Midwives' lived experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini: a qualitative study.

BACKGROUND: Midwives encounter various difficulties while aiming to achieve excellence in providing maternity care to women with mobility disabilities. The study aimed to explore and describe midwives' experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini. METHODS: A qualitative, exploratory, descriptive, contextual research design with a phenomenological approach was followed. Twelve midwives working in maternal health facilities in the Hhohho and Manzini regions in Eswatini were interviewed. Purposive sampling was used to select midwives to participate in the research. In-depth phenomenological interviews were conducted, and Giorgi's descriptive phenomenological method was used for data analysis. RESULTS: Three themes emerged from the data analysis: midwives experienced physical and emotional strain in providing maternity care to women with mobility disabilities, they experienced frustration due to the lack of equipment to meet the needs of women with mobility disabilities, and they faced challenges in providing support and holistic care to women with mobility disabilities during pregnancy, labour and puerperium. CONCLUSIONS: Midwives experienced challenges caring for women with mobility disabilities during pregnancy, labour and the puerperium in Eswatini. There is a need to develop and empower midwives with the knowledge and skill to implement guidelines and enact protocols. Moreover, equipment and infrastructure are required to facilitate support and holistic maternity care for women with mobility disabilities.

Supplementation of rumen-protected lysine during the close-up period improves vaginal discharge clearance in Holstein dairy cows.

We aimed to evaluate the effects of rumen-protected lysine (RPL) supplementation during the close-up period on uterine involution and the resumption of ovarian function in dairy cows. Fifty-two multiparous Holstein cows were categorized based on parity and expected calving date and randomly assigned to the RPL or control (CON) groups. The RPL group received 80 g of RPL daily from day 21 before the expected calving date until parturition. Blood samples were obtained twice weekly from pre-supplementation to 6 weeks postpartum. The onset of luteal activity postpartum was determined via ultrasonography twice weekly for up to 6 weeks postpartum. Uterine involution was tracked at 3 and 5 weeks postpartum through the vaginal discharge score, percentage of polymorphonuclear cells (PMN) in endometrial cytology samples, presence of intrauterine fluid, and gravid horn diameter via ultrasonography. Before supplementation, the RPL group showed amino acid imbalance, which was improved by RPL supplementation. There were no significant differences in the onset of luteal activity, percentage of PMN, intrauterine fluid, or the diameter of the uterine horn between the two groups. The vaginal discharge score in the RPL group decreased from 3 to 5 weeks postpartum, whereas that in the CON groups did not decrease. The number of cows with clinical endometritis was lower in the RPL group. Overall, RPL supplementation during the close-up period enhanced vaginal discharge clearance, potentially averting clinical endometritis, but did not affect the first ovulation in dairy cows.

Postpartum uterine involution promoted by penetrating-moxibustion therapy: a randomized controlled trial. / é€ç¸æ³•ä¿ƒè¿›äº§åŽå­å®«å¤æ—§ï¼šéšæœºå¯¹ç §è¯•éªŒ.

OBJECTIVES: To observe the effect of penetrating-moxibustion therapy on postpartum uterine involution. METHODS: Eighty puerpera were randomized into an observation group and a control group, 40 cases in each one. In the control group, oxytocin injection was administered by intravenous drip, 20 U each time, once daily. In the observation group, on the base of the treatment as the control group, the penetrating-moxibustion therapy was used at Shenque (GV 8), Qihai (CV 6) and Guanyuan (CV 4), 30 min to 40 min each time, twice a day. The intervention of each group started from the first day after childbirth and lasted 3 days. The uterine volume before and after treatment, and in 42 days of postpartum, the height decrease of the fundus of the uterus, the score of visual analogue scale (VAS) for uterine contraction, the volume of lochia rubra in 1 to 3 days of treatment, and lochia duration were compared between the two groups; and the clinical effect was evaluated. RESULTS: The uterine volume in the observation group was smaller than that of the control group after treatment (P<0.01). In 1 to 3 days of treatment, the height decrease of the fundus of the uterus in the observation group was larger (P<0.01), VAS scores of uterine contraction were lower (P<0.05, P<0.01), the lochia rubra volume was less (P<0.01) than those in the control group. The duration of lochia rubra and lochia was shorter (P<0.01) in the observation group when compared with that of the control group. The favorable rate of uterine involution in the observation group was 95.0% (38/40), higher than that of the control group (75.0%, 30/40, P<0.05). CONCLUSIONS: Penetrating-moxibustion therapy accelerates the recovery of the uterine volume, relieves uterine contraction, shortens the duration of lochia, reduces the lochia volume and promotes the postpartum uterine involution.

The magnitude and associated factors of immediate postpartum anemia among women who gave birth in Ethiopia: systematic review and meta-analysis, 2023.

BACKGROUND: The immediate postpartum period is a very crucial phase for both the life of the mother and her newborn baby. Anemia is the most indirect leading cause of maternal mortality. However, anemia in the immediate postpartum period is a neglected public health problem in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of immediate postpartum anemia and the pooled effect size of associated factors in Ethiopia. METHODS: Searching of published studies done through PubMed, Medline, Cochrane, African index Medicus, List of Reference Index, Hinari, and Google Scholar. This systematic review and meta-analysis follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) godliness. The quality of studies was assessed by using a Newcastle- Ottawa Scale (NOS) assessment tool. Analysis was performed using a random effect model by using STATA 17 version software. Egger's weighted regression and I2 test were used to evaluate publication bias and heterogeneity respectively. RESULTS: In this systematic review and meta-analysis, a total of 6 studies were included. The pooled magnitude of immediate postpartum anemia in Ethiopia was 27% (95%CI: 22, 32). Instrumental mode of delivery (OR = 3.14, 95%CI: 2.03, 4.24), mid-upper arm circumference (MUAC) measurement < 23 cm (OR = 3.19, 95%CI: 1.35, 5.03), Antepartum Hemorrhage (OR = 4.75, 95%CI: 2.46, 7.03), postpartum hemorrhage (OR = 4.67, 95%CI: 2.80, 6.55), and no iron/foliate supplementation (OR = 2.72, 95%CI: 1.85, 3.60) were the identified factors associated with developing anemia in the immediate postpartum period. CONCLUSION: The overall pooled magnitude of anemia in the immediate postpartum period among Ethiopian women was still a moderate public health problem. Instrumental mode of delivery, mid upper arm circumference (MUAC) measurement < 23 cm, antepartum hemorrhage, postpartum hemorrhage, and no iron/foliate supplementation were the identified factors associated with higher odds of developing anemia among immediate postpartum women in Ethiopia. Therefore, midwives, and doctors, shall focus on prevention of maternal hemorrhage, nutritional advice and counseling including iron /foliate supplementation, and avoid unnecessary instrumental delivery to prevent and reduce anemia related maternal mortality and morbidity in Ethiopia. PROSPERO REGISTRATION: CRD42023437414 with registration date on 02/08/2023.

Inpatient midwifery staffing levels and postpartum readmissions: a retrospective multicentre longitudinal study.

BACKGROUND: Preventing readmission to hospital after giving birth is a key priority, as rates have been rising along with associated costs. There are many contributing factors to readmission, and some are thought to be preventable. Nurse and midwife understaffing has been linked to deficits in care quality. This study explores the relationship between staffing levels and readmission rates in maternity settings. METHODS: We conducted a retrospective longitudinal study using routinely collected individual patient data in three maternity services in England from 2015 to 2020. Data on admissions, discharges and case-mix were extracted from hospital administration systems. Staffing and workload were calculated in Hours Per Patient day per shift in the first two 12-hour shifts of the index (birth) admission. Postpartum readmissions and staffing exposures for all birthing admissions were entered into a hierarchical multivariable logistic regression model to estimate the odds of readmission when staffing was below the mean level for the maternity service. RESULTS: 64 250 maternal admissions resulted in birth and 2903 mothers were readmitted within 30 days of discharge (4.5%). Absolute levels of staffing ranged between 2.3 and 4.1 individuals per midwife in the three services. Below average midwifery staffing was associated with higher rates of postpartum readmissions within 7 days of discharge (adjusted OR (aOR) 1.108, 95% CI 1.003 to 1.223). The effect was smaller and not statistically significant for readmissions within 30 days of discharge (aOR 1.080, 95% CI 0.994 to 1.174). Below average maternity assistant staffing was associated with lower rates of postpartum readmissions (7 days, aOR 0.957, 95% CI 0.867 to 1.057; 30 days aOR 0.965, 95% CI 0.887 to 1.049, both not statistically significant). CONCLUSION: We found evidence that lower than expected midwifery staffing levels is associated with more postpartum readmissions. The nature of the relationship requires further investigation including examining potential mediating factors and reasons for readmission in maternity populations.

Effects of pasture management and supplementation on the productive performance of recently lambed ewes.

The hypothesis was tested that the performance of lactating ewes is affected by the supplementation level and pasture management. Two supplementation levels (0.5 and 1.0% of body weight, BW) and two pasture managements (mowed and non-mowed) were tested. Forty adult ewes (2 years old) with an average weight at lambing of 62.97 ± 7.0 kg (day 0) and an average the body condition score of 2.5 points (day 0) were evaluated. Verminosis was monitored with periodic deworming. The number of eggs per gram of feces (EPG) of ewes at lambing was used as a covariate for performance assessments. Ewes lost an average of 7.5 kg over the 90 days post-partum (12% BW). The weaning rate was 53%. The body condition of the ewes was influenced by the post-partum period. The ewes mobilized their body reserves in the first 30 days of lactation. Mowing management negatively affected the nutritive value of the forage. Supplementation with 0.5% BW was sufficient for nutritional management post-partum. Pasture management (mowed vs. not mowed) cannot prevent post-partum weight loss. Supplementation levels and pasture management altered the morphological and chemical components of the pasture.

Forgotten Fundamentals: A Review of State Legislation on Nutrition for Incarcerated Pregnant and Postpartum People.

Adequate nutritional intake during pregnancy is critical to infant health and development. People with the capacity for pregnancy who are incarcerated have limited control over their diets and rely on prisons and jails to meet their nutritional needs. This study examined state and federal statutes pertaining to nutrition care for pregnant people while incarcerated. Following a systematic search and review, we identified four qualitative codes relating to access to vitamins, supplemental food, additional hydration, and prenatal nutrition education. Summaries of state and federal statutes pertaining to nutrition were developed and compared with current prenatal nutrition recommendations. Less than a third of states had nutrition-related mandates and no states had statutes that included all key nutrition recommendations. No federal statutes addressed nutrition during pregnancy. Additionally, our review found no provisions for enforcement of the limited nutritional statutes that do exist. To mitigate adverse health consequences for pregnant people and their fetuses, policymakers should enact or amend legislation to align nutrition standards in all prisons and jails with national policy recommendations and provide mechanisms to oversee compliance.

Effect of Reflexology on Pain, Fatigue, Sleep Quality, and Lactation in Postpartum Primiparous Women After Cesarean Delivery: A Randomized Controlled Trial.

BACKGROUND: Mothers commonly experience pain, fatigue, sleep disruption, and breastfeeding problems after cesarean delivery. To date, no follow-up study has examined all of these variables to evaluate the utility of reflexology in reducing these problems and supporting breastfeeding. RESEARCH AIM: This study aimed to determine the effect of foot reflexology performed in the postpartum period on pain, fatigue, sleep quality, and lactation in primiparous women who underwent cesarean delivery. METHODS: This is a two-arm, parallel-group randomized controlled trial. Data were collected between January 1, 2020, and January 31, 2021, with a sample of 80 women who were randomly assigned to the reflexology (n = 40) and control (n = 40) groups. The reflexology group received 40 minutes of foot reflexology once a week for 8 weeks. The primary outcomes of the study were pain, fatigue, sleep quality, and breastfeeding efficacy. RESULTS: Pain scores in the reflexology group decreased by 90.9% in week 1, 90.2% in week 2, and 59.8% in week 3 compared to the control group. Pain resolved at week 4 in the reflexology group and week 7 in the control group. The reflexology group showed a 36.9% decrease in fatigue level, a 48.0% increase in energy level, a 70.7% increase in sleep quality, and a 20.2% increase in breastfeeding efficacy compared to the control group (p < 0.05). CONCLUSIONS: Foot reflexology reduces postpartum symptoms and positively affects breastfeeding and can be used safely in postnatal care practices.

Effectiveness of Acupressure on Post-Cesarean Bowel Function: A Randomized Controlled Trial.

Background: In cesarean delivery, factors such as general anesthesia affect bowel function, leading postpartum women to experience abdominal tenderness, gas, and constipation. Objective: This study aims to assess the impact of acupressure on bowel function after cesarean delivery. Design: A randomized-controlled experimental study was conducted. Participants: The study population comprised postpartum women who underwent cesarean delivery at Ondokuz Mayis University Health Practice and Research Hospital between July 2021 and January 2022. The sample consisted of 61 postpartum women (acupressure group: 31, control group: 30). Intervention: Participants were divided into two groups: the acupressure group and the control group. Women in the acupressure group received 14 minutes of acupressure application to the LI4 and TH6 points twice, once within the first postoperative hour and again three hours later. The control group received no acupressure intervention. Outcome Measures: Data were collected using a Postpartum Information Form and a Post-cesarean Follow-up Form. Statistical analyses included the Mann-Whitney U test, Student's t test, and chi-squared analysis. Results: The mean age of postpartum women in the acupressure group was 27.61±4.39, while in the control group, it was 28.50±3.85. The mean times for bowel sounds, flatulence, and bowel movements in the acupressure group (9.98±2.77, 19.43±10.25, and 27.13±10.77 hours, respectively) were significantly shorter than those in the control group (14.41±5.07, 23.33±4.20, and 46.16±17.95 hours, respectively) (P < .05). Conclusions: Acupressure was found to be effective in improving bowel function after cesarean delivery, significantly reducing the time taken for participants to experience bowel sounds, flatulence, and bowel movements.

Immediate postpartum anemia and associated factors at shewarobit health facilities, Amhara, Ethiopia, 2022: a cross sectional study.

BACKGROUND: Immediate postpartum anemia occurs when the amount of red blood cell count is reduced or hemoglobin concentration is below 10 g/dl in the immediate postpartum. It occurs primarily due to inadequate iron intake before and during pregnancy and blood loss during delivery. The aim of this study is to assess the proportion of immediate postpartum anemia and associated factors among mothers who gave birth at Shewarobit health facilities; in Amhara, Ethiopia. METHODS: Institutional-based cross-sectional study was conducted from June to September 2022. A systematic random sampling method was employed to select the study participants. The data were collected through interviewer-assisted questions. Data were entered into Epi Data software version 4.6.0.4 and exported to SPSS 21 for analysis, and descriptive statistics were computed. Logistic regression was applied, and P-values less than 0.05 were considered statistically significant. RESULTS: This study was conducted among 307 study participants and, the proportion of immediate postpartum anemia was 41.4% [95% CI: 36.7-46.6]. Having postpartum hemorrhage [AOR = 4.76, 95% CI: 2.44-9.28], not taking iron and folic acid supplementation [AOR = 6.19, 95% CI: 2.69, 14.22], having a prolonged second stage of labor [AOR = 2.52, 95% CI: 1.16-5.44], and mid-upper arm circumference < 23 cm [AOR = 2.02, 95% CI: 1.11-3.68] were factors significantly associated with immediate postpartum anemia. CONCLUSIONS: The proportion of immediate postpartum anemia was public problem in Shewarobit health facilities. Following the progress of labor using a partograph, closely monitoring and immediate intervention of PPH, and prevent undernutrition during antenatal care is recommended.

[Pregnancy and bariatric surgery : from pre-conception to postpartum]. / Grossesse et chirurgie bariatrique : du préconceptionnel au postpartum.

Bariatric surgery is regularly offered to women of childbearing age. Pregnancy after such surgery should be planned and requires special attention. Some complications associated with obesity during pregnancy are reduced after bariatric surgery, but reduced dietary intake and malabsorption can cause nutritional deficiencies, that need to be carefully screened for and supplemented. Dietary management is recommended, and any unusual abdominal pain should be referred to a bariatric surgeon. We offer a summary of recommendations for appropriate follow-up of these pregnancies.

La chirurgie bariatrique est régulièrement proposée à des femmes en âge de procréer. Une grossesse après une telle chirurgie devrait être planifiée et demande une attention particulière. Certaines complications liées à l'obésité durant la grossesse sont réduites après une chirurgie bariatrique mais une diminution des apports alimentaires et la malabsorption peuvent engendrer des carences nutritionnelles qui doivent être attentivement dépistées et supplémentées. Une prise en charge diététique est recommandée et toute douleur abdominale inhabituelle doit faire demander l'avis d'un chirurgien bariatrique. Nous proposons une synthèse des recommandations pour un suivi adéquat de ces grossesses.

Ultra-performance liquid chromatography-quadrupole time-of-flight mass combined with UNIFI to study the mechanism of Tao Hong Si Wu Decoction in the treatment of postpartum blood stasis.

Postpartum hemorrhage can lead to a variety of maternal complications. Tao Hong Si Wu Decoction (THSWD) is a traditional Chinese medicine used for treating gynecological diseases. However, the active ingredients of THSWD and its pharmacological mechanism of treatment for postpartum blood stasis still remained unclear. In this study, 201 components were identified in THSWD ethanol extract using ultra-performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry, including 59 terpenoids and volatile oil, 61 Phenylpropanoids, 41 flavonoids, 22 alkaloids, and other 18 components. A total of 45 active compounds were identified in the blood and 33 active compounds were identified in the uterine. Taking the common components into the blood and into the uterus combined with network pharmacology. It was demonstrated that the active compounds can bind to the core target with good affinity through molecular docking. The results of this study will provide a reference for the quality control and pharmacodynamic material base research of THSWD.

Preconception Micronutrient Supplementation Affects Maternal BMI and Body Composition Postpartum: A Randomized Controlled Trial in Vietnam.

BACKGROUND: Although there is growing evidence on the role of preconception nutrition for birth outcomes, limited evidence exists for its effects on maternal health. OBJECTIVES: This study evaluates the impact of preconception micronutrient supplementation on maternal BMI (kg/m2) and body composition at 6 to 7 y postpartum (PP). METHODS: We followed females who participated in a randomized controlled trial of preconception supplementation in Vietnam and delivered live offspring (n = 1599). Females received weekly supplements containing either 2800 µg folic acid (FA) only, 60 mg iron and 2800 µg FA (IFA), or multiple micronutrients (MMs) (15 micronutrients including IFA) from baseline until conception followed by daily prenatal IFA supplements until delivery. Height, weight, mid-upper arm circumference, triceps skinfold, and waist-hip circumference were measured at recruitment and at 1, 2, and 6 to 7 y PP. Body fat was assessed using bioelectric impedance at 6 to 7 y PP (n = 867). Group comparisons were made using analysis of variance or chi-square tests and general linear models for adjusted models. RESULTS: At 6 to 7 y PP, we found significant differences (P < 0.05) by treatment group for mean percent fat (MM: 29.2%; IFA: 27.6%; FA: 27.8%), absolute fat mass (MM: 15.1 kg; IFA: 14.0 kg; FA: 14.3 kg), and prevalence of underweight based on BMI < 18.5 (MM: 5.8%; IFA: 10.3%; FA: 14.3%). Mean BMI and triceps skinfold thickness were higher in the MM group, but these differences were not statistically significant; the differences in absolute fat mass were also attenuated after controlling for body weight. No differences were observed for fat-free mass, prevalence of overweight (BMI >23), or other anthropometric measurements. CONCLUSIONS: Preconception MM supplementation was associated with lower prevalence of underweight and higher percent fat when compared with IFA and/or FA only. Preconception micronutrient interventions may have long-term effects on maternal health and merit further examination. This trial was registered at clinicaltrials.gov as NCT01665378.

Understanding cannabis use and mental health difficulties in context with women's experiences of stressful events and social health issues in pregnancy: The Aboriginal Families Study.

BACKGROUND: Few population-based data sources fully recognise the intersections between stressful events, social health issues, and cannabis use in pregnancy, and little is known about sequelae for women's mental health. METHODS: We draw on two waves of population-based data for 344 families participating in the Aboriginal Families Study longitudinal cohort. We examine women's mental health in the first year postpartum and when children were aged 5-9 years in context with life experiences and use of cannabis in pregnancy. OUTCOMES: One in five women (19·5%) used cannabis during pregnancy (with or without co-use of tobacco). Within this group of women, 88·3% experienced 3 or more (3+) stressful events or social health issues. Psychological distress (Kessler-5 scale, K-5) in the year postpartum was substantially higher amongst women who had used cannabis or experienced 3+ stressful events or social health issues. High proportions of women met criteria for support and referral for depression and/or anxiety (52·5% of women who had used cannabis compared to 20·9% amongst women who had neither used cannabis nor tobacco; 43·2% of women who had experienced 3+ stressful events or social health issues compared to 15·6% amongst women who had not indicated these experiences). Similar patterns of psychological distress, depressive (9-item adapted Personal Health Questionnaire, aPHQ-9) and anxiety symptoms (7-item Generalised Anxiety Disorder score, GAD-7) were evident when the study children were aged 5-9 years. INTERPRETATION: Amongst women who had used cannabis in pregnancy, a high burden of psychological distress, depression, and anxiety is evident in the postpartum period and as their children turn 5-9 years. The overlay of stressful events and social health issues and the high proportion of women meeting criteria for referral for mental health assessment and support indicate an urgent need to offer women opportunities for safe disclosure of cannabis use and opportunities to access sustained holistic services. Reducing the harms of cannabis use on Aboriginal and Torres Strait Islander families must be coupled with culturally safe ways of addressing the social, historical, and structural determinants of mental health distress and harmful use of substances.

Current concepts in postpartum anemia management.

PURPOSE OF REVIEW: Postpartum anemia (PPA) is common in women after childbirth and affects about 50-80% of all women worldwide. Iron deficiency (ID) is the main cause for anemia and constitutes a potentially preventable condition with great impact on the mother's physical and mental condition after delivery. In most cases, PPA is associated with antenatal ID and peripartum blood losses. Numerous published studies confirmed the positive effect of PPA diagnosis and treatment. RECENT FINDINGS: Iron deficiency as well as iron deficiency anemia (IDA) are common in the postpartum period and represent significant health problems in women of reproductive age. SUMMARY: Important movements towards early detection and therapy of postpartum anemia have been observed. However, postpartum anemia management is not implemented on a large scale as many healthcare professionals are not aware of the most recent findings in the field. Diagnosis and therapy of PPA, particularly iron supplementation in ID and IDA, has proven to be highly effective with a tremendous effect on women's wellbeing and outcome.

Transition to Motherhood of Puerperal Women With Preterm Birth in a Challenging Lifetime: Transition Theory-Based Study.

Background and purpose: Although the transition process to motherhood of mothers who gave birth preterm has been examined using other theories, no studies have yet utilized Meleis's Transition Theory (TT). The aim of this study was to examine the transition process of mothers who gave birth preterm according to Meleis's TT. Methods: This study is a holistic single-pattern qualitative case study. The qualitative research paradigm was used based on the 32-item Qualitative Research Reporting Consolidated Criteria checklist, a guide for qualitative studies. Face-to-face interviews were conducted with 10 preterm mothers using a semistructured interview form between February 2019 and December 2021. The thematic analysis analysis method was used for the data obtained. After the data were transcribed, all the documents were read, and the data were deciphered. Using the notes, the codings were themed as titles and subtitles according to Meleis' TT. Results: Three main themes were determined using Meleis' TT: facilitators and inhibitors of the transition process, response patterns to motherhood, and nursing care. Visiting the baby in the intensive care unit, touching, and expressing milk for the baby were found to be important milestones in the mothers' transition process. Conclusion: Mothers faced numerous problems after premature birth and required support to cope with the transition process. They attempted to adapt to the transition to motherhood with the support of nurses, husbands, and families. Implications for practice: The researchers stated that may assist a healthy transition process by supporting health professionals to understand the problems faced by mothers during the transition to motherhood and to provide nursing care according to mothers' needs.

Acupuncture for postpartum diastasis recti abdominis and its effects on abdominal circumference, separation distance of rectus abdominis. / é’ˆåˆºæ²»ç–—äº§åŽè ¹ç›´è‚Œåˆ†ç¦»æ‚£è€ çš„ç–—æ•ˆåŠå¯¹è ¹å›´ã€è ¹ç›´è‚Œåˆ†ç¦»é—´è·çš„å½±å“.

OBJECTIVES: To observe the therapeutic efficacy of acupuncture and its effects on abdominal circumference, separation distance of rectus abdominis and quality of life in patients with postpartum diastasis recti abdominis on the basis of diastasis recti abdominis exercise. METHODS: A total of 87 postpartum women with diastasis recti abdominis were randomly divided into an observation group (44 cases) and a control group (43 cases) . The control group was treated with conventional diastasis recti abdominis rehabilitation exercise, including abdominal breathing training and supine leg lifting training, 3 times a day for 2 weeks. On the basis of the treatment in the control group, the observation group was treated with acupuncture at Zhongwan(CV 12), Qihai(CV 6)and bilateral Shenshu(BL 23), Daimai(GB 26), Daheng(SP 15), Zusanli (ST 36), etc., 30 min each time, once a day for 2 weeks. Before and after treatment, the separation distance of rectus abdominis, low back pain visual analogue scale (VAS) score, abdominal circumference and 36-item short form health survey questionnaire (SF-36) score in the two groups were compared, and the clinical effect was evaluated. RESULTS: After treatment, the separation distance of rectus abdominis, low back pain VAS scores, abdominal circumference of the two groups were lower than those before treatment(P<0.05), and the physiological function, physiological role, pain, mental health, emotional role, social function, energy, general health scores and total scores of SF-36 were higher than those before treatment(P<0.05); the separation distance of rectus abdominis, low back pain VAS score, abdominal circumference of the observation group were lower than those in the control group(P<0.05), the sub-item scores and total score of SF-36 of the observation group were higher than those in the control group(P<0.05).The effective rate of the observation group was 95.5% (42/44), which was higher than 79.1% (34/43) in the control group(P<0.05). CONCLUSIONS: Acupuncture combined with diastasis recti abdominis exercise can effectively relieve the low back pain of postpartum diastasis recti abdominis patients, promote the recovery of recti abdominis function, and improve the quality of life. The clinical effect is superior to diastasis recti abdominis exercise alone.

Efficacy of Warm Acupuncture Therapy Combined with Kegel Exercise on Postpartum Pelvic Floor Dysfunction in Women.

INTRODUCTION AND HYPOTHESIS: The objective was to observe the clinical efficacy of warm acupuncture combined with Kegel exercise in treating postpartum pelvic floor dysfunction in women. METHODS: A total of 70 primiparous women with postpartum pelvic floor muscle (PFM) injury were randomly divided into a combination group (n = 35, receiving warm acupuncture at Zhibian (BL54) acupoint and Kegel exercise) and a sham control group (n = 35, receiving sham warm acupuncture and Kegel exercise). Both groups were treated three times a week for 4 consecutive weeks. The recovery of PFM strength and changes in Urethral Rotation Angle (URA), Bladder Neck Descent (BND), and Retrovesical Angle (RVA) in pelvic floor ultrasound reports, the scores of pelvic floor dysfunction-related questionnaires, and the efficacy of urinary incontinence treatment of the two groups were compared before and after treatment. RESULTS: After treatment, the recovery rates of type I and II PFM strength, pelvic floor ultrasound parameters, pelvic floor dysfunction-related scale scores, and urinary incontinence treatment efficacy in the combination group were significantly better than those in the sham control group (p < 0.05). CONCLUSION: Warm acupuncture combined with Kegel exercise can significantly improve PFM strength and promote the recovery of postpartum pelvic floor function in women.

Evaluation of blood minerals and oxidative stress changing pattern in prepartum and postpartum Achai and Holstein Friesian dairy cows.

This research focused on evaluating blood mineral levels and malondialdehyde (MDA) as an indicator of oxidative stress before and after giving birth in Achai and Holstein Friesian (HF) dairy cows. Blood samples were obtained from a total of 50 cows representing both breeds on the third, second, and first week prior to calving, as well as on the day of calving (day 0). Subsequently, samples were collected on the 1-3 weeks postpartum to allow a comprehensive evaluation of blood parameters throughout the peripartum period. Results showed a significant (p < .01) decrease in serum zinc (Zn) levels on the day of parturition in both breeds. Additionally, HF cows exhibited higher (p < .01) Zn levels on week 2 before giving birth. Interestingly, blood selenium (Se) concentration increased (p < .01) in HF cows on weeks 2 and 3 after calving. In contrast, Achai cows showed a rise (p < .01) in blood Se on week 3 of parturition. Blood copper (Cu) levels were higher (p < .01) on weeks 2 and 3 after parturition in HF cows and on third week before parturition compared to Achai cows, where serum Cu remained high on week 1 of parturition. The findings indicated that blood magnesium (Mg) was higher (p < .01) on third week before parturition in Achai cows and on weeks 2 and 3 after parturition. Serum calcium (Ca) was higher (p < .01) in both HF and Achai cows on weeks 2 and 3 after parturition, and lower (p < .01) on third week before giving birth in both breeds. The mean blood MDA levels in Achai cows were lower (p < .01) on weeks 1 to 3 postpartum or 3 weeks before giving birth. In HF cows, serum MDA increased (p < .01) just before 2 weeks of parturition and remained elevated until 3 weeks of parturition. Thus, both breeds exhibited a similar pattern of mineral fluctuations; yet, Achai cows demonstrated greater resilience to oxidative stress compared to HF cows during the transition period.

Evaluation of the Impact of a Midwife-Led Breastfeeding Group Intervention on Prevention of Postpartum Depression: A Multicentre Randomised Clinical Trial.

Postpartum depression is a significant health issue affecting both mothers and newborns during the postpartum period. Group support interventions during this period have proven effective in helping women cope with depression and improving breastfeeding rates. This study aimed to assess the effectiveness of a midwife-led breastfeeding support group intervention on breastfeeding rates, postpartum depression and general self-efficacy. This was a multicentric cluster randomised controlled trial with control and intervention groups and was not blinded. It was conducted in Andalusia (southern Spain) from October 2021 to May 2023. A total of 382 women participated in the study. The results showed a significant difference in exclusive breastfeeding rates at 4 months postpartum between the groups (control 50% vs. intervention 69.9%; p < 0.001). Additionally, there was a lower mean score on the Edinburgh Postnatal Depression Scale in the intervention group (12.49 ± 3.6 vs. 13.39 ± 4.0; p = 0.044). Similarly, higher scores of general self-efficacy were observed among breastfeeding women at 2 and 4 months postpartum (77.73 ± 14.81; p = 0.002 and 76.46 ± 15.26; p < 0.001, respectively). In conclusion, midwife-led breastfeeding support groups enhanced self-efficacy, prolonged breastfeeding and reduced postpartum depression 4 months after giving birth.