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1.
Animal ; 14(S1): s44-s54, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32024567

RESUMO

Aspects of neutrophil function are diminished or dysregulated in dairy cows in the weeks just before and after calving, which appears to be an important contributor to the occurrence of retained placenta, mastitis, metritis and endometritis. The timing and mechanisms by which specific elements of neutrophil function are impaired are only partially understood. Oxidative burst capacity is the element of neutrophil function most consistently shown to be impaired in the week after calving, but that observation may partially be biased because oxidative burst has been studied more than other functions. There is sufficient evidence to conclude that the availability of calcium and glucose, and exposure to elevated concentrations of non-esterified fatty acids or ß-hydroxybutyrate affect some aspects of neutrophil function. However, these factors have mostly been studied in isolation and their effects are not consistent. Social stressors such as a competitive environment for feeding or lying space should plausibly impair innate immune function, but when studied under controlled conditions such effects have generally not been produced. Similarly, treatment with recombinant bovine granulocyte colony-stimulating factor consistently produces large increases in circulating neutrophil count with modest improvements in function, but this does not consistently reduce the incidence of clinical diseases thought to be importantly attributable to impaired innate immunity. Research is now needed that considers the interactions among known and putative risk factors for impaired neutrophil function in dairy cows in the transition period.


Assuntos
Doenças dos Bovinos/imunologia , Endometrite/veterinária , Imunidade Inata , Mastite Bovina/imunologia , Placenta Retida/veterinária , Ácido 3-Hidroxibutírico/metabolismo , Adaptação Fisiológica , Animais , Bovinos , Endometrite/imunologia , Metabolismo Energético , Ácidos Graxos não Esterificados/metabolismo , Feminino , Fator Estimulador de Colônias de Granulócitos , Hipocalcemia , Lactação , Contagem de Leucócitos , Neutrófilos/metabolismo , Período Periparto , Placenta Retida/imunologia , Gravidez , Proteínas Recombinantes
2.
Am J Obstet Gynecol ; 222(4): 293.e1-293.e52, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31917139

RESUMO

OBJECTIVE: To assess the efficacy, effectiveness, and safety of uterine balloon tamponade for treating postpartum hemorrhage. STUDY DESIGN: We searched electronic databases (from their inception to August 2019) and bibliographies. We included randomized controlled trials, nonrandomized studies, and case series that reported on the efficacy, effectiveness, and/or safety of uterine balloon tamponade in women with postpartum hemorrhage. The primary outcome was the success rate of uterine balloon tamponade for treating postpartum hemorrhage (number of uterine balloon tamponade success cases/total number of women treated with uterine balloon tamponade). For meta-analyses, we calculated pooled success rate for all studies, and relative risk with 95% confidence intervals for studies that included a comparative arm. RESULTS: Ninety-one studies, including 4729 women, met inclusion criteria (6 randomized trials, 1 cluster randomized trial, 15 nonrandomized studies, and 69 case series). The overall pooled uterine balloon tamponade success rate was 85.9% (95% confidence interval, 83.9-87.9%). The highest success rates corresponded to uterine atony (87.1%) and placenta previa (86.8%), and the lowest to placenta accreta spectrum (66.7%) and retained products of conception (76.8%). The uterine balloon tamponade success rate was lower in cesarean deliveries (81.7%) than in vaginal deliveries (87.0%). A meta-analysis of 2 randomized trials that compared uterine balloon tamponade vs no uterine balloon tamponade in postpartum hemorrhage due to uterine atony after vaginal delivery showed no significant differences between the study groups in the risk of surgical interventions or maternal death (relative risk, 0.59; 95% confidence interval, 0.02-16.69). A meta-analysis of 2 nonrandomized before-and-after studies showed that introduction of uterine balloon tamponade in protocols for managing severe postpartum hemorrhage significantly decreased the use of arterial embolization (relative risk, 0.29; 95% confidence interval, 0.14-0.63). A nonrandomized cluster study reported that use of invasive procedures was significantly lower in the perinatal network that routinely used uterine balloon tamponade than that which did not use uterine balloon tamponade (3.0/1000 vs 5.1/1000; P < .01). A cluster randomized trial reported that the frequency of postpartum hemorrhage-related invasive procedures and/or maternal death was significantly higher after uterine balloon tamponade introduction than before uterine balloon tamponade introduction (11.6/10,000 vs 6.7/10,000; P = .04). Overall, the frequency of complications attributed to uterine balloon tamponade use was low (≤6.5%). CONCLUSION: Uterine balloon tamponade has a high success rate for treating severe postpartum hemorrhage and appears to be safe. The evidence on uterine balloon tamponade efficacy and effectiveness from randomized and nonrandomized studies is conflicting, with experimental studies suggesting no beneficial effect, in contrast with observational studies. Further research is needed to determine the most effective programmatic and healthcare delivery strategies on uterine balloon tamponade introduction and use.


Assuntos
Hemorragia Pós-Parto/etiologia , Hemorragia Pós-Parto/terapia , Tamponamento com Balão Uterino , Cesárea/estatística & dados numéricos , Feminino , Humanos , Mortalidade Materna , Parto , Placenta Acreta/etiologia , Placenta Prévia/etiologia , Placenta Retida/etiologia , Gravidez , Embolização da Artéria Uterina/estatística & dados numéricos , Tamponamento com Balão Uterino/efeitos adversos , Inércia Uterina/etiologia
4.
BJOG ; 127(5): 628-634, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31808245

RESUMO

OBJECTIVE: To assess the maternal characteristics and causes associated with refractory postpartum haemorrhage (PPH). DESIGN: Secondary analysis of the WHO CHAMPION trial data. SETTING: Twenty-three hospitals in ten countries. POPULATION: Women from the CHAMPION trial who received uterotonics as first-line treatment of PPH. METHODS: We assessed the association between sociodemographic, pregnancy and childbirth factors and refractory PPH, and compared the causes of PPH between women with refractory PPH and women responsive to first-line PPH treatment. MAIN OUTCOME MEASURES: Maternal characteristics; causes of PPH. RESULTS: Women with labour induced or augmented with uterotonics (adjusted odds ratio [aOR] 1.35; 95% CI 1.07-1.72), with episiotomy or tears requiring suturing (aOR 1.82; 95% CI 1.34-2.48) and who had babies with birthweights ≥3500 g (aOR 1.33; 95% CI 1.04-1.69) showed significantly higher odds of refractory PPH compared with the reference categories in the multivariate analysis adjusted by centre and trial arm. While atony was the sole PPH cause in 53.2% (116/218) of the women in the responsive PPH group, it accounted for only 31.5% (45/143) of the causes in the refractory PPH group. Conversely, tears were the sole cause in 12.8% (28/218) and 28% (40/143) of the responsive PPH and refractory PPH groups, respectively. Placental problems were the sole cause in 11 and 5.6% in the responsive and refractory PPH groups, respectively. CONCLUSION: Women with refractory PPH showed a different pattern of maternal characteristics and PPH causes compared with those with first-line treatment responsive PPH. TWEETABLE ABSTRACT: Women with refractory postpartum haemorrhage are different from those with first-line treatment responsive PPH.


Assuntos
Parto Obstétrico/efeitos adversos , Hemorragia Pós-Parto/etiologia , Adulto , Peso ao Nascer , Colo do Útero/lesões , Episiotomia/estatística & dados numéricos , Feminino , Humanos , Trabalho de Parto Induzido/estatística & dados numéricos , Estudos Multicêntricos como Assunto , Ocitócicos/efeitos adversos , Períneo/lesões , Placenta Retida/epidemiologia , Hemorragia Pós-Parto/epidemiologia , Hemorragia Pós-Parto/terapia , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Inércia Uterina/epidemiologia , Vagina/lesões , Adulto Jovem
5.
J Dairy Sci ; 103(1): 823-839, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31677831

RESUMO

The objective of this study was to investigate whether health, survival, and performance of dairy heifers from birth through first lactation are associated with parity and health status of their dams. Holstein heifers (n = 1,811) derived from artificial insemination were categorized as (1) daughters of primiparous cows that, consequently, were nonlactating heifers during gestation (Prim-NoL; n = 787); (2) daughters of multiparous cows that did not have any clinical diseases in the previous lactation (Mult-NoCD; n = 638); and (3) daughters of multiparous cows that had at least one clinical disease in the previous lactation (Mult-CD; n = 386). Clinical diseases of the multiparous dams included retained placenta, metritis, mastitis, lameness, and digestive and respiratory problems. Data collected for evaluation of daughters included genotypic and phenotypic characteristics at birth, morbidity, reproductive performance, and culling from birth through 305 d in milk of first lactation. Orthogonal contrasts were used to evaluate the effect of the parity of the dam (Prim-NoL vs. Mult-NoCD + Mult-CD) and the effect of clinical disease occurrence in the previous lactation among multiparous dams (Mult-NoCD vs. Mult-CD). Compared with daughters of multiparous cows, daughters of Prim-NoL were lighter at birth (36 vs. 41 kg), had greater genetic merit for production traits (e.g., genomic estimated breeding value for milk yield: 875 vs. 746 kg), were less likely to leave the herd (17 vs. 28%) and to lose pregnancy as a heifer (9 vs. 14%), calved earlier (703 vs. 711 d old), were less likely to have clinical diseases as a first lactation cow (30 vs. 37%), and had reduced performance in the first lactation when considering their genetic merit (e.g., 305-d yield of energy-corrected milk: 11,270 vs. 11,539 kg). Compared with daughters of Mult-NoCD, daughters of Mult-CD were less likely to have digestive problems as a heifer (17 vs. 27%) and clinical disease as a first lactation cow (32 vs. 42%), but were also more likely to leave the herd as a heifer (32 vs. 25%) even though genetic merit for production traits were similar (e.g., genomic estimated breeding value for milk: 744 vs. 749 kg). In conclusion, both parity and health status of the dam in the previous lactation were associated with morbidity, survival, and performance of their daughters from birth through 305 d in milk of the first lactation and might represent factors affecting developmental programming of dairy heifers in utero.


Assuntos
Doenças dos Bovinos , Bovinos/crescimento & desenvolvimento , Indústria de Laticínios , Lactação , Paridade , Animais , Cruzamento , Bovinos/fisiologia , Feminino , Nível de Saúde , Inseminação Artificial/veterinária , Leite , Parto , Placenta Retida/veterinária , Gravidez , Reprodução , Estudos Retrospectivos
6.
J Dairy Sci ; 103(1): 649-665, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31704020

RESUMO

In this longitudinal study, we tested the hypothesis that cows that are lame around dry-off are at increased risk of transition diseases (TD), including metritis, subclinical ketosis (SCK), retained fetal membranes, hypocalcemia, or displaced abomasum. We also hypothesized that the relationship between lameness and TD would be mediated through reduced feeding time. We enrolled 461 cows at 9 wk before their expected calving date on 6 commercial freestall farms in the lower Fraser Valley, British Columbia, Canada. Cows were gait-scored weekly using a scale of 1 to 5. Lameness status was classified based on consecutive gait scores as lame (2 consecutive gait scores = 3 or 1 score ≥4) or sound (2 consecutive gait scores ≤2). Lameness status was summarized as (1) lameness at dry-off (sound or lame); (2) lameness group (always sound = sound on all visits, chronically lame = lame on all visits, and other = changed from sound to lame or vice versa); and (3) proportion of weeks lame during the dry period. Body condition scores were recorded at dry-off and at calving and collectively used to calculate change in body condition for each cow. A subsample of cows (n = 159) was evaluated for feeding time once a week during the dry period. All cows were evaluated for SCK (positive = ß-hydroxybutyrate ≥1.2 mmol/L) and metritis (positive = foul smell, red/brown watery vaginal discharge) every 3 to 4 d between d 3 and 17 after calving. We retrieved data on treatment of retained fetal membranes, hypocalcemia, and displaced abomasum during the first 17 d after calving, cow parity, and milk production in the previous lactation from farm records. We created a binary variable, TD (any of SCK, metritis, retained fetal membranes, hypocalcemia, or displaced abomasum), to differentiate between healthy cows and cows that developed TD. Lameness at dry-off was associated with the occurrence of metritis and TD, but not with SCK. Cows that were chronically lame and cows that had an increased proportion of weeks lame during the dry period had higher occurrence of metritis and TD. Lameness was also associated with reduced feeding time, which in turn was associated with increased likelihood of SCK and TD, but not with metritis. Lameness was not associated with change in body condition; however, cows that lost body condition score during the dry period had increased odds of developing SCK, metritis, and TD. Change in body condition was highly associated with body condition score at dry-off. These results suggest that association between lameness and TD is partially mediated through reduced feeding time.


Assuntos
Doenças dos Bovinos/etiologia , Comportamento Alimentar , Ácido 3-Hidroxibutírico/sangue , Animais , Colúmbia Britânica , Bovinos , Doenças dos Bovinos/epidemiologia , Indústria de Laticínios , Fazendas , Feminino , Marcha , Nível de Saúde , Cetose/etiologia , Cetose/veterinária , Lactação , Estudos Longitudinais , Paridade , Placenta Retida/veterinária , Gravidez , Fatores de Risco
7.
PLoS Med ; 16(12): e1003001, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31887169

RESUMO

BACKGROUND: Retained placenta following vaginal delivery is a major cause of postpartum haemorrhage. Currently, the only effective treatments for a retained placenta are the surgical procedures of manual removal of placenta (MROP) and uterine curettage, which are not universally available, particularly in low- and middle-income countries. The objective of the trial was to determine whether sublingual nitroglycerin spray was clinically effective and cost-effective for medical treatment of retained placenta following vaginal delivery. METHODS AND FINDINGS: A randomised, placebo-controlled, double-blind trial was undertaken between October 2014 and July 2017 at 29 delivery units in the UK (Edinburgh, Glasgow, Manchester, Newcastle, Preston, Warrington, Chesterfield, Crewe, Durham, West Middlesex, Aylesbury, Furness, Southampton, Bolton, Sunderland, Oxford, Nottingham [2 units], Burnley, Chertsey, Stockton-on-Tees, Middlesborough, Chester, Darlington, York, Reading, Milton Keynes, Telford, Frimley). In total, 1,107 women with retained placenta following vaginal delivery were recruited. The intervention was self-administered 2 puffs of sublingual nitroglycerin (800 µg; intervention, N = 543) or placebo spray (control, N = 564). The primary clinical outcome was the need for MROP, assessed at 15 minutes following administration of the intervention. Analysis was based on the intention-to-treat principle. The primary safety outcome was measured blood loss between study drug administration and transfer to the postnatal ward or other clinical area. The primary patient-sided outcomes were satisfaction with treatment and side-effect profile, assessed by questionnaires pre-discharge and 6 weeks post-delivery. Secondary clinical outcomes were measured at 5 and 15 minutes after study drug administration and prior to hospital discharge. There was no statistically significant or clinically meaningful difference in need for MROP by 15 minutes (primary clinical outcome, 505 [93.3%] for nitroglycerin versus 518 [92.0%] for placebo, odds ratio [OR] 1.01 [95% CI 0.98-1.04], p = 0.393) or blood loss (<500 ml: nitroglycerin, 238 [44.3%], versus placebo, 249 [44.5%]; 500 ml-1,000 ml: nitroglycerin, 180 [33.5%], versus placebo, 224 [40.0%]; >1,000 ml: nitroglycerin, 119 [22.2%], versus placebo, 87 [15.5%]; ordinal OR 1.14 [95% CI 0.88-1.48], p = 0.314) or satisfaction with treatment (nitroglycerin, 288 [75.4%], versus placebo, 303 [78.1%]; OR 0.87 [95% CI 0.62-1.22], p = 0.411) or health service costs (mean difference [£] 55.3 [95% CI -199.20 to 309.79]). Palpitations following drug administration were reported more often in the nitroglycerin group (36 [9.8%] versus 15 [4.0%], OR 2.60 [95% CI 1.40-4.84], p = 0.003). There were 52 serious adverse events during the trial, with no statistically significant difference in likelihood between groups (nitroglycerin, 27 [5.0%], versus placebo, 26 [4.6%]; OR 1.13 [95% CI 0.54-2.38], p = 0.747). The main limitation of our study was the low return rate for the 6-week postnatal questionnaire. There were, however, no differences in questionnaire return rates between study groups or between women who did and did not have MROP, with the patient-reported use of outpatient and primary care services at 6 weeks accounting for only a small proportion (approximately 5%) of overall health service costs. CONCLUSIONS: In this study, we found that nitroglycerin is neither clinically effective nor cost-effective as a medical treatment for retained placenta, and has increased side effects, suggesting it should not be used. Further research is required to identify an effective medical treatment for retained placenta to reduce the morbidity caused by this condition, particularly in low- and middle-income countries where surgical management is not available. TRIAL REGISTRATION: ISRCTN.com ISRCTN88609453 ClinicalTrials.gov NCT02085213.


Assuntos
Análise Custo-Benefício/estatística & dados numéricos , Parto Obstétrico/economia , Nitroglicerina/uso terapêutico , Placenta Retida/tratamento farmacológico , Administração Sublingual , Adulto , Parto Obstétrico/métodos , Método Duplo-Cego , Feminino , Humanos , Hemorragia Pós-Parto/tratamento farmacológico , Gravidez , Reino Unido
8.
BMC Pregnancy Childbirth ; 19(1): 515, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864314

RESUMO

BACKGROUND: Men's involvement in obstetrics care is an important strategy in reducing preventable maternal morbidity and mortality. This is particularly important in developing countries where men often make decision on financial, health and other family issues. Hence, the objective of this study was to assess men's knowledge and involvement in obstetric danger signs; birth preparedness and complication readiness in Burayu town administration, Oromia, Ethiopia. METHODS: A community based cross-sectional study was conducted in Burayu town administration, Oromia Region from May 2016 to July 2016. Multistage with systematic random sampling techniques were employed. Bivariate and multivariate logistic regression analyses were performed using SPSS version 20. P-value less than 0.05 were taken as a cutoff point to declare significant association. RESULT: A total of 523 men were involved in the study. The mean and ± SD age of the study participant was 36.6 ± 7 years. Majority of the participants were Orthodox religion followers and, employees of private organization, regarding residency majority were residing in urban setting. Pregnancy related vaginal bleeding was the most familiar danger sign recognized by the study participants which was 342(65.4%). From the total, 441(84.3%) of men were highly involved in preparation of arranging for postpartum cultural food expenses, 345(66.0%) for clean clothes both for the baby and mother; and 71-76% participants were involved in availing transport money for antenatal, delivery and postnatal care. The study revealed that educational status of men, monthly income, knowledge of pregnancy danger sign, delivery and post-delivery care, and knowledge of birth preparedness and complication readiness (BP/CR) were significantly associated with men's involvement in BP/CR. CONCLUSION: Majority of participants had knowledge on obstetric danger sign. Men showed low interest to donate blood to their wives during antenatal, delivery and postpartum care. There is a need continued awareness creation on danger sings as well as birth preparedness.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Homens , Parto , Complicações na Gravidez , Adulto , Estudos Transversais , Edema , Escolaridade , Etiópia , Feminino , Humanos , Renda , Masculino , Mortalidade Materna , Complicações do Trabalho de Parto , Placenta Retida , Cuidado Pós-Natal , Gravidez , Cuidado Pré-Natal , Convulsões , Hemorragia Uterina
9.
Medicine (Baltimore) ; 98(38): e17219, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567979

RESUMO

RATIONALE: Retained placenta accreta is an increasing obstetric problem in recent years, and pulmonary embolism (PE) during pregnancy and the postpartum period is a vital condition, but lack of standard therapy guidelines. This report describes a case of postpartum PE combined with retained placenta accreta. PATIENT CONCERNS: A 27-year-old woman presenting with fever and dyspnea after delivery was admitted to our hospital with retained placenta accreta. DIAGNOSES: The patient was diagnosed with the infection, postpartum PE, and residual placenta. INTERVENTIONS: The antibiotics and low molecular weight heparin were initially started to cure the infection and control PE. Mifepristone was then used to promote the necrosis of residual placenta while long-term use of warfarin was served as continuous anticoagulant therapy. Hysteroscopic resection of retained placenta was not performed until thrombi had been almost disappeared after more than 2 months of anticoagulation therapy. OUTCOMES: The patient's menstruation returned to normal within several weeks after hysteroscopic resection and she completely recovered from PE after 3 months of anticoagulant therapy. LESSONS: Treatment of retained placenta accreta can be postponed when encountering complicated cases, such as postpartum PE. PE in perinatal stage can be managed referring to nonmaternal PE.


Assuntos
Placenta Acreta/terapia , Placenta Retida/terapia , Período Pós-Parto , Embolia Pulmonar/terapia , Adulto , Feminino , Humanos , Placenta Acreta/diagnóstico , Placenta Retida/diagnóstico , Gravidez , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/etiologia , Tomografia Computadorizada por Raios X
10.
Artigo em Alemão | MEDLINE | ID: mdl-31634938

RESUMO

OBJECTIVE: The post partum use of analgesics in cows has increased in consequence to society's increased awareness of animal welfare. However, it is known that the post partum administration of a subset of nonsteroidal anti-inflammatory drugs to cows may lead to an increased rate of retained placenta. Therefore, the aim of this study was clarify, whether a single administration of meloxicam to cows that experienced dystocia results in an increased rate of this disease. MATERIAL AND METHODS: The study was conducted in 63 Holstein-Friesian cows in 4 farms with random allocation into 2 groups: In animals of the treatment group (n = 27) a single subcutaneous injection of meloxicam (0.5 mg/kg) was administered within 2-8 hours after calving. The animals of the control group (n = 36) received the same volume of a bovine infusion solution (Amynin®, bovine infusion solution, Boehringer Ingelheim) subcutaneously. A clinical examination of the cows was performed on the day of parturition and on the 21st day post partum. Findings on the days in between were obtained by questioning of the farmers. The exact Fisher-test was calculated in order to test for statistical differences between the treatment and control groups. RESULTS: In cows of the treatment group, retained placenta was not observed more frequently than in cows of the control group. CONCLUSION AND CLINICAL RELEVANCE: A single administration of meloxicam to cows that experienced dystocia does not increase the incidence of retained placenta.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Doenças dos Bovinos/induzido quimicamente , Doenças dos Bovinos/tratamento farmacológico , Distocia/veterinária , Meloxicam/administração & dosagem , Placenta Retida/veterinária , Animais , Anti-Inflamatórios não Esteroides/efeitos adversos , Bovinos , Distocia/tratamento farmacológico , Feminino , Incidência , Injeções Subcutâneas/veterinária , Meloxicam/efeitos adversos , Placenta Retida/induzido quimicamente , Gravidez
11.
J Dairy Sci ; 102(11): 10316-10328, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31495609

RESUMO

To evaluate the effect of recombinant bovine interleukin-8 (rbIL-8) on uterine health and milk production, 2 separate studies were conducted. For study 1, postpartum Holstein cows (n = 213) were randomly allocated into 1 of 3 intrauterine treatment groups: control (CTR, 250 mL of saline solution), low dose (L-IL8, 11.25 µg of rbIL-8 diluted in 250 mL of saline solution), and high dose (H-IL8, 1,125 µg of rbIL-8 diluted in 250 mL of saline solution). Intrauterine delivery of treatments was performed within 12 h of parturition. Cows were evaluated for retained fetal membranes, puerperal metritis, and clinical endometritis. Blood samples were collected immediately before treatment and 1, 2, and 3 d in milk for assessment of IL-8, haptoglobin, fatty acids, and ß-hydroxybutyrate concentrations. Treatment with rbIL-8 reduced the incidence of puerperal metritis in multiparous cows (CTR = 34.3, L-IL8 = 8.11, and H-IL8 = 6.35%). Both the L-IL8 and H-IL8 groups produced significantly more milk, fat-corrected milk, and energy-corrected milk yields when compared with placebo-treated controls. A second study was performed to confirm the effect of rbIL-8 on milk production. In study 2, 164 primiparous cows were randomly allocated into 1 of 4 treatment groups: control (CTR, 250 mL of saline solution), low dose (L-IL8, 0.14 µg of rbIL-8), medium dose (M-IL8, 14 µg of rbIL-8), and high dose (H-IL8, 1,400 µg of rbIL-8). Treatments were prepared and administered as described for study 1. Cows in the L-IL8, M-IL8, and H-IL8 groups produced significantly more milk, fat-corrected milk, and energy-corrected milk yields when compared with control cows. In conclusion, treatment with rbIL-8 decreased the incidence of puerperal metritis in multiparous cows. The administration of rbIL-8 was repeatedly associated with a dramatic and long-lasting improvement of lactation performance.


Assuntos
Doenças dos Bovinos/prevenção & controle , Bovinos/fisiologia , Interleucina-8/farmacologia , Cetose/veterinária , Lactação/efeitos dos fármacos , Ácido 3-Hidroxibutírico/sangue , Animais , Bovinos/imunologia , Bovinos/metabolismo , Doenças dos Bovinos/metabolismo , Doenças dos Bovinos/fisiopatologia , Quimiotaxia , Endometrite/prevenção & controle , Endometrite/veterinária , Feminino , Fermentação , Haptoglobinas/metabolismo , Nível de Saúde , Interleucina-8/administração & dosagem , Interleucina-8/sangue , Interleucina-8/genética , Cetose/metabolismo , Cetose/fisiopatologia , Cetose/prevenção & controle , Leite/química , Paridade , Parto , Placenta Retida/prevenção & controle , Placenta Retida/veterinária , Período Pós-Parto , Gravidez , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/sangue , Proteínas Recombinantes/genética , Proteínas Recombinantes/farmacologia
12.
J Dairy Sci ; 102(11): 10030-10038, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31521347

RESUMO

Incidences of ketosis, metritis, mastitis, and retained placenta were studied in Israeli Holstein cows calving between 2008 and 2017. These diseases were selected based on their economic impact. Ketosis, metritis, and retained placenta were scored dichotomously. Mastitis was scored as absent, a single occurrence during the lactation, or more than 1 occurrence. Ketosis and metritis were recorded during the first 21 d after calving, retained placenta during the first 5 d after calving, and mastitis up to 305 d in milk. The effects of herd-year-season, calving age, month of calving, gestation length, and occurrence of dystocia were included in the first-parity analysis models. All effects were significant for metritis and retained placenta. For ketosis, all effects were significant, except for gestation length. For mastitis, only the effects of herd-year-season and calving age were significant. Variance components were computed by the multitrait animal model. The 4 diseases were analyzed jointly based on first-parity records, and each disease was analyzed separately for parities 1 to 3 with the different parities considered separate traits. The 4 disease traits in first parity were also analyzed jointly with the 6 major traits included in the Israeli breeding index: milk, fat, and protein production; somatic cell score; female fertility; and longevity. Heritability was highest for metritis and lowest for mastitis, but all heritabilities were <0.07, similar to previous studies. For all 4 diseases, genetic correlations among the first 3 parities were >0.65, and all residual correlations were <0.07. Selection of herd-years assumed to have more accurate recording of mastitis did not result in higher heritability estimates. Genetic correlations between the disease traits and milk, fat, and protein production were economically unfavorable, while correlations between the disease traits and somatic cell score, female fertility, and longevity were economically favorable. Expected genetic changes in the disease traits after 10 yr of selection with the current Israeli breeding index were all <1%, except for ketosis, which was predicted to increase by 1.5%. Inclusion of these traits in a proposed index with the disease traits constituting 7% of the index would result in only marginal improvements for the disease traits and adversely affect genetic gain for fat and protein production. Thus, inclusion of these traits in the breeding index cannot be justified economically.


Assuntos
Doenças dos Bovinos/economia , Indústria de Laticínios/economia , Cetose/veterinária , Mastite Bovina/economia , Placenta Retida/veterinária , Animais , Bovinos , Doenças dos Bovinos/genética , Distocia/genética , Distocia/veterinária , Meio Ambiente , Feminino , Israel , Cetose/economia , Lactação/genética , Longevidade , Leite , Paridade , Fenótipo , Placenta Retida/economia , Gravidez
13.
J Dairy Sci ; 102(11): 9983-9994, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31521359

RESUMO

The susceptibility of animals to periparturient diseases has a great effect on the economic efficiency of dairy industries, on the frequency of antibiotic treatment, and on animal welfare. The use of selection for breeding cows with reduced susceptibility to diseases offers a sustainable tool to improve dairy cattle farming. Several studies have focused on the association of distinct bovine chromosome 18 genotypes or haplotypes with performance traits. The aim of this study was to test whether selection of Holstein Friesian heifers via SNP genotyping for alternative paternal chromosome 18 haplotypes associated with favorable (Q) or unfavorable (q) somatic cell scores influences postpartum reproductive and metabolic diseases. Thirty-six heifers (18 Q and 18 q) were monitored from 3 wk before calving until necropsy on d 39 (± 4 d) after calving. Health status and rectal temperature were measured daily, and body condition score and body weight were assessed once per week. Blood samples were drawn twice weekly, and levels of insulin, nonesterified fatty acids, insulin-like growth factor-I, growth hormone, and ß-hydroxybutyrate were measured. Comparisons between the groups were performed using Fisher's exact test, chi-squared test, and the GLIMMIX procedure in SAS. Results showed that Q-heifers had reduced incidence of metritis compared with q-heifers and were less likely to develop fever. Serum concentrations of ß-hydroxybutyrate were lower and insulin-like growth factor-I plasma concentrations were higher in Q- compared with q-heifers. However, the body condition score and withers height were comparable between haplotypes, but weight loss tended to be lower in Q-heifers compared with q-heifers. No differences between the groups were detected concerning retained fetal membranes, uterine involution, or onset of cyclicity. In conclusion, selection of chromosome 18 haplotypes associated with a reduced somatic cell score resulted in a decreased incidence of postpartum reproductive and metabolic diseases in this study. The presented data add to the existing knowledge aimed at avoiding negative consequences of genetic selection strategies in dairy cattle farming. The underlying causal mechanisms modulated by haplotypes in the targeted genomic region and immune competence necessitate further investigation.


Assuntos
Bovinos/genética , Cromossomos de Mamíferos , Haplótipos , Período Pós-Parto , Reprodução , Seleção Genética , Ácido 3-Hidroxibutírico/sangue , Animais , Peso Corporal , Bovinos/metabolismo , Doenças dos Bovinos/genética , Indústria de Laticínios , Ácidos Graxos não Esterificados/sangue , Feminino , Hormônio do Crescimento/sangue , Insulina/sangue , Lactação , Placenta Retida/veterinária , Polimorfismo de Nucleotídeo Único , Gravidez
14.
BMC Res Notes ; 12(1): 618, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31547856

RESUMO

OBJECTIVE: Since data related to postpartum hemorrhage in Ethiopia is scarce, this study was aimed to assess the magnitude and associated factors of postpartum hemorrhage among mothers who delivered in Debre Tabor general hospital. RESULTS: In this study, one hundred forty-four mothers' charts were reviewed which made the response rate 100%. This study revealed that the magnitude of postpartum hemorrhage was 7.6% (CI 6.2, 9.8). Chi-square test revealed that there was an association between postpartum hemorrhage and gravidity, parity, having antenatal care visit, and the previous history postpartum hemorrhage. This finding confirmed that uterine atony, retained placenta, and genital tract trauma were the most common leading cause of postpartum hemorrhage.


Assuntos
Hospitais Gerais , Placenta Retida/fisiopatologia , Hemorragia Pós-Parto/diagnóstico , Inércia Uterina/fisiopatologia , Adolescente , Adulto , Estudos Transversais , Parto Obstétrico , Etiópia/epidemiologia , Feminino , Genitália Feminina/lesões , Número de Gestações/fisiologia , Humanos , Visita a Consultório Médico/estatística & dados numéricos , Paridade/fisiologia , Hemorragia Pós-Parto/epidemiologia , Hemorragia Pós-Parto/etiologia , Hemorragia Pós-Parto/fisiopatologia , Gravidez , Fatores de Risco
15.
J Dairy Sci ; 102(12): 11428-11438, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31548074

RESUMO

The objectives of this study were to evaluate postpartum serum calcium dynamics for different parity groups of dairy cows and to assess whether serum calcium concentration on d 0, 1, and 3 postpartum was associated with the risk of developing acute puerperal metritis (APM). The study took place on a commercial dairy farm in northern Germany and included 4,043 Holstein dairy cows. Calving difficulties, such as dystocia, twins, or stillbirth, were recorded. Blood samples were obtained on d 0, 1, and 3 after calving for analysis of serum calcium concentration. Animals were examined daily for clinical symptoms of retained placenta, APM, mastitis, and displaced abomasum until 10 d in milk. To determine serum calcium dynamics postpartum, we performed repeated-measures ANOVA with first-order autoregressive covariance. A logistic regression model was used to evaluate the association of serum calcium concentration with the risk of developing metritis. Serum calcium concentration was affected by time relative to calving, parity, and APM. Increasing parity negatively affected serum calcium concentration on d 0 and 1. Serum calcium concentration reached its lowest level on d 1 and 3 in multiparous and primiparous cows, respectively. The concentration increased from d 1 to 3 in multiparous cows and decreased from d 0 to 3 in primiparous cows. The association of APM and serum calcium dynamics varied by parity. On d 3, serum calcium concentration was significantly lower in animals with subsequent APM than in those without APM. The overall incidence of APM was 12.0% (primiparous cows, 20.4%; multiparous cows, 8.6%). An association existed between serum calcium concentration on d 3 after calving and APM. Primiparous cows had an odds ratio of 0.12 for serum calcium concentration on d 3, indicating that a primiparous cow with serum calcium concentration of 2.5 mmol/L had a 88% lower chance of developing APM compared with a cow with a concentration of 1.5 mmol/L. Multiparous cows had an odds ratio of 0.34 for serum calcium concentration on d 3, indicating that a multiparous cow with serum calcium concentration of 2.5 mmol/L had a 66% lower chance of developing APM compared with a cow with a concentration of 1.5 mmol/L. Primiparous cows with low serum calcium concentration had the highest predicted probability of developing APM. Our results reveal a dynamic in serum calcium concentration in the first 3 d in milk. Consequently, the day of sampling and the observed risk period for hypocalcemia are important when conducting epidemiological studies to evaluate associations between hypocalcemia and clinical diseases.


Assuntos
Cálcio na Dieta/farmacocinética , Cálcio/sangue , Doenças dos Bovinos/epidemiologia , Distocia/veterinária , Hipocalcemia/veterinária , Leite/química , Placenta Retida/veterinária , Doenças Uterinas/veterinária , Animais , Bovinos , Distocia/epidemiologia , Feminino , Alemanha , Hipocalcemia/epidemiologia , Lactação , Paridade , Período Pós-Parto , Gravidez , Doenças Uterinas/epidemiologia
16.
Sex Reprod Healthc ; 21: 21-25, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31395229

RESUMO

INTRODUCTION: Retained placenta can be defined as lack of expulsion of the placenta within 30 min of delivery of the infant. It is a significant cause of maternal mortality and morbidity throughout the developing world. AIM OF THE WORK: The aim of this study was to compare the efficacy of intra-umbilical vein injection of carbetocin versus oxytocin in the management of retained placenta. PATIENTS AND METHODS: A total of 200 women were included in this study. They were divided into two groups; each 100 women. The first group received intra-umbilical vein injection of 1 mL carbetocin (containing 100 µg carbetocin) diluted in 20 mL normal saline 0.9% and the second group received intra-umbilical vein injection of 20 IU oxytocin diluted in 20 mL normal saline 0.9%. RESULTS: Total blood loss (ml) and duration of the third stage of labor (minutes) were significantly lower in carbetocin group when compared to oxytocin group. Postoperative Hb concentration (g/dl) was significantly higher in carbetocin group. Also there was a highly significant difference between both groups as regard change in Hb concentration (g/dl) with less change in the carbetocin group. The need for additional uterotonic drugs following placental delivery and the occurrence of postpartum hemorrhage and the need for blood transfusion were significantly lower in the carbetocin group. CONCLUSION: Intra-umbilical carbetocin is more effective than intra-umbilical oytocin as a method for management of retained placenta. Intra-umbilical carbetocin seems to have more acceptable hemodynamic safety profile when compared to intra-umbilical oxytocin in the management of retained placenta.


Assuntos
Ocitócicos/uso terapêutico , Ocitocina/análogos & derivados , Ocitocina/uso terapêutico , Placenta Retida/tratamento farmacológico , Hemorragia Pós-Parto/prevenção & controle , Adulto , Transfusão de Sangue , Volume Sanguíneo , Método Duplo-Cego , Feminino , Hemoglobinas/metabolismo , Humanos , Injeções Intravenosas , Ocitócicos/administração & dosagem , Ocitocina/administração & dosagem , Ocitocina/efeitos adversos , Gravidez , Estudos Prospectivos , Veias Umbilicais , Adulto Jovem
17.
Arch Gynecol Obstet ; 300(3): 669-674, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31321494

RESUMO

PURPOSE: Retained products of conception (RPOC) may occur as the result of a morbidly adherent placenta. In these cases, the hysteroscopic removal of RPOC may be technically challenging, and may require more than one hysteroscopic procedure. We sought to compare the clinical, surgical, and postoperative characteristics of cases managed by either a one-step hysteroscopy procedure or a two-step hysteroscopy approach. METHODS: A retrospective review of all RPOC cases managed by hysteroscopy from 1/2013 to 3/2018. We included cases of RPOC occurring following delivery and medical or surgical pregnancy terminations. The rates of postoperative intrauterine adhesions were assessed by office hysteroscopy. RESULTS: A two-step procedure was required in 11 (3.9%) of the 358 women who underwent hysteroscopy for removal of RPOC during the study period. Comparison between the two-step and the one-step procedure groups revealed that the women in the two-step group were significantly older and the mean RPOC size was significantly larger (35.5 ± 4.1 years versus 30.7 ± 5.9 years, respectively, p = 0.01, and 38.6 ± 9.8 mm versus 22.3 ± 7.5 mm, p < 0.001, respectively). While the rates of intraoperative complications were similar between groups, readmission for postoperative fever was more common in the two-step group (18.2% versus 2.0%, respectively, p = 0.03). Postoperative intrauterine adhesions were diagnosed in 20.0% and 5.2%, respectively (p = 0.05). CONCLUSIONS: The two-step hysteroscopic approach enabled the complete removal of larger RPOC masses without the use of uterine curettage. The women who underwent the two-step procedure, however, were at increased risk for postoperative fever and postoperative intrauterine adhesions.


Assuntos
Aborto Induzido/efeitos adversos , Histeroscopia/métodos , Placenta Retida/cirurgia , Complicações na Gravidez/cirurgia , Trofoblastos/patologia , Adulto , Feminino , Fertilização , Humanos , Morbidade , Gravidez , Complicações na Gravidez/etiologia , Estudos Retrospectivos , Aderências Teciduais/prevenção & controle , Resultado do Tratamento , Doenças Uterinas/patologia , Doenças Uterinas/cirurgia
18.
Vet Clin North Am Equine Pract ; 35(2): 289-298, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31279434

RESUMO

Retained fetal membranes are the most common postpartum condition in mares. Although the incidence of retained fetal membranes is low, the consequences for the health of the mare can be severe (metritis, endotoxemia, laminitis, death). Oxytocin administration is often the first line of therapy for management of retained fetal membranes. Removal of fetal membranes using umbilical vessel infusion and manual membrane removal are effective tools for reducing risks associated with abnormally heavy membranes, retained membranes, or for mares that are geographically limited for veterinary care.


Assuntos
Membranas Extraembrionárias , Doenças dos Cavalos/terapia , Placenta Retida/veterinária , Animais , Feminino , Cavalos , Placenta Retida/terapia , Gravidez
19.
Res Vet Sci ; 125: 315-322, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31352280

RESUMO

This study evaluated and compared infrared thermography (IRT) and rectal temperature (RT) as screening tests to identify sick transition dairy cows. Holstein cows (n = 72; 42 primiparous) had RT and IRT temperatures taken daily from 1 to 12 days in milk (DIM). Health examinations were performed daily to diagnose retained fetal membrane, milk fever and metritis, and blood was analyzed for ß-hydroxybutyrate at 6 and 9 DIM to diagnose ketosis. Plasma concentrations of cortisol, interleukin-6, tumor necrosis factor α and serum amyloid A at 3, 6, 9 and 12 DIM were included as additional indicators of illness. Cows were categorized as true sick if clinically diagnosed with an illness, or if at least 2 blood parameters were above the normal range. Diagnostic test performances for RT and IRT variables were determined for each variable at a test referent value that provided the highest Youden's (J) index. The best performing screening test depended on the definition of true sickness. In general, the J index for RT was 0.15-0.17 whereas the highest J index for the IRT variables was 0.22 for the mean eye temperature and 0.19 for the mean cheek temperature. Infrared thermography was at least comparable to RT and some IRT variables performed better as a screening tests than RT. Future studies into the automation of IRT for surveillance of early postpartum diseases is warranted.


Assuntos
Temperatura Corporal , Doenças dos Bovinos/diagnóstico , Cetose/veterinária , Paresia Puerperal/diagnóstico , Placenta Retida/veterinária , Termografia/veterinária , Animais , Bovinos , Indústria de Laticínios , Feminino , Cetose/diagnóstico , Placenta Retida/diagnóstico , Período Pós-Parto , Gravidez , Termografia/métodos
20.
BMC Pregnancy Childbirth ; 19(1): 240, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296180

RESUMO

BACKGROUND: Ragged placental membranes is a distinct entity from retained placenta and not uncommonly reported in midwifery texts. Although the incidence of postpartum endometritis is merely 1-5% after vaginal births, it remains the most common source of puerperal sepsis, contributing up to 15% of maternal mortality in low income countries. Geographically-remote centres in Malaysia prophylactically administer antibiotics for women with ragged placental membranes after vaginal birth, extrapolating evidence from retained placenta. We sought to clarify the rationale in continuing such practices. METHODS: This was an open-label, prospective, multicentre, randomized trial. Three hospitals where the current protocol was to administer prophylactic amoxycillin-clavulanic acid served as the sites of recruitment. Women who delivered vaginally beyond 24+ 0 weeks of gestation with ragged membranes were invited to participate in the trial and randomized into prophylaxis or expectant management with medical advice by blocks of 10, at a 1:1 ratio. A medication adherence diary was provided and patients followed up at 2 weeks and 6 weeks postpartum. RESULTS: A total of 6569 women gave birth vaginally in three centres during the trial period, of which 10.9% had ragged membranes. The incidence of endometritis was not significantly raised in women with or without prophylaxis (0.90% vs 0.29%; p = 0.60). All cases of endometritis presented within the first 2 weeks and preventive use of antibiotics did not ameliorate the severity of endometritis since rates of ICU admission, surgical evacuation and transfusion were comparable. CONCLUSION: Preventive use of antibiotics after vaginal delivery in women with ragged placental membranes did not result in a reduction of endometritis. Educating women on the signs and symptoms of endometritis would suffice. Based on the reported incidence of ragged membranes, a change in practice would result in 1500 less prescriptions of antibiotics per annum in these three centres. TRIAL REGISTRATION: NCT03459599 (Retrospectively registered on 9 March 2018).


Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Antibacterianos/administração & dosagem , Antibioticoprofilaxia/métodos , Endometrite/prevenção & controle , Placenta Retida/tratamento farmacológico , Transtornos Puerperais/prevenção & controle , Adulto , Parto Obstétrico , Feminino , Humanos , Malásia , Período Pós-Parto , Gravidez , Estudos Prospectivos , Resultado do Tratamento , Vagina
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