Shaping birth: variation in the birth canal and the importance of inclusive obstetric care.

Regional variation in pelvic morphology and childbirth has long occurred alongside traditional labour support and an understanding of possible normal courses of childbirth for each population. The process of migration and globalization has broken down these links, while a European model of 'normal' labour has become widespread. The description of 'normal' childbirth provided within obstetrics and midwifery textbooks, in fact, is modelled on a specific pelvic morphology that is common in European women. There is mounting evidence, however, that this model is not representative of women's diversity, especially for women of non-white ethnicities. The human birth canal is very variable in shape, both within and among human populations, and differences in pelvic shapes have been associated with differences in the mechanism of labour. Normalizing a white-centred model of female anatomy and of childbirth can disadvantage women of non-European ancestry. Because they are less likely to fit within this model, pelvic shape and labour pattern in non-white women are more likely to be considered 'abnormal', potentially leading to increased rates of labour intervention. To ensure that maternal care is inclusive and as safe as possible for all women, obstetric and midwifery training need to incorporate women's diversity. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Neonatal diethylstilbestrol exposure disrupts female reproductive tract structure/function via both direct and indirect mechanisms in the hamster.

We assessed neonatal diethylstilbestrol (DES)-induced disruption at various endocrine levels in the hamster. In particular, we used organ transplantation into the hamster cheek pouch to determine whether abnormalities observed in the post-pubertal ovary are due to: (a) a direct (early) mechanism or (b) an indirect (late) mechanism that involves altered development and function of the hypothalamus and/or pituitary. Of the various disruption endpoints and attributes assessed: (1) some were consistent with the direct mechanism (altered uterine and cervical dimensions/organization, ovarian polyovular follicles, vaginal hypospadius, endometrial hyperplasia/dysplasia); (2) some were consistent with the indirect mechanism (ovarian/oviductal salpingitis, cystic ovarian follicles); (3) some were consistent with a combination of the direct and indirect mechanisms (altered endocrine status); and (4) the mechanism(s) for one (lack of corpora lutea) was uncertain. This study also generated some surprising observations regarding vaginal estrous assessments as a means to monitor periodicity of ovarian function in the hamster.

Does supplementing dairy cows with ß-carotene during the dry period affect postpartum ovarian activity, progesterone, and cervical and uterine involution?

ß-carotene is the main natural precursor of vitamin A and plays an important role in reproductive efficiency and immune function in dairy cows. The objective of this study was to investigate whether a supplement of ß-carotene given during the dry period is able to 1) increase blood concentrations of ß-carotene postpartum, 2) improve ovarian function and progesterone production, and 3) enhance uterine involution and uterine health. This study was conducted using 40 Holstein cows. On the day of drying-off, cows were allocated to one of two dietary treatments: control diet (C, n = 20) or control diet plus 1g/d ß-carotene (BC, n = 20). The ß-carotene supplement was given individually to the cows until calving. Blood samples were obtained regularly before and after calving from the cows to measure the concentrations of ß-carotene. The diameters of the cervix and uterine horns were measured regularly using ultrasonography. Endometrial cytology samples were acquired from the cervix and uterus to determine uterine health. Milk samples were obtained three times per week for progesterone assay. Additional blood samples were taken on the day of calving, 7 and 21 days postpartum to determine the plasma concentrations of amino acids. Blood concentrations of ß-carotene were not different before the start of the experiment (C, 3.03 ± 0.22 mg/L vs BC, 3.12 ± 0.22 mg/L, P > 0.05). Blood concentrations of ß-carotene in the BC group peaked (7.45 ± 0.24 mg/L) 1 month after drying-off while the concentrations in the C group remained constant. ß-carotene concentrations then decreased in both groups. The difference in blood concentrations of ß-carotene between groups became significant 2 weeks after the start of the supplement until 2 weeks postpartum. There was no significant difference in the interval from calving to ovulation between groups (C, 27.8 ± 3.46 d vs BC, 35.8 ± 3.55 d, P > 0.05). The dietary supplement of ß-carotene during the dry period had no effect on ovarian activity, progesterone production, cervix and uterine horn diameters. Plasma concentrations of hydroxyproline in the BC group were higher than in the C group on day 21 postpartum (BC, 20.8 ± 1.33 µmol/L vs C, 15.0 ± 1.33 µmol/L; P < 0.01). On day 28 postpartum the percentage of neutrophils in the BC group was lower than in the C group (cervical smear; C, 21.0 ± 3.22% vs BC, 9.7 ± 3.14%, P < 0.05 and uterine smear; C, 32.0 ± 3.86% vs BC, 20.9 ± 3.76%, P < 0.05). In the present experiment a dietary supplement of ß-carotene had no effect on ovarian activity. However, due to effects of ß-carotene on hydroxyproline profiles and their potential relationship with uterine function we speculate that uterine involution may have been more complete and that uterine inflammation may have been reduced in cows which received the ß-carotene compared to controls.

Maduración cervical: aceleración de un proceso natural / Cervical ripening: natural process acceleration

Los cada vez más eficaces métodos de diagnóstico prenatal, el aumento de gestantes mayores de 35 años, el aumento de los procesos de fecundación y el mejor conocimiento de la fisiología fetal hacen que sean cada día más frecuentes los procesos de maduración e inducción del parto. Esta revisión bibliográfica pretende mostrar el amplio espectro de métodos de maduración cervical; además, se hace una pequeña incursión en la fisiología de la maduración cervical para facilitar la comprensión del éxito o fracaso de los diferentes métodos (AU)

The each time more effective methods of prenatal diagnosis, the increase of primigravidas aging more than 35 years, the increase of fertilization processes and the improvement on the knowledge of the fetal physiology, Makes procedures of cervical ripening more frequent. The aim of this bibliographic review is to show the wide spectrum of methods used to reach a cervical ripening, furthermore a description of the physiology of cervical ripening to understand how do they work or don’t sometimes (AU)

O óleo de milho como substância control no colo uterino de ratase / The corn oil as control substance in the uterus colo of the rats

O óleo de milho é frequentementeempregado como substância controle em estudos esperimentais que investigam outras substâncias oleosas empregadas empiricamente pra fins terapêuticos, como o óleo de copaíba e o óleo de andiroba. O presente trabalho se propõe a realizar estudo morfológico e morfométrico no colo uterino de ratas, após aplicação de óleo de milho, uma vez que há relatos do uso de substâncias oleosas como óleo de copaíba no tratamento de blenorragia e leucorréia, via vaginal, na forma de óvulos. Foram utilizadas 90 ratas, adultas, distribuídas em 3 grupos: grupo óleo de milho (GM), grupo água (GA) e grupo padrão (GP). Todos os animais foram submetidos a ooforectomia bilateral e posteriormente mantidos em gaiolas por um período de 20 dias, antes de iniciar a aplicação das substâncias. Estas foram administradas, via vaginal, na dose de 0,3ml,diariamente, uma vez ao dia, até o dia determinado para eutanásia (7,14,e 21 ), sendo 5 animais por dia de cada grupo. A vagina foi retirada em bloco para, em seguida, serem realizadois estudos morfológico e morfométrico. O óleo de milho utilizado neste modelo experimental não mostrou alterações morfológicas e morfométrica no epitélio e lâmina propria do colo uterino de ratas ooforectomizadas

Interleukin-8 induces cervical ripening in rabbits.

OBJECTIVE: The purpose of this study was to determine whether cervical ripening can be induced in rabbits by interleukin-8. STUDY DESIGN: Nonpregnant and pregnant rabbits were treated for 5 days with vaginal suppositories containing 100 ng of interleukin-8. Collagen and glycosaminoglycan concentration in the cervices were assessed histologically by picrosirius red and alcian blue, and the mean optical density was calculated. The mean neutrophil count in five random fields was calculated from each biopsy specimen. RESULTS: Interleukin-8 induced softening and dilatation of the rabbit cervices. Water content was significantly increased (p < 0.0001 and p < 0.001, respectively). Cervical collagen concentration was found to be significantly decreased (p < 0.0004 and p < 0.0001, respectively). Glycosaminoglycan concentration was significantly increased in nonpregnant and pregnant cervices (p < 0.0009 and p < 0.1, respectively). The mean number of neutrophils was significantly increased (p < 0.0005 and p < 0.006, respectively). CONCLUSION: Interleukin-8 can induce cervical ripening in nonpregnant and pregnant rabbits.

Effects of adding beta-carotene to rations of lactating cows consuming different forages.

Thirty-six Holstein cows fed a corn silage-based ration and 34 fed an alfalfa-grass silage-based ration were assigned according to calving date to receive either 300 mg/head per day of synthetic beta-carotene in a gelatin capsule or an empty gelatin capsule daily for the first 100 days postpartum. Supplemental vitamin A was provided at 3919 IU/kg of ration dry matter. Cervix diameters for cows supplemented with beta-carotene were smaller at 21 days and 28 days postpartum. Days from parturition to first observed estrus were less when beta-carotene was added and less when corn silage was fed. Means of other reproductive traits were more favorable for cows treated with beta-carotene (fewer services per conception and shorter intervals between parturition and conception). Milk progesterone at 21 and 28 days postpartum was not affected by either roughage or beta-carotene treatment. Milk from cows receiving alfalfa-grass silage contained lower somatic cell concentrations than that produced by cows fed corn silage. Milk somatic cell concentrations were lower in both roughage treatment groups for cows supplemented with beta-carotene. No effects of roughage or beta-carotene on milk production or milk fat percentages were significant.