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Animals : An Open Access Journal From... Oct 2021Parturition is a complex physiological process and involves many hormonal, morphological, physiological, and behavioural changes. Labour is a crucial moment for numerous... (Review)
Review
Parturition is a complex physiological process and involves many hormonal, morphological, physiological, and behavioural changes. Labour is a crucial moment for numerous species and is usually the most painful experience in females. Contrary to the extensive research in humans, there are limited pain studies associated with the birth process in domestic animals. Nonetheless, awareness of parturition has increased among the public, owners, and the scientific community during recent years. Dystocia is a significant factor that increases the level of parturition pain. It is considered less common in polytocous species because newborns' number and small size might lead to the belief that the parturition process is less painful than in monotocous animal species and humans. This review aims to provide elements of the current knowledge about human labour pain (monotocous species), the relevant contribution of the rat model to human labour pain, and the current clinical and experimental knowledge of parturition pain mechanisms in domestic animals that support the fact that domestic polytocous species also experience pain. Moreover, both for women and domestic animal species, parturition's pain represents a potential welfare concern, and information on pain indicators and the appropriate analgesic therapy are discussed.
PubMed: 34679979
DOI: 10.3390/ani11102960 -
PloS One 2022A caesarean section is a major obstetric procedure that can save the life of mother and child. Its purpose is to protect the mother's health from the complications of...
INTRODUCTION
A caesarean section is a major obstetric procedure that can save the life of mother and child. Its purpose is to protect the mother's health from the complications of childbirth and to protect the baby's health. In sub-Saharan Africa (SSA), there are major inequalities in access to caesarean sections and significant variations in practices to determine the indications for the procedure. Periodic analyses of maternal deaths have shown that more than half of maternal and new born deaths are due to suboptimal care and are therefore potentially preventable. The objective of our study is to assess the impact of health staff training under the PADISS project (to support the health system's integrated development) on the quality of CS procedures in North Kivu, by comparing two periods.
MATERIAL AND METHODS
The populations compared were recruited from the referral hospitals in North Kivu, DRC (Democratic Republic of Congo). The first (group 1) was made up of patient files studied retrospectively for the period from 01/11/2013 to 01/01/2016. The second group (group 2), studied prospectively, comprised patient files from June 2019 to January 2020. Obstetric, maternal and foetal data were compared. Statistical analyses were performed using STATA/IC 15.0 for Windows. Univariate and multiple logistic regression was performed to determine which characteristics are associated with maternal and perinatal morbidity and mortality. A p value < 0.05 was considered statistically significant.
RESULTS
CS frequency was approximately 17% in both study periods. We observed a CS frequency of about 34% at North Kivu provincial hospital for the two populations studied. The main indications for CS were dystocia, foetal distress and scarred uterus for both populations. In the population studied prospectively, after the implementation of health staff training, there were fewer incidence rate of dystocia, foetal distress and neonatal death, a more complete patient record, shorter hospital stay, and fewer blood transfusions but more incidence rate of scarred uterus, post-operative complications and low birth weight. Intervention had no statistically significant impact on low birth weight (OR = 1.9, p = 0.13), on neonatal mortality (OR = 0.69, p = 0.21).
CONCLUSION
Our study shows a decrease in neonatal deaths, dystocia and foetal distress, but an increase in post-operative complications, maternal deaths and cases of scarred uterus and low birth weight. However, multiple logistic regression did no support the conclusion.
Topics: Caregivers; Cesarean Section; Cicatrix; Dystocia; Female; Fetal Distress; Humans; Infant, Newborn; Maternal Death; Pregnancy; Retrospective Studies
PubMed: 35617343
DOI: 10.1371/journal.pone.0264251 -
International Journal of Women's Health 2023Amniotic fluid volumes are tightly regulated, and amniotic fluid derangement can indicate maternal complications or fetal abnormalities. Ultrasound estimate of amniotic... (Review)
Review
Amniotic fluid volumes are tightly regulated, and amniotic fluid derangement can indicate maternal complications or fetal abnormalities. Ultrasound estimate of amniotic fluid provides a tool to evaluate the maternal-fetal-placental interface in real-time. Oligohydramnios and polyhydramnios are associated with adverse maternal and neonatal outcomes. Oligohydramnios is associated with adverse maternal and neonatal outcomes including cesarean delivery, operative vaginal delivery, induction of labor, postpartum hemorrhage, small for gestational age neonate, intrauterine demise, neonatal death, NICU admission, and APGAR less than 7 at. 5 minutes of life Polyhydramnios is associated with adverse outcomes including cesarean delivery, induction of labor, placental abruption, shoulder dystocia, cord prolapse, postpartum hemorrhage, intrauterine fetal demise, NICU admission, neonatal death, APGAR less than 7 at 5 minutes of life, large for gestational age neonate, and respiratory distress syndrome. Therefore, Amniotic fluid should be evaluated when maternal or fetal well-being is in question.
PubMed: 36756186
DOI: 10.2147/IJWH.S378020 -
Revista Brasileira de Ginecologia E... Jul 2022
Topics: Delivery, Obstetric; Dystocia; Female; Humans; Pregnancy; Shoulder Dystocia
PubMed: 35940174
DOI: 10.1055/s-0042-1755446 -
Archives Animal Breeding 2022Few studies have investigated risk factors for dystocia in swine, although this birthing abnormality can compromise welfare of both sows and piglets by increasing...
Few studies have investigated risk factors for dystocia in swine, although this birthing abnormality can compromise welfare of both sows and piglets by increasing stillbirth rate and decreasing sow productivity. This study aimed to determine risk factors associated with dystocia at piglet level in cloprostenol-induced farrowings. A dystocia event was recorded when a birth interval exceeded 45 or when manual extraction was applied. Data were collected from 898 piglets born from 77 Landrace Yorkshire crossbred sows, which were induced for farrowing on day 114 of gestation. Generalized linear mixed models (GLMMs) were used to evaluate the association between dystocia and parity, gestation length, litter size, relative birth order (RBO (%) 100 birth order/litter size), birth weight, crown rump length, body mass index, ponderal index, piglet's sex, use of oxytocin, and stillbirth. Sows nested in farrowing batches were fitted as random factors in GLMMs. Incidence of dystocia at piglet and farrowing levels was 11.0 % and 75.3 %, respectively. The final multivariate model explained 20.1 % variation of dystocia. RBO had a quadratic effect on dystocia in which incidence of dystocia decreased from RBO 40 % to RBO 60 %-70 %, and then increased to the end of parturition. Piglets with birth weight 1700 and stillborn piglets had higher odds of dystocia in comparison with piglets with a birth weight of 900-1700 (OR 2.63; 95 % CI 1.66-4.18) and live-born piglets (OR 2.62; 95 % CI 1.12-6.15), respectively. This study indicates that dystocia is very common in cloprostenol-induced farrowings and suggests that the last one-third of parturitions is the most important stage to be supervised, and selection for homogenous litters and moderate high birth weight may reduce the rate of dystocia.
PubMed: 35282397
DOI: 10.5194/aab-65-97-2022 -
Journal of Obstetrics and Gynaecology... Dec 2019Doubling of C-section rates from year 2000 to 2015 globally was declared an eye-opener on October 13, 2018, in FIGO World Congress. Rapid increase in rates without clear... (Review)
Review
Doubling of C-section rates from year 2000 to 2015 globally was declared an eye-opener on October 13, 2018, in FIGO World Congress. Rapid increase in rates without clear evidence of concomitant decrease in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused. This review addresses issues related to exponentially rising rates, reasons for it, and strategies to reduce. Previous cesarean delivery has main contribution to rising rates as per evidence from the literature search in last 5 years. Focus on optimizing indications of primary C-section resulted in making us rethink modifiable indications like labor dystocia, indeterminate fetal heart rate tracing, suspected fetal macrosomia, malposition, risk-adapted obstetrics, litigation fears, on demand cesarean in literate women and overuse of labor induction. Use of uniform classification system (Robson/WHO classification) with recommendations of WHO, FIGO and annual audits with cloud-based anonymous registry will streamline decisions for cesarean in nullipara and help to control the situation.
PubMed: 31844361
DOI: 10.1007/s13224-019-01246-y -
Journal of Dairy Science Nov 2021Retained fetal membranes (RFM), dystocia, and twinning are common postpartum events that increase the risk of metritis, impair reproductive performance, and contribute...
Retained fetal membranes (RFM), dystocia, and twinning are common postpartum events that increase the risk of metritis, impair reproductive performance, and contribute to antimicrobial use on dairies. The overall objective of this study was to describe treatment decisions after RFM, severe dystocia (cesarean section and fetotomy), nonsevere dystocia (nonmechanical and mechanical assistance to extract the calf), and twinning. A total of 44 dairies from California's San Joaquin Valley (39 Holstein and 6 Jersey or crossbreed herds) with 450 to 9,500 lactating cows were enrolled in this study. Researchers visited each dairy once to observe cow-side fresh cow health evaluations and to interview health evaluators and maternity workers, using a standardized survey tool. The survey included questions about antimicrobial (class, dose, and duration) and nonantimicrobial therapies for calving-related events. Antimicrobial therapy was used in all 44 dairies to treat RFM at 24 (n = 23), 48 (n = 10), or 72 h (n = 5) after calving, or when puerperal metritis signs were observed (n = 6). Antimicrobial therapy was used after all severe dystocia cases, and after nonsevere dystocia (n = 27) and twinning (n = 15). Ceftiofur products were the most common antimicrobial class; they were used to treat RFM cases (n = 29), nonsevere dystocia (n = 13), and twinning (n = 10). Supportive therapy for calving-related events included nonantimicrobial intrauterine treatments, nonsteroidal antiinflammatory drugs, oxytocin, i.v. calcium, or oral drenches. Our study highlights opportunities to reduce extra-label use of antimicrobials in postpartum cows affected with RFM, and the need for education and outreach efforts on judicious use of antimicrobials. Furthermore, antimicrobial treatment choices differed largely across dairies, indicating a need to reach consensus and promote standardized practices within the industry.
Topics: Animals; Cattle; Cattle Diseases; Cesarean Section; Farms; Female; Lactation; Placenta, Retained; Pregnancy
PubMed: 34482983
DOI: 10.3168/jds.2021-20593 -
Veterinary World Jul 2021Dystocia in swine can increase the stillbirth rate; however, its importance in pig-breeding systems has been underestimated. Until now, few studies have investigated...
BACKGROUND AND AIM
Dystocia in swine can increase the stillbirth rate; however, its importance in pig-breeding systems has been underestimated. Until now, few studies have investigated dystocia and associated risk factors. Therefore, in this study, we aimed to evaluate the effects of various risk factors on dystocia in swine.
MATERIALS AND METHODS
Out of 5,557 piglets, we included 4,997 piglets in risk analysis study. The dependent variable was dystocia, which was recorded when a birth interval exceeded 45 min or when obstetric assistance was applied. The independent variables were parity, gestation length, litter size, birth order, gender, presence of a dead piglet, birthweight, crown rump length, body mass index, ponderal index, and oxytocin use. We used generalized linear mixed models to examine the associations between potential risk factors and dystocia at the piglet level.
RESULTS
A total of 6% of the piglets were born with a dystocia event, and 47.2% of the farrowing experienced at least one event. Dead piglets and piglets with a crown rump length of >31 cm were associated with an increased dystocia rate. This rate decreased from birth order 2 to 7, stabilized to 11, and then increased till the end of the fetal expulsion process.
CONCLUSION
Dystocia is common in swine. Therefore, this condition should be carefully addressed by veterinarians and farrowing house personnel so that its adverse effect on welfare and productivity of sows and survivability of piglets can be reduced. Further studies investigating dystocia status and risk factors in different swine farrowing systems should be undertaken to provide more knowledge about this neglected condition.
PubMed: 34475706
DOI: 10.14202/vetworld.2021.1835-1839 -
Open Medicine (Warsaw, Poland) 2023Congenital malformations are defined as single or multiple defects of the morphogenesis of organs or body parts, identifiable during intrauterine life or at birth. With... (Review)
Review
Congenital malformations are defined as single or multiple defects of the morphogenesis of organs or body parts, identifiable during intrauterine life or at birth. With recent advances in prenatal detection of congenital malformations, many of these disorders can be identified early on a routine fetal ultrasound. The aim of the present systematic review is to systematize the current knowledge about the mode of delivery in pregnancies complicated by fetal anomalies. The databases Medline and Ebsco were searched from 2002 to 2022. The inclusion criteria were prenatally diagnosed fetal malformation, singleton pregnancy, and known delivery mode. After the first round of research, 546 studies were found. For further analysis, studies with full text available concerning human single pregnancy with known neonatal outcomes were considered. Publications were divided into six groups: congenital heart defects, neural tube defects, gastroschisis, fetal tumors, microcephaly, and lung and thorax malformations. Eighteen articles with a descripted delivery mode and neonatal outcome were chosen for further analysis. In most pregnancies complicated by the presence of fetal anomalies, spontaneous vaginal delivery should be a primary option, as it is associated with lower maternal morbidity and mortality. Cesarean delivery is generally indicated if a fetal anomaly is associated with the risk of dystocia, bleeding, or disruption of a protective sac; examples of such anomalies include giant omphaloceles, severe hydrocephalus, and large myelomeningocele and teratomas. Fetal anatomy ultrasound should be carried out early, leaving enough time to familiarize parents with all available options, including pregnancy termination, if an anomaly is detected.
PubMed: 37197356
DOI: 10.1515/med-2023-0704 -
Turkish Journal of Medical Sciences Aug 2021This study aimed to evaluate the relationship between second- and third-trimester clavicle lengths and birth weight and shoulder dystocia. (Observational Study)
Observational Study
BACKGROUND/AIM
This study aimed to evaluate the relationship between second- and third-trimester clavicle lengths and birth weight and shoulder dystocia.
MATERIALS AND METHODS
This prospective observational study included 181 patients who presented to the Private Etlik Lokman Hekim Hospital for routine pregnancy visits between March 2019 and March 2020. In addition to routine pregnancy examinations, the patients also underwent ultrasonography twice at weeks 20–23 and 33–36 to determine the length of the fetal clavicle. The patients were evaluated for shoulder dystocia in the second stage of labor. The birth weight of the neonates was recorded. The primary objective of this study was to establish the relationship between third-trimester clavicle length and shoulder dystocia.
RESULTS
Fetal clavicle length increases in the second trimester with the advancing gestational week but does not significantly change in the third trimester. We did not observe any significant difference for second trimester clavicle length between the type of delivery, birth weight, or shoulder dystocia. Moreover, we did not observe any significant difference for third trimester clavicle length between types of delivery. However, we found a significant relationship between third trimester clavicle length and birth weight and shoulder dystocia. The median third-trimester clavicle length was 39.5 mm (range: 30.7–43.9) in neonates who did not develop shoulder dystocia and 42.5 mm (range: 41.4–43.1) in the 3 neonates who developed shoulder dystocia. The third-trimester clavicle length cut-off for shoulder dystocia was calculated as 41.35 mm (sensitivity: 100.00%, specificity: 83.82%, accuracy: 84.5%). The third-trimester clavicle length cut-off for macrosomia (defined as birth weight of ≥4100 g) was 40.75 mm (sensitivity: 87.50%, specificity: 77.56%, accuracy: 78.05%).
CONCLUSION
Third-trimester fetal clavicle length, an important component of biacromial diameter, as measured by ultrasonography, is a practical and significant method for predicting macrosomia and shoulder dystocia.
Topics: Adult; Birth Weight; Clavicle; Dystocia; Female; Fetal Macrosomia; Humans; Infant, Newborn; Male; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Risk Factors; Shoulder Dystocia
PubMed: 33843172
DOI: 10.3906/sag-2011-145