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BACKGROUND: Dystocia is rare in horses, but is life-threatening for mares and foals. Therefore, veterinary research depends on up-to-date data to optimise equine dystocia management. In addition, knowledge of the prognosis of equine dystocia is necessary to advise animal owners. This retrospective study of equine dystocia aimed to enrich existing datasets with up-to-date information. For the first time, the focus was on the causes of dystocia that occurred alone or in combination. Over a period of 10 years, 72 cases of dystocia were analysed using a standardised, predetermined diagnosis code. RESULTS: Of the 72 cases of dystocia, an isolated cause of dystocia was identified in 37 cases (51.4%) and 35 mares showed a combination of two or more causes (48.6%). Foetal causes were significantly more frequent origin of dystocia (66/69) than maternal causes (3/66) (P < 0.0001). Incorrect posture of the foetal forelimbs and head was the most common combination at 25.7%. The most common isolated cause of dystocia was incorrect posture of the foetal forelimbs (18.9%). A foetotomy was performed in 68% of cases. A caesarean section or an extraction was performed in 13.9% of the cases. Three mares died before any obstetric care was provided. Nine mares (12.5%) were not discharged alive. 73 foals were delivered of which 55 were already dead before veterinary treatment began. In relation to the total number of births in which the foetus was alive at the start of obstetric care, the foetal mortality rate was 61.1% and 88.9% by the time the mare was discharged. CONCLUSIONS: It has been demonstrated for the first time that multiple causes of dystocia in horses are almost as common as isolated causes of dystocia. Neonatal mortality remains high, indicating that the timely detection and treatment of dystocia has the highest priority.
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Distocia , Enfermedades de los Caballos , Caballos , Animales , Distocia/veterinaria , Embarazo , Femenino , Enfermedades de los Caballos/epidemiología , Enfermedades de los Caballos/etiología , Estudios RetrospectivosRESUMEN
In guinea pigs (Cavia porcellus), dystocia is a common occurrence. Several factors have been identified in the literature, including the ossification of the pubic symphysis following failure to breed before 9-12 months of age. The objective of this study was to investigate the ossification of pubic symphysis and its evolution during growth in two groups of females. The first group consisted of non-breeding females, while the second group comprised females introduced to breeding at 4-6 months of age. Twelve pairs of sows were selected for comparison, with one non-breeding and one breeding sow in each pair. Symphysis width and tissue density were assessed using micro-computed tomography. Measurements included the distance between the acetabula, width and bone density of the pubic symphysis. Serial computed tomography scans were performed on each sow over several months, both before and after parturition. The results revealed a significantly higher symphysis width in females that had bred. In addition, symphysis ossification was absent in both breeding and non-breeding sows, contrary to previous descriptions of this species. Therefore, dystocia in guinea pigs may not be attributable to ossification of the pubic symphysis.
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Sínfisis Pubiana , Animales , Femenino , Sínfisis Pubiana/diagnóstico por imagen , Sínfisis Pubiana/anatomía & histología , Cobayas/fisiología , Paridad , Microtomografía por Rayos X/veterinaria , Embarazo , Tomografía Computarizada por Rayos X/veterinaria , Distocia/veterinaria , Distocia/diagnóstico por imagenRESUMEN
As part of a literature review, a systematic search was carried out to determine how the focus of research on dystocia in cattle has changed in the German- and English-spoken literature between the 1960s and 2020 as well as to evaluate the the quality of the scientific literature to date. To this end, 621 references were analyzed. It is evident that the number of publications increased between 2010 and 2020, which emphasizes the importance of the subject. Case series (35.3%) are the most common type of publication. Controlled studies (4.5%) and meta-analyses (0.3%) were found much less frequently. The causes (43.8%) and consequences of dystocia (28.8%) have been investigated most frequently to date, while the frequency has only been analyzed in few studies (7.2%). While treatment methods were mainly evaluated from 1960 to 1979, no chronological focus can be found for the topics "causes of dystocia" and "consequences of dystocia". Publications focusing on the prevention of dystocia are increasingly found from the 1980s onwards.To summarize, it can be stated that publications on the causes of dystocia are currently the most relevant in quantitative terms. For future research projects, the studies should be planned in such a way that they can form the basis for systematic studies, reviews and meta-analyses.
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Enfermedades de los Bovinos , Distocia , Distocia/veterinaria , Distocia/historia , Bovinos , Embarazo , Animales , Femenino , Enfermedades de los Bovinos/historiaRESUMEN
This case report describes the findings of craniofacial anomalies associated with dystocia in a mixed-breed bitch. A bitch in labour was presented for evaluation of dystocia, and an emergency caesarean section was performed. Two pups with craniofacial abnormalities were delivered by hysterotomy. One pup was stillborn, with congenital anomalies including palatoschisis (cleft palate), cheiloschisis (cleft lip), an open fontanelle, and a narrow teardrop-shaped skull. The second pup was delivered alive and had cheiloschisis. Craniofacial malformations are a reported cause of dystocia in the dog, usually due to obstruction. However, dystocia in the reported case is presumed to have developed because the pup's craniofacial malformations prevented stimulation of uterine contractions. To the authors' knowledge, this is the first case report to describe craniofacial abnormalities affecting 100% of the litter and is the first known report to describe the relationship between craniofacial abnormalities and presumptive primary uterine inertia.
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Anomalías Craneofaciales , Enfermedades de los Perros , Distocia , Animales , Femenino , Perros , Embarazo , Distocia/veterinaria , Distocia/etiología , Enfermedades de los Perros/etiología , Anomalías Craneofaciales/veterinaria , Anomalías Craneofaciales/etiología , Mortinato/veterinaria , Cesárea/veterinariaRESUMEN
INTRODUCTION: Obstetrics research has predominantly focused on the management and identification of factors associated with labor dystocia. Despite these efforts, clinicians currently lack the necessary tools to effectively predict a woman's risk of experiencing labor dystocia. Therefore, the objective of this study was to create a predictive model for labor dystocia. MATERIAL AND METHODS: The study population included nulliparous women with a single baby in the cephalic presentation in spontaneous labor at term. With a cohort-based registry design utilizing data from the Copenhagen Pregnancy Cohort and the Danish Medical Birth Registry, we included women who had given birth from 2014 to 2020 at Copenhagen University Hospital-Rigshospitalet, Denmark. Logistic regression analysis, augmented by a super learner algorithm, was employed to construct the prediction model with candidate predictors pre-selected based on clinical reasoning and existing evidence. These predictors included maternal age, pre-pregnancy body mass index, height, gestational age, physical activity, self-reported medical condition, WHO-5 score, and fertility treatment. Model performance was evaluated using the area under the receiver operating characteristics curve (AUC) for discriminative capacity and Brier score for model calibration. RESULTS: A total of 12,445 women involving 5,525 events of labor dystocia (44%) were included. All candidate predictors were retained in the final model, which demonstrated discriminative ability with an AUC of 62.3% (95% CI:60.7-64.0) and Brier score of 0.24. CONCLUSIONS: Our model represents an initial advancement in the prediction of labor dystocia utilizing readily available information obtainable upon admission in active labor. As a next step further model development and external testing across other populations is warranted. With time a well-performing model may be a step towards facilitating risk stratification and the development of a user-friendly online tool for clinicians.
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Índice de Masa Corporal , Distocia , Edad Materna , Paridad , Humanos , Femenino , Embarazo , Distocia/epidemiología , Adulto , Factores de Riesgo , Dinamarca/epidemiología , Curva ROC , Inicio del Trabajo de Parto , Sistema de Registros , Edad GestacionalRESUMEN
BACKGROUND: This study aims to comprehensively examine the academic development of shoulder dystocia (SD) through bibliometric and document analysis and to identify topics that can guide future research. METHODS: In this study, performance, co-citation, co-word, and document analyses were used as bibliometric analysis techniques. RESULTS: The study identified 3 main themes in terms of the intellectual structure of Shoulder Dystocia (SD): "Management of SD, Risk Factors and Associated Complications," "Clinical Practices, Birth Abnormalities and Effects of Complications," and "Impact of Education, Clinical Maneuvers and Fetal Health Outcomes." Co-occurrence analysis identified 4 significant themes: "Management and Clinical Practice of SD," "Fetal Macrosomia and Risk Factors," "Obstetric Maneuvers and Brachial Plexus Injury," and "Clinical Trends and Risks in SD." Additionally, ten consolidated themes were identified as a result of thematic coding analysis. CONCLUSION: Shoulder dystocia remains a critical component of obstetric practice. Themes such as training and simulation, risk factors, and technical and management approaches are consistently emphasized. Technological advances and studies on how machine learning techniques can be used effectively in this field reflect innovative approaches in the scientific literature. This analysis confirms that shoulder dystocia is a complex topic requiring a multidisciplinary approach and that research in this field is constantly evolving.
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Bibliometría , Distocia de Hombros , Humanos , Embarazo , Femenino , Distocia de Hombros/epidemiología , Factores de Riesgo , Parto Obstétrico , Investigación Biomédica , Macrosomía Fetal , Distocia/terapiaRESUMEN
OBJECTIVE: To describe the development of uroabdomen secondary to spontaneous bladder rupture in a dog with dystocia. CASE SUMMARY: A 2-year-old intact female Boston Terrier was referred for prolonged labor of 72 hours. At presentation, the dog had delivered 8 puppies at home, with the last pup being stillborn. The dog was in hypovolemic shock and had free abdominal effusion. Abdominal radiographs showed no evidence of remaining fetuses. Abdominal fluid analysis revealed a fluid potassium that was 1.8 times higher than the peripheral blood potassium. Retrograde positive contrast cystography identified leakage of contrast into the abdomen, consistent with uroabdomen secondary to bladder rupture. Bloodwork abnormalities included a mild monocytic leukocytosis with a left shift, moderate azotemia, mild hyperbilirubinemia, mild increase of alkaline phosphatase activity, moderate hyponatremia, and moderate hypochloremia. The dog was resuscitated with IV fluids and received IV antimicrobials out of concerns for septic peritonitis and sepsis. An exploratory laparotomy revealed a moderate volume abdominal effusion, uterine enlargement with no identifiable fetuses, and a small rupture of the urinary bladder wall apex. The bladder wall defect was repaired, and the dog underwent an ovariohysterectomy. Perioperative systemic hypotension was treated with a norepinephrine constant rate infusion and resolved within 24 hours. The dog was discharged 5 days later. The combined peritoneal fluid and uterine fluid culture and sensitivity testing revealed Enterococcus spp. and Staphylococcus pseudintermedius, both susceptible to amoxicillin/clavulanic acid and enrofloxacin. Bladder wall histopathology revealed severe mural congestion, edema, and hemorrhage, without evidence of neoplasia, cystitis, or urolithiasis. UNIQUE INFORMATION PROVIDED: This is the first case report of a dog with uroabdomen secondary to a bladder wall rupture associated with dystocia. Early recognition of this rare phenomenon and vigilance in treatment is essential for a good prognosis and outcome.
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Enfermedades de los Perros , Distocia , Enfermedades de la Vejiga Urinaria , Animales , Perros , Femenino , Enfermedades de los Perros/etiología , Enfermedades de los Perros/terapia , Rotura Espontánea/veterinaria , Embarazo , Distocia/veterinaria , Enfermedades de la Vejiga Urinaria/veterinaria , Enfermedades de la Vejiga Urinaria/etiología , Enfermedades de la Vejiga Urinaria/terapia , Vejiga UrinariaRESUMEN
BACKGROUND: As South Korea grapples with a declining birthrate, maternity care accessibility has become challenging. This study examines the association with labour intervention and pregnancy complication, specifically focusing on C-section and dystocia in maternity disparities. METHODS: Data from the South Korean NHIS-NID was used to analyze 1,437,186 women with childbirths between 2010 and 2015. The research defines 50 specific districts as Obstetrically Underserved Areas produced by the Ministry of Health and Welfare in 2011. C-Section were assessed through using medical procedure and DRG codes, while dystocia was defined using ICD-10 code. Logistic regression analysis was used to examine the significance of the association. RESULTS: Among the population residing in underserved areas, 42,873 out of a total of 1,437,186 individuals were identified. For nationwide cases, the odds ratios (ORs) for C-Section were 1.11 (95% CI: 1.08-1.13) and dystocia were 1.07 (95% CI: 1.05-1.09). In relatively accessible urban areas, the ORs for C-Section and dystocia, based on whether they were obstetrically underserved areas, were 1.16 (95% CI: 1.13-1.18) and 1.10 (95% CI: 1.08-1.19), respectively. CONCLUSION: Poor accessibility to maternity care facilities is closely linked to high-risk pregnancies, including an increased incidence of dystocia and a higher rate of C-sections. Insufficient access to maternity care not only raises the risk of serious pregnancy complications. Consequently, there is a pressing need for multi-faceted efforts to bridge this disparity.
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Cesárea , Distocia , Accesibilidad a los Servicios de Salud , Servicios de Salud Materna , Humanos , Femenino , Embarazo , Distocia/epidemiología , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Cesárea/estadística & datos numéricos , República de Corea/epidemiología , Adulto , Servicios de Salud Materna/estadística & datos numéricos , Área sin Atención Médica , Adulto Joven , Disparidades en Atención de Salud/estadística & datos numéricos , Modelos Logísticos , Oportunidad RelativaRESUMEN
OBJECTIVE: The aim of the study is to determine diagnostic traction for shoulder dystocia and to assess whether applied traction is modifiable with force training. METHODS: We tethered a force-measuring fetal mannequin (PROMPT, Limbs & Things) within a simulated pelvis such that it would not deliver. We asked participants to apply traction to diagnose shoulder dystocia then stop. Blinded from participants' view, we recorded the peak traction. We then asked them to apply what they perceived to be 20 lb (89 N) traction. Each participant estimated the traction s/he applied. The actual force applied was then revealed to the participants and another blinded sequence was performed. We then allowed participants to view actual force measurements in real time while they practiced getting to their diagnostic traction and to 20 lb (89 N); this was followed by another blinded sequence of traction applications and estimations. Median diagnostic traction and injury threshold values (20 lb [89 N]), and mean ratio of estimated to actual force applied were compared pretraining and posttraining, using Wilcoxon signed rank sum test and t test. Rates of clinical shoulder dystocia and associated brachial plexus injury before and after the study period were compared using chi-square. Significance was set at P < 0.05. RESULTS: One hundred participants demonstrated a range of diagnostic traction. For 23 participants, traction exceeded injury thresholds, but the average was lowered with training. Before training, participants underestimated their own applied traction by an average of 30%. CONCLUSIONS: Subjective diagnosis of shoulder dystocia during simulation training varies widely and exceeds possible injury threshold for 22% of participants. Accuracy of self-assessment applied delivery traction improves significantly with force training as does clinical diagnosis of shoulder dystocia and decrease in brachial plexus injury incidence.
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Maniquíes , Distocia de Hombros , Entrenamiento Simulado , Tracción , Humanos , Tracción/métodos , Entrenamiento Simulado/métodos , Femenino , Embarazo , Autoevaluación (Psicología) , DistociaRESUMEN
A dynamic tracheal collapse caused by multiple rib fractures in a neonatal wagyu calf was diagnosed by radiography, endoscopy and computed tomography. Conservative treatment, consisting of the medical treatment of respiratory inflammation and the reduction of environmental and social stress was initiated. The respiratory signs improved significantly, and the calf was discharged. The condition deteriorated after several weeks without treatment, most likely due to of excessive callus formation of the fractured ribs causing increased reduction in tracheal diameter.
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Animales Recién Nacidos , Distocia , Fracturas de las Costillas , Animales , Fracturas de las Costillas/veterinaria , Fracturas de las Costillas/diagnóstico por imagen , Bovinos , Femenino , Embarazo , Distocia/veterinaria , Distocia/terapia , Enfermedades de los Bovinos , Tráquea/lesiones , Tráquea/diagnóstico por imagen , Tomografía Computarizada por Rayos X/veterinariaRESUMEN
This study aimed to evaluate the relationship between prepartum subclinical hypomagnesemia (pre-SHMg) and the occurrence of dystocia, metritis, clinical mastitis, lameness, and subclinical hypomagnesemia postpartum (post-SHMg) in pasture-based dairy cows. Also, the difference in means of prepartum magnesium (Mg) concentration by postpartum health events was evaluated. A total of 890 dairy cows from 32 commercial farms located in southern Chile were enrolled. Cows were examined twice, once between 30 and 3 days before and once between 3 and 30 days after calving. Blood samples were collected on both assessments, and cows were considered as having SHMg if serum total Mg < 0.65 mmol/L. On the postpartum visit, cows were evaluated for metritis and lameness. Information about clinical mastitis and dystocia was collected from on-farm records. Data were analyzed using multivariable mixed linear models and multivariable mixed logistic regression models. The overall prevalence of pre-SHMg was 9.9%, and its presence was associated with the occurrence of post-SHMg (odd ratio [OR] = 5.7; P < 0.0001) and metritis (OR = 3.1; P = 0.04). However, we did not detect an association between pre-SHMg and dystocia, clinical mastitis, or lameness after calving. Prepartum serum Mg concentrations were lower in cows that developed post-SHMg than those that did not (LSM ± SE = 0.75 ± 0.02 mmol/L vs. 0.83 ± 0.02 mmol/L; P < 0.0001). In conclusion, pre-SHMg was associated with a higher risk of post-SHMg and metritis in grazing dairy cows but not other postpartum health events.
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Enfermedades de los Bovinos , Magnesio , Periodo Posparto , Animales , Bovinos , Femenino , Chile/epidemiología , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/sangre , Embarazo , Magnesio/sangre , Magnesio/análisis , Distocia/veterinaria , Distocia/epidemiología , Prevalencia , Endometritis/veterinaria , Endometritis/epidemiología , Endometritis/sangre , Deficiencia de Magnesio/veterinaria , Deficiencia de Magnesio/epidemiología , Deficiencia de Magnesio/sangre , Mastitis Bovina/epidemiología , Mastitis Bovina/sangre , Cojera Animal/epidemiología , Cojera Animal/etiología , Cojera Animal/sangre , Industria LecheraRESUMEN
Labour care must balance aspirations of parents with vigilance for unanticipated calamities. The 'on-site midwife-led primary care birth unit' facilitates this. The World Health Organization have replaced the traditional partograph with the 'Labour Care Guide'. An implementation project in Botswana included the mnemonic COPE: Companion, Oral fluids, Pain relief and Eliminate the supine position. The Parto-Ma project in Tanzania used guidelines, training and support to improve childbirth outcomes. We list labour practices supported by recent evidence, and highlight new developments. Foetal macrosomia increases risk but mistaken diagnosis increases caesarean births. Obstructed labour is a complex clinical diagnosis, and is difficult to predict. For shoulder dystocia prioritise delivery of the posterior shoulder, facilitated if needed by posterior axilla sling traction. 'Extended balloon labour induction' with two or three Foley catheters side by side, may reduce risks associated with uterine stimulants. Bedside ultrasound may facilitate the diagnosis of cephalic malpositions and malpresentations.
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Países en Desarrollo , Primer Periodo del Trabajo de Parto , Segundo Periodo del Trabajo de Parto , Humanos , Embarazo , Femenino , Parto Obstétrico/métodos , Partería , Complicaciones del Trabajo de Parto/terapia , Complicaciones del Trabajo de Parto/diagnóstico , Tanzanía , Distocia/terapia , Distocia/diagnóstico , BotswanaRESUMEN
The cervix is an important organ that has to dilate sufficiently at delivery to allow the foetus to transition to extrauterine life. Insufficient dilatation of the cervix (IDC) is a frequent cause of dystocia in cattle. The mechanisms underlying cervical opening and the pathogenesis of IDC are still widely unclear. Systematic studies on the relationship between IDC and steroid hormones have been limited and have yielded inconsistent findings. This study aimed to measure oestrogen and progesterone (P4) concentrations in intrapartum cows presented with dystocia due to IDC and in a comparison (C) group of cows with eutocic delivery. Before any obstetrical procedures, and right after the initial evaluation, blood samples were taken from IDC and C animals. Concentrations of P4, oestradiol-17ß (E2), free total oestrogens (FTE) and conjugated total oestrogens (CTE) were measured by established radioimmunoassays. Concentrations of P4 (p = .538), FTE (p = .065) and CTE (p = .605) were not statistically different between C and IDC groups. However, E2 levels in group C were significantly lower when compared to those in the IDC group (p = .013), which is inconsistent with the function of oestrogens in cervical dilatation. The correlation analysis demonstrated significant positive correlations between the pairs P4 versus FTE, P4 versus E2 and FTE versus E2 in group C and between the pair FTE versus E2 in group IDC. In conclusion, the results suggest that local activities of steroids relevant to the aetiology of IDC are not reflected by concentrations in the systemic circulation or that other factors are clearly more important.
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Cuello del Útero , Estrógenos , Progesterona , Animales , Femenino , Bovinos , Progesterona/sangre , Embarazo , Estrógenos/sangre , Distocia/veterinaria , Estradiol/sangre , Enfermedades de los Bovinos/sangreRESUMEN
Over 35% of reproductive-age women in the USA have obesity, putting them at increased risk for numerous obstetric complications due to abnormal labor. While the association between maternal obesity and abnormal labor has been well documented, the mechanisms responsible for this remain understudied. The uterine smooth muscle, myometrium, has high energy needs in order to fuel regular uterine contractions during parturition. However, the precise mechanisms by which the myometrium meets its energy demands has not been defined. Here, our objective was to define the effects of obesity on energy utilization in the myometrium during labor. We generated a mouse model of maternal diet-induced obesity and found that these mice had a higher rate of dystocia than control chow-fed mice. Moreover, compared to control chow-fed mice, DIO mice at term, both before and during labor had lower in vivo spontaneous uterine contractility. Untargeted transcriptomic and metabolomic analyses suggest that diet-induced obesity is associated with elevated long-chain fatty acid uptake and utilization in the uterus, but also an accumulation of medium-chain fatty acids. Diet-induced obesity uteri also had an increase in the abundance of long chain-specific beta-oxidation enzymes, which may be responsible for the observed increase in long-chain fatty acid utilization. This altered energy substrate utilization may be a contributor to the observed contractile dysfunction.
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Metabolismo Energético , Contracción Uterina , Útero , Femenino , Animales , Ratones , Embarazo , Metabolismo Energético/fisiología , Contracción Uterina/fisiología , Útero/metabolismo , Obesidad/metabolismo , Obesidad/fisiopatología , Ratones Obesos , Miometrio/metabolismo , Distocia/metabolismo , Distocia/fisiopatología , Ratones Endogámicos C57BLRESUMEN
Dystocia, or obstructed labor, is a well-documented phenomenon in various captive vertebrates, including fish. However, despite the documentation of dystocia in several viviparous (live-bearing) Chondrichthyan species (i.e., sharks, rays, skates, and chimaeras), there are no reports to date of dystocia in any oviparous (egg-laying) species. Here we present a case of a captive female epaulette shark (Hemiscyllium ocellatum) that demonstrated symptoms of dystocia in a research-related captive breeding programme. This communication serves as documentation that dystocia can occur in oviparous Chondrichthyans, and this information can help inform researchers and veterinary practitioners for improved care.
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Distocia , Tiburones , Animales , Tiburones/fisiología , Femenino , Distocia/veterinaria , Oviparidad , Embarazo , Enfermedades de los PecesRESUMEN
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.
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Gemelos Siameses , Humanos , Femenino , Embarazo , Adulto , Cesárea , Hallazgos Incidentales , Recién Nacido , DistociaRESUMEN
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 (E1S) 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 E1S 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 E1S 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 E1S concentrations between 70 and 280 days after AI was greater (P < 0.05) in the dystocia group (1276.6⯱â¯229.1â¯%) than in the eutocia group (852.6⯱â¯69.6â¯%). These results suggest that blood PAGs S-N values at mid-pregnancy (100-199 days after AI) and the ratio of changes in blood E1S concentrations between 70 and 280 days after AI may be new parameters for predicting dystocia.
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Peso al Nacer , Distocia , Estrona , Animales , Femenino , Embarazo , Estrona/sangre , Estrona/análogos & derivados , Bovinos/sangre , Distocia/veterinaria , Distocia/sangre , Enfermedades de los Bovinos/sangre , Proteínas Gestacionales/sangre , Glicoproteínas/sangreRESUMEN
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.
Asunto(s)
Distocia , Cabeza , Humanos , Femenino , Embarazo , Estudios Retrospectivos , Adulto , Estudios de Casos y Controles , Recién Nacido , Cabeza/diagnóstico por imagen , Desproporción Cefalopelviana/diagnóstico por imagen , Pelvis/diagnóstico por imagen , Cesárea/estadística & datos numéricos , CefalometríaRESUMEN
Placental abnormalities more frequently occur during pregnancy of somatic cell clones and may lead to pregnancy loss or dystocia. Adventitious placentation, or diffuse semi-placenta, is determined by the development of areas of accessory placentation between the cotyledons due to the abnormal growth of placentomes.After a full-term pregnancy, a 3-year-old Jersey heifer was referred for dystocia which resulted in the delivery of a dead calf. The cause of dystocia was found to be foetal malposition, while the placenta was physiologically expelled after dystocia resolution.Grossly, cotyledons appeared reduced in size and number in one placental horn, while the surface of the other horn was covered with microplacentomes. Numerous villous structures without trophoblastic coating were highlighted after histopathology. The dominant sign was an inflammatory reaction. The findings were consistent with inter-cotyledonal placentitis, which led to adventitial placentation.Diffuse semi-placenta compensates for the inadequate development of placentomes and may occur as a congenital or acquired defect. The outcome depends on its severity: in the worst scenario, pregnancy may not proceed beyond midterm and may be complicated by hydrallantois. In the case under examination, the dimensions of the cotyledons (from 2 to 10 cm) allowed for the natural course of pregnancy.