Haemostatic management of von Willebrand disease during childbirth with a plasma-derived VWF/FVIII concentrate.

BACKGROUND: Females with VWD do not show the same increases in VWF and FVIII levels during pregnancy as females without VWD and are at higher risk of excessive bleeding associated with childbirth. Data on haemostatic management for childbirth in VWD patients are limited. OBJECTIVES: To evaluate the dosing, efficacy and safety of plasma-derived VWF/FVIII (wilate) for prevention of excessive bleeding associated with childbirth in females with any type of VWD. METHODS: Data for females with VWD who received wilate for haemostatic coverage for childbirth during two prospective clinical studies were analysed. RESULTS: Ten females with VWD and a mean age at enrolment of 29.6 years were treated with wilate to prevent excessive bleeding associated with childbirth. Two patients had Type 1, four had Type 2 (two 2A, one 2B and one 2M) and four had Type 3 VWD. Of the ten deliveries, five were by caesarean section. Patients received a mean of 9.5 infusions of wilate over 6.8 exposure days, with a mean total dose of 234 IU/kg per delivery and 25 IU/kg per infusion. Haemostatic management for all deliveries was rated excellent or good, with no excessive bleeding during delivery and no postpartum bleeds during the period of wilate treatment in any patient. Two patients experienced eight possible or probable treatment-related adverse events; all were mild or moderate and resolved. No thromboembolic events were observed. CONCLUSION: The results of this case series indicate that wilate provided effective haemostatic cover for childbirth in females with VWD during delivery and postpartum.

A fine-scale examination of parturition timing in temperate ungulates.

Parturition timing has long been a topic of interest in ungulate research. However, few studies have examined parturition timing at fine scale (e.g., <1 day). Predator activity and environmental conditions can vary considerably with diel timing, which may result in selective pressure for parturition to occur during diel times that maximize the likelihood of neonate survival. We monitored parturition events and early-life survival of elk (Cervus canadensis) and mule deer (Odocoileus hemionus) in Utah, USA to better understand diel timing of parturition in temperate ungulates. Diel timing of parturition was moderately synchronous among conspecifics and influenced by environmental variables on the date of parturition. For elk, parturition events were most common during the morning crepuscular period and generally occurred later (i.e., closer to 12:00) when a relatively large proportion of the moon was illuminated. For mule deer, parturition events were most common during the diurnal period and generally occurred later (i.e., closer to 15:00) on cold, wet dates. Diel timing of parturition did not influence neonate survival, but larger datasets may be required to verify the apparent lack of influence. Although additional work could evaluate alternative variables that might affect parturition timing, our data provide an improved and finer scale understanding of reproductive ecology and phenology in ungulates.

Influence of non-pharmacological methods on duration of labor: a systematic review / A influência de métodos não farmacológicos na duração do parto: uma revisão sistemática

Abstract The article aims to verify the influence of MNFs on the duration of the birth process. A systematic review was carried out in the MEDLINE, Web of Science and LILACS databases, through a combination of terms that cover the topic addressed, from 1996 to 2021/April. The Excel spreadsheet was used to collect data to extract information regarding each selected article, in turn, data analysis included the evaluation and classification of quality, reliability and risk of bias, thus, the following tools were used: Cochrane RoB 2, Checklist and Newcastle-Ottawa Scale. Warm bath, walking, exercises with a birthing ball, breathing techniques, supine position, acupuncture, acupressure and water birth reduced labor time. While spontaneous pushing, massage and immersion baths prolonged labor. Non-pharmacological methods capable of reducing the duration of labor were hot/warm shower, walking, birth ball exercises, breathing techniques, maternal mobility, dorsal position, acupuncture, acupressure and water birth, as well. associated applied techniques such as hot/warm bath, ball exercises and lumbosacral massage, as well as immersion bath, ball exercises, aromatherapy, vertical postures and maternal mobility with alternating vertical postures, shortened the birth time.

Resumo O objetivo do artigo é verificar a influência dos MNFs na duração do processo de parto. Realizou-se uma revisão sistemática nas bases de dados MEDLINE, Web of Science e LILACS, por meio da combinação de termos que contemple a temática abordada, no período de 1996 a 2021/abril. Utilizou-se para coleta de dados a planilha Excel para extração de informações referentes a cada artigo selecionado, por sua vez, a análise dos dados compreendeu a avaliação e classificação da qualidade, confiabilidade e risco de viés, assim, utilizou-se como ferramentas: Cochrane RoB 2, Checklist e Escala de Newcastle-Ottawa. Reduziram o tempo de trabalho de parto banho morno, caminhada, exercícios com bola de parto, técnicas respiratórias, decúbito dorsal, acupuntura, acupressão e parto na água. Enquanto empurrões espontâneos, massagem e banho de imersão prolongaram o trabalho de parto. Os métodos não farmacológicos capazes de reduzir a duração do trabalho de parto foram banho de chuveiro quente/morno, caminhada, exercícios com bola de parto, técnicas de respiração, mobilidade materna, posição dorsal, acupuntura, acupressão e parto na água, também encurtaram o tempo de parto técnicas aplicadas associadas como banho quente/morno, exercícios com bola e massagem lombossacral, assim como banho de imersão, exercícios com bola, aromaterapia, posturas verticais e mobilidade materna com posturas verticais alternadas.

Measuring hoof horn haemorrhage in heifers: A history.

Understanding the aetiology and pathogenesis of claw-horn disease (CHD) is essential for developing prevention/treatment programmes. Haemorrhages in the hoof horn (i.e. white line/sole haemorrhages) are an important part of the pathogenesis of CHD, being precursors to and predictors of lesions such as white-line disease and sole ulcer. Understanding haemorrhage development can provide useful information about the aetiology and pathogenesis of CHD. The development of hoof horn haemorrhages is best studied in cattle without previous claw-horn damage, as previous history of damage can markedly alter the hoof's response to stressors. Since the early 1990s, many prospective studies of the risk factors associated with CHD have been undertaken in late pregnant and early lactation heifers, which have a low risk of having had CHD but which are exposed to the same risk factors as lactating cows. Those studies have used a range of methods to assess hoof horn haemorrhages, with the principal focus, particularly initially (but also more recently), being on measuring lesion severity. However, as the science developed it became clear that measuring lesion extent was also important and that combining severity and extent in a single measure was the best approach to assess hoof horn haemorrhages. Studies of hoof horn haemorrhage in heifers have significantly increased our understanding of CHD, demonstrating the importance of housing and the relative lack of importance of post-calving nutrition. Most importantly, they have shown the importance of parturition as a risk factor for CHD, and how parturition interacts with other risk factors to accentuate their effect. The use of such studies has decreased in recent years, despite recent research showing that we still have much to learn from prospective studies of hoof horn haemorrhages in heifers.

Insights into the role of PGF2α in canine periparturient myometrium.

Parturition in dogs is subjected to complex hormonal regulation, with the involvement of prostaglandin F2α (PGF2α) still not fully understood. To investigate uterine inertia (UI), the most prevalent maternal reason for dystocia in the bitch, a better understanding of undisturbed uterine, especially myometrial function, is crucial. Our aim was to gain deeper insights into the role of PGF2α in the canine parturient myometrium. Uterine biopsies were obtained during medically indicated cesarean sections. To test for stimulatory effects of PGF2α in vitro, circular and longitudinal myometrial layer tissue strips were challenged with 50 pM, 0.5 µM, and 50 µM PGF2α. Prostaglandin-endoperoxide synthase 2 (PTGS2) and PGF2α-receptor (PTGFR) mRNA expressions were compared between primary UI (PUI) and obstructive dystocia (OD) samples in isolated parturient myometrium. PTGFR protein expression was assessed in full thickness uterine samples. PGF2α concentrations were analyzed in canine interplacental tissue around term. In the organ bath, the contractile response to PGF2α was limited to the circular layer at the highest dosage. Correspondingly, PTGFR immunohistochemical staining was significantly stronger in the circular layer (p ≤ 0.01). PTGS2 gene expression did not differ between PUI and OD, whereas PTGFR gene expression could not be quantified. Local uterine PGF2α concentrations correlated negatively with serum P4 levels and were the highest during prepartum luteolysis while being significantly lower in PUI. Conclusively, despite the significant increase in local PGF2α concentrations at birth, confirming the interplacental tissue as a production site, our results suggest that PGF2α might affect uterine contractility during labor, mainly indirectly.

Obese mice have decreased uterine contractility and altered energy metabolism in the uterus at term gestation.

Over 35% of reproductive-age women in the US are obese, 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 (DIO) and found that these mice had a higher rate of dystocia than control chow-fed (CON) mice. Moreover, compared to CON mice, DIO mice at term, both before and during labor had lower in vivo spontaneous uterine contractility. Untargeted transcriptomic and metabolomic analyses suggest that DIO is associated with elevated long-chain fatty acid uptake and utilization in the uterus, but also an accumulation of medium-chain fatty acids. DIO uteri also had an increase in the abundance of long chain-specific ß-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.

Injecting postpartal gilts or sows with a supraphysiological dose of oxytocin: effects on sow and piglet performances.

The goal of this project was to determine the effects of a supraphysiological dose of oxytocin given to gilts or multiparous sows 8 to 12 h after the end of farrowing on the performance of their progeny. Sows from three parity groups (1 = parity 1; 2 = parities 2, 3, and 4; 3 = parities 5 to 14) received no injection (CTL, controls; n = 17, 27, and 23 for parity groups 1, 2, and 3, respectively) or one intramuscular injection of 75 IU of oxytocin (OXY, n = 17, 24, and 26 for parity groups 1, 2, and 3, respectively) 8 to 12 h after birth of the last piglet. Colostrum samples were obtained 8 h after oxytocin injection in 18 sows from parity group 2 (CTL, n = 10; OXY, n = 8). Standard milk composition was measured as well as the Na/K ratio, and IGF-1, IgG, and IgA concentrations. The same sows were used to obtain blood samples from four male piglets of average litter body weight (BW) 8 h post-treatment to measure concentrations of IGF-1, IgG, and IgA. Piglets and sows were weighed at farrowing and weaning (day 21) and sow feed intake and piglet mortality were recorded. There was no effect of OXY on sow or piglet BW at any measured times and percent preweaning piglet mortality was not affected by OXY or parity. First-parity sows had lower BW than multiparous sows at both times (P < 0.001), and piglet average daily gain from birth to weaning was greater in parity group 2 compared with first-parity litters (P < 0.05). Average daily sow feed intake over the first week of lactation tended to be greater in OXY vs CTL sows (P = 0.07), and multiparous sows consumed more feed than first-parity sows on all weeks of lactation (P < 0.001). Eight hours after treatment, there was a tendency for colostral Na to be greater in OXY vs CTL sows (P = 0.06), and none of the measured variables in piglet blood were affected by treatment. In conclusion, injecting 75 IU of oxytocin 8 to 12 h after the birth of the last piglet did not prolong the period of colostrogenesis or improve the growth or survival of piglets and this was consistent across parities.

Peripartal changes of metabolic and hormonal parameters in Romanian spotted cows and their relation with retained fetal membranes.

This clinical study investigates various metabolic and physiological parameters in dairy cows during puerperium. Retained fetal membranes (RFM) is a significant postpartum complication that can affect the overall health, fertility and productivity of dairy cattle. The research focuses on changes in total proteins, albumin, glucose, triglycerides, total cholesterol, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), cortisol, insulin, and insulin-like growth factor 1 (IGF-1) levels among cows experiencing normal post-partum period (NP) and those with RFM. A significant increase in protein levels was noted during the post-partum period in the RFM group, indicating physiological impacts of RFM at this stage. Albumin levels showed significant differences, highlighting a significant biological effect of RFM in the post-partum period. Glucose levels varied significantly in the weeks leading to parturition, suggesting altered metabolic states in cows that suffered RFM. Triglyceride and cholesterol levels were significantly higher during the antepartum period in the group that experienced reproductive failure, indicating substantial alterations in lipid metabolism which could herald the apparition of RFM. AST and ALT levels provided insights into cellular stress and liver function, with significant increases noted around parturition which could be attributed to the substantial physiological strain of parturition itself. Cortisol levels were higher in RFM cows 2 weeks before parturition, which could indicate an increasing stress response or a physiological preparation for the upcoming labor, and may be more pronounced in cows predisposed to RFM. Insulin levels decreased significantly before and at parturition in RFM cows, indicating a strong energy deficit. IGF-1 levels decreased significantly in RFM cows after parturition. Significant changes in metabolic parameters, such as glucose, triglycerides, and cholesterol levels, delineate the pronounced metabolic challenges faced by cows with RFM. The study elucidates that while some variations are noted as parturition approaches, the most substantial impacts attributable to RFM on metabolic and physiological parameters occur after parturition. These changes may have implications for the health, recovery, and productivity of cows postpartum, suggesting the need for targeted management strategies to mitigate the effects of RFM.

Local vaginal bioelectrical impedance can predict preterm delivery in mice.

Preterm birth is a serious pregnancy complication that affects neonatal mortality, morbidity, and long-term neurological prognosis. Predicting spontaneous preterm delivery (PTD) is important for its management. While excluding the risk of PTD is important, identifying women at high risk of PTD is imperative for medical intervention. Currently used PTD prediction parameters in clinical practice have shown high negative predictive values, but low positive predictive values. We focused on sulfated and sialylated glycocalyx changes in the uterus and vagina prior to the onset of parturition and explored the potential of electrophysiological detection of these changes as a PTD prediction parameter with a high positive predictive value. In vivo local vaginal bioelectrical impedance (VZ) was measured using two different mouse PTD models. PTD was induced in ICR mice through the subcutaneous injection of mifepristone or local intrauterine injection of lipopolysaccharide (LPS). The PTD rates were 100% and 60% post-administration of mifepristone (16-20 h, n = 4) and LPS (12-24 h, n = 20), respectively. The local VZ values (15 and 10 h after mifepristone or LPS treatment, respectively) were significantly lower in the PTD group than in the non-PTD group. Receiver operator characteristic (ROC) curve analysis of VZ at 125 kHz as a predictor of PTD showed an area under the ROC curve of 1.00 and 0.77 and positive predictive values of 1.00 and 0.86, for the mifepristone and LPS models, respectively, suggesting that local VZ value can predict PTD. Histological examination of the LPS-treated model 6 h post-treatment revealed increased expression of sulfomucins and/or sulfated proteoglycans and sialomucins in the cervical epithelium, cervical stroma and vaginal stroma. In conclusion, local VZ values can determine sulfated and sialylated glycocalyx alterations within the uterus and vagina and might be a useful PTD prediction parameter.

Progesterone inactivation in decidual stromal cells: A mechanism for inflammation-induced parturition.

The process of human parturition involves inflammation at the interface where fetal chorion trophoblast cells interact with maternal decidual stromal (DS) cells and maternal immune cells in the decidua (endometrium of pregnancy). This study tested the hypothesis that inflammation at the chorion-decidua interface (CDI) induces labor by negating the capacity for progesterone (P4) to block labor and that this is mediated by inactivation of P4 in DS cells by aldo-keto reductase family 1 member C1 (AKR1C1). In human, Rhesus macaque, and mouse CDI, AKR1C1 expression increased in association with term and preterm labor. In a human DS cell line and in explant cultures of term human fetal membranes containing the CDI, the prolabor inflammatory cytokine, interleukin-1ß (IL-1ß), and media conditioned by LPS-stimulated macrophages increased AKR1C1 expression and coordinately reduced nuclear P4 levels and P4 responsiveness. Loss of P4 responsiveness was overcome by inhibition of AKR1C1 activity, inhibition of AKR1C1 expression, and bypassing AKR1C1 activity with a P4 analog that is not metabolized by AKR1C1. Increased P4 activity in response to AKR1C1 inhibition was prevented by the P4 receptor antagonist RU486. Pharmacologic inhibition of AKR1C1 activity prevented parturition in a mouse model of inflammation-induced preterm parturition. The data suggest that inflammatory stimuli at the CDI drive labor by inducing AKR1C1-mediated P4 inactivation in DS cells and that inhibiting and/or bypassing of AKR1C1-mediated P4 inactivation is a plausible therapeutic strategy to mitigate the risk of inflammation-associated preterm birth.

Labor of a free-living buffy-tufted marmoset (Callithrix aurita) at a Wildlife Rehabilitation Center in southeastern Brazil.

Callithrix aurita is an endangered small primate endemic to the Atlantic Forest. The present work reports the labor of a free-living C. aurita, through observation of its length and offspring viability. A conservative treatment was used to maintain fetal viability, in view of the species conservation importance.

Neonatal and maternal upregulation of antileukoproteinase in horses.

Introduction: The end of gestation, ensuing parturition, and the neonatal period represent highly dynamic phases for immunological changes in both mother and offspring. The regulation of innate immune cells at the maternal-fetal interface during late term pregnancy, after birth, and during microbial colonization of the neonatal gut and other mucosal surfaces, is crucial for controlling inflammation and maintaining homeostasis. Innate immune cells and mucosal epithelial cells express antileukoproteinase (SLPI), which has anti-inflammatory and anti-protease activity that can regulate cellular activation. Methods: Here, we developed and validated new monoclonal antibodies (mAbs) to characterize SLPI for the first time in horses. Peripheral blood and mucosal samples were collected from healthy adults horses and a cohort of mares and their foals directly following parturition to assess this crucial stage. Results: First, we defined the cell types producing SLPI in peripheral blood by flow cytometry, highlighting the neutrophils and a subset of the CD14+ monocytes as SLPI secreting immune cells. A fluorescent bead-based assay was developed with the new SLPI mAbs and used to establish baseline concentrations for secreted SLPI in serum and secretion samples from mucosal surfaces, including saliva, nasal secretion, colostrum, and milk. This demonstrated constitutive secretion of SLPI in a variety of equine tissues, including high colostrum concentrations. Using immunofluorescence, we identified production of SLPI in mucosal tissue. Finally, longitudinal sampling of clinically healthy mares and foals allowed monitoring of serum SLPI concentrations. In neonates and postpartum mares, SLPI peaked on the day of parturition, with mares returning to the adult normal within a week and foals maintaining significantly higher SLPI secretion until three months of age. Conclusion: This demonstrated a physiological systemic change in SLPI in both mares and their foals, particularly at the time around birth, likely contributing to the regulation of innate immune responses during this critical period.

A double-blinded randomised controlled study of fluid restriction versus liberal fluid during induction of labour: A pilot study.

BACKGROUND: Excess intravenous fluid for women requiring an induction of labour may adversely affect the duration of labour and maternal/neonatal outcomes. AIMS: This study aimed to determine the difference in duration of labour and outcomes with a low background infusion rate, compared to liberal background intravenous fluid management. MATERIALS AND METHODS: A double blind randomised controlled pilot study was performed on 200 women who underwent induction of labour at a single institution. Women were randomised to an intravenous rate of 40 mL/h versus 250 mL/h of Hartmann's solution. Fluid boluses were strictly controlled to limit bias. This trial was registered with the Australian clinical trial registry: ACTRN12621001298808. RESULTS: Analysis of the total amount of fluid received showed good separation with Group 1 (40 mL/h) receiving 1,736 mL less than Group 2 (250 mL/h), median (interquartile range) 841 mL (458, 1691) versus 2,577 mL (1620, 4326) (P < 0.001). Median duration of labour was shorter in Group 1 by 24 min (P = ns). Subset analysis of nulliparous women showed that duration of labour was shorter in Group 1 by 83.5 min (P = ns). CONCLUSION: As this was a pilot study, a significant difference in duration of labour or secondary outcomes was not seen. Given the increasing numbers of nulliparous women having an induction of labour, potential for adverse maternal and neonatal outcomes and the associated higher rate of operative birth, this study guides power calculations and supports proof of concept for future research into optimum fluid management during induction of labour for these women.

The curse of the firstborn: Effects of dam primiparity on developmental programming in ruminant offspring.

The first parity, or first pregnancy, of ruminant females has negative effects on offspring during fetal, perinatal, and pre-weaning periods which ultimately lead to diminished pre-weaning productivity. Offspring born to primiparous ruminant females can have decreased fetal and pre-weaning growth, resulting in lower body weights at birth and weaning in cattle, sheep, and goats. Moreover, mortality is greater during both neonatal and pre-weaning periods. Insults during these critical developmental windows likely also have long-term consequences on first-parity offspring through developmental programming, but less research has been done to investigate effects in the post-weaning period. Many potential physiological, metabolic, and behavioral mechanisms exist for the outcomes of dam primiparity. Although competition for nutrient partitioning between maternal and fetal growth or lactation is often cited as a major contributor, we hypothesize that the most important mechanism causing most first-parity outcomes is the relative physiological inexperience of reproductive tissues such as the uterus and mammary gland during the first pregnancy and lactation, or a "first use theory" of tissues. More research is necessary to explore these areas, as well as if primiparous dams respond differently to stressors than multiparous dams, and if stress during the first parity affects subsequent parities.

The significance of paramedic communication during women's birth experiences: A scoping review.

BACKGROUND: Internationally, over one-third of women experience birth trauma, leading to adverse mental health outcomes. Poor communication with healthcare professionals is a primary contributing factor. Paramedics attend various clinical presentations, including childbirth, yet their potential impact on women's birth experiences has been largely overlooked. METHODS: A systematic literature search was conducted following the Joanna Briggs Institute methodological framework. The search identified 1015 potentially suitable articles, and 5 articles met the inclusion criteria. Data was analysed using reflexive thematic analysis from a feminist standpoint. RESULTS: Three themes were generated: 1. First Impressions Count: paramedic demeanour impacted the woman's sense of safety and perception of paramedic clinical competence. 2. Choice as a Pathway to Control: when paramedics involved women in decision-making, it led to empowerment, while non-involvement led to women becoming passive participants. 3. Exposed, Violated and Disempowered: some paramedics disrespected and abused women, treating them solely as objects for the purpose of producing a baby. CONCLUSIONS: This review highlights the influence of paramedic communication on women's birth experiences. While some paramedics communicated respectfully, other paramedics were the perpetrators of Obstetric Violence. Future research should inform paramedic education and improve outcomes for birthing women.

High rates of placental inflammation among samples collected by the Multi-Omics for Mothers and Infants consortium.

BACKGROUND: The Multi-Omics for Mothers and Infants consortium aims to improve birth outcomes. Preterm birth is a major obstetrical complication globally and causes significant infant and childhood morbidity and mortality. OBJECTIVE: We analyzed placental samples (basal plate, placenta or chorionic villi, and the chorionic plate) collected by the 5 Multi-Omics for Mothers and Infants sites, namely The Alliance for Maternal and Newborn Health Improvement Bangladesh, The Alliance for Maternal and Newborn Health Improvement Pakistan, The Alliance for Maternal and Newborn Health Improvement Tanzania, The Global Alliance to Prevent Prematurity and Stillbirth Bangladesh, and The Global Alliance to Prevent Prematurity and Stillbirth Zambia. The goal was to analyze the morphology and gene expression of samples collected from preterm and uncomplicated term births. STUDY DESIGN: The teams provided biopsies from 166 singleton preterm (<37 weeks' gestation) and 175 term (≥37 weeks' gestation) deliveries. The samples were fixed in formalin and paraffin embedded. Tissue sections from these samples were stained with hematoxylin and eosin and subjected to morphologic analyses. Other placental biopsies (n=35 preterm, 21 term) were flash frozen, which enabled RNA purification for bulk transcriptomics. RESULTS: The morphologic analyses revealed a surprisingly high rate of inflammation that involved the basal plate, placenta or chorionic villi, and the chorionic plate. The rate of inflammation in chorionic villus samples, likely attributable to chronic villitis, ranged from 25% (Pakistan site) to 60% (Zambia site) of cases. Leukocyte infiltration in this location vs in the basal plate or chorionic plate correlated with preterm birth. Our transcriptomic analyses identified 267 genes that were differentially expressed between placentas from preterm vs those from term births (123 upregulated, 144 downregulated). Mapping the differentially expressed genes onto single-cell RNA sequencing data from human placentas suggested that all the component cell types, either singly or in subsets, contributed to the observed dysregulation. Consistent with the histopathologic findings, gene ontology analyses highlighted the presence of leukocyte infiltration or activation and inflammatory responses in both the fetal and maternal compartments. CONCLUSION: The relationship between placental inflammation and preterm birth is appreciated in developed countries. In this study, we showed that this link also exists in developing geographies. In addition, among the participating sites, we found geographic- and population-based differences in placental inflammation and preterm birth, suggesting the importance of local factors.

In the Murine and Bovine Maternal Mammary Gland Signal Transducer and Activator of Transcription 3 is Activated in Clusters of Epithelial Cells around the Day of Birth.

Signal transducers and activators of transcription (STAT) proteins regulate mammary development. Here we investigate the expression of phosphorylated STAT3 (pSTAT3) in the mouse and cow around the day of birth. We present localised colocation analysis, applicable to other mammary studies requiring identification of spatially congregated events. We demonstrate that pSTAT3-positive events are multifocally clustered in a non-random and statistically significant fashion. Arginase-1 expressing cells, consistent with macrophages, exhibit distinct clustering within the periparturient mammary gland. These findings represent a new facet of mammary STAT3 biology, and point to the presence of mammary sub-microenvironments.

Characterization of Typical Behaviors of Mares in the Opening Phase of Parturition-Influence of Parity and Dystocia.

The identification of typical behaviors in stage I of parturition, the opening phase, can be used to improve birth monitoring in the mare. Therefore, this study aimed to comprehensively analyze mare behavior during the opening phase. Real-time recordings of 66 births involving 56 warmblood mares were analyzed using camera footage. Behaviors such as increased locomotor activity, pawing with front hooves, lifting the tail, rolling, kicking with the hind legs toward the abdomen, and looking at the abdomen increased significantly (p < 0.001) in the four hours preceding parturition. Within the last hour of the observation period, a statistically significant change was observed for the duration of lying in the sternal and lateral position (p < 0.001). Significant correlations were observed between parity and the total number of repetitions of lying in the sternal position (p < 0.05). Furthermore, the birth process influenced the repetitions of lying in the lateral position (p < 0.05). These findings indicate distinct behavioral patterns during the opening phase of parturition, which were evident across the observed mares. Nonetheless, notable individual differences were also identified among the mares.

Use of a Calving Blind That Imitates a Natural Environment.

Many indoor-housed cows isolate at calving when given the opportunity, and calving behaviors vary by blind and pen design. The objectives of this study were to determine if cows preferred calving in a visibly separated (blind) or an open area of a group maternity pen, and if there was a preference for the degree of seclusion provided by the blind (50% vs. 100% coverage). Two calving blinds were provided in a group calving pen, and the amount of visibility through the blinds was created using firehoses secured from the top of a metal frame that lined the entire front of the blind (100%) or with every other hose rolled up (50%). Holstein cows and heifers (n = 79) were enrolled into a dynamic group calving pen 21 ± 3 d before calving. Calving location, the difference in blind use prior to calving compared to a baseline period, and social behaviors were recorded using video observation. There was no difference in the number of cows that calved in or outside of a blind (28 vs. 37 calvings, respectively). Cows were more likely to calve in a blind during the day than at night and as the number of cows in the pen increased. For cows who calved in a blind, there was no preference for calving in the 50% or 100% blind (10 vs. 18, respectively). Providing a varied environment for intensively managed cattle can improve their welfare by allowing cows the opportunity to perform natural behaviors and choice over their environment.

Birth outcomes associated with a natural delivery approach in a perinatal center: A comparative retrospective study.

OBJECTIVES: At our center, natural home-like delivery settings have been established in or near conventional labor wards, for the care of pregnant women who prefer little or no medical intervention during labor and birth. We compared obstetrical and neonatal outcomes of women in active spontaneous labor, between those who chose to deliver in a natural-delivery setup and those who chose a conventional setting. METHODS: This retrospective study included low-risk women who delivered at term between March 1, 2020 and December 31, 2022, in a single tertiary university affiliated medical center. Birth outcomes were compared between 124 women who delivered by natural birth (the study group) and 244 who gave birth in a conventional setting (the control group). RESULTS: No cesarean deliveries were performed in the study group, compared to 18 (7.4%) of the control group, p = 0.004. Intrapartum fever, postpartum hemorrhage, and uterotonic administration were similar between the groups. For the study compared to the control group, breastfeeding was more common (71.3% vs. 12.3%, p < 0.001), analgesia administration within 48 h delivery was lower (4.1% vs. 10.7%, p = 0.033), and maternal and neonatal length of hospitalization were shorter. Of the women initially admitted to the natural-delivery room, 14 (11.5%) were transferred to a conventional-delivery room. CONCLUSIONS: Birth in a hospital natural-delivery setting was associated with increased likelihood of vaginal birth, increased immediate breastfeeding and breastfeeding at discharge, and lower postpartum pain.