A Pilot Study of the Maternal-Fetal Pharmacokinetics of Furosemide in Plasma, Urine, and Amniotic Fluid of Hypertensive Parturient Women Under Cesarean Section.

The third trimester of pregnancy is related to physiological changes that can modify the process of absorption, distribution, metabolism, and excretion and, consequently, the efficacy and toxicity of drugs. However, little is known about furosemide pharmacokinetics and placental transfer in pregnancy. This study evaluated the maternal-fetal pharmacokinetics and distribution to amniotic fluid of furosemide in hypertensive parturient women under cesarean section. Twelve hypertensive parturient women under methyldopa (250 mg/8 h) and/or pindolol (10 mg/12 h) treatment received a 40-mg single oral dose of furosemide 1 to 10 hours before delivery by cesarean section. Blood and urine samples were collected for 12 hours after furosemide administration. At delivery, samples were obtained from maternal and umbilical cord blood (n = 8) to assess the transplacental transfer. Amniotic fluid (n = 4) was collected at the time of delivery. The following furosemide pharmacokinetic parameters were obtained as median (interquartile range): Cmax , 403 ng/mL (229 to 715 ng/mL); Tmax , 2.00 hours (1.50 to 4.83 hours); elimination half-life (t1/2 ), 2.50 hours (1.77 to 2.97 hours); AUC0-12 h , 1366 ng⋅h/mL (927 to 2531 ng⋅h/mL); AUC0-∞ , 1580 ng⋅h/mL (1270 to 2881 ng⋅h/mL); CL/F 25.3 L/h (13.8 to 31.4 L/h); CLR, 2.50 L/h (1.77 to 2.97 L/h); CLNR, 22.7 L/h (12.1 to 25.6 L/h); and Vd /F 82.8 L (34.4 to 173 L). The transplacental transfer of furosemide was 0.43 (0.10 to 0.73), and the amniotic fluid concentration was 11.0 ng/mL (5.51 to 14.6 ng/mL). From a clinical point of view, these results suggest that substrates of uridine diphosphate-glucuronosyltransferase isoenzymes such as furosemide may have increased clearance during pregnancy and could require dose adjustment in this population.

Calving duration and obstetric assistance influence pulmonary function of Holstein calves during immediate fetal-to-neonatal transition.

Neonatal immediate adaptation to extrauterine life depends mainly on adequate lung function, which is under the influence of previous fetal maturation and obstetrical condition, both acting to stimulate the efficient liquid removal from the pulmonary parenchyma during the immediate transition period. The objective of the present study is to identify chest radiographic changes of neonatal calves born under the influence of different duration of calving and obstetric assistance and correlate with clinical analysis and blood acid-base balance. Experimental groups were determined according to the duration of calving: 2 h (n = 16), 2-4 h (n = 16) and >4 h (n = 12), and additionally by two sub-groups: no-intervention calving (n = 22) and intervention calving (n = 22). Neonatal calves were evaluated for heart and respiratory rate at birth, 5 min, every 10 min until 90 min. Arterial acid-base balance was determined immediately after calving and thoracic radiographs were made at 10 min of life. Lung radiopacity was higher in the 2-4 hr Group compared to the 2 hr Group. When calving duration was greater than 4 hours, a significant respiratory depression was observed. Calving greater than 2 hours slower neonatal pulmonary clearance, 100% and 91.6% of the calves born in the 2-4 hr and >4 hr Groups, respectively, had mild to moderate lung parenchyma opacity. There was a positive correlation between lung radiographic changes and blood TCO2 and negative correlation between pulmonary opacity score and blood PaO2 and SO2. Hence, it is possible to infer that neonatal hypoxia during prolonged calving has an imperative influence on pulmonary fluid absorption in calves. In conclusion, calving greater than 2 hours impacts pulmonary function at birth, leading to altered lung gas exchange, pulmonary clearance, cardiac and respiratory pattern. Conversely, obstetric intervention when calving has duration greater than 4 hours is beneficial for neonatal oxygenation.

Perinatal Na+ overload programs raised renal proximal Na+ transport and enalapril-sensitive alterations of Ang II signaling pathways during adulthood.

BACKGROUND: High Na(+) intake is a reality in nowadays and is frequently accompanied by renal and cardiovascular alterations. In this study, renal mechanisms underlying perinatal Na(+) overload-programmed alterations in Na(+) transporters and the renin/angiotensin system (RAS) were investigated, together with effects of short-term treatment with enalapril in terms of reprogramming molecular alterations in kidney. METHODOLOGY/PRINCIPAL FINDINGS: Male adult Wistar rats were obtained from dams maintained throughout pregnancy and lactation on a standard diet and drinking water (control) or 0.17 M NaCl (saline group). Enalapril (100 mg/l), an angiotensin converting enzyme inhibitor, was administered for three weeks after weaning. Ninety day old offspring from dams that drank saline presented with proximal tubules exhibiting increased (Na(+)+K(+))ATPase expression and activity. Ouabain-insensitive Na(+)-ATPase activity remained unchanged but its response to angiotensin II (Ang II) was lost. PKC, PKA, renal thiobarbituric acid reactive substances (TBARS), macrophage infiltration and collagen deposition markedly increased, and AT(2) receptor expression decreased while AT(1) expression was unaltered. Early treatment with enalapril reduced expression and activity of (Na(+)+K(+))ATPase, partially recovered the response of Na(+)-ATPase to Ang II, and reduced PKC and PKA activities independently of whether offspring were exposed to high perinatal Na(+) or not. In addition, treatment with enalapril per se reduced AT(2) receptor expression, and increased TBARS, macrophage infiltration and collagen deposition. The perinatally Na(+)-overloaded offspring presented high numbers of Ang II-positive cortical cells, and significantly lower circulating Ang I, indicating that programming/reprogramming impacted systemic and local RAS. CONCLUSIONS/SIGNIFICANCE: Maternal Na(+) overload programmed alterations in renal Na(+) transporters and in its regulation, as well as severe structural lesions in adult offspring. Enalapril was beneficial predominantly through its influence on Na(+) pumping activities in adult offspring. However, side effects including down-regulation of PKA, PKC and AT(2) receptors and increased TBARS could impair renal function in later life.

Fetal venous Doppler in pregnancies with placental dysfunction and correlation with pH at birth.

OBJECTIVES: To determine the correlation between ph at birth and venous Doppler parameters in pregnancies with placental dysfunction. METHODS: This was a prospective cohort study of 58 pregnancies with the diagnosis of placental dysfunction between 26 and 34 weeks of gestation. Inclusion criteria were singleton pregnancies, abnormal umbilical artery (UA) Doppler, fetal growth restriction diagnosed by estimated fetal weight <10th centile for gestational age, intact membranes, and absence of fetal congenital abnormalities. The Doppler measurements were the following: UA pulsatility index (PI), ductus venosus (DV) pulsatility index for veins (PIV), intra-abdominal umbilical vein (UV) time-averaged maximum velocity (TAMxV) and blood flow and left portal vein (LPV) time-averaged maximum velocity (TAMxV) and blood flow. All Doppler parameters were transformed into z-scores (SD values from the mean) according to normative references. RESULTS: The UA pH at birth showed a negative significant correlation with the DV-PIV (p = 0.004) and the DV-PIV z-score (p = 0.004), while LPV TAMxV (p = 0.004), LPV TAMxV z-score (p = 0.002), LPV blood flow (p = 0.01), LPV blood flow normalized (p = 0.04) and UV blood flow (p = 0.04) positively correlated with pH at birth. Multiple regression analysis was performed and the DV-PIV z-score was the variable that independently correlated with pH at birth (p = 0.002). CONCLUSIONS: the present results suggest that changes in fetal venous blood flow, mainly DV and LPV are useful in the management of cases with early onset placental insufficiency and that venous Doppler parameters correlate with pH at birth.

Cytokines and chemokines production by mononuclear cells from parturient women after stimulation with live Toxoplasma gondii.

Toxoplasma gondii is an obligate intracellular parasite that can cause variable clinical symptoms or can even be asymptomatic in immunocompetent individuals. More severe symptoms are observed in immunocompromised patients and congenital transmission of the parasite has been reported. The objective of this study was to evaluate the response of peripheral blood mononuclear cells (PBMC) in parturient and non-pregnant women exposed to live tachyzoites of T. gondii strain RH or ME49. PBMC were isolated from parturient and non-pregnant women with negative or positive serology for toxoplasmosis and cultured with live tachyzoites of the two T. gondii strains for 24 h. Next, the cell culture supernatants were collected and levels of CCL2, CCL5, IL-6, IL-10, IL-12, and TNF-α produced by PBMC after tachyzoite exposure were measured. Live tachyzoite forms of T. gondii significantly inhibited the synthesis of CCL2 in seropositive parturient women, whereas a stimulatory effect on CCL5 was observed in seronegative parturient women. Cells from T. gondii-seronegative non-pregnant women produced significantly higher levels of TNF-α and IL-12, demonstrating the proinflammatory profile induced by the presence of the parasite in culture. The results suggest that the immunomodulation seen during pregnancy contributes to the development of an environment that facilitates escape of the parasite from the immune response.

Predicting pH at birth in pregnancies with abnormal pulsatility index and positive end-diastolic velocity in the umbilical artery.

OBJECTIVES: To identify potential associations between fetal surveillance tests and acidosis at birth in pregnancies with abnormal but positive end-diastolic velocity in the umbilical artery. METHODS: A prospective case-control study [group 1: pH < 7.2; group 2: pH ≥ 7.2] including 46 fetuses with abnormal but positive end-diastolic velocity in the umbilical artery was conducted between February 2007 and March 2009. Outcome variables were evaluated by univariate analysis and compared between the two groups. Clinically relevant and statistically significant variables were analyzed by logistic regression. RESULTS: Abnormal nonstress test, presence of deceleration, and absent fetal breathing movements were statistically significant. Logistic regression analysis revealed that fetal heart rate (FHR) deceleration in the nonstress test is the only predictor of fetal acidosis at birth (p = 0.024; OR = 8.2; 95%CI: 1.2-52). CONCLUSIONS: In fetuses with positive end-diastolic flow velocity, acute variables of the antenatal surveillance tests are correlated with acidosis at birth and FHR deceleration in the nonstress test is the only predictor of fetal acidosis.

Características radiológicas de los tumores malignos intracraneales mediante resonancia magnética y espectroscopia en el Instituto Nacional de Enfermedades Neoplásicas, durantye el periodo Setiembre 2008 - Julio 2010 / Hematologic and clinical characteristics before and after the childbirth in patients attended in the National Institute Materno Perinatal 2011

OBJETIVO: Comparar las características hematológicas y clínicas antes y después del parto en pacientes atendidas en el Instituto Nacional Materno Perinatal. MATERIAL Y METODOS: Se realizó una investigación comparativa, con un diseño Prospectivo, transversal. Se analizaron las características hematológicas y clínicas antes y después del parto en 235 pacientes atendidas en el Instituto Nacional Materno Perinatal, El tipo de muestreo fue probabilístico sistemático con arranque cada 3 pacientes. La información se obtuvo de la revisión de historias clínicas, de entrevista con un formulario estructurado y de un examen clínico antes y después del parto. Se procedió a analizar los datos con estadísticas descriptivas medidas de tendencia central, medidas de posición en las variables cuantitativas, distribución de frecuencias en las variables cualitativas, se aplicaron la estadística inferencial t-student en las variables cuantitativas, prueba Chi cuadrado en las variables cualitativas ambas con un nivel significación estadística p=11 g/dL antes del parto (59.57 por ciento) que después del parto (22.98 por ciento). Se con nivel concentración de hemoglobina 10-10.9 g/dL antes del parto (36.17 por ciento) menor que después del parto (38.72 por ciento). se encontró menos casos con nivel de concentración de hemoglobina 7-9.9 g/dL antes del parto(4.26 por ciento) que después del parto (28.51 por ciento) y no se encontró ningún caso con nivel de concentración de hemoglobina <7 g/dL antes del parto en comparación con después el parto ( 9.79 por ciento), el promedio de valor de hematocrito antes del parto (33.2 por ciento ± 2.9) es mayor que el promedio de concentración de hematocrito después del parto (29.2 por ciento ± 3.9). Existe menor presencia de palidez de piel y mucosas antes del parto (40.2 por ciento) que después del parto (26.9 por ciento). Se tiene palidez leve antes del parto (56.8 por ciento) mayor que después del parto (48.7 por ciento).Además se encontró que el promedio de concentración de hemoglobina antes de parto (11.2 g/dL ± 1.2) es mayor que el promedio de concentración de hemoglobina después del parto (9.5 g/dL ± 1.7). CONCLUSION: Se concluye que los valores de las características hematológicas y presencia de características clínicas son mayores antes que después del parto eutócico en pacientes atendidas en e/Instituto Nacional Materno Perinatal

The effect of offering an energy and protein supplement to grazing Canchim beef cows either postpartum or both pre- and postpartum on lipid blood metabolites and folliculogenesis.

This study was designed to evaluate the effect of nutritional supplementation offered during the pre- and postpartum periods on serum cholesterol, triglycerides and total lipids of Canchim beef cows and their relationship with folliculogenesis. Thirty cows with predicted calving date between September and October, kept in pastures of Brachiaria brizantha cv. Marandú together with their calves, were randomly distributed into three experimental groups: the first received only a mineral mixture (Control Group, CG); the second group received a concentrate with 16%crude protein/kg dry matter (DM) and 3000 kcal digestible energy/kg DM offered for 45 days prepartum and 120 days postpartum (PREG); the third group received the concentrate from parturition until the 120th day postpartum (POSG). Consumption was estimated at 1% of body weight, and each cow received approximately 4.0 kg/day (fresh weight) of supplement. Blood samples were taken and an ultrasound examination of the ovaries was performed twice a week until the 60th day postpartum. The body condition score (BCS) and the weight of the cows were recorded at 15-day intervals from calving until the 60th day postpartum. Data are presented as mean+/-SEM. Mean weight and BCS at calving were, respectively, 448+/-54.9 kg and 6.2+/-0.25 (PREG); 432+/-71.1 kg and 5.5+/-0.69 (POSG); and 434+/-66.4 kg and 5.5+/-0.69 (CG). Total cholesterol (TC), triglycerides (TRIG) and total lipids (TLIP) were measured using colorimetry until the 60th day postpartum. TC averages were PREG 186+/-62.6 mg/dL, POSG 159+/-43.1mg/dL and CG 133+/-35.1mg/dL (P<0.05). For TRIG, the means were PREG 29+/-11.3mg/dL (P<0.05), POSG 24+/-8.1mg/dL and CG 26+/-12.1mg/dL (P>0.05). Serum concentrations of TLIP were PREG 588+/-145.6 mg/dL, POSG 512+/-137.6 mg/dL and CG 452+/-122.4 mg/dL (P<0.05). The first dominant follicle (DF) was identified on Day 21+/-10.3 (PREG), 36+/-28.5 (POSG) and 51+/-32.8 (CG) after calving. The difference between PREG and CG was significant (P<0.05). TC was positively correlated with the calving to first estrus interval (P<0.05). Results showed that nutritional supplementation before parturition assured good body condition at calving and suggested that it was effective at increasing cholesterol availability to maintain ovarian follicle function and to favor earlier resumption of ovarian activity.

Prevención de la hemorragia posparto / Post partum hemorrhage prevention

OBJETIVO: evaluar los cambios en la pérdida estimada de sangre y tasas de Hemorragia Posparto [HPP] derivados del entrenamiento en el Manejo Activo de la Tercera Etapa del Parto [MATED] en cinco Clínicas Materno Infantiles del departamento de Yoro, Honduras. METODOLOGÍA: durante nueve meses, el equipo de investigación enseña las habilidades sobre la pérdida estimada de sangre, establece una tasa base para la HPP y enseña el manejo activo de la tercera etapa del parto. En cada nacimiento se registran la pérdida estimada de sangre, los resultados para la madre y el neonato, así como el uso calculado de Oxitocina en el periodo posnatal. Los datos obtenidos se analizan estadísticamente con SPSS descriptivo, prueba-T y Chi-cuadrado. RESULTADOS: el periodo de estudio previo al entrenamiento en MATEP incluye 178 casos, el periodo posterior al entrenamiento incluye 392 casos. La pérdida estimada de sangre durante el periodo previo es de 109 ml en promedio, comparado con 81 ml en promedio que se obtiene durante el periodo posterior al entrenamiento (p=.004). En la fase previa y posterior a/ entrenamiento, el uso de Oxitocina en el periodo posparto es de 99.5%, aunque en el 17% de los casos reportados la administración de Oxitocina se realiza después de la expulsión de la placenta. Después del entrenamiento en MATER la tasa de hemorragia posparto disminuye del 7.3% al 3.8%, dato que no es estadísticamente significativo.

AIM: evaluate the changes in estimated blood loss and Post Partum Hemorrhage [PPH] rates with dissemination of Active Management of Third Stage of Labor [AMTSL] training to five Clinicas Materno Infantiles in the state of Yoro, Honduras. METHODS: over a nine month period, the research team utilized a two part training module to first teach the skills of estimated blood loss to establish a baseline rate for PPH and then in the second phase teach skills of active management of third stage labor. Estimated blood loss, outcomes for mother and neonate as well as the use and timing of Oxytocin in the postpartum period were recorded for each birth for the research team. The collected data were analyzed with SPSS for descriptive, t-test and chi-square statistics. RESULTS: pre-AMTSL training period N= 178, post AMTSL training N=392. Estimated blood loss pre-AMTSL training was a mean of 109 ml compared with post-training period of 81ml (p=.004). The use of Oxytocin in the postpartum period was 99.5% in both pre and post AMTSL training, though 17% of the cases reported Oxytocin administration after delivery of the placenta. The postpartum hemorrhage rate decreased from 7.3% to 3.8% after the AMTSL training, but was not statistically significant. CONCLUSION: AMTSL training reduced estimated blood loss though did not significantly change PPH rates in this study. Use of Oxytocin postpartum has become a regular component of care provided.

Endocrine changes during pregnancy, parturition and post-partum in guanacos (Lama guanicoe).

Plasma concentrations of progesterone (P4), estradiol-17beta (E2), estrone (E1) and estrone sulfate (E1S) were measured during gestation in eight guanacos kept in captivity. Gestational length was 346.1+/-9.8 days. P4 plasma concentrations increased after ovulation and remained elevated until parturition. However, during the last 4 weeks of gestation, a gradual decrease from 4.17x1.17(+/-1)nmol/L to 2.02x1.95(+/-1)nmol/L on day 5 before parturition was observed, followed by a more abrupt final decline to baseline concentrations which were reached on the day after parturition. Mean E2 plasma concentrations started to increase during the eighth month of gestation, and were significantly elevated up to maximum concentrations of 484.7x1.21(+/-1)pmol/L during the last 2 months of pregnancy. Concentrations returned to baseline during the last 2 days of gestation. An increase of E1S concentrations (p<0.01) was observed in the eleventh month of gestation. Mean E1S concentrations remained rather constant during the last 3 weeks of gestation between 4 to 8nmol/L until parturition, when a steep precipitous decline was observed. E1 concentrations were slightly elevated during the last 4 weeks of gestation, however, maximum concentrations did not exceed 1.5nmol/L. The results show distinct species specific features of gestational steroid hormone profiles in the guanaco in comparison to domestic South American camelids, such as a more pronounced gradual prepartal decrease of P4 concentrations prior to the final decline to baseline, and clearly lesser E1S concentrations during the last 4 weeks of gestation, which lack a continuous prepartal increase.

Evaluation of the serum fructosamine test to monitor plasma glucose concentration in the transition dairy cow.

The usefulness of the serum fructosamine (Fser) to monitor the retrospective glucose concentrations in transitional dairy cows (n=17) was evaluated. In weekly blood samples (3 weeks before to 5 weeks after calving) concentrations of plasma glucose and serum fructosamine, beta-hydroxybutyrate (beta OHB) and total proteins were determined. The observed Fser concentrations (271+/-55 mean value, range 152-423 mumol/l) were within the range reported in the literature, and showed a progressive and significant decrease after calving. Mean plasma glucose concentration was 60.6+/-5.0 (range 39.9-82.2) mg/dl increasing from week 3 before calving to the week of calving and then decreasing during the next 5 weeks of lactation. This decrease was coincident with inverse relationships between plasma glucose and milk yield (P=0.03) and serum beta OHB (P<0.001). Linear regression analysis performed between serum fructosamine and (a) plasma glucose concentration of the same sampling and (b) plasma glucose concentration of 1, 2 and 3 weeks preceding the sampling, did not show significant and systematizing positive correlations. Persistent hypoproteinaemias that could affect the fructosamine concentrations were not found: mean value and range of serum proteins was 6.3+/-1.0 and 4.8-7.8 g/dl, respectively, and no correlation was found between serum proteins and Fser (P=0.26). Results did not support the possibility of retrospective monitoring of the plasma glucose concentration by serum fructosamine in dairy cows in the transition period.

Teores séricos de proteína total, imunoglobulina g e cortisol em bezerros Nelore, ao nascimento e às 24 horas de vida: influência do tipo e da duração dos partos / Serum levels of total protein, immunoglobulin g and cortisol in Nellore calves, at the birth and at 24 hours old: influence of the type and the duration of the parturition

Foram avaliadas as concentrações séricas de proteína total (PT), imunoglobulina G (IgG) e cortisol de 251 bezerros da raça Nelore, comparando-se quanto ao tipo de parto (normal ou distócico) e o tempo de duração. Os teores médios de proteína total não apresentaram diferenças significativas em relação ao tipo e nem à duração dos partos. Os valores médios de imunoglobulina G não apresentaram diferença significativa em relação ao tipo de parto. Já o tempo de duração dos partos influenciou os valores séricos de IgG, sendo que os animais que demoraram entre quatro e seis horas para o seu nascimento apresentaram menores valores (1.250 mg/dL) do que os que demoraram entre o nascimento a duas horas para nascerem (3.200 mg/dL). Os teores de cortisol não foram influenciados pelo tipo ou duração dos partos.

The serum levels of total protein (PT), immunoglobulin G (IgG) and cortisol of 251 Nelore calves, born from normal and dystocics calving or according the duration of the calving were evaluated. There were no statistically significant differences between the average contents of total protein in relation to the type or time of calving. The serum values of IgG were not influenced by the type of calving but by the duration of the calving, since the animals requiring from four to six hours to be born showed lesser IgG value (1.250 mg/dL) than those that were born in shorter time (3.200 mg/dL). The cortisol levels were not influenced by the type or duration of calving.

Plasma concentrations of ascorbic acid in parturients from a hospital in Southeast Brazil.

BACKGROUND & AIMS: Pregnancy is a period characterized by high metabolic requirements and physiological changes in the female organism. During this period, low body stores of vitamins and minerals including antioxidants can have adverse effects on the mother and foetus. This cross-sectional study assessed plasma concentrations of ascorbic acid (AA) in 117 parturients admitted into a university hospital in São Paulo city, Brazil. METHODS: The concentrations of AA were determined by the high performance liquid chromatographic method. Data concerning socioeconomic, demographic, obstetric and nutritional characteristics of the parturients were collected by a standardized questionnaire. RESULTS: The prevalence of AA deficiency (<22.7 micromol/L) among the parturients was 30.8%. Mean plasma AA concentrations were lower in single/divorced women (27.84+/-3.48 micromol/L) compared with married/single with partner women (34.78+/-1.85 micromol/L) (p=0.047). Blood AA concentrations were significantly correlated with per capita income (r=0.36, p<0.001) and vitamin C-rich food intake score (r=0.42, p<0.001). CONCLUSION: The high prevalence of hypovitaminosis C detected in this study is probably due to an inadequate intake of foods rich in vitamin C and low income. We alert to the need for increasing the intake of vitamin C-rich foods through educational programs, especially for low income populations.

Tiempo de alumbramiento con drenaje y sin drenaje de sangre del cordón umbilical en pacientes anémicas y no anémicas en el Hospital Vicente Corral Moscoso / Delivery time with drainage and no drainage of blood from the umbilical cord in anemic and nonanemic patients in the Vicente Corral Moscoso Hospita

Comparar el tiempo del tercer período del parto de las pacientes anémicas y no anémicas sujetas al procedimiento de drenaje de sangre del cordón umbilical versus pinzamiento del cordón, en los ambientes del Centro Obstétrico del Hospital Vicente Corral Moscoso.Con un diseño experimental se realizó un estudio clínico, controlado, aleatorizado La muestra incluyó 200 pacientes, el grupo experimental comprendió 100 pacientes en las que se drenó la sangre de cordón umbilical 50 anémicas y 50 no anémicas, y el grupo de control con pinzamiento del cordón lo integraron 100 pacientes, 50 anémicas y 50 no anémicas. Al comparar la duración del tercer período del parto del grupo con drenaje se obtuvo una media de 4,6 ± 1,4 min y en el grupo con pinzamiento 9,07 ± 2,5 min. La diferencia fue significativa (P = 0,0001). Cuando se comparó la duración del tercer período del parto de 1 a 5 min vs 6 a 10 min, la mayoría de las pacientes del grupo con drenaje, estuvo entre 1 a 5 min, con un RR 0.239 (IC 95: 0.188 – 0.358), RRA 70.1%, RRR 76.1%, NNT 1.426, en las anémicas, y un RR 0.250 (IC 95: 0.179 – 0.383), RRA 66.1%, RRR 75%, NNT 1.513 en las no anémicas. El volumen de drenaje en el grupo de estudio, tuvo una media de 60.3 ± 19.5 ml en las anémicas y 56.9 ± 18 ml en las no anémicas (P = 0.369). La hemorragia del tercer período del parto del grupo con drenaje tuvo una media de 197.6 ± 36 ml vs el grupo con pinzamiento 277.4 ± 49 ml con un valor (P = 0,0001) lo cual es estadísticamente significativo a favor del drenaje. Cuando se comparó la hemorragia del tercer período del parto de < 250 ml vs 250 a 500 ml la mayoría de las pacientes del grupo con drenaje, estuvo en < 250 ml, con un RR 0.070 (IC 95: 0.025 – 0.168), RRA 80%, RRR 93%, NNT 1.25, en las anémicas, y un RR 0.074 (IC 95: 0.020 – 0.246), RRA 50%, RRR 92.6 %, NNT 2 en las no anémicas.

Influência da parição e do puerpério no leucograma de caprinos (Capra hircus) da raça Saanen, criados no Estado de São Paulo / Influence of parturition and puerperium in the leucogram of Saanen goats (Capra hircus), raised in the State of São Paulo - Brazil

Com o objetivo de avaliar a influência da parição e do puerpério no leucograma de caprinos da raça Saanen foram colhidas 360 amostras de sangue de 20 cabras, sendo os resultados apresentados em 18 grupos experimentais: 32, 16,8,4,3,2, 1 e ½ dias antes do parto, imediatamente após aparição, ½, 1,2,3,4,8,16,32 e 64 dias após o parto. Nas amostras de sangue colhidas em frascos contendo EDTA, foram realizadas as seguintes provas: contagem do número total de leucócitos, em câmara de Neubauer modificada, utilizando-se o liquído de Thoma como diluidor e contagem diferencial de leucócitos, efetuada em esfregaços sangüíneos, corados pelo método de Rosenfeld. A avaliação dos resultados obtidos demonstrou que o leucograma sofreu influência da parição e do puerpério, sendo que durante todo o experimento o quadro leucocitário foi predominantemente neutrofilico. Nos últimos três dias de gestação observou-se gradual aumento do número de leucócitos, em decorrência das variações observadas no número de neutrófilos. No momento do parto o leucograma era caracterizado por leucocitose devido à neutrofilia associado a linfopenia. Nas primeiras 24 horas após o parto foi observado a existência de leucocitose por neutrofilia que desapereceu nos dias subseqüentes, passando o quadro leucocitário a assemelhar-se entre o 2° e 64° dia após o parto àquele observado na fase final da gestação.

Influência da parição e do puerpério no leucograma de caprinos (Capra hircus) da raça Saanen, criados no Estado de São Paulo / Influence of parturition and puerperium in the leucogram of Saanen goats (Capra hircus), raised in the State of São Paulo - Brazil

Com o objetivo de avaliar a influência da parição e do puerpério no leucograma de caprinos da raça Saanen foram colhidas 360 amostras de sangue de 20 cabras, sendo os resultados apresentados em 18 grupos experimentais: 32, 16,8,4,3,2, 1 e ½ dias antes do parto, imediatamente após aparição, ½, 1,2,3,4,8,16,32 e 64 dias após o parto. Nas amostras de sangue colhidas em frascos contendo EDTA, foram realizadas as seguintes provas: contagem do número total de leucócitos, em câmara de Neubauer modificada, utilizando-se o liquído de Thoma como diluidor e contagem diferencial de leucócitos, efetuada em esfregaços sangüíneos, corados pelo método de Rosenfeld. A avaliação dos resultados obtidos demonstrou que o leucograma sofreu influência da parição e do puerpério, sendo que durante todo o experimento o quadro leucocitário foi predominantemente neutrofilico. Nos últimos três dias de gestação observou-se gradual aumento do número de leucócitos, em decorrência das variações observadas no número de neutrófilos. No momento do parto o leucograma era caracterizado por leucocitose devido à neutrofilia associado a linfopenia. Nas primeiras 24 horas após o parto foi observado a existência de leucocitose por neutrofilia que desapereceu nos dias subseqüentes, passando o quadro leucocitário a assemelhar-se entre o 2° e 64° dia após o parto àquele observado na fase final da gestação.(AU)

ith the intention of evaluating the influence of parturition andpuerperium on the leukogram of Saanen goats (Capra hircus) 360blood samples were collected from 20 goats and allotted into 18experimental groups as described: 32, 16, 8, 4, 3, 2, 1 e ½ days beforeparturition, immediately after parturition, ½, 1, 2, 3, 4, 8, 16, 32 e 64days after parturition. The blood samples were collected with EDTAand submitted to the following tests: total leukocyte counts, at themodified Neubauer hemocytometer, using Thomas liquid as a diluteand differential leukocyte count, made up with blood smears stainedwith Rosenfeld method. The evaluation of the leukogram showedsignificant variation that could be attributed to parturition and thepuerperium. The leucograma became mostly neutrophilic at the endof pregnancy and puerperium. On the last three days of pregnancy, agradual raise on the number of leukocytes was observed due to samechanges on the total number of neutrophils. At the moment ofparturition the leukogram was characterized by a leukocytosis due toneutrhophilia and lymphopenia. On the first 24 hours after parturition,it was still possible to observe this leukocytosis due to neutrophiliathat disappeared on the subsequent days making the leukogram looksimilar to taht obseved at the late pregnancy until the end ofpuerperium. (AU)