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BMC Anesthesiology Jul 2023Labor pain intensity is known to predict persistent postpartum pain, whereas acute postpartum pain may interfere with maternal postpartum physical, mental, and emotional... (Clinical Trial)
Clinical Trial
BACKGROUND
Labor pain intensity is known to predict persistent postpartum pain, whereas acute postpartum pain may interfere with maternal postpartum physical, mental, and emotional well-being. Nevertheless, there is little research studying the association between labor pain intensity and acute postpartum pain. This study investigated the associations between labor pain intensity and psychological factors with acute postpartum pain.
METHODS
We included women with American Society of Anesthesiologists (ASA) physical status II, having ≥ 36 gestational weeks and a singleton pregnancy. We investigated the association between labor pain intensity (primary exposure) and high acute postpartum pain at 0 to 24 h after delivery (Numeric Rating Scale (NRS) ≥ 3 of 10; primary outcome). Pre-delivery questionnaires including Angle Labor Pain Questionnaire (A-LPQ), Pain Catastrophizing Scale (PCS), Fear Avoidance Components Scale (FACS) and State Trait Anxiety Inventory (STAI) were administered. Demographic, pain, obstetric and neonatal characteristics were also collected accordingly.
RESULTS
Of the 880 women studied, 121 (13.8%) had high acute postpartum pain at 0 to 24 h after delivery. A-LPQ total, PCS, FACS and STAI scores were not significantly associated with acute postpartum pain. Greater A-LPQ subscale on birthing pain (adjusted odds ratio (aOR) 1.03, 95% CI 1.01-1.05, p = 0.0008), increased blood loss during delivery (for every 10ml change; aOR 1.01, 95% CI 1.00-1.03, p = 0.0148), presence of shoulder dystocia (aOR 10.06, 95% CI 2.28-44.36, p = 0.0023), and use of pethidine for labor analgesia (aOR 1.74, 95% CI 1.07-2.84, p = 0.0271) were independently associated with high acute postpartum pain. "Sometimes" having nausea during menstruation before current pregnancy (aOR 0.34, 95% CI 0.16-0.72, p = 0.0045) was found to be independently associated with reduced risk of high acute postpartum pain.
CONCLUSIONS
Pre-delivery pain factor together with obstetric complications (shoulder dystocia, blood loss during delivery) were independently associated with high acute postpartum pain.
TRIAL REGISTRATION
This study was registered on clinicaltrials.gov registry (NCT03167905) on 30/05/2017.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Cohort Studies; Labor, Obstetric; Pain; Postpartum Period; Shoulder Dystocia
PubMed: 37491196
DOI: 10.1186/s12871-023-02214-w -
Clinical Case Reports Oct 2023Schistosomus reflexus (SR), an unusual congenital defect in calves, can be diagnosed grossly by exposed viscera and curved spine with hindquarters twisted up toward the...
KEY CLINICAL MESSAGE
Schistosomus reflexus (SR), an unusual congenital defect in calves, can be diagnosed grossly by exposed viscera and curved spine with hindquarters twisted up toward the head. SR is typically associated with dystocia and fetal deaths in cows. Hence, cattle breeding programs must be aware of these anomalies to avoid losses from abnormal, non-viable calves.
ABSTRACT
Schistosomus reflexus (SR) is a rare and fatal congenital malformation in bovines from autosomal recessive disorders. We report a typical case of SR in a non-viable calf after the cesarean section of a crossbred Friesian cow. It was characterized by the inversion of the spinal column and a pronounced ventral curvature causing the cranium to be positioned near the sacrum and tail, along with exposed thoracic and abdominal viscera, limb ankylosis, and tongue protrusion. The postoperative management of the cow, along with the outcome, is also described here.
PubMed: 37808575
DOI: 10.1002/ccr3.8009 -
Animals : An Open Access Journal From... May 2024This study aimed to assess the relationship between the length of the dry period (DL) and the risks of dystocia and stillbirths in Holstein cows. A total of 1072 healthy...
This study aimed to assess the relationship between the length of the dry period (DL) and the risks of dystocia and stillbirths in Holstein cows. A total of 1072 healthy cows in lactations 1 and ≥2 were categorized based on the DL (mean: 58.07 ± 0.33 days) into three groups: short DL (<40 days; 13.0% of cows), medium DL (40-70 days; 60.1%), and long DL (>70 days; 26.9%). Dystocia occurred in 12.4% of cows, while stillbirths accounted for 4.1% of calves. The medium DL group had the highest number of unassisted calvings. The dystocia rates were 11.4% for cows with gestation (GA) ≤ 274 days; 6.0% for cows with GA = 275-282 days; and 19.9% for cows with GA ≥ 283 days ( < 0.001). In season 1 (November-April), dystocia occurred in 15.0% of cases compared to 8.8% in season 2 (May-October) ( < 0.001). The stillbirth rates ranged from 3.6% to 4.0% for cows with medium and long DLs; while those with a short DL had 5.8% ( < 0.05). The stillbirth rates were 5.2% for cows with GA ≤ 274 days; 3.2% for cows with GA = 275-282 days; and 5.1% for cows with GA ≥ 283 days ( < 0.001). Season 1 had a stillbirth rate of 4.8%, while season 2 had a stillbirth rate of 3.3% ( < 0.001). This research provides insights that could assist the dairy industry in making informed decisions to reduce the incidence rates of dystocia and stillbirths in cows.
PubMed: 38791662
DOI: 10.3390/ani14101444 -
BMC Pregnancy and Childbirth May 2024Australian Aboriginal and Torres Strait Islander women with diabetes in pregnancy (DIP) are more likely to have glycaemic levels above the target range, and their babies...
BACKGROUND
Australian Aboriginal and Torres Strait Islander women with diabetes in pregnancy (DIP) are more likely to have glycaemic levels above the target range, and their babies are thus at higher risk of excessive fetal growth. Shoulder dystocia, defined by failure of spontaneous birth of fetal shoulder after birth of the head requiring obstetric maneuvers, is an obstetric emergency that is strongly associated with DIP and fetal size. The aim of this study was to investigate the epidemiology of shoulder dystocia in Aboriginal babies born to mothers with DIP.
METHODS
Stratifying by Aboriginal status, characteristics of births complicated by shoulder dystocia in women with and without DIP were compared and incidence and time-trends of shoulder dystocia were described. Compliance with guidelines aiming at preventing shoulder dystocia in women with DIP were compared. Post-logistic regression estimation was used to calculate the population attributable fractions (PAFs) for shoulder dystocia associated with DIP and to estimate probabilities of shoulder dystocia in babies born to mothers with DIP at birthweights > 3 kg.
RESULTS
Rates of shoulder dystocia from vaginal births in Aboriginal babies born to mothers with DIP were double that of their non-Aboriginal counterparts (6.3% vs 3.2%, p < 0.001), with no improvement over time. Aboriginal mothers with diabetes whose pregnancies were complicated by shoulder dystocia were more likely to have a history of shoulder dystocia (13.1% vs 6.3%, p = 0.032). Rates of guideline-recommended elective caesarean section in pregnancies with diabetes and birthweight > 4.5 kg were lower in the Aboriginal women (28.6% vs 43.1%, p = 0.004). PAFs indicated that 13.4% (95% CI: 9.7%-16.9%) of shoulder dystocia cases in Aboriginal (2.7% (95% CI: 2.1%-3.4%) in non-Aboriginal) women were attributable to DIP. Probability of shoulder dystocia among babies born to Aboriginal mothers with DIP was higher at birthweights > 3 kg.
CONCLUSIONS
Aboriginal mothers with DIP had a higher risk of shoulder dystocia and a stronger association between birthweight and shoulder dystocia. Many cases were recurrent. These factors should be considered in clinical practice and when counselling women.
Topics: Adult; Female; Humans; Infant, Newborn; Pregnancy; Young Adult; Australia; Birth Weight; Cohort Studies; Diabetes, Gestational; Incidence; Pregnancy in Diabetics; Risk Factors; Shoulder Dystocia; Australian Aboriginal and Torres Strait Islander Peoples
PubMed: 38816708
DOI: 10.1186/s12884-024-06484-1 -
Veterinary Parasitology Nov 2023We present a fixed-dose combination injectable (FDCI) solution for cattle formulated for a single subcutaneous administration at a dose rate of 1 ml/25 kg of body...
We present a fixed-dose combination injectable (FDCI) solution for cattle formulated for a single subcutaneous administration at a dose rate of 1 ml/25 kg of body weight to deliver a dose of 0.2 mg/kg of doramectin and 6.0 mg/kg of levamisole hydrochloride (5.1 mg/kg base equivalent). This drug product is marketed in the United States under the tradename Valcor® and in Australia and New Zealand under the tradename Dectomax V®. Both levamisole and doramectin have histories of safe and effective use in ruminants, with safety margins of 3X and 25X, respectively. Three studies were conducted to demonstrate the safety of the new FDCI: margin of safety (Study 1), and reproductive safety in sexually nulliparous beef heifers (Studies 2 and 3). In Study 1, 3-month-old sexually intact male and female calves were given either saline (control) or 1X, 2X, or 3X FDCI on Days 0, 14, and 28. General health, clinical, and neurological observations were made throughout the study, and clinical and pathology evaluations were made at study end. Studies 2 and 3 demonstrated the reproductive safety of the FDCI on sexually nulliparous beef heifers using estrus synchronization and timed artificial insemination. Treatments of either saline (control) or 3X FDCI were administered to coincide with either folliculogenesis, implantation, organogenesis, early gestation, or late gestation. Reproductive safety was demonstrated by evaluating rates of conception, calving, abortion, and stillbirth, dystocia scores, and calf health. In all studies, the FDCI at 1X, 2X, or 3X dosages was well tolerated. In the margin of safety study, 3X calves showed increased incidence of salivation for up to 8 h post-dosing compared to other groups. Injection sites were palpable post-dosing in all three FDCI groups but resolved by Day 28 in all but one animal each in 2X and 3X. In the reproductive safety studies, the FDCI had no effect on conception, pregnancy, fetal development, or postnatal viability. Injection site swelling was increased in frequency and duration compared to controls. The studies demonstrate the safety of the new FDCI in cattle from 3 months of age and in reproducing heifers during all reproductive stages from folliculogenesis through gestation and up to a month post-partum.
Topics: Animals; Cattle; Pregnancy; Female; Male; Levamisole; Reproduction; Ivermectin; Body Weight; Insemination, Artificial
PubMed: 37951737
DOI: 10.1016/j.vetpar.2023.110071 -
JDS Communications Sep 2023The onset of lactation and the subsequent habituation to the milking routine is a stressful period, particularly for primiparous (PRI) cows. The objective of this study...
The onset of lactation and the subsequent habituation to the milking routine is a stressful period, particularly for primiparous (PRI) cows. The objective of this study was to describe the dynamics of milking unit kick-off (KO) behavior in PRI cows during the first 3 mo of lactation, considering multiparous (MUL) cows as a reference for comparison. In addition, the potential associations between KO and milk yield and mastitis presentation were investigated. A total of 869 cows (PRI = 199; MUL = 670) on a dairy farm in northern CO were included in the analysis. Cows calving between August and November 2020 were enrolled from 3 DIM until 90 DIM. Participants were milked 3×/day in a 60-unit rotary parlor and data from each milking session were downloaded from parlor management software. Milking unit kick-off was used as a proxy for habituation to the milking procedure. Kick-off events were reported by the milking system and defined as an abrupt interruption in the milk flow during the milking process. Cow KO events were recorded for each milking session. Subsequently, occurrence of KO was analyzed by grouping the 3 consecutive milking sessions in each day and categorized as yes or no, indicating whether or not an individual kicked at least once in a given day. Data were analyzed by repeated measures ANOVA and logistic regression, including parity category, calving season, occurrence of dystocia, and their potential interactions in the models. Least squares means for daily proportions of KO were calculated considering the number of cows with KO events per day in the PRI and MUL categories. Subsequently, odds ratios for the occurrence of KO in PRI versus MUL were calculated at multiple periods of time. When KO was analyzed by DIM, proportions of KO were greater in PRI than in MUL during the whole monitoring period. In PRI, proportions of KO increased from 0.10/d to 0.20/d between 3 DIM and 15 DIM, to start decreasing around 30 DIM and remaining above MUL up to 90 DIM. On the contrary, in MUL cows, proportions of KO remained close to 0.05/d during the 90-d period. Overall, the odds of KO were greater for PRI versus MUL cows (odds ratio [95% confidence interval] = 2.07 [1.58-2.73]). No differences in milk yield were established among KO categories, while the percentage of cows affected with mastitis was greater in cows grouped in the quartile with more frequent KO events. We concluded that the relationship between days in milk and the proportion of PRI cows displaying KO was not linear, but rather KO increased during the first 2 wk postpartum before decreasing after the first month of lactation. First-parity cows had greater levels of KO than MUL cows, which is most likely associated with the process of habituation to milking during their first lactation.
PubMed: 37727250
DOI: 10.3168/jdsc.2023-0384 -
Journal of Veterinary Internal Medicine 2023Colostral immunoglobulin G (IgG) concentration is critical to the attainment of adequate transfer of passive immunity in cattle, however, studies comparing available...
BACKGROUND
Colostral immunoglobulin G (IgG) concentration is critical to the attainment of adequate transfer of passive immunity in cattle, however, studies comparing available tools for measurement of colostral IgG concentration in beef cattle are limited.
OBJECTIVES
To report the agreement between 3 commercially available tests for evaluating IgG concentration in beef colostrum.
ANIMALS
Two hundred six beef-breed cows hospitalized for calving management or dystocia.
METHODS
Retrospective study to assess IgG of whole colostrum measured stall-side via turbidimetric immunoassay (TI) and brix refractometry (BRIX), compared to fat separated (FS) analysis via single radial-immunodiffusion (RID; reference standard), TI-FS and BRIX-FS. Test performance was assessed using Passing Bablock regression, Bland-Altman analysis, and area under the curve to determine optimal thresholds.
RESULTS
Correlation between RID and TI-FS, BRIX-FS, or BRIX was similar (Spearman's ρ = 0.717, 0.715, 0.716, respectively) but correlation for TI was poor (ρ = 0.586). Regression analysis identified a substantial constant (-214.75 [CI: -272.03 to -178.07]) and proportional (13.24 [CI: 11.81-15.37]) bias between the RID and TI-FS which was similar for TI. TI-FS concentrations of 28.47, 38.75, and 50.62 g/L, BRIX-FS of ≤21.9%, ≤24.0%, and ≤27.4%, and BRIX of ≤21.3%, ≤23.8%, and ≤26.4% indicated IgG concentrations <50, <100, and <150 g/L, respectively; appropriate cutoffs for TI could not be generated.
CONCLUSIONS AND CLINICAL IMPORTANCE
Both TI and TI-FS demonstrated a large constant and proportional bias compared to RID; BRIX and BRIX-FS were well correlated with RID and remain a reliable method for estimation of colostral IgG concentration in beef cattle.
Topics: Pregnancy; Female; Animals; Cattle; Colostrum; Refractometry; Retrospective Studies; Immunoglobulin G; Immunoassay; Immunodiffusion; Animals, Newborn
PubMed: 37596893
DOI: 10.1111/jvim.16833 -
Veterinary Research Forum : An... 2024The interval between parturition and subsequent pregnancy is called the days open or calving to conception interval and is affected by several factors, especially...
The interval between parturition and subsequent pregnancy is called the days open or calving to conception interval and is affected by several factors, especially dystocia. Dystocia is an ab-normal or difficult calving that may require assistance during labor. This study is a field trial in health education and the research team developed a comprehensive training program for farmers to educate them about the normal process of parturition in dairy cows and when and how to assist in parturition or dystocia. A series of classes was held for farmers and the study covered 486 multi-parous dairy cows, with 173 belonging to the group of trained farms (educated farmers) and 313 to the control group (non-educated farmers). Although dystocia was lower in the educated group, there were no significant differences in retained placenta between two groups. However, cows in the educated group had a better conception rate (lower service conception) in sub-sequent parturitions. Hence, the median number of days open for cows from trained farmers was significantly lower than other farmers (85 days compared to 120 days, respectively). Based on Cox regression analysis, uterine prolapse, retained placenta, and dystocia could significantly impact subsequent pregnancies. Dystocia affects days open, and training on parturition and dystocia management can effectively reduce the numbers of days open in dairy cows.
PubMed: 38770379
DOI: 10.30466/vrf.2023.2007348.3945 -
Veterinary World Dec 2023Mineral deficiencies can lead to dystocia and abnormalities in neonates. Stillbirth of neonatal calves in dairy cows due to dystocia has become an economic problem....
BACKGROUND AND AIM
Mineral deficiencies can lead to dystocia and abnormalities in neonates. Stillbirth of neonatal calves in dairy cows due to dystocia has become an economic problem. Uterine torsion (UT) is a common form of dystocia observed in dairy cows. However, to the best of our knowledge, there have been no reports on the characteristics of serum trace element concentrations in dairy cows with UT. This study aimed to comprehensively measure serum trace element concentrations in dairy cows with UT and dystocia.
MATERIALS AND METHODS
Dairy cows with (n = 15) and without (n = 27) UT and neonates (n = 9 and n = 26, respectively) were included in this study. Blood samples (10 mL) were collected, and serum trace element concentrations were evaluated using inductively coupled plasma mass spectrophotometry.
RESULTS
The mortality rate at birth was significantly higher in calves delivered by cows with UT than those delivered by cows without UT. The odds ratio for mortality rate at birth in dairy cows with UT was 7.85. Serum zinc (Zn) levels were significantly lower in cows with UT than in cows without UT (p = 0.01). The copper: Zn ratio was significantly higher in cows with UT than in cows without torsion (p = 0.05). In contrast, serum Cobalt (Co) concentrations were significantly higher in neonates from cows with UT than in neonates from cows without UT (p = 0.01).
CONCLUSION
Uterine torsion is associated with a high mortality rate at birth and considerable economic losses. Cows with UT had low serum Zn levels, and neonates born to these cows had high serum Co levels.
PubMed: 38328366
DOI: 10.14202/vetworld.2023.2533-2537 -
The Journal of Maternal-fetal &... Dec 2023This study aims to analyze the risk factors associated with different degrees of postpartum hemorrhage in patients with pregnancy-induced hypertension and construct a...
Analysis of risk factors associated with different degrees of postpartum hemorrhage in patients with pregnancy-induced hypertension and construction of a prediction model using line graph.
OBJECTIVE
This study aims to analyze the risk factors associated with different degrees of postpartum hemorrhage in patients with pregnancy-induced hypertension and construct a prediction model using line graph.
METHODS
The patients who were treated in our hospital for pregnancy-induced hypertension from January 2021 to December 2022 were enrolled as the study subjects. Their clinical data were collected, and the risk factors associated with postpartum hemorrhage in patients with pregnancy-induced hypertension were analyzed by single-factor and multi-factor logistic regression. The nomogram prediction model was constructed and validated internally, and the discrimination and consistency of the model were verified by the ROC curve and calibration graph.
RESULTS
In this experiment, 125 out of the 482 patients with hypertensive disorder complicating pregnancy experienced different degrees of postpartum hemorrhage, with an incidence of 25.93%. Multivariate Logistic regression analysis showed that patients with severe disease (OR = 2.454), the degree of proteinuria +++ or ++++ (OR = 6.754, 7.206), fetal body mass ≥4000 g (OR = 5.972), uterine atony (OR = 11.789), abnormal HDL-C (OR = 3.174), abnormal LDL-C (OR = 8.812), and abnormal VEGF (OR = 7.702) had a higher risk of postpartum hemorrhage ( < .05). The risk of postpartum hemorrhage was lower in patients with onset gestational week ≥28 weeks (OR = 0.158, 0.025) and delivery gestational week ≥28 weeks (OR = 0.085, 0.152) ( < .05). Columnar line graph models for postpartum hemorrhage in patients with gestational hypertension were constructed based on nine independent risk factors, and the model differentiation (AUC 0.912 and 0.919, respectively) and precision (goodness of fit HL = 8.441, = .392, = 7.741, = .459) were better in the modeling and validation groups.
CONCLUSION
The severity of disease, the gestational week upon onset, the gestational week upon delivery, the degree of proteinuria, systolic blood pressure, diastolic blood pressure, uterine atony, HDL-C, LDL-C, VEGF are factors affecting the incidence of postpartum hemorrhage in patients with hypertensive disorder complicating pregnancy. The prediction model based on the above factors can accurately evaluate the risk of different degrees of postpartum hemorrhage in patients with hypertensive disorder complicating pregnancy.
Topics: Pregnancy; Female; Humans; Hypertension, Pregnancy-Induced; Postpartum Hemorrhage; Uterine Inertia; Cholesterol, LDL; Vascular Endothelial Growth Factor A; Risk Factors; Retrospective Studies
PubMed: 37558281
DOI: 10.1080/14767058.2023.2239983