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3.
J Pregnancy ; 2020: 9083264, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32411467

RESUMO

The Australasian Diabetes in Pregnancy Society recommends screening high-risk women for gestational diabetes mellitus (GDM) before 24 weeks gestation, under the assumption that an earlier diagnosis and opportunity to achieve normoglycemia will minimize adverse outcomes. However, little evidence exists for this recommendation. The study objective was to compare the pregnancy outcomes of high-risk women diagnosed with GDM before 24 weeks gestation and routinely diagnosed women after 24 weeks gestation. A retrospective audit was conducted of all pregnancies diagnosed with GDM using International Association of Diabetes and Pregnancy Study Groups criteria over 12 months at a tertiary Australian hospital. Adverse perinatal outcomes were compared between "Early GDM" diagnosed before 24 weeks (n = 133) and "Late GDM" diagnosed from 24 weeks (n = 636). Early GDM had a significantly lower newborn composite outcome frequency (hypoglycemia, birth trauma, NICU/SCN admission, stillbirth, neonatal death, respiratory distress, and phototherapy) compared to Late GDM (20.3% vs. 30.0%, p = 0.02). Primary cesarean, hypertensive disorders, postpartum hemorrhage, birthweight >90th percentile, macrosomia, and preterm birth frequencies were not significantly different between groups. Therefore, high-risk women diagnosed with GDM in early pregnancy were not more likely to have an adverse outcome compared to routinely diagnosed women. As they are a high-risk group, this may indicate a possible benefit to the early diagnosis of GDM.


Assuntos
Diabetes Mellitus/diagnóstico , Testes Diagnósticos de Rotina , Diagnóstico Precoce , Doenças do Recém-Nascido/prevenção & controle , Complicações na Gravidez/diagnóstico , Resultado da Gravidez , Testes de Gravidez , Feminino , Humanos , Recém-Nascido , Gravidez , Risco
4.
Am J Vet Res ; 81(5): 442-447, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32343177

RESUMO

OBJECTIVE: To assess the effect of transrectal palpation (TRP) performed with the fetal membrane slip (FMS) technique for early pregnancy diagnosis on the proportion and type of associated pregnancy losses (PLs) in dairy cattle. ANIMALS: 580 healthy pregnant cattle. PROCEDURES: Data for artificially inseminated females with 1 or 2 viable embryos detected by transrectal ultrasonography (TRUS) at approximately 30 days of gestation were retrospectively assessed. Cattle were assigned to 1 of 2 groups on the basis of whether they did or did not undergo TRP once between 34 and 41 days of gestation (palpation and control group, respectively). At approximately 45 and 60 days of gestation, all cattle were reevaluated by TRUS; PL was categorized as type I (FMS detectable by TRP and TRUS-confirmed evidence of embryo or fetus degeneration and a functional corpus luteum) or type II (FMS undetectable by TRP and no TRUS-confirmed evidence of an embryo or fetus or of a functional corpus luteum). RESULTS: Of the 580 healthy pregnant cattle, 271 underwent TRP and 309 did not. In the palpation and control groups, PL occurred in 40 (14.8%) and 47 (15.2%) cattle, respectively. Among the palpation group's PLs, 17 (43%) were type I and 23 (58%) were type II. Among the control group's PLs, 27 (57%) were type I and 20 (43%) were type II. The prevalance and type of PL did not differ between groups. CONCLUSIONS AND CLINICAL RELEVANCE: TRP with the FMS technique for early pregnancy diagnosis did not increase the prevalence of PL in dairy cattle or alert the proportion of type I versus type II PL.


Assuntos
Aborto Animal , Testes de Gravidez/veterinária , Animais , Bovinos , Membranas Extraembrionárias , Feminino , Palpação , Gravidez , Estudos Retrospectivos
5.
J Dairy Sci ; 103(4): 3264-3274, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32037165

RESUMO

Pregnancy diagnosis is an essential part of successful breeding programs on dairy farms. Milk composition alters with pregnancy, and this is well documented. Fourier-transform mid-infrared (MIR) spectroscopy is a rapid and cost-effective method for providing milk spectra that reflect the detailed composition of milk samples. Therefore, the aim of this study was to assess the ability of MIR spectroscopy to predict the pregnancy status of dairy cows. The MIR spectra and insemination records were available from 8,064 Holstein cows of 19 commercial dairy farms in Australia. Three strategies were studied to classify cows as open or pregnant using partial least squares discriminant analysis models with random cow-independent 10-fold cross-validation and external validation on a cow-independent test set. The first strategy considered 6,754 MIR spectra after insemination used as independent variables in the model. The results showed little ability to detect the pregnancy status as the area under the receiver operating characteristic curve was 0.63 and 0.65 for cross-validation and testing, respectively. The second strategy, involving 1,664 records, aimed to reduce noise in the MIR spectra used as predictors by subtracting a spectrum before insemination (i.e., open spectrum) from the spectrum after insemination. The accuracy was comparable with the first approach, showing no superiority of the method. Given the limited results for these models when using combined data from all stages after insemination, the third strategy explored separate models at 7 stages after insemination comprising 348 to 1,566 records each (i.e., progressively greater gestation) with single MIR spectra after insemination as predictors. The models developed using data recorded after 150 d of pregnancy showed promising prediction accuracy with the average value of area under the receiver operating characteristic curve of 0.78 and 0.76 obtained through cross-validation and testing, respectively. If this can be confirmed on a larger data set and extended to somewhat earlier stages after insemination, the model could be used as a complementary tool to detect fetal abortion.


Assuntos
Bovinos , Leite/química , Testes de Gravidez/veterinária , Espectrofotometria Infravermelho/veterinária , Animais , Austrália , Feminino , Análise de Fourier , Análise dos Mínimos Quadrados , Gravidez , Curva ROC
6.
Am J Obstet Gynecol ; 222(4S): S883.e1-S883.e6, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31945336

RESUMO

BACKGROUND: Prescribing information for the levonorgestrel-releasing intrauterine system allows placement when the clinician is reasonably certain the patient is not pregnant. A 6 item checklist aids clinicians in determining pregnancy risk but may be too restrictive, resulting in delaying placement for many women. Same-day placement, however, may risk placement during an unrecognized luteal-phase pregnancy, that is, a preimplantation fertilized ovum not yet detectable by urine pregnancy test. OBJECTIVE: We assessed the applicability of pregnancy checklist criteria in 2 gynecology practices that routinely provide same-day placements following a negative urine pregnancy test. STUDY DESIGN: In this retrospective cohort study, we reviewed electronic medical records of all women who underwent levonorgestrel-releasing intrauterine system placement from July 2009 to August 2012. We evaluated each record to identify whether the woman met any of the checklist criteria to exclude pregnancy. We ascertained luteal-phase pregnancies and other outcomes within 12 months following placement. RESULTS: Of 885 placements, 293 (33%) were immediately after abortion. Of the remaining 592 placements, 353 (60%) met at least 1 pregnancy checklist criterion to rule out pregnancy but 239 (40%) met none. Two percent received levonorgestrel emergency contraception at the time of placement. One luteal-phase pregnancy occurred in the group not meeting pregnancy checklist criteria. Removals and expulsions were rare and similar whether or not patients met checklist criteria. CONCLUSION: In 2 practices that provide same-day intrauterine system placements, strict adherence to pregnancy checklist criteria would have resulted in 239 patients (40%) not receiving a same-day intrauterine system. Twelve month outcomes were similar whether or not patients met pregnancy checklist criteria. Providers need not withhold intrauterine system placement based on the pregnancy checklist criteria.


Assuntos
Lista de Checagem , Contraceptivos Hormonais/administração & dosagem , Dispositivos Intrauterinos Medicados , Levanogestrel/administração & dosagem , Aborto Induzido , Adolescente , Adulto , Estudos de Coortes , Anticoncepção Pós-Coito , Feminino , Humanos , Fase Luteal , Gravidez , Testes de Gravidez , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , Adulto Jovem
7.
PLoS Negl Trop Dis ; 14(1): e0007901, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31999690

RESUMO

BACKGROUND: Large-scale deworming programs have, to date, mostly targeted preschool- and school-age children. As community-based deworming programs become more common, deworming will be offered to women of reproductive age. The World Health Organization recommends preventive chemotherapy be administered to pregnant women only after the first trimester. It is therefore important for deworming programs to be able to identify women in early pregnancy. Our objective was to validate a short questionnaire which could be used by deworming program managers to identify and screen out women in early pregnancy. METHODOLOGY/PRINCIPAL FINDINGS: In May and June 2018, interviewers administered a questionnaire, followed by a pregnancy test, to 1,203 adult women living in the Peruvian Amazon. Regression analyses were performed to identify questions with high predictive properties (using the pregnancy test as the gold standard). Test parameters were computed at different decision tree nodes (where nodes represented questions). With 106 women confirmed to be pregnant, the positive predictive value of asking the single question 'Are you pregnant?' was 100%, at a 'cost' of a false negative rate of 1.9% (i.e. 21 women were incorrectly identified as not pregnant when they were truly pregnant). Additional questions reduced the false negative rate, but increased the false positive rate. Rates were dependent on both the combination and the order of questions. CONCLUSIONS/SIGNIFICANCE: To identify women in early pregnancy when deworming programs are community-based, both the number and order of questions are important. The local context and cultural acceptability of different questions should inform this decision. When numbers are manageable and resources are available, pregnancy tests can be considered at different decision tree nodes to confirm pregnancy status. Trade-offs in terms of efficiency and misclassification rates will need to be considered to optimize deworming coverage in women of reproductive age.


Assuntos
Gravidez , Inquéritos e Questionários , Adulto , Feminino , Helmintíase/tratamento farmacológico , Helmintíase/prevenção & controle , Humanos , Pessoa de Meia-Idade , Peru , Testes de Gravidez
8.
Theriogenology ; 141: 128-133, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31539641

RESUMO

The objective of this experiment was to determine if circulating concentrations of pregnancy associated glycoproteins (PAG) on day 24 of gestation can be utilized to diagnose pregnancy and embryo viability in beef cattle. Postpartum beef cows (n = 677) and heifers (n = 127) were exposed to a 7-day CO-Synch + CIDR estrus synchronization protocol followed by fixed-time AI (FTAI) on day 0. Blood samples were collected at day 24 after TAI to assess circulating concentrations of PAG utilizing an in-house ELISA. Pregnancy diagnosis was performed 30 and 100 days after FTAI via transrectal ultrasonography. Mean circulating PAG concentration at day 24 differed (P < 0.001) between animals diagnosed pregnant and non-pregnant at day 30 (1.69 ±â€¯0.10 ng/mL vs 0.30 ng/mL ±â€¯0.07 ng/mL; mean ±â€¯SEM; respectively). Pregnant heifers had increased PAG concentration at day 24 compared with pregnant cows (P < 0.01; 3.29 ±â€¯0.36 ng/mL vs 1.39 ±â€¯0.10 ng/mL, respectively). Based on receiver operating characteristic (ROC) curve analysis, serum concentration of PAG at day 24 ≥ 0.33 ng/mL in cows and ≥0.54 ng/mL in heifers was 95% accurate at determining pregnancy status at day 30. Heifers that experienced late embryonic mortality between day 30 and 100 of gestation had decreased circulating concentrations of PAG on day 24 (2.02 ng/mL ±â€¯0.73) compared with heifers that maintained an embryo until day 100 (3.69 ng/mL ±â€¯0.39; P = 0.02). However, there was no difference in day 24 PAG concentration (P = 0.39) between cows that maintained or lost a pregnancy (1.31 ng/mL ±â€¯0.25 vs 0.92 ng/ml ±â€¯0.50). In summary, circulating PAG concentration on day 24 of gestation may be a useful marker for early pregnancy detection in beef cattle, and might be a potential marker for predicting embryonic loss.


Assuntos
Aborto Animal/diagnóstico , Doenças dos Bovinos/diagnóstico , Bovinos/sangue , Proteínas da Gravidez/sangue , Testes de Gravidez/veterinária , Animais , Doenças dos Bovinos/sangue , Sincronização do Estro , Feminino , Inseminação Artificial/métodos , Inseminação Artificial/veterinária , Paridade , Gravidez
9.
Anim Reprod Sci ; 211: 106233, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31785622

RESUMO

Slaughter of pregnant animals is a common abattoir practice. This study was designed to compare the diagnostic capacity of pregnancy specific protein-B (PSPB) with post slaughter inspection (PSI) procedures in detecting cows pregnant at slaughter. Blood was collected from cows presenteded for slaughter at an abattoir. The uteri were examined post slaughter for the presence or absence of a foetus. Recovered foetuses were aged using crown-rump length to estimate the stage of pregnancy. Of the 361 cows examined, 72 (19.9 %) were diagnosed pregnant using the PSPB procedure, while 32 (8.9 %) were diagnosed pregnant using PSI diagnosis. Furthermore, with PSI there was a lack of pregnancy diagnosis in 42 (11.6 %) cows detected pregnant using PSPB procedure, and two (0.6 %) cows detected pregnant using PSI were not detected to be pregnant using PSPB diagnosis. Validity of the diagnostic procedures indicated that sensitivity and specificity of the PSPB was 93.8 % and 87.2 %, respectively, while with the PSI diagnosis there was a sensitivity and specificity of 41.7 % and 99.3 %, respectively. The PSPB diagnosis, had an excellent predictive value (AUC - 0.92; p < 0.001; 95 % CI - 0.856 to 0.981). Most of the pregnancy wastage (n = 22; 68.8 %) diagnosed using the PSI method were in the second trimester. The results of this study indicate that PSPB is reliable and a more sensitive diagnostic method than PSI . It is therefore recommended that the PSPB test be incorporated in routine screening for pregnancy status of cows before slaughter.


Assuntos
Bovinos/sangue , Proteínas da Gravidez/sangue , Testes de Gravidez/veterinária , Prenhez/sangue , Animais , Feminino , Gravidez
10.
Pol J Vet Sci ; 22(4): 769-775, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31867935

RESUMO

One of the effective reproductive management programs in dairy cattle is the accurate detection of pregnancy. A total of 204 non-descriptive cows were examined for pregnancy before slaughter in Sulaimani abattoir. Examinations were done by rectal palpation and enzyme-linked immunosorbent assay (ELISA) to measure the levels of progesterone and bovine pregnancy- -associated glycoproteins (bPAGs) in their blood. Detection of a live conceptus in the uterus of slaughtered cows was used as the gold standard to determine the accuracy of the three pregnancy detection methods. The results showed that the accuracies of rectal palpation, progesterone assay, and bPAGs assay in the diagnosis of pregnancy were 87.2%, 84.8%, and 97.05%, respectively. The bPAGs assay scored the highest sensitivity (100%) for detection of pregnancy, followed by the progesterone assay (92.3%) and rectal palpation (84.6%). In addition, the specificity of the bPAGs assay was the highest (96.0%), while progesterone assay exhibited the lowest specificity (80.1%) and rectal palpation showed a specificity rate of (88.8%). In conclusion, the best method for the detection of either for early or late pregnancy in cows was the bPAGs assay, which gave the lowest number of false-positive and false-negative results.


Assuntos
Bovinos/sangue , Ensaio de Imunoadsorção Enzimática/veterinária , Glicoproteínas/sangue , Proteínas da Gravidez/sangue , Testes de Gravidez/veterinária , Animais , Feminino , Inseminação Artificial/veterinária , Gravidez , Testes de Gravidez/métodos , Sensibilidade e Especificidade
11.
Anim Reprod Sci ; 209: 106144, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31514923

RESUMO

The objective was to compare the use of corpus luteum (CL) vascular perfusion to CL diameter and/or echogenicity to diagnose pregnancy at 21 d after timed-AI. Ovaries of Nelore heifers were assessed using ultrasonography in B-mode and color Doppler simultaneously 21 d after timed-AI (n = 113). Objective evaluations were performed using an image processing software to extract the number of colored pixels (ColorPix), diameter (mm) and echogenicity/mm² (EchoPix) of the CL. Subjective evaluations of the CL were performed by five evaluators using scores of estimated vascular perfusion area of color Doppler scan videos and estimated CL size and qualitative echogenicity of B-mode scan videos. The reference pregnancy diagnosis was performed 33 d after timed-AI using an ultrasonic device. Corpus luteum ColorPix, diameter and EchoPix were highly correlated (P < 0.001) with pregnancy. Pregnancy diagnosis accuracy, sensitivity, and negative predictive value were not different for CL ColorPix and diameter and was less with use of EchoPix compared to the other parameters. Size and vascular perfusion scores were correlated to the greatest extent (0.88-0.94) with the respective objective values within evaluator. The results from the ROC curve analysis indicated a smaller area under the curve for qualitative echogenicity compared to CL size and vascular perfusion. Corpus luteum vascular perfusion was the only subjective evaluation that when assessed there were no false negative pregnancy diagnoses. In conclusion, the use of the objective CL diameter resulted in the same efficacy as CL vascular perfusion evaluations for early pregnancy diagnosis in Nelore heifers.


Assuntos
Bovinos , Corpo Lúteo/irrigação sanguínea , Corpo Lúteo/citologia , Corpo Lúteo/diagnóstico por imagem , Testes de Gravidez , Prenhez , Animais , Diagnóstico Precoce , Sincronização do Estro , Feminino , Inseminação Artificial/veterinária , Tamanho do Órgão , Valor Preditivo dos Testes , Gravidez , Testes de Gravidez/métodos , Testes de Gravidez/veterinária , Fluxo Sanguíneo Regional , Sensibilidade e Especificidade , Fatores de Tempo , Ultrassonografia/métodos , Ultrassonografia/veterinária
12.
J Immunoassay Immunochem ; 40(6): 642-652, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31556778

RESUMO

The objectives of this study were to investigate the usability and performance of seven visual home pregnancy tests, available in Europe. Part one of the study was home-based and involved volunteers testing a selection of four home pregnancy tests. The tests used and order of use were randomized. Part two, performed at a study site, involved volunteers reading and interpreting the results of the same selection of home pregnancy tests used in part one, but using urine standards representing early pregnancy (25 mIU/mL human chorionic gonadotropin) or a 'not pregnant' (0 mIU/mL human chorionic gonadotropin) sample. The volunteers completed a questionnaire after each test in both parts. Three of the seven tests met their accuracy/reliability claims: tests A (99.8%), B (100%), and F (97.6%) (not statistically different from the claimed 99% accuracy). The remaining four tests had accuracies/reliabilities of <99% at 81.6% (C), 89.0% (E), 92.5% (D), and 95.9% (G), respectively. Test A was the highest-rated test for each attribute tested in both settings. Test D was ranked the lowest in part one and test C was ranked lowest overall for part two. Home pregnancy tests vary in performance and usability, therefore requiring better standardization and performance evaluation in Europe.Clinical Trials Reference Number: NCT03589534.


Assuntos
Gonadotropina Coriônica/urina , Testes de Gravidez , Adulto , Europa (Continente) , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Reprodutibilidade dos Testes , Adulto Jovem
13.
Health Policy Plan ; 34(8): 566-573, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31408150

RESUMO

Task-shifting the provision of pregnancy tests to community health workers (CHWs) in low-resource settings has the potential to reach significantly more underserved women at risk of pregnancy with essential reproductive health services. This study assessed whether an intervention to supply CHWs with home pregnancy tests brought more clients for antenatal care (ANC) counselling. We implemented a randomized controlled trial among CHWs providing reproductive health services to women in Eastern Madagascar. We used ordinary least squares regressions to estimate the effect of the intervention, with district- and month-fixed effects and CHW baseline characteristics as control variables. Our outcomes of interest included whether the intervention increased: (1) the number of women at risk of pregnancy who sought services from CHWs; (2) the number of these women who knew they were pregnant by the end of visit; and (3) the number of these women who received ANC counselling during visit. We found that providing pregnancy tests to CHWs to distribute to their clients for free significantly increased the number of women at risk of pregnancy who sought services from CHWs. At follow-up, treatment-group CHWs provided services to 6.3 clients compared with 4.2 clients among control-group CHWs, which represents a 50% relative increase from the control-group mean. A significantly higher number of these clients knew they were pregnant by the end of the visit, with a mean of 0.95 in treatment compared with 0.10 in control (Coeff. 0.86; 95% CI 0.59-1.13). A significantly higher number of these clients received antenatal counselling at the visit (Coeff. 0.4; 95% CI 0.14-0.64). Introducing free home pregnancy tests as part of community-based health services can improve pregnancy care by attracting more clients at risk of pregnancy to services at the community level, enabling more women to confirm they are pregnant and receive antenatal counselling.


Assuntos
Agentes Comunitários de Saúde/organização & administração , Testes de Gravidez/economia , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Aconselhamento/estatística & dados numéricos , Feminino , Humanos , Madagáscar , Masculino , Pessoa de Meia-Idade , Gravidez , Testes de Gravidez/estatística & dados numéricos
14.
J Dairy Sci ; 102(10): 9236-9240, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31400904

RESUMO

Transrectal palpation of the reproductive tract is the most common method for pregnancy determination in cattle and is considered a veterinary skill that new veterinary medicine (DVM) graduates should perform proficiently. However, using privately owned cattle to train students can be difficult because producers may believe that transrectal palpation by inexperienced students increases the risk of pregnancy wastage compared with examination by an experienced clinician. We used a randomized field trial of 1,216 healthy Holstein and Jersey cattle in 2 commercial dairy herds to estimate the effect of veterinary student transrectal palpation on early pregnancy loss. All cattle were determined to be pregnant using transrectal ultrasonography at approximately 37 d after artificial insemination. Cattle were then allocated into 2 groups based upon their ear tag number (study group = 598; control group = 618). Cattle in the study group were immediately palpated after ultrasonography by a fourth-year veterinary student, whereas control cattle were not subject to any additional pregnancy assessment. For analysis, the student palpators were divided into 2 groups: students who had previously had formal palpation training via an elective bovine palpation class (n = 30) and students who had not had palpation training (n = 134). All cattle were reevaluated using transrectal ultrasonography approximately 70 d after artificial insemination. A total of 53 (4.36%) animals lost their pregnancy between the first and second pregnancy assessments. Of the animals that lost their pregnancy, 26 (4.35%) were study group cows and 27 (4.37%) were control cows. Of the 26 cows documented to have had pregnancy loss within the study group, 20 out of 378 (5.3%) had been palpated by students who had not taken the palpation elective and 6 out of 220 (2.7%) had been palpated by students who had completed the elective. We found no difference in pregnancy loss between student-palpated and clinician-ultrasounded cattle, supporting the safety of using privately owned animals for student bovine palpation and pregnancy diagnosis training without affecting early pregnancy loss.


Assuntos
Aborto Animal/etiologia , Educação em Veterinária , Palpação/efeitos adversos , Testes de Gravidez/veterinária , Animais , Bovinos , Feminino , Humanos , Gravidez , Estudantes , Ultrassonografia Pré-Natal/veterinária
16.
Eur J Contracept Reprod Health Care ; 24(4): 319-321, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31204845

RESUMO

Purpose: The European Society of Contraception Expert Group on Abortion identified as one of its priorities the need to disseminate up-to-date evidence-based information on the use of urine pregnancy tests by women for the self assessment of the success of early medical abortion (EMA). Methods and materials: A concise communication was produced which summarises the latest research in an easy-to-read format suitable for busy clinicians. Information about individual urinary pregnancy tests is presented in boxes for ease of reference. Results: Urinary pregnancy tests (low sensitivity, high sensitivity and multilevel) can be used in combination with signs and symptoms of pregnancy to exclude an ongoing pregnancy after EMA. Conclusion: Women are able to determine the success of early medical abortion (EMA) themselves using a combination of signs, symptoms and a urine pregnancy test. This simplifies EMA, expands the range of professionals able to provide EMA and most importantly gives women greater control over their bodies and treatment.


Assuntos
Aborto Induzido , Testes de Gravidez/métodos , Gravidez/urina , Abortivos Esteroides/uso terapêutico , Aborto Induzido/métodos , Feminino , Humanos , Mifepristona/uso terapêutico , Autoavaliação
17.
J Wildl Dis ; 55(4): 912-916, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31075050

RESUMO

Uterine examinations provide an inexpensive and reliable postmortem alternative to monitor pregnancy rates in free-ranging elk (Cervus canadensis). However, this technique may be insensitive during early pregnancies (i.e., <20 d postconception), relies on proper collection of tissues, and may not be comparable to antemortem approaches used throughout the rest of the year. To circumvent some of these issues, the sensitivity and specificity of a commercially available serum pregnancy-specific protein B (PSPB) enzyme-linked immunosorbent assay (ELISA) was determined relative to uterine examination. From 2013 to 2017, paired serum samples and uteri were collected from 245 harvested free-ranging cow elk in Pennsylvania, US in November. Uteri were examined to determine whether the cow was pregnant, and, if so, gestation age was estimated based on embryo crown-rump (CR) length. The serum PSPB ELISA testing was then performed. Since harvested elk could not be retested, samples with optical densities close to the threshold for pregnancy determination (i.e., high-recheck samples) were considered as both not pregnant and pregnant, and analyses were performed separately under each scenario. Overall, the PSPB ELISA had a sensitivity of 95% (high-recheck considered pregnant) and 93% (high-recheck considered not pregnant), and a specificity of 91% (high-recheck considered pregnant) and 93% (high-recheck considered not pregnant) relative to uterine examinations. Based on CR length, gestation age was <14 to 55 d. Our results indicated the PSPB ELISA was an accurate serum-based pregnancy test for elk.


Assuntos
Cervos/sangue , Proteínas da Gravidez/sangue , Testes de Gravidez/veterinária , Animais , Animais Selvagens , Cervos/fisiologia , Ensaio de Imunoadsorção Enzimática/métodos , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Pennsylvania , Gravidez , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
18.
Theriogenology ; 133: 144-148, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31100558

RESUMO

Besides chemical testing, thermographic imaging is a possible method to determine pregnancy in some animals. Hilsberg (2001) defined the unilateral warming at the end of a pregnancy, caused by the metabolizing fetus and the uterus near the outer skin, as the pregnancy field. Its appearance was observed in various species at the end of the gestation period. No studies were yet carried out to investigate the changing of thermal patterns during pregnancy. This study monitored the thermographic changes of one pregnant babirusa (Babyrousa babyrussa) sow and one babirusa male by taking thermal images once a week from the estimated 3rd pregnancy week until parturition in the 23rd pregnancy week. Images were searched manually for heat areas correlated to pregnancy as well as analysed automatically for median and maximum temperatures of the animal's side. Additionally, the locations of all pixels, which were not more than 2 K below the maximum temperature, were evaluated. In the female, there was a positive correlation between maximum temperatures of left and right side to pregnancy weeks (R = 0.61, R = 0.66, respectively; p < 0.05). The female's median temperatures and all temperatures of the male were not correlated to pregnancy weeks. Differences between median and maximum temperatures were significantly different during the 2nd, and 3rd trimester in the female, but not in the male. Temperature differences between 1st and 2nd trimester were not significant in both animals. The location of the warmest areas in the female shifted from thorax and flank to be mainly localised on the teats. In the male, the warmest areas remain localised on thorax and flank. No distinct pregnancy field was observed, but the warming of the teats could be seen in the images and the evaluated data. The teats are less insulated in most animals. Contraindications for thermal imaging like insulation could therefore become less important, allowing thermal pregnancy diagnosis for a larger range of animals than before. Based on these findings we suggest that the warming of the teats could be used for thermal pregnancy diagnosis when a pregnancy field is not observable.


Assuntos
Testes de Gravidez/veterinária , Prenhez/fisiologia , Gravidez , Suínos/fisiologia , Temperatura , Termografia/veterinária , Animais , Feminino , Masculino , Testes de Gravidez/métodos , Termografia/métodos
19.
Maturitas ; 124: 39-42, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097177

RESUMO

OBJECTIVE: We previously conducted an audit of the care provided for survivors of sexual violence seen at our emergency department and observed that 90% of them did not receive optimal care. This study analysed whether the implementation of a new protocol and educational sessions for staff increased the proportion of such patients who received optimal medical care. METHODS: A computerized chart detailing a new care protocol was developed specifically for rape survivors. Educational sessions focusing on the use of the new protocol were organized for healthcare providers. We then conducted another audit that reviewed retrospectively the charts of all survivors of sexual violence who were cared for at a public university hospital. MAIN OUTCOME MEASURE: Optimal medical care was defined as including systematic investigations for sexually transmitted diseases, and the provision of prophylactic antibiotics, a pregnancy test, emergency contraception, and psychological and medical follow-up. RESULTS: We analysed the charts of 362 survivors of sexual violence and observed that all of the required procedures were completed for 337 patients (93%) and the required preventive measures were provided to 325 patients (90%). CONCLUSION: After the implementation of the new protocol and educational sessions, the proportion of survivors who received optimal medical care increased from 10% to 90%. Nevertheless, optimal management also implies social, psychological and legal support. We hope that the establishment of specialist sexual assault centres will further improve management.


Assuntos
Pessoal de Saúde/educação , Assistência ao Paciente/métodos , Estupro , Sobreviventes , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Protocolos Clínicos , Anticoncepção Pós-Coito , Serviço Hospitalar de Emergência , Feminino , Humanos , Pessoa de Meia-Idade , Assistência ao Paciente/normas , Testes de Gravidez , Estudos Retrospectivos , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto Jovem
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