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Frontiers in Physiology 2024Parturition in dogs is subjected to complex hormonal regulation, with the involvement of prostaglandin F2α (PGF2α) still not fully understood. To investigate uterine...
Parturition in dogs is subjected to complex hormonal regulation, with the involvement of prostaglandin F2α (PGF2α) still not fully understood. To investigate uterine inertia (UI), the most prevalent maternal reason for dystocia in the bitch, a better understanding of undisturbed uterine, especially myometrial function, is crucial. Our aim was to gain deeper insights into the role of PGF2α in the canine parturient myometrium. Uterine biopsies were obtained during medically indicated cesarean sections. To test for stimulatory effects of PGF2α , circular and longitudinal myometrial layer tissue strips were challenged with 50 pM, 0.5 µM, and 50 µM PGF2α. 2 () and () mRNA expressions were compared between primary UI (PUI) and obstructive dystocia (OD) samples in isolated parturient myometrium. PTGFR protein expression was assessed in full thickness uterine samples. PGF2α concentrations were analyzed in canine interplacental tissue around term. In the organ bath, the contractile response to PGF2α was limited to the circular layer at the highest dosage. Correspondingly, PTGFR immunohistochemical staining was significantly stronger in the circular layer ( ≤ 0.01). gene expression did not differ between PUI and OD, whereas gene expression could not be quantified. Local uterine PGF2α concentrations correlated negatively with serum P4 levels and were the highest during prepartum luteolysis while being significantly lower in PUI. Conclusively, despite the significant increase in local PGF2α concentrations at birth, confirming the interplacental tissue as a production site, our results suggest that PGF2α might affect uterine contractility during labor, mainly indirectly.
PubMed: 38863475
DOI: 10.3389/fphys.2024.1392080 -
Archives of Gynecology and Obstetrics Apr 2024Shoulder dystocia is an obstetric emergency with severe complications. Our objective was to evaluate the major pitfalls in the diagnostics of shoulder dystocia,...
PURPOSE
Shoulder dystocia is an obstetric emergency with severe complications. Our objective was to evaluate the major pitfalls in the diagnostics of shoulder dystocia, diagnostic descriptions documented in medical records, use of obstetric maneuvers, and their correlations to Erb's and Klumpke's palsy and the use of ICD-10 code 066.0.
METHODS
A retrospective, register-based case-control study included all deliveries (n = 181 352) in Hospital District of Helsinki and Uusimaa (HUS) area in 2006-2015. Potential shoulder dystocia cases (n = 1708) were identified from the Finnish Medical Birth Register and the Hospital Discharge Register using ICD-10 codes O66.0, P13.4, P14.0, and P14.1. After thorough assessment of all medical records, 537 shoulder dystocia cases were confirmed. Control group consisted of 566 women without any of these ICD-10 codes.
RESULTS
The pitfalls in the diagnostic included suboptimal following of guidelines for making the diagnosis of shoulder dystocia, subjective interpretation of diagnostic criteria, and inexact or inadequate documentation in medical records. The diagnostic descriptions in medical record were highly inconsistent. The use of obstetric maneuvers was suboptimal among shoulder dystocia cases (57.5%). Overall, the use of obstetric maneuvers increased during the study period (from 25.7 to 97.0%, p < 0.001), which was associated with decreasing rate of Erb's palsy and increasing use of ICD-10 code O66.0.
CONCLUSION
There are diagnostic pitfalls, which could be addressed by education regarding shoulder dystocia guidelines, by improved use obstetric maneuvers, and more precise documentation. The increased use of obstetric maneuvers was associated with lower rates of Erb's palsy and improved coding of shoulder dystocia.
Topics: Pregnancy; Female; Humans; Dystocia; Shoulder Dystocia; Retrospective Studies; Case-Control Studies; Brachial Plexus Neuropathies; Shoulder; Delivery, Obstetric
PubMed: 37010615
DOI: 10.1007/s00404-023-07022-8 -
Animal Bioscience Jan 2024The present study was performed to determine risk factors associated with the frequency of farrowing assistance in hyperprolific sows in a tropical environment and to...
OBJECTIVE
The present study was performed to determine risk factors associated with the frequency of farrowing assistance in hyperprolific sows in a tropical environment and to investigate the impacts of farrowing assistance on piglet colostrum consumption and sow colostrum yield.
METHODS
Farrowing data from 352 Landrace×Yorkshire crossbred sows and 5,554 piglets in five commercial swine herds in Thailand were investigated. The sows were classified according to parity numbers: 1 (n = 72), 2 to 4 (n = 128), 5 to 6 (n = 84), and ≥7 (n = 68) and the total number of piglets born per litter (TB): 10 to 13 (n = 90), 14 to 16 (n = 117), and ≥17 (n = 145). The incidence of farrowing assistance and associated parameters were investigated.
RESULTS
The TB and farrowing duration averaged 15.8±0.2 and 279.9±11.2 min, respectively. The percentage of sows that required farrowing assistance was 29.8% and varied among herds from 5.7% to 53.3% (p<0.001). The percentage of piglets born after birth assistance using manual intervention was 8.4%. Sows with parity numbers 1 and 2 to 4 had a lower frequency of farrowing assistance than sows with parity numbers ≥7 (p<0.01). The colostrum yield of sows that required farrowing assistance did not differ from sows that farrowed without assistance (5.3±0.2 and 5.1±0.1 kg; p = 0.288); however, the colostrum consumption of piglets born from sows that required farrowing assistance was lower than those born from sows that farrowed without assistance (302.2±15.7 and 354.2±5.6 g; p<0.001). Blood oxygen saturation of the piglets born after birth assistance tended to be lower than the piglets that farrowed without birth assistance (87.8%±1.3% vs 90.4%±0.4%; p = 0.054).
CONCLUSION
The frequency of farrowing assistance in sows varied among herds and was influenced by parity number. The piglets born after receiving birth assistance should receive special care to improve their blood oxygen saturation and enhance colostrum intake.
PubMed: 37654166
DOI: 10.5713/ab.23.0169 -
Journal of Dairy Science Dec 2023Gains through breeding can be achieved through a combination of both between-breed and within-breed selection. Two suites of traits of particular interest to dairy...
Gains through breeding can be achieved through a combination of both between-breed and within-breed selection. Two suites of traits of particular interest to dairy producers when selecting beef bulls for mating to dairy females are calving-related attributes and the expected value of the subsequent calf, the latter usually being a function of expected carcass value. Estimated breed effects can be informative, particularly in the absence of across-breed genetic evaluations. The objective of the present study was to use a large national database of the progeny from beef-on-dairy matings to estimate the mean breed effects of the used beef sires. Calving performance (i.e., gestation length, calving difficulty score, and perinatal morality) as well as calf value were investigated; a series of slaughter-related traits (i.e., carcass metrics and age at slaughter) of the prime progeny were also investigated. Phenotypic data on up to 977,037 progeny for calving performance, 79,903 for calf price and 103,175 for carcass traits (including dairy × dairy progeny for comparative purposes) were used; sire breeds represented were Holstein-Friesian, Angus, Aubrac, Belgian Blue, Charolais, Hereford, Limousin, Salers, and Simmental. Large interbreed differences existed. The mean gestation length of male calves from beef sires varied from 282.3 d (Angus) to 287.4 d (Limousin) which were all longer than the mean of 280.9 d for Holstein-Friesian sired male calves. Relative to a Holstein-Friesian sire, the odds of dystocia varied from 1.43 (Angus) to 4.77 (Belgian Blue) but, once adjusted for both the estimated maternal genetic merit of the dam and direct genetic merit of the calf for calving difficulty, the range in odds ratios shrunk. A difference of €125.4 existed in calf sale price between the progeny of the different beef breeds investigated which represented over twice the residual standard deviation in calf price within the day of sale-Angus was the cheapest while Charolais calves were, on average, the most expensive calves. Mean carcass weight of steers, not adjusted for age at slaughter or carcass fat, varied from 327.1 kg (Angus) to 363.2 kg (Belgian Blue) for the beef breeds with the mean carcass weight of Holstein-Friesian steer progeny being 322.4 kg. Belgian Blues had, on average, the best carcass conformation with the Herefords and Angus having the worst of all beef breeds. Angus and Hereford steers were slaughtered the youngest of all beef breeds but just 9 d younger than the average of all other beef breeds yet 24 d younger than Holstein-Friesian sired progeny. Clear breed differences in calving and carcass performance exist among beef breeds mated to dairy females. Those breeds excelling in calving performance were not necessarily the best for carcass merit.
Topics: Pregnancy; Female; Cattle; Animals; Male; Reproduction; Parturition; Phenotype; Commerce; Cell Communication; Body Weight
PubMed: 37641315
DOI: 10.3168/jds.2023-23632 -
BMC Pregnancy and Childbirth Jun 2024Peripartum asphyxia is one of the main causes of neonatal morbidity and mortality. In moderate and severe cases of asphyxia, a condition called hypoxic-ischemic...
BACKGROUND
Peripartum asphyxia is one of the main causes of neonatal morbidity and mortality. In moderate and severe cases of asphyxia, a condition called hypoxic-ischemic encephalopathy (HIE) and associated permanent neurological morbidities may follow. Due to the multifactorial etiology of asphyxia, it may be difficult prevent, but in term neonates, therapeutic cooling can be used to prevent or reduce permanent brain damage. The aim of this study was to assess the significance of different antenatal and delivery related risk factors for moderate and severe HIE and the need for therapeutic hypothermia.
METHODS
We conducted a retrospective matched case-control study in Helsinki University area hospitals during 2013-2017. Newborn singletons with moderate or severe HIE and the need for therapeutic hypothermia were included. They were identified from the hospital database using ICD-codes P91.00, P91.01 and P91.02. For every newborn with the need for therapeutic hypothermia the consecutive term singleton newborn matched by gender, fetal presentation, delivery hospital, and the mode of delivery was selected as a control. Odds ratios (OR) between obstetric and delivery risk factors and the development of HIE were calculated.
RESULTS
Eighty-eight cases with matched controls met the inclusion criteria during the study period. Maternal and infant characteristics among cases and controls were similar, but smoking was more common among cases (aOR 1.46, CI 1.14-1.64, p = 0.003). The incidence of preeclampsia, diabetes and intrauterine growth restriction in groups was equal. Induction of labour (aOR 3.08, CI 1.18-8.05, p = 0.02) and obstetric emergencies (aOR 3.51, CI 1.28-9.60, p = 0.015) were more common in the case group. No difference was detected in the duration of the second stage of labour or the delivery analgesia.
CONCLUSIONS
Smoking, induction of labour and any obstetric emergency, especially shoulder dystocia, increase the risk for HIE and need for therapeutic hypothermia. The decisions upon induction of labour need to be carefully weighed, since maternal smoking and obstetric emergencies can hardly be controlled by the clinician.
Topics: Humans; Hypoxia-Ischemia, Brain; Female; Infant, Newborn; Hypothermia, Induced; Case-Control Studies; Risk Factors; Pregnancy; Retrospective Studies; Male; Adult; Asphyxia Neonatorum; Finland; Delivery, Obstetric
PubMed: 38867160
DOI: 10.1186/s12884-024-06596-8 -
PloS One 2024Neonatal birth trauma, although it has steadily decreased in industrialized nations, constitutes a significant health burden in low-resource settings. Keeping with this,... (Meta-Analysis)
Meta-Analysis
Neonatal birth trauma, although it has steadily decreased in industrialized nations, constitutes a significant health burden in low-resource settings. Keeping with this, we sought to determine the pooled cumulative incidence (incidence proportion) of birth trauma and identify potential contributing factors in low and middle-income countries. Besides, we aimed to describe the temporal trend, clinical pattern, and immediate adverse neonatal outcomes of birth trauma. We searched articles published in the English language in the Excerpta Medica database, PubMed, Web of Science, Google, African Journals Online, Google Scholar, Scopus, and in the reference list of retrieved articles. Literature search strategies were developed using medical subject headings and text words related to the outcomes of the study. The Joana Briggs Institute quality assessment tool was employed and articles with appraisal scores of seven or more were deemed suitable to be included in the meta-analysis. Data were analyzed using the random-effect Dersimonian-Laird model. The full search identified a total of 827 articles about neonatal birth trauma. Of these, 37 articles involving 365,547 participants met the inclusion criteria. The weighted pooled cumulative incidence of birth trauma was estimated at 34 per 1,000 live births (95% confidence interval (CI) 30.5 to 38.5) with the highest incidence observed in Africa at 52.9 per 1,000 live births (95% CI 46.5 to 59.4). Being born to a mother from rural areas (odds ratio (OR), 1.61; 95% CI1.18 to 2.21); prolonged labor (OR, 5.45; 95% CI 2.30, 9.91); fetal malpresentation at delivery (OR, 4.70; 95% CI1.75 to 12.26); shoulder dystocia (OR, 6.11; 95% CI3.84 to 9.74); operative vaginal delivery (assisted vacuum or forceps extraction) (OR, 3.19; 95% CI 1.92 to 5.31); and macrosomia (OR, 5.06; 95% CI 2.76 to 9.29) were factors associated with neonatal birth trauma. In conclusion, we found a considerably high incidence proportion of neonatal birth trauma in low and middle-income countries. Therefore, early identification of risk factors and prompt decisions on the mode of delivery can potentially contribute to the decreased magnitude and impacts of neonatal birth trauma and promote the newborn's health.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Developing Countries; Delivery, Obstetric; Birth Injuries; Labor, Obstetric; Infant, Newborn, Diseases
PubMed: 38512995
DOI: 10.1371/journal.pone.0298519 -
NPJ Digital Medicine Jul 2023The rapid changes in clinical maternity situations that occur in a labor and delivery unit can lead to unpredictable maternal and newborn morbidities. Cesarean section...
The rapid changes in clinical maternity situations that occur in a labor and delivery unit can lead to unpredictable maternal and newborn morbidities. Cesarean section (CS) rate is a key indicator of the accessibility and quality of a labor and delivery unit. This retrospective cross-sectional study assesses the nulliparous, term, singleton, vertex (NTSV) cesarean delivery rates before and after the implementation of a smart intrapartum surveillance system. Research data were collected from the electronic medical records of a labor and delivery unit. The primary outcome was the CS rate of the NTSV population. The data of 3648 women admitted for delivery were analyzed. Of the studied deliveries, 1760 and 1888 occurred during the preimplementation and postimplementation periods, respectively. The CS rate for the NTSV population was 31.0% and 23.3% during the preimplementation and postimplementation periods, respectively, indicating a significant 24.7% (p = 0.014) reduction in CS rate after the implementation of the smart intrapartum surveillance system (relative risk, 0.75; 95% confidence interval, 0.71-0.80). In the NTSV population, the vaginal and CS birth groups, no significant difference in terms of newborn weight, neonatal Apgar scores, composite neonatal adverse outcome indicator, and the occurrence of the following: neonatal intensive care unit admission, neonatal meconium aspiration, chorioamnionitis, shoulder dystocia, perineal laceration, placental abruption, postpartum hemorrhage, maternal blood transfusion, and hysterectomy before and after the implementation of the smart intrapartum surveillance system. This study reveals that the use of the smart intrapartum surveillance system can effectively reduce the primary CS rate for low-risk NTSV pregnancies without significantly affecting perinatal outcomes.
PubMed: 37433963
DOI: 10.1038/s41746-023-00867-y -
Animals : An Open Access Journal From... Oct 2023Prenatal diagnosis comprises a set of investigations, both instrumental and laboratory-based, which aim to monitor the health of the foetus during pregnancy, from the...
Prenatal diagnosis comprises a set of investigations, both instrumental and laboratory-based, which aim to monitor the health of the foetus during pregnancy, from the early stages of embryonic development to the moments preceding delivery. A growing interest is emerging for the preterm ultrasound morphological screening of embryos and foetuses, aimed at assessing the integrity and viability of the conceptus, as well as the early diagnosis of anomalies which can cause complications. This study is a retrospective study of the ultrasonographic findings of twins in the authors' clinical activity from 2016 to 2022. Only seven cases of monochorionic twins were recorded, out of the whole number of evaluations performed on 3120 foetuses, with a prevalence of 0.6% and 0.2% in feline and canine foetuses. All the twins had their own amniotic sac and umbilical cord but presented a single placenta and a single allantoic sac. Unfortunately, the three feline cases were not more recognizable at term. In the four canine cases, three were of opposite sex and then necessarily dizygotic. Twins may have an impact on the success of a pregnancy due to the risk of dystocia, as observed in some of the reported cases. Prenatal ultrasound allows early recognition of twins in dogs and cats.
PubMed: 37958064
DOI: 10.3390/ani13213309 -
Acta Veterinaria Scandinavica Mar 2024Professor Gerhard Sand (1861-1921) was the first professor of veterinary obstetrics at the Royal Veterinary and Agricultural University, Copenhagen, Denmark. He began...
Professor Gerhard Sand (1861-1921) was the first professor of veterinary obstetrics at the Royal Veterinary and Agricultural University, Copenhagen, Denmark. He began teaching the theory and practice of obstetrics to veterinary students in 1887 and spent the following years until his death in 1921 developing the veterinary obstetrics teaching program. During this period, veterinary obstetrics was established as an independent discipline at the Royal Veterinary and Agricultural University. Professor Sand's teaching had a major impact on the field of veterinary obstetrics in Scandinavia. He was devoted to teaching veterinary obstetrics and produced a number of obstetrical illustrations, some of which showed different causes of dystocia, mainly fetal malpresentation in cattle and horses. Professor Sand created the illustrations with the intention of publishing a handbook of obstetrics, but due to illness and an early death, this work was never completed. This compilation of historical artworks of dystocia in cattle and horses includes some of these illustrations and is published to honour Professor Sand, with the intention of making his illustrations widely available for the teaching of veterinary obstetrics.
Topics: Animals; Cattle; Female; Humans; Pregnancy; Agriculture; Cattle Diseases; Dystocia; Horse Diseases; Horses; Scandinavian and Nordic Countries; Students; History, 19th Century; History, 20th Century
PubMed: 38491360
DOI: 10.1186/s13028-024-00733-1 -
Gynecologic Oncology Reports Aug 2023Primary vaginal cancer is infrequent, corresponding to 1-2% of all female genital tract cancer diagnoses.Treatment for vaginal cancer varies depending on tumor...
INTRODUCTION
Primary vaginal cancer is infrequent, corresponding to 1-2% of all female genital tract cancer diagnoses.Treatment for vaginal cancer varies depending on tumor histology, size, location and staging, and may include one or more of the following: surgical excision, radiation therapy and/or chemotherapy. All treatments negatively affect fertility/pregnancy outcomes.Pelvic radiation therapy, even in doses < 2 Gy, may extinguish up to 50% of immature oocytes. In addition, radiotherapy may cause modifications in cervical length, loss of uterine junctional zone anatomy and lead to myometrial atrophy and fibrosis, increasing the risk for adverse pregnancy outcomes.
METHODS
Case report of a patient who carried a pregnancy to term after surgery and brachytherapy for vaginal cancer.
RESULTS
A 28 year-old woman, presented with a 3 cm right midvagina wall tumor, diagnosed as grade 2, vaginal squamous cell carcinoma - FIGO 2009, stage IB. Computed tomography showed no evidence of lymph node involvement or distant metastasis. The patient underwent surgery followed by 4 fractions of vaginal brachytherapy, once a week, with a dose of 6 Gy at a 5 mm depth, amounting to a total dose of 24 Gy.One year and 9 months after treatment, the patient gave birth to a healthy child at 39 weeks pregnancy. A C-section was needed due functional dystocia during labor.
CONCLUSION
This case report recounts a successful pregnancy carried to term after surgery and brachytherapy for squamous cell vaginal cancer.
PubMed: 37408771
DOI: 10.1016/j.gore.2023.101208