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Veterinary Medicine International 2024Cow is the national animal of Nepal, yet it is one of the most abused animal species here. Under realized utilities of cow that is nonlactating or pregnant is the reason...
Cow is the national animal of Nepal, yet it is one of the most abused animal species here. Under realized utilities of cow that is nonlactating or pregnant is the reason for demonic cruelty. Since the Vedic period, gaushalas have been caring for cows. At present, most gaushalas have responsibility to rescue, offer refuge, and treat poorly treated or confiscated cattle from smuggling rackets in Nepal. It is no surprise that these abused animals suffer from many health issues and compromised reproductive ability. This study was conducted to know about husbandry practice and to determine prevalence of reproductive disorders in cows of Gaushala from Nepal. Altogether, 27 gaushalas were visited throughout the study period and cows (≥2 years) ( = 2959) were included for the study. From the study, respondents from 14.81% Gaushala admitted indigenous cattle only, 11.11% admitted any breed (indigenous and crossbreed), 44.44% admitted stray animals only, and 29.63% admitted all types (indigenous, crossbreed, and stray animals). The study revealed that among ( = 2959) animals examined, 5.54% ( = 164) were affected by either one or more reproductive problems. The major reproductive disorders identified in study area were repeat breeding 0.47%, cervico-vaginal and uterine prolapse 0.34%, retention of placenta 2.13%, dystocia 0.61%, and abortion 1.66%. Herd size of Gaushala had a significant difference ( < 0.05) on the overall prevalence of reproductive problems in cows of Gaushala. The main issues with gaushalas included a lack of resources like adequate fund, feeds, fodder, and water, shortage of grazing acreage, veterinary services, and difficulties in managing male cattle. To mitigate the issues and welfare related to gaushalas strict adherence to disease surveillance and biosecurity rules, avoidance of unlimited reproduction in cows, and separation of males and females, fund raising and resource management, collaboration with local government and NGOs, veterinary hospital, clinics, research, and innovation with veterinary institution and universities.
PubMed: 38716201
DOI: 10.1155/2024/3058386 -
Midwifery Jul 2024This review was conducted to examine the effectiveness of antenatal follow-up using telehealth in the pre-COVID-19 and active pandemic periods. (Meta-Analysis)
Meta-Analysis Review
The impact of antenatal telehealth services on maternal and neonatal outcomes, a comparison of results before and during the COVID-19 pandemic: A systematic review and meta-analysis (The impact of telehealth services on maternal and neonatal outcomes).
OBJECTIVE
This review was conducted to examine the effectiveness of antenatal follow-up using telehealth in the pre-COVID-19 and active pandemic periods.
DESIGN
A systematic review and meta-analysis of randomized controlled trials.
METHODS
Searches were conducted from inception to September 2023 through PubMed, the Cochrane Library, EBSCO, Embase, Web of Science, all via Ovid SP, the National Thesis Center, TR Index, Turkiye Clinics, and DergiPark Academic. Data were combined in the meta-analysis. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation guidelines.
RESULTS
The meta-analysis examining the effectiveness of antenatal telehealth services included 35 studies with a total sample size of 16 033. The combined results of the studies revealed that antenatal telehealth services were similar to face-to-face follow-ups for many maternal and newborn health outcomes. Maternal outcomes included abortion, preterm delivery, gestational diabetes, weight gain, hypertensive disorders, maternal hospitalization, number of antenatal follow-ups, use of induction, vaginal and instrumental delivery, planned and emergency cesarean section, shoulder dystocia, episiotomy, perineal laceration, childbirth under the supervision of qualified personnel, breastfeeding problems and postpartum depression. Neonatal outcomes included an APGAR score of <7, neonatal hypoglycemia, hyperbilirubinemia, admission into the neonatal intensive care unit, respiratory distress syndrome, neonatal death, birth weight, low birth weight and macrosomia. However, statistically significant reductions in excessive weight gain (p<0.001) and a 1.23-fold increase in vaccination administration (p=0.001) were observed with telehealth services. Additionally, the effects of telehealth services on preterm and cesarean delivery rates were similar in the pre-pandemic and pandemic periods.
CONCLUSION AND IMPLICATIONS FOR PRACTICE AND RESEARCH
This review reveals that while antenatal telehealth services are comparable to face-to-face care in terms of multiple pregnancy, delivery, and neonatal outcomes, they contribute to improvements in preventing extreme weight gain and vaccination hesitancy. These findings suggest that the telehealth method can be used as an alternative to face-to-face monitoring in antenatal follow-ups.
Topics: Humans; COVID-19; Pregnancy; Telemedicine; Female; Infant, Newborn; Pregnancy Outcome; Prenatal Care; SARS-CoV-2; Pandemics; Adult
PubMed: 38714075
DOI: 10.1016/j.midw.2024.104017 -
Reproduction in Domestic Animals =... May 2024This study was conducted to assess the disparities in camel activities such as eating, drinking, sitting, standing, and sleeping between primiparous and multiparous...
This study was conducted to assess the disparities in camel activities such as eating, drinking, sitting, standing, and sleeping between primiparous and multiparous females before parturition using computer vision. Also, any extraordinary behaviours during the final 2 h before parturition and the necessary manual interventions were meticulously recorded. Five primiparous (age: 4.5-7 years) and 7 multiparous (age: 8-14 years; parity: 2.1 ± 1.5) dromedary camels, were included in this study. Pre-partum females were housed double in a parturition pen provided with two Reolink RLC-810A cameras and the data were collected and recorded for each female. Two primiparous and 1 multiparous female required assistance in pulling the calf from both forelimbs to complete their parturition (27.3%). The drinking and sleeping activities were similar in primiparous and multiparous females during the recorded 32 h leading up to calving. Only eating activity exhibited a longer period in primiparous females compared to multiparous females specifically during the 12-h before calving. Sitting activity was longer, and standing activity was shorter in multiparous than in primiparous females during the 24, 12, and 6 h before calving. All parturient camels, whether primiparous or multiparous, exhibited signs of distress. Some extraordinary behaviours were observed, such as two multiparous females attempting to deter their primiparous counterparts from eating. Additionally, three females displayed a distinctive standing position on their knees while their hind limbs were in a complete standing position for 3-5 min before transitioning to sitting or standing positions. Furthermore, one primiparous female stood while the head and forelimbs of the calf partially protruded from her vulva. In conclusion, the application of computer vision and deep learning technology proves valuable for observing prepartum camels under farm conditions, potentially reducing economic losses stemming from delayed human intervention in dystocia cases.
Topics: Animals; Female; Camelus; Pregnancy; Parity; Behavior, Animal; Parturition; Eating
PubMed: 38698636
DOI: 10.1111/rda.14572 -
Child's Nervous System : ChNS :... May 2024Conjoined twins (CT), which used to be historically defined as "monstrous human" and previously so-called Siamese twins in the early eighteenth century, are one of the...
Parasitic pygopagus conjoined twins' incidental findings in the obstructed labor of an intrapartum dead baby that had undergone emergency C-section: rare case report in South Papua.
BACKGROUND
Conjoined twins (CT), which used to be historically defined as "monstrous human" and previously so-called Siamese twins in the early eighteenth century, are one of the very rare congenital malformations with an uncertain etiology and complex yet remain inconclusively debatable regarding its pathophysiological mechanisms of fusion and fission theories. Among all types of CT, parasitic CT, especially the pygopagus sub-type, is exceedingly rarer. To the best of the authors' knowledge, no parasitic CT had been reported in Papua, and this is the first finding in South Papua.
CASE REPORT
Herein, a 30-year-old multigravida female with 37th-week gestation, previous twice spontaneous miscarriage, and non-adequate antenatal care history is presented with a chief complaint of painful construction and greenish fluid leakage from the vagina, with an examination that showed a cephalic presentation with a "peculiar" big mass at the upper uterus and complete cervical dilation toward second-stage inpartu. Vaginal delivery was performed with a complication of obstructed labor due to uncommon dystocia with a suspected "big mass" below the fetal buttocks and intrapartum dead. Intrapartum transabdominal ultrasound demonstrates a gross anatomically like an organ inside a fluid-filled mass with unidentified parts, leading to a suspected type of congenital malformation at the baby's sacral region. Emergency C-section was done with findings of parasitic pygopagus CT, showing an attachment of a large irregular fluid-filled mass-like incomplete twin (parasite) with palpable soft tissue and bony structure inside to the buttocks of a male autosite twin, and an additional third leg which happened to be an under-developed lower extremity with a sacrum-like structure.
CONCLUSIONS
An obstetrician's routine ANC and critical radiological evaluation will increase the odds of identifying CT or other congenital malformations to provide better delivery planning or further management. Increasing maternal health knowledge in society, improving medical skills and knowledge levels for health providers, and advancing supporting facilities and specialists are future strategies for managing and preventing such cases in low-middle-income countries.
PubMed: 38695890
DOI: 10.1007/s00381-024-06440-6 -
Journal of Veterinary Internal Medicine 2024Hypothermia is a cause of neonatal calf death in cold climates. Practical and effective rewarming methods are important for bovine health within affected regions. (Comparative Study)
Comparative Study
BACKGROUND
Hypothermia is a cause of neonatal calf death in cold climates. Practical and effective rewarming methods are important for bovine health within affected regions.
HYPOTHESIS/OBJECTIVES
To compare the rewarming rate and blood analytes (glucose, lactate, and cortisol) of calves resuscitated with forced air with warm water bath, with or without oral administration of caffeine.
ANIMALS
Twenty healthy neonatal Holstein bull calves.
METHODS
In this randomized, prospective study, calves born healthy and without history of dystocia were cooled to 32°C rectal temperature then thermally resuscitated using either forced air rewarming or warm water bath (40°C) with or without oral administration of caffeine. Rectal temperatures were used to quantify recovery rate. Measurements of glucose, lactate, and cortisol were recorded for every 2°C change in rectal temperature.
RESULTS
Rectal temperature decline (0.03°C per minute) and total cooling time (191.0 ± 33.3 minutes) did not significantly differ among treatment groups. Calves were successfully resuscitated to 38°C by either method. Time required to euthermia using warm water was significantly faster (0.1°C per minute; 64.3 ± 17.8 minute; P < .05) than forced air (0.05°C per minute; 123.1 ± 20.0 minutes). Caffeine had no significant effect on resuscitation rate (P = .14; 95% CI, -0.002 to 0.024) in either treatment; however, caffeine was associated with reduced time to euthermia by 8.3 and 10.8 minutes, respectively. Changes in metabolic variables (glucose, lactate, and cortisol), were inversely related to rectal temperature with no statistical significance among rewarming methods.
CONCLUSIONS AND CLINICAL IMPORTANCE
Although warm water submersion is faster, forced air rewarming is an effective alternative for restoration of euthermia.
Topics: Animals; Cattle; Hypothermia; Animals, Newborn; Caffeine; Male; Cattle Diseases; Prospective Studies; Rewarming; Resuscitation; Hydrocortisone; Administration, Oral; Baths; Blood Glucose; Lactic Acid; Body Temperature; Random Allocation
PubMed: 38685595
DOI: 10.1111/jvim.17066 -
Obesity Reviews : An Official Journal... Jul 2024Maternal obesity and gestational diabetes mellitus (GDM) prevalence are increasing, with both conditions associated with adverse neonatal outcomes. This review aimed to... (Meta-Analysis)
Meta-Analysis Review
Maternal obesity and gestational diabetes mellitus (GDM) prevalence are increasing, with both conditions associated with adverse neonatal outcomes. This review aimed to determine the risk of adverse outcomes in women with obesity and GDM, compared with women with obesity alone. A systematic search identified 28 eligible articles. Meta-analysis was conducted using a random effects model, to generate pooled estimates (odds ratios, OR, or mean difference, MD). Compared with normal-weight controls, women with obesity had increased risks of large for gestational age (LGA, OR 1.98, 95% CI: 1.56, 2.52) and macrosomia (OR 2.93, 95% CI: 1.71, 5.03); the latter's risk almost double in women with obesity than GDM. Birth weight (MD 113 g, 95% CI: 69, 156) and shoulder dystocia (OR 1.23, 95% CI: 0.85, 1.78) risk was also higher. GDM significantly amplified neonatal risk in women with obesity, with a three- to four-fold risk of LGA (OR 3.22, 95% CI: 2.17, 4.79) and macrosomia (OR 3.71, 95% CI: 2.76, 4.98), as well as higher birth weights (MD 176 g, 95% CI: 89, 263), preterm delivery (OR 1.49, 95% CI: 1.25, 1.77), and shoulder dystocia (OR 1.99, 95% CI: 1.31, 3.03), when compared with normal-weight controls. Our findings demonstrate that maternal obesity increases serious neonatal adverse risk, magnified by the presence of GDM. Effective strategies are needed to safeguard against neonatal complications associated with maternal obesity, regardless of GDM status.
Topics: Humans; Pregnancy; Diabetes, Gestational; Female; Infant, Newborn; Pregnancy Outcome; Fetal Macrosomia; Birth Weight; Obesity, Maternal; Risk Factors; Obesity; Pregnancy Complications; Shoulder Dystocia
PubMed: 38679418
DOI: 10.1111/obr.13747 -
Medicina (Kaunas, Lithuania) Apr 2024Uterine fibroids are common benign tumors found in fertile women. Numerous obstetrical issues, such as dystocia during labor, fetal hypotrophy, a ruptured amniotic sac,...
Uterine fibroids are common benign tumors found in fertile women. Numerous obstetrical issues, such as dystocia during labor, fetal hypotrophy, a ruptured amniotic sac, early labor, low-birth-weight newborns, etc., are associated with fibrous pregnant uteri. Cesarean myomectomy is not a common procedure because of the possibility of postpartum hysterectomy or a potentially lethal hemorrhage. For the chosen topic, we present two instances of emergency postpartum hysterectomies following cesarean myomectomy. After a cesarean myomectomy, two women experienced a perioperative hemorrhage that required a postpartum hysterectomy without a salpingo-oophorectomy. A postpartum hysterectomy was required in every instance due to the failure of additional hemostatic techniques to control the bleeding after the cesarean myomectomy. In every case, the location and number of fibroids-rather than their size-were the primary factors leading to the postpartum hysterectomy. In order to ensure that the patient is safe and that the advantages outweigh the dangers, the current trends in cesarean myomectomy include aiming to conduct the procedure either electively or when it offers an opportunity. The treatment is still up for debate because it is unknown how dangerous a second hysterectomy is for people who have had a cesarean myomectomy.
Topics: Humans; Female; Cesarean Section; Hysterectomy; Uterine Myomectomy; Adult; Pregnancy; Leiomyoma; Uterine Neoplasms; Postpartum Period; Postoperative Complications
PubMed: 38674240
DOI: 10.3390/medicina60040594 -
Cureus Mar 2024Introduction Gestational diabetes mellitus (GDM) is a form of glucose intolerance that arises during pregnancy, affecting a significant portion of women. It has...
Introduction Gestational diabetes mellitus (GDM) is a form of glucose intolerance that arises during pregnancy, affecting a significant portion of women. It has immediate and long-term effects on both the mother and fetus, including complications like preeclampsia, premature delivery, and an increased risk of cesarean sections. A cross-sectional study among Saudi Arabia's general population, which included 979 women aged between 18 and 60, found varying levels of awareness of GDM, emphasizing the need for more research on awareness levels regarding GDM in Saudi Arabia and more educational campaigns to improve awareness. Objectives The study evaluates the knowledge of pregnant women about GDM and its implications for the mother and fetus. It investigates the relationship between knowledge levels and demographic factors like age, education, and socioeconomic status, aiming to identify knowledge gaps regarding this health issue and develop targeted educational initiatives. Methodology This was a cross-sectional study that included 979 women and was conducted using a Google Forms (Google Inc., Mountainview, CA) questionnaire. The questionnaire covered demographics and explored the knowledge level of women about the impact of GDM on the mother and fetus. Statistical analysis was implemented by IBM SPSS software version 27.0 (IBM Corp., Armonk, NY), with a 5% significance level. Ethical approval was sought, emphasizing anonymous data collection. We did not collect any identifying or private information from participants, and all responses were kept confidential. Results A study of 979 women revealed that their knowledge of GDM was significantly influenced by their age, gestational age, and the number of prior deliveries (p-value < 0.05). The total mean knowledge score for women's correct responses stood at 7.62 (±4.49). The study found that a majority of women, exceeding 60%, accurately answered certain questions about GDM, such as its association with heightened risks, neonatal intensive care unit (NICU) admissions, cesarean section likelihood, high birth weight, and preeclampsia. However, less than 30% could answer yes to questions that indicated that GDM could increase the risk of shoulder dystocia, hypoglycemia at birth, premature rupture of membranes, postpartum hemorrhage, and vacuum delivery. Conclusion There is a need for targeted educational initiatives, particularly focusing on knowledge gaps that women are lacking regarding GDM. Age and prior deliveries were identified as significant determinants of knowledge levels.
PubMed: 38665742
DOI: 10.7759/cureus.56969 -
Women's Health Nursing (Seoul, Korea) Mar 2024The present study investigated experiences of traumatic perinatal events, the provision of related education, and educational needs of nurses working in the labor and...
PURPOSE
The present study investigated experiences of traumatic perinatal events, the provision of related education, and educational needs of nurses working in the labor and delivery room (LDR).
METHODS
Nurses working in the LDRs of six institutions and two nurse portal sites were invited to participate in the survey, delivered on paper or online. The data were collected from October 1 to November 25, 2022. Data from 129 nurses were analyzed using frequency, the chi-square test, the Fisher exact test, the t-test, and analysis of variance.
RESULTS
Virtually all participants (98.6%) reported having experienced at least one traumatic perinatal event (dystocia, postpartum hemorrhage, neonatal congenital anomalies, severe maternal or neonatal injury, stillbirth, and maternal or neonatal death) while working in the LDR. The most shocking traumatic perinatal event experienced was the maternal or neonatal death (40.3%), but 24.8% of participants did not recall ever receiving education on the topic. About 63% of participants experienced traumatic perinatal events within a year of working in the LDR. The average score for education needs regarding traumatic perinatal events was 3.67±0.37 out of 4, and participants preferred simulation education as the most effective educational method.
CONCLUSION
Since most of the participants had experienced various traumatic perinatal events in the early stages of working in the LDR and expressed a high level of need for education on traumatic perinatal events, it is necessary to provide more effective stimulation education programs in the early period of work in the LDR.
Topics: Adult; Female; Humans; Infant, Newborn; Male; Pregnancy; Cross-Sectional Studies; Delivery Rooms; Delivery, Obstetric; Labor, Obstetric; Needs Assessment; Nurses; Republic of Korea; Surveys and Questionnaires; Young Adult
PubMed: 38650328
DOI: 10.4069/whn.2024.03.10 -
Obstetrical & Gynecological Survey Apr 2024Macrosomia represents the most significant risk factor of shoulder dystocia (SD), which is a severe and emergent complication of vaginal delivery. They are both... (Review)
Review
IMPORTANCE
Macrosomia represents the most significant risk factor of shoulder dystocia (SD), which is a severe and emergent complication of vaginal delivery. They are both associated with adverse pregnancy outcomes.
OBJECTIVE
The aim of this study was to review and compare the most recently published influential guidelines on the diagnosis and management of fetal macrosomia and SD.
EVIDENCE ACQUISITION
A comparative review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Royal College of Obstetricians and Gynaecologists, the National Institute for Health and Care Excellence, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), and the Department for Health and Wellbeing of the Government of South Australia on macrosomia and SD was conducted.
RESULTS
The ACOG and RANZCOG agree that macrosomia should be defined as birthweight above 4000-4500 g regardless of the gestational age, whereas the National Institute for Health and Care Excellence defines macrosomia as an estimated fetal weight above the 95th percentile. According to ACOG and RANZCOG, ultrasound scans and clinical estimates can be used to rule out fetal macrosomia, although lacking accuracy. Routine induction of labor before 39 weeks of gestation with the sole indication of suspected fetal macrosomia is unanimously not recommended, but an individualized counseling should be provided. Exercise, appropriate diet, and prepregnancy bariatric surgery are mentioned as preventive measures. There is also consensus among the reviewed guidelines regarding the definition and the diagnosis of SD, with the "turtle sign" being the most common sign for its recognition as well as the poor predictability of the reported risk factors. Moreover, there is an overall agreement on the algorithm of SD management with McRoberts technique suggested as first-line maneuver. In addition, appropriate staff training, thorough documentation, and time keeping are crucial aspects of SD management according to all medical societies. Elective delivery for the prevention of SD is discouraged by all the reviewed guidelines.
CONCLUSIONS
Macrosomia is associated not only with SD but also with maternal and neonatal complications. Similarly, SD can lead to permanent neurologic sequalae, as well as perinatal death if managed in a suboptimal way. Therefore, it is crucial to develop consistent international practice protocols for their prompt diagnosis and effective management in order to safely guide clinical practice and improve pregnancy outcomes.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Fetal Macrosomia; Dystocia; Shoulder Dystocia; Australia; Delivery, Obstetric
PubMed: 38640129
DOI: 10.1097/OGX.0000000000001253