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Veterinary Journal (London, England :... Jun 2024Preventing dystocia can stabilise beef cattle management. This study aimed to investigate the relationship between serum pregnancy-associated glycoproteins (PAGs) S-N... (Comparative Study)
Comparative Study
Preventing dystocia can stabilise beef cattle management. This study aimed to investigate the relationship between serum pregnancy-associated glycoproteins (PAGs) S-N values and estrone sulphate (ES) concentrations during pregnancy and the calf birth weight in beef cattle and to evaluate their usefulness as new predictive parameters for dystocia due to foetal overgrowth. Thirty-eight pregnant Japanese Black cattle were used. Blood samples were collected at 40, 70, 100, 150, 200, 250, 280, and 285 days after artificial insemination (AI), and birth weight of the offspring was measured. Serum PAGs S-N values and ES concentrations were measured, and the area under the curve (AUC) and the ratio of change based on 70 days after AI were calculated, followed by calculation of the correlation coefficient with the birth weight of the offspring and comparison between the eutocia (n = 32) and dystocia (n = 6) groups. The birth weight of the offspring was moderately positively correlated with the AUC of serum PAGs S-N values and ES concentrations in the second (r = 0.425, P < 0.01) and third (r = 0.595, P < 0.01) trimesters, respectively. The ratio of change in serum ES concentrations between 70 and 280 days after AI was greater (P < 0.05) in the dystocia group (1276.6 ± 229.1 %) than in the eutocia group (852.6 ± 69.6 %). These results suggest that blood PAGs S-N values at mid-pregnancy (100-199 days after AI) and the ratio of changes in blood ES concentrations between 70 and 280 days after AI may be new parameters for predicting dystocia.
Topics: Animals; Female; Pregnancy; Estrone; Cattle; Dystocia; Birth Weight; Cattle Diseases; Pregnancy Proteins; Glycoproteins
PubMed: 38810930
DOI: 10.1016/j.tvjl.2024.106147 -
JFMS Open Reports 2024A 2-year-old domestic shorthair queen sustained a tear in the vaginal wall through which the queen herniated a fetus during parturition. An exploratory laparotomy was...
CASE SUMMARY
A 2-year-old domestic shorthair queen sustained a tear in the vaginal wall through which the queen herniated a fetus during parturition. An exploratory laparotomy was performed, the patient had an ovariohysterectomy and the fetus was removed vaginally. The tear was managed medically with antibiotics, analgesics and careful monitoring. Assessment of the injury site 2 weeks later confirmed successful healing without the need for surgical intervention in the vaginal wall.
RELEVANCE AND NOVEL INFORMATION
This is the first report in veterinary medicine describing the successful medical management of a dystocia-related vaginal wall tear in a feline patient without surgical repair.
PubMed: 38803554
DOI: 10.1177/20551169241243016 -
Birth (Berkeley, Calif.) May 2024Diagnoses of labor dystocia, and subsequent labor augmentation, make one of the biggest contributions to childbirth medicalization, which remains a key challenge in...
BACKGROUND
Diagnoses of labor dystocia, and subsequent labor augmentation, make one of the biggest contributions to childbirth medicalization, which remains a key challenge in contemporary maternity care. However, labor dystocia is poorly defined, and the antithetical concept of physiological plateaus remains insufficiently explored.
AIM
To generate a definition of physiological plateaus as a basis for further research.
METHODS
This qualitative study applied grounded theory methods and comprised interviews with 20 midwives across Australia, conducted between September 2020 and February 2022. Data were coded in a three-phase approach, starting with inductive line-by-line coding, which generated themes and subthemes, and finally, through axial coding.
RESULTS
Physiological plateaus represent a temporary slowing of one or multiple labor processes and appear to be common during childbirth. They are reported throughout the entire continuum of labor, typically lasting between a few minutes to several hours. Their etiology/function appears to be a self-regulatory mechanism of the mother-infant dyad. Physiological plateaus typically self-resolve and are followed by a self-resumption of labor. Women with physiological plateaus during labor appear to experience positive birth outcomes.
DISCUSSION
Despite appearing to be common, physiological plateaus are insufficiently recognized in contemporary childbirth discourse. Consequently, there seems to be a significant risk of misinterpretation of physiological plateaus as labor dystocia. While findings are limited by the qualitative design and require validation through further quantitative research, the proposed novel definition provides an important starting point for further investigation.
CONCLUSION
A better understanding of physiological plateaus holds the potential for a de-medicalization of childbirth through preventing unjustified labor augmentation.
PubMed: 38800984
DOI: 10.1111/birt.12843 -
Cureus Apr 2024Birth injury or birth trauma refers to physical damage or trauma that occurs to a newborn during the birthing process. To ensure continuous care and improve neonatal...
BACKGROUND
Birth injury or birth trauma refers to physical damage or trauma that occurs to a newborn during the birthing process. To ensure continuous care and improve neonatal outcomes, it is crucial to know the incidence, types, relation to the mode of delivery, and their management.
METHODOLOGY
This is a retrospective cohort study conducted at Aga Khan University Hospital, Pakistan from January 2018 to December 2022. Neonates aged from birth to 28 days of life identified to sustain any form of mechanical birth injuries were included. Data analysis was done using SPSS version 19 (IBM Corp., Armonk, NY).
RESULTS
In the last five years, 51 mechanical birth injuries were found among 27,854 deliveries, which accounts for one in 546 births with an overall prevalence of 0.001%. Out of the total mechanical birth injuries, 12 (23.5%) were noticed in spontaneous vaginal delivery, six (11.8%) had instrumental delivery, and 33 (64.7%) patients had cesarean sections. More birth injuries were noticed in emergency cesarean section as compared to vaginal deliveries. There were 40 babies (78%) with soft tissue injuries, seven (14%) had musculoskeletal injuries/fractures, two (4%) babies had intracranial bleeding, and two (4%) had fractures along with intracranial bleeding. There was no mortality reported among these neonates.
CONCLUSION
The overall rate of birth injuries was significantly lower as compared to other low and middle-income countries. Most of the birth injuries were soft tissue injuries in patients with cesarean sections. The rate of birth injury did not show any association with the time of delivery. More frequent obstetric emergency drills would improve complications associated with shoulder dystocia.
PubMed: 38800218
DOI: 10.7759/cureus.58997 -
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 -
Journal of Dairy Science May 2024An economic simulation was carried out over 183 milk-producing countries to estimate the global economic impacts of 12 dairy cattle diseases and health conditions:...
An economic simulation was carried out over 183 milk-producing countries to estimate the global economic impacts of 12 dairy cattle diseases and health conditions: mastitis (subclinical and clinical), lameness, paratuberculosis (Johne's disease), displaced abomasum, dystocia, metritis, milk fever, ovarian cysts, retained placenta, and ketosis (subclinical and clinical). Estimates of disease impacts on milk yield, fertility, and culling were collected from the literature, standardized, meta-analyzed using a variety of methods ranging from simple averaging to random-effects models, and adjusted for comorbidities to prevent overestimation. These comorbidity-adjusted disease impacts were then combined with a set of country-level lactational incidence and/or prevalence estimates, herd characteristics, and price estimates within a series of Monte Carlo simulations that estimated and valued the economic losses due to these diseases. It was estimated that total annual global losses are USD 65 billion (B). Subclinical ketosis, clinical mastitis, and subclinical mastitis were the costliest diseases modeled, resulting in mean annual global losses of approximately USD 18B, USD 13B, and USD 9B, respectively. Estimated global annual losses due to clinical ketosis, displaced abomasum, dystocia, lameness, metritis, milk fever, ovarian cysts, paratuberculosis, and retained placenta were estimated to be USD 0.2B, 0.6B, 0.6B, 6B, 5B, 0.6B, 4B, 4B, and 3B, respectively. Without adjustment for comorbidities, when statistical associations between diseases were disregarded, mean aggregate global losses would have been overestimated by 45%. Although annual losses were greatest in India (USD 12B), the USA (USD 8B), and China (USD 5B), depending on the measure of losses used (losses as a percent of GDP, losses per capita, losses as a percent of gross milk revenue), the relative economic burden of these dairy cattle diseases across countries varied markedly.
PubMed: 38788837
DOI: 10.3168/jds.2023-24626 -
Journal of Imaging Apr 2024The position of the fetal head during engagement and progression in the birth canal is the primary cause of dystocic labor and arrest of progression, often due to...
The position of the fetal head during engagement and progression in the birth canal is the primary cause of dystocic labor and arrest of progression, often due to malposition and malrotation. The authors performed an investigation on pregnant women in labor, who all underwent vaginal digital examination by obstetricians and midwives as well as intrapartum ultrasonography to collect four "geometric parameters", measured in all the women. All parameters were measured using artificial intelligence and machine learning algorithms, called AIDA (artificial intelligence dystocia algorithm), which incorporates a human-in-the-loop approach, that is, to use AI (artificial intelligence) algorithms that prioritize the physician's decision and explainable artificial intelligence (XAI). The AIDA was structured into five classes. After a number of "geometric parameters" were collected, the data obtained from the AIDA analysis were entered into a red, yellow, or green zone, linked to the analysis of the progress of labor. Using the AIDA analysis, we were able to identify five reference classes for patients in labor, each of which had a certain sort of birth outcome. A 100% cesarean birth prediction was made in two of these five classes. The use of artificial intelligence, through the evaluation of certain obstetric parameters in specific decision-making algorithms, allows physicians to systematically understand how the results of the algorithms can be explained. This approach can be useful in evaluating the progress of labor and predicting the labor outcome, including spontaneous, whether operative VD (vaginal delivery) should be attempted, or if ICD (intrapartum cesarean delivery) is preferable or necessary.
PubMed: 38786561
DOI: 10.3390/jimaging10050107 -
Obstetrics and Gynecology May 2024To evaluate the association between continuous glucose monitoring in pregnant people with type 2 diabetes and perinatal outcomes.
OBJECTIVE
To evaluate the association between continuous glucose monitoring in pregnant people with type 2 diabetes and perinatal outcomes.
METHODS
This was a retrospective cohort study of pregnant people with type 2 diabetes who received prenatal care and delivered singleton, nonanomalous neonates at a single academic tertiary care center from November 1, 2019, to February 28, 2023. The primary outcome was a composite of neonatal morbidity, including hypoglycemia, hyperbilirubinemia, shoulder dystocia, large for gestational age at birth, preterm birth, neonatal intensive care unit (NICU) admission, or perinatal death. Demographics and outcomes were compared by type of monitoring (continuous glucose monitoring vs intermittent self-monitoring of blood glucose), and multivariable logistic regression estimated the association between continuous glucose monitoring use and perinatal outcomes.
RESULTS
Of 360 pregnant people who met the inclusion criteria, 82 (22.7%) used continuous glucose monitoring. The mean gestational age at continuous glucose monitoring initiation was 21.3±6.4 weeks. The use of continuous glucose monitoring was associated with lower odds of the primary composite neonatal morbidity (65.9% continuous glucose monitoring vs 77.0% self-monitoring of blood glucose, adjusted odds ratio [aOR] 0.48, 95% CI, 0.24-0.94). Continuous glucose monitoring use was also associated with lower odds of preterm birth (13.4% vs 25.2%, aOR 0.48, 95% CI, 0.25-0.93) and NICU admission (33.8% vs 47.6%, aOR 0.36, 95% CI, 0.16-0.81).
CONCLUSION
In pregnant people with type 2 diabetes, continuous glucose monitoring use was associated with less neonatal morbidity, fewer preterm births, and fewer NICU admissions.
PubMed: 38781595
DOI: 10.1097/AOG.0000000000005609 -
The Journal of Obstetrics and... May 2024This study aimed to examine maternal and neonatal factors in cesarean deliveries due to dystocia, including cephalopelvic disproportion, latent-phase prolongation, and...
OBJECTIVE
This study aimed to examine maternal and neonatal factors in cesarean deliveries due to dystocia, including cephalopelvic disproportion, latent-phase prolongation, and fetal malposition or malpresentation. Additionally, we sought to compare the differences between the dystocia subgroups.
METHOD AND MATERIALS
This retrospective case-control study included women who delivered between January 2010 and June 2021 after 37 weeks of pregnancy and underwent abdominal-pelvic CT scans within 5 years before and after delivery. Neonatal factors were extracted from medical charts immediately after delivery.
RESULTS
Among the 292 women studied, those with cesarean deliveries for dystocia were older (mean ± SD, 34.2 ± 4.27 vs. 32.2 ± 3.8, p-value = 0.002), had higher pre-pregnancy BMI (22.7 ± 3.67 vs. 21.4 ± 3.48, p-value = 0.012) and term-BMI (27.4 ± 3.72 vs. 25.9 ± 3.66, p-value = 0.010), shorter interspinous distance (ISD, the distance between ischial spine) (10.8 ± 0.76 vs. 11.2 ± 0.85 cm, p-value = 0.003), and longer head circumference (HC) (35 ± 1.47 vs. 34.4 ± 1.36 cm, p-value = 0.003) compared to those who had vaginal deliveries. Univariate logistic regression for dystocia revealed associations between HC/maternal height and HC/ISD ratios (OR, 2.02 [95% confidence interval, CI, 1.4 ~ 2.92], 12.13 [3.2 ~ 46.04], respectively). Multivariate logistic analysis indicated that maternal age, ISD, and HC were significant factors for dystocia (OR, 1.11 [95% CI, 1.01 ~ 1.21], 0.49 [0.26 ~ 0.91], 1.53 [1.07 ~ 2.19], respectively). The subgroup with latent-phase prolongation exhibited the lowest birthweight/term-BMI ratio (124 ± 18.8 vs. 113 ± 10.3 vs. 134 ± 19.1, p-value = 0.013).
CONCLUSION
The HC/ISD ratio emerged as a crucial predictor of dystocia, suggesting that reducing term-BMI could potentially mitigate latent-phase prolongation. Further research assessing the maternal mid-pelvis during pregnancy and labor is warranted, along with efforts to reduce BMI during pregnancy.
PubMed: 38777330
DOI: 10.1111/jog.15974 -
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