic increase during thepostpartum period and this risky period may continue upto six months, one year or even two years.As the onset of postpartum depression is insidious it caneasily be overlooked if the patient’s seeking help is notsupported, especially when the severity of postpartum depressionis mild or moderate. In these cases, postpartumdepression may persist for a long time and at last it can beso severe that hospitalization would be needed. Therefore,early diagnose is very important and primary carephysicians and other health care workers should be alert.Postpartum Depression should be diagnosed using reliabledescriptive methods in puerperant women. Thescales such as Postnatal Depression Screening Scale,Beck Depression Inventory, Edinburgh Postnatal DepressionScale and State-Trait Anxiety Inventory, all of whichwere tested for validity and reliability in our country can beused during follow-up of pregnant and puerperal women.Key words: Postpartum depression, screening methods,primary health care professionals

  17. Implementation of a Hydrotherapy Protocol to Improve Postpartum Pain Management.

    Science.gov (United States)

    Batten, Meghann; Stevenson, Eleanor; Zimmermann, Deb; Isaacs, Christine

    2017-03-01

    A growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth. The postpartum hydrotherapy protocol was initiated in a certified nurse-midwife (CNM) practice in an urban academic medical center. All women who met criteria were offered a 30-minute warm water immersion bath at one hour postpartum. Pain scores were assessed prior to the bath, at 15 minutes after onset, and again at the conclusion (30 minutes). Women who completed the bath were also asked to complete a brief survey on their experience with postpartum hydrotherapy. In women who used the bath (N = 45), there was a significant reduction in pain scores (P hydrotherapy protocol as an alternative or adjunct to medication for early postpartum pain management that significantly reduced pain and improved the birth experience for those who used it. It offers a nonpharmacologic alternative where there have traditionally been limited options. © 2017 by the American College of Nurse-Midwives.

  18. Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb.

    Science.gov (United States)

    Mbekenga, Columba K; Pembe, Andrea B; Darj, Elisabeth; Christensson, Kyllike; Olsson, Pia

    2013-01-15

    Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania. In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the control of sexuality for ensuring family health and avoiding the social implications of non-adherence to sexual abstinence norms. Both abstinence and control were emphasised more with regard to women than to men. Although the traditional discourse on prolonged sexual abstinence for protecting child health was reproduced in Ilala, some modern aspects such as the use of condoms and other contraceptives prevailed in the discussion. Discourses on sexuality after childbirth are instrumental in reproducing gender-power inequalities, with women being subjected to more restrictions and control than men are. Thus, interventions that create openness in discussing sexual relations and health-related matters after childbirth and mitigate gendered norms suppressing women and perpetuating harmful behaviours are needed. The involvement of males in the interventions would benefit men, women, and children through improving the gender relations that promote family health.

  19. Postpartum dönemde nadir bir non-anevrizmal subaraknoid kanama nedeni: Postpartum serebral anjiyopati

    OpenAIRE

    Güler, A; Deveci, E; Çiftçi, Ş; Toprak, Gökçay F; Şirin, H

    2014-01-01

    Serebral vazokonstrüksiyon sendromu serebral arterlerin reversibl multifokal vazokonstrüksiyonu ile karakterize bir tablodur. Postpartum serebral anjiyopati (PSA) eklampsisi olmayan kadınlarda sıklıkla doğumdan 1-4 hafta sonra görülen serebrovasküler hastalıktır. PSA komplikasyonu olarak daha çok intraserebral hemoraji ve serebral infarkt bildirilmiştir. Bu yazıda, PSA'nın nadir bir komplikasyonu olan non-anevrizmal subaraknoid hemoraji saptanan bir olgu bildirilmektedir.

  20. Effect of ibuprofen vs acetaminophen on postpartum hypertension in preeclampsia with severe features: a double-masked, randomized controlled trial.

    Science.gov (United States)

    Blue, Nathan R; Murray-Krezan, Cristina; Drake-Lavelle, Shana; Weinberg, Daniel; Holbrook, Bradley D; Katukuri, Vivek R; Leeman, Lawrence; Mozurkewich, Ellen L

    2018-06-01

    Nonsteroidal antiinflammatory drug use has been shown to increase blood pressure in nonpregnant adults. Because of this, the American College of Obstetricians and Gynecologists suggests avoiding their use in women with postpartum hypertension; however, evidence to support this recommendation is lacking. Our goal was to test the hypothesis that nonsteroidal antiinflammatory drugs, such as ibuprofen, adversely affect postpartum blood pressure control in women with preeclampsia with severe features. At delivery, we randomized women with preeclampsia with severe features to receive around-the-clock oral dosing with either 600 mg of ibuprofen or 650 mg of acetaminophen every 6 hours. Dosing began within 6 hours after delivery and continued until discharge, with opioid analgesics available as needed for breakthrough pain. Study drugs were encapsulated in identical capsules such that patients, nurses, and physicians were masked to study allocation. Exclusion criteria were serum aspartate aminotransferase or alanine aminotransferase >200 mg/dL, serum creatinine >1.0 mg/dL, infectious hepatitis, gastroesophageal reflux disease, age <18 years, or current incarceration. Our primary outcome was the duration of severe-range hypertension, defined as the time (in hours) from delivery to the last blood pressure ≥160/110 mm Hg. Secondary outcomes were time from delivery to last blood pressure ≥150/100 mm Hg, mean arterial pressure, need for antihypertensive medication at discharge, prolongation of hospital stay for blood pressure control, postpartum use of short-acting antihypertensives for acute blood pressure control, and opioid use for breakthrough pain. We analyzed all outcome data according to intention-to-treat principles. We assessed 154 women for eligibility, of whom 100 met entry criteria, agreed to participate, and were randomized to receive postpartum ibuprofen or acetaminophen for first-line pain control. Seven patients crossed over or did not receive their

  1. Critical views on postpartum care expressed by new mothers

    Directory of Open Access Journals (Sweden)

    Waldenström Ulla

    2007-11-01

    Full Text Available Abstract Background Women's evaluation of hospital postpartum care has consistently been more negative than their assessment of other types of maternity care. The need to further explore what is wrong with postpartum care, in order to stimulate changes and improvements, has been stressed. The principal aim of this study was to describe women's negative experiences of hospital postpartum care, expressed in their own words. Characteristics of the women who spontaneously gave negative comments about postpartum care were compared with those who did not. Methods Data were taken from a population-based prospective longitudinal study of 2783 Swedish-speaking women surveyed at three time points: in early pregnancy, at two months, and at one year postpartum. At the end of the two follow-up questionnaires, women were asked to add any comment they wished. Content analysis of their statements was performed. Results Altogether 150 women gave negative comments about postpartum care, and this sample was largely representative of the total population-based cohort. The women gave a diverse and detailed description of their experiences, for instance about lack of opportunity to rest and recover, difficulty in getting individualised information and breastfeeding support, and appropriate symptom management. The different statements were summarised in six categories: organisation and environment, staff attitudes and behaviour, breastfeeding support, information, the role of the father and attention to the mother. Conclusion The findings of this study underline the need to further discuss and specify the aims of postpartum care. The challenge of providing high-quality follow-up after childbirth is discussed in the light of a development characterised by a continuous reduction in the length of hospital stay, in combination with increasing public demands for information and individualised care.

  2. Incidence of postpartum depression and couple relationship quality.

    Science.gov (United States)

    Małus, Aleksandra; Szyluk, Justyna; Galińska-Skok, Beata; Konarzewska, Beata

    2016-12-23

    The childbirth constitutes a significant event in a woman's life and in the marital/ couple dyad. The changes which follow childbirth require re-organization of previous coping styles and development of new methods of adaptation, which proves difficult. The current study evaluated to what extent the development of postpartum depression symptoms in new mothers was associated with their level of satisfaction in marital relationship. The study included 100 women in their first month after delivery. The women completed questionnaires regarding postpartum depression (Postpartum Depression Screening Scale) and marital relationship quality (Marital Compatibility Questionnaire). There was a significant correlation between the level of postpartum depression and relationship quality. A greater severity of postpartum depression symptoms (sleeping/ eating disturbances, anxiety/insecurity, emotional lability, mental confusion, loss of self, guilt/ shame, suicidal thoughts) occurred in women who were less satisfied with their relationship, i.e., those who experienced a decreased level of intimacy, self-fulfillment and partner similarity, as well as a deeper sense of disillusionment. Women who declared deeper satisfaction with their relationship displayed a greater sense of mental well-being. No correlation was found between the occurrence of postpartum depression and socio-demographic factors (age, education level, place of residence) and factors associated with the subjects' childbearing history (number of children, number of pregnancies, history of miscarriage, family planning, prior diagnosis of depression, type of delivery, newborn's condition following birth, infant feeding method). Patients dissatisfied with the quality of their marital relationship experienced an increased severity of postpartum depression symptoms. Greater satisfaction with relationship quality was expressed by women in formalized relationships.

  3. Postpartum depression and culture: Pesado Corazon.

    Science.gov (United States)

    Callister, Lynn Clark; Beckstrand, Renea L; Corbett, Cheryl

    2010-01-01

    The purpose of this article is to describe what the literature has shown about postpartum depression (PPD) in culturally diverse women. The majority of qualitative studies done with women identified as having PPD have been conducted with Western women, with the second largest group focusing on Chinese women. This article reviews the qualitative studies in the literature and discusses how the management of PPD in technocentric and ethnokinship cultures differs. Social support has been shown to be significantly related to fewer symptoms of PPD, and culturally prescribed practices may or may not be cultural mediators in decreasing the incidence of PPD. Nurses should be sensitive to the varied ways in which culturally diverse women perceive, explain, and report symptoms of PPD. Exemplary interventions for culturally diverse women suffering from PPD are examined in this article as well, although it is clear that additional research is needed to develop models for culturally competent interventions for PPD in culturally diverse women and to document the outcomes of such interventions.

  4. Postpartum depression: psychoneuroimmunological underpinnings and treatment

    Directory of Open Access Journals (Sweden)

    Anderson G

    2013-02-01

    Full Text Available George Anderson,1 Michael Maes21CRC Clincial Research Centre/Communications, Glasgow, Scotland; 2Department of Psychiatry, Chulalongkorn University, Bangkok, ThailandAbstract: Postpartum depression (PPD is common, occurring in 10%–15% of women. Due to concerns about teratogenicity of medications in the suckling infant, the treatment of PPD has often been restricted to psychotherapy. We review here the biological underpinnings to PPD, suggesting a powerful role for the tryptophan catabolites, indoleamine 2,3-dixoygenase, serotonin, and autoimmunity in mediating the consequences of immuno-inflammation and oxidative and nitrosative stress. It is suggested that the increased inflammatory potential, the decreases in endogenous anti-inflammatory compounds together with decreased omega-3 poly-unsaturated fatty acids, in the postnatal period cause an inflammatory environment. The latter may result in the utilization of peripheral inflammatory products, especially kynurenine, in driving the central processes producing postnatal depression. The pharmacological treatment of PPD is placed in this context, and recommendations for more refined and safer treatments are made, including the better utilization of the antidepressant, and the anti-inflammatory and antioxidant effects of melatonin.Keywords: SSRI, kynurenine, IDO, TDO, melatonin

  5. Autologous Blood Transfusion for Postpartum Hemorrhage.

    Science.gov (United States)

    Greenawalt, Julia A; Zernell, Denise

    Postpartum hemorrhage (PPH) is a leading contributor to maternal morbidity and mortality in the United States and globally. Although the rate of PPH is generally decreasing nationally, severity of PPH appears to be increasing, potentially related to the various comorbidities associated with women of childbearing age. There is increasing evidence of risks associated with allogeneic blood transfusion, which has historically been the classic therapeutic approach for treatment to PPH. Pregnant women are particularly susceptible to the implications of sensitization to red cell antigens, a common sequela to allogenic blood transfusion. Autologous blood transfusion eliminates the potential of communicable disease transmission as well as the conceivable threat of a blood transfusion reaction. Recent technological advances allow cell salvage coupled with the use of a leukocyte filter to be used as an alternative approach for improving the outcome for women experiencing a PPH. Modest changes in standard operating procedure and continued training in use and application of cell salvaged blood may assist in minimizing negative outcomes from PPH. Salvaged blood has been demonstrated to be at least equal and often superior to banked blood. We discuss nursing implications for application of this technology for women with PPH. Continued research is warranted to evaluate the impact that application of cell salvage with filtration has on the patient experiencing a PPH.

  6. 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.

  7. A case of taeniasis diagnosed postpartum.

    Science.gov (United States)

    Noss, Matthew R; Gilmore, Katherine; Wittich, Arthur C

    2013-04-01

    A case of postpartum taeniasis will be discussed along with the pathophysiology, proper treatment, potential risks, and prevention of taeniasis infections to the pregnant mother, her infant, and her family members. Taenia spp. infections are relatively rare in developed societies. Increasing immigration to developed countries and an expanding role of medical aid in developing countries will lead to an increase in the number of taeniasis cases seen by medical providers. Taenia solium and T. saginata are the most common species and can be differentiated by proglottids (a segment of a tapeworm containing both male and female reproductive organs) or scolex (the head of a tapeworm which attaches to the intestine of the definitive host). Both carry different risks when considering autoinfection and transmission. Cystercercosis caused by T. solium is a risk for neonates and is cause for immediate treatment of the mother. A 23-year-old new mother, originally from Ethiopia, passed T. strobili shortly after giving birth. Her pregnancy was complicated by limited prenatal care. She did not experience any symptoms related to tapeworm infection. The patient received treatment with praziquantel. With a possible future increase in the number of cases seen by health care providers, understanding the risks of Taenia sp. infection is important as proper treatment and education are needed to halt the life cycle of the tapeworm before more serious infection ensues. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  8. SALIVARY ANTIMICROBIAL PROTEIN RESPONSE TO PROLONGED RUNNING

    Directory of Open Access Journals (Sweden)

    Suzanne Schneider

    2013-01-01

    Full Text Available Prolonged exercise may compromise immunity through a reduction of salivary antimicrobial proteins (AMPs. Salivary IgA (IgA has been extensively studied, but little is known about the effect of acute, prolonged exercise on AMPs including lysozyme (Lys and lactoferrin (Lac. Objective: To determine the effect of a 50-km trail race on salivary cortisol (Cort, IgA, Lys, and Lac. Methods: 14 subjects: (6 females, 8 males completed a 50km ultramarathon. Saliva was collected pre, immediately after (post and 1.5 hrs post race ( 1.5. Results: Lac concentration was higher at 1.5 hrs post race compared to post exercise (p0.05. IgA concentration, secretion rate, and IgA/Osm were lower 1.5 hrs post compared to pre race (p<0.05. Cort concentration was higher at post compared to 1.5 (p<0.05, but was unaltered from pre race levels. Subjects finished in 7.81 ± 1.2 hrs. Saliva flow rate did not differ between time points. Saliva Osm increased at post (p<0.05 compared to pre race. Conclusions: The intensity could have been too low to alter Lys and Lac secretion rates and thus, may not be as sensitive as IgA to changes in response to prolonged running. Results expand our understanding of the mucosal immune system and may have implications for predicting illness after prolonged running.

  9. Prolonged displacement may compromise resilience in Eritrean ...

    African Journals Online (AJOL)

    Objective: to assess the impact of prolonged displacement on the resilience of Eritrean mothers. Methods: an adapted SOC scale (short form) was administered. Complementary qualitative data were gathered from study participants' spontaneous reactions to and commentaries on the SOC scale. Results: Displaced ...

  10. Prolonged Cholestatic Jaundice Associated With Flurbiprofen.

    Science.gov (United States)

    Dogan, Serkan; Celikbilek, Mehmet; Demirkan, Kutay; Yilmaz, Semih; Deniz, Kemal; Gursoy, Sebnem; Yucesoy, Mehmet

    2014-08-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely consumed drugs throughout the world for pain relief. Although the adverse effects of NSAIDs to the liver are well known, flurbiprofen-induced liver cholestasis is extremely rare. Herein, we present a patient with prolonged icterus that is associated with the use of flurbiprofen without causing ductopenia. © The Author(s) 2013.

  11. Hippocampal Abnormalities after Prolonged Febrile Convulsions

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-11-01

    Full Text Available Hippocampal volume and T2 relaxation times were determined in an MRI study of 14 children with prolonged febrile convulsions (PFC who were investigated, 1 within 5 days of a PFC, and 2 at follow-up 4-8 months after the acute study, at the Institute of Child Health, University College, and Great Ormond Street Hospital, London, UK.

  12. Acute Right Ventricular Dysfunction Complicating Prolonged ...

    African Journals Online (AJOL)

    We report a case of transient right ventricular dysfunction associated with prolonged cardiac tamponade, an unusual complication of uncertain etiology. We believe that in this case dynamic coronary flow restriction resulted in ischemic injury and stunning of the right ventricle. Other possible causes are briefly reviewed. Right ...

  13. Prefrontal activity during response inhibition decreases over time in the postpartum period.

    Science.gov (United States)

    Bannbers, Elin; Gingnell, Malin; Engman, Jonas; Morell, Arvid; Sylvén, Sara; Skalkidou, Alkistis; Kask, Kristiina; Bäckström, Torbjörn; Wikström, Johan; Poromaa, Inger Sundström

    2013-03-15

    The postpartum period is characterized by complex hormonal changes, but human imaging studies in the postpartum period have thus far predominantly focused on the neural correlates of maternal behavior or postpartum depression, whereas longitudinal studies on neural correlates of cognitive function across the postpartum period in healthy women are lacking. The aim of this study was to longitudinally examine response inhibition, as a measure of executive function, during the postpartum period and its neural correlates in healthy postpartum women and non-postpartum controls. Thirteen healthy postpartum women underwent event-related functional magnetic resonance imaging while performing a Go/NoGo task. The first assessment was made within 48 h of delivery, and the second at 4-7 weeks postpartum. In addition, 13 healthy women examined twice during the menstrual cycle were included as non-postpartum controls. In postpartum women region of interest analyses revealed task-related decreased activations in the right inferior frontal gyrus, right anterior cingulate, and bilateral precentral gyri at the late postpartum assessment. Generally, postpartum women displayed lower activity during response inhibition in the bilateral inferior frontal gyri and precentral gyri compared to non-postpartum controls. No differences in performance on the Go/NoGo task were found between time-points or between groups. In conclusion, this study has discovered that brain activity in prefrontal areas during a response inhibition task decreases throughout the course of the first postpartum weeks and is lower than in non-postpartum controls. Further studies on the normal adaptive brain activity changes that occur during the postpartum period are warranted. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Prolonged QRS Widening After Aripiprazole Overdose.

    Science.gov (United States)

    Mazer-Amirshahi, Maryann; Porter, Robert; Dewey, Kayla

    2018-05-05

    Aripiprazole is an atypical antipsychotic with a long half-life. Overdose can result in protracted somnolence and cardiac disturbances, particularly QT interval prolongation. This is a single case report of a 14-year-old boy who took an overdose of aripiprazole and developed QRS widening. A 14-year-old boy intentionally ingested 20 tablets of aripiprazole (5 mg). He was brought to the emergency department when his ingestion was discovered. The patient's vital signs were as follows: temperature, 37.7°C; heart rate, 108 beats/min; blood pressure, 138/98 mm Hg; and respirations, 16 breaths/min. Activated charcoal was administered within 90 minutes of ingestion. Initial electrocardiogram (EKG) showed sinus tachycardia, with a QRS of 138 ms and QT interval of 444 ms. QRS duration was 90 ms on an EKG performed 3 months earlier. A bolus of sodium bicarbonate was administered, and the patient was transferred to the pediatric intensive care unit. Repeat EKG demonstrated a QRS of 156 ms, and a sodium bicarbonate infusion was initiated. The patient continued to have QRS prolongation for the next 8 days, reaching a peak of 172 ms 3 days postingestion. Despite aggressive treatment with sodium bicarbonate, there was persistent QRS prolongation; however, the patient did not have any dysrhythmias and remained hemodynamically stable. The patient was discharged 9 days postingestion when the QRS duration normalized to 82 ms. Genetic testing revealed that the patient was a CYP2D6 poor metabolizer. This case suggests that aripiprazole toxicity may possibly be associated with QRS prolongation without associated dysrhythmias or cardiovascular compromise. In addition, toxicity may be prolonged in patients who are CYP2D6 poor metabolizers.

  15. Licence prolongations of US nuclear power plants; Les prolongations de licence des centrales nucleaires americaines

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-04-01

    Licences of US nuclear reactors were initially attributed for a 40 years duration. However, the vast majority of the reactors can benefit of a licence prolongation for a period of 20 years maximum. This article recalls first the procedure to follow for the licence prolongation demands (safety analysis, components aging, environmental impact statement), and then it makes a status of the accepted prolongations, of the demands under examination, and of the demands that should be presented in the next 5 years. (J.S.)

  16. Postpartum psychiatric illness in Arab culture: prevalence and psychosocial correlates.

    Science.gov (United States)

    Ghubash, R; Abou-Saleh, M T

    1997-07-01

    There have been numerous studies of the prevalence of postpartum depression and its putative risk factors in Western Europe and North America, but very few studies in developing countries including the Arab world. Ninety-five women admitted to the New Dubai Hospital in Dubai, United Arab Emirates, for childbirth were studied. All subjects were assessed in the postpartum period using clinical and socio-cultural instruments: the Self Report Questionnaire (SRQ) at day 2, the Edinburgh Postnatal Depression Scale (EPDS) at day 7, and the Present State Examination (PSE) at week 8 +/- 2 and week 30 +/- 2 after delivery. The prevalence rate of psychiatric morbidity was 24.5% by the SRQ, 17.8% by the EPDS, and 15.8% by the PSE. A number of psychosocial factors emerged as putative risk factors for postpartum depression. The prevalence rates of postpartum psychiatric morbidity and its risk factors in this Arab culture are similar to the results obtained in numerous previous studies in industrialised countries. These findings have implications for the early detection and care of women at risk for postpartum depression.

  17. Birth setting, labour experience, and postpartum psychological distress.

    Science.gov (United States)

    MacKinnon, Anna L; Yang, Lisa; Feeley, Nancy; Gold, Ian; Hayton, Barbara; Zelkowitz, Phyllis

    2017-07-01

    although psychosocial risk factors have been identified for postpartum depression (PPD) and perinatal posttraumatic stress disorder (PTSD), the role of labour- and birth-related factors remains unclear. The present investigation explored the impact of birth setting, subjective childbirth experience, and their interplay, on PPD and postpartum PTSD. in this prospective longitudinal cohort study, three groups of women who had vaginal births at a tertiary care hospital, a birthing center, and those transferred from the birthing centre to the tertiary care hospital were compared. Participants were followed twice during pregnancy (12-14 and 32-34 weeks gestation) and twice after childbirth (1-3 and 7-9 weeks postpartum). symptoms of PPD and PTSD did not significantly differ between birth groups; however, measures of subjective childbirth experience and obstetric factors did. Moderation analyses indicated a significant interaction between pain and birth group, such that higher ratings of pain among women who were transferred was associated with greater symptoms of postpartum PTSD. women who are transferred appear to have a unique experience that may put them at greater risk for postpartum psychological distress. It may be beneficial for care providers to help prepare women for pain management and potential unexpected complications, particularly if it is their first childbirth. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. [Vaginal misoprostol in the prevention of postpartum hemorrhage].

    Science.gov (United States)

    Quiroga Díaz, Ricardo; Esparza Arechiga, Miguel; Batiza Reséndiz, Víctor; Coronado López, Oscar; Hernández Ayup, Samuel; Martínez Cuervo, Jesús

    2002-11-01

    To show the advantages of the use of vaginal misoprostol, a prostaglandine E1 analogue, in the prevention of the post-partum haemorrhage. This was a prospective, observational, comparative study. The study included 400 patients with high risk of postpartum haemorrhage at our center between January 1999 and may 2001. Patients were divided in two groups. In group I (208 patients) misoprostol was used in a dose of 800 ugr and in group II (192 patients) in whom misoprostol was not used. Both groups were treated initially with our conventional oxytocin protocol. We evaluated the use of additional oxytocin or ergotamine, haemoglobin levels pre and post-partum, the amount of blood loss, and the need for blood transfusion or hysterectomy. The need for additional oxytocin or ergotamine was reduced to less than 10% in group I when compared to group II; the drop in haemoglobin levels and the amount of blood loss were also less in group I (p: 0.03). In this group only one patient needed for blood transfusion and no patient needed hysterectomy. In group II six patients need a blood transfusion and there was the need for two hysterectomies. The use of vaginal misoprostol is effective to control the postpartum bleeding, reducing the blood loss after birth in women with high risk of post-partum haemorrhage as well as the need for blood transfusion. It's use has mild side effects and is of low cost.

  19. Impact of childhood trauma on postpartum depression: a prospective study.

    Science.gov (United States)

    De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip

    2016-04-01

    Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth.

  20. Modeling postpartum depression in rats: theoretic and methodological issues

    Science.gov (United States)

    Ming, LI; Shinn-Yi, CHOU

    2016-01-01

    The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions. PMID:27469254

  1. Postpartum electroconvulsive therapy: a systematic review and case report.

    Science.gov (United States)

    Gressier, Florence; Rotenberg, Samuel; Cazas, Odile; Hardy, Patrick

    2015-01-01

    Postpartum depression can have devastating consequences on the mother and child. Prompt treatment is challenging. Whereas electroconvulsive therapy (ECT) is considered to be an effective treatment modality in severe depression and brings about rapid clinical improvement, little is known about ECT during the postpartum period. We systematically reviewed the literature on the use of ECT during the postpartum period using PubMed, Institute for Scientific Information Web of Knowledge and PsycINFO databases until September 2014, using the search terms "electroconvulsive therapy" or "ECT" and "postpartum". Then, we described the successful treatment with ECT and the joint mother-baby hospitalization of a woman with severe depression. Eight case reports and 8 studies were identified. All of the studies reported that ECT is effective in the postpartum period. It is well tolerated, provides a fast response and allows for breastfeeding. In addition, our case report showed the benefits of the hospitalization of the mother-baby unit. Combined ECT and joint mother-baby hospitalization could be a valuable treatment by targeting both the mother-infant relationship and the maternal depressive symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Modeling postpartum depression in rats: theoretic and methodological issues

    Directory of Open Access Journals (Sweden)

    Ming LI

    2018-06-01

    Full Text Available The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions.

  3. High risk of postpartum relapses in neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Klawiter, Eric C; Bove, Riley; Elsone, Liene; Alvarez, Enrique; Borisow, Nadja; Cortez, Melissa; Mateen, Farrah; Mealy, Maureen A; Sorum, Jaime; Mutch, Kerry; Tobyne, Sean M; Ruprecht, Klemens; Buckle, Guy; Levy, Michael; Wingerchuk, Dean; Paul, Friedemann; Cross, Anne H; Jacobs, Anu; Chitnis, Tanuja; Weinshenker, Brian

    2017-11-28

    To study the effect of pregnancy on the frequency of neuromyelitis optica spectrum disorder (NMOSD) relapse and evaluate rates of pregnancy-related complications in an international multicenter setting. We administered a standardized survey to 217 women with NMOSD from 7 medical centers and reviewed their medical records. We compared the annualized relapse rate (ARR) during a baseline period 2 years prior to a participant's first pregnancy to that during pregnancy and to the 9 months postpartum. We also assessed pregnancy-related complications. There were 46 informative pregnancies following symptom onset in 31 women with NMOSD. Compared to baseline (0.17), ARR was increased both during pregnancy (0.44; p = 0.035) and during the postpartum period (0.69; p = 0.009). The highest ARR occurred during the first 3 months postpartum (ARR 1.33). A total of 8 of 76 (10.5%) with onset of NMOSD prior to age 40 experienced their initial symptom during the 3 months postpartum, 2.9 times higher than expected. The postpartum period is a particularly high-risk time for initial presentation of NMOSD. In contrast to published observations in multiple sclerosis, in neuromyelitis optica, relapse rate during pregnancy was also increased, although to a lesser extent than after delivery. © 2017 American Academy of Neurology.

  4. Food Insecurity During Pregnancy Leads to Stress, Disordered Eating, and Greater Postpartum Weight Among Overweight Women

    Science.gov (United States)

    This study examines food insecurity during and after pregnancy and how that affects postpartum weight retention. The results show that food insecurity was associated with higher levels of stress, eating behaviors, dietary fat intake, and higher postpartum weight status.

  5. Effect of Smoking Cessation on Gestational and Postpartum Weight Gain and Neonatal Birth Weight

    DEFF Research Database (Denmark)

    Rode, Line; Kjærgaard, Hanne; Damm, Peter

    2013-01-01

    To examine the association among smoking cessation, gestational and postpartum weight gain, and neonatal birth weight.......To examine the association among smoking cessation, gestational and postpartum weight gain, and neonatal birth weight....

  6. Hypertensive crisis during pregnancy and postpartum period.

    Science.gov (United States)

    Too, Gloria T; Hill, James B

    2013-08-01

    Hypertension affects 10% of pregnancies, many with underlying chronic hypertension, and approximately 1-2% will undergo a hypertensive crisis at some point during their lives. Hypertensive crisis includes hypertensive urgency and emergency; the American College of Obstetricians and Gynecologists describes a hypertensive emergency in pregnancy as persistent (lasting 15 min or more), acute-onset, severe hypertension, defined as systolic BP greater than 160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia. Pregnancy may be complicated by hypertensive crisis, with lower blood pressure threshold for end-organ damage than non-pregnant patients. Maternal assessment should include a thorough history. Fetal assessment should include heart rate tracing, ultrasound for growth and amniotic assessment, and Doppler evaluation if growth restriction is suspected. Initial management of hypertensive emergency (systolic BP >160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia) generally includes the rapid reduction of blood pressure through the use of intravenous antihypertensive medications, with goal systolic blood pressure between 140 mmHg and 150 mmHg and diastolic pressure between 90 mmHg and 100 mmHg. First-line intravenous drugs include labetalol and hydralazine, but other agents may be used, including esmolol, nicardipine, nifedipine, and, as a last resort, sodium nitroprusside. Among patients with hypertensive urgency, slower blood pressure reduction can be provided with oral agents. The objective of this article is to review the current understanding, diagnosis, and management of hypertensive crisis during pregnancy and the postpartum period. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Uterine massage for preventing postpartum haemorrhage.

    Science.gov (United States)

    Hofmeyr, G Justus; Abdel-Aleem, Hany; Abdel-Aleem, Mahmoud A

    2013-07-01

    Postpartum haemorrhage (PPH) (bleeding from the genital tract after childbirth) is a major cause of maternal mortality and disability, particularly in under-resourced areas. In these settings, uterotonics are often not accessible. There is a need for simple, inexpensive techniques which can be applied in low-resourced settings to prevent and treat PPH. Uterine massage is recommended as part of the routine active management of the third stage of labour. However, it is not known whether it is effective. If shown to be effective, uterine massage would represent a simple intervention with the potential to have a major effect on PPH and maternal mortality in under-resourced settings. To determine the effectiveness of uterine massage after birth and before or after delivery of the placenta, or both, to reduce postpartum blood loss and associated morbidity and mortality. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2013). All published, unpublished and ongoing randomised controlled trials comparing uterine massage alone or in addition to uterotonics before or after delivery of the placenta, or both, with non-massage. Two researchers independently considered trials for eligibility, assessed risk of bias and extracted the data using the agreed form. Data were checked for accuracy. The effect of uterine massage commenced before or after placental delivery were first assessed separately, and then the combined for an overall result. This review included two randomised controlled trials. The first trial included 200 women who were randomised to receive uterine massage or no massage following delivery of the placenta, after active management of the third stage of labour including use of oxytocin. The numbers of women with blood loss more than 500 mL was small, with no statistically significant difference (risk ratio (RR) 0.52, 95% confidence interval (CI) 0.16 to 1.67). There were no cases of retained placenta in either group. The mean

  8. Predictors of postpartum weight change among overweight and obese women: results from the Active Mothers Postpartum study.

    Science.gov (United States)

    Østbye, Truls; Peterson, Bercedis L; Krause, Katrina M; Swamy, Geeta K; Lovelady, Cheryl A

    2012-02-01

    The postpartum period may be critical for the development of midlife obesity. Identifying factors associated with postpartum weight change could aid in targeting women for healthy lifestyle interventions. Data from Active Mothers Postpartum (AMP), a study of overweight and obese postpartum women (n=450), were analyzed to determine the effect of baseline characteristics, breastfeeding, diet, physical activity, and contraception on weight change from 6 weeks to 12, 18, and 24 months postpartum. The repeated measures mixed model was used to test the association of these effects with weight change. Although mean weight loss was modest (0.49 kg by 24 months), the range of weight change was striking (+21.5 kg to -24.5 kg, standard deviation [SD] 7.4). Controlling only for baseline weight, weight loss was associated with breastfeeding, hormonal contraception, lower junk food and greater healthy food intake, and greater physical activity. Only junk food intake and physical activity were significant after controlling for all other predictors. Eating less healthy foods and being less physically active put overweight and obese women at risk of gaining more weight after a pregnancy.

  9. Four Cases of Parkinson Disease Diagnosed During the Postpartum Period.

    Science.gov (United States)

    Maltête, David; Grangeon, Lou; Le Goff, Floriane; Ozel, Gulden; Fetter, Damien; Ahtoy, Patrick; Temgoua, Olivier; Rouillé, Audrey; Lefaucheur, Romain

    2017-07-01

    There is little experience with the effect of pregnancy on Parkinson disease because the number of women with Parkinson disease who are of childbearing age is small. We report four cases beginning during the postpartum period and discuss the potential contribution of different factors that may influence the occurrence of Parkinson disease in this time period. Four women aged 29-35 years developed arm tremor, shoulder pain, dizziness, or decreased dexterity of the hand in the first few days or months after childbirth. They were initially diagnosed with postpartum depression or psychogenic parkinsonism. Finally, dopamine transporter imaging confirmed the diagnosis of young-onset Parkinson disease. Early-onset Parkinson disease may present in postpartum women. In women with atypical motor symptoms in addition to depression, this diagnosis should be considered.

  10. Postpartum depression and infant-mother attachment at one year

    DEFF Research Database (Denmark)

    Smith-Nielsen, Johanne; Tharner, Anne; Steele, Howard

    Findings on effects of Postpartum depression (PPD) on infant-mother attachment have been contradictory. This may be due to not considering maternal interpersonal difficulties, for example co-morbid personality disorder (PD). We examined the role of PD in the association between postpartum...... depression and infant-mother attachment. Mothers were recruited either during pregnancy (non-clinical group, n=56) or eight weeks postpartum (PPD-group, n=29). Infants of mothers with PPD only or in combination with PD were compared with infants of mothers with no psychopathology. Depression and PD were...... assessed with questionnaires and clinical interviews. Infant-mother attachment was assessed when infants were 13 months using Strange Situation Procedure. Mothers with PPD were more likely to have co-morbid PD compared with non-clinical mothers. PPD was associated with attachment insecurity only...

  11. Hemostatic resuscitation in postpartum hemorrhage - a supplement to surgery

    DEFF Research Database (Denmark)

    Ekelund, Kim; Hanke, Gabriele; Stensballe, Jakob

    2015-01-01

    : This review summarizes the background, current evidence and recommendations with regard to the role of fibrinogen, tranexamic acid, prothrombin complex concentrate, desmopressin, and recombinant factor VIIa in the treatment of patients with postpartum hemorrhage. The benefits and evidence behind traditional...... be considered when hypofibrinogenemia is identified. Early administration of 1-2 g of tranexamic acid is recommended, followed by an additional dose in case of ongoing bleeding. Uncontrolled hemorrhage requires early balanced transfusion. CONCLUSION: Despite the lack of conclusive evidence for optimal...... hemostatic resuscitation in postpartum hemorrhage, the use of viscoelastic hemostatic assays, fibrinogen, tranexamic acid and balanced transfusion therapy may prove to be potentially pivotal in the treatment of postpartum hemorrhage. This article is protected by copyright. All rights reserved....

  12. The role of fibrinogen and haemostatic assessment in postpartum haemorrhage

    DEFF Research Database (Denmark)

    Wikkelsø, Anne Juul

    2015-01-01

    Pregnancy is a state of hypercoagulobility that might be an evolutionary way of protecting parturients from exsanguination following child birth. Observational studies suggest an association between a low level of fibrinogen (coagulation factor I) at the start of postpartum haemorrhage (PPH....... Paper III was based on two national Danish registries evaluating the predictability of postpartum blood transfusion. Prediction was found difficult. However, retained placental parts seemed to be the strongest predictor. Since this diagnosis is made very late and often in association with the onset...... describes the protocol for a RCT of early fibrinogen supplementation in women with severe postpartum haemorrhage. Several practical, ethical and trial management challenges need to be addressed when conducting independent clinical research involving parturients with severe bleeding, placebo...

  13. Pre-emptive treatment with fibrinogen concentrate for postpartum haemorrhage

    DEFF Research Database (Denmark)

    Wikkelsø, A J; Edwards, H M; Afshari, A

    2015-01-01

    BACKGROUND: In early postpartum haemorrhage (PPH), a low concentration of fibrinogen is associated with excessive subsequent bleeding and blood transfusion. We hypothesized that pre-emptive treatment with fibrinogen concentrate reduces the need for red blood cell (RBC) transfusion in patients...... and the fibrinogen concentration at inclusion. The primary outcome was RBC transfusion up to 6 weeks postpartum. Secondary outcomes were total blood loss, total amount of blood transfused, occurrence of rebleeding, haemoglobin ... concentrate, thereby significantly increasing fibrinogen concentration compared with placebo by 0.40 g litre(-1) (95% confidence interval, 0.15-0.65; P=0.002). Postpartum blood transfusion occurred in 25 (20%) of the fibrinogen group and 26 (22%) of the placebo group (relative risk, 0.95; 95% confidence...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  15. Postpartum depression among women who have experienced intimate partner violence

    DEFF Research Database (Denmark)

    Rogathi, Jane J.; Manongi, Rachael; Mushi, Declare

    2017-01-01

    Depression Scale (EPDS) and self-reported IPV experiences were assessed using structured questions adopted from the WHO's Multi-country Study on Women's Health and Domestic Violence; 3) Assessment for postpartum depression using EPDS was repeated at 40 days post-partum. Data were analyzed using bivariate......BACKGROUND: Post-partum depression (PPD) in many low-income countries, including Tanzania, is not well recognized, and the underlying predictors and causes of PPD remain unclear. Results from previous studies suggest that PPD is associated with intimate partner violence (IPV) experienced during.......10; 95% CI: 2.04-4.40) as compared to those women who were not exposed to IPV during their pregnancy. Stratified analyses showed that this risk of PPD was highest among younger women (aged 18-24 years) who were exposed to physical violence (AOR=3.75; 95% CI: 1.21-11.67). Among women exposed to emotional...

  16. Bidirectional psychoneuroimmune interactions in the early postpartum period influence risk of postpartum depression.

    Science.gov (United States)

    Corwin, Elizabeth J; Pajer, Kathleen; Paul, Sudeshna; Lowe, Nancy; Weber, Mary; McCarthy, Donna O

    2015-10-01

    More than 500,000 U.S. women develop postpartum depression (PPD) annually. Although psychosocial risks are known, the underlying biology remains unclear. Dysregulation of the immune inflammatory response and the hypothalamic-pituitary-adrenal (HPA) axis are associated with depression in other populations. While significant research on the contribution of these systems to the development of PPD has been conducted, results have been inconclusive. This is partly because few studies have focused on whether disruption in the bidirectional and dynamic interaction between the inflammatory response and the HPA axis together influence PPD. In this study, we tested the hypothesis that disruption in the inflammatory-HPA axis bidirectional relationship would increase the risk of PPD. Plasma pro- and anti-inflammatory cytokines were measured in women during the 3rd trimester of pregnancy and on Days 7 and 14, and Months 1, 2, 3, and 6 after childbirth. Saliva was collected 5 times the day preceding blood draws for determination of cortisol area under the curve (AUC) and depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS). Of the 152 women who completed the EPDS, 18% were depressed according to EDPS criteria within the 6months postpartum. Cortisol AUC was higher in symptomatic women on Day 14 (p=.017). To consider the combined effects of cytokines and cortisol on predicting symptoms of PPD, a multiple logistic regression model was developed that included predictors identified in bivariate analyses to have an effect on depressive symptoms. Results indicated that family history of depression, day 14 cortisol AUC, and the day 14 IL8/IL10 ratio were significant predictors of PPD symptoms. One unit increase each in the IL8/IL10 ratio and cortisol AUC resulted in 1.50 (p=0.06) and 2.16 (p=0.02) fold increases respectively in the development of PPD. Overall, this model correctly classified 84.2% of individuals in their respective groups. Findings

  17. Severe bradycardia and prolonged hypotension in ciguatera.

    Science.gov (United States)

    Chan, Thomas Yan Keung

    2013-06-01

    Ciguatera results when ciguatoxin-contaminated coral reef fish from tropical or subtropical waters are consumed. The clinical features that present in affected persons are mainly gastrointestinal, neurological, general, and much less commonly, cardiovascular. We report the case of a 50-year-old man who developed the characteristic combination of acute gastrointestinal and neurological symptoms after the consumption of an unidentified coral reef fish head. In addition to those symptoms, he developed dizziness, severe bradycardia (46 bpm) and prolonged hypotension, which required the administration of intravenous atropine and over three days of intravenous fluid replacement with dopamine infusion. Patients with ciguatera can develop severe bradycardia and prolonged hypotension. Physicians should recognise the possible cardiovascular complications of ciguatera and promptly initiate treatment with intravenous atropine, intravenous fluid replacement and inotropic therapy if such complications are observed.

  18. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health.

    Science.gov (United States)

    Simavli, Serap; Kaygusuz, Ikbal; Gumus, Ilknur; Usluogulları, Betul; Yildirim, Melahat; Kafali, Hasan

    2014-03-01

    Childbirth is an important experience in a woman's life, and unfavorable birth experiences have been shown to negatively impact postpartum maternal health. Aim of this study was to evaluate the effects of music therapy on postpartum pain, anxiety level, satisfaction and early pospartum depression rate. Totally 161 primiparous women were recruited and randomized either music group (n=80) or a control group (n=81). Women in the music group listened to self-selected music during labor. Postpartum pain intensity, anxiety level and satisfaction rate were measured using the visual analog scale (VAS), postpartum depression rate was assessed with Edinburg Postpartum Depression Scale (EPDS) at postpartum day one and day eight. Mothers in the music therapy group had a lower level of postpartum pain and anxiety than the control group and it was statistically significant at all time intervals (1, 4, 8, 16 and 24h, pmusic therapy on early postpartum depression rate. Effect of music on late postpartum depression rate should be investigated in future. Using music therapy during labor decreased postpartum anxiety and pain, increased the satisfaction with childbirth and reduced early postpartum depression rate. Music therapy can be clinically recommended as an alternative, safe, easy and enjoyable nonpharmacological method for postpartum well-being. Published by Elsevier B.V.

  19. Prevention of postpartum psychosis and mania in women at high risk

    NARCIS (Netherlands)

    V. Bergink (Veerle); P.F. Bouvy (Paul); J. Vervoort (Jeroen); K.M. Koorengevel (Kathelijne); E.A.P. Steegers (Eric); S.A. Kushner (Steven)

    2012-01-01

    textabstractObjective: Women with a history of bipolar disorder or postpartum psychosis are at extremely high risk of relapse postpartum. Although lithium prophylaxis has demonstrated efficacy in reducing postpartum relapse, the timing of prophylaxis remains controversial given the balance of risks

  20. Risk factors for postpartum endometritis and the effect of endometritis on reproductive performance in dairy cows in Korea.

    Science.gov (United States)

    Kim, Ill-Hwa; Kang, Hyun-Gu

    2003-12-01

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

  1. Risk factors for Staphylococcus aureus postpartum breast abscess.

    Science.gov (United States)

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

    2012-01-01

    Staphylococcus aureus (SA) breast abscesses are a complication of the postpartum period. Risk factors for postpartum SA breast abscesses are poorly defined, and literature is conflicting. Whether risk factors for methicillin-resistant SA (MRSA) and methicillin-susceptible SA (MSSA) infections differ is unknown. We describe novel risk factors associated with postpartum breast abscesses and the changing epidemiology of this infection. We conducted a cohort study with a nested case-control study (n = 216) involving all patients with culture-confirmed SA breast abscess among >30 000 deliveries at our academic tertiary care center from 2003 through 2010. Data were collected from hospital databases and through abstraction from medical records. All SA cases were compared with both nested controls and full cohort controls. A subanalysis was completed to determine whether risk factors for MSSA and MRSA breast abscess differ. Univariate analysis was completed using Student's t test, Wilcoxon rank-sum test, and analysis of variance, as appropriate. A multivariable stepwise logistic regression was used to determine final adjusted results for both the case-control and the cohort analyses. Fifty-four cases of culture-confirmed abscess were identified: 30 MRSA and 24 MSSA. Risk factors for postpartum SA breast abscess in multivariable analysis include in-hospital identification of a mother having difficulty breastfeeding (odds ratio, 5.00) and being a mother employed outside the home (odds ratio, 2.74). Risk factors did not differ between patients who developed MRSA and MSSA infections. MRSA is an increasingly important pathogen in postpartum women; risk factors for postpartum SA breast abscess have not changed with the advent of community-associated MRSA.

  2. Postpartum depression: Etiology, treatment and consequences for maternal care.

    Science.gov (United States)

    Brummelte, Susanne; Galea, Liisa A M

    2016-01-01

    This article is part of a Special Issue "Parental Care". Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Maternal postpartum depressive symptoms and infant externalizing and internalizing behaviors.

    Science.gov (United States)

    Vafai, Yassaman; Steinberg, Julia R; Shenassa, Edmond D

    2016-02-01

    Maternal postpartum depression has been shown to be one of the main predictors of externalizing and internalizing behaviors in toddlers and adolescents. Research suggests that presence of such behaviors can be observed as early as infancy. The current study uses longitudinal data from 247 mothers to examine the relationship between postpartum depressive symptoms at 8 weeks and the infant's externalizing and internalizing behaviors at 12 months. In unadjusted linear regression models, there were associations between postpartum depressive symptoms and infant externalizing behaviors (β=0.082, SE=0.032, p=0.012) and internalizing behaviors (β=0.111, SE=0.037, p=0.003). After controlling for potential confounding factors, including maternal age, race, education, home ownership, smoking status in the postpartum period, marital status, parenting stress, and happiness from becoming a parent, the associations between postpartum depressive symptoms and infant externalizing (β=0.051, SE=0.034, p=0.138) and internalizing behaviors (β=0.077, SE=0.040, p=0.057) were reduced and became non-significant. Furthermore, in these models the total amount of variance explained was 17.2% (pexternalizing behaviors and 10.5% (pexternalizing behaviors was maternal age (β=-0.074, SE=0.030, p=0.014), and of internalizing behaviors was white non-Hispanic ethnicity (β=-1.33, SE=0.378, p=0.0005). A combined effect of the confounding factors seems to explain the finding of no significant independent association between postpartum depressive symptoms and infant externalizing and internalizing behaviors. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Variation in Definition of Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Rose, Louise; McGinlay, Michael; Amin, Reshma; Burns, Karen Ea; Connolly, Bronwen; Hart, Nicholas; Jouvet, Philippe; Katz, Sherri; Leasa, David; Mawdsley, Cathy; McAuley, Danny F; Schultz, Marcus J; Blackwood, Bronagh

    2017-10-01

    Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym. We screened 5,331 references, reviewed 539 full-text references, and excluded 120. Of the 419 studies (representing 38 countries) meeting inclusion criteria, 297 (71%) reported data on a heterogeneous subject cohort, and 66 (16%) included surgical subjects only (46 of those 66, 70% cardiac surgery). Other studies described COPD (16, 4%), trauma (22, 5%), neuromuscular (17, 4%), and sepsis (1, 0.2%) cohorts. A total of 741 terms were used to refer to the 419 study cohorts. The most common terms were: prolonged mechanical ventilation (253, 60%), admission to specialized unit (107, 26%), and long-term mechanical ventilation (79, 19%). Some authors (282, 67%) defined their cohorts based on duration of mechanical ventilation, with 154 studies (55%) using this as the sole criterion. We identified 37 different durations of ventilation ranging from 5 h to 1 y, with > 21 d being the most common (28 of 282, 7%). For studies describing a surgical cohort, minimum ventilation duration required for inclusion was ≥ 24 h for 20 of 66 studies (30%). More than half of all studies (237, 57%) did not provide a reason/rationale for definitional criteria used, with only 28 studies (7%) referring to a consensus definition. We conclude that substantial variation exists in the terminology and definitional criteria for cohorts of subjects receiving prolonged mechanical ventilation. Standardization of

  5. Prolonged Exposure: a Rapid Treatment for Phobias

    Science.gov (United States)

    Watson, J. P.; Gaind, R.; Marks, I. M.

    1971-01-01

    Ten adult patients with long-standing specific phobias were treated by prolonged continuous exposure to their phobic objects in fantasy and reality without avoidance. All patients were greatly helped by four to five hours' treatment in two or three sessions, and all improved more after practice than after imaginal sessions. The treatment method is more economical and efficient than other methods described so far. PMID:5539135

  6. CHANGING PRESCRIBING CULTURE - A FOCUS ON CODEINE POSTPARTUM.

    Science.gov (United States)

    Al-Adhami, Noor; Whitfield, Karen; North, Angela

    2016-09-01

    To eliminate the prescribing of codeine and codeine combination products postpartum to improve safety in breast fed infants.Concerns have been raised over the use of codeine and codeine combination products during breast feeding after the death of a neonate whose mother had been prescribed codeine postpartum. High concentrations of morphine were found in the infant's blood and this was attributed to the mother being a CYP2D6 ultrafast metaboliser.1 METHODS: The evidence surrounding the safety of codeine and codeine combination products in children, during the postpartum period and specifically for breast fed infants was collated. The evidence was presented to key stakeholders including obstetricians, midwives, safety and quality representatives, nurse unit managers and acute pain team representatives. Postpartum analgesia was discussed and an agreed protocol developed. Training and education sessions were undertaken to obstetric medical and nursing staff. The evidence that was presented to key stakeholders included:▸ Reports over the safety concerns surrounding the use of codeine and codeine combination products during breast feeding▸ Guidelines and contraindications about the use of codeine in children that had been issued by international regulatory bodies (US Food and Drug Administration and European Medicines Agency).▸ Recommendations from the Australian Medicines Handbook to avoid in breast feeding2 ▸ Recommendations from Hale's Medications and Mothers Milk that reported limited data and had made a recent re-classification from L3 (limited data-probably compatible) to L4 (limited data-possibly hazardous).3 Before presenting the evidence to key stakeholders and undertaking training to nursing and medical staff, more than 90% of postpartum women were prescribed a codeine containing product as part of their 'as required' analgesic regimen.Since the intervention, codeine combination products have now been almost completely eliminated on medication

  7. Modern tactics of observation the postpartum purulent-septic complications

    Directory of Open Access Journals (Sweden)

    O. M. Slinko

    2014-04-01

    Full Text Available Introduction. Postpartum purulent-septic diseases remain an urgent problem of modern obstetrics and are one of the important causes of maternal mortality. The presence of lethal proceeds from septic complications in the postpartum period is above all due to late diagnosis of this complication, delayed acceptance decision on the need and extent of surgery, inadequate capacity of syndromic and intensive care. The aim of research. The clinical analysis of different methods of diagnosis and treatment of patients with postpartum purulent-septic complications, obtained during the period from January 2011 to June 2013, based on work of gynecological department of Zaporozhye Regional Clinical Hospital. Materials and methods. During the period from January 2011 to June 2013 in the gynecological department of Zaporozhye Regional Clinical Hospital specialized medical care of 30 patients with purulent-septic complications in the postpartum period have been provided. 5 women in labor (16.67% were transferred from the maternity homes of Zaporozhye city and the rest (83.33% from different regions. Results. All patients admitted to gynecology department of Zaporozhye Regional Clinical Hospital were conducted massive antibiotic, syndromic therapy. 11 additional patients had an operation vacuum aspiration contents of the uterus, and 5 mothers had absolute indications for surgery: hysterectomy with uterine tube (2 patients diagnosed - septic condition, 3 cases - failure scar on the uterus after cesarean. Conclusion. 1. Delivery by cesarean section surgery significantly increases the risk of developing pyo-septic complications. Prompt delivery should be made according to strict indications, using modern sutures , intraoperative blood loss objective assessment (if necessary with timely appointment of replacement therapy and anti-anemic , with mandatory drainage of the abdominal cavity with repeated cesarean operations . 2. Using the entire set of clinical

  8. Postpartum reversibility of impaired incretin effect in gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Kosinski, M; Knop, F K; Vedtofte, L

    2013-01-01

    The potential reversibility of a reduced incretin effect is unclear. We investigated the incretin effect during third trimester and 3 to 4months postpartum in women with and without gestational diabetes mellitus (GDM). Ten women with GDM (plasma glucose (PG) concentration at 120min after 75g...... with GDM, the incretin effect increased significantly postpartum (31±6 vs. 56±6%, p=0.02), whereas the increment in women with NGT was insignificant (35±12 vs. 56±9%, p=0.08). Similarly, the gastrointestinal-mediated glucose disposal (GIGD=100%×(glucoseOGTT-glucoseIIGI)/glucoseOGTT) was reduced to diabetic...

  9. [Postpartum stress urinary incontinence and associated obstetric factors].

    Science.gov (United States)

    Wang, Xiao-rong; Shi, Jun-xia; Zhai, Gui-rong; Zhang, Wei-yuan

    2010-02-01

    To evaluate the effect of cesarean section (CS) and vaginal delivery (VD) on postpartum stress urinary incontinence (SUI) and pelvic floor muscles strength and to find out the correlated obstetric factors and prevention for postpartum SUI. Totally, 788 women, who visited the antenatal clinics, delivered and had the follow-up at 6-8 weeks after delivery in Beijing Obstetrics and Gynecology Hospital in the year of 2008, were enrolled in this study and were divided into 3 groups: CS group (n = 212); normal vaginal delivery (NVD) group (n = 534) and forceps delivery (FD) group (n = 42). Women in the NVD and FD group were merged into one VD group and then divided into SUI and non-SUI group. Information of delivery mode and the correlated obstetric factors were obtained through questionnaires and medical records. Femiscan pelvic floor muscle examine system was applied to measure the pelvic floor muscle strength to understand the relationship between postpartum SUI and pelvic floor muscle strength. (1) Incidence of SUI: the overall proportion of women who complained of urinary incontinence (UI) during pregnancy was 15.4% (121/788), and it was 15.9% (85/534), 11.9% (5/42) and 14.6% (31/212) in the NVD, FD and CS group, respectively (P > 0.05). The overall incidence of postpartum SUI was 17.1% (135/788), and it was 19.1% (102/534), 26.2% (11/42) and 10.4% (22/212) in the NVD, FD and CS group, respectively, with significant difference between the NVD and FD group, and between the CS and NVD group (all P factors of postpartum SUI: among the VD group, 113 women were in the postpartum SUI group and 463 in the non-SUI group. Univariate analysis and logistic multivariate analysis showed that delivery mode, neonatal birth weight and UI during pregnancy were risk factors of postpartum SUI. CS decreased and higher neonatal birth weight and UI during pregnancy increased the risk of postpartum SUI. In the VD group, neonatal birth weight, forceps delivery and UI during pregnancy

  10. Glucose intolerance in early postpartum in women with gestational diabetes: Who is at increased risk?

    Science.gov (United States)

    Leuridan, Liesbeth; Wens, Johan; Devlieger, Roland; Verhaeghe, Johan; Mathieu, Chantal; Benhalima, Katrien

    2015-08-01

    Women with a history of gestational diabetes (GDM) have an increased risk for developing type 2 diabetes in the years after the index pregnancy. Some women with GDM already develop glucose intolerance in early postpartum. The best screening strategy for glucose intolerance in early postpartum among women with a history of GDM is still debated. We review the most important risk factors of women with GDM to develop glucose intolerance within one year postpartum. We also discuss the current recommendations for screening in early postpartum and the many challenges to organize postpartum follow up in primary care. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  11. Prolonged labour as indication for emergency caesarean section

    DEFF Research Database (Denmark)

    Maaløe, Nanna; Sorensen, B L; Onesmo, R

    2012-01-01

    To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour.......To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour....

  12. Prevalence of Postpartum Depression and its Correlation with Breastfeeding: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Wedad Saad Al-Muhaish

    2018-02-01

    Full Text Available Background: The relationship between breastfeeding and postpartum depression is bidirectional. Breastfeeding improves the maternal and neonatal health. There is now growing evidence that it might play a role in the prevention of postpartum depression. Objective: This study explores the relationship between breastfeeding and maternal postpartum depression. It also estimates the prevalence rate of postpartum depression among Saudi women. Methods: This is a cross-sectional study. Three-hundred postpartum women were recruited for this study from various hospitals in the Eastern Province of Saudi Arabia. Likelihood of depression was assessed using the Edinburgh Postpartum Depression Scale (EPDS. Socio-demographic data were collected as well as data regarding breastfeeding duration and intention to breastfeed. Data analysis was done using SPSS version 21, using parametric tests; independent t-test and One-Way ANOVA. Results: Postpartum mothers who intended to breast-feed their babies had a lower EPDS scores compared with those who did not intend to breast-feed. No correlation was found between the duration of breastfeeding and EPDS scores. Prevalence rate of postpartum depression in our sample was 14%. Greater age, having previous babies, intention to breastfeed and vaginal delivery were significantly associated with actual breastfeeding. Conclusion: Screening for mothers in the early postpartum period is essential to detect those who are at risk for postpartum depression. Breastfeeding may help to reduce and prevent the appearance of symptoms of depression. Prevalence rate of postpartum depression in Saudi Arabia, 14%, is similar to the worldwide rate.

  13. Suppression of natural killer cell cytotoxicity in postpartum women: time course and potential mechanisms.

    Science.gov (United States)

    Groer, Maureen W; El-Badri, Nagwa; Djeu, Julie; Williams, S Nicole; Kane, Bradley; Szekeres, Karoly

    2014-07-01

    Little is known about the recovery of the immune system from normal pregnancy and whether the postpartum period is a uniquely adapted immune state. This report extends previous observations from our group of decreased natural killer (NK) cell cytotoxicity in the postpartum period. NK cytotoxicity was measured from 1 week through 9 months postpartum. In addition, NK cytotoxicity was assayed in the presence or absence of pooled plasmas collected from either postpartum or nonpostpartum women. Samples of cells were stained for inhibitory receptors and analyzed by flow cytometry. NK cytotoxicity remained decreased in postpartum women compared to controls through the first 6 postpartum months, returned to normal levels by 9 months, and remained normal at 12 months. NK cytotoxicity during the first 6 months was further inhibited by the addition of pooled plasma to NK cultures from postpartum women, but the addition of pooled plasma from the control group did not affect that group's NK cultures. There were differences in inhibitory receptor staining between the two groups, with decreased CD158a and CD158b and increased NKG2A expression on postpartum NK cells during the first 3 postpartum months. These data suggest that NK cytotoxicity postpartum inhibition lasts 6 months and is influenced by unidentified postpartum plasma components. The effect may also involve receptors on NK cells. © The Author(s) 2013.

  14. Postpartum Uterine Artery Embolization in a Patient with Uncontrolled Hemorrhage

    Directory of Open Access Journals (Sweden)

    Mehmet Osmanağaoğlu

    2011-04-01

    from the cervical os was continued. After consultation with an interventional radiologist, bilaterally uterine artery embolization was performed. Angiographic embolisation should be considered as the treatment of choice for intractable primary postpartum haemorrhage in appropriate selected cases.

  15. New trends in the management of postpartum haemorrhage | Dyer ...

    African Journals Online (AJOL)

    New trends in the management of postpartum haemorrhage. ... Africa is poor access to basic obstetric care, blood products and basic commodities, such as electricity, for the refrigeration of blood and drugs such as oxytocin.1 Nevertheless, there are many areas where management, and hence outcomes, could be improved.

  16. Affective reactivity differences in pregnant and postpartum women.

    Science.gov (United States)

    Rosebrock, Laina; Hoxha, Denada; Gollan, Jackie

    2015-06-30

    Reactions to emotional cues, termed affective reactivity, promote adaptation and survival. Shifts in affective reactivity during pregnancy and postpartum may invoke altered responses to environmental and biological changes. The development and testing of affective reactivity tasks, with published normative ratings for use in studies of affective reactivity, has been based on responses provided by healthy college students. A comparison of the healthy norms with ratings provided by peripartum women has yet to be conducted, despite its value in highlighting critical differences in affective reactivity during peripartum phases. This study compared arousal ratings of unpleasant, neutral, pleasant, and threat stimuli from the International Affective Picture System (IAPS; Lang, P.J., Bradley, M.M., Cuthbert, B.N. 2008. International Affective Picture System (IAPS): Affective Ratings of Pictures and Instruction Manual (Technical Report A-8). University of Florida, Gainseville, FL.) between three samples: (a) women measured during pregnancy and again at postpartum, (b) age-matched nonpregnant women, and (c) college-aged women from the normative sample used to test the stimuli. Using mixed-design GLMs, results showed that the pregnant and postpartum women and the age-matched women showed suppressed arousal relative to the college-age women. Additionally, postpartum women showed increased arousal to unpleasant/threat images compared to other types of images. The data suggest that future research on peripartum women should include affective reactivity tasks based on norms reflective of this specific population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Postpartum urinary retention : Risk factors, clinical impact and management

    NARCIS (Netherlands)

    Mulder, F.E.M.

    2017-01-01

    Pregnancy as well as delivery are both associated with pelvic floor disorders such as pelvic organ prolapse, overactive bladder syndrome and urinary incontinence. However, little is known about the relationship between voiding dysfunction and postpartum urinary retention (PUR). It is feasible that

  18. The dialectic in becoming a mother: experiencing a postpartum phenomenon.

    Science.gov (United States)

    Sethi, S

    1995-01-01

    In this study of the phenomenon of the postpartum period grounded theory methodology was used to investigate the experiences of first-time mothers during the first three months following their deliveries. The sample consisted of 12 primipara women and 3 multipara women. The data were generated by using unstructured interviews and field notes. Each woman was interviewed twice, the first time between 2 and 3 weeks postpartum, and the second time between 10 and 12 weeks postpartum. The final data for analysis consisted of: data generated through interviews, field notes, and the narratives of four mothers found in the non-fiction literature. Constant comparative analysis resulted in the generation of four categories and corresponding subcategories. These were: (1) Giving of Self; (2) Redefining Self; (3) Redefining Relationships; and (4) Redefining Professional Goals. The categories were not mutually exclusive. All the categories converged to provide support for the core variable 'Dialectic in Becoming a Mother'. The dialectic perspective demonstrated that, in becoming mothers, the women experienced transition, contradictions, tensions and transformations. A theoretical model was developed to show relationships among these major concepts. The findings of this study will be useful in effecting change in the provision of care to postpartum women and their families.

  19. The effect of prenatal counselling on postpartum family planning use ...

    African Journals Online (AJOL)

    The aim of this study was to evaluate the effect of prenatal contraceptive counselling on postpartum contraceptive use and pregnancy outcomes after one year. Methods: Sixteen health centres were equally and randomly allocated to control and intervention arms. Mothers were consecutively recruited during their first ...

  20. CARDIOMYOPATHIE DU POSTPARTUM: A propos de cinq cas au ...

    African Journals Online (AJOL)

    The main presenting symptom was congestive heart failure with acute pulmonary edema. In all cases, the chest x-ray showed ... The treatment administered to these patients included bed rest, salt restriction, digitalics, ... The main issues concerning the management of postpartum cardiomyopathy are raised in this article.

  1. Venous thromboembolism during pregnancy, postpartum or during contraceptive use.

    Science.gov (United States)

    Blanco-Molina, A; Rota, L L; Di Micco, P; Brenner, B; Trujillo-Santos, J; Ruiz-Gamietea, A; Monreal, M

    2010-02-01

    Venous thromboembolism (VTE) is a leading cause of maternal death during pregnancy or postpartum, and in women using hormonal contraceptives. However, important issues concerning its natural history and therapy remain unsolved, and most of the protocols for treatment of VTE in this patient population are based on data extrapolated from other populations. RIETE is an ongoing registry of consecutive patients with objectively confirmed, symptomatic, acute VTE. We examined the clinical characteristics and three-month outcome of all enrolled women with pregnancy, postpartum or using hormonal contraceptives. As of December 2008, 173 pregnant women, 135 postpartum, and 798 contraceptive users were enrolled. Of these, 438 (40%) presented with pulmonary embolism (PE) and 668 with deep-vein thrombosis (DVT). Most women with acute PE had dyspnea (72%) or chest pain (75%), but only 2.0% had hypoxaemia. During the three-month study period, five women (0.45%; 95% CI: 0.17-1.00) died (3 had fatal PE), 13 (1.18%; 95% CI: 0.66-1.95) had VTE recurrences, and seven (0.63%; 95% CI: 0.28-1.25) major bleeding. Two of the three women with fatal PE died during the first few hours after arriving at the emergency ward, with no time to start any therapy. The outcome of pregnant or postpartum women with VTE is similar to that in contraceptive users, even though the treatment is different. The non-specific nature of PE signs may have caused some delay in PE diagnosis.

  2. Postpartum haemorrhage: a preventable cause of maternal mortality

    International Nuclear Information System (INIS)

    Shaheen, B.; Hassan, L.

    2007-01-01

    To assess the preventable predictors of severe postpartum haemorrhage and the adverse outcome associated with it. All the admitted patients who developed severe postpartum haemorrhage (>1500 ml) were included in the study. Clinical and sociodemographic data was obtained along with results of investigations to categorize the complications encountered. Odds ratio (OR) and 95% confidence intervals were determined. During the study period, 75 out of 4683 obstetrical admissions, developed severe postpartum haemorrhage (1.6 %). About 65% of the patients were admitted with some other complications including obstructed labour, antepartum haemorrhage and eclampsia. The risk factors were grand multiparity (OR=3.4), pre-eclampsia (OR=2.75), antepartum haemorrhage (OR=13.35), active labour of more than 10 hours (OR=46.92), twin delivery (OR=3.25), instrumental delivery (OR=8.62) and caesarean section (OR=9.74). Maternal mortality in these cases was 2.66% and residual morbidity being 40%. Birth attendant other than doctor and delivery outside the study unit were significantly associated with the adverse outcome in these patients. Maternal outcome associated with postpartum haemorrhage is a function of care given during labour and postnatal period with early diagnosis and management of the complication and its risk factors, being the key of good maternal outcome. (author)

  3. Psychosocial employment characteristics and postpartum maternal mental health symptoms.

    Science.gov (United States)

    Schwab-Reese, Laura M; Ramirez, Marizen; Ashida, Sato; Peek-Asa, Corinne

    2017-01-01

    For new mothers returning to work, the role of the workplace psychosocial environment on maternal mental health has not been fully described. The purpose of this study was to identify the relationship between psychosocial employment characteristics and mothers' postpartum depression, anxiety, and stress symptoms. Ninety-seven women answered survey questions regarding employment, job demand, control, and support, and postpartum depression, anxiety, and stress symptoms soon after live birth and 6 months later. Working and nonworking mothers reported similar mental health symptoms. Psychological characteristics of employment were not associated with increased odds of mental health symptoms. Increased social support provided by coworkers, supervisors, and the organization was associated with reduced odds of anxiety symptoms. Our findings identified lack of workplace social support as a modifiable risk factor for postpartum anxiety. Future evaluations of workplace social support interventions may be explored to improve postpartum mental health symptoms. Am. J. Ind. Med. 60:109-120, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Evaluation of emergency transcatheter arterial embolization in intractable postpartum hemorrhage

    International Nuclear Information System (INIS)

    Qi Weihong; Wang Song; Zhan Ying

    2008-01-01

    Objective: To assess the efficacy and safety of emergency transcatheter arterial embolization in the management of intractable postpartum hemorrhage. Methods: Twenty-five patients with intractable postpartum hemorrhage were undertaken superselective catheterization into the bilateral internal iliac arteries or uterial arteries to find the causes and sites of bleeding through DSA and then followed by arterial embolization with gelfoam particles. Result: All of the 25 patients with obstetrical bleeding were successfully controlled by TAE, the procedure lasted for 25-60 min, (mean 42.5 ± 4.6 min); with both catheterization and bleeding halt successful rates of 100%. Comparison of hemoglobin and heartbeat before and after the procedure showed significance (t=29.49, P<0.01; t=16.51, P<0.01). The uterus showed reintegration on time and menstruation resumed in all patients. Conclusions: Emergency arterial embolization is a safe and effective means for control of intractable postpartum hemorrhage, providing less trauma and no severe complications, especially as an unique management for fetal postpartum hemorrhage. (authors)

  5. Internal iliac artery embolotherapy for primary postpartum hemorrhage

    International Nuclear Information System (INIS)

    Chen Weijun; Mei Haibing; He Zhongwei; Li Meimei

    2001-01-01

    Objective: To evaluate the effectiveness of internal iliac artery embolotherapy (IIAE) for primary postpartum hemorrhage (PPH). Methods: 9 cases of PPH were treated with IIAE. Results: Selective catheterization and embolotherapy were successful in 9 cases of PPH, with only one case of left lower extremity arterial thrombosis. No serious complications occurred in others. Conclusions: IIAE is a quick, safe, effective technique for PPH

  6. The Structure of Women's Mood in the Early Postpartum

    Science.gov (United States)

    Buttner, Melissa M.; O'Hara, Michael W.; Watson, David

    2012-01-01

    The "postpartum blues" is a mild, predictable mood disturbance occurring within the first several days following childbirth. Previous analyses of the "blues" symptom structure yielded inconclusive findings, making reliable assessment a significant methodological limitation. The current study aimed to explicate the symptom…

  7. Study on treatment of postpartum hemorrhage with urgent interventional embolization

    International Nuclear Information System (INIS)

    Xi Jiayuan; Ren Shuping; Lu Liang; Jiao Cunxian; Liu Yunxia; Yang Yu; Deng Gang; Li Jikang; Cao Xinhua; Mi Lan

    2002-01-01

    Objective: To evaluate urgent selective arterial embolization to treat massive postpartum hemorrhage. Methods: Twenty-seven patients with ages of 21-53 years undergoing severe postpartum hemorrhage, were due to central placental previa, uterine atony, birth canal trauma, placenta accretio, cervical pregnancy etc. All of the patients had lost a volume of blood about 1000 ml to 5000 ml while the hemorrhage could not be controlled with vaginal packing and administration of uterotonic drugs. Urgent hemostatic embolization was performed for them. After angiography, super selective catheterization was performed for bilateral anterior division of internal iliac branch of uterine arteries and embolized with Gelfoam particles. Results: Catheterization success rate was 96.3%. Angiography showed ectopic uterine artery in one case. Immediate block of hemorrhage took place in 22 cases and gradual hemostasis appeared in 4 cases, the efficacy rate was 96.3%. The one with ectopic uterine artery was operated upon to ablate the uterus. 11 patients with (bleeding) shock and 8 patients with DIC were all saved. Conclusions: Urgent arterial embolization is an ideal method for treating life-threatening postpartum hemorrhage. The procedure saves the maternal uterus and is also effective for postpartum DIC

  8. Postpartum Patient Teaching Success: Implications from Nursing and Patient Perspectives

    Science.gov (United States)

    Day, Dawn

    2014-01-01

    A recent examination of postpartum patient satisfaction scores in an inner-city hospital revealed decreased satisfaction of discharge teaching practices. Guided by Knowles' model of andragogy and Donabedian's model of structure-process-outcome, the purpose of this study was to gain an understanding of how the structure and process of discharge…

  9. Postpartum depression, suicidality, and mother-infant interactions.

    Science.gov (United States)

    Paris, Ruth; Bolton, Rendelle E; Weinberg, M Katherine

    2009-10-01

    To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77-87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n = 32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants' cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.

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

    Science.gov (United States)

    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.

  11. A Family Approach to Treatment of Postpartum Depression

    Science.gov (United States)

    McKay, Judith; Shaver-Hast, Laura; Sharnoff, Wendy; Warren, Mary Ellen; Wright, Harry

    2009-01-01

    Postpartum depression (PPD) has an impact on the entire family. The authors describe a model of intervention that emphasizes the family system and includes mothers, fathers, and children in the treatment of PPD. The intervention is provided by a multidisciplinary team consisting of a psychiatrist, social worker, child psychologist, and therapists.…

  12. Association of Hormonal Contraception with depression in the postpartum period.

    Science.gov (United States)

    Roberts, Timothy A; Hansen, Shana

    2017-12-01

    Studies have demonstrated an association between hormonal contraception use with subsequent depression and antidepressant use. This association has not been assessed among postpartum women. This study is a secondary analysis of insurance records from 75,528 postpartum women enrolled in the US military medical system, who delivered between October 2012 and September 2014. Our analyses excluded women who used antidepressants or had a diagnosis of depression in the 24months prior to delivery. We assessed the relationship of hormonal contraception use with subsequent antidepressant use or diagnosis with depression in the first 12months postpartum using Cox proportional hazards regression, with a time dependent covariate measuring exposure to hormonal contraception. Antidepressants were prescribed to 7.8% of women and 5.0% were diagnosed with depression. In multivariable analysis adjusting for demographics, both antidepressant use and diagnosis with depression were associated with: younger age, lower socioeconomic status, and a history of military service. Compared to women with no hormonal contraceptive use, use of etonogestrel containing contraception was associated with a higher risk of antidepressant use (Implant: adjHR:1.22(95%CI:1.06-1.41), pdepression diagnosis (0.56(0.49-0.64), pdepression diagnoses (0.65(0.52-0.82), pdepression diagnosis and antidepressant use in the postpartum period varies with the type of hormonal contraception used. Further research is required to describe the mechanisms of these relationships. Published by Elsevier Inc.

  13. Trajectories of Postpartum Maternal Depressive Symptoms and Children's Social Skills

    Science.gov (United States)

    Wu, Yelena P.; Selig, James P.; Roberts, Michael C.; Steele, Ric G.

    2011-01-01

    The vast majority of new mothers experience at least some depressive symptoms. Postpartum maternal depressive symptoms can greatly influence children's outcomes (e.g., emotional, cognitive, language, and social development). However, there have been relatively few longitudinal studies of how maternal depressive symptoms may influence children's…

  14. Predicting Change in Postpartum Depression: An Individual Growth Curve Approach.

    Science.gov (United States)

    Buchanan, Trey

    Recently, methodologists interested in examining problems associated with measuring change have suggested that developmental researchers should focus upon assessing change at both intra-individual and inter-individual levels. This study used an application of individual growth curve analysis to the problem of maternal postpartum depression.…

  15. [Clinical trial of aromatherapy on postpartum mother's perineal healing].

    Science.gov (United States)

    Hur, Myung Haeng; Han, Sun-Hee

    2004-02-01

    This study was designed to verify the effect of aromatherapy on a postpartum mother's perineal healing. The research design was a clinical trial. The methods of aromatherapy were applied sitz bath or soap application using essential oils with Lavender, Myrrh, Neroli, Rose, Grapefruit, Mandarin, Orange, and Roman Chamomile. The subjects of this experiment were postpartum mothers who delivered vaginally with an episiotomy. They were allocated to one of three groups; the aroma-sitz bath group, aroma-soap application group or control group. To evaluate the effect of aromatherapy, the perineal healing status was measured using the REEDA scale and smears of episiotomy wound were obtained. The data were analyzed by repeated measures of ANOVA, ANCOVA, chi2-test, and multiple response analysis via SPSS program. The REEDA scale was significantly low in the experimental group at postpartum 5th and 7th days (P=.009, P=.003), respectively. Most were observed 'few'(5-10 bacteria per field) bacteria in the smears of episiotomy wound. The one bacteria was identified in the 50.8% of subjects in pretest and two bacteria in the 60.3% in posttest. Most frequently identified bacteria were Escherichia coli and Enterococcus faecalis. In conclusion, these findings indicate that postpartum aromatherapy for perineal care could be effective in healing the perineum perineal care could be effective in healing the perineum.

  16. Introducing the World Health Organization Postpartum Family Planning Compendium.

    Science.gov (United States)

    Sonalkar, Sarita; Gaffield, Mary E

    2017-01-01

    The postpartum period offers multiple opportunities for healthcare providers to assist with family planning decision making. However, there are also many changing factors during the first year after delivery that can affect family planning choices. Given that several different documents have addressed WHO guidance on postpartum family planning, the electronic WHO Postpartum Family Planning Compendium (http://srhr.org/postpartumfp) has been introduced. This resource integrates essential guidance on postpartum family planning for clinicians, program managers, and policy makers. The development of the Compendium included consultations with family planning experts, key international stakeholders, and web developers. Once the website had been created, user testing by family planning experts allowed for improvements to be made before the official launch. Future directions are adaptation of the website into a mobile application that can be more easily integrated to low-resource settings, and translation of the content into French and Spanish. © 2016 World Health Organization. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  17. Prediction of postpartum blood transfusion – risk factors and recurrence

    DEFF Research Database (Denmark)

    Wikkelsø, Anne J; Hjortøe, Sofie; Gerds, Thomas A

    2014-01-01

    OBJECTIVE: The aim was to find clinically useful risk factors for postpartum transfusion and to assess the joint predictive value in a population of women with a first and second delivery. METHODS: All Danish women with a first and second delivery from January 2001 to September 2009 who gave birt...

  18. Prevention of Postpartum Hemorrhage: Options for Home Births in ...

    African Journals Online (AJOL)

    This paper sought to determine the safety and feasibility of home-based prophylaxis of postpartum hemorrhage (PPH) with misoprostol, including assessment of the need for referrals and additional interventions. In rural Tigray, Ethiopia, traditional birth attendants (TBAs) in intervention areas were trained to administer ...

  19. Fulminant leukemoid reaction due to postpartum Clostridium sordellii infection

    Directory of Open Access Journals (Sweden)

    Prabhat Agrawal

    2012-01-01

    Full Text Available Clostridium sordellii is gram positive anaerobic spore forming rod and it has been demonstrated to cause gas gangrene, refractory shock, leukemoid reaction, and pleuroperitoneal effusion due to capillary leak. We report here a case of postpartum female who presented with leukemoid reaction, ascites, pleural effusion, and shock without fever 7 days after normal vaginal home delivery.

  20. 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...

  1. Influence of psychosocial factors on postpartum weight retention

    DEFF Research Database (Denmark)

    Pedersen, Pernille; Baker, Jennifer L; Henriksen, Tine Brink

    2011-01-01

    For some women, pregnancy may increase the risk of future obesity with consequences for health and well-being. Psychosocial factors may be partly responsible for this. The aim of this study was to examine the association between psychosocial factors during pregnancy and postpartum weight retention...

  2. Longitudinal change in sleep and daytime sleepiness in postpartum women.

    Directory of Open Access Journals (Sweden)

    Ashleigh J Filtness

    Full Text Available Sleep disruption strongly influences daytime functioning; resultant sleepiness is recognised as a contributing risk-factor for individuals performing critical and dangerous tasks. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, postpartum women have been comparatively overlooked. Thirty-three healthy, postpartum women recorded every episode of sleep and wake each day during postpartum weeks 6, 12 and 18. Although repeated measures analysis revealed there was no significant difference in the amount of nocturnal sleep and frequency of night-time wakings, there was a significant reduction in sleep disruption, due to fewer minutes of wake after sleep onset. Subjective sleepiness was measured each day using the Karolinska Sleepiness Scale; at the two earlier time points this was significantly correlated with sleep quality but not to sleep quantity. Epworth Sleepiness Scores significantly reduced over time; however, during week 18 over 50% of participants were still experiencing excessive daytime sleepiness (Epworth Sleepiness Score ≥12. Results have implications for health care providers and policy makers. Health care providers designing interventions to address sleepiness in new mothers should take into account the dynamic changes to sleep and sleepiness during this initial postpartum period. Policy makers developing regulations for parental leave entitlements should take into consideration the high prevalence of excessive daytime sleepiness experienced by new mothers, ensuring enough opportunity for daytime sleepiness to diminish to a manageable level prior to reengagement in the workforce.

  3. Postpartum smoking relapse--a thematic synthesis of qualitative studies.

    Science.gov (United States)

    Notley, Caitlin; Blyth, Annie; Craig, Jean; Edwards, Alice; Holland, Richard

    2015-11-01

    Many women quit smoking during pregnancy, but relapse after the baby is born. To understand why and identify ways of preventing this, this study reviewed the qualitative literature on women's experience of postpartum smoking relapse. A systematic review of qualitative studies and process evaluations of trials. We undertook a thematic synthesis of published qualitative data. We screened 1336 papers. Twenty-two papers reporting on 16 studies were included, reporting on the views of 1031 postpartum women. Factors affecting relapse and barriers and facilitators to relapse prevention were identified around the key themes of beliefs, social influences, motivation, physiological factors and identity. Women's beliefs about smoking as a means of coping with stress and the need for social support, especially from a partner, emerged as important. Extrinsic motivation to quit during the pregnancy (for the health of the fetus) appeared to be a factor in prompting relapse after the baby was born. During the immediate postpartum period women believed that physiological changes influence cigarette cravings. The stress of caring for a newborn, sleeplessness and adjusting to a new mothering identity were also reported to be important. Among women who quit smoking during pregnancy, those who relapse postpartum talk commonly about no longer needing to protect the baby and the effects of stress. Partner support and a sense of changed identity are cited as factors preventing relapse. © 2015 Society for the Study of Addiction.

  4. Postpartum family planning: current evidence on successful interventions

    Directory of Open Access Journals (Sweden)

    Blazer C

    2016-04-01

    Full Text Available Cassandra Blazer, Ndola Prata Bixby Center for Population, Health, and Sustainability, School of Public Health, University of California, Berkeley, CA, USA Abstract: We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations. Keywords: postpartum period, family planning, birth spacing, interventions, systematic review, contraception, less developed countries

  5. Postpartum hemorrhage is related to the hemoglobin levels at labor ...

    African Journals Online (AJOL)

    Kaima A. Frass

    2015-01-06

    Jan 6, 2015 ... Abstract Background: Anemia in pregnancy is common and linked to postpartum hemorrhage in terms of uterine atony. The more severe the anemia, the more likely the greater blood loss and adverse outcome. The aim of this study was to examine the association between anemic women at labor and ...

  6. Late onset postpartum preeclampsia 3 months after delivery.

    Science.gov (United States)

    Giwa, Al; Nguyen, Melissa

    2017-10-01

    Preeclampsia is defined by the American College of Obstetrics and Gynecology (ACOG) as "the occurrence of new onset hypertension plus new-onset proteinuria" [1]. Up-to-Date elaborates a little further on this by defining preeclampsia as "the new onset of hypertension and proteinuria, or hypertension and end-organ dysfunction with or without proteinuria, after 20 weeks of gestation in a previously normotensive woman. It may also develop postpartum. Severe hypertension or signs/symptoms of end-organ injury represent the severe end of the disease spectrum" [2] In 2013, the American College of Obstetricians and Gynecologists removed proteinuria as a key component in the diagnosis of preeclampsia. They also removed massive proteinuria (previously, 5 g/24 hours) and fetal growth restriction as possible features of severe disease. They found that were was a poor correlation in many outcomes between massive proteinuria and fetal growth restriction when managed similarly, with or without preeclampsia as a diagnosis. Oliguria was also removed as a characteristic of severe disease. [3] There have been several cases reported in the literature as well as by Obstetricians citing the incidence of preeclampsia occurring upwards of 6 to even 12 weeks postpartum. We hope to demonstrate what we believe to be a case of postpartum preeclampsia at 89 days postpartum. Published by Elsevier Inc.

  7. 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

  8. Promoting Postpartum Exercise: An Opportune Time for Change.

    Science.gov (United States)

    Ringdahl, Erika N.

    2002-01-01

    During the postpartum period clinicians can promote the importance of physical fitness, help patients incorporate exercise into lifestyle changes, and encourage them to overcome barriers to exercise. New responsibilities, physical changes, and time constraints may make exercise seem impossible. By emphasizing weight control, stress reduction, and…

  9. Breastfeeding and postpartum depression: state of the art review

    Directory of Open Access Journals (Sweden)

    Bárbara Figueiredo

    2013-07-01

    Conclusions: Studies demonstrate that breastfeeding can protect mothers from postpartum depression, and are starting to clarify which biological and psychological processes may explain this protection. However, there are still equivocal results in the literature that may be explained by the methodological limitations presented by some studies.

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

    Science.gov (United States)

    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.

  11. 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.

  12. Antenatal and postpartum depression: effects on infant and young ...

    African Journals Online (AJOL)

    terms of physical, cognitive and emotional well-being during crucial stages of ... postpartum depression (PPD).4 Symptoms of maternal depression ... health services and play a productive role in society.6 As depressed ... 45% of those who were depressed had a HIV-positive status.30 In ..... Psychological aspects of nipple.

  13. Community-level Distribution of Misoprostol to Prevent Postpartum ...

    African Journals Online (AJOL)

    In Nigeria, most deaths due to postpartum hemorrhage (PPH) occur in the absence of skilled birth attendants. A study using community mobilization and the training of community drug keepers to increase access to misoprostol for PPH prevention was conducted in five communities around Zaria in Kaduna State, Nigeria.

  14. Postpartum Depression among Women in Uyo, Akwa-Ibom State ...

    African Journals Online (AJOL)

    Abstract. Background Postpartum depression is a common psychiatric complication of childbearing among women. The increasing rate in addition to poor clinical diagnosis is attributable to poor health care services and inadequate medical attention. The implication is the high morbidity with adverse social and medical ...

  15. Postpartum major depression at six weeks in primary health care ...

    African Journals Online (AJOL)

    Background: Major depression is a common and disabling complication of the postpartum period in women. It is thought to occur three times more commonly in the developing than in developed countries. Objectives: The objectives of this study were to determine the prevalence of and factors associated with major ...

  16. Laryngotracheal Injury following Prolonged Endotracheal Intubation

    Directory of Open Access Journals (Sweden)

    J. Mehdizadeh

    2006-07-01

    Full Text Available Background: Prolonged endotracheal intubation is a growing method for supporting ventilation in patients who require intensive care. Despite considerable advancement in endotracheal intubation, this method still has some complications; the most important is laryngo-tracheal injuries. Methods: Over a 2-year period, this retrospective study was conducted on 57 patients with history of prolonged intubation who were referred to the ENT Department of Amir Alam Hospital. For each patient, a complete evaluation including history, physical examination, and direct laryngoscopy and bronchoscopy was done under general anesthesia. Results: Fifty-seven patients (44 male; mean age, 23.014.7 years were studied. Mean intubation period was 15.88 days. The most common presenting symptom was dyspnea (62%. Head trauma was responsible for most cases of intubation (72.4%. The most common types of tracheal and laryngeal lesions were tracheal (56.9% and subglottic (55.2% stenosis, respectively. Mean length of tracheal stenosis was 0.810.83 cm. There was a statistically significant relationship between length of tracheal stenosis and intubation period (P=0.0001 but no relation was observed between tracheal stenosis and age, sex, and etiology of intubation (All P=NS. Among the glottic lesions, inter- arytenoids adhesion was the most common lesion (25.9%. No statistically significant relation was found between glottic and subglottic lesions and age, sex and intubation period (all P=NS. Length of stenosis and intubation period was significantly greater in tracheal/ subglottic lesions than those in glottic/ supraglottic lesions (all P=NS. Conclusion: After prolonged endotracheal intubation, laryngo-tracheal lesions had no relation with patient’s age, sex, and cause of intubation.There was direct relation between length of tracheal stenosis and intubation period. Glottic lesions were more commonly observed in head trauma patients. Lesion length and intubation

  17. Duration of Second Stage of Labour at Term and Pushing Time: Risk Factors for Postpartum Haemorrhage.

    Science.gov (United States)

    Looft, Emelie; Simic, Marija; Ahlberg, Mia; Snowden, Jonathan M; Cheng, Yvonne W; Stephansson, Olof

    2017-03-01

    Prolonged labour is associated with increased risk of postpartum haemorrhage (PPH), but the role of active pushing time and the relation with management during labour remains poorly understood. A population-based cohort study from electronic medical record data in the Stockholm-Gotland Region, Sweden. We included 57 267 primiparous women with singleton, term gestation, livebirths delivered vaginally in cephalic presentation in 2008-14. We performed multivariable Poisson regression to estimate the association between length of second stage, pushing time, and PPH (estimated blood loss >500 mL during delivery), adjusting for maternal, delivery, and fetal characteristics as potential confounders. The incidence of PPH was 28.9%. The risk of PPH increased with each passing hour of second stage: compared with a second stage pushing time exceeding 30 min. Compared to pushing time between 15 and 29 min, the RR for PPH were for pushing time during labour are both associated with increased risk of PPH. © 2017 John Wiley & Sons Ltd.

  18. Prenatal and Postpartum Care Disparities in a Large Medicaid Program.

    Science.gov (United States)

    Parekh, Natasha; Jarlenski, Marian; Kelley, David

    2018-03-01

    Objectives Pennsylvania's maternal mortality, infant mortality, and preterm birth rates rank 24th, 35th, and 25th in the country, and are higher among racial and ethnic minorities. Provision of prenatal and postpartum care represents one way to improve these outcomes. We assessed the extent of disparities in the provision and timeliness of prenatal and postpartum care for women enrolled in Pennsylvania Medicaid. Methods We performed a cross-sectional evaluation of representative samples of women who delivered live births from November 2011 to 2015. Our outcomes were three binary effectiveness-of-care measures: prenatal care timeliness, frequency of prenatal care, and postpartum care timeliness. Pennsylvania's Managed Care Organizations (MCOs) were required to submit these outcomes to the state after reviewing administrative and medical records through a standardized, validated sampling process. We assessed for differences in outcomes by race, ethnicity, region, year, and MCO using logistic regression. Results We analyzed data for 12,228 women who were 49% White, 31% Black/African American, 4% Asian, and 15% Hispanic/Latina. Compared to Black/African American women, white and Asian women had higher odds of prenatal and postpartum care. Hispanic/Latina women had higher frequency of prenatal care than non-Hispanic women. Pennsylvania's Southeast had lower prenatal care and Northwest had lower postpartum care than other regions. Prenatal care significantly decreased in 2014 and increased in 2015. We observed differences between MCOs, and as MCO performance diminished, racial disparities within each plan widened. We explored hypotheses for observed disparities in secondary analyses. Conclusions for Practice Our data demonstrate that interventions should address disparities by race, region, and MCO in equity-promoting measures.

  19. 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

  20. Risk factors associated with postpartum depression in the Saudi population

    Directory of Open Access Journals (Sweden)

    Alharbi AA

    2014-02-01

    Full Text Available Abeer A Alharbi,1 Hamza Mohammad Abdulghani2 1Department of Family and Community Medicine, 2Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia Introduction: Postpartum depression (PPD is one of the major psychological disorders worldwide that affects both mother and child. The aim of this study was to correlate the risk of PPD with obstetric and demographic variables in Saudi females. Materials and methods: Data were collected by interviewing females 8–12 weeks postpartum. PPD symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Variables included in this study were age, education, occupation, parity, baby's sex, pregnancy period, delivery type, hemoglobin level, anemia, and iron pills taken during pregnancy. Results: Of the 352 postpartum females, the prevalence of PPD symptom risk was 117 (33.2%. Among the PPD symptomatic females, 66 (39.8% had low hemoglobin levels, and 45 (40.5% females were anemic during pregnancy (P≤0.05. These results suggest that early postpartum anemia, indicated by low hemoglobin level, is a significant risk factor for PPD (adjusted odds ratio 1.70, 95% confidence interval 1.05–2.74; P=0.03. Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95, but marginally indicative of the risk of depressive symptoms. Conclusion: Low hemoglobin level and anemia during pregnancy were risk factors for PPD in Saudi females. Many other factors may be considered risk factors, such as age, occupation, and parity. Anemic women need more attention and to be checked regarding their PPD, and treated if necessary. Keywords: postpartum depression, hemoglobin level, anemia, EPDS

  1. Topical Drug Formulations for Prolonged Corneal Anesthesia

    Science.gov (United States)

    Wang, Liqiang; Shankarappa, Sahadev A.; Tong, Rong; Ciolino, Joseph B.; Tsui, Jonathan H.; Chiang, Homer H.; Kohane, Daniel S.

    2013-01-01

    Purpose Ocular local anesthetics (OLA’s) currently used in routine clinical practice for corneal anesthesia are short acting and their ability to delay corneal healing makes them unsuitable for long-term use. In this study, we examined the effect on the duration of corneal anesthesia of the site-1 sodium channel blocker tetrodotoxin (TTX), applied with either proparacaine or the chemical permeation enhancer OTAB. The effect of test solutions on corneal healing was also studied. Methods Solutions of TTX, proparacaine, and OTAB, singly or in combination were applied topically to the rat cornea. The blink response, an indirect measure of corneal sensitivity, was recorded using a Cochet-Bonnet esthesiometer, and the duration of corneal anesthesia calculated. The effect of test compounds on the rate of corneal epithelialization was studied in vivo following corneal debridement. Results Combination of TTX and proparacaine resulted in corneal anesthesia that was 8–10 times longer in duration than that from either drug administered alone, while OTAB did not prolong anesthesia. The rate of corneal healing was moderately delayed following co-administration of TTX and proparacaine. Conclusion Co-administration of TTX and proparacaine significantly prolonged corneal anesthesia but in view of delayed corneal re-epithelialization, caution is suggested in use of the combination. PMID:23615270

  2. Postpartum Intimate Partner Violence and Health Risks Among Young Mothers in the United States: A Prospective Study

    Science.gov (United States)

    Ickovics, Jeannette; Lewis, Jessica B.; Magriples, Urania; Kershaw, Trace S.

    2014-01-01

    The study assessed the relationship between postpartum intimate partner violence (IPV) and postpartum health risks among young mothers over time. Data were collected from 2001 to 2005 on young women aged 14–25 attending obstetrics and gynecology clinics in two US cities. Postpartum IPV (i.e., emotional, physical, sexual) was assessed at 6 and 12 months after childbirth (n = 734). Four types of postpartum IPV patterns were examined: emerged IPV, dissipated IPV, repeated IPV, and no IPV. Emerged IPV occurred at 12 months postpartum, not 6 months postpartum. Dissipated IPV occurred at 6 months postpartum, not 12 months postpartum. Repeated IPV was reported at 6 months and 12 months postpartum. Postpartum health risks studied at both time points were perceived stress, depression, fear of condom negotiation, condom use, infant sleeping problems, and parental stress. Repeated measures analysis of covariance was used. The proportion of young mothers reporting IPV after childbirth increased from 17.9 % at 6 months postpartum to 25.3 % at 12 months postpartum (P postpartum IPV were associated with increased perceived stress, depression, fear of condom negotiation, and infant sleeping problems as well as decreased condom use (P postpartum IPV was associated with decreased depression (P postpartum period. PMID:24562504

  3. POSTPARTUM BONDING DIFFICULTIES AND ADULT ATTACHMENT STYLES: THE MEDIATING ROLE OF POSTPARTUM DEPRESSION AND CHILDBIRTH-RELATED PTSD.

    Science.gov (United States)

    S Hairston, Ilana; E Handelzalts, Jonathan; Assis, Chen; Kovo, Michal

    2018-03-01

    Despite decades of research demonstrating the role of adult attachment styles and early mother-infant bonding in parenting behaviors and maternal mental health, these constructs have seldom been studied together. The present study aimed to investigate the relationship between attachment styles and specific bonding difficulties of mothers. In addition, as postpartum depression and childbirth-related posttraumatic stress symptoms have been associated with both constructs, we explored their possible mediation effect. One hundred fourteen mothers, 4 to 12 weeks' postpartum, completed a demographic questionnaire, the Adult Attachment Style Questionnaire (M. Mikulincer, V. Florian, & A. Tolmacz, 1990), the Postpartum Bonding Questionnaire (L.F. Brockington, C. Fraser, & D. Wilson, 2006), the Modified Perinatal Posttraumatic Stress Disorder Questionnaire (J.L. Callahan, S.E. Borja, & M.T. Hynan, 2006), and the Edinburgh Postnatal Depression Scale (J.L. Cox, G. Chapman, D. Murray, & P. Jones, 1996), using an online survey system. As predicted, insecure attachment styles were associated with bonding difficulties wherein anxious/ambivalent attachment was associated with greater infant-focused anxiety, mediated by postpartum depression but not childbirth-related PTSD symptoms. In contrast, greater avoidant attachment style was associated with greater rejection and anger, mediated by childbirth-related posttraumatic stress disorder (PTSD), but not depression symptoms. The current study confirmed the association of different attachment styles with bonding as well as the mediating roles of childbirth-related PTSD and postpartum depression symptoms. Future psychological interventions may utilize such evidence to target interventions for bonding disorders in accordance with individual differences. © 2018 Michigan Association for Infant Mental Health.

  4. Women’s experiences with postpartum anxiety disorders: a narrative literature review

    Directory of Open Access Journals (Sweden)

    Ali E

    2018-05-01

    Full Text Available Elena Ali Faculty of Nursing, University of Calgary, Calgary, AB, Canada Purpose: Postpartum anxiety disorders are common and may have significant consequences for mothers and their children. This review examines the literature on women’s experiences with postpartum generalized anxiety disorder (GAD, postpartum panic disorder (PD, obsessive compulsive disorder (OCD, and posttraumatic stress disorder (PTSD. Methods: MEDLINE (Ovid, CINAHL, PsycINFO, and reference lists were searched. Qualitative and quantitative studies assessing women’s experiences with GAD, postpartum PD, OCD, and PTSD were included. Narrative approach to literature synthesis was used. Results: Fourteen studies (among 44 articles met the criteria for review to identify descriptions of women’s cognitive, affective, and somatic experiences related to postpartum anxiety disorders. Loss, frustration, and guilt, accompanied by physical symptoms of tension, were some of the experiences identified across studies. Most women suffered from more than one anxiety disorder, in addition to postpartum depression. To date, research has focused on prevalence rates of postpartum anxiety disorders, and evidence about clinical and subclinical symptoms of postpartum anxiety disorders and outcomes on mother and child is lacking. Postpartum anxiety disorders may have negative effects on parenting and child development; however, the nature of the underlying mechanisms is unclear. Conclusion: More robust longitudinal studies are needed to examine the impact of postpartum GAD, PD, OCD, and PTSD symptoms on the mother and the mother–child relationship to develop targets for therapeutic preventative interventions. Keywords: postnatal anxiety, postnatal distress, childbirth, women’s beliefs and attitudes

  5. Multifactorial QT Interval Prolongation and Takotsubo Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Michael Gysel

    2014-01-01

    Full Text Available A 71-year-old woman collapsed while working as a grocery store cashier. CPR was performed and an AED revealed torsades de pointes (TdP. She was subsequently defibrillated resulting in restoration of sinus rhythm with a QTc interval of 544 msec. Further evaluation revealed a diagnosis of Takotsubo Cardiomyopathy (TCM contributing to the development of a multifactorial acquired long QT syndrome (LQTS. The case highlights the role of TCM as a cause of LQTS in the setting of multiple risk factors including old age, female gender, hypokalemia, and treatment with QT prolonging medications. It also highlights the multifactorial nature of acquired LQTS and lends support to growing evidence of an association with TCM.

  6. Prolonged toxicity from Kambo cleansing ritual.

    Science.gov (United States)

    Li, Kai; Horng, Howard; Lynch, Kara; Smollin, Craig G

    2018-04-02

    Kambo cleanse is a purification, cleansing ritual traditionally performed by South American shaman to confer luck and health to hunters. We report a patient who presented to the emergency department with prolonged symptoms of vomiting, flushing, facial swelling, altered mental status, and agitation requiring chemical restraints, 22 h after a Kambo cleanse. The patient was found with four small, circular, superficial burns to the ankle at the site where the resin was introduced. The cleanse consists of rubbing resin obtained from the secretions of the giant leaf frog (Phyllomedusa bicolor) into superficial wounds to produce intense gastrointestinal symptoms followed by a sensation of increased stamina and strength. The cleanse is now being increasingly performed in Europe and USA.

  7. Bywalled plasma formation in vacuum prolonged channels

    International Nuclear Information System (INIS)

    Korenev, S.A.; Rubin, N.B.

    1982-01-01

    To produce homogeneous along the channel length plasma the application of incomplete rate-in surface dielectric discharge for generating the bywalled plasma in prolonged cylindrical channels at a pressure of the residual gas of P approximately 10 -5 Torr is proposed. Experimental set-up consisted of a pulse voltage generator and a plasma channel. The plasma channel was a coaxial system of three tubes inserted into each other. The first outer tube is made of a stainless steel, the second - of a dielectric material, the third - of smallsized stainless steel greed. It is demonstrated that the plasma being formed in the process is sufficiently homogeneous by concentration of the components, by the channel length and azimuth. The length of the experimental channel under investigation was 1.6 m, its diameter amounted 0.05 m. The maximum concentration of electron component was 10 17 m -3

  8. Neurohumoral responses during prolonged exercise in humans

    DEFF Research Database (Denmark)

    Nybo, Lars; Nielsen, Bodil; Blomstrand, Eva

    2003-01-01

    This study examined neurohumoral alterations during prolonged exercise with and without hyperthermia. The cerebral oxygen-to-carbohydrate uptake ratio (O2/CHO = arteriovenous oxygen difference divided by arteriovenous glucose difference plus one-half lactate), the cerebral balances of dopamine......, and the metabolic precursor of serotonin, tryptophan, were evaluated in eight endurance-trained subjects during exercise randomized to be with or without hyperthermia. The core temperature stabilized at 37.9 +/- 0.1 degrees C (mean +/- SE) in the control trial, whereas it increased to 39.7 +/- 0.2 degrees C...... in the hyperthermic trial, with a concomitant increase in perceived exertion (P exercise trials. Both the arterial and jugular venous dopamine levels...

  9. Prolonged grieving after abortion: a descriptive study.

    Science.gov (United States)

    Brown, D; Elkins, T E; Larson, D B

    1993-01-01

    Although flawed by methodological problems, the research literature tends to provide support for the assumption that induced abortion in the 1st trimester is not accompanied by enduring negative psychological sequelae. In cases where such sequelae are reported, the morbidity is attributed to a pre-existing psychiatric condition or circumstances precipitating the choice of abortion. However, detailed descriptive letters from 45 women prepared in response to a request by a pastor of an upper-middle-class Protestant congregation in Florida indicate that prolonged grieving after abortion may be more widespread phenomenon than previously believed. Letter writers ranged in age from 25-60 years; 75% were unmarried at the time of the procedure and 29% aborted before the legalization of abortion in the US. The most frequently cited long-term sequela, especially among those who felt coerced to abort, was a continued feeling of guilt. Fantasies about the aborted fetus was the next most frequently mentioned experience. Half of the letter writers referred to their abortions, as "murder" and 44% voiced regret about their decision to abort. Other long-term effects included depression (44%), feelings of loss (31%), shame (27%), and phobic responses to infants (13%). For 42% of these women, the adverse psychological effects of abortion endured over 10 years. Since letter-writers came from a self-selected population group with a known bias against abortion and only negative experiences were solicited, these experiences must be regarded as subjectives and anecdotal. However, they draw attention to the need for methodologically sound studies of a possible prolonged grief syndrome among a small percentage of women who have abortions, especially when coercion is involved.

  10. Antifibrinolytic drugs for treating primary postpartum haemorrhage.

    Science.gov (United States)

    Shakur, Haleema; Beaumont, Danielle; Pavord, Sue; Gayet-Ageron, Angele; Ker, Katharine; Mousa, Hatem A

    2018-02-20

    Postpartum haemorrhage (PPH) - heaving bleeding within the first 24 hours after giving birth - is one of the main causes of death of women after childbirth. Antifibrinolytics, primarily tranexamic acid (TXA), have been shown to reduce bleeding in surgery and safely reduces mortality in trauma patients with bleeding without increasing the risk of adverse events.An earlier Cochrane review on treatments for primary PPH covered all the various available treatments - that review has now been split by types of treatment. This new review concentrates only on the use of antifibrinolytic drugs for treating primary PPH. To determine the effectiveness and safety of antifibrinolytic drugs for treating primary PPH. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (28 May 2017) and reference lists of retrieved studies. Randomised controlled trials (RCTs), including cluster-randomised trials of antifibrinolytic drugs (aprotinin, TXA, epsilon-aminocaproic acid (EACA) and aminomethylbenzoic acid, administered by whatever route) for primary PPH in women.Participants in the trials were women after birth following a pregnancy of at least 24 weeks' gestation with a diagnosis of PPH, regardless of mode of birth (vaginal or caesarean section) or other aspects of third stage management.We have not included quasi-randomised trials, or cross-over studies. Studies reported as abstracts have not been included if there was insufficient information to allow assessment of risk of bias.In this review we only identified studies looking at TXA. Two review authors independently extracted data from each study using an agreed form. We entered data into Review Manager software and checked for accuracy.For key review outcomes, we rated the quality of the evidence as 'high', 'moderate', 'low' or 'very low' according to the GRADE approach. Three trials (20,412 women) met our inclusion criteria. Two trials

  11. Prolonged pain and disability are common after rib fractures.

    Science.gov (United States)

    Fabricant, Loic; Ham, Bruce; Mullins, Richard; Mayberry, John

    2013-05-01

    The contribution of rib fractures to prolonged pain and disability may be underappreciated and undertreated. Clinicians are traditionally taught that the pain and disability of rib fractures resolves in 6 to 8 weeks. This study was a prospective observation of 203 patients with rib fractures at a level 1 trauma center. Chest wall pain was evaluated by the McGill Pain Questionnaire (MPQ) pain rating index (PRI) and present pain intensity (PPI). Prolonged pain was defined as a PRI of 8 or more at 2 months after injury. Prolonged disability was defined as a decrease in 1 or more levels of work or functional status at 2 months after injury. Predictors of prolonged pain and disability were determined by multivariate analysis. One hundred forty-five male patients and 58 female patients with a mean injury severity score (ISS) of 20 (range, 1 to 59) had a mean of 5.4 rib fractures (range, 1 to 29). Forty-four (22%) patients had bilateral fractures, 15 (7%) had flail chest, and 92 (45%) had associated injury. One hundred eighty-seven patients were followed 2 months or more. One hundred ten (59%) patients had prolonged chest wall pain and 142 (76%) had prolonged disability. Among 111 patients with isolated rib fractures, 67 (64%) had prolonged chest wall pain and 69 (66%) had prolonged disability. MPQ PPI was predictive of prolonged pain (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.4 to 2.5), and prolonged disability (OR, 2.2; 95% CI, 1.5 to 3.4). The presence of significant associated injuries was predictive of prolonged disability (OR, 5.9; 95% CI, 1.4 to 29). Prolonged chest wall pain is common, and the contribution of rib fractures to disability is greater than traditionally expected. Further investigation into more effective therapies that prevent prolonged pain and disability after rib fractures is needed. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Serial ultrasonographic appearance of postpartum uterine involution in beagle dogs.

    Science.gov (United States)

    Yeager, A E; Concannon, P W

    1990-09-01

    Postpartum changes in uterine shape, architecture, echogenicity and diameter were determined during the serial examinations of five beagle bitches. During postpartum Week 1, the uterine horns were tubular structures composed of multiple layers of various echogenicity and had multiple, discrete enlargements with hypoechoic centers at placental sites. Diameters ranged from 1.1 to 3.8 cm at placental site enlargements, and 0.5 to 1.4 cm between enlargements. Uterine involution appeared to be completed by 15 wk post partum. At 15 weeks the uterine horns of each dog were uniform hypoechoic, tubular structures without enlargements and had a reduced diameter of 0.3 to 0.6 cm. These ultrasonographic findings are similar to previously reported gross and light microscopic descriptions of canine uterine involution.

  13. Parent-Infant Psychotherapy and Postpartum Depression: The Fathers Participation

    Directory of Open Access Journals (Sweden)

    Milena da Rosa Silva

    2013-05-01

    Full Text Available Given the specificities of postpartum maternal depression, the literature recommends that fathers become involved in psychological interventions within this context. This study presents an investigation of the participation of fathers in parent-infant psychotherapy in the context of maternal postpartum depression. Two families participated in this study, both with a child aged between 7 and 8 months old, whose mothers showed depressive symptoms. These families participated in parent-infant psychotherapy lasting approximately 12 sessions. Analysis of the fathers’ participation in psychotherapy showed that their presence during sessions enables the therapy to address aspects of parenthood, and also reduce the feeling of mothers as being the only ones responsible for the family’s process of change. In regard to the technique, the presence of fathers during sessions allows the therapist to see and address the issues concerning mother-father-infant during sessions.

  14. Postpartum depression in Indonesia women: a national study

    Directory of Open Access Journals (Sweden)

    Sri Idaiani

    2012-09-01

    Full Text Available AbstrakLatar belakang: Ibu yang melahirkan diharapkan tidak mengalami rasa sedih pasca persalinan yang berdampak jangka panjang antara lain menyebabkan gangguan pertumbuhan dan perkembangan anak. Tujuan analisis ini untuk mengidentifikasi beberapa faktor terhadap rasa sedih pasca melahirkan.Metode: Analisis ini merupakan sebagian data Riset Kesehatan Dasar (Riskesdas 2010 yang dilaksanakan di seluruh Indonesia dengan sampling bertahap. Analisis dilakukan terhadap wanita yang menikah atau pernah menikah berumur 13-49 tahun yang melahirkan bayi antara 1 January 2005 sampai 31 August 2010. Analisis mempergunakan regresi logistik.Hasil:Prevalensi rasa sedih pasca persalinan sebesar 2,32% (440/18937. Wanita yang melahirkan bayi dengan ukuran sangat kecil berisiko tertinggi mengalami (4,8-lipat rasa sedih pasca persalinan [rasio odds suaian (ORa=4,84; 95% interval kepercayaan (CI=2,89-8,12], dan yang mempunyai bayi kecil 67% lebih besar mengalami rasa sedih pasca persalinan (ORa=1,67; 95% CI =1,20-2,33. Selain itu wanita yang mengalami komplikasi pasca persalinan berisiko lebih besar mengalami rasa sedih pasca persalinan. Dibandingkan dengan yang tidak mengalami komplikasi, wanita yang mengalami pecah ketuban dini mengalami risiko lebih tinggi 6 kali lipat (ORa=6,02; 95% CI=4,63-7,83, disusul yang mengalami partus macet (ORa=5.75; 95% CI=3,05-10,85.Kesimpulan:Wanita yang mengalami komplikasi selama persalinan atau mempunyai besar bayi tidak rata-rata berisiko lebih besar mengalami rasa sedih pasca persalinan.(Health Science Indones 2012;1:3-8Kata kunci: post partum, rasa sedih, komplikasi, besar bayi, IndonesiaAbstractBackground:A mother’s postpartum depression may have long-term impacts on a child’s growth and development. This analysis aimed to identify several risk factors related to postpartum depression.Methods:The data analyzed originated from a cross-sectional Basic Health Survey (Riskesdas 2010 of Indonesia which provided specific

  15. Optimizing postpartum care for the patient with gestational diabetes mellitus.

    Science.gov (United States)

    Martinez, Noelle G; Niznik, Charlotte M; Yee, Lynn M

    2017-09-01

    Gestational diabetes mellitus poses well-established risks to both the mother and infant. As >50% of women with gestational diabetes mellitus will develop type 2 diabetes mellitus in their lifetime, performing postpartum oral glucose tolerance testing is paramount to initiation of appropriate lifestyle interventions and pharmacologic therapy. Nonetheless, test completion among women with gestational diabetes mellitus is estimated to be diabetes mellitus. Based on existing evidence, we propose best practices for the postpartum care of women with gestational diabetes mellitus: (1) enhanced patient support for identifying long-term health care providers, (2) patient-centered medical home utilization when possible, (3) patient and provider test reminders, and (4) formalized obstetrician-primary care provider hand offs using the Situation Background Assessment Recommendation (SBAR) mnemonic. These strategies deserve future investigation to solidify a multilevel approach for identifying and preventing the continuum of diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Educational technologies to encourage (self) care in postpartum women.

    Science.gov (United States)

    Barbosa, Eryjosy Marculino Guerreiro; Sousa, Albertina Antonielly Sydney de; Vasconcelos, Mardênia Gomes Ferreira; Carvalho, Rhanna Emanuela Fontenele Lima de; Oriá, Mônica Oliveira Batista; Rodrigues, Dafne Paiva

    2016-06-01

    to evaluate national and international literature regarding the use of educational technologies to encourage self care in postpartum women. an integrative review of the literature. The articles were collected from the CINAHL, SCOPUS, PubMed, SciELO, LILACS and Cochrane databases; the time period for the articles referred to January/2004 to July/2014; the languages used in the articles were Portuguese, English, Spanish and French; the articles were selected from the following descriptors: postpartum care period, educational technology, nursing and self care. Twenty-seven articles were selected for analysis Results: based on the information found, the scales, counseling and home visits were among the most recommended educational technologies. the technologies promote communication, but are sometimes dependent on computer and internet access, which hinder their use by low-income women.

  17. Postpartum Spontaneous Subcapsular Hepatic Hematoma Related to Preeclampsia

    Directory of Open Access Journals (Sweden)

    Dimitrios Anyfantakis

    2014-01-01

    Full Text Available Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency department of our institution complaining of severe epigastric pain. Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively. Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus. For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

  18. Conceptualizations of postpartum depression by public-sector health care providers in Mexico.

    Science.gov (United States)

    Place, Jean Marie S; Billings, Deborah L; Blake, Christine E; Frongillo, Edward A; Mann, Joshua R; deCastro, Filipa

    2015-04-01

    In this article we describe the knowledge frameworks that 61 physicians, nurses, social workers, and psychologists from five public-sector health care facilities in Mexico used to conceptualize postpartum depression. We also demonstrate how providers applied social and behavioral antecedents in their conceptualizations of postpartum depression. Using grounded theory, we identify two frameworks that providers used to conceptualize postpartum depression: biochemical and adjustment. We highlight an emerging model of the function of social and behavioral antecedents within the frameworks, as well as the representation of postpartum depression by symptoms of distress and the perception among providers that these symptoms affected responsibilities associated with motherhood. The results provide a foundation for future study of how providers' conceptualizations of postpartum depression might affect detection and treatment practices and might be useful in the development of training materials to enhance the quality of care for women who experience any form of distress in the postpartum period. © The Author(s) 2014.

  19. Interventions to Improve Rate of Diabetes Testing Postpartum in Women With Gestational Diabetes Mellitus.

    Science.gov (United States)

    Hamel, Maureen S; Werner, Erika F

    2017-02-01

    Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy. In the USA, four million women are screened annually for GDM in pregnancy in part to improve pregnancy outcomes but also because diagnosis predicts a high risk of future type 2 diabetes mellitus (T2DM). Therefore, among women with GDM, postpartum care should be focused on T2DM prevention. This review describes the current literature aimed to increase postpartum diabetes testing among women with GDM. Data suggest that proactive patient contact via a health educator, a phone call, or even postal mail is associated with higher rates of postpartum diabetes testing. There may also be utility to changing the timing of postpartum diabetes testing. Despite the widespread knowledge regarding the importance of postpartum testing for women with GDM, testing rates remain low. Alternative testing strategies and large randomized trials addressing postpartum testing are warranted.

  20. Meeting the needs of the postpartum woman with epilepsy.

    Science.gov (United States)

    Rousseau, Jennifer B

    2008-01-01

    Although pregnancy and postpartum are times of emotional and physical change for all women, women with epilepsy have additional concerns and face special challenges. This article describes the nursing care for this special population to help the clinical nurse provide for the safety of these women and their infants. A multidisciplinary approach is essential, and families need to be included in the care planning. Special considerations for medication management, additional rest, seizure precautions, and discharge instructions are described.

  1. Bipolar II disorder as a risk factor for postpartum depression.

    Science.gov (United States)

    Mandelli, Laura; Souery, Daniel; Bartova, Lucie; Kasper, Siegfried; Montgomery, Stuart; Zohar, Joseph; Mendlewicz, Julien; Serretti, Alessandro

    2016-11-01

    There is evidence for a bipolar diathesis in postpartum depression (PPD) and women presenting with a first PPD frequently receive a diagnosis of bipolar type II disorder (BD-II). However formal evidence for an association between BD-II and PPD has not yet been reported. In the present study we tested a potential association between BD-II and PPD. Parous women with a diagnosis of bipolar type I disorder (BD-I) (n=93), BD-II (n=36) or major depressive disorder (MDD) (n=444) were considered in the present study. All women were retrospectively evaluated for history of PPD (DSM-IV criteria) and other clinical and socio-demographic features. Women with a history of PDD (n=139, 24%) were younger, younger at illness onset and had more family history for BD compared to women without history of PPD (n=436, 75.9%). Half of BD-II women reported PPD (50%), compared to less than one-third of BD-I and MDD women (respectively 27.5% and 21.6%) (p=0.004). Limitations include the retrospective assessment of PPD and no available data about the timing of postpartum episodes, illness onset or psychiatric care before or after childbirth, and the number of postpartum episodes. BD-II may confer a remarkable risk for PPD, which may be even higher than that of women affected by BD-I disorder. Careful monitoring of BD-II women during the pregnancy and postpartum period, as well as assessment of bipolar features in women with a PPD without a current diagnosis of BD are recommended. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Auricular Chondritis in a Postpartum Flare of SLE and APS

    Directory of Open Access Journals (Sweden)

    Elodie Ponce

    2014-10-01

    Full Text Available Introduction: Auricular chondritis has been occasionally described in patients with systemic lupus erythematosus (SLE and antiphospholipid syndrome (APS. Materials and methods: We report the case of a woman with a previous history of APS who presented with auricular chondritis with onset of SLE symptoms during the postpartum period. Conclusion: SLE and APS should be taken into consideration in the differential diagnosis of auricular chondritis.

  3. Postpartum mental health after Hurricane Katrina: A cohort study

    Directory of Open Access Journals (Sweden)

    Harville Emily W

    2009-06-01

    Full Text Available Abstract Background Natural disaster is often a cause of psychopathology, and women are vulnerable to post-traumatic stress disorder (PTSD and depression. Depression is also common after a woman gives birth. However, no research has addressed postpartum women's mental health after natural disaster. Methods Interviews were conducted in 2006–2007 with women who had been pregnant during or shortly after Hurricane Katrina. 292 New Orleans and Baton Rouge women were interviewed at delivery and 2 months postpartum. Depression was assessed using the Edinburgh Depression Scale and PTSD using the Post-Traumatic Stress Checklist. Women were asked about their experience of the hurricane with questions addressing threat, illness, loss, and damage. Chi-square tests and log-binomial/Poisson models were used to calculate associations and relative risks (RR. Results Black women and women with less education were more likely to have had a serious experience of the hurricane. 18% of the sample met the criteria for depression and 13% for PTSD at two months postpartum. Feeling that one's life was in danger was associated with depression and PTSD, as were injury to a family member and severe impact on property. Overall, two or more severe experiences of the storm was associated with an increased risk for both depression (relative risk (RR 1.77, 95% confidence interval (CI 1.08–2.89 and PTSD (RR 3.68, 95% CI 1.80–7.52. Conclusion Postpartum women who experience natural disaster severely are at increased risk for mental health problems, but overall rates of depression and PTSD do not seem to be higher than in studies of the general population.

  4. [Carbetocin versus Oxytocin during caesarean section for preventing postpartum haemorrhage].

    Science.gov (United States)

    Pizzagalli, F; Agasse, J; Marpeau, L

    2015-05-01

    The aim of the study was to compare the effectiveness of Carbetocin versus Oxyotcin during caesarean section for preventing postpartum haemorrhage. Prospective observational study (before/after design). Five hundred and forty patients who received an injection of Oxytocin were compared to 262 patients with single injection of 100 micrograms of Carbetocin. The primary outcome was to compare the differential hematocrit level between pre- and postoperative blood samples. The secondary outcome was to compare differential hemoglobin level and the use of complementary therapies for postpartum haemorrhage. We did not find any difference between the Oxytocin and Carbetocin groups on differential hematocrit level. There was no difference between the groups regarding the use of additionnal therapies (Sulproston injections, blood transfusions and surgery methods). The rate of postpartum haemorrhage was similar in the two groups (18.7% vs 21.6%; P=0.33). We found a lower percentage of patients with differential of hemoglobin level between 2 g/dL and 4 g/dL in the Carbetocin group (6.5% vs 15.6%, Poxytocin. Carbetocin seems to reduce the need for postoperative intravenous iron injection. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  5. Resumption Of Postpartum Fecundability In Rural Guatemala: A Multistate Approach

    Directory of Open Access Journals (Sweden)

    Pinto Aguirre, Guido

    2008-01-01

    Full Text Available The purpose of this paper is to investigate and re-estimate the effects of breastfeeding patterns, women's nutritional and health status, and energy expenditure on the timing of resumption of postpartum fecundability (i.e. resumption of postpartum menses using all the relevant information in the Instituto de Nutrición de Centroamérica y Panamá longitudinal study and a more adequate estimation procedure (hazard models. The data used in this study come from a Longitudinal Study carried out in Guatemala between 1967 and 1979. In this article we use a multi-state hazard model that recognizes different pathways and states in the process of returning to the postpartum fecundability. The model relies on the existence of five states (fully breastfeeding, partial breastfeeding, weaning, infant mortality and menses. It also includes explicitly maternal nutrition and women's energy expenditure as strategic elements of the model. The study shows that the estimated effects of breastfeeding patterns, maternal nutrition and women's work patterns (energy expenditure on resumption of fecundability in rural Guatemala are strong and significant. The contribution of this paper is to show that application of hazard models with multiple states provides estimates that are consistent with hypotheses relating lactation patterns, maternal nutritional status and maternal external stressors to processes that accelerate (decelerate resumption of normal menstrual cycles.

  6. [Prevalence of postpartum impaired glucose tolerance after gestational diabetes].

    Science.gov (United States)

    Romero Gutiérrez, Gustavo; Macias Rocha, Ana Laura; Puente Alvarez, Erika Isela

    2012-10-01

    gestational diabetes mellitus (GDM) affects 2 to 10% of pregnancies and it has been postulated as a variant of type 2 diabetes mellitus (DM2) because they share a similar pathophysioiogy. Approximately in 90% the carbohydrate intolerance resolves after pregnancy, however after 5 to 16 years after delivery women will have a risk of 17 to 63% to the development of type 2 diabetes mellitus. to determine the frequency of postpartum impaired glucose tolerance in women with previous GDM. 125 patients with diagnosis of GMD were included, general data were captured, type of control during pregnancy and complications occurred. The women were instructed to undergo a postpartum oral glucose tolerance test of 75 g and 2 h, 6 weeks after their delivery date and they were classified into five groups: normal patients, type 2 diabetes mellitus, impaired glucose tolerance, impaired fasting glucose and combined both. after follow up 13 women (10.4%) were diagnosed as DM2; 14 patients (11.2%) were classified as glucose intolerance; 16 (12.8%) were catalogued with impaired fasting glucose; 6 (4.8%) had both disorders; and 76 (60.8%) were diagnosed as healthy women. the detection with a postpartum oral glucose tolerance test is necessary for the identification of the various types of disorders of the carbohydrate metabolism including DM2.

  7. Preventive and therapeutic effects of tranexamic acid on postpartum bleeding

    Directory of Open Access Journals (Sweden)

    Samaneh Solltani

    2014-12-01

    Full Text Available Postpartum hemorrhage is among the leading causes of maternal mortality throughout the world. Severe blood loss contributes to  the increased blood transfusion risk with its concerned inherent adverse events and therefore increased rate of emergency re-operative interventions such as arterial ligation or hysterectomy. It also can lead to protracted anemia, particularly in low or median income countries. Extended application of antifibrinolytic agents such as tranexamic acid has been customary for long years to stop or reduce blood loss in postpartum period. However, there are not enough reliable evidence to approve the real efficacy of these drugs. In this brief and summary review, we pointed to a few conducted studies. The PubMed was searched for keyword including postpartum hemorrhage, tranexamic acid, cesarean section, vaginal delivery, and blood loss prevention. The articles with language other than English were excluded from our review.  We concluded that more convincing information is needed to determine the precise effects of tranexamic acid, and its benefits against adverse effects.

  8. The obstetrical and postpartum benefits of continuous support during childbirth.

    Science.gov (United States)

    Scott, K D; Klaus, P H; Klaus, M H

    1999-12-01

    The purpose of this article is to review the evidence regarding the effectiveness of continuous support provided by a trained laywoman (doula) during childbirth on obstetrical and postpartum outcomes. Twelve individual randomized trials have compared obstetrical and postpartum outcomes between doula-supported women and women who did not receive doula support during childbirth. Three meta-analyses, which used different approaches, have been performed on the results of the clinical trials. Emotional and physical support significantly shortens labor and decreases the need for cesarean deliveries, forceps and vacuum extraction, oxytocin augmentation, and analgesia. Doula-supported mothers also rate childbirth as less difficult and painful than do women not supported by a doula. Labor support by fathers does not appear to produce similar obstetrical benefits. Eight of the 12 trials report early or late psychosocial benefits of doula support. Early benefits include reductions in state anxiety scores, positive feelings about the birth experience, and increased rates of breastfeeding initiation. Later postpartum benefits include decreased symptoms of depression, improved self-esteem, exclusive breastfeeding, and increased sensitivity of the mother to her child's needs. The results of these 12 trials strongly suggest that doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor.

  9. Postpartum fatigue in the active-duty military woman.

    Science.gov (United States)

    Rychnovsky, Jacqueline D

    2007-01-01

    (a) To describe fatigue levels in military active-duty women, (b) to describe the relationship among selected predictor variables of fatigue, and (c) to examine the relationship between predictor variables, fatigue levels, and performance (as measured by functional status) after childbirth. Based on the Theory of Unpleasant Symptoms, a longitudinal, prospective design. A large military medical facility in the southwest United States. A convenience sample of 109 military active-duty women. Postpartum fatigue. Women were found to be moderately fatigued across time, with no change in fatigue levels from 2 to 6 weeks after delivery. All variables correlated with fatigue during hospitalization and at 2 weeks after delivery, and depression, anxiety, maternal sleep, and functional status correlated with fatigue at 6 weeks after delivery. Regression analyses indicated that maternal anxiety predicted fatigue at 6 weeks after delivery. Over half the women had not regained full functional status when they returned to work, and 40% still displayed symptoms of postpartum depression and anxiety. Military women continue to experiencing postpartum fatigue when they return to the workplace. Future research is needed to examine issues surrounding fatigue and its associated variables during the first year after delivery.

  10. Maternal perspectives on postpartum return to the workplace.

    Science.gov (United States)

    Nichols, Mary R; Roux, Gayle M

    2004-01-01

    To describe maternal perceptions about postpartum return to the workplace. The research framework was McCubbin and McCubbin's Resiliency Model of Family Stress, Adjustment, and Adaptation. Employed, postpartum women, who resided in six different states, were recruited from day care and primary care settings to participate in this descriptive study. Seventy-four employed, married women, who returned to the workplace within one year after childbirth. As part of a larger study, perceptions about combining multiple roles after return to the workplace are the focus for this report. Participants responded to open-ended questions about their return to the workplace during the first months after giving birth. Content analysis of those responses resulted in two major categories, Resiliency Challenges: Negative Aspects (role conflict/overload, family stress, family/child issues, finances, psychosocial issues) and Resiliency Building: Positive Aspects (social support, maternal role satisfaction, positive adaptation, career role satisfaction). The data support the premise that employed women view returning to the workforce as having more challenges than they expected because the experience was viewed as being mostly negative. Preparing for return to the workplace is an important, but neglected, topic that needs to be addressed and defined more clearly in the literature. Therefore, future research is needed to identify resources and interventions that will help women experience fewer challenges associated with postpartum employment.

  11. Salivary buffer effect in relation to late pregnancy and postpartum.

    Science.gov (United States)

    Laine, M; Pienihäkkinen, K

    2000-02-01

    We studied the salivary pH, buffer effect (BE), and flow rates of unstimulated and paraffin-stimulated saliva of 8 women in their late pregnancy and postpartum. Salivary samples were collected about 1 month prior to and about 2 months after delivery. In non-pregnant control women, two paraffin-stimulated salivary samples were collected 1 month apart. The salivary BE increased significantly from late pregnancy to postpartum without exception. The increase was 2.04 +/- 1.17 pH units (P pH) to 6.82 +/- 1.01 (final pH). This change was not due to variation in salivary flow rates, since both unstimulated and paraffin-stimulated flow rates remained unchanged. In control women the difference between the 2 BE measurements was only 0.13 +/- 0.47 pH units on average. We concluded that women with high postpartum BE values may have moderate or even low BE values in late pregnancy. In control women, individual variation was found to be low in all variables studied.

  12. Postpartum family planning: current evidence on successful interventions.

    Science.gov (United States)

    Blazer, Cassandra; Prata, Ndola

    2016-01-01

    We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations.

  13. Urinary stress incontinence in postpartum women. Bibliographic review

    Directory of Open Access Journals (Sweden)

    Jose Manuel Barranco Cuadros

    2017-11-01

    Full Text Available Introduction: Both pregnancy and childbirth are important risk factors for urinary stress incontinence in women. For its prevention, exercies of the pelvic floor musculature have been shown to be effective. Guidelines for urinary stress incontinence management recommend offering pelvic floor muscle training to women during their first pregnancy as a preventive measure. Objective: To update the information provided in the scientific literature on urinary stress incontinence during postpartum and possible forms of treat it. Methodology: A systematic bibliographic review was carried out in the following databases: PUBMED, COCHRANE, CINHAL, MEDLINE, SciELO and SCOPUS. The date was restricted to the last 5 years (2012-2017, in Spanish, English and Portuguese. Restrictions were made regarding the type of study, and Randomized Clinical Trials (RCTs were considered for this review. Results: After reviewing the literature consulted, it is concluded that the training of the pelvic floor musculature is beneficial to prevent the occurrence of urinary stress incontinence during pregnancy and the postpartum period. Conclusions: The results obtained in this review are consistent with previous studies and bibliographic reviews of the same topic. It follows that training of the pelvic floor muscles is beneficial in preventing the occurrence of urinary stress incontinence during pregnancy or postpartum.

  14. Application of cloprostenol in the postpartum period of dairy goats

    Directory of Open Access Journals (Sweden)

    Leandro Becalete Rizzoni

    2014-06-01

    Full Text Available ABSTRACT. Rizzoni L.B., Gioso M.M., Ribeiro S.D. de A., Ribeiro A.C., Fernandes C.A. de C. & Garcia J.A.D. [Application of cloprostenol in the postpartum period of dairy goats.] Aplicação do cloprostenol sódico no período puerperal de cabras leiteiras. Revista Brasileira de Medicina Veterinária, 36(2:0183-187, 2014. Departamento de Medicina Veterinária, Universidade José do Rosário Vellano, Rodovia MG 179, km 0, Alfenas, MG 37130-000, Brasil. E-mail: leandro_vet@hotmail.com.br This study assessed the effects of application of cloprostenol in postpartum dairy goats. We used twenty-nine Anglonubianas goats, divided evenly into two groups: group PGF2a (0.133 mg cloprostenol and control group (0.5 mL of saline (0.9%, both received two doses on days 1 and 4 postpartum. By transrectal ultrasonography on days 1, 4, 10, 16, 22, 28, 34, 40 and 46 after birth, were evaluated uterus and ovaries. The uterine diameter behaved differently between the groups (P 0.05, however there were no ovulations. The cloprostenol during the study period acted beneficially in the process of uterine involution and the expulsion of uterine contents in dairy goats.

  15. Does UTI cause prolonged jaundice in otherwise well infants?

    Science.gov (United States)

    Chowdhury, Tanzila; Kisat, Hamudi; Tullus, Kjell

    2015-07-01

    The symptoms of urinary tract infections in infants are very non-specific and have historically included prolonged hyperbilirubinaemia. We studied the results of routine urine samples in 319 infants with prolonged jaundice. Convincing findings of UTI was not found in any of these children even if one of them was treated with antibiotics after four consecutive urine cultures with different bacteria. A urine culture might thus not be an appropriate investigation in a child with prolonged jaundice without any other symptoms of UTI. • The symptoms of UTI in infancy are very non-specific. • Old studies suggest that prolonged hyperbilirubinaemia is one such symptom; more modern studies give more conflicting results. What is New: • Our study could not confirm that children with prolonged jaundice have an increased risk of UTI. • Routine urine testing is thus not needed in otherwise healthy infants with prolonged jaundice.

  16. Cobalamin status during normal pregnancy and postpartum: a longitudinal study comprising 406 danish women

    DEFF Research Database (Denmark)

    Milman, N; Byg, KE; Bergholt, T

    2006-01-01

    -) cobalamin, P-methylmalonic acid and P-homocysteine was measured at 18, 32 and 39 wk gestation and 8 wk postpartum during lactation. RESULTS: P-cobalamin showed a gradual, significant decline during pregnancy (P ... and 8 wk postpartum median values were 225, 172, 161 and 319 pmol/L, respectively. P-methylmalonic displayed a gradual, significant increase during pregnancy as well as postpartum (P homocysteine demonstrated...

  17. Self-Efficacy and Postpartum Depression Teaching Behaviors of Hospital-Based Perinatal Nurses

    OpenAIRE

    Logsdon, M. Cynthia; Foltz, Melissa Pinto; Scheetz, James; Myers, John A.

    2010-01-01

    Based upon the Self-Efficacy Theory, this study examined the relationship between self-efficacy, self-efficacy-related variables, and postpartum depression teaching behaviors of hospital-based perinatal nurses. Findings revealed that teaching new mothers about postpartum depression is related to a perinatal nurse's self-efficacy in postpartum-depression teaching, self-esteem, and the following self-efficacy-related variables: social persuasion (supervisor's expectations for teaching); mastery...

  18. Postpartum Teens’ Breakfast Consumption is Associated with Snack and Beverage Intake and Body Mass Index

    OpenAIRE

    Haire-Joshu, Debra; Schwarz, Cynthia; Budd, Elizabeth L; Yount, Byron W; Lapka, Christina

    2011-01-01

    Addressing high risk dietary patterns among postpartum teens may help reduce weight retention and prevent intergenerational obesity. The objective of this study was to describe the relationship between breakfast consumption and outcomes of snack and beverage intake and body mass index (BMI) among postpartum teens. During 2007–2009, 1,330 postpartum teens across 27 states participated in a cross-sectional, baseline assessment of a group-randomized, nested cohort study. Participants were enroll...

  19. Perceived barriers and enablers of physical activity in postpartum women: a qualitative approach

    OpenAIRE

    Saligheh, Maryam; McNamara, Beverley; Rooney, Rosanna

    2016-01-01

    Background Postpartum women?s recovery from birth can be assisted through increased physical activity (PA). However, women face substantial barriers to participating in exercise and require support to enable them to benefit from increased PA. Methods This study sought to explore women?s beliefs about and experiences of PA and exercise during the 6?weeks to 12?months postpartum period. A cohort of 14 postpartum women from a survey study of the barriers and enablers to exercise participation ag...

  20. Prolonged response without prolonged chemotherapy: a lesson from PCV chemotherapy in low-grade gliomas

    Science.gov (United States)

    Peyre, Matthieu; Cartalat-Carel, Stéphanie; Meyronet, David; Ricard, Damien; Jouvet, Anne; Pallud, Johan; Mokhtari, Karima; Guyotat, Jacques; Jouanneau, Emmanuel; Sunyach, Marie-Pierre; Frappaz, Didier; Honnorat, Jérôme; Ducray, François

    2010-01-01

    Previous studies with temozolomide suggest that a prolonged duration of chemotherapy is important for treating low-grade gliomas (LGGs). PCV (procarbazine, CCNU, vincristine) chemotherapy has demonstrated efficacy in treating LGGs, but this therapy cannot be used for a prolonged period because of the cumulative toxicity. The aim of the present study was to evaluate the impact of first-line PCV chemotherapy on LGGs growth kinetics. The mean tumor diameter (MTD) of 21 LGGs was measured on serial magnetic resonance images before (n=13), during, and after PCV onset (n=21). During PCV treatment, a decrease in the MTD was observed in all patients. After PCV discontinuation, an ongoing decrease in MTD was observed in 20 of the 21 patients. Median duration of the MTD decrease was 3.4 years (range, 0.8–7.7) after PCV onset and 2.7 years (range, 0–7) after the end of PCV treatment with 60% of LGGs, demonstrating an ongoing and prolonged (>2 years) response despite chemotherapy no longer being administered. According to McDonald's criteria, the rates of partial and minor responses were 5% and 38% at the end of PCV but 38% and 42% at the time of maximal MTD decrease, which occurred after a median period of 3.4 years after PCV onset. These results challenge the idea that a prolonged duration of chemotherapy is necessary for treating LGGs and raise the issue of understanding the mechanisms involved in the persistent tumor volume decrease once chemotherapy is terminated. PMID:20488959

  1. Fermionic covariant prolongation structure theory for supernonlinear evolution equation

    International Nuclear Information System (INIS)

    Cheng Jipeng; Wang Shikun; Wu Ke; Zhao Weizhong

    2010-01-01

    We investigate the superprincipal bundle and its associated superbundle. The super(nonlinear)connection on the superfiber bundle is constructed. Then by means of the connection theory, we establish the fermionic covariant prolongation structure theory of the supernonlinear evolution equation. In this geometry theory, the fermionic covariant fundamental equations determining the prolongation structure are presented. As an example, the supernonlinear Schroedinger equation is analyzed in the framework of this fermionic covariant prolongation structure theory. We obtain its Lax pairs and Baecklund transformation.

  2. Trajectories of maternal depressive symptoms during pregnancy and the first 12 months postpartum and child externalizing and internalizing behavior at three years

    Science.gov (United States)

    Kehler, Heather; Austin, Marie-Paule; Mughal, Muhammad Kashif; Wajid, Abdul; Vermeyden, Lydia; Benzies, Karen; Brown, Stephanie; Stuart, Scott; Giallo, Rebecca

    2018-01-01

    persistent high depressive symptoms, followed by mothers with moderate symptoms (early postpartum and subclinical trajectories) and lowest for minimal symptoms. After accounting for demographic, child and psychosocial factors, the relationships between depression trajectories and child hyperactivity/inattention, physical aggression (subclinical trajectory only) and separation anxiety symptoms remained significant. Conclusion These findings suggest both externalizing and internalizing children’s behaviors are associated with prolonged maternal depressive symptoms. There is a good case for the need to move beyond overly simplistic clinical cutoff approaches of depressed/not depressed in screening for perinatal depression. Women with elevated depressive symptoms at clinical and subclinical levels need to be identified, provided with evidence-based treatment, and monitored with repeat screening to improve maternal mental health outcomes and reduce the risk of associated negative outcomes on children’s early social-emotional and behavior development. PMID:29652937

  3. Effects of first postpartum progesterone rise, metabolites, milk yield, and body condition score on the subsequent ovarian activity and fertility in lactating Holstein dairy cows.

    Science.gov (United States)

    Kafi, Mojtaba; Mirzaei, Abdolah

    2010-04-01

    Seventy multiparous healthy lactating Holstein cows (fat-corrected milk yield = 7,561.8 kg) were monitored from 14 days before to 70 days after calving. Transrectal ultrasound scanning was performed twice weekly from 7 to 65 days postpartum. Blood samples were also collected twice weekly to measure serum P(4) and biweekly to detect serum beta-hydroxybutyrate (betaHB) and nonesterified fatty acid (NEFA) concentrations. Body condition score (BCS) was taken biweekly after calving. Based on the serum P(4) profile of 59 cows (11 cows were excluded due to the occurrence of postpartum diseases) studied, 27 (45.8%) had normal ovarian activity, while 21 (35.6%), six (10.1%), three (5.1%), and two (3.4%) had delayed ovulation (DOV), prolonged luteal phase (PLP), short luteal phase (SLP), and cessation of ovarian activity, respectively. Cows with PLP had an earlier ovulation compared to that of cows with normal ovarian activity (23.16 +/- 4.02 vs 31.9 +/- 8.35 days; P cows also had a greater mean +/- standard deviation peak milk yield (44.2 +/- 5.8 vs 37.2 +/- 5.7 kg/day, 75 days postpartum; P cows with normal postpartum ovarian activity. The PLP group also had greater milk production in the previous lactation period. Logistic regression analysis indicated that cows with P(4) concentration > or =1 ng/ml on day 24 after calving were more at risk for PLP by 1.1 for each 1 kg increase in mean peak milk yield during 75 days after calving. BCS was lower in cows with DOV compared to that of cows with normal ovarian activity at any time after calving (P cows were significantly higher than that of normal cows on day 42 after calving (0.69 +/- 0.29 vs 0.54 +/- 0.12 mmol/L, P cows in different groups at any time after calving (P > 0.05). The concentrations of P(4) on days 28 and 31 were negatively correlated with betaHB concentration on day 42 after calving in cows with normal ovarian activity (R = -0.44, P = 0.02). In conclusion, these findings suggest that early ovulation and hence

  4. Mind the Gap: Assessing the Disconnect Between Postpartum Health Information Desired and Health Information Received.

    Science.gov (United States)

    Guerra-Reyes, Lucia; Christie, Vanessa M; Prabhakar, Annu; Siek, Katie A

    Seeking and receiving health information are critical aspects of prenatal and postpartum care; however, many informational sources lack postpartum content. This study explores the gaps between information desired and information received postpartum and identifies the sources women use for health information seeking, with an emphasis on emergent online and mobile phone-based resources. Participants were recruited from our community partners' client base for a cross-sectional study. Mothers (n = 77) of a child 48 months or younger completed a survey on health information seeking, health information needs, and technology use. Postpartum health information gaps were defined as topics about which a participant indicated that she wanted information, but did not receive information. Bivariate analyses assessed the association between demographic characteristics, sources of health information used during pregnancy, and postpartum information gaps. Health care providers, Internet-based resources, and mobile applications were common sources of health information during pregnancy. Mental and sexual health were the most common types of postpartum health information gaps. In bivariate analyses, higher income and education were associated with postpartum information gaps in mental health and sexual health, respectively (p higher levels of education and income and postpartum health information gaps were observed in bivariate analyses. Health educators have the opportunity to capitalize on high rates of Internet information seeking by providing health information online. Health care providers must incorporate mental and sexual health into routine postpartum care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  5. Postpartum Depression and the Affordable Care Act: Recommendations for Social Work Educators

    Directory of Open Access Journals (Sweden)

    Robert H. Keefe

    2016-02-01

    Full Text Available The Patient Protection and Affordable Care Act (ACA mandates ongoing research on postpartum depression; however, very little research has been published in social work journals and in advanced-level textbooks on this topic. This article describes the problem of postpartum depression and argues that social work educators and researchers must pay greater attention to this issue in light of the ACA mandates, so that social workers can provide effective services to postpartum mothers and their children. The Council on Social Work Education’s recently published Educational Policy and Accreditation Standards are considered while making curriculum recommendations on postpartum depression for social work educators.

  6. 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.

  7. Hair cortisol levels, psychological stress and psychopathological symptoms as predictors of postpartum depression.

    Science.gov (United States)

    Caparros-Gonzalez, Rafael A; Romero-Gonzalez, Borja; Strivens-Vilchez, Helen; Gonzalez-Perez, Raquel; Martinez-Augustin, Olga; Peralta-Ramirez, Maria Isabel

    2017-01-01

    Postpartum depression affects a huge number of women and has detrimental consequences. Knowing the factors associated with postpartum depression during pregnancy can help its prevention. Although there is evidence surrounding behavioral or psychological predictors of postpartum depression, there is a lack of evidence of biological forecasters. The aim of this study was to analyze the sociodemographic, obstetric, and psychological variables along with hair cortisol levels during the first, second, and third trimesters of pregnancy that could predict postpartum depression symptoms. A sample of 44 pregnant women was assessed during 3 trimesters of pregnancy and the postpartum period using psychological questionnaires and hair cortisol levels. Participants were divided into 2 groups: a group with postpartum depression symptoms and a group with no postpartum depression symptoms. Results showed significant positive differences between groups in the first trimester regarding the Somatization subscale of the SCL-90-R (p Depression, Anxiety, and GSI subscales (p postpartum depression symptoms. In conclusion, our study provided evidence that psychopathological symptoms, pregnancy-specific stress, and hair cortisol levels can predict postpartum depression symptoms at different time-points during pregnancy. These findings can be applied in future studies and improve maternal care in clinical settings.

  8. Sleep duration, depression, and oxytocinergic genotype influence prepulse inhibition of the startle reflex in postpartum women.

    Science.gov (United States)

    Comasco, Erika; Gulinello, Maria; Hellgren, Charlotte; Skalkidou, Alkistis; Sylven, Sara; Sundström-Poromaa, Inger

    2016-04-01

    The postpartum period is characterized by a post-withdrawal hormonal status, sleep deprivation, and susceptibility to affective disorders. Postpartum mothering involves automatic and attentional processes to screen out new external as well as internal stimuli. The present study investigated sensorimotor gating in relation to sleep duration, depression, as well as catecholaminergic and oxytocinergic genotypes in postpartum women. Prepulse inhibition (PPI) of the startle reflex and startle reactivity were assessed two months postpartum in 141 healthy and 29 depressed women. The catechol-O-methyltransferase (COMT) Val158Met, and oxytocin receptor (OXTR) rs237885 and rs53576 polymorphisms were genotyped, and data on sleep duration were collected. Short sleep duration (less than four hours in the preceding night) and postpartum depression were independently associated with lower PPI. Also, women with postpartum depression had higher startle reactivity in comparison with controls. The OXTR rs237885 genotype was related to PPI in an allele dose-dependent mode, with T/T healthy postpartum women carriers displaying the lowest PPI. Reduced sensorimotor gating was associated with sleep deprivation and depressive symptoms during the postpartum period. Individual neurophysiological vulnerability might be mediated by oxytocinergic genotype which relates to bonding and stress response. These findings implicate the putative relevance of lower PPI of the startle response as an objective physiological correlate of liability to postpartum depression. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

  9. The effect of interpersonal psychotherapy on marriage adaptive and postpartum depression in Isfahan

    Directory of Open Access Journals (Sweden)

    Mahnaz Hajiheidari

    2013-01-01

    Conclusions: The findings of this research confirm marriage interpersonal psychotherapy on the depression recovery and the increasing marriage satisfaction of women suffering from postpartum depression.

  10. Postpartum Pyomyoma, a Rare Complication of Sepsis Associated with Chorioamnionitis and Massive Postpartum Haemorrhage Treated with an Intrauterine Balloon

    Directory of Open Access Journals (Sweden)

    Mandeep Kaler

    2015-01-01

    Full Text Available We report the successful treatment of a postpartum pyomyoma, a rare but serious complication of uterine leiomyomata in a 28-year-old primigravida. The patient was treated for an Escherichia Coli (E. Coli urinary tract infection (UTI at 16 weeks of gestation. She had asymptomatic short cervical length on ultrasound scan at 20 weeks that was managed conservatively due to the presence of further UTI and received antibiotics. She was known to have a left sided intramural leiomyoma. She presented with abdominal pain and vaginal bleeding at 23+1 weeks of gestation and the next day she had spontaneous vaginal delivery and collapsed with E. Coli septic shock, massive postpartum haemorrhage, and disseminated intravascular coagulation and was successfully treated with oxytocic drugs, a Rusch intrauterine balloon, and intravenous antibiotics. Eleven days postnatally she re-presented with systemic sepsis and was treated for retained products of conception. Sepsis persisted and investigations showed a postpartum pyomyoma that was initially managed with intravenous antibiotics to avoid surgery. Ultimately she required laparotomy, drainage of pyomyoma, and myomectomy. Postoperative recovery was good and the patient had a successful pregnancy two years later.

  11. Carbohydrate Dependence During Prolonged, Intense Endurance Exercise.

    Science.gov (United States)

    Hawley, John A; Leckey, Jill J

    2015-11-01

    A major goal of training to improve the performance of prolonged, continuous, endurance events lasting up to 3 h is to promote a range of physiological and metabolic adaptations that permit an athlete to work at both higher absolute and relative power outputs/speeds and delay the onset of fatigue (i.e., a decline in exercise intensity). To meet these goals, competitive endurance athletes undertake a prodigious volume of training, with a large proportion performed at intensities that are close to or faster than race pace and highly dependent on carbohydrate (CHO)-based fuels to sustain rates of muscle energy production [i.e., match rates of adenosine triphosphate (ATP) hydrolysis with rates of resynthesis]. Consequently, to sustain muscle energy reserves and meet the daily demands of training sessions, competitive athletes freely select CHO-rich diets. Despite renewed interest in high-fat, low-CHO diets for endurance sport, fat-rich diets do not improve training capacity or performance, but directly impair rates of muscle glycogenolysis and energy flux, limiting high-intensity ATP production. When highly trained athletes compete in endurance events lasting up to 3 h, CHO-, not fat-based fuels are the predominant fuel for the working muscles and CHO, not fat, availability becomes rate limiting for performance.

  12. Prolonged disengagement from distractors near the hands

    Directory of Open Access Journals (Sweden)

    Daniel B Vatterott

    2013-08-01

    Full Text Available Because items near our hands are often more important than items far from our hands, the brain processes visual items near our hands differently than items far from our hands. Multiple experiments have attributed this processing difference to spatial attention, but the exact mechanism behind how spatial attention near our hands changes is still under investigation. The current experiments sought to differentiate between two of the proposed mechanisms: a prioritization of the space near the hands and a prolonged disengagement of spatial attention near the hands. To differentiate between these two accounts, we used the additional singleton paradigm in which observers searched for a shape singleton among homogenously shaped distractors. On half the trials, one of the distractors was a different color. Both the prioritization and disengagement accounts predict differently colored distractors near the hands will slow target responses more than differently colored distractors far from the hands, but the prioritization account also predicts faster responses to targets near the hands than far from the hands. The disengagement account does not make this prediction, because attention does not need to be disengaged when the target appears near the hand. We found support for the disengagement account: Salient distractors near the hands slowed responses more than those far from the hands, yet observers did not respond faster to targets near the hands.

  13. First-time parents' prenatal to postpartum changes in health, and the relation of postpartum health to work and partner characteristics.

    Science.gov (United States)

    Gjerdingen, Dwenda K; Center, Bruce A

    2003-01-01

    The purpose of this study was to evaluate prenatal to postnatal changes in first-time parents' physical and mental health, and to describe social and health predictors of parents' postpartum health. This prospective study surveyed 261 expectant fathers and mothers during pregnancy and again at 6 months' postpartum regarding their health, partner, and work characteristics. Postpartum changes in health were evaluated by paired t tests, and predictors of postpartum health were determined using multiple regression analyses. Both fathers and mothers experienced significant postpartum declines in perceived quality of life. In addition, fathers reported an increase in the number of days ill and a decrease in general health and vitality after childbirth. Mothers perceived an increase in vitality despite their diminishing sleep. Parents' postpartum health was associated with mothers' partner satisfaction, fewer illness days, and certain work characteristics, such as total work time and the balance of work between mothers and fathers. Both mothers and fathers experienced declines in health that persisted at least 6 months after the birth of their first child. Notably, postpartum health was associated with partner satisfaction and work characteristics. This information might be used to develop interventions for improving parents' health during this vulnerable time.

  14. The effects of gestational stress and SSRI antidepressant treatment on structural plasticity in the postpartum brain - a translational model for postpartum depression

    Science.gov (United States)

    Haim, Achikam; Albin-Brooks, Christopher; Sherer, Morgan; Mills, Emily; Leuner, Benedetta

    2015-01-01

    Postpartum depression (PPD) is a common complication following childbirth experienced by one in every five new mothers. Although the neural basis of PPD remains unknown previous research in rats has shown that gestational stress, a risk factor for PPD, induces depressive-like behavior during the postpartum period. Moreover, the effect of gestational stress on postpartum mood is accompanied by structural modifications within the nucleus accumbens (NAc) and the medial prefrontal cortex (mPFC) – limbic regions that have been linked to PPD. Mothers diagnosed with PPD are often prescribed selective serotonin reuptake inhibitor (SSRI) antidepressant medications and yet little is known about their effects in models of PPD. Thus, here we investigated whether postpartum administration of Citalopram, an SSRI commonly used to treat PPD, would ameliorate the behavioral and morphological consequences of gestational stress. In addition, we examined the effects of gestational stress and postpartum administration of Citalopram on structural plasticity within the basolateral amygdala (BLA) which together with the mPFC and NAc forms a circuit that is sensitive to stress and is involved in mood regulation. Our results show that postpartum rats treated with Citalopram do not exhibit gestational stress-induced depressive-like behavior in the forced swim test. In addition, Citalopram was effective in reversing gestational stress-induced structural alterations in the postpartum NAc shell and mPFC. We also found that gestational stress increased spine density within the postpartum BLA, an effect which was not reversed by Citalopram treatment. Overall, these data highlight the usefulness of gestational stress as a valid and informative translational model for PPD. Furthermore, they suggest that structural alterations in the mPFC-NAc pathway may underlie stress-induced depressive-like behavior during the postpartum period and provide much needed information on how SSRIs may act in the

  15. Gestational stress induces persistent depressive-like behavior and structural modifications within the postpartum nucleus accumbens

    Science.gov (United States)

    Haim, Achikam; Sherer, Morgan; Leuner, Benedetta

    2015-01-01

    Postpartum depression (PPD) is a common complication following childbirth experienced by one in every five new mothers. Pregnancy stress enhances vulnerability to PPD and has also been shown to increase depressive-like behavior in postpartum rats. Thus, gestational stress may be an important translational risk factor that can be used to investigate the neurobiological mechanisms underlying PPD. Here we examined the effects of gestational stress on depressive-like behavior during the early/mid and late postpartum periods and evaluated whether this was accompanied by altered structural plasticity in the nucleus accumbens (NAc), a brain region that has been linked to PPD. We show that early/mid (PD8) postpartum female rats exhibited more depressive-like behavior in the forced swim test as compared to late postpartum females (PD22). However, two weeks of restraint stress during pregnancy increased depressive-like behavior regardless of postpartum timepoint. In addition, dendritic length, branching, and spine density on medium spiny neurons in the NAc shell were diminished in postpartum rats that experienced gestational stress although stress-induced reductions in spine density were evident only in early/mid postpartum females. In the NAc core, structural plasticity was not affected by gestational stress but late postpartum females exhibited lower spine density and reduced dendritic length. Overall, these data not only demonstrate structural changes in the NAc across the postpartum period, they also show that postpartum depressive-like behavior following exposure to gestational stress is associated with compromised structural plasticity in the NAc and thus may provide insight into the neural changes that could contribute to PPD. PMID:25359225

  16. [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

  17. Risk, treatment duration, and recurrence risk of postpartum affective disorder in women with no prior psychiatric history

    DEFF Research Database (Denmark)

    Rasmussen, Marie-Louise H; Strøm, Marin; Wohlfahrt, Jan

    2017-01-01

    BACKGROUND: Some 5%-15% of all women experience postpartum depression (PPD), which for many is their first psychiatric disorder. The purpose of this study was to estimate the incidence of postpartum affective disorder (AD), duration of treatment, and rate of subsequent postpartum AD and other...... total of 789,068 births) and no prior psychiatric hospital contacts and/or use of antidepressants. These women were followed from 1 January 1996 to 31 December 2014. Postpartum AD was defined as use of antidepressants and/or hospital contact for PPD within 6 months after childbirth. The main outcome.......4%. The recurrence risk of postpartum AD for women with a PPD hospital contact after first birth was 55.4 per 100 person-years; for women with postpartum antidepressant medication after first birth, it was 35.0 per 100 person-years. The rate of postpartum AD after second birth for women with no history of postpartum...

  18. [Breastfeeding (part one): Frequency, benefits and drawbacks, optimal duration and factors influencing its initiation and prolongation. Clinical guidelines for practice].

    Science.gov (United States)

    Chantry, A A; Monier, I; Marcellin, L

    2015-12-01

    The objectives were to on assess the frequency and the duration of breastfeeding in France. On the other hand, the objectives were to identify its benefits and drawbacks, and to study the factors influencing its initiation and its extension. Bibliographic research in Medline, Google Scholar and in the Cochrane Library. Breastfeeding concerns in France about 70% of children at birth (EL2). Its median duration is about 15 weeks and 3 weeks ½ for exclusive breastfeeding. At three months, only one third of children breastfed at birth are still being breastfed (EL2). Whether this is due to the composition of breast milk or the behavior of mothers with their children or their socio-cultural level, or even by all these components at once, breastfeeding is associated with better cognitive development children (EL2). This effect is even more reinforced that mothers breastfeed exclusively and prolonged (EL2). As part of the prevention of many diseases (ear infections, gastrointestinal infections, atopic diseases, obesity and cardiovascular diseases…), exclusive and prolonged breastfeeding (grade B) between 4 to 6 months is recommended (professional consensus). Breastfeeding is not a means of preventing postpartum depression (professional consensus). To reduce the incidence of breast cancer, prolonged breastfeeding is recommended (grade B). In order to increase the rate of initiation of breastfeeding as well as its duration, it is recommended that health professionals work closely with mothers in their project (grade A), the breastfeeding promotion messages include message to husbands (grade B), and to promote breastfeeding on demand without fixed interval between feedings (grade B). However, there is not enough data to recommend the use of a specific position during breastfeeding, or the use of one or two breast or to early start breastfeeding or not (professional consensus). Exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (professional

  19. Are pregnant and postpartum women: at increased risk for violent death? Suicide and homicide findings from North Carolina.

    Science.gov (United States)

    Samandari, Ghazaleh; Martin, Sandra L; Kupper, Lawrence L; Schiro, Sharon; Norwood, Tammy; Avery, Matt

    2011-07-01

    The purpose of this study is to estimate rates of suicide and homicide death among pregnant, postpartum and non-pregnant/non-postpartum women ages 14-44, and to determine comparative rates of violent death for pregnant and/or postpartum women compared to non-pregnant/non-postpartum women. North Carolina surveillance and vital statistics data from 2004 to 2006 were used to examine whether pregnant or postpartum women have higher (or lower) rates of suicide and homicide compared to other reproductive-aged women. The suicide rate for pregnant women was 27% of the rate for non-pregnant/non-postpartum women (rate ratio= 0.27, 95% CI = 0.11-0.66), and the suicide rate for postpartum women was 54% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.54, 95% CI = 0.31-0.95). Homicide rates also were lower for pregnant and postpartum women, with the homicide rate for pregnant women being 73% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.73, 95% CI = 0.39-1.37), and the homicide rate for postpartum women being half the rate for non-pregnant/non-postpartum women (rate ratio = 0.50, 95% CI = 0.26-0.98). Although pregnant and postpartum women are at risk for homicide and suicide death, the highest risk group is non-pregnant/non-postpartum women. Violence prevention efforts should target all women of reproductive age, and pay particular attention to non-pregnant/non-postpartum women, who may have less access to health care services than pregnant and postpartum women.

  20. Postpartum depression predicts offspring mental health problems in adolescence independently of parental lifetime psychopathology

    NARCIS (Netherlands)

    Verbeek, Tjitte; Bockting, Claudi L H; van Pampus, Mariëlle G; Ormel, Johan; Meijer, Judith L; Hartman, Catharina A; Burger, Huibert

    BACKGROUND: Postpartum depression (PPD) follows 5-15% of the life births and forms a major threat to the child's mental health and psychosocial development. However, the nature, continuance, and mediators of the association of postpartum depression (PPD) with the child's mental health are not well

  1. Postpartum home care and its effects on mothers' health: A clinical trial

    Directory of Open Access Journals (Sweden)

    Hourieh Shamshiri Milani

    2017-01-01

    Full Text Available Background: Postpartum home care plays an important role in prevention of postpartum complications. Regular visits of mothers during this period are imperative. This study aimed to provide postpartum home care for mothers to assess its effects on mothers' health in Iran. Materials and Methods: This study was carried out in two phases. First, a comprehensive postpartum home care program was compiled by performing a comparative study, using the available guidelines in this regard in different countries and based on the opinions of the experts. Next, a clinical trial was carried out on 276 women who gave birth in the university hospitals affiliated to Shahid Beheshti University of Medical Sciences. There were 92 mothers in the intervention and 184 in the control group. The intervention group mothers were provided with postpartum home care service while the control group did not receive such a service. Results: Outcome assessment at 60 days' postpartum revealed a significant difference between the two groups in terms of the use of supplements, birth control methods, postpartum depression, breastfeeding problems, constipation, and fatigue (P 0.05. Conclusion: The postpartum home care program had a positive effect on some aspects of the mothers' health status and their satisfaction in our society.

  2. Screening for Postpartum Depression in Well-Baby Care Settings: : A Systematic Review

    NARCIS (Netherlands)

    van den Berg, Angarath; Boere-Boonekamp, Magdalena M.; IJzerman, Maarten Joost; Haasnoot-Smallegange, Riet M.E.; Reijneveld, Sijmen A.

    2017-01-01

    Introduction Postpartum depression (PPD) is a mental health problem frequently experienced by mothers in the first year postpartum. Early detection and treatment can help to reduce its negative effect on the development of the newborn child. Well-baby care (WBC) is a promising screening setting for

  3. Post-up study : Postpartum depression screening in well-child care and maternal outcomes

    NARCIS (Netherlands)

    Van Der Zee-Van Den Berg, Angarath I.; Boere-Boonekamp, Magda M.; Groothuis-Oudshoorn, Catharina G.M.; IJzerman, Maarten J.; Haasnoot-Smallegange, Riet M.E.; Reijneveld, Sijmen A.

    2017-01-01

    OBJECTIVES: Postpartum depression often remains unaddressed. Screening in well-child care (WCC) may improve early detection, promote maternal recovery, and reduce effects on child development. We assessed the effectiveness of screening for postpartum depression in WCC compared with care as usual

  4. Post-Up Study : Postpartum Depression Screening in Well-Child Care and Maternal Outcomes

    NARCIS (Netherlands)

    van der Zee-van den Berg, Angarath I; Boere-Boonekamp, Magda M; Groothuis-Oudshoorn, Catharina G M; IJzerman, Maarten J; Haasnoot-Smallegange, Riet M E; Reijneveld, Sijmen A

    2017-01-01

    OBJECTIVES: Postpartum depression often remains unaddressed. Screening in well-child care (WCC) may improve early detection, promote maternal recovery, and reduce effects on child development. We assessed the effectiveness of screening for postpartum depression in WCC compared with care as usual

  5. Predictors for postpartum pelvic girdle pain in working women: the Mom@Work cohort study

    NARCIS (Netherlands)

    Stomp-van den Berg, G.M.; Hendriksen, I.J.M.; Bruinvels, D.J.; Twisk, J.W.R.; Mechelen, W. van; Poppel, M.N.M. van

    2012-01-01

    The objective of this study was to examine which factors during pregnancy and postpartum predict pelvic girdle pain (PGP) at 12 weeks postpartum among working women. A total of 548 Dutch pregnant employees were recruited in 15 companies, mainly health care, child care, and supermarkets. The

  6. The Knowledge of Third Trimester Pregnant Women about Postpartum and Newborn Infants Care

    Science.gov (United States)

    Rahayuningsih, Faizah Betty

    2015-01-01

    Introduction: Postpartum period is a transition period but it is being neglected aspect from women health care. Mother's knowledge and education before childbirth is important to be prepared for postpartum. Misinformation about traditions/customs in society are considered irrational, causing confusion in puerperal women, especially for mothers who…

  7. Practices related to postpartum uterine involution in the Western Highlands of Guatemala.

    Science.gov (United States)

    Radoff, K A; Thompson, Lisa M; Bly, K C; Romero, Carolina

    2013-03-01

    Guatemala has the third highest level of maternal mortality in Latin America. Postpartum haemorrhage is the main cause of maternal mortality. In rural Guatemala, most women rely on Traditional Birth Attendants (TBAs) during labour, delivery, and the postpartum period. Little is known about current postpartum practices that may contribute to uterine involution provided by Mam- and Spanish-speaking TBAs in the Western Highlands of Guatemala. a qualitative study was conducted with 39 women who participated in five focus groups in the San Marcos Department of Guatemala. Questions regarding postpartum practices were discussed during four focus groups of TBAs and one group of auxiliary nurses. three postpartum practices believed to aid postpartum uterine involution were identified: use of the chuj (Mam) (Spanish, temazcal), a traditional wood-fired sauna-bath used by Mam-speaking women; herbal baths and teas; and administration of biomedicines. TBAs provide the majority of care to women during childbirth and the postpartum period and have developed a set of practices to prevent and treat postpartum haemorrhage. Integration of these practices may prove an effective method to reduce maternal morbidity and mortality in the Western Highlands of Guatemala. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Predictors of the Longitudinal Course of Postpartum Depression Following Interpersonal Psychotherapy

    Science.gov (United States)

    Nylen, Kimberly J.; O'Hara, Michael W.; Brock, Rebecca; Moel, Joy; Gorman, Laura; Stuart, Scott

    2010-01-01

    Objective: We examined the course and predictors of postpartum depression in the 18 months following interpersonal psychotherapy (IPT). Method: We enrolled 120 community women with major depression in a 12-week randomized trial of individual IPT during the postpartum period (O'Hara, Stuart, Gorman, & Wenzel, 2000). At 6, 12, and 18 months…

  9. Early School Outcomes for Children of Postpartum Depressed Mothers: Comparison with a Community Sample

    Science.gov (United States)

    Kersten-Alvarez, Laura E.; Hosman, Clemens M. H.; Riksen-Walraven, J. Marianne; van Doesum, Karin T. M.; Smeekens, Sanny; Hoefnagels, Cees

    2012-01-01

    Previous studies of the long-term effects of maternal postpartum depression (PPD) on child development have mostly focused on a limited set of outcomes, and have often not controlled for risk factors associated with maternal depression. The present study compared children of postpartum depressed mothers (n = 29) with children from a community…

  10. A longitudinal study of women's depression symptom profiles during and after the postpartum phase.

    Science.gov (United States)

    Fox, Molly; Sandman, Curt A; Davis, Elysia Poggi; Glynn, Laura M

    2018-04-01

    An issue of critical importance for psychiatry and women's health is whether postpartum depression (PPD) represents a unique condition. The Diagnostic and Statistical Manual of Mental Disorders asserts that major depressive disorder (MDD) may present with peripartum onset, without suggesting any other differences between MDD and PPD. The absence of any distinct features calls into question the nosologic validity of PPD as a diagnostic category. The present study investigates whether symptom profiles differ between PPD and depression occurring outside the postpartum phase. In a prospective, longitudinal study of parturient women (N = 239), we examine the manifestation of depression symptoms. We assess factor structure of symptom profiles, and whether factors are differentially pronounced during and after the postpartum period. Factors were revealed representing: Worry, Emotional/Circadian/Energetic Dysregulation, Somatic/Cognitive, Appetite, Distress Display, and Anger symptoms. The factor structure was validated at postpartum and after-postpartum timepoints. Interestingly, the Worry factor, comprising anxiety and guilt, was significantly more pronounced during the postpartum timepoint, and the Emotional/Circadian/Energetic Dysregulation factor, which contained sadness and anhedonia, was significantly less pronounced during the postpartum period. These results suggest that PPD may be a unique syndrome, necessitating research, diagnosis, and treatment strategies distinct from those for MDD. Results indicate the possibility that Worry is an enhanced feature of PPD compared to depression outside the postpartum period, and the crucial role of sadness/anhedonia in MDD diagnosis may be less applicable to PPD diagnosis. © 2018 Wiley Periodicals, Inc.

  11. Developmental Transition of Motherhood: Treating Postpartum Depression Using a Feminist Approach

    Science.gov (United States)

    Davis-Gage, Darcie; Kettmann, Julie Jenks; Moel, Joy

    2010-01-01

    During the developmental lifeline for women, some individuals are affected by postpartum depression. This article describes the treatment of a Latina woman experiencing postpartum depression. The authors illustrate the feminist approach using counseling interventions that incorporate the client's developmental level, cultural background, and…

  12. Latinas and Postpartum Depression: Role of Partner Relationship, Additional Children, and Breastfeeding

    Science.gov (United States)

    Hassert, Silva; Kurpius, Sharon E. Robinson

    2011-01-01

    Breastfeeding, additional children, and partner relationship predicted postpartum depression among 59 Latinas who had an infant who was 6 months old or younger. The most powerful predictor was conflict with partner. Counselors working with Latinas experiencing postpartum depression should explore the partner relationship, particularly relationship…

  13. Psychosocial risk and protective factors for postpartum depression in the United Arab Emirates.

    Science.gov (United States)

    Hamdan, Aisha; Tamim, Hani

    2011-04-01

    Limited research has been conducted in the United Arab Emirates in relation to postpartum depression. The purpose of this study was to investigate the risk and protective factors of postpartum depression in women in Sharjah, United Arab Emirates. We carried out a prospective study in which we followed women from the second trimester of pregnancy until 4 months postpartum. Data were collected during the second and third trimesters and then at 2- and 4- months postpartum. The risk/protective factors that were investigated included: depression and anxiety during pregnancy, stressful life events, breastfeeding, employment status following delivery, religiosity, and socio-demographic variables. The Edinburgh Postnatal Depression Scale (screening) and the Mini International Neuropsychiatric Inventory (diagnostic) were used as outcome variables. Using the Mini International Neuropsychiatric Inventory (diagnostic), 10% of the 137 participants in the study were diagnosed with postpartum depression. The following variables were found to be predictive of postpartum depression: depression during pregnancy in both the second and third trimesters: number of children, religion, and use of formula for feeding. Several factors were of borderline significance including educational level of mother, lack of breastfeeding, personal stressful life events, and employment status following delivery. These risk factors are important as they indicate potential areas for early identification. Screening of pregnant women during pregnancy and in the postpartum phase would be important. This study forms the foundation for further research and development related to prevention and intervention for postpartum depression in this Arab context.

  14. Developmental Profile of Infants Born to Mothers with Postpartum Depression and Anxiety: A Comparative Study

    Science.gov (United States)

    Kalita, Kamal Narayan

    2010-01-01

    Background: Postpartum period is associated with higher rates for depression, blues and psychosis. Anxiety is also significant. These disorders may have serious implications in the cognitive development of the infant. There is relative lack of data in this area. So we tried to estimate postpartum anxiety and depression in a group of women and…

  15. Oxytocin and postpartum depression: Delivering on what's known and what's not

    Science.gov (United States)

    The role of oxytocin in the treatment of postpartum depression has been a topic of growing interest. This subject carries important implications, given that postpartum depression can have detrimental effects on both the mother and her infant, with life long consequences for infant socioemotional and...

  16. Maternal expectations and postpartum emotional adjustment in first-time mothers: results of a questionnaire survey.

    Science.gov (United States)

    Henshaw, Erin J; Fried, Rachel; Teeters, Jenni Beth; Siskind, Emily E

    2014-09-01

    Several predictors of postpartum mood have been identified in the literature, but the role of maternal expectations in postpartum mental health remains unclear. The aim of this study was to identify whether maternal expectations during the postpartum hospital stay predict adjustment and depressive symptoms at 6 weeks postpartum. The sample included 233 first-time mothers recruited from the postpartum unit of a Midwestern hospital. Participants completed measures of maternal expectations and depressive symptoms (EPDS) at Time 1 (2 d postpartum) and completed EPDS and an Emotional Adjustment Scale (BaM-13) at Time 2 (6 weeks postpartum). A conditional relationship between the expectation that an infant's behavior will reflect maternal skill and Time 2 outcomes (BaM-13 and EPDS) was found, such that endorsing this belief predicted increased depression and poorer adjustment in those with higher (but not lower) Time 1 EPDS scores. Time 2 BaM-13 scores were also negatively predicted by expectations of self-sacrifice and positively predicted by expectations that parenthood would be naturally fulfilling. The expectations that new mothers hold about parenting soon after delivery are predictive of emotional adjustment in the early postpartum period, suggesting a role for discussion of expectations in future preventive strategies.

  17. Screening for Postpartum Depression in Well-Baby Care Settings : A Systematic Review

    NARCIS (Netherlands)

    van der Zee-van den Berg, Angarath I.; Boere-Boonekamp, Magda M.; IJzerman, Maarten J; Haasnoot-Smallegange, Riet M. E.; Reijneveld, Sijmen A.

    Introduction Postpartum depression (PPD) is a mental health problem frequently experienced by mothers in the first year postpartum. Early detection and treatment can help to reduce its negative effect on the development of the newborn child. Well-baby care (WBC) is a promising screening setting for

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

    Science.gov (United States)

    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.

  19. Endovascular Management of Intractable Postpartum Hemorrhage Caused by Vaginal Laceration

    International Nuclear Information System (INIS)

    Koganemaru, Masamichi; Nonoshita, Masaaki; Iwamoto, Ryoji; Kuhara, Asako; Nabeta, Masakazu; Kusumoto, Masashi; Kugiyama, Tomoko; Kozuma, Yutaka; Nagata, Shuji; Abe, Toshi

    2016-01-01

    PurposeWe evaluated the management of transcatheter arterial embolization for postpartum hemorrhage caused by vaginal laceration.Materials and MethodsWe reviewed seven cases of patients (mean age 30.9 years; range 27–35) with intractable hemorrhages and pelvic hematomas caused by vaginal lacerations, who underwent superselective transcatheter arterial embolization from January 2008 to July 2014. Postpartum hemorrhage was evaluated by angiographic vascular mapping to determine the vaginal artery’s architecture, technical and clinical success rates, and complications.ResultsThe vaginal artery was confirmed as the source of bleeding in all cases. The artery was found to originate from the uterine artery in three cases, the uterine and obturator arteries in two, or the internal pudendal artery in two. After vaginal artery embolization, persistent contrast extravasation from the inferior mesenteric artery as an anastomotic branch was noted in one patient. Nontarget vessels (the inferior vesical artery and nonbleeding vaginal arterial branches) were embolized in one patient. Effective control of hemostasis and no post-procedural complications were confirmed for all cases.ConclusionPostpartum hemorrhages caused by vaginal lacerations involve the vaginal artery arising from the anterior trunk of the internal iliac artery with various branching patterns. Superselective vaginal artery embolization is clinically acceptable for the successful treatment of vaginal laceration hemorrhages, with no complications. After vaginal artery embolization, it is suggested to check for the presence of other possible bleeding vessels by pelvic aortography with a catheter tip at the L3 vertebral level, and to perform a follow-up assessment.

  20. BREAST MILK AS AN ALTERNATIVE FOR POSTPARTUM PERINEAL CARE

    Directory of Open Access Journals (Sweden)

    Yuli Admasari

    2017-07-01

    Full Text Available Background: Perineal laceration during childbirth is very common among mothers; however some of them may suffer from its complication if not treated properly. Objective: To prove the effectiveness of breast milk as an alternative topical ingredient in the treatment of perineal wound in postpartum mothers. Methods: This was a quasi-experimental study with non-equivalent control group posttest only design. There were 30 respondents selected in this study, with 15 assigned in the intervention and control group. Accidental sampling was used to select the samples with the criteria that the respondents had perineal laceration in level 1 and 2. Data were analzed using Mann Whitney test. Results: Effective wound healing process can be seen in the intervention group from 80% of poor category in 6- 10 hours (1st period of postpartum became 86.7% of good category in 7 days of postpartum (4th period. Different from the control group that showed the slow progress of wound healing, which was 86.7% of poor category in the 1st period to only 33.3% of good category in the 4th period. Mann Whitney test showed that there was a significant mean difference of the perineal wound healing process between the intervention group (11.23 and the control group (19.77 with p-value 0.002 (<0.05. Conclusion: Breast milk was more effective than povidone iodine in the treatment of perineal wound. It is suggested for health workers, especially midwife to apply this intervention to accelerate the healing of perineal wound in midwifery care.

  1. Postpartum follow-up: can psychosocial support reduce newborn readmissions?

    Science.gov (United States)

    Barilla, Dora; Marshak, Helen Hopp; Anderson, S Eric; Hopp, Joyce W

    2010-01-01

    To determine whether there was a relationship between postpartum psychosocial support from healthcare providers and the rate of normal newborn readmissions (NNRs), and whether there was a cost benefit to justify an intervention. Data were abstracted for all normal newborn births from 1999 to 2006 (N = 14,786) at a community hospital in southern California at three different time periods: (1) at baseline prior to any intervention (1999-2000), (2) the 4 years during the comprehensive psychosocial support intervention (2001-2004), and (3) the 2 years during a limited psychosocial support intervention (2004-2006). A cost-benefit analysis was performed to analyze whether the financial benefits from the intervention matched or exceeded the costs for NNRs. There was a significantly lower readmission rate of 1.0% (p = < .001) during the comprehensive intervention time period compared to baseline (2.3%) or to the limited intervention time period (2.3%). Although there was no significant difference in the average cost per newborn readmitted across the three study time periods, during the comprehensive intervention time period the average costs of a NNR were significantly lower ($4,180, p = .041) for the intervention group compared to those who received no intervention ($5,338). There was a cost benefit of 513,540 dollars due to fewer readmissions during the comprehensive time period, but it did not exceed the cost of the intervention. Providing comprehensive follow-up for new mothers in the postpartum period can reduce NNRs, thus lowering the average newborn readmission costs for those who receive psychosocial support. Followup for new mothers should be an accepted norm rather than the exception in postpartum care, but NNRs should not be considered the sole outcome in such programs.

  2. Endovascular Management of Intractable Postpartum Hemorrhage Caused by Vaginal Laceration

    Energy Technology Data Exchange (ETDEWEB)

    Koganemaru, Masamichi, E-mail: mkoganemaru@med.kurume-u.ac.jp; Nonoshita, Masaaki, E-mail: z2rs-1973@yahoo.co.jp; Iwamoto, Ryoji, E-mail: iwamoto-ryouji@kurume-u.ac.jp; Kuhara, Asako, E-mail: kuhara-asako@med.kurume-u.ac.jp; Nabeta, Masakazu, E-mail: nabeta-masakazu@med.kurume-u.ac.jp; Kusumoto, Masashi, E-mail: kusumoto-masashi@med.kurume-u.ac.jp; Kugiyama, Tomoko, E-mail: kugiyama-tomoko@med.kurume-u.ac.jp [Kurume University School of Medicine, Department of Radiology (Japan); Kozuma, Yutaka, E-mail: kouduma-yutaka@kurume-u.ac.jp [Kurume University School of Medicine, Department of Obstetrics and Gynecology (Japan); Nagata, Shuji, E-mail: sn4735@med.kurume-u.ac.jp; Abe, Toshi, E-mail: toshiabe@med.kurume-u.ac.jp [Kurume University School of Medicine, Department of Radiology (Japan)

    2016-08-15

    PurposeWe evaluated the management of transcatheter arterial embolization for postpartum hemorrhage caused by vaginal laceration.Materials and MethodsWe reviewed seven cases of patients (mean age 30.9 years; range 27–35) with intractable hemorrhages and pelvic hematomas caused by vaginal lacerations, who underwent superselective transcatheter arterial embolization from January 2008 to July 2014. Postpartum hemorrhage was evaluated by angiographic vascular mapping to determine the vaginal artery’s architecture, technical and clinical success rates, and complications.ResultsThe vaginal artery was confirmed as the source of bleeding in all cases. The artery was found to originate from the uterine artery in three cases, the uterine and obturator arteries in two, or the internal pudendal artery in two. After vaginal artery embolization, persistent contrast extravasation from the inferior mesenteric artery as an anastomotic branch was noted in one patient. Nontarget vessels (the inferior vesical artery and nonbleeding vaginal arterial branches) were embolized in one patient. Effective control of hemostasis and no post-procedural complications were confirmed for all cases.ConclusionPostpartum hemorrhages caused by vaginal lacerations involve the vaginal artery arising from the anterior trunk of the internal iliac artery with various branching patterns. Superselective vaginal artery embolization is clinically acceptable for the successful treatment of vaginal laceration hemorrhages, with no complications. After vaginal artery embolization, it is suggested to check for the presence of other possible bleeding vessels by pelvic aortography with a catheter tip at the L3 vertebral level, and to perform a follow-up assessment.

  3. Knowledge and choices of postpartum contraception among pregnant teens.

    Science.gov (United States)

    Ortiz-González, Karla M; Benabe, Erika; Rivera-Rosa, Edgardo; Negrón, Ivette; Romaguera, Josefina

    2014-09-01

    To describe the general knowledge and choices of postpartum contraception among pregnant teens who, at the time of the study, ranged in age from 13 to 19 years old and were receiving prenatal care at a hospital-based prenatal clinic. Questionnaires to obtain information regarding demographic characteristics and to explore contraception knowledge and choices were voluntarily completed by 44 pregnant teens, ranging in age from 13 to 19 years old. The frequency and distribution of the variables under study were analyzed and are presented herein. Forty-four teens participated in the study. They had a mean age of 17.5 years. A significant proportion of the participants, 20 (45.5%), claimed not to know where to find information about contraception. All the participants acknowledged knowing about the male condom; as to other methods of contraception, 41 (93.2%) knew about oral contraceptive pills (OCPs), 31 (70.5%) knew about the patch, 30 (68.2%) knew about Depo-Provera, and 25 (56.8%) knew about intrauterine devices (IUD). The contraception methods about which the participants reported having the least knowledge were the sponge, the diaphragm, implants, the vaginal ring, and various natural methods. The majority (90.0%) of the participants agreed that they would prefer to use postpartum contraception. The contraceptive method of choice for postpartum contraception was the IUD (40%), which was followed in terms of preference by OCPs (17.5%), the patch (12.5%), and Depo-Provera (12.5%). The majority of the pregnant teens who participated in the study professed the desire to use some sort of contraceptive method to ensure that they would not become pregnant again in the near future. To that end, most of them expressed a preference for the IUD, one of the most effective contraceptive methods available today. Nevertheless, they need more access to and information about available contraceptive methods.

  4. Effect of Pilates exercises on postpartum maternal fatigue

    Science.gov (United States)

    Ashrafinia, Farzaneh; Mirmohammadali, Mandana; Rajabi, Hamid; Kazemnejad, Anoshirvan; Haghighi, Khosro Sadeghniiat; Amelvalizadeh, Mehrnoosh

    2015-01-01

    INTRODUCTION Postpartum fatigue is a pervasive phenomenon and often affects mothers immediately after delivery. The present study aimed to assess the effect Pilates home exercises had on postpartum maternal fatigue. METHODS A total of 80 women participated in our clinical trial study. The women were randomly divided into two groups – the intervention group (n = 40) and the control group (n = 40). In the intervention group, the women performed Pilates exercises five times a week (30 min per session) for eight consecutive weeks. The first session was conducted 72 hours after delivery. The control group did not receive any intervention. Each woman’s level of fatigue was evaluated at hospital discharge (as a baseline), and at four and eight weeks after delivery, using the standard Multidimensional Fatigue Inventory (MFI-20) questionnaire and repeated measures analysis. RESULTS During the eight weeks of follow-up, we found that the intervention group had lower mean MFI-20 scores than the control group with regard to general fatigue (7.80 ± 2.07 vs. 12.72 ± 1.79; p < 0.001), physical fatigue (7.12 ± 1.41 vs. 10.42 ± 2.02; p < 0.001), reduced activity (6.95 ± 1.35 vs. 11.27 ± 1.70; p < 0.001), reduced motivation (6.20 ± 1.01 vs. 9.80 ± 2.04; p < 0.001) and mental fatigue (6.85 ± 1.45 vs. 10.72 ± 1.98; p < 0.001). CONCLUSION The present study’s findings show that physical exercise can significantly reduce postpartum maternal fatigue in all subscales. PMID:25820848

  5. Novel urinary metabolite signature for diagnosing postpartum depression

    Directory of Open Access Journals (Sweden)

    Lin L

    2017-05-01

    Full Text Available Lin Lin, Xiao-mei Chen, Rong-hua Liu Department of Obstetrics and Gynecology, Linyi People’s Hospital, Shandong, People’s Republic of China Background: Postpartum depression (PPD could affect ~10% of women and impair the quality of mother–infant interactions. Currently, there are no objective methods to diagnose PPD. Therefore, this study was conducted to identify potential biomarkers for diagnosing PPD.Materials and methods: Morning urine samples of PPD subjects, postpartum women without depression (PPWD and healthy controls (HCs were collected. The gas chromatography-mass spectroscopy (GC-MS-based urinary metabolomic approach was performed to characterize the urinary metabolic profiling. The orthogonal partial least-squares-discriminant analysis (OPLS-DA was used to identify the differential metabolites. The logistic regression analysis and Bayesian information criterion rule were further used to identify the potential biomarker panel. The receiver operating characteristic curve analysis was conducted to evaluate the diagnostic performance of the identified potential biomarker panel.Results: Totally, 73 PPD subjects, 73 PPWD and 74 HCs were included, and 68 metabolites were identified using GC-MS. The OPLS-DA model showed that there were 22 differential metabolites (14 upregulated and 8 downregulated responsible for separating PPD subjects from HCs and PPWD. Meanwhile, a panel of five potential biomarkers – formate, succinate, 1-methylhistidine, a-glucose and dimethylamine – was identified. This panel could effectively distinguish PPD subjects from HCs and PPWD with an area under the curve (AUC curve of 0.948 in the training set and 0.944 in the testing set.Conclusion: These results demonstrated that the potential biomarker panel could aid in the future development of an objective diagnostic method for PPD. Keywords: postpartum depression, gas chromatography-mass spectroscopy, biomarker, metabolomics

  6. Postpartum psychiatric emergency visits: a nested case-control study.

    Science.gov (United States)

    Barker, Lucy Church; Kurdyak, Paul; Fung, Kinwah; Matheson, Flora I; Vigod, Simone

    2016-12-01

    Mental health conditions are one of the most common reasons for postpartum emergency department (ED) visits. Characteristics of women using the ED and their mental health service use before presentation are unknown. We characterized all women in Ontario, Canada (2006-2012), who delivered a live born infant and had a psychiatric ED visit within 1 year postpartum (n = 8728). We compared those whose ED visit was the first physician mental health contact since delivery to those who had accessed mental health services on specific indicators of marginalization hypothesized to be associated with lower likelihood of mental health contact prior to the ED visit. For 60.4 % of women, this was the first physician mental health contact since delivery. The majority were presenting with a mood or anxiety disorder, and only 13.6 % required hospital admission. These women were more likely to have material deprivation and residential instability than women with contact (Q5 vs. Q1 aORs 1.30, 95 % CI 1.12-1.50; 1.17, 95 % CI 1.01-1.36), to live in rural vs. urban areas (aOR 1.58, 95 % CI 1.38-1.80), and to be low vs. high income quintile (aOR 1.18, 95 % CI 1.01-1.38). The frequent use of ED services as the first point of contact for mental health concerns suggests that interventions to improve timely and equitable access to effective outpatient postpartum mental health care are needed. Marginalized women are at particularly high risk of not having accessed outpatient services prior to an ED visit, and therefore, future research and interventions will specifically need to consider the needs of this group.

  7. Prevention of postpartum haemorrhage with the oxytocin analogue carbetocin.

    Science.gov (United States)

    Rath, Werner

    2009-11-01

    Postpartum haemorrhage is the leading cause of maternal mortality worldwide: 67-80% of cases are caused by uterine atony. Preventive measures include prophylactic drug use to aid uterine contraction after delivery, thus avoiding severe blood loss and reducing maternal morbidity and mortality. Carbetocin is a synthetic analogue of oxytocin with a half-life approximately 4-10 times longer than that reported for oxytocin. It combines the safety and tolerability profile of oxytocin with the sustained uterotonic activity of injectable ergot alkaloids. Furthermore, carbetocin can be administered as a single dose injection either intravenously or intramuscularly rather than as an infusion over several hours as is the case with oxytocin. Carbetocin is currently indicated for prevention of uterine atony after delivery by caesarean section in spinal or epidural anaesthesia. Data from three randomised controlled trials in caesarean delivery and a meta-analysis indicate that carbetocin significantly reduces the need for additional uterotonic agents or uterine massage to prevent excessive bleeding compared with placebo or oxytocin. The risk of headache, tremor, hypotension, flushing, nausea, abdominal pain, pruritus and feeling of warmth was similar in women who received carbetocin or oxytocin. The findings from two more recent double-blind randomised trials and one retrospective study suggest that carbetocin may also represent a good alternative to conventional uterotonic agents for prevention of postpartum haemorrhage after vaginal deliveries. A reduced need for additional uterotonics was observed with carbetocin vs. oxytocin in high-risk women and carbetocin was at least as effective as syntometrine in low-risk women. In these studies of vaginal deliveries, carbetocin was associated with a low incidence of adverse effects and demonstrated a better tolerability profile than syntometrine. Carbetocin had a long duration of action compared with intravenous oxytocin alone and a

  8. Preventing postpartum smoking relapse: an opportunity for neonatal nurses.

    Science.gov (United States)

    Forest, Sharron

    2009-08-01

    Smoking during pregnancy and exposure to environmental tobacco smoke have harmful and sometimes devastating effects on the health of the newborn. Although interventions for smoking cessation during pregnancy demonstrate effectiveness for increasing smoking abstinence, the majority of women relapse in the postpartum period. However, modifying contributing factors for relapse may improve the success of sustained abstinence. Many parents are eager to quit smoking and willing to participate in smoking cessation interventions. Through a population-based approach to healthcare, neonatal nurses are in an ideal position to prevent relapse and to promote smoking abstinence; they can coordinate and lead efforts for establishing smoking cessation strategies that integrate obstetric, newborn, and pediatric services.

  9. Treatment for women with postpartum iron deficiency anaemia

    DEFF Research Database (Denmark)

    Markova, Veronika; Norgaard, Astrid; Jørgensen, Karsten Juhl

    2015-01-01

    Literature database (LILACS) (8 April 2015) and reference lists of retrieved studies. SELECTION CRITERIA: We included published, unpublished and ongoing randomised controlled trials that compared a treatment for postpartum iron deficiency anaemia with placebo, no treatment, or another treatment......), but no difference between groups was seen at six weeks. Maternal mortality was not reported.The remaining comparisons evaluated oral iron (with or without other food substances) versus placebo (three studies), intravenous iron with oral iron versus oral iron (two studies) and erythropoietin (alone or combined...

  10. Maternal identity of women in the postpartum period

    OpenAIRE

    Maria B. Perun

    2013-01-01

    The article provides a theoretical analysis of the notions of “maternity”, “maternal sphere”, “maternal role” and “maternal identity”. The place of maternal identity in the system of a woman’s identities is determined. This article provides a brief description of the structural elements (cognitive, emotional, behavioural and axiological) of maternal identity. It also emphasizes the significance of the postpartum period in a women’s psychic life and stresses its pivotal role in the devel...

  11. Pyomyoma as a Rare Source of Postpartum Sepsis

    Directory of Open Access Journals (Sweden)

    A. DeMaio

    2015-01-01

    Full Text Available Pyomyoma, also known as suppurative leiomyoma, is a rare clinical complication that occurs when a leiomyoma undergoes infarction and subsequent infection. A high index of suspicion is required to make the diagnosis and can be guided by a classic triad of symptoms that includes abdominal pain, sepsis without an obvious source, and a history of leiomyoma. In the vast majority of these cases, total abdominal hysterectomy is required to avoid severe morbidity and potential mortality. We present an unusual case of a postpartum pyomyoma that was successfully treated without the need for hysterectomy. With strong clinical suspicion, early diagnosis, and appropriate management, some affected patients may preserve fertility.

  12. Effects of delivery mode and sociodemographic factors on postpartum stress urinary incontinency in primipara women: A prospective cohort study

    Directory of Open Access Journals (Sweden)

    Roya Kokabi

    2017-08-01

    Conclusion: Vaginal delivery is associated with a twofold increased risk of postpartum SUI in primipara women compared with elective cesarean section. Age and birth weight are the main risk factors of postpartum SUI in both modes of delivery. Tool-assisted delivery and episiotomy were determined as the risk factors of postpartum SUI in vaginal delivery.

  13. 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.

  14. Parental acceptance, postpartum depression, and maternal sensitivity: mediating and moderating processes.

    Science.gov (United States)

    Crockenberg, Susan C; Leerkes, Esther M

    2003-03-01

    Mothers (n = 92), fathers (n = 84), and their infants (60% male) participated in a longitudinal study of postpartum depression and maternal sensitivity. Mothers completed questionnaire measures of remembered parental acceptance, depressive symptoms, and infant distress to novelty and limits. Mothers and partners reported on marital aggression and avoidance. Maternal sensitivity was observed in the laboratory at 6 months. Characteristics of mothers, partners, and infants combined to predict postpartum depression and maternal sensitivity. Remembered parental rejection predicted postpartum depressive symptoms with prenatal depression controlled; self-esteem mediated this effect. Paternal acceptance buffered against postpartum depression when infants were highly reactive and when partners were aggressive. Paternal acceptance reduced the impact of postpartum depression on maternal sensitivity; having an aggressive marital partner exacerbated the effect.

  15. The relationship of women's postpartum mental health to employment, childbirth, and social support.

    Science.gov (United States)

    Gjerdingen, D K; Chaloner, K M

    1994-05-01

    This study was conducted to examine changes in women's mental health over the first postpartum year and factors that are associated with mental health. Participants included women who were married, employed, English-speaking, and giving birth to their first child at one of two hospitals in St Paul, Minnesota. Women who were eligible and willing to participate were mailed questionnaires at 1, 3, 6, 9, and 12 months postpartum. There were significant changes in mothers' general mental health, depression, and anxiety over the first postpartum year (P appearance, and infant illnesses. In addition, postpartum symptoms were predicted by physical illness, previous mental problems, poor general health, poor social support, fewer recreational activities, young age, and low income (R2 = 37% to 57%). In this select group of women, postpartum mental health was found to be least favorable 1 month after delivery and related to factors associated with employment, recent delivery, and level of social support.

  16. Influence of nutrition and suckling patterns on the postpartum cyclic activity of swamp buffaloes

    International Nuclear Information System (INIS)

    Wongsrikeao, W.; Boon-Ek, L.; Wanapat, M.; Taesakul, S.

    1990-01-01

    Two studies were conducted to investigate the effects of nutrition and suckling patterns on the ovarian cyclicity of postpartum buffaloes. In Study 1, which was conducted on an institutional farm, two different diets were fed to 24 buffaloes during late gestation and postpartum period. Restricted (twice daily) suckling began on day 30 postpartum in half the animals on each diet. The body weight of both ad libitum suckled and twice daily suckled groups declined during the postpartum period, irrespective of the diet fed. Buffaloes subjected to restricted suckling lost less body weight and re-established ovarian cyclicity earlier than those suckled ad libitum. In Study 2, which was conducted under village conditions, temporary calf removal for 72 hours on days 91-93 postpartum in anoestrous buffaloes induced the re-establishment of ovarian cyclicity within 14 days. (author). 11 refs, 7 tabs

  17. The Effect of Media on Body Image in Pregnant and Postpartum Women.

    Science.gov (United States)

    Coyne, Sarah M; Liechty, Toni; Collier, Kevin M; Sharp, Aubrey D; Davis, Emilie J; Kroff, Savannah L

    2018-07-01

    Much research has found that exposure to certain types of media portrayals of women can be related to body image concerns among women. The current paper focuses on the impact of certain messages on pregnant and postpartum women. These women are rarely examined in a media research context but are particularly vulnerable to body image concerns. This experimental study involved 192 pregnant or postpartum women who read a magazine containing glamorized media portrayals of pregnant/postpartum women or a control magazine. Pregnant women reported lower body image after only five minutes of exposure to the magazine with pregnant/postpartum women compared to the control group. There was no immediate effect on postpartum women. Implications for the media industry, health professionals, and women are discussed.

  18. Clinical value of arteriography in postpartum hemorrhage by transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Wang Kai; Jiang Guomin; Zhao Jinwei; Huang Wenhua; Liu Yizhi; Jin Yonghai

    2010-01-01

    Objective: To analyze the arterial supply in postpartum hemorrhage and to evaluate the clinical value of arteriography in transcatheter arterial embolization (TAE) for treating postpartum hemorrhage. Methods: The arteriography of 37 patients with postpartum hemorrhage was analyzed. TAE were performed after the bleeding artery was identified. Post TAE angiography was performed to confirm the success of embolization. Results: The bleeding artery in atonic uterus and abnormal placenta was the uterine artery. The bleeding artery in birth canal laceration is mainly non-uterine artery. Postpartum hemorrhage was successfully controlled in all 37 patients without sever complication of TAE. Conclusion: Arteriography in postpartum hemorrhage can demonstrate the bleeding artery and is potential collaterals allowing adequate embolization without complication. (authors)

  19. Barriers to Receiving Long-acting Reversible Contraception in the Postpartum Period.

    Science.gov (United States)

    Zerden, Matthew L; Tang, Jennifer H; Stuart, Gretchen S; Norton, Deborah R; Verbiest, Sarah B; Brody, Seth

    2015-01-01

    To assess why postpartum women who desired long-acting reversible contraception (LARC) did not receive it in the postpartum period and to assess which contraceptive methods they were using instead. This was a subgroup analysis of 324 women enrolled in a randomized, controlled trial to receive or not receive an educational LARC script during their postpartum hospitalization. Participants in this subgroup analysis stated that they were either using LARC (n = 114) or interested in using LARC (n = 210) during a follow-up survey completed after their scheduled 6-week postpartum visit. Modified Poisson regression analysis was used to assess for characteristics associated with using LARC by the time of the follow-up survey. Women who were interested in LARC but not using it were more likely to be multiparous (relative risk [RR], 1.59; 95% CI, 1.19-2.11) and to have missed their postpartum visit (RR, 25.88; 95% CI, 3.75-178.44) compared with those using LARC. Among the interested 210 who were not using LARC, the most common reasons provided for non-use were that they were told to come back for another insertion visit (45%), missed the postpartum visit (26%), and could not afford LARC (11%). The most common contraceptive methods used instead of LARC were barrier methods (42%) and abstinence (19%); 18% used no contraceptive method. Two-thirds (65%) of postpartum women who desired to use LARC did not receive it in the postpartum period and used less effective contraceptive methods. Increasing access to immediate postpartum LARC and eliminating two-visit protocols for LARC insertion may increase postpartum LARC use. As the Affordable Care Act moves toward full implementation, it is necessary to understand the barriers that prevent interested patients from receiving LARC. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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.

  1. PENGETAHUAN GIZI, KELUHAN KESEHATAN, KONDISI PSIKOLOGIS, DAN POLA PEMBERIAN ASI IBU POSTPARTUM

    Directory of Open Access Journals (Sweden)

    Armina Puji Utari

    2014-05-01

    Full Text Available ABSTRACTThis study was aimed to assess nutritional knowledge, health complaints, psychological conditions, and their association with breastfeeding pattern on postpartum mother. A cross sectional study with interview method was conducted in five villages in Dramaga Subdistrict, Bogor District, during the period of April to May 2013. Subjects included in this study were 30 postpartum mothers who met inclusion criteria. Subjects were mothers of 10—40 days old newborn baby and it was not the first childbirth, willing to be subject through informed consent agreement, and was able to communicate. The majority of postpartum mothers had fair nutritional knowledge (60.0%, low health complaints (66.7%, and depression (56.7%. The nutritional knowledge of exclusive breastfeeding tended to correlate with exclusive breastfeeding practice (r=0.126; p=0.508. Meanwhile, lower health complaints tended to correlate with better breastfeeding practices (r=0.063; p=0.74.Keywords: breastfeeding, health complaints, nutritional knowledge, postpartum mother, psychologicalconditionsABSTRAKPenelitian ini bertujuan untuk mengetahui pengetahuan gizi, status kesehatan, kondisi psikologis serta kaitannya dengan pola pemberian ASI ibu postpartum. Penelitian ini menggunakan desain cross sectional study dengan metode wawancara yang dilakukan di lima desa di Kecamatan Dramaga, Kabupaten Bogor, pada bulan April hingga Mei 2013. Subjek penelitian adalah 30 ibu postpartum dengan kriteria inklusi, ibu dari bayi berusia 10—40 hari dan bukan persalinan pertama, bersedia menjadi subjek penelitian, dan dapat berkomunikasi dengan baik. Hasil penelitian menunjukkan bahwa sebagian besar ibu postpartum memiliki tingkat pengetahuan gizi cukup (60%, keluhan kesehatan rendah (66.7% serta mengalami depresi (56.7%. Pengetahuan gizi tentang definisi ASI yang semakin baik pada ibu postpartum cenderung berkorelasi dengan pemberian ASI eksklusif yang baik (r=0.126; p=0.508. Sebaliknya, semakin

  2. Thyroid peroxidase antibodies during early gestation and the subsequent risk of first-onset postpartum depression: A prospective cohort study.

    Science.gov (United States)

    Wesseloo, Richard; Kamperman, Astrid M; Bergink, Veerle; Pop, Victor J M

    2018-01-01

    During the postpartum period, women are at risk for the new onset of both auto-immune thyroid disorders and depression. The presence of thyroid peroxidase antibodies (TPO-ab) during early gestation is predictive for postpartum auto-immune thyroid dysfunction. The aim of this study was to investigate the association between TPO-ab status during early gestation and first-onset postpartum depression. Prospective cohort study (n = 1075) with follow-up during pregnancy up to one year postpartum. Thyroid function and TPO-ab status were measured during early gestation. Depressive symptomatology was assessed during each trimester and at four time points postpartum with the Edinburgh Depression Scale (EDS). Women with antenatal depression were not eligible for inclusion. Self-reported postpartum depression was defined with an EDS cut-off of ≥ 13. The cumulative incidence of self-reported first-onset depression in the first postpartum year was 6.3%. A positive TPO-ab status was associated with an increased risk for self-reported first-onset depression at four months postpartum (adjusted OR 3.8; 95% CI 1.3-11.6), but not at other postpartum time points. Prevalence rates of self-reported postpartum depression declined after four months postpartum in the TPO-ab positive group, but remained constant in the TPO-ab negative group. Depression was defined with a self-rating questionnaire (EDS). Women with an increased TPO-ab titer during early gestation are at increased risk for self-reported first-onset depression. The longitudinal pattern of self-reported postpartum depression in the TPO-ab positive group was similar to the typical course of postpartum TPO-ab titers changes. This suggests overlap in the etiology of first-onset postpartum depression and auto-immune thyroid dysfunction. Thyroid function should be evaluated in women with first-onset postpartum depression. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Pregnancy and postpartum control in HIV infected women

    Directory of Open Access Journals (Sweden)

    Eduardo M. Warley

    2017-04-01

    Full Text Available Pregnancy and postpartum control in HIV infected women. We present data from a retrospective observational descriptive study with the objective of evaluating characteristics of HIV-infected pregnant women, analyze the level of control of pregnancy and assess adherence to treatment and loss of follow up after delivery. We analyzed reported data of 104 pregnancies, 32.7% of them under 25 years old. The diagnosis was performed as part of pregnancy control in 36.5% of women. TARV started before 24 weeks of pregnancy in 70% of them and a regimen with 2 nucleos(tides and 1 ritonavir potenciated protease inhibitor (PIr was prescribed in 84.5%. Elective c-section was the most frequent mode of delivery. The viral load after 32 weeks of pregnancy was available in 82.7%, being less than 1000 cop/ml in 78 (75%, less than 200 cop/ml in 70 (67.3% and not available in 18 (17.3% of cases. We observed a considered high rate of adherence failure and loss of follow up after delivery. Reported data should alert programs on the need to implement strategies to promote early pregnancy control and increase adherence and retention in care, especially in the postpartum period

  4. Uterine involution: its role in regulating postpartum intervals.

    Science.gov (United States)

    Kiracofe, G H

    1980-01-01

    An involuting uterus is a temporary barrier to fertility in cows, ewes and sows. Parturition is followed by a period when conception is not possible: about 1 week in sows and about 3 weeks in cows and ewes. Estrus and ovulation seldom occur together during this period and, if fertilization occurred and the embryo reached the uterus, placentation would be virtually impossible. The period of no fertility is followed by 2 to 3 weeks when fertility is possible, but not optimal. The extent to which the involuting uterus contributes to infertility during the second period is difficult to determine. Embryonic mortality in sows bred during this latter period appears to be a major cause of reduced litter size, so changes in uterine environment associated with involution may be essential for optimum fertility. Conception rate is lower up to 40 days after parturition than later in cows and ewes. Uterine involution appears not to be a barrier to fertility after 3 to 4 weeks postpartum in sows or 5 to 6 weeks postpartum in cows and ewes unless delayed by inflammation or infection.

  5. [Effect of paternity leave on maternal postpartum depression].

    Science.gov (United States)

    Séjourné, N; Beaumé, M; Vaslot, V; Chabrol, H

    2012-06-01

    The aim of this study was to explore the role of the paternity leave in the appearance of the maternal postpartum depression. Fifty-one couples took part in the whole study. Between the second and the fifth day after the childbirth, the mother completed the Edinburgh Postnatal Depression Scale (EPDS), which measures the symptoms of depression and the Multidimensional Scale of Perceived Social Support (MSPSS) which measures the social support the mother has become. The father completed the EPDS. Two months and then the second time four months after the childbirth, the mother received the EPDS, the MSPSS, and questionnaires measuring the temperament of the baby, the maternal skills, the feeling of being a mother and the quality of life postpartum. In order to evaluate the paternal involvement, the father completed the EPDS and questions about paternal skills and involvement. The paternity leave seemed not to have any consequences on the results at the EPDS or other questionnaires. However, lack of paternal involvement was a significant predictor of the intensity of the depressive symptoms of the mothers. It is not the presence of the father wich seems important to take into account for detection and the traitement of postpatum depression but his participation in the care of the baby. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. Thyroid Peroxidase Antibody and Screening for Postpartum Thyroid Dysfunction

    Directory of Open Access Journals (Sweden)

    Mohamed A. Adlan

    2011-01-01

    Full Text Available Postpartum thyroid dysfunction (PPTD is a common disorder which causes considerable morbidity in affected women. The availability of effective treatment for hypothyroid PPTD, the occurrence of the disease in subsequent pregnancies and the need to identify subjects who develop long term hypothyroidism, has prompted discussion about screening for this disorder. There is currently no consensus about screening as investigations hitherto have been variable in their design, definitions and assay frequency and methodology. There is also a lack of consensus about a suitable screening tool although thyroid peroxidase antibody (TPOAb is a leading contender. We present data about the use of TPOAb in early pregnancy and its value as a screening tool. Although its positive predictive value is moderate, its sensitivity and specificity when used in early pregnancy are comparable or better compared to other times during pregnancy and the postpartum period. Recent studies have also confirmed this strategy to be cost effective and to compare favourably with other screening strategies. We also explore the advantages of universal screening.

  7. Postpartum Visit Attendance Increases the Use of Modern Contraceptives

    Directory of Open Access Journals (Sweden)

    Saba W. Masho

    2016-01-01

    Full Text Available Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008–2012. Information on the most recent delivery for mothers with singleton births was analyzed (N = 24,619. Routine PPCV (yes, no and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8% and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72. Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates.

  8. [Pregnancy and postpartum control in HIV infected women].

    Science.gov (United States)

    Warley, Eduardo M; Tavella, Silvina; Rosas, Alejandra

    2017-01-01

    Pregnancy and postpartum control in HIV infected women. We present data from a retrospective observational descriptive study with the objective of evaluating characteristics of HIV-infected pregnant women, analyze the level of control of pregnancy and assess adherence to treatment and loss of follow up after delivery. We analyzed reported data of 104 pregnancies, 32.7% of them under 25 years old. The diagnosis was performed as part of pregnancy control in 36.5% of women. TARV started before 24 weeks of pregnancy in 70% of them and a regimen with 2 nucleos(t)ides and 1 ritonavir potenciated protease inhibitor (PIr) was prescribed in 84.5%. Elective c-section was the most frequent mode of delivery. The viral load after 32 weeks of pregnancy was available in 82.7%, being less than 1000 cop/ml in 78 (75%), less than 200 cop/ml in 70 (67.3%) and not available in 18 (17.3%) of cases. We observed a considered high rate of adherence failure and loss of follow up after delivery. Reported data should alert programs on the need to implement strategies to promote early pregnancy control and increase adherence and retention in care, especially in the postpartum period.

  9. Left ventricular calcification following postpartum toxic shock syndrome

    Directory of Open Access Journals (Sweden)

    Stella C Pak

    2018-01-01

    Full Text Available Toxic shock syndrome (TSS is a rare but lethal clinical event that can occur during the postpartum period. Early recognition and intervention is critical to improve patient outcomes. This is a case of TSS complicated by cardiac arrest and left ventricular calcification. This is a case report of streptococcal TSS in a 29-year-old female in the postpartum period who presented with fever, abdominal distension, and a purpuric rash. Her hospital course was characterized by multiple organ failure, including respiratory distress syndrome, liver failure, renal failure, and coagulopathy. She was found to have acute compartment syndrome, which resulted in a below-the-knee amputation. She deteriorated further after experiencing cardiac arrest and the development of hypoxic-ischemic encephalopathy with hemorrhagic transformation. A computed tomography scan of the chest revealed evidence of dystrophic myocardial calcification in the left ventricle. She improved clinically but remained ventilator dependent upon discharge to an extended acute care facility. Sepsis-induced cardiomyopathy can result in myocardial calcification. As dystrophic calcification can significantly affect cardiac function, clinicians should rule out cardiac calcification in patients who have had severe septic shock.

  10. Time off work and the postpartum health of employed women.

    Science.gov (United States)

    McGovern, P; Dowd, B; Gjerdingen, D; Moscovice, I; Kochevar, L; Lohman, W

    1997-05-01

    Parental and maternity leave policies are a popular fringe benefit among childbearing employed women and a benefit employers frequently are required to offer. However, few rigorous evaluations of the effect of maternal leave on maternal health exist. Using a hybrid of the household and health production theories of Becker and Grossman and a sample of women identified from state vital statistics records, a nonlinear relationship between maternal postpartum health and time off work after childbirth was estimated. For women taking more than 12 weeks leave, time off work had a positive effect on vitality. With more than 15 weeks leave, time off work had a positive effect on maternal, mental health, and with more than 20 weeks leave, time off work had a positive effect on role function. Subjects' mental health scores were comparable and vitality scores slightly lower than age- and gender-specific norms; 70% of women studied reported role function limitations. Findings suggest employed women experience problems in well-being at approximately seven months postpartum. Variables associated with improved health include: longer maternity leaves, fewer prenatal mental health symptoms, fewer concurrent physical symptoms, more sleep, increased social support, increased job satisfaction, less physical exertion on the job, fewer infant symptoms, and less difficulty arranging child care.

  11. Return to work, economic hardship, and women's postpartum health.

    Science.gov (United States)

    Tucker, Jenna N; Grzywacz, Joseph G; Leng, Iris; Clinch, C Randall; Arcury, Thomas A

    2010-10-01

    This study followed a sample of 217 new mothers in a North Carolina county as they returned to work full-time, measuring their mental and physical health-related quality of life through 16 months postpartum. In general, working mothers of infants had mental health scores that were comparable to the general population of U.S. women, and physical health that was slightly better than women in general. Using ANCOVA and controlling for important demographic characteristics, health-related quality of life was compared between mothers experiencing low and high levels of economic hardship. Across the study period, women with high economic hardship, who constituted 30.7% of the sample, had levels of mental and physical health below those of women with low economic hardship. Mothers with high economic hardship also had less stable health trajectories than mothers with low economic hardship. The findings highlight the importance of reconsidering the traditionally accepted postpartum recovery period of six weeks and extending benefits, such as paid maternity and sick leave, as well as stable yet flexible work schedules.

  12. Factors associated with attitudes toward seeking mental health treatment postpartum.

    Science.gov (United States)

    Bina, Rena; Glasser, Saralee

    2017-12-27

    Attitudes toward seeking mental health treatment are a major predictor of seeking such treatment. Rates of seeking mental health treatment for postpartum depression are low despite contacts with health-care providers and available treatment. This study examined factors associated with four dimensions of attitude toward seeking mental health treatment among Israeli women in the postpartum period. Women (N = 1,059) were recruited (June 2008-February 2009) from a medical center's maternity department within the first two days following delivery and completed a sociodemographic survey and the Attitudes Toward Seeking Professional Psychological Help Scale. Low recognition of need for mental health treatment was associated with having a below average income and no personal and family depression history; low stigma tolerance was associated with being younger, having more children, and defining oneself as ultra-orthodox; low interpersonal openness was associated with having a below average income. Moreover, low confidence in mental health practitioners was associated with being younger and non-ultra-orthodox. Understanding which women are likely to score low on various dimensions of attitude can help target interventions for improving these factors, reducing barriers to receiving mental health treatment among specific groups of women. Research should continue to explore specific attitude dimensions among various populations.

  13. Postpartum Visit Attendance Increases the Use of Modern Contraceptives.

    Science.gov (United States)

    Masho, Saba W; Cha, Susan; Charles, RaShel; McGee, Elizabeth; Karjane, Nicole; Hines, Linda; Kornstein, Susan G

    2016-01-01

    Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV) is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008-2012). Information on the most recent delivery for mothers with singleton births was analyzed ( N = 24,619). Routine PPCV (yes, no) and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8%) and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72). Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates.

  14. A veterinary perspective of on-farm evaluation of nutrition and reproduction.

    Science.gov (United States)

    Studer, E

    1998-03-01

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

  15. Prolonged hypothyroidism severely reduces ovarian follicular reserve in adult rats

    NARCIS (Netherlands)

    Meng, Li; Rijntjes, Eddy; Swarts, Hans J.M.; Keijer, Jaap; Teerds, Katja J.

    2017-01-01

    Background: There is substantial evidence both in humans and in animals that a prolonged reduction in plasma thyroid hormone concentration leads to reproductive problems, including disturbed folliculogenesis, impaired ovulation and fertilization rates, miscarriage and pregnancy complications. The

  16. Predictive factors associated with prolonged chest drain production after esophagectomy

    NARCIS (Netherlands)

    Lagarde, S. M.; Omloo, J. M. T.; Ubbink, D. T.; Busch, O. R. C.; Obertop, H.; van Lanschot, J. J. B.

    2007-01-01

    After esophagectomy, pleural drainage is performed to ensure complete drainage of the pleural cavities. The aim of this study was to detect predisposing factors for prolonged drainage. Patients who underwent transhiatal or extended transthoracic esophagectomy for adenocarcinoma of the distal

  17. Prolongation of rapacuronium neuromuscular blockade by clindamycin and magnesium.

    Science.gov (United States)

    Sloan, Paul A; Rasul, Mazhar

    2002-01-01

    We report a prolonged neuromuscular block with the nondepolarizing muscle relaxant rapacuronium in the presence of clindamycin. Even when using "short-acting" muscle relaxants, the anesthesiologist must routinely monitor the neuromuscular function.

  18. Ways to Optimize Therapy of Prolonged Conjugation Jaundice in Infants

    Directory of Open Access Journals (Sweden)

    O.G. Shadrin

    2015-09-01

    Full Text Available The article is devoted to the optimization of the treatment of prolonged conjugation jaundice. Inclusion of ursodeoxycholic acid in the treatment of neonatal prolonged conjugation jaundice in a dose of 15–20 mg/kg of body mass per day increases the terms of regression of clinical and paraclinical signs of jaundice as much as 2 times and leads to cytolysis normalization. The preparation has a sufficient level of safety, there were not revealed side effects whilst its application.

  19. The Challenges of Providing Postpartum Education in Dar es Salaam, Tanzania: Narratives of Nurse-Midwives and Obstetricians.

    Science.gov (United States)

    Mselle, Lilian Teddy; Aston, Megan; Kohi, Thecla W; Mbekenga, Columba; Macdonald, Danielle; White, Maureen; Price, Sheri; Tomblin Murphy, Gail; O'Hearn, Shawna; Jefferies, Keisha

    2017-10-01

    Postpartum education can save lives of mothers and babies in developing countries, and the World Health Organization recommends all mothers receive three postpartum consultations. More information is needed to better understand how postpartum education is delivered and ultimately improves postpartum health outcomes. The purpose of this qualitative study was to examine how postpartum care was delivered in three postnatal hospital clinics in Dar es Salaam, Tanzania. Semistructured interviews with 10 nurse-midwives and three obstetricians were conducted. Feminist poststructuralism guided the research process. Postpartum education was seen to be an urgent matter; there was a lack of supportive resources and infrastructure in the hospital clinics, and nurse-midwives and obstetricians had to negotiate conflicting health and traditional discourses using various strategies. Nurse-midwives and obstetricians are well positioned to deliver life-saving postpartum education; however, improvements are required including increased number of nurse-midwives and obstetricians.

  20. Doing the month in a Taiwanese postpartum nursing center: an ethnographic study.

    Science.gov (United States)

    Yeh, Yueh-Chen; St John, Winsome; Venturato, Lorraine

    2014-09-01

    Traditionally Chinese and Taiwanese postpartum women conducted postpartum ritual practices, called "doing the month," at home. Today, many Taiwanese women undertake this ritual in postpartum nursing centers. However, little is known about how the traditional practices are being transformed in relation to contemporary health care in Taiwan. In this ethnographic study observations were carried out in a large post-partum center attached to a major hospital in Taipei for nine months, and 27 postpartum women were interviewed. Data were analyzed using ethnographic approaches to extract codes and categories. Doing the month was reshaped by being relocated from the home to a healthcare setting. Midwives took on roles traditionally taken by family members, which had an impact on family roles and relationships. Some postpartum practices were maintained, based on traditional explanations. However, many were modified or challenged, based on explanations from contemporary scientific knowledge. Midwives need to be aware that there could be differences between their culture of care and the cultural values of the women they care for. This study informs culturally appropriate postpartum care and support for women with traditional and contemporary cultural beliefs and attitudes to doing the month in a range of healthcare contexts. © 2013 Wiley Publishing Asia Pty Ltd.

  1. Urinary incontinence and weight change during pregnancy and postpartum: a cohort study.

    Science.gov (United States)

    Wesnes, Stian Langeland; Hunskaar, Steinar; Bo, Kari; Rortveit, Guri

    2010-11-01

    Weight gain during pregnancy may contribute to increased urinary incontinence (UI) during and after pregnancy, but scientific support is lacking. The effect of weight loss on UI postpartum is unclear. From 1999 to 2006, investigators in the Norwegian Mother and Child Cohort Study recruited pregnant women during pregnancy. This study was based on 12,679 primiparous women who were continent before pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and 6 months postpartum. Weight gain greater than the 50th percentile during weeks 0-15 of pregnancy was weakly associated with higher incidence of UI at week 30 compared with weight gain less than or equal to the 50th percentile. Weight gain greater than the 50th percentile during pregnancy was not associated with increased prevalence of UI 6 months postpartum. For each kilogram of weight loss from delivery to 6 months postpartum among women who were incontinent during pregnancy, the relative risk for UI decreased 2.1% (relative risk = 0.98, 95% confidence interval: 0.97, 0.99). Weight gain during pregnancy does not seem to be a risk factor for increased incidence or prevalence of UI during pregnancy or postpartum. However, weight loss postpartum may be important for avoiding incontinence and regaining continence 6 months postpartum.

  2. Urinary incontinence during pregnancy and postpartum. Associated risk factors and influence of pelvic floor exercises.

    Science.gov (United States)

    Martin-Martin, Sergio; Pascual-Fernandez, Angela; Alvarez-Colomo, Cristina; Calvo-Gonzalez, Raul; Muñoz-Moreno, Marife; Cortiñas-Gonzalez, Jose Ramon

    2014-05-01

    To determine the prevalence of urinary incontinence (UI) before pregnancy, in the third trimester and postpartum. To analyze its influence on quality of life and associated potential risk factors and the efficacy of pelvic floor exercises. Prospective study in 413 pregnant women. The modified ICIQ-SF incontinence questionnaire was given to the pregnant women at the end of the third quarter. This questionnaire was administered by telephone at 3 and 6 months postpartum. The influence of several risk factors for UI in pregnancy and postpartum were analyzed. Patients with persistent UI at 6 months postpartum were trained to do pelvic floor exercises. Patients with UI before pregnancy were excluded from the study. UI in the third trimester was 31%. Analyzed risk factors did not condition a higher percentage of UI. Prevalence of UI was 11.3% at 3 months postpartum and 6.9% at 6 months. 70% of the incontinent patients already had it during pregnancy and it appeared de novo post-delivery in 30% of the patients. Prevalence of UI after delivery was higher in women with UI in pregnancy and lower in caesarean cases. Most women improved with pelvic floor exercises. Analysed risk factors did not significantly increase UI in pregnancy. Prevalence of UI after delivery is higher in women with UI in pregnancy and lower in caesarean cases. Postpartum pelvic floor exercises for three months in patients with persistent stress UI at 6 months postpartum clearly improved the degree of continence.

  3. 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.

  4. Contraceptive usage and awareness among postpartum mothers in urban field practice area of a tertiary hospital

    Directory of Open Access Journals (Sweden)

    Tanvir Kaur Sidhu

    2015-03-01

    Full Text Available Background: To study contraceptive usage and awareness among postpartum mothers. Objective: To assess prevalence of postpartum contraception and factors affecting the usage of contraceptives in Urban area. Material and Methods: A cross-sectional descriptive study was carried out in the Urban Field practice area of Adesh Institute of Medical Sciences & Research, Bathinda. All females who delivered within last one year were included in the study. A pre-structured questionnaire was used to collect socio-demographic and other details. A total of 92 females were included. The appropriate statistical analysis was done to present the results. Results: 30.4% females had adopted one or the other postpartum contraceptive measure. Condom was the most common method used. Usage of postpartum contraception was significantly associated with women’s and husband’s education, type of delivery and availing of antenatal and postnatal visits. The main reason for not using postpartum contraception was lack of knowledge and access. 16.3% females had unmet need of postpartum contraception. Conclusions: Overall usage of postpartum contraception was low and mainly related to lack of awareness and knowledge.

  5. The Associations of Maternal Weight Change with Breastfeeding, Diet and Physical Activity During the Postpartum Period.

    Science.gov (United States)

    López-Olmedo, Nancy; Hernández-Cordero, Sonia; Neufeld, Lynnette M; García-Guerra, Armando; Mejía-Rodríguez, Fabiola; Méndez Gómez-Humarán, Ignacio

    2016-02-01

    To determine the association between breastfeeding practices, diet and physical activity and maternal postpartum weight. This was a secondary data analysis of a randomized community trial on beneficiaries of the Programa de Desarrollo Humano Oportunidades, recently renamed Prospera (n = 314 pregnant women), without any diseases that could affect body weight. Generalized estimating equations were used to determine the association between postpartum weight change and changes in diet, physical activity and type of breastfeeding. The mean postpartum weight change from the first to the third month was 0.6 ± 2.2 kg. Women who breastfed exclusively for 3 months had a 4.1 (SE = 1.9) kg weight reduction in comparison with women who did not provide exclusive breastfeeding or who discontinued breastfeeding before 3 months (p = 0.04). There was no association between postpartum weight change and physical activity (p = 0.24) or energy intake (p = 0.06). Exclusive breastfeeding was associated with maternal postpartum weight reduction. These results reinforce the World Health Organization recommendation of exclusive breastfeeding during the first 6 months of life in order to reduce the risk of weight retention or weight gain in postpartum women. It has been well established that exclusive breastfeeding is beneficial for both infants and mothers, but promoting breastfeeding as a strategy to promote postpartum weight loss is of paramount importance, especially in countries like Mexico where excessive weight in women of reproductive age is a public health problem.

  6. Ovarian activity and embryo yield in relation to the postpartum period in superovulated dairy cows

    Directory of Open Access Journals (Sweden)

    Luděk Stádník

    2017-01-01

    Full Text Available The aim of this study was to evaluate superovulation response in cows at various postpartum periods (early postpartum period up to 3.5 months; middle postpartum period 3.7–7 months; later postpartum period above 7.5 months after calving. The data included observation of 55 Holstein cows superovulated at one farm in the Czech Republic during the years 2010 and 2013. Reproduction traits (dependent variable were represented as number of the corpora lutea, number of transferable embryos, morulae, blastocysts, total number of embryos and embryo recovery. For statistical evaluation we used the PROC GLM of SAS® with fixed effect - breeding value of milk production. The study results show significant differences (P < 0.05–0.01 in the three postpartum periods (early, middle, and later postpartum periods and the number of corpora lutea (4.6; 7.4; 10.8, number of total embryos (3.2; 2.9; 6.5 and transferable embryos (1.8; 1.7; 4.4. Effective timing of embryo transfer in the later postpartum period resulted in greater ovarian activity and embryo yield compared to early lactation periods.

  7. [The role of some psychological, psychosocial and obstetrical factors in the intensity of postpartum blues].

    Science.gov (United States)

    Séjourné, N; Denis, A; Theux, G; Chabrol, H

    2008-04-01

    Within days following birth, most women show signs of mood changes, commonly named baby blues. Baby blues can result in postpartum depression. Hence it appears important to explore in more details the clinical background related to the intensity of postpartum blues. The aim of this study is to investigate the contribution of psychological, psychosocial and obstetrical factors to the intensity of postpartum blues. One hundred and forty-eight women participated in the study and completed questionnaires three days after delivery. A questionnaire was built to collect information on psychosocial and obstetrical factors. The Maternity Blues (Kennerley and Gath, 1989) was used to assess postpartum blues. Psychological factors were measured with the Maternal Self-Report Inventory (Shea et Tronick, 1988), the Perceived Stress Scale (Cohen, Kamarch et Mermelstein, 1983) and the Sarason's Social Support Questionnaire (1983). Four multiple regression analyses were conducted to predict the intensity of postpartum blues by entering psychosocial factors, history of depression, obstetrical factors and psychological and relational factors. Significant predictors (maternal self-esteem, marital status, previous psychotherapeutic treatment, previous antidepressant treatment) were entered in a multiple regression analysis predicting the intensity of postpartum blues. This model accounted for 31% of the variance in the intensity of postpartum blues (F(4, 143)=17.9; Pself-esteem (beta=-0.37; Porder to detect women who exhibit risk factors.

  8. Integrating family planning into postpartum care through modern quality improvement: experience from Afghanistan.

    Science.gov (United States)

    Tawfik, Youssef; Rahimzai, Mirwais; Ahmadzai, Malalah; Clark, Phyllis Annie; Kamgang, Evelyn

    2014-05-01

    To address low contraceptive use in Afghanistan, we supported 2 large public maternity hospitals and 3 private hospitals in Kabul to use modern quality improvement (QI) methods to integrate family planning into postpartum care. In 2012, QI teams comprising hospital staff applied root cause analysis to identify barriers to integrated postpartum family planning (PPFP) services and to develop solutions for how to integrate services. Changes made to service provision to address identified barriers included creating a private counseling space near the postpartum ward, providing PPFP counseling training and job aids to staff, and involving husbands and mothers-in-law in counseling in person or via mobile phones. After 10 months, the proportion of postpartum women who received family planning counseling before discharge in the 5 hospitals increased from 36% to 55%, and the proportion of women who received family planning counseling with their husbands rose from 18% to 90%. In addition, the proportion of postpartum women who agreed to use family planning and left the hospital with their preferred method increased from 12% to 95%. Follow-up telephone surveys with a random sample of women who had received PPFP services in the 2 public hospitals and a control group of postpartum women who had received routine hospital services found significant differences in the proportion of women with self-reported pregnancies: 3% vs. 15%, respectively, 6 months after discharge; 6% vs. 22% at 12 months; and 14% vs. 35% at 18 months (P family planning and postpartum services by testing changes they deemed feasible.

  9. The Relationship between the Level of Religious Attitudes and Postpartum Blues among Pregnant Women

    Directory of Open Access Journals (Sweden)

    Tahereh Mokhtaryan

    2016-04-01

    Full Text Available Postpartum blues, as a transient phenomenon of mood changes, generally begins 1 to 3 days after the child birth.1 This phenomenon is accompanied with symptoms such as unstable moods, ranging from euphoria to sadness, high sensitivity, crying for no reason, restlessness, poor concentration, anxiety, irritability, and anger.2 Prevalence of postpartum blues has been estimated 44.3% in Hong- Kong,3 31.3% in Nigeria,2 and 58% in India.4 In Iran, 22.3% of women suffer from weak postpartum blues, 10.8% have medium, and 21.1% suffer from severe postpartum blues.5 Interaction between different biological, psychological and social factors could affect the postpartum blues.6 Some researchers have indicated that there is a reverse relationship between religion related beliefs and spiritual attitudes, participation in religious activities and reduction of pregnancy and postpartum anxiety and depression.7 Also, according to another study, 57% of the doctors believe that praying could enhance the healing effect of treatment.8 However, some other studies reject this idea.9-10 In this cross-sectional study conducted in selected prenatal clinics of Tehran University of Medical Sciences in 2013, 176 healthy pregnant women aged 18-35 years old participated. For assessment of postpartum blues, standard questionnaire of Edinburg Postnatal Depression Scale (EPDS11 and Religious Attitude Scale (RAS-R containing 25 questions with a Cronbach’s alpha of 0.954 in Iran were used.12

  10. Can we identify mothers at-risk for postpartum anxiety in the immediate postpartum period using the State-Trait Anxiety Inventory?

    Science.gov (United States)

    Dennis, Cindy-Lee; Coghlan, Michelle; Vigod, Simone

    2013-09-25

    This study assessed the stability of maternal anxiety and concordance between State-Trait Anxiety Inventory (STAI) scores in the immediate postpartum period to 8 weeks postpartum. A population-based sample of 522 mothers completed the STAI at 1, 4, and 8 weeks postpartum. Sensitivity, specificity, and predictive power of the 1-week STAI in relation to identifying mothers with elevated STAI scores at 4 and 8 weeks was determined. Predictive power of the STAI was further assessed using odds ratios and receiver operator characteristic (ROC) curves. At 1 week postpartum, 22.6% of mothers scored >40 on the STAI, decreasing to 17.2% at 4 weeks and 14.8% at 8 weeks. Using the cut-off score of >40, the 1-week STAI accurately classified 84.0% mothers at 4 weeks and 83.6% at 8 weeks with or without anxiety symptomatology. The 1-week STAI was significantly correlated to the 4-week (r=0.68, p40 were 15.2 times more likely at 4 weeks (95% CI=8.9-26.1) and 14.0 times more likely at 8 weeks (95% CI=7.9-24.8) to exhibit postpartum anxiety symptomatology. Psychiatric interviews were not completed in collaboration with the STAI and specific types of anxiety disorders were not identified. A cut-off score of >40 on the STAI administered early in the postpartum period is recommended in a 2-phase identification program in order to not miss mothers with postpartum anxiety. © 2013 Elsevier B.V. All rights reserved.

  11. Traditional Belief and Practice on Postpartum Recovery among Mothers in East Coast of Peninsular Malaysia

    Directory of Open Access Journals (Sweden)

    Abdul Ghani Radiah

    2018-01-01

    Full Text Available Postpartum care is highly important to prevent maternal and infant morbidity. In Malaysia, there are several traditional postpartum care practices by mothers. Different states adopted different ways to perform those practices. In spite of long and established practices in Malaysia, its effect and safety profile is not well understood. This study aims to gain an understanding of the traditional practices that Malay women follow in relation to postpartum care and the rationales underpinning such practices. A cross sectional study (n=100 was conducted using self-administered questionnaire consists of demographic information, practice of postpartum care and knowledge of postpartum care. Data was analyzed using Statistical Package Social Software (2.0. The findings shown that, there was no significant association of socio-demographic data with confinement period (p>0.05. For postpartum dietary practice, there were only association between age and encourage more water intake (p=0.047, p<0.05 and also between number of children and prohibit greasy food (p=0.032, p<0.05. For association between socio-demographic data and postpartum physical practice, there was only association between age and body scrub (p=0.046, p<0.05. The most significant factor that influenced postpartum care practice and its knowledge was family tradition with 83% and 97%, respectively. Traditional postpartum care practice is still significant and dominant among mothers in Kuantan, Pahang. This information is important for health care professional to educate women and provide strategies to help them to integrate their beliefs and the practices recommended in contemporary health care practice.

  12. Healthcare Provider Attitudes of Safety of Intrauterine Devices in the Postpartum Period.

    Science.gov (United States)

    Rauh-Benoit, Lisa A; Tepper, Naomi K; Zapata, Lauren B; Whiteman, Maura K; Curtis, Kathryn M; Mandel, Michele G; Marchbanks, Polly A; Jamieson, Denise J

    2017-07-01

    Immediate postpartum intrauterine devices (IUDs) have been underutilized in the United States despite their known safety. Understanding how providers' attitudes contribute to underutilization is important in improving access. Our objective was to examine healthcare providers' perceptions of the safety of immediate postpartum IUDs before publication of United States contraceptive guidelines. We analyzed survey data collected from December 2009 to March 2010 from 635 office-based physicians and 1368 Title X clinic providers (overall response rate of 64.8%). Providers were asked how safe they thought copper and levonorgestrel (LNG) IUDs were in postpartum women (very safe, safe, unsafe, very unsafe, and unsure). Multivariable logistic regression was used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for characteristics associated with considering immediate and delayed postpartum IUDs to be safe. Less than 40% of respondents considered immediate or delayed IUD insertion to be safe. Providers with postpartum IUD insertion to be safe compared with unsafe/unsure (aOR 0.18, 95% CI 0.04-0.84 for copper IUD and aOR 0.17, 95% CI 0.04-0.81 for LNG-IUD). Providers without training in postpartum or interval copper IUD insertion had decreased odds of considering immediate postpartum copper IUD insertion (aOR 0.40, 95% CI 0.16-0.79) and delayed postpartum insertion for both IUD types to be safe (aOR 0.34, 95% CI 0.18-0.66 for copper IUD and aOR 0.41, 95% CI 0.21-0.77 for LNG-IUD). Before United States contraceptive guidelines, a majority of providers perceived immediate postpartum IUDs to be unsafe.

  13. Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism.

    Science.gov (United States)

    Choi, Karmel W; Sikkema, Kathleen J; Vythilingum, Bavi; Geerts, Lut; Faure, Sheila C; Watt, Melissa H; Roos, Annerine; Stein, Dan J

    2017-03-15

    Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. Predictive pathways from maternal childhood trauma to child outcomes, as mediated by postpartum depression, require investigation. A longitudinal sample of South African women (N=150) was followed through pregnancy and postpartum. Measures included maternal trauma history reported during pregnancy; postpartum depression through six months; and maternal-infant bonding, infant development, and infant physical growth at one year. Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children's outcomes. A subset of women (N=33) also participated in a lab-based emotional Stroop paradigm, and their responses to fearful stimuli at six weeks were explored as a potential mechanism linking maternal childhood trauma, postpartum depression, and child outcomes. Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. Limitations included modest sample size, self-report measures, and unmeasured potential confounders. Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes. Perinatal interventions that address maternal trauma histories and depression, as well as underlying affective mechanisms, may help interrupt cycles of disadvantage, particularly in high-trauma settings such as South Africa. Copyright © 2017. Published by Elsevier B.V.

  14. Prenatal and Postpartum Evening Salivary Cortisol Levels in Association with Peripartum Depressive Symptoms

    Science.gov (United States)

    Iliadis, Stavros I.; Comasco, Erika; Sylvén, Sara; Hellgren, Charlotte; Sundström Poromaa, Inger; Skalkidou, Alkistis

    2015-01-01

    Background The biology of peripartum depression remains unclear, with altered stress and the Hypothalamus-Pituitary-Adrenal axis response having been implicated in its pathophysiology. Methods The current study was undertaken as a part of the BASIC project (Biology, Affect, Stress, Imaging, Cognition), a population-based longitudinal study of psychological wellbeing during pregnancy and the postpartum period in Uppsala County, Sweden, in order to assess the association between evening salivary cortisol levels and depressive symptoms in the peripartum period. Three hundred and sixty-five pregnant women from the BASIC cohort were recruited at pregnancy week 18 and instructed to complete a Swedish validated version of the Edinburgh Postnatal Depression Scale at the 36th week of pregnancy as well as the sixth week after delivery. At both times, they were also asked to provide evening salivary samples for cortisol analysis. A comprehensive review of the relevant literature is also provided. Results Women with postpartum EPDS score ≥ 10 had higher salivary evening cortisol at six weeks postpartum compared to healthy controls (median cortisol 1.19 vs 0.89 nmol/L). A logistic regression model showed a positive association between cortisol levels and depressive symptoms postpartum (OR = 4.1; 95% CI 1.7–9.7). This association remained significant even after controlling for history of depression, use of tobacco, partner support, breastfeeding, stressful life events, and sleep problems, as possible confounders (aOR = 4.5; 95% CI 1.5–14.1). Additionally, women with postpartum depressive symptoms had higher postpartum cortisol levels compared to both women with depressive symptoms antenatally and controls (p = 0.019 and p = 0.004, respectively). Conclusions Women with depressive symptoms postpartum had higher postpartum cortisol levels, indicating an altered response of the HPA-axis in postpartum depression. PMID:26322643

  15. Return of ovulation and menses in postpartum nonlactating women: a systematic review.

    Science.gov (United States)

    Jackson, Emily; Glasier, Anna

    2011-03-01

    To estimate, from the literature, when nonlactating postpartum women regain fertility. We searched PubMed and Cochrane Library databases for all articles (in all languages) published in peer-reviewed journals from database inception through May 2010 for evidence related to the return of ovulation and menses in nonlactating postpartum women. Search terms included "Fertility" (Mesh) OR "Ovulation" (Mesh) OR "Ovulation Detection" (Mesh) OR "Ovulation Prediction" (Mesh) OR fertility OR ovulat* AND "Postpartum Period" (Mesh) OR postpartum OR puerperium AND Human AND Female. We included articles assessing nonlactating women's first ovulation postpartum. Studies in which women breastfed for any period of time or in whom lactation was suppressed with medications were excluded. We identified 1,623 articles; six articles reported four studies met our inclusion criteria. In three studies utilizing urinary pregnanediol levels to measure ovulation, mean day of first ovulation ranged from 45 to 94 days postpartum; 20%-71% of first menses were preceded by ovulation and 0%-60% of these ovulations were potentially fertile. In one study that used basal body temperature to measure ovulation, mean first ovulation occurred on day 74 postpartum; 33% of first menses were preceded by ovulation and 70% of these were potentially fertile. Most nonlactating women will not ovulate until 6 weeks postpartum. A small number of women will ovulate earlier, potentially putting them at risk for pregnancy sooner, although the fertility of these early ovulations is not well-established. The potential risk of pregnancy soon after delivery underscores the importance of initiating postpartum contraception in a timely fashion.

  16. A STUDY OF THE VARIED AETIOLOGY AND CLINICAL PRESENTATION OF NEW ONSET SEIZURES IN POSTPARTUM PERIOD

    Directory of Open Access Journals (Sweden)

    Ravindra Kumar Sudarsi

    2016-08-01

    Full Text Available BACKGROUND Seizures in the postpartum period are the major cause of mortality and morbidity. A variety of neurological disorders causing seizures may be encountered during pregnancy and puerperium. These disorders may be unrelated to pregnancy (e.g. Meningitis or peculiar to pregnancy (e.g. Eclampsia or. Pregnancy may affect the course of the pre-existing neurological disorders such as epilepsy. So, keeping in mind the varied aetiology of postpartum seizures and its response to appropriate treatment, our study has been conducted to find out the most common causes in our setup to guide the optimal therapy. AIM OF THE STUDY To study the varied aetiology and clinical presentation of new onset seizures in the postpartum period over a period of two years. MATERIALS AND METHODS 50 patients who developed first episode of seizures in postpartum period (that is after delivery to 6 weeks admitted to Osmania General Hospital on random selection. All women complaining of new onset seizure with in postpartum period up to 6 weeks. All those women who are known epileptics and who had seizures in the antenatal period were excluded from the study. The selected patients were studied in detail with history and physical examination. RESULTS Different causes for first episode of seizures in postpartum period are enlisted here. Cavernous sinus thrombosis in 17 patients, late postpartum eclampsia accounted for 13 patients, intracranial haemorrhage in 6 patients, ischaemic stroke in 5 patients, posterior reversible encephalopathy syndrome in 4 patients, CNS infections in 6 patients, glioma in 1 patient, viral hepatitis in one patient, idiopathic in 3 patients. CONCLUSIONS Cavernous sinus thrombosis and late postpartum eclampsia constitute the major aetiology of first onset of seizes occurring in the postpartum period.

  17. Stress response in postpartum women with and without obsessive–compulsive symptoms: an fMRI study

    Science.gov (United States)

    Lord, Catherine; Steiner, Meir; Soares, Claudio N.; Carew, Caitlin L.; Hall, Geoffrey B.

    2012-01-01

    Background During the postpartum period, some women might be under a considerable amount of stress and at increased risk for onset or exacerbation of obsessive–compulsive disorder (OCD). Little is known about the stress response correlates during the postpartum period and in patients with OCD. This study aimed to examine the cerebral, psychologic and endocrine correlates of the stress response in patients with OCD and during the postpartum period. Methods Women with postpartum OCD, healthy postpartum women and healthy mothers past the postpartum period underwent functional magnetic resonance imaging while facing a reliable psychosocial stressor (the Montreal Imaging Stress Task). Stress-related psychologic and endocrine responses (i.e., cortisol) were obtained. Results We enrolled 12 women with postpartum OCD, 16 healthy postpartum women and 11 healthy mothers past the postpartum period in our study. Compared with healthy postpartum counterparts, postpartum women with OCD had a heightened self-reported and endocrine stress response associated with a distinct brain activation pattern in response to psychosocial stress involving the orbitofrontal and temporal cortices. Moreover, compared with mothers assessed in a period of time beyond the postpartum period, healthy postpartum women did not differ in psychologic and cortisol response to stress, but recruited different brain regions, such as the dorsolateral pre-frontal cortex and the anterior cingulate cortex, during exposure to stress. Limitations Potential confounding factors, such as medication use, breastfeeding, parity and personality factors, may have modulated the stress-related endocrine response and could not be assessed in this study. Conclusion Obsessive–compulsive disorder and the postpartum period differentially influence the brain circuitry underlying psychosocial stress as well as the psychologic and endocrine responses. PMID:22122779

  18. Posterior reversible encephalopathy with late postpartum eclampsia and short-term memory loss: a case report.

    Science.gov (United States)

    Gimovsky, Martin L; Guzman, Guillermo M; Koscica, Karen L; Nazir, Munir A; Ross, Diane E

    2010-01-01

    Late postpartum eclampsia is more frequently recognized than past reports indicate. This report describes the association of a reversible encephalopathy in a woman with late postpartum eclampsia. A woman with lupus nephritis presented 7 days postpartum with eclampsia. Postseizure findings included dramatic short-term memory loss. Although a computed tomography scan was negative, subsequent magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) demonstrated vascular changes associated with a reversible encephalopathy. Conservative treatment with analeptic and antihypertensive therapy allowed a rapid resolution of all symptomatology. In women with eclampsia and unusual neurologic findings, an MRI/MRA may be useful even in the presence of a negative computed tomography scan.

  19. 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.

  20. Effect of propylene glycol on adipose tissue mobilization in postpartum over-conditioned Holstein cows

    DEFF Research Database (Denmark)

    Bjerre-Harpøth, Vibeke; Storm, Adam Christian; Eslamizad, M

    2015-01-01

    Our objective was to investigate the quantitative and qualitative effects of propylene glycol (PG) allocation on postpartum adipose tissue mobilization in over-conditioned Holstein cows. Nine ruminally cannulated and arterially catheterized cows were, at parturition, randomly assigned to a ruminal...... from –7 to 7 DIM. Postpartum feed intake and milk yield was not affected by PG allocation. The body content of lipid was not affected by treatment, but tended to decrease from 4 to 29 DIM with both treatments. Except for the first week postpartum, no difference in plasma nonesterified fatty acids...