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Animals : An Open Access Journal From... Aug 2022The objective of this study was to investigate the effect of herd size on stillbirth and dystocia rates; the relationships between herd size, calving season, parity, and...
The objective of this study was to investigate the effect of herd size on stillbirth and dystocia rates; the relationships between herd size, calving season, parity, and gestation length in Japanese Black cattle were also explored. Data were collected for 41,184 calvings from 15,512 animals on 905 farms between 2006 and 2010. In this study, herds were classified into three groups based on size: small (1−10 cows), medium (11−50 cows), and large (≥51 cows). Herd size had an effect on the dystocia rate (p < 0.05) but not the stillbirth rate. Additionally, interactions between herd size and gestation length were associated with the dystocia rate (p < 0.05), and the dystocia rate was the highest in small herds, followed by medium and large herds for cows with a gestation length of 281−300 days, which is considered a pregnancy of normal duration. In summary, in Japanese Black cattle, there were different effects of herd size on the stillbirth rate and dystocia rates, as herd size was associated with the dystocia rate but not with the stillbirth rate.
PubMed: 35953983
DOI: 10.3390/ani12151994 -
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 -
Medical Hypotheses Jan 2020Acne is a disease unique to humans and is associated with sebaceous glands that are found at high density on the scalp, forehead and face. Despite being a near universal...
Acne is a disease unique to humans and is associated with sebaceous glands that are found at high density on the scalp, forehead and face. Despite being a near universal problem in adolescence, the reason why such troublesome sebaceous glands exist at all is not well understood. Some interesting theories have been postulated including roles for skin maintenance, immunological function and perhaps even pheromones, but pre-pubertal skin which has sebaceous glands that are largely inactive, is healthy. Dystocia, obstructed labour, is unique to humans and no other animal has as much trouble giving birth. This is thought to reflect the relatively large human foetal head and proportionally small maternal pelvis. Noting the high density of sebaceous glands on the face, chest and back; these are exactly the same structures that pose the greatest obstruction during childbirth. Sebaceous glands develop after the fourth month of gestation and are large and well-developed at birth. Sebum production is also relatively high at birth. Having extra lubrication at these sites would help make the baby more slippery for birth conferring a selective advantage to successful delivery, as does the presence of the vernix caseosa, a white creamy substance, unique to humans that coats new-born infants. It is proposed that the sebaceous glands that cause acne are present on the face and forehead as they confer a selective advantage by 'lubricating' the widest parts of the new born baby to ease the passage of childbirth. Later in life, sebaceous glands may be inappropriately and pathologically primed, driven by a combination of hormones, diet and lifestyle to create acne.
Topics: Acne Vulgaris; Adolescent; Androgens; Biofilms; Diet; Dystocia; Female; Hair Follicle; Head; Humans; Infant, Newborn; Inflammation; Models, Biological; Organ Size; Parturition; Pregnancy; Propionibacterium acnes; Scalp; Sebaceous Glands; Sebum; Selection, Genetic; Species Specificity; Vernix Caseosa
PubMed: 31622924
DOI: 10.1016/j.mehy.2019.109412 -
European Journal of Midwifery 2021Shoulder dystocia is an obstetric emergency which is unpredictable and complicates approximately 0.5-1% of vaginal births. This article discusses the risk factors and... (Review)
Review
Shoulder dystocia is an obstetric emergency which is unpredictable and complicates approximately 0.5-1% of vaginal births. This article discusses the risk factors and the associated fetal and maternal complications, while it is also an overview of techniques and algorithms to handle shoulder dystocia.
PubMed: 34723155
DOI: 10.18332/ejm/142097 -
Journal of Feline Medicine and Surgery Apr 2022The aim of this study was to describe the characteristics of cases of feline dystocia presenting to a university emergency service.
OBJECTIVES
The aim of this study was to describe the characteristics of cases of feline dystocia presenting to a university emergency service.
METHODS
The medical records of queens presenting for dystocia between January 2009 and September 2020 were reviewed. Data collected included queen signalment, presenting complaints, treatments, and maternal and neonatal outcomes. Clinicopathologic data included serum ionized calcium concentration, blood glucose level, packed cell volume and total solids. Owing to the small sample size, descriptive statistics were used and data presented as median (range).
RESULTS
Thirty-five cases were reviewed. Dystocia was attributed to maternal factors in 69% (n = 24) and fetal factors in 31% (n = 11). Venous blood gas data from 19 queens in stage 2 labor revealed that no queens were hypocalcemic (median ionized calcium 5.4 mg/dl [range 4.9-5.8]) or hypoglycemic (median glucose 143 mg/dl [range 78-183]). Medical management was attempted in 21/35 queens. Successful medical management was achieved in 29% (n = 6/21). Thirteen queens underwent surgical management, six of these after failing medical management. Seven queens received no treatment. Fifteen queens were discharged and one queen was euthanized while still in labor. The remaining 19 queens delivered all fetuses with medical (n = 6) or surgical management (n = 13). Maternal survival was 94% (n = 33/35). A total of 136 kittens were born to all queens, with 58% (n = 79/136) born prior to initiation of treatment, 16% (n = 22/136) after medical management and 26% (n = 35/136) after surgical management. Overall neonatal survival to discharge was 66% (n = 90/136).
CONCLUSIONS AND RELEVANCE
Feline dystocia is an emergent condition that can result in up to 34% neonatal mortality for kittens delivered via both medical and surgical means. Hypoglycemia and hypocalcemia were not precipitating causes of feline dystocia in this population.
Topics: Animals; Calcium; Cat Diseases; Cats; Dystocia; Female; Glucose; Humans; Pregnancy; Retrospective Studies
PubMed: 34124965
DOI: 10.1177/1098612X211024154 -
Journal of the Turkish German... Dec 2022To evaluate the relationship between neonatal biacromial and bideltoid diameter (BDD), birth weight and shoulder dystocia (SD).
OBJECTIVE
To evaluate the relationship between neonatal biacromial and bideltoid diameter (BDD), birth weight and shoulder dystocia (SD).
MATERIAL AND METHODS
This was a prospective observational study conducted on 161 pregnancies who applied to Private Lokman Hekim Hospital for follow-up between February 2021 and August 2021. Maternal height, weight, parity, and presence of SD in the second stage of labor were evaluated in the patients included in the study. The weight, height, head circumference, biacromial and BDD measurements of newborn babies were taken within the first two hours after birth. The primary purpose of the study was to evaluate the relationship between the biacromial and BDD and SD. The secondary purpose of the study was to evaluate the relationship between the biacromial and BDD and macrosomia.
RESULTS
The mean age and post-pregnancy body mass index of the participants were 31.3±4.4 years and 29.0±4.0 kg/m2, respectively, and 42.9% (n=69) delivered vaginally. The incidence of macrosomia was 6.8% (n=11) in all women and the incidence of SD was 7.2% (n=5) in women who had vaginal deliveries. The mean biacromial diameter (BAD) was 12.4±1.0 cm and the mean BDD was 18.2±1.7 cm. A correlation rate of 0.373 was found between SD and the BAD, and 0.484 between SD and the BDD. The correlation coefficients between macrosomia and the biacromial and BDD were 0.213 and 0.420, respectively. In cases in which the BDD was ≥21 cm, the sensitivity for SD was 100%, the specificity was 90.63%, and the accuracy was 91.30%. The cut-off point for the BAD was ≥14 cm, and the sensitivity and specificity for SD was 63.64% and 89.33%, respectively. The highest correlation for SD was obtained in cases in which there was a history of SD (0.648).
CONCLUSION
The relationship between neonatal biacromial and BDD, and macrosomia and SD were significant. There was no difference between the correlation values of the two measurements in terms of SD. However, the correlation coefficient of the BDD was greater for macrosomia.
PubMed: 36285906
DOI: 10.4274/jtgga.galenos.2022.2022-6-10 -
International Journal of Molecular... Nov 2023Parturition is the final and essential step for mammalian reproduction. While the uterus is quiescent during pregnancy, fundamental changes arise in the myometrial...
Parturition is the final and essential step for mammalian reproduction. While the uterus is quiescent during pregnancy, fundamental changes arise in the myometrial contractility, inducing fetal expulsion. Extracellular matrix (ECM) remodeling is fundamental for these events. The gelatinases subgroup of matrix metalloproteinases (MMPs), MMP2 and MMP9, participate in uterine ECM remodeling throughout pregnancy and parturition. However, their loss-of-function effect is unknown. Here, we determined the result of eliminating and/or on parturition in vivo, using single- and double-knockout (dKO) mice. The dystocia rates were measured in each genotype, and uterine tissue was collected from nulliparous synchronized females at the ages of 2, 4, 9 and 12 months. Very high percentages of dystocia (40-55%) were found in the and dKO females, contrary to the and wild-type females. The histological analysis of the uterus and cervix revealed that tissues undergo marked structural alterations, including highly enlarged myometrial, endometrial and luminal cavity. Increased collagen deposition was also demonstrated, suggesting a mechanism of extensive fibrosis in the myometrium, which may result in dystocia. Overall, this study describes a new role for MMP2 in myometrium remodeling during mammalian parturition process, highlighting a novel cause for dystocia due to a loss in MMP2 activity in the uterine tissue.
Topics: Animals; Female; Mice; Pregnancy; Dystocia; Mammals; Matrix Metalloproteinase 2; Matrix Metalloproteinase 9; Myometrium; Parturition
PubMed: 38069145
DOI: 10.3390/ijms242316822 -
Frontiers in Endocrinology 2022Gestational diabetes mellitus (GDM), is one of the most important pregnancy complications affecting approximately 15% of pregnant women. It is related to several... (Review)
Review
Gestational diabetes mellitus (GDM), is one of the most important pregnancy complications affecting approximately 15% of pregnant women. It is related to several gestational adverse outcomes in the fetus, , macrosomia, shoulder dystocia, stillbirth, neonatal hypoglycemia, and respiratory distress. Women with GDM have a high risk of developing type 2 diabetes in the future. The pathogenesis of GDM is not completely understood; nevertheless, two factors could contribute to its development: β-cell dysfunction and failure in insulin secretion in response to insulin resistance induced by gestation. Both processes, together with the physiological activities of the insulin-like growth factors (IGFs), play a crucial role in glucose transport to the fetus and hence, fetal growth and development. IGFs (both IGF-1 and IGF-2) and their binding proteins (IGFBPs) regulate glucose metabolism and insulin sensitivity. Maternal nutritional status determines the health of the newborn, as it has substantial effects on fetal growth and development. Maternal obesity and an energy-dense diet can cause an increase in insulin and IGF-1 serum levels, producing metabolic disorders, such as insulin resistance, GDM, and high birth weight (> 4,000 g) due to a higher level of body fat. In this way, in GDM pregnancies there is an increase in IGF-1 and IGF-2 serum levels, and a decrease in IGFBP-1 and 4 serum levels, suggesting the crucial role of the insulin/IGF system in this gestational outcome. Here, the present review tries to elucidate the role that energy-dense diets and the insulin/IGF-1 signaling pathway perform in GDM pregnancies.
Topics: Diabetes Mellitus, Type 2; Diabetes, Gestational; Diet; Female; Humans; Infant, Newborn; Insulin; Insulin Resistance; Insulin-Like Growth Factor I; Insulin-Like Growth Factor II; Pregnancy
PubMed: 35813659
DOI: 10.3389/fendo.2022.916042 -
Frontiers in Medicine 2022Cesarean section (CS) has become an effective means to solve dystocia and some obstetric complications, and to save the lives of women and perinatal women. Disparities...
BACKGROUND
Cesarean section (CS) has become an effective means to solve dystocia and some obstetric complications, and to save the lives of women and perinatal women. Disparities in quality obstetric care and rehabilitation in CS result from differences in health care systems across regions, and more scientific and reasonable rehabilitation programmes and management measures will benefit more parturient and newborns worldwide who must take CS. In this study, we performed a bibliometric analysis to collect a graphical representation of the CS recovery.
METHODS
A total of 995 documents of CS recovery were retrieved from the Web of Science Core Collection (WOSCC) on December 31, 2021, and then VOS viewer 1.6.18 was used for visual analysis.
RESULTS
Over the last 20 years, the researches of CS recovery have gradually increased and it will continue to grow in the next period. Anesthesia and Analgesia is the most popular journal in CS recovery. Most of the representative achievements are concentrated in the relevant institutions of European and American countries, Brendan Carvalho and Ian J. Wrench are among the outstanding scholars in this field, but the overall outcome is limited by limited regional work and lack of broad cooperation and representation. "CS," "surgery," "management," "recovery," "enhanced recovery," and "risk factors" are high frequency keywords, and there is a close relationship between "management" and "enhanced recovery" around the CS and they also become one of the key factors to regulate the condition of patients.
CONCLUSION
This work firstly analyzed the research condition of CS recovery by a bibliometric analysis. According to the practice guideline, it produces some outstanding representative productions, which involves enhanced recovery after surgery (ERAS) and will continue to be the focus of researchers. More substantive research articles and large-scale clinical studies may greatly enhance the scientific value, and it is necessary to strengthen the ERAS guideline and cooperation between researchers, generate broader consensus and results, and ultimately provide help for CS recovery.
PubMed: 36582295
DOI: 10.3389/fmed.2022.1071707