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Results for “Postpartum Period”

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PubMed2002

Macular capillary blood flow velocity by blue-field entoptoscopy in diabetic and healthy women during pregnancy and the postpartum period.

PURPOSE: To study macular capillary blood flow velocity in diabetic and healthy women during pregnancy and the postpartum period. METHODS: A prospective study of 46 pregnant women with insulin-dependent diabetes and 11 healthy pregnant women was performed. Macular capillary blood flow velocity was measured by blue-field entoptic simulation. Diabetic retinopathy was graded from colour fundus photographs. RESULTS: In diabetic women, the macular capillary blood flow velocity was 0.94+/-0.27 mm/s (mean +/- SD) during the first trimester, 1.00+/-0.28 mm/s during the third trimester and 1.03+/-0.24 mm/s 3 months postpartum, compared with values of 0.71+/-0.20, 0.77+/-+/-0.20 and 0.82+/-0.19 mm/s, respectively, in healthy women (P=0.0026 between groups). Diabetic women with no or very mild retinopathy had lower macular capillary blood flow velocities than those with more severe retinopathy (P=0.0164), but higher velocities than healthy women (P=0.0167). An increase temporally from the first trimester to the postpartum period was observed in diabetic women (P=0.0294) but not in healthy (P=0.2449) women. CONCLUSIONS: According to our study macular capillary blood flow velocity is higher in diabetic than in healthy women during pregnancy and the postpartum period. Further, capillary blood flow velocity seems to depend on the grade of retinopathy in pregnant diabetic women. These data support the concept that capillary hyperperfusion may play a role in the development of diabetic retinopathy during pregnancy.

Adult↗

PubMed2000

Continuity and change in women's weight orientations and lifestyle practices through pregnancy and the postpartum period: the influence of life course trajectories and transitional events.

The life course perspective offers a framework for understanding continuity and change in health and health practices. Body weight, and the diet and physical activity strategies used to manage weight in pregnancy and the postpartum period, are a focus of much study because of an association between parity and body weight. The motherhood transition offers an opportunity to study weight concerns and weight management strategies during a period of weight fluctuation that is part of a life transition for many women. Our aim was to develop an in-depth understanding of women's experiences of pregnancy and postpartum weight changes, the strategies that women used to deal with weight changes, and patterns in their attitudes and strategies across pregnancy and the postpartum period. A longitudinal design, using multiple, in-depth, qualitative interviews with 36 women from pregnancy through the postpartum period, was chosen for data collection. Prepregnancy orientations towards body weight emerged as the primary influence on women's pregnancy and postpartum attitudes towards weight, on patterns of physical activity and diet, and on postpartum weight outcomes among most study participants. Four different trajectories ("relaxed maintenance", "exercise", "determined", and "unhurried"), characterized by differences in women's orientations towards their body weight and their diet and physical activity patterns across pregnancy and the postpartum period, emerged from the data. Only a few women diverged from prepregnancy trajectories in weight orientation and diet and physical activity patterns postpartum. Delayed resumption of prepregnancy physical activity and dietary patterns contributed to postpartum weight retention for a subset of "exercisers". Stress and age- or role-related changes in perspective interrupted the continuity of weight orientations and behavioral patterns for three other women. These findings highlight the direction and momentum provided by trajectories in health attitudes and strategies as processes shaping responses to a life transition.

Adult↗

PubMed1992

Thyroid-stimulating antibodies and thyroid stimulation-blocking antibodies during the pregnancy and postpartum period: a case report.

This report describes a unique pattern of changes in thyroid function and thyroid antibodies in a woman during the course of two pregnancies and two postpartum periods. A 25-year-old woman developed hypothyroidism in the postpartum period after the delivery of her first child. She was found to have potent thyroid stimulation-blocking antibodies (TSBAb) in the serum. One year later, she became pregnant again, and during the pregnancy, TSBAb had decreased to an undetectable level. She gave birth to the second healthy child and developed postpartum thyrotoxicosis, probably due to destruction of the thyroid gland, which gradually resolved. In this postpartum period, serum TSBAb levels increased. Eight months postpartum, she developed what appeared to be Graves' disease with an elevated 123I-thyroid uptake. Serum thyroid-stimulating antibodies (TSAb) were found at that time, and the TSBAb had disappeared from her serum.

Adult↗

PubMed1986

Opioid inhibition of luteinizing hormone secretion during the postpartum period in suckled beef cows.

Recent studies have shown that naloxone (N), an opioid antagonist, increases concentrations of luteinizing hormone (LH) in the postpartum anestrous beef cow. However, the LH response to N was influenced by the postpartum interval. For example, a significant LH response to 200 mg of N occurred on d 42 but not on d 14 or 28 postpartum. The present study was conducted to determine the effect of different doses of N on LH secretion during the postpartum period of beef cows. Twelve cows were given 200, 400 or 800 mg of N on d 14, 28 and 42 postpartum in a Latin square design with repeat measures within cells. On d 14, serum concentrations of LH increased (P less than .01) from .5 +/- .1 ng/ml (mean +/- SE) before N to a peak of 2.0 +/- .5 and 1.4 +/- .5 ng/ml for cows given 400 and 800 mg of N, respectively. In contrast, 200 mg of N had no effect on serum concentrations of LH. On d 28 and 42 all three doses of N elevated (P less than .01) serum concentrations of LH. Therefore, a larger dose of N was required to increase serum concentrations of LH on d 14 postpartum compared with d 28 and 42. Based on these data we suggest that endogenous opioids participate in the regulation of LH secretion in the early postpartum period. The differential response to naloxone may be due to changes in endogenous opioid inhibition of LH secretion during the postpartum period.

Animals↗

PubMed1992

Urinary ascites in the immediate postpartum period.

New onset ascites in the immediate postpartum period is a rare occurrence most often associated with the Budd-Chiari syndrome. We report a patient who developed postpartum ascites secondary to an intraperitoneal bladder perforation.

Adult↗

PubMed1989

Dietary cravings and aversions in the postpartum period.

Although food cravings and aversions are commonly experienced by pregnant women, the degree to which they persist in the postpartum period is unknown. This study examines this issue in both lactating and nonlactating women. A random sample of 463 subjects was selected from all prenatal patients receiving care at a large health maintenance organization (HMO). Even though almost all of the subjects reported craving some food or beverage during the last trimester of pregnancy and half reported some aversion, those phenomena dropped markedly in the postpartum period. Evaluation of dietary quality as related to food cravings revealed no clear association; that is, the data provided no evidence to support the hypothesis that cravings are caused by dietary deficiencies or that they result in significantly augmented intake of key nutrients found in those foods. Overall, food cravings and aversions do not continue into the postpartum period at a higher rate than one would expect in the adult female population; manifestation of food cravings/aversions is not related to dietary quality.

Female↗

PubMed2005

Comparison of the calving-to-conception interval in dairy cows with different degrees of lameness during the prebreeding postpartum period.

OBJECTIVE: To compare calving-to-conception intervals among cows classified as nonlame, moderately lame, or lame during the prebreeding postpartum period and to examine the relationship between severity of lameness and time to conception in cows that were classified as lame. DESIGN: Longitudinal study. ANIMALS: 499 Holstein cows. PROCEDURE: Cows in the prebreeding postpartum period were classified as nonlame, moderately lame, or lame by use of a 6-point locomotion scoring system. Time to conception (days) was compared among cows. A low, medium, or high cumulative locomotion score was assigned to lame cows, and time to conception among those cows was compared. Cows classified as lame were examined on a tilt table for diagnosis and treatment of lameness. RESULTS: 154 (31%), 214 (43%), and 131 (26%) cows were classified as nonlame, moderately lame, and lame, respectively. Most cows classified as lame had laminitis (54%) or disorders of the claw (33%). Median time to conception was 36 to 50 days longer in lame cows than in nonlame cows. Among lame cows, the median time to conception was 66 days longer in cows with high cumulative locomotion scores than in cows with low scores. CONCLUSION AND CLINICAL RELEVANCE: Nonlame cows became pregnant more quickly than lame cows. Lame cows with low cumulative locomotion scores during the prebreeding postpartum period became pregnant sooner than lame cows with high scores. Early diagnosis and intervention may mitigate the effects of lameness and improve reproductive performance in lame dairy cows.

Animals↗

PubMed2003

Urinary incontinence in the 12-month postpartum period.

OBJECTIVE: To describe the prevalence and severity of urinary incontinence in the 12-month postpartum period and to relate this incontinence to several potential risk factors including body mass index, smoking, oral contraceptives, breast-feeding, and pelvic floor muscle exercise. METHODS: Participants were 523 women, aged 14 to 42 years, who had obstetrical deliveries. The women were interviewed in their rooms on postpartum day 2 or 3 and by telephone 6 weeks, 3 months, 6 months, and 12 months postpartum. Chart abstraction was conducted to obtain obstetrical data from the index delivery. RESULTS: At 6 weeks postpartum, 11.36% of women reported some degree of urinary incontinence since the index delivery. Although the rate of incontinence did not change significantly over the postpartum year, frequency of accidents decreased over time. In the generalized estimating equation, postpartum incontinence was significantly associated with seven variables: baseline report of smoking (odds ratio [OR] 2.934; P =.002), incontinence during pregnancy (OR 2.002; P =.007), length of breast-feeding (OR 1.169; P =.023), vaginal delivery (OR 2.360; P =.002), use of forceps (OR 1.870; P =.024), and two time-varying covariates: frequency of urination (OR 1.123; P = <.001) and body mass index (OR 1.055; P =.005). Factors not associated with postpartum incontinence included age, race, education, episiotomy, number of vaginal deliveries, attendance at childbirth preparation classes, and performing pelvic floor muscle exercises during the postpartum period. CONCLUSION: Postpartum incontinence is associated with several risk factors, some of which are potentially modifiable and others that can help target at-risk women for early intervention.

Adolescent↗

PubMed2000

Acute pancreatitis in the postpartum period: a population-based case-control study.

OBJECTIVE: To determine relationships among pregnancy (during and postpartum), acute pancreatitis, and gallstones. PATIENTS AND METHODS: In this retrospective population-based case-control study, we identified all 12- to 50-year-old Rochester, Minn, females diagnosed between 1976 and 1991 as having acute pancreatitis (cases). For each case, we matched 4 women of the same age (+/- 6 years) with no history of acute pancreatitis (controls). Acute pancreatitis was defined as associated with pregnancy if it occurred from 10 months prior to delivery to delivery and with the postpartum period if it occurred within 10 months of the date of delivery. Logistic regression was used to assess associations between pregnancy-related acute pancreatitis, age, gallstone occurrence, and alcohol use. RESULTS: In a cohort of 61 women who developed acute pancreatitis and 244 controls, the relative risk for acute pancreatitis associated with pregnancy was 1.43 (95% confidence interval, 0.61-3.40). All 10 cases of acute pancreatitis associated with pregnancy occurred in the postpartum period. Gallstones were present in 6 of them compared with 13 of 51 women with non-pregnancy-related acute pancreatitis (P < .05). Women with postpartum-related pancreatitis were younger than those with non-pregnancy-related pancreatitis (mean, 28 vs 36 years; P < .05). Alcohol was not associated with pregnancy-related pancreatitis. CONCLUSIONS: Acute pancreatitis during the postpartum period is not directly related to pregnancy but is associated with gallstones and occurs in younger women.

Acute Disease↗

PubMed1999

The thyroid immunology of the postpartum period.

Autoimmune thyroid disease (AITD) is suppressed during pregnancy and is exacerbated in the postpartum period. Studies indicate that new-onset AITD occurs in up to 10% of all women in the postpartum period and that up to 60% of Graves' patients in the reproductive years give a history of postpartum onset. Despite this extraordinary epidemiological evidence, the causes of these exacerbations are uncertain and have yet to be adequately investigated. Explaining these postpartum changes, therefore, remains hypothetical. Mechanisms invoked include the passage of fetal cells to the mother during pregnancy establishing maternal microchimerism, pregnancy-induced changes in the thyroid gland itself, and the role of prolactin as a consequence of breast-feeding. Once the disease onset or exacerbation, is established, then there have been considerable advances in our understanding of the immunopathology. Thyroid cell destruction (via apoptosis) or activation (via thyrotropin [TSH] receptor autoantibody induction) appear to be similar to nonpostpartum-related disease. The reasons for the transience in postpartum disease, particularly thyroiditis, is likely to be related to the induction of clonal suicide and the mechanisms for this phenomenon are beginning to be explored. While we have a number of clinical indicators that allow us to predict postpartum thyroid disease (such as autoantibody titers), at present, we have no treatment to prevent the disease. Furthermore, our predictions are not helpful in a high enough proportion of the population to warrant screening of all women before delivery. At this time, the best clinical approach is watchful waiting and postpartum thyroid function testing where suspected.

Female↗

PubMed2002

Pulmonary embolism during pregnancy and the postpartum period: report of 2 cases.

OBJECTIVE: To investigate the high risk factors, clinical features, diagnosis and treatment of pulmonary embolism (PE) during pregnancy and the postpartum period. METHODS: Two cases of PE during pregnancy and postpartum period were reported retrospectively. RESULTS: The first case was a pregnant woman with congenital heart disease at 39-week gestation. She underwent a successful cesarean section (CS) because of heart disease, but she manifested tachycardia, tachypnea, cyanosis, and dyspnea suddenly on the 10th day after CS and died soon after the onset of these symptoms. The diagnosis of PE was highly suspected clinically. The second case was a twin-pregnancy woman at 35-week gestation. Because of severe perinatal myocardiopathy, cesarean section was performed. Unfortunately, the patient died abruptly on the operation table. The diagnosis of PE was confirmed by autopsy. CONCLUSIONS: The maternal mortality of PE during pregnancy and postpartum period is quite high. Whenever there is any doubt, objective examinations for PE should be started early in order to strive for the chances of the anticoagulant therapy.

Adult↗

PubMed2001

Non-MHC driven exacerbation of experimental thyroiditis in the postpartum period.

Many human autoimmune diseases, including those of the thyroid gland, are affected by immune changes during pregnancy and the postpartum period. To investigate this influence, we have developed an animal model of pregnancy thyroiditis by using thyroglobulin (Tg)-induced experimental autoimmune thyroiditis (EAT). We now report a study of the post-partum period in mice with EAT. At 5 weeks postpartum, which was 9 weeks after the completion of a Tg immunization regime, the mean thyroiditis grade was significantly increased in the postpartum group from 0.23 to 0.43 (p<0.05) and the thyroiditis Index, which reflected both the frequency and severity of thyroiditis, was similarly increased compared to controls (29.0 vs 9.0). When Tg immunized CBA/J (H-2k) female mice were mated with BALB/c (H-2d) males, there was a similar increase in the severity of thyroiditis in the postpartum period as seen with CBA/J males suggesting that allogeneic factors were not able to further this postpartum exacerbation. Spleen cell IL-4 secretion was enhanced in the postpartum but only in the presence of thyroiditis indicating enhanced activity of Th2 immune responses. There were no differences in IFN-gamma secretion, titers of anti-Tg, CD8+ & CD4+ T cells and T cell chemokine receptor (CCR5, CCR3) expression between non-pregnant control mice with thyroiditis and postpartum thyroiditis. In summary, we found that the severity of EAT during the postpartum was significantly greater than in non-pregnant control mice and was associated with enhanced Th2 immune responses. The allogenicity of the pregnancy had no influence on these findings. The lack of allogenic impact was in contrast to earlier observations in pregnancy itself where an exacerbation of thyroiditis was male strain-dependent and involved primarily Th1 responses. This indicated that the postpartum exacerbation of autoimmune thyroid disease was not a simple response to fetal antigens but secondary to unique postpartum factors.

Animals↗

PubMed2002

Advances in bovine theriogenology in New Zealand. 1. Pregnancy, parturition and the postpartum period.

Unique systems of breeding and calving management have been developed to allow New Zealand cattle herd owners to maintain seasonally concentrated calving patterns. Improved pastures are used as the sole ration for most beef and dairy cows with limited conservation and no grain feeding. Patterns of calving are described in relation to herd Planned Start of Calving (PSC) dates, calculated as 282 days after the first date of insemination in the preceding seasonal artificial breeding (AB) programme. Corticosteroids have been systematically used in over 80% of New Zealand dairy herds to induce premature parturition (calving induction) during the third trimester of pregnancy for about 25 years, to condense calving patterns into periods of 6-12 weeks. Widespread use of calving induction has minimised the adverse effects of declining reproductive performance in dairy herds on the sustainability of seasonally concentrated calving. The use of calving induction is now discouraged on animal welfare grounds and due to possible consequences for the marketing of New Zealand dairy products. Recent declines in the reproductive performance of dairy herds are linked to increased prevalence of extended periods of postpartum anovulatory anoestrus (AA), which has become the major form of infertility in dairy herds in New Zealand and can be related to reliance on grazed pasture as the sole diet for cows of increasing genetic merit. The prevalence of AA is influenced by by parity, breed, recent genetic origin within a breed, body condition score, herd and year. management strategies such as once-daily milking, preferential grazing or feeding of silage, have not proven as successful as hormonal treatments. Although seasonal concentrated calving has remained a standard feature of the industry's low-cost, pasture-based system of management, continuing research will be required to economically maintain this pattern.

Journal Article↗

PubMedDate not supplied

[The molecular variants of thyroxine-binding protein and the concentration of a number of hormones in the blood in the postpartum period].

The serum concentrations of the total thyroxine-binding globulin (TBGt), its pregnancy-associated molecular variant (TBG-1), thyroxine, progesterone, estradiol, and prolactin were measured by radioimmunoassay in the course of the postpartum period (0-40 days) in women. High serum TBG-1 concentrations (an average of 36% of the level observed at the time of delivery) were unexpectedly detected in the late postpartum period (days 36-40) when the concentrations of TBGt, thyroxine, estradiol and progesterone were within normal. The presence of TBG-1 in the maternal blood for a long time after delivery may be caused by estrogen-dependent synthesis and secretion rather than by its slow clearance from the blood.

Adolescent↗

PubMed2004

A comparison of sleep and daytime sleepiness in depressed and non-depressed mothers during the early postpartum period.

Taiwanese mothers have identified insufficient sleep as a major manifestation of postpartum depression. Few studies have thoroughly examined the relationship between sleep and depression during the early postpartum period, however. The objectives of this study were to compare the characteristics of both the postpartum sleep and daytime sleepiness of depressed first-time mothers and of their non-depressed counterparts, and to determine the factors that significantly increased mothers' risks of being depressed. A non-probability sample of 163 first-time mothers completed a questionnaire between the 13th and 20th days of the postpartum period. The Center of Epidemiological Studies- Depression and Pittsburgh Sleep Quality Index were used to measure mothers' experiences of depression symptoms and sleep. Daytime sleepiness was estimated in four ways, derived from the Roy Adaptation Model. The results indicated that the depressed mothers had poorer sleep quality than the non-depressed mothers, slept less efficiently, reported more sleep disturbances, and exhibited more daytime dysfunctions. Mothers who frequently perceived their daytime sleepiness to be affected by infant-care performance were more likely to be depressed. The study' s findings support the view that there is a connection between depression and poor sleep among postpartum mothers in Taiwan, and indicate that depressed mothers' experiences of poor sleep are multi-faceted, and not simply a matter of insufficient sleep.

Adaptation, Psychological↗

PubMed1996

Hypothalamic corticotropin-releasing hormone suppression during the postpartum period: implications for the increase in psychiatric manifestations at this time.

The third trimester of human pregnancy is characterized by a hyperactive hypothalamic-pituitary-adrenal axis, possibly driven by progressively increasing circulating levels of placental CRH and gradually decreasing levels of CRH-binding protein. The postpartum period, on the other hand, is characterized by an increased vulnerability to psychiatric manifestations (postpartum "blues," depression, and psychosis), a phenomenon compatible with suppressed hypothalamic CRH secretion. To investigate the hypothesis that the postpartum period is associated with suppression of hypothalamic CRH secretion, we studied prospectively 17 healthy euthymic women (mean +/- SE age, 32.0 +/- 1.1 yr) with no prior history of depression, starting at the 20th week of gestation. Psychometric testing was performed monthly during pregnancy and postpartum on day 2 and weeks 2, 3, 6, 8, 12, 16, and 20, whereas serial ovine (o) CRH tests were performed postpartum at 3, 6, and 12 weeks. While pregnant, all 17 subjects remained euthymic; in the postpartum period, 7 women developed the "blues," and 1 developed depression. Overall, the mean plasma ACTH response to an iv bolus of 1 microgram/kg oCRH was markedly blunted at 3 and 6 weeks, but normal at 12 weeks postpartum, whereas the mean plasma cortisol response was at the upper limit of normal at all 3 times. These data are compatible with a suppressed hypothalamic CRH neuron that gradually returns to normal while hypertropic adrenal cortexes are progressively down-sizing. When the postpartum ACTH responses to oCRH were analyzed separately for the euthymic women and the women who had the "blues" or depression, the blunting of ACTH was significantly more severe and long lasting in the latter group; this was observed at all 3 times of testing. We conclude that there is central suppression of hypothalamic CRH secretion in the postpartum, which might explain the increased vulnerability to the affective disorders observed during this period. The suppressed ACTH response to oCRH might serve as a biochemical marker of the postpartum "blues" or depression.

Adrenocorticotropic Hormone↗

PubMed1995

Hmong cultural practices and beliefs: the postpartum period.

The purpose of this study was to explore the cultural practices and beliefs of the Hmong in the postpartum period. Using the qualitative research method of in-depth interviewing, data were collected through semistructured interviews. A convenience sample of 52 childbearing Hmong women was interviewed with the help of Hmong interpreters. The interviews were audiotaped and transcribed for analysis. Data analysis revealed cultural practices and beliefs categories related to diet, rest period, appropriate clothing, breast feeding, and sex practices in the postpartum period. Implications for nursing include both cultural sensitivity and an understanding of such traditional practices, before suggesting or implementing any health-promotion activities.

Adolescent↗

PubMed1986

Iodoprotein formation by rat mammary glands during pregnancy and early postpartum period.

Iodide organification by rat mammary glands was studied during the trimesters of pregnancy and early postpartum period. Organification was followed by measuring trichloroacetic acid (TCA) precipitation of delipidated tissue homogenates. The radiolabeled material was sensitive to proteolytic cleavage by a bacterial protease indicating that the 125I was protein-bound. Gel filtration column chromatography in the presence of sodium dodecyl sulfate (SDS) of delipidated mammary tissue homogenates of pregnant and postpartum rats reproducibly resolved several iodoproteins from free iodide. The Kav value for each iodoprotein peak was calculated and was used to estimate each subunit molecular weight which averaged 37,500, 25,100, and 8500. Another iodoprotein with a very large subunit molecular weight of greater than 300,000 was also detected in mammary tissue. Incorporation of 125I-iodide into the three smaller iodoproteins increased logarithmically from the start of the second trimester of pregnancy through the early postpartum period when approximately 20% of the total 125I uptake by mammary tissue was incorporated into protein. Hyperplasia, acinar development, and intracytoplasmic vacuolization of mammary tissue correlated with the increased incorporation of 125I-iodide into these iodoproteins. The characterization and quantitation of specific iodoproteins in mammary tissue may be important as organification of iodide is believed to be a marker for normal hormone-responsive cells.

Animals↗