The effects of diazepam on fear extinction in nulliparous and primiparous female rats.

Benzodiazepines undermine the success of exposure therapy in humans with anxiety disorders, and impair the long-term memory of fear extinction (the laboratory basis of exposure therapy) in rodents. However, most rodent studies on fear extinction and benzodiazepines have been conducted in male rodents. In female rodents, the estrous cycle influences the consolidation of fear extinction memories and sensitivity to benzodiazepines. In addition, pregnancy leads to long-term changes in the neurobiological, hormonal, and behavioural features of fear extinction, as well as the responsivity to benzodiazepines. Therefore, the present experiments examined the impact of benzodiazepines on fear extinction in female rats with and without reproductive experience. Age-matched nulliparous (no reproductive experience) and primiparous (one prior reproductive experience; tested one-month post-weaning) rats received fear conditioning to a discrete cue. The next day, rats were administered the benzodiazepine diazepam (2 mg/kg, s.c), or vehicle, prior to or immediately after extinction training. Rats were then tested the next day, drug free, for extinction retention. Similar to previous findings in males, diazepam impaired extinction retention in both nulliparous and primiparous rats when administered either pre- or post-extinction training. These findings may have potential clinical implications as they suggest that benzodiazepine use in conjunction with exposure therapy may undermine long-term treatment success in women with and without reproductive experience, although this remains to be tested in human populations. Moreover, these findings are theoretically important when considered in light of previous studies showing dissociable mechanisms of fear extinction in females pre- versus post-pregnancy.

Histone deacetylase inhibitor treatment induces postpartum-like maternal behavior and immediate early gene expression in the maternal neural pathway in virgin mice.

The peripartum period is associated with the onset of behaviors that shelter, feed and protect young offspring from harm. The neural pathway that regulates caregiving behaviors has been mapped in female rats and is conserved in mice. However, rats rely on late gestational hormones to shift their perception of infant cues from aversive to attractive, whereas laboratory mice are "spontaneously" maternal, but their level of responding depends on experience. For example, pup-naïve virgin female mice readily care for pups in the home cage, but avoid pups in a novel environment. In contrast, pup-experienced virgin mice care for pups in both contexts. Thus, virgin mice rely on experience to shift their perception of infant cues from aversive to attractive in a novel context. We hypothesize that alterations in immediate early gene activation may underlie the experience-driven shift in which neural pathways (fear/avoidance versus maternal/approach) are activated by pups to modulate context-dependent changes in maternal responding. Here we report that the effects of sodium butyrate, a drug that allows for an amplification of experience-induced histone acetylation and gene expression in virgins, are comparable to the natural onset of caregiving behaviors in postpartum mice and induce postpartum-like patterns of immediate early gene expression across brain regions. These data suggest that pups can activate a fear/defensive circuit in mice and experience-driven improvements in caregiving behavior could be regulated in part through decreased activation of this pathway.

Interactions of human chorionic gonadotropin with genotype and parity on fertility responses of lactating dairy cows.

Fertility-promoting effects of treatment of lactating dairy cattle with human chorionic gonadotropin (hCG) after artificial insemination (AI) have been variable. Here, we tested whether fertility response to hCG in lactating Holstein cows interacts with genotype and parity. Primiparous (n = 538) and multiparous (n = 613) cows were treated with hCG (3,300 IU) or vehicle 5 d after AI. Pregnancy was diagnosed on d 32 and 60 after AI. A subset of cows (n = 593-701) was genotyped for 4 single nucleotide polymorphisms (SNP) previously associated with fertility. Treatment with hCG increased progesterone concentration on d 12 after AI regardless of genotype or parity. Pregnancy per AI was improved by hCG in primiparous cows but not in multiparous cows. Moreover, hCG treatment interacted with a SNP in coenzyme Q9 (COQ9) to affect fertility. Fertility of cows treated with vehicle was greatest for the AA allele, whereas fertility was lowest for the same genotype among cows treated with hCG. Pregnancy per AI was also affected by genotype for heat shock protein A1-like (HSPA1L) and progesterone receptor (PGR), but no interactions were observed with treatment. Genotype for a SNP in prostate androgen-regulated mucin-like protein 1 (PARM1) was not associated with fertility. Overall, results show that variation in response to hCG treatment on fertility depends on parity and interacts with a SNP in COQ9.

The Labor Analgesia Requirements in Nulliparous Women Randomized to Epidural Catheter Placement in a High or Low Intervertebral Space.

BACKGROUND: We hypothesized that an epidural catheter placed in a lower vertebral interspace will require less medication for labor analgesia. METHODS: Nulliparous women requesting neuraxial labor analgesia were randomized to epidural catheter placement at the ultrasound-confirmed L1-2 or L4-5 interspace. Patient-controlled epidural analgesia and breakthrough manual epidural boluses of 10 mL of 0.125% bupivacaine with 50 µg of fentanyl or 8 mL of 2% lidocaine were utilized. Abdominal and perineal pain scores were assessed at 30 and 60 minutes after standardized initiation of epidural analgesia. Pain scores during pushing were assessed after delivery. The primary outcome was the proportion of patients requiring manual boluses and was compared using a χ test. Secondarily, we analyzed the number of boluses given in early (up to 4 hours before delivery) versus late labor using χ tests and the pain scores using Mann-Whitney U tests, with adjustment of P values for multiple testing. RESULTS: We analyzed 148 patients. Overall, the percentage of patients in the low versus high groups who required manual boluses was 46% vs 51% (P = 1.0). For the 56 patients in each group who delivered vaginally, 22 (52%) vs 20 (48%) manual boluses were given to the low epidural group in early versus late labor, compared to 9 (20%) vs 36 (80%) in the high epidural group (P = .014). There was no statistical difference in patient-controlled epidural analgesia requirements or patient satisfaction. Comparing the low versus high groups, the median (interquartile range) pain scores were: 3 (1, 6) vs 0 (0, 2) (P = .013) at 30 minutes and 1 (1, 3) vs 0 (0, 1) (P = .013) at 60 minutes for abdominal pain; 0 (0, 2) vs 1 (1, 3) (P = .36) and 0 (0, 1) vs 1 (1, 3) (P = .014) at these same time points for perineal pain; and 1 (0, 5) vs 0 (0, 3) (P = .9) for abdominal and 2 (0, 5) vs 4 (1, 8) (P = .025) for perineal pain during pushing. The percentage of patients who underwent instrumental delivery was 15% vs 5% (P = .06) for the low versus high group. CONCLUSIONS: An L4-5 epidural catheter initially provides less relief of abdominal pain but more relief of perineal labor pain. Patients with an L4-5 catheter require more manual boluses during early labor but less during late labor. The possible association of low epidural catheters with instrumental delivery merits further investigation.

Anti-Müllerian hormone and lifestyle, reproductive, and environmental factors among women in rural South Africa.

BACKGROUND: Few data exist regarding anti-Müllerian hormone, a marker of ovarian reserve, in relation to environmental factors with potential ovarian toxicity. METHODS: This analysis included 420 women from Limpopo, South Africa studied in 2010-2011. Women were administered comprehensive questionnaires, and plasma concentrations of anti-Müllerian hormone and dichlorodiphenyltrichloroethane were determined. We used separate multivariable models to examine the associations between natural log-transformed anti-Müllerian hormone concentration (ng/ml) and each of the lifestyle, reproductive, and environmental factors of interest, adjusted for age, body mass index, education, and parity. RESULTS: The median age of women was 24 years (interquartile range [IQR] = 22 to 26); the median anti-Müllerian hormone concentration was 3.1 ng/ml (IQR = 2.0 to 6.0). Women who reported indoor residual spraying in homes with painted walls (indicative of exposure to pyrethroids) had 25% lower (95% confidence interval [CI] = -39%, -8%) anti-Müllerian hormone concentrations compared with women who reported no spraying. Little evidence of decreased anti-Müllerian hormone concentrations was observed among women with the highest dichlorodiphenyltrichloroethane levels. Compared with women who used an electric stove, no association was observed among women who cooked indoors over open wood fires. The findings also suggested lower anti-Müllerian hormone concentrations among women who drank coffee (-19% [95% CI = -31%, -5%]) or alcohol (-21% [95% CI = -36%, -3%]). CONCLUSIONS: These are among the first data regarding anti-Müllerian hormone concentrations relative to pesticides and indoor air pollution. Our results are suggestive of decreased ovarian reserve associated with exposure to pyrethroid pesticides, which is consistent with laboratory animal data.

Effect of intrauterine dextrose on reproductive performance of lactating dairy cows diagnosed with purulent vaginal discharge under certified organic management.

The objectives of the study were to assess responses to treatments (clinical cure and resumption of estrous cycles) of cows with purulent vaginal discharge (PVD) that received intrauterine infusion of a hypertonic solution of 50% dextrose (DEX) or untreated control (CON) cows and the subsequent pregnancy per artificial insemination (PAI) in cows with and without PVD. Cows (n=2,852) from 2 dairy herds were screened for PVD using the gloved hand technique at exam 1 [26±3 d in milk (DIM)]. Cows with vaginal discharge scores of 2 or 3 (0-3 scale) were stratified by parity and randomly allocated into 1 of 2 treatment groups: (1) intrauterine infusion (~200 mL) of 50% DEX solution (n=456), or (2) untreated control animals (CON, n=491). Fourteen days posttherapy (40±3 DIM), cows with PVD were re-examined at exam 2 (40±3 DIM) to assess the response to treatments. All cows were subjected to the same reproductive program, which consisted of estrus detection twice daily (using tail chalking and visual observation) for the first 5 artificial inseminations; then, open lactating cows were turned out with bulls. Cows displaying signs of standing estrus underwent AI and no reproductive hormones were used. Pregnancy diagnosis (PD) was performed via transrectal palpation at 40±3 d post-AI. The risk of culling within 14 d posttherapy was not different among treatment groups. Cows with PVD had greater cervical diameter at exam 1 and decreased PAI compared with cows without PVD. Treatment with DEX increased the proportion of cows with clear vaginal discharge (clinical cure) and cyclicity 14 d posttherapy compared with CON cows. Pregnancy per AI for DEX (29.2±2%) cows was significantly greater than that for CON (22.5±2%) cows. Cows without PVD had a greater proportion of cycling cows (65.6%) and PAI (37%) with reduced pregnancy losses (5.7%) compared with DEX or CON cows. The use of intrauterine DEX alone improved reproductive performance of cows with PVD.

Effect of cow parity and synchronization method with PGF2α on conception rates of Bos indicus cows in Cameroon.

The objective of this work was to evaluate the effect of two synchronization methods with prostaglandins F2α (PGF2α) on heifers and multiparous cows. Fourty-three Bos indicus cows (white and Red Fulani) were divided into four groups in a two-by-two factorial structure, parity x method of synchronization. The synchronization methods consisted of a two-dose regime which involved injection of animals on day 0 with PGF2α (Lutalyse) at 5 ml per cow intramuscularly. On day 11, the injection was repeated at the same dosage. On day 14 (72 h after the second injection), a fixed-time artificial insemination (AI) was done. On day 15 (96 h after the second injection), a second insemination was done. The one-and-a-half-dose regime consisted of an injection similar to the first treatment mentioned above on day 0. Thereafter, cows were observed for heat, and anyone showing heat was inseminated. A second dose was given on day 11 to all animals not having shown any heat. A fixed-time AI was done on days 14 and 15. Blood samples were collected on the day 0 of insemination for each cow while day 11 and day 21 after insemination. Progesterone was analysed by means of standard ELISA progesterone kits to determine its profiles after insemination. Results show no evidence of the effect of treatments on conception rates (P > 0.05). Similarly, heifers and multiparous cows had similar conception rates (P > 0.05). Between 3 weeks and 3 months of pregnancy, there was a loss of embryos of 28% in heifers and 20% in multiparous cows, but the difference between the two groups was not significant (P > 0.05). It recommended that farmers do not synchronize animals with poor body condition score (BCS). They should also monitor weight gains of heifers, remove them from the herd when they have been mixed with young growing bulls and put them in a breeding herd. The two-dose regime is better to be used in areas where the inseminator cannot easily be available.

Evaluation of ivermectin mass drug administration for malaria transmission control across different West African environments.

BACKGROUND: Mass drug administration (MDA) of ivermectin to humans for control and elimination of filarial parasites can kill biting malaria vectors and lead to Plasmodium transmission reduction. This study examines the degree and duration of mosquitocidal effects resulting from single MDAs conducted in three different West African countries, and the subsequent reductions in parity and Plasmodium sporozoite rates. METHODS: Indoor-resting, blood-fed and outdoor host-seeking Anopheles spp. were captured on days surrounding MDAs from 2008-2013 in Senegalese, Liberian and Burkinabé villages. Mortality was assessed on a portion of the indoor collection, and parity status was determined on host-seeking mosquitoes. The effect of MDA was then analysed against the time relative to the MDA, the distributed drugs and environmental variables. RESULTS: Anopheles gambiae survivorship was reduced by 33.9% for one week following MDA and parity rates were significantly reduced for more than two weeks after the MDAs. Sporozoite rates were significantly reduced by >77% for two weeks following the MDAs in treatment villages despite occurring in the middle of intense transmission seasons. These observed effects were consistent across three different West African transmission dynamics. CONCLUSIONS: These data provide a comprehensive and crucial evidence base for the significant reduction in malaria transmission following single ivermectin MDAs across diverse field sites. Despite the limited duration of transmission reduction, these results support the hypothesis that repeated MDAs with optimal timing could help sustainably control malaria as well as filarial transmission.

Supplementation with conjugated linoleic acids extends the adiponectin deficit during early lactation in dairy cows.

Decreasing insulin sensitivity (IS) in peripheral tissues allows for partitioning nutrients towards the mammary gland. In dairy cows, extensive lipid mobilization and continued insulin resistance (IR) are typical for early lactation. Adiponectin, an adipokine, promotes IS. Supplementation with conjugated linoleic acids (CLA) in rodents and humans reduces fat mass whereby IR and hyperinsulinemia may occur. In dairy cows, CLA reduce milk fat, whereas body fat, serum free fatty acids and leptin are not affected. We aimed to investigate the effects of CLA supplementation on serum and adipose tissue (AT) adiponectin concentrations in dairy cows during the lactation driven and parity modulated changes of metabolism. High yielding cows (n=33) were allocated on day 1 post partum to either 100 g/day of a CLA mixture or a control fat supplement (CON) until day 182 post partum. Blood and subcutaneous (sc) AT (AT) biopsy samples were collected until day 252 post partum to measure adiponectin. Serum adiponectin decreased from day 21 pre partum reaching a nadir at calving and thereafter increased gradually. The distribution of adiponectin molecular weight forms was neither affected by time, parity nor treatment. Cows receiving CLA had decreased serum adiponectin concentrations whereby primiparous cows responded about 4 weeks earlier than multiparous cows. The time course of adiponectin concentrations in sc AT (corrected for residual blood) was similar to serum concentrations, without differences between CLA and CON. CLA supplementation attenuated the post partum increase of circulating adiponectin thus acting towards prolongation of peripartal IR and drain of nutrients towards the mammary gland.

Reproductive experience modifies the effects of estradiol on learning and memory bias in female rats.

Previous studies have shown that estrogen affects whether a hippocampus-mediated place (allocentric) or a striatum-mediated response (egocentric) memory system is employed by female rats when searching for a food reward in a maze. Because it has been suggested that reproductive experience alters some of the responses to E in the brain, two experiments were carried out to investigate whether reproductive experience would also alter the effect of E on place and response learning. In experiment 1, 152 ovariectomized nulliparous (n=77; no reproductive experience) and primiparous (n=74; having had and raised one litter of pups) Wistar rats were trained on an ambiguous t-maze task and tested for memory system bias. In experiment 2, 35 ovariectomized nulliparous (n=16) and primiparous (n=19) Wistar rats were trained on place and response plus-maze tasks. All rats were exposed to no, chronic low or chronic low with pulsatile high 17ß-estradiol (E2) replacement. Congruent with previous findings, low E2 nulliparous rats showed predominant use of response memory and faster response learning, whereas high E2 nulliparous rats showed a trend towards predominant place memory use. Interestingly, the facilitatory effect of low E2 on response task learning and memory seen in nulliparous rats was not observed in low E2 primiparous rats in either experiment. In conclusion, E2 levels do dictate the rate at which female rats learn a response task and utilize response memory, but only in those with no reproductive experience.

The impact of cyclophosphamide on menstruation and pregnancy in women with rheumatologic disease.

BACKGROUND: While cyclophosphamide (CYC) can save the life of a young woman with severe rheumatologic disease, it may lead to the long-term side-effects of infertility and premature menopause. We compared the reproductive health histories of young women with rheumatologic disease with and without prior CYC exposure to identify the impact of this medication on this important component of health. METHODS: This research includes a case-series study of women diagnosed with SLE, vasculitis, and scleroderma prior to age 35. Each patient completed a questionnaire about desired childbearing, menstrual regularity, infertility, and pregnancy history. Women with prior CYC therapy were queried about the use of gonadotropin-releasing hormone agonists (GnRH-a) for fertility preservation. The responses to this questionnaire were compared for women with and without CYC exposure. RESULTS: Of the 43 participants, 23 had prior CYC exposure and 20 were CYC naïve. The current age of these groups was similar (average age 32), but women with prior CYC were four years younger at diagnosis than women without CYC. More women with prior CYC had cessation of menses in the year prior to the study (30.4% vs 0%, p < 0.05). Of the women with prior CYC exposure, those with loss of menses were older at study enrollment, older at CYC treatment, and had a higher cumulative CYC dose than those with preserved menstruation. While more women with GnRH-a co-therapy during CYC had maintained menses, this difference did not reach statistical significance. Women with prior CYC without GnRH-a co-therapy had a higher frequency of nulliparity and had greater trouble conceiving than women with GnRH-a co-therapy. Few pregnancies were conceived following CYC exposure and all resulted in elective termination, miscarriage, or preterm birth. CONCLUSION: In this cohort of young women with rheumatologic disease, more women with prior CYC than without had amenorrhea, nulliparity, and infertility. GnRH-a co-therapy may prevent these adverse effects of CYC.

Vitamin B(12) intake and status in early pregnancy among urban South Indian women.

AIM: To evaluate the vitamin B(12) status of South Indian women in early pregnancy and its relationship with sociodemographic, anthropometry and dietary intake. METHODS: Cross-sectional study among 366 pregnant urban South Indian women ≤14 weeks of gestation with outcome variables defined as low vitamin B(12) blood concentration (<150 pmol/l) and impaired vitamin B(12) status [low vitamin B(12) plus elevated methylmalonic acid (MMA) >0.26 µmol/l)]. RESULTS: Low plasma vitamin B(12) concentration was observed in 51.1% of the women, while 42.4% had impaired B(12) status. Elevated MMA, elevated homocysteine (>10 µmol/l) and low erythrocyte folate (<283 nmol/l) were observed among 75.8, 43.3 and 22.2% of the women, respectively. The median (25th, 75th percentile) dietary intake of vitamin B(12) was 1.25 (0.86, 1.96) µg/day. Lower maternal body weight was associated with higher vitamin B(12) concentration [prevalence ratios (PR) (95% CI) 0.57 (0.39, 0.84)]. The predictors of impaired vitamin B(12) status were no consumption of yoghurt [PR (95% CI) 1.63 (1.03, 2.58)] or fish [PR (95% CI) 1.32 (1.01, 1.71)] and primiparity [PR (95% CI) 1.41 (1.05, 1.90)]. CONCLUSION: A high prevalence of vitamin B(12) deficiency in early pregnancy among urban South Indian women was related to primiparity and to a low consumption of yoghurt and fish.

Effect of gonadotropin-releasing hormone or prostaglandin F(2α)-based estrus synchronization programs for first or subsequent artificial insemination in lactating dairy cows.

The objective was to evaluate the effects of GnRH or PGF(2α)-based synchronization and resynchronization programs on fertility in lactating dairy cows. For experiment 1, cows (n=1,521) were presynchronized with 2 injections of PGF given at 36 and 50 DIM and assigned to 1 of 3 protocols: Ovsynch [OVS; n=552; GnRH injection, PGF(2α) injection 7 d later, GnRH injection 56 h later, and timed artificial insemination (TAI) 16 h later] beginning at 14 d after presynchronization (PS), GnRH-GnRH-PGF(2α)-GnRH (GGPG; n=402) treatment with a GnRH injection given 7 d after PS and OVS 7 d later, or PGF(2α)-GnRH-PGF(2α)-GnRH (P7GPG; n=567) treatment with a PGF(2α) injection given 7 d after PS and OVS beginning 7 d later. Experiment 2 cows (n=2,327) were assigned to 1 of 3 resynchronization protocols 7 d before nonpregnancy diagnosis (NPD): GGPG cows (n=458) received a GnRH injection at enrollment and OVS at NPD; P7GPG cows (n=940) received a PGF(2α) injection at NPD and OVS 7 d later; and P11GPG cows (n=929) received a PGF(2α) injection 3 d after NPD and OVS 11 d later. In both experiments, cows were artificially inseminated upon estrus detection (ED). In experiment 1, 52.3% of cows were artificially inseminated upon ED, with GGPG having reduced ED (GGPG=46.8 vs. OVS=50.7 and P7GPG=57.7%). Treatments did not affect overall pregnancy per artificial insemination (P/AI) at 36 and 66 d after AI (OVS=34.1 and 32.3, P7GPG=34.6 and 31.9, and GGPG=31.3 and 28.1%, respectively) or pregnancy loss but cows artificially inseminated upon ED had higher P/AI than cows undergoing TAI (ED cows=37.9 vs. TAI cows=28.8%). Treatment did not affect P/AI for cows artificially inseminated upon ED or TAI at 36 and 66 d after AI (OVS=34.1 and 32.3, P7GPG=34.6 and 31.9, and GGPG=31.3 and 28.1%). Median days in milk at first AI was affected by treatment (P7GPG=59 vs. OVS=68 and GGPG=68 d). In experiment 2, GGPG reduced ED (GGPG=23.3 vs. P7GPG=74.9 and P11GPG=79.6%). Treatment did not affect overall P/AI at 36 and 66 d after AI (GGPG=29.2 and 25.8, P7GPG=28.7 and 26.6, and P11GPG=31.9 and 30.2%) or pregnancy loss. Cows artificially inseminated upon ED had greater P/AI than TAI cows (ED=32.3 and TAI=25.1%). However, treatment did not affect P/AI for cows artificially inseminated upon ED at 36 and 66 d after AI (GGPG=29.6 and 27.3, P7GPG=29.4 and 28.1, and P11GPG=35.7 and 33.7%) or TAI (GGPG=29.1 and 25.3, P7GPG=25.0 and 22.1, and P11GPG=16.9 and 16.9%). Median days between NPD and AI was affected by treatment (GGPG=10 vs. P7GPG=4 and P11GPG=7 d). Prostaglandin-based programs increased ED and reduced interval to first AI and between AI. Gonadotropin-releasing hormone-based programs increased the proportion of TAI cows. Cows artificially inseminated upon ED had increased P/AI compared with TAI cows.

[Characteristics of thyroid para-follicular cells in the offspring of female rats with chronic experimental liver injury at different stages of postnatal ontogenesis].

Structural and functional features of thyroid gland parafol-licular cell (PFC) population were studied the in 48 animals born to females with chronic experimental liver injury induced by injection of D-galactosamine hydrochloride. Using Grimelius silver nitrate impregnation method, PFC numbers were calculated and their subtypes according to their granular content and degranulation degree determined. Compared with the animals of the control group, the increase of PFC number per unit area together with the number of degranulated cells and the cells with a predominant location of granules on vascular pole was found. At the same time, the increase in the number of cells with moderate and significant degranulation was detected. The changes observed may be indicative of increased functional activity of PFC population in the experimental animals

17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30 mm.

OBJECTIVE: We sought to evaluate whether 17 alpha-hydroxyprogesterone caproate (17-OHP) reduces preterm birth (PTB) in nulliparous women with a midtrimester cervical length (CL) <30 mm. STUDY DESIGN: In this multicenter randomized controlled trial, nulliparous women with a singleton gestation between 16 and 22 3/7 weeks with an endovaginal CL <30 mm (<10th percentile in this population) were randomized to weekly intramuscular 17-OHP (250 mg) or placebo through 36 weeks. The primary outcome was PTB <37 weeks. RESULTS: The frequency of PTB did not differ between the 17-OHP (n = 327) and placebo (n = 330) groups (25.1% vs 24.2%; relative risk, 1.03; 95% confidence interval, 0.79-1.35). There also was no difference in the composite adverse neonatal outcome (7.0% vs 9.1%; relative risk, 0.77; 95% confidence interval, 0.46-1.30). CONCLUSION: Weekly 17-OHP does not reduce the frequency of PTB in nulliparous women with a midtrimester CL <30 mm.

Clinical parameters for prediction of successful labor induction after application of intravaginal dinoprostone in nulliparous Chinese women.

BACKGROUND: The aim of this study was to compare the possible clinical parameters for prediction of successful labor induction in Chinese nulliparous women. MATERIAL/METHODS: A retrospective, observational trial of labor induction was performed, using a single dose of 10 mg controlled-release dinoprostone for preinduction cervical ripening in 127 nulliparous women (gestational age 38-42 weeks, singleton cephalic presentation). The characteristics of the women with successful labor induction (defined as vaginal delivery achieved on the day of admission; n=80) and failed labor induction (n=47) were compared. RESULTS: The main differences observed between the groups were gravidity (P<0.05), induction-active labor interval (5.16±2.98 vs. 8.40±3.41; P<0.05) and birth weight (3421.11±368.14 vs. 3566.36±345.16; P<0.05). Logistic regression demonstrated that gravidity (P<0.05) and induction-active labor interval (P<0.05), but not Bishop score, were significant and independent contributing factors for successful labor induction. In the receiver operating characteristic curves for the prediction of successful labor induction, the best cut-off value for gravidity was 3 (95% confidence interval [CI] 0.64-0.83, P=0.000), and the best cut-off value for the induction-active labor interval was 7.96 (95%CI 0.66-0.85, P=0.000). CONCLUSIONS: Less gravidity and shorter induction-active labor interval predict successful labor induction with reasonable accuracy.

Presynchronization with Double-Ovsynch improves fertility at first postpartum artificial insemination in lactating dairy cows.

The objective of this study was to compare circulating progesterone (P4) profiles and pregnancies per AI (P/AI) in lactating dairy cows bred by timed artificial insemination (TAI) following Ovsynch-56 after 2 different presynchronization protocols: Double-Ovsynch (DO) or Presynch-Ovsynch (PS). Our main hypothesis was that DO would increase fertility in primiparous cows, but not in multiparous cows. Within each herd (n=3), lactating dairy cows (n=1,687; 778 primiparous, 909 multiparous) were randomly assigned to DO [n=837; GnRH-7d-PGF(2α)-3d-GnRH-7d-Ovsynch-56 (GnRH-7d-PGF(2α)-56h-GnRH-16hTAI)] or PS (n=850; PGF(2α)-14d-PGF(2α)-12d-Ovsynch-56). In 1 herd, concentrations of P4 were determined at the first GnRH (GnRH1) of Ovsynch-56 and at d 11 after TAI (n=739). In all herds, pregnancy was diagnosed by palpation per rectum at 39 d. In 1 herd, the incidence of late embryo loss was determined at 74d, and data were available on P/AI at the subsequent second service. Presynchronization with DO reduced the percentage of animals with low P4 concentrations (<0.50 ng/mL) at GnRH1 of Ovsynch-56 (5.4 vs. 25.3%, DO vs. PS). A lesser percentage of both primiparous and multiparous cows treated with DO had low P4 concentrations at GnRH1 of Ovsynch-56 (3.3 vs. 19.7%, DO vs. PS primiparous; and 8.8 vs. 31.9%, DO vs. PS multiparous). Presynchronization with DO improved P/AI at the first postpartum service (46.3 vs. 38.2%, DO vs. PS). Statistically, a fertility improvement could be detected for primiparous cows treated with DO (52.5 vs. 42.3%, DO vs. PS, primiparous), but only a tendency could be detected in multiparous cows (40.3 vs. 34.3%, DO vs. PS, multiparous), consistent with our original hypothesis. Presynchronization treatment had no effect on the incidence of late embryo loss after first service (8.5 vs. 5.5%, DO vs. PS). A lower body condition score increased the percentage of cows with low P4 at GnRH1 of Ovsynch-56 and reduced fertility to the TAI. In addition, P4 concentration at d 11 after TAI was reduced by DO. The method of presynchronization at first service had no effect on P/AI at the subsequent second service (34.7 vs. 36.5%, DO vs. PS). Thus, presynchronization with DO induced cyclicity in most anovular cows and improved fertility compared with PS, suggesting that DO could be a useful reproductive management protocol for synchronizing first service in commercial dairy herds.

Trends and morbidity associated with oxytocin use in labour in nulliparas at term.

AIM: To determine the trends in oxytocin use at a population level within New South Wales and to assess the maternal and neonatal morbidities associated with the use of oxytocin. METHODS: Trends in oxytocin use were assessed for women in NSW who were nulliparas at term with a singleton, cephalic fetus between 1998 and 2008. Maternal and neonatal morbidities were assessed in 2007-2008 using linked hospital and birth data with regression analysis. Oxytocin was also assessed by indication for use being either induction or augmentation of labour. RESULTS: The overall use of oxytocin increased from 10,291 (36.5%) of births in 1998 to 14,440 (45.4%) of births in 2008 (P < 0.0001) with the increase entirely because of the increased use for induction of labour. The use of oxytocin was associated with an increase in regional analgesia (65 to 22%), instrumental delivery (21 to 18%) and caesarean section (29 to 14%) as compared to women who did not receive oxytocin in labour. Oxytocin was also associated with an increase in severe maternal adjusted odds ratios ((aOR) 1.48, 95% CI 1.30-1.68) and neonatal morbidity (aOR 1.29, 95% CI 1.17-1.41). This increase in morbidity was maintained when both augmentation and induction were assessed separately. CONCLUSION: Oxytocin has an important role in the management of labour. However, its use should be carefully monitored with standardised treatment regimes to minimise maternal and neonatal morbidity.

[The influence of calcium N-(5-hydroxynicotinoyl)-L-glutamate on reproductive function, prenatal and postnatal development of rats].

The safety of a new nootrope and neuroprotector--calcium N-(5-hydroxynicotinoyl)-L-glutamate (ampasse)--has been evaluated. It is shown that ampasse at a dose of 6.7 mg/kg (10 times the maximum therapeutic dose for humans) did not affect the reproductive function in experimental animals and did not produced any embryotoxic and teratogenic effects.

Episiotomy wound healing by Commiphora myrrha (Nees) Engl. and Boswellia carteri Birdw. in primiparous women: A randomized controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Traditional Persian medicine manuscripts refer to plants such as Commiphora myrrha (Nees) Engl. (myrrh) and Boswellia carteri Birdw. (frankincense), which could be used to improve wound healing process. Since that time, local midwives in Iran continue to provide these herbs to precipitate episiotomy wound healing. AIM OF THE STUDY: To investigate the efficacy and safety of myrrh- and frankincense-based sitz-baths on episiotomy wound healing in primiparous women. MATERIALS AND METHODS: This randomized controlled trial was conducted on 90 primiparous women with singleton pregnancies after normal vaginal delivery at Hafez hospital affiliated to Shiraz University of Medical Sciences from July to October 2019. Study participants were randomly allocated in three groups (2 intervention groups and 1 control group). Women in intervention groups were assigned to receive either 10-min sitz-bath of myrrh extract or frankincense extract twice a day for 1 week. While the women in control group received the betadine sitz-bath for the same period of time. The main outcome was the episiotomy wound healing, which was measured using the REEDA scale before intervention, on 2nd and 7th postpartum days. RESULTS: An improvement in the episiotomy wound healing was significantly greater in patients receiving myrrh than those receiving the frankincense or betadine on 2nd (p = 0.003 and p < 0.001) and 7th (p = 0.043 and p = 0.015) postpartum days. However, the total REEDA score was not statistically different between the frankincense and betadine groups on 2nd and 7th postpartum days (p > 0.05). CONCLUSION: The present results suggest that myrrh was more efficient than frankincense and betadine in healing of the episiotomy wound and could be recommended as a safe natural therapy.