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Animals : An Open Access Journal From... Oct 2022Animal production industries rely on efficient and successful reproductive outcomes, with pigs being no exception. The process of parturition in pigs (farrowing) can be... (Review)
Review
Animal production industries rely on efficient and successful reproductive outcomes, with pigs being no exception. The process of parturition in pigs (farrowing) can be especially prolonged, due to the large numbers of piglets being born (on average, approximately 13 piglets per litter in Australian conditions). Difficulties in farrowing (dystocia) lead to poor piglet outcomes and health problems in sows, in turn, causing economic loss for producers and welfare concerns for the animals. Despite the importance of this topic and publications in the area stretching back nearly 50 years, there is still no consensus on the prevalence of dystocia in pigs nor on how to identify a pig experiencing the condition. Understanding the process of parturition and the factors that influence its success is a crucial step towards the early identification of sows undergoing dystocia and development of best practices to assist them. This article describes the key factors that contribute to successful farrowing and identifies areas in which more research is required before the parturition process in the pig can be fully understood.
PubMed: 36290140
DOI: 10.3390/ani12202754 -
JAMA Network Open May 2023Elective induction of labor at 39 weeks of gestation is common. Thus, there is a need to assess maternal labor-related complications and neonatal outcomes associated... (Meta-Analysis)
Meta-Analysis
Comparison of Maternal Labor-Related Complications and Neonatal Outcomes Following Elective Induction of Labor at 39 Weeks of Gestation vs Expectant Management: A Systematic Review and Meta-analysis.
IMPORTANCE
Elective induction of labor at 39 weeks of gestation is common. Thus, there is a need to assess maternal labor-related complications and neonatal outcomes associated with elective induction of labor.
OBJECTIVE
To examine maternal labor-related complications and neonatal outcomes following elective induction of labor at 39 weeks compared with expectant management.
DATA SOURCES
A systematic review of the literature was conducted using the MEDLINE (Ovid), Embase (Ovid), Cochrane Central Library, World Health Organization, and ClinicalTrials.gov databases and registries to search for articles published between database inception and December 8, 2022.
STUDY SELECTION
This systematic review and meta-analysis included randomized clinical trials, cohort studies, and cross-sectional studies reporting perinatal outcomes following induction of labor at 39 weeks vs expectant management.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently assessed study eligibility, extracted data, and assessed studies for bias. Pooled odds ratios (ORs) and 95% CIs were calculated using a random-effects model. This study is reported per the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guideline, and the protocol was prospectively registered with PROSPERO.
MAIN OUTCOMES AND MEASURES
Maternal outcomes of interest included emergency cesarean section, perineal injury, postpartum hemorrhage, and operative vaginal birth. Neonatal outcomes of interest included admission to the neonatal intensive care unit, low 5-minute Apgar score (<7) after birth, macrosomia, and shoulder dystocia.
RESULTS
Of the 5827 records identified in the search, 14 studies were eligible for inclusion in this review. These studies reported outcomes for 1 625 899 women birthing a singleton pregnancy. Induction of labor at 39 weeks of gestation was associated with a 37% reduced likelihood of third- or fourth-degree perineal injury (OR, 0.63 [95% CI, 0.49-0.81]), in addition to reductions in operative vaginal birth (OR, 0.87 [95% CI, 0.79-0.97]), macrosomia (OR, 0.66 [95% CI, 0.48-0.91]), and low 5-minute Apgar score (OR, 0.62 [95% CI, 0.40-0.96]). Results were similar when confined to multiparous women only, with the addition of a substantial reduction in the likelihood of emergency cesarean section (OR, 0.61 [95% CI, 0.38-0.98]) and no difference in operative vaginal birth (OR, 1.01 [95% CI, 0.84-1.21]). However, among nulliparous women only, induction of labor was associated with an increased likelihood of shoulder dystocia (OR, 1.22 [95% CI, 1.02-1.46]) compared with expectant management.
CONCLUSIONS AND RELEVANCE
In this study, induction of labor at 39 weeks was associated with improved maternal labor-related and neonatal outcomes. However, among nulliparous women, induction of labor was associated with shoulder dystocia. These results suggest that elective induction of labor at 39 weeks may be safe and beneficial for some women; however, potential risks should be discussed with nulliparous women.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Cesarean Section; Fetal Macrosomia; Cross-Sectional Studies; Shoulder Dystocia; Labor, Induced; Labor, Obstetric; Obstetric Labor Complications; Infant, Newborn, Diseases
PubMed: 37171818
DOI: 10.1001/jamanetworkopen.2023.13162 -
Ugeskrift For Laeger Jun 2024Shoulder dystocia is a serious obstetric complication, where one or both shoulders of a child are trapped after the head is born during vaginal delivery. The situation...
Shoulder dystocia is a serious obstetric complication, where one or both shoulders of a child are trapped after the head is born during vaginal delivery. The situation is life-threatening for the child and requires quick management with obstetric manoeuveres for delivering the shoulders. Rarely, the abdominal approach called Zavanelli manoeuvre is used to achieve delivery after a replacement of the head back in the birth canal, prior to acute caesarean section. This is a case report of a 26-year-old woman with severe shoulder dystocia, failed Zavanelli manoeuvre and vaginal delivery of a lifeless child.
Topics: Humans; Female; Pregnancy; Adult; Stillbirth; Delivery, Obstetric; Shoulder Dystocia; Infant, Newborn
PubMed: 38904285
DOI: 10.61409/V02240095 -
Annual Review of Pharmacology and... Jan 2023While there is not a wide range of pregnancy-specific drugs, there are some very specific high-risk areas of obstetric care for which unique pharmacological approaches... (Review)
Review
While there is not a wide range of pregnancy-specific drugs, there are some very specific high-risk areas of obstetric care for which unique pharmacological approaches have been established. In preterm birth, labor induction and augmentation, and the management of postpartum hemorrhage, these pharmacological approaches have become the bedrock in managing some of the most common and problematic areas of antenatal and intrapartum care. In this review, we summarize the existing established and emerging evidence that supports and broadens these pharmacological approaches to obstetric management and its impact on clinical practice. It is clear that existing therapeutics are limited. They have largely been developed from our knowledge of the physiology of the myometrium and act on hormonal receptors and their signaling pathways or on ion channels influencing excitability. Newer drugs in development are mostly refinements of these two approaches, but novel agents from plants and improved formulations are also discussed.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Premature Birth; Uterine Contraction; Postpartum Hemorrhage; Labor, Obstetric; Delivery, Obstetric
PubMed: 36151050
DOI: 10.1146/annurev-pharmtox-051921-122822 -
Animals : An Open Access Journal From... Jan 2021Clinical problems associated with twin pregnancies have been well established, and twin births are now considered undesirable or even disastrous for the dairy cattle... (Review)
Review
Clinical problems associated with twin pregnancies have been well established, and twin births are now considered undesirable or even disastrous for the dairy cattle industry and the individual cow. The high incidence of early fetal loss, abortion during the mid-lactation period, dystocia, stillbirth, and placenta retention should be considered a preventable consequence of management, as these disorders greatly compromise the welfare and productive lifespan of a cow carrying or delivering twins. The use of sexed semen generates herd replacements and additional heifers, so a proposed strategy for twin pregnancy prevention is the transfer of a single in vitro-produced female beef cow embryo to cows not suitable for producing replacements. Another proposed strategy is drainage at insemination of co-dominant follicles to prevent twin pregnancies in cows with genetic merit. As a result, embryo survival should improve, economic losses associated with twin pregnancies will be prevented, beef output from the herd will be increased, and the health and welfare of the cow will certainly benefit. In this review, the clinical prospects of preventing or avoiding twin pregnancies using both procedures are discussed.
PubMed: 33440763
DOI: 10.3390/ani11010148 -
Animals : An Open Access Journal From... Feb 2021Twinning in Holstein dairy cows has increased over time concurrent with increased milk production. Twinning in dairy cattle is not desirable due to the negative effects... (Review)
Review
Twinning in Holstein dairy cows has increased over time concurrent with increased milk production. Twinning in dairy cattle is not desirable due to the negative effects on both cows that calve twins and calves born as twins that result in economic losses to dairy farms. Although a twin pregnancy could bring additional income from extra calves and shorten gestation length, twinning compromises milk production, increases the incidence of dystocia and perinatal mortality, decreases calf birth weight, increases the incidence of metabolic diseases, decreases fertility, increases the incidence of freemartinism, increases overall culling risks, and shortens the productive lifespan of cows. Based on a summary of economic analyses from several studies, the estimated losses due to twinning range between $59 to $161 per twin pregnancy. Most twinning in dairy cows is dizygotic and directly related to the incidence of double ovulations, and economic losses are greater for unilateral than for bilateral twins. Hormonal manipulation before artificial insemination that allows for timed artificial insemination is a primary strategy for decreasing twinning in dairy cows before it occurs by decreasing the incidence of double ovulation thereby decreasing conception of dizygotic twins and the associated negative economic consequences. When twins are diagnosed early during gestation, management options might include doing nothing, terminating the pregnancy, or attempting manual embryo reduction. Based on a recent economic analysis of these options, attempting manual embryo reduction decreased the economic losses of a twin pregnancy by $23 to $45.
PubMed: 33672462
DOI: 10.3390/ani11020552 -
Food and Chemical Toxicology : An... Jun 2023An important data gap in determining a safe level of cannabidiol (CBD) intake for consumer use is determination of CBD's potential to cause reproductive or developmental...
An important data gap in determining a safe level of cannabidiol (CBD) intake for consumer use is determination of CBD's potential to cause reproductive or developmental toxicity. We conducted an OECD Test Guideline 421 GLP-compliant study in rats, with extended postnatal dosing and hormone analysis, where hemp-derived CBD isolate (0, 30, 100, or 300 mg/kg-bw/d) was administered orally. Treatment-related mortality, moribundity, and decreased body weight and food consumption were observed in high-dose F adult animals, consistent with severe maternal toxicity. No effects were observed on testosterone concentrations, F reproductive performance, or reproductive organs. Hepatocellular hypertrophy in the 100- and 300 mg/kg-bw/day groups correlated with hypertrophy/hyperplasia in the thyroid gland and changes in mean thyroid hormone concentrations in F animals. Mean gestation length was unaffected; however, total litter loss for two females and dystocia for two additional females in the high-dose group occurred. Other developmental effects were limited to lower mean pup weights in the 300 mg/kg-bw/d group compared to those of concurrent controls. The following NOAELs were identified for CBD isolate based on this study: 100 mg/kg-bw/d for F systemic toxicity and female reproductive toxicity, 300 mg/kg-bw/d for F male reproductive toxicity, and 100 mg/kg-bw/d for F neonatal and F generation toxicity.
Topics: Pregnancy; Rats; Female; Male; Animals; Cannabidiol; Reproduction; Testosterone; Thyroid Gland; No-Observed-Adverse-Effect Level; Body Weight
PubMed: 37105390
DOI: 10.1016/j.fct.2023.113786 -
Journal of Veterinary Diagnostic... Sep 2023Clinical signs in 4 cases of salmonellosis in cats included vomiting, diarrhea (2 cases each), fever, dystocia, icterus, and seizures (1 case each). Three cats died, and...
Clinical signs in 4 cases of salmonellosis in cats included vomiting, diarrhea (2 cases each), fever, dystocia, icterus, and seizures (1 case each). Three cats died, and one was euthanized. Grossly, all cats were in poor body condition and had yellow-to-dark-red perianal feces (3 cases), oral and ocular pallor (2 cases) or icterus (1 case), fluid or pasty yellow intestinal contents (4 cases), white or dark-red-to-black depressed areas on the hepatic surface (2 cases), yellow abdominal fluid with swollen abdominal lymph nodes (1 case), and fibrin strands on the placental chorionic surface (1 case). Histologically, all cats had necrotizing enterocolitis and random hepatocellular necrosis. Other histologic findings included mesenteric (4 cases) or splenic (2 cases) lymphoid necrosis, and endometrial and chorioallantoic necrosis (1 case). Gram-negative bacilli were observed within neutrophils and macrophages in the intestinal lamina propria (4 cases), liver, spleen, lymph node, endometrium, and placenta (1 case each). Aerobic bacterial culture on frozen samples of small intestine, mesenteric lymph node, lung, and liver yielded subsp. . Serotyping was consistent with Enteritidis (cases 1, 3) and Typhimurium (cases 2, 4).
Topics: Pregnancy; Cats; Female; Animals; Salmonella Infections, Animal; Placenta; Salmonella; Salmonella enterica; Necrosis; Cat Diseases
PubMed: 37329122
DOI: 10.1177/10406387231181389