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Parturition - Top 30 Publications

"Is the doctor God to punish me?!" An intersectional examination of disrespectful and abusive care during childbirth against single mothers in Tunisia.

Disrespectful and abusive treatment during childbirth is a violation of women's right to dignified, respectful healthcare throughout pregnancy and childbirth. Although reports point out that marginalized groups in society such as single mothers are particularly vulnerable to abusive and disrespectful care, there is a lack of in-depth research exploring single mothers' encounters at the maternal healthcare facilities, especially in Tunisia. In Tunisia, single mothers are particularly vulnerable due to their social stigmatization and socio-economic marginalization. This study examines the self-perceptions and childbirth experiences of single mothers at the public healthcare facilities in Tunisia.

Dairy cows with prolonged calving seek additional isolation.

In modern calving facilities, dairy cows either calve in a group pen or are moved to a separate individual pen when calving is imminent. In practice, cows are often moved too close to calving, which poses a health risk to cow and calf. Thus, a need exists for new calving facility designs and management practices that better align with the motivations of the cow. This study examined dairy cow preferences for individual calving pens by offering 3 different levels of isolation (tall and narrow, low and wide, and tall and wide) by analyzing the association between precalving behavior, choice of degree of isolation, and the progress of calving. The hypotheses were that cows would prefer the highest level of isolation when giving birth, and that calving in a high level of isolation would be associated with less restlessness and a shorter calving duration. Contrary to these hypotheses, no specific preference between degrees of isolation or difference in calving behavior in the different calving pens was found. However, cows experiencing a longer calving duration chose to calve in the most secluded calving pen (tall and wide). These results cannot determine cause and effect, but may suggest that interactions between motivation for isolation seeking and calving behavior exist.

What accounts for the association between late preterm births and risk of asthma?

Although results of many studies have indicated an increased risk of asthma in former late preterm (LPT) infants, most of these studies did not fully address covariate imbalance.

Paternal Depression Symptoms During Pregnancy and After Childbirth Among Participants in the Growing Up in New Zealand Study.

Antenatal and postnatal depression are known to be common and associated with poor outcomes for women and their children. There is little evidence on depression symptoms among men during the perinatal period.

Consequences of delivery at home in a woman without prenatal care.

This is a case report of a 39-year-old multigravida woman without allopathic prenatal care who, after three previous caesarean sections, attempted to deliver her fourth child at home with the help of a direct entry midwife. During labour, fetal movement and fetal heart tones became undetectable, at which time the patient was referred by the midwife to the hospital. The patient was diagnosed with uterine rupture, bladder rupture and fetal demise; she was rushed to emergency surgery. The patient's lack of allopathic prenatal care, attempt of vaginal birth after three previous caesarean sections, coupled with her desire for delivery at home, led to her complicated course. The patient related that she was never made aware that attempting a home birth after three prior caesarean sections put her at increased risk for complications, and she was also unaware that midwives could have varying levels of training.

Shelter type and birth number influence the birth and death sites of lambs and ewe movement around lambing time.

A significant number of lambs born each yr in Australia die within 72 h of birth. Periods of high wind, combined with rain and low temperatures, can lead to marked increases in the level of mortality. Under these weather conditions mortality levels may be reduced with the provision of shelter, provided it is utilized by lambs. This study used GPS collars to determine the use of shelter by ewes and lambs, to compare the movement of ewes with twin lambs across 2 types of shelter (hedgerows and shrubs), while also comparing ewes with single and twin lambs in a single shelter type (hedgerows). Additionally, the birth sites of 364 lambs and death sites of 252 lambs were recorded across the 3 shelter type and litter size combinations (Twins in shrubs, Twins in hedgerows, Singles in hedgerows) plus an unsheltered group (Singles in unsheltered). A higher (P < 0.001) than randomly expected percentage of ewes lambed in the areas closest to both shelter types; in the shrub shelter 42% of ewes lambed within 2.5 m of shrub rows compared to an expected 11% based on the proportion of the paddock this area constituted. Despite the higher than expected percentage of ewes lambing close to the shelter rows, ewes in both twin lamb shelter types avoided the areas close to the shelter before and after lambing (Hedgerows-2.5 m; Shrubs- 6.25 m) and single bearing ewes showed no preference for or against these areas. With a high proportion of twin bearing ewes lambing close to the shelter, a design that reduces the potential for ewe and offspring separation while providing good shelter will offer the greatest potential reduction in newborn twin lamb mortality arising from exposure.

Elevation of blood β-hydroxybutyrate concentration affects glucose metabolism in dairy cows before and after parturition.

Recent studies in mid- and late-lactation dairy cows showed that β-hydroxybutyrate (BHB) infusion had a considerable effect on glucose metabolism and immune response during intramammary lipopolysaccharide challenge. The objective of the present study was to infuse BHB during the dry period and after parturition to investigate the effects of elevated plasma BHB concentrations on metabolism and endocrine changes in transition dairy cows. The hypothesis tested was that regulation of glucose metabolism would change at different physiological stages and an additional elevation of BHB concentration would alter glucose concentration. Multiparous Holstein cows in wk -2 (antepartum, a.p.; n = 6) and wk +2 (postpartum, p.p.; n = 8) relative to calving were infused (4 h from 0800 to 1200 h) with a BHB solution to increase plasma BHB concentration to 1.5 to 2.0 mmol/L (HyperB). The same period the next day without any infusion was considered the control period (CON). Blood samples were taken 1 h before the start of infusion as reference samples and every 30 min during the following 6 h (4 h of infusion and 2 h after infusion) in the HyperB and CON periods, and analyzed for glucose, BHB, insulin, and glucagon concentrations. During the steady state period (the latter 2 h of the 4-h infusion), plasma BHB concentration reached 1.87 ± 0.05 mmol/L (a.p.) and 1.93 ± 0.05 mmol/L (p.p.) in HyperB compared with 0.55 ± 0.06 mmol/L (a.p.) and 0.64 ± 0.04 mmol/L (p.p.) in CON, respectively. The 4-h average BHB infusion rate was 12.4 ± 1.0 and 13.3 ± 0.9 μmol/kg of BW per minute in wk -2 and +2, respectively. Infusion of BHB caused a decrease of plasma glucose concentrations relative to preinfusion levels both before and after parturition, although basal glucose concentrations were different before and after calving. Infusion of BHB increased plasma insulin concentrations a.p. but not p.p., despite a higher basal insulin concentration before than after parturition. These findings show that effects of hyperketonemia on plasma glucose concentrations are similar before and after calving but that endocrine adaptation to hyperketonemia differs before and after parturition. We assume that BHB is a metabolic key regulator in early lactating dairy cows and may affect glucose concentration by further pathways such as gluconeogenesis and altered lipolysis.

Effect of Tramadol on Rabbit Uterine Contractile Activity Induced in Late Pregnancy.

Effect of Tramadol infusion (5 mg/ml) on oxytocin-induced uterine contractile activity was studied in chronic experiment on female rabbits with different degrees of biological readiness for parturition. In case of sufficient biological readiness for parturition, Tramadol did not change the number of uterine contractions, but increased the amplitude and duration of each contraction against the background of increased creatine phosphate consumption by the myometrium. At the same time, Tramadol infusion to females without biological readiness for partirition suppressed induced uterine contractile activity by reducing the amplitude of each uterine contraction.

Perceptions and experiences of the mistreatment of women during childbirth in health facilities in Guinea: a qualitative study with women and service providers.

Every woman is entitled to respectful care during childbirth; so it is concerning to hear of informal reports of mistreatment during childbirth in Guinea. This study sought to explore the perceptions and experiences of mistreatment during childbirth, from the perspectives of women and service providers, and the analysis presents findings according to a typology of mistreatment during childbirth.

Is prophylactic tranexamic acid administration effective and safe for postpartum hemorrhage prevention?: A systematic review and meta-analysis.

To assess the efficacy and safety of tranexamic acid (TA) in reducing blood loss and lowering transfusion needs for patients undergoing caesarean section (CS) or vaginal delivery (VD).

Successful covered stent-graft repair in symptomatic renal artery aneurysm early after childbirth.

Renal artery aneurysm (RAA) rupture during pregnancy is a rare but life-threatening event and few cases have been reported in literature. Currently the best approach, endovascular or surgical, seems to be under discussion. A case of a 31-year-old woman with a symptomatic right RAA detected three days after childbirth is reported. A successful endovascular repair by a covered stent-graft was performed.

Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more).

Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour.

Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section.

Caesarean section is thought to be a risk factor for childhood asthma, but this association may be caused by confounding from, for instance, familial factors. To address this problem, we used twin pairs to assess the risk of childhood asthma after emergency caesarean section.

Increased serum serotonin improves parturient calcium homeostasis in dairy cows.

Hypocalcemia in dairy cows is caused by the sudden increase in calcium demand by the mammary gland for milk production at the onset of lactation. Serotonin (5-HT) is a key factor for calcium homeostasis, modulating calcium concentration in blood. Therefore, it is hypothesized that administration of 5-hydroxy-l-tryptophan (5-HTP), a 5-HT precursor, can increase 5-HT concentrations in blood and, in turn, induce an increase in blood calcium concentration. In this study, 20 Holstein dairy cows were randomly assigned to 2 experimental groups. Both groups received a daily i.v. infusion of 1 L of either 0.9% NaCl (C group; n = 10) or 0.9% NaCl containing 1 mg of 5-HTP/kg of BW (5-HTP group, n = 10). Infusions started d 10 before the estimated parturition and ceased the day of parturition, resulting in at least 4 d of infusion (8.37 ± 0.74 d of infusion). Until parturition, blood samples were collected every morning before the infusions, after parturition samples were taken daily until d 7, and a final sample was collected on d 30. Milk yield was recorded during this period. No differences between groups were observed for blood glucose, magnesium, and β-hydroxybutyrate. Cows receiving the 5-HTP infusion showed an increase in fatty acid concentrations from d -3 to -1 before parturition. Serum 5-HT concentrations were increased at d -4 related to parturition until d 5 postpartum in the 5-HTP group compared with the C group. In addition, cows from the 5-HTP group had increased 5-HT concentrations in colostrum, but not in mature milk, on d 7 postpartum. Serum calcium concentrations decreased in both groups around parturition; however, calcium remained higher in the 5-HTP group than in controls, with a significant difference between groups on d 1 (1.62 ± 0.08 vs. 1.93 ± 0.09 mmol/L in control and 5-HTP groups, respectively) and d 2 (1.83 ± 0.06 vs. 2.07 ± 0.07 mmol/L in control and 5-HTP groups, respectively). Additionally, colostrum yield (first milking) was lower in the 5-HTP group compared with the C group, but without consequences on colostrum IgG concentrations. Milk yield did not differ between groups during the rest of the experiment. The study data were consistent with the concept that infusion of 5-HTP to dairy cows increases blood 5-HT concentrations, which in turn is a significant regulatory component in the chain of effectors that affect calcium status around parturition, hence the occurrence of clinical or subclinical hypocalcemia.

Maternal factors associated with birth weight in term infants, Colombia, 2002-2011.

The study aimed to identify maternal factors associated with birth weight in Colombia from 2002 to 2011. This was a descriptive study based on data from the Live Birth Registry of Colombia, Administrative Department of Vital Statistics. Birth weight was classified as low birth weight < 2,500g, insufficient birth weight 2,500-2,999g, normal birth weight 3,000-3,999g, and high birth weight ≥ 4,000g. Data analysis used Mann-Whitney U test, Kruskal-Wallis test, and multinomial logistic regression. Women with increased likelihood of low birth weight newborns were 35 years or older (OR = 1.4; 95%CI: 1.39-1.4), had little schooling (OR = 1.1; 95%CI: 1.1-1.1), were single (OR = 1.1; 95%CI: 1.1-1.2), without prenatal care (OR = 1.9; 95%CI: 1.9-2.0), and lived in rural areas (OR = 1.2; 95%CI: 1.1-1.2). Women with higher prevalence of high birth weight newborns were 35 years or older (OR = 1.1; 95%CI: 1.1-1.1) and had four or more children (OR = 2.1; 95%CI 2.0-2.1). Insufficient birth weight showed a similar pattern to low birth weight. In conclusion, social, demographic, and maternal factors influence the birth weight of newborns in Colombia.

Short communication: Calving site selection of multiparous, group-housed dairy cows is influenced by site of a previous calving.

A calving cow and her newborn calf appear to have an attracting effect on periparturient cows, which may potentially influence the functionality of future motivation-based calving pen designs. In this pilot study we examined whether calving site selection of group-housed Holstein dairy cows was affected by the site of a previous calving. Ten multiparous cows moved to 1 of 2 group pens 11 (range = 4-27) d before calving were included. Each pen consisted of an open area (9 × 9 m) connected to 6 secluded areas (4.5 × 3 m each), where cows could move freely between all areas. Time of calving, location of the breaking of the amniotic sac, as well as the place of birth were recorded. In all but 1 case cows calved within a distance of 1 cow length from where the previous calving took place, suggesting that the cows did not select calving site at random. These preliminary observations indicate that choice of calving site may be affected by the site of a previous calving, potentially explained by the presence of amniotic fluids.

The determinants of essential newborn care for home births in Bangladesh.

To examine the association of sociodemographic, antenatal and delivery care factors with the essential newborn care (ENC) practices of neonates born at home in Bangladesh.

Successful foaling by a Standardbred mare with a ruptured prepubic tendon.

A 12-year-old Standardbred mare was diagnosed with a ruptured prepubic tendon 1 month prepartum. The mare was treated with analgesia, stall rest, and an abdominal support wrap that was tightened daily. Both a live foal born 1 month later and the mare are doing well.

Uterine blood flow in sheep and goats during the peri-parturient period assessed by transrectal Doppler sonography.

The aim of the present study was to evaluate uterine blood flow (UBF) during the postpartum period in small ruminants. The study involved measures of UBF in 5 ewes and 5 goats during the first 4 weeks after parturition. Transrectal quantification of UBF was assessed by determining the diameter (DM), time averaged mean velocity (TAMEAN), blood flow volume (BFV), blood flow acceleration (ACCE) and pulsatility index (PI) in the uterine arteries ipsilateral to the previously gravid uterine horn(s) at Wk 20 of gestation and every 3days from the day of parturition (D 0) until Day 27 postpartum (D 27). The diameters of the uterine arteries decreased (P<0.01) in both species during the postpartum period. The results revealed decreases (P<0.0001) in BFV, ACCE and TAMEAN, while PI increased during the postpartum period in both sheep and goats. Furthermore, there were positive correlations (P<0.05) between blood flow parameters in sheep and goats, respectively (BFV and DM, r=0.62 and 0.58; BFV and ACCE, r=0.32 and 0.26; BFV and TAMEAN, r=0.51 and 0.37). There were negative correlations (P<0.05) between PI and other parameters (PI and BFV, r=-0.39 and -0.36; PI and DM, r=-0.54 and -0.24; PI and ACCE, r=-0.58 and -0.48; and PI and TAMEAN, r=-0.80 and -0.79) in sheep and goats, respectively. Altogether, these results indicate that non-invasive Doppler ultrasound parameters provide important information toward understanding changes in the vasculature and its perfusion of the uterus during the postpartum period in sheep and goats.

Authors' reply re: Does the Epi-No birth trainer prevent vaginal birth-related pelvic floor trauma? A multicenter prospective randomised controlled trial.

Editor's reply re: Does the Epi-No birth trainer prevent vaginal birth-related pelvic floor trauma? A multicenter prospective randomised controlled trial.

Position for labor and birth: State of knowledge and biomechanical perspectives.

This review aims to examine how childbirth position during labour affects maternal, fetal and neonatal outcomes. Epidemiological data suggest that vertical birthing positions have many benefits. But when we consider the players and mechanisms of delivery, including the forces generated to move the fetus and obstacles to its progression, many questions remain about the advantage of one position over another. Thus, childbirth could be considered in a way as an athletic feat that probably requires the choice of optimal positions. These should be individually suited to each woman at different stage of labour to improve its efficiency and effectiveness. Tweetable abstract: Beyond epidemiological data, biomechanical investigations is necessary to assess birth's position.

The good stress of being born.

The effects of periparturient administration of flunixin meglumine on the health and production of dairy cattle.

Research on the assessment and management of pain in cows following difficult or assisted calving is still limited, especially on the effects of analgesics intended to mitigate this pain. The purpose of this study was to assess the effects of flunixin meglumine on the health and production of Holstein cows after calving. In total, 34 flunixin-treated and 38 placebo-treated animals were enrolled in a precalving treatment trial. A total of 633 animals given flunixin and 632 animals administered a placebo were enrolled in a postcalving treatment trial. In both cases, animals were randomly assigned to treatment, and researchers were blind to treatment condition until after analysis. A total of 1,265 animal records were analyzed for milk production for the first 14d in milk and health outcomes for the first 30d in milk. Animals treated with flunixin meglumine before calving had a significantly increased risk of stillbirth. Animals treated immediately after calving had increased odds of having a retained placenta and, in turn, increased risk of a high temperature, decreased milk production, and an increased risk of developing metritis. The administration of flunixin meglumine within 24h of parturition is not recommended in dairy cattle.

Characterization of the motor performance of newborns in a neonatal unit of tertiary level.

To characterize the motor performance of newborns in a neonatal unit of tertiary level and compare the results to the values recommended by the Test of Infant Motor Performance (TIMP).

Home births in the context of free health care: The case of Kaya health district in Burkina Faso.

To identify the factors associated with home births in the Kaya health district in Burkina Faso, where child delivery was free of charge between 2007 and 2011.

Trends and changes in home deliveries in Kassena-Nankana districts in northern Ghana: Results from repeated cross-sectional surveys.

To investigate trends and changes in home deliveries in northern Ghana following the implementation of interventions targeting common barriers to utilization of health services.

Systematic early obstetrical assistance at calving: I. Effects on dairy calf stillbirth, vigor, and passive immunity transfer.

A critical time for dairy cattle is the perinatal period. Good calving management is critical to reduce periparturient losses and ensure the health of the offspring. Generally, it has been recommended that cows be allowed to calve unassisted when possible, but very few studies have been published that support or refute this general guideline. To investigate the effect of early assistance, a clinical trial enrolled 257 Holstein cows that were observed through the second stage of calving and assigned randomly to 1 of 2 calving interventions: not assisted (NA) or early assistance (EA) during the second stage of parturition. Early assistance was given 15min after the first sight of both front hooves of the calf and done using only human force. After calving, the animals were classified into 4 actual calving intervention groups: too quick to be assisted (TQ), NA, EA, and late assistance (LA; for cows in the NA group that did not calve unassisted within the 1h maximum time frame allowed). Giving early assistance to cows during calving as a routine management practice (assigned intervention) did not negatively influence calves' stillbirth risk, vigor at birth, or transfer of passive immunity. Calves in the LA intervention group had significantly greater odds of stillbirth than calves in the NA and EA groups, respectively. Calves in the LA group also had significantly worse vigor at birth than calves in the TQ, NA, or EA groups. Early assistance given at calving to cows that did not present signs of calving difficulties did not adversely affect calves' likelihood of being stillborn, vigor at birth, or transfer of passive immunity.

Human Parturition Involves Phosphorylation of Progesterone Receptor-A at Serine-345 in Myometrial Cells.

The hypothesis that phosphorylation of progesterone receptor (PR) isoforms, PR-A and PR-B, in myometrial cells affects progesterone action in the context of human parturition was tested. Immunodetection of phosphoserine (pSer) PR forms in term myometrium revealed that the onset of labor is associated with increased phosphorylation of PR-A at serine-345 (pSer345-PRA) and that pSer345-PRA localized to the nucleus of myometrial cells. In explant cultures of term myometrium generation of pSer345-PRA was induced by interleukin-1β and dependent on progesterone, suggesting that pSer345-PRA generation is induced by a proinflammatory stimulus. In the hTERT-HM(A/B) human myometrial cell line, abundance of pSer345-PRA was induced by progesterone in a dose- (EC50 ∼1 nM) and time-dependent manner. Prevention of pSer345 (by site-directed mutagenesis) abolished the capacity for PR-A to inhibit anti-inflammatory actions of progesterone mediated by PR-B but had no effect on the transrepressive activity of PR-A at a canonical progesterone response element. Taken together, the data show that human parturition involves the phosphorylation of PR-A at serine-345 in myometrial cells and that this process is ligand dependent and induced by a proinflammatory stimulus. We also found that in myometrial cells, pSer345 activates the capacity for PR-A to inhibit antiinflammatory actions of progesterone mediated by PR-B. Phosphorylation of PR-A at serine-345 may be an important functional link between tissue-level inflammation and PR-A-mediated functional progesterone withdrawal to trigger parturition.

Astrophysics: Birth of stellar siblings.