Delayed and prolonged labor, placental retention, and hemorrhages in rabbits.
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Animals↗
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Results for “Placenta, Retained”
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Effect of oral misoprostol after second-trimester delivery: a randomized, blinded study.
OBJECTIVE: To determine whether serial oral misoprostol shortens the third stage of labor in second-trimester pregnancy loss. METHODS: This was a randomized, double-blind, placebo-controlled study of women between 13 and 28 weeks' gestation admitted for spontaneous or induced pregnancy termination. Subjects were randomized to receive either misoprostol (200 microg) or placebo orally every hour for a maximum of three doses if the placenta had not delivered spontaneously within 10 minutes of the fetus. A dilute oxytocin infusion was given to women in both groups. The patients were managed expectantly until intervention was required or up to 6 hours when curettage was scheduled. RESULTS: One hundred eighteen women were randomized to misoprostol and 119 randomized to placebo. Fifty-eight (49%) and 55 (46%) of the misoprostol and placebo groups, respectively, did not receive their medication (P =.65, chi(2) test). There was no difference between the groups with regard to demographic features, method of pregnancy termination, or gestational age. Sixty-seven (57%) and 62 (52%) of the misoprostol and placebo groups, respectively, completed the third stage of labor within 2 hours (P =.47, chi(2) test). There was no statistically significant difference in the median time from fetus to placenta (60 versus 91 minutes in the misoprostol versus placebo group, P =.57, Mann-Whitney U test). There was no difference between the groups in the incidence of hemorrhage, need for transfusion, or curettage rate. CONCLUSION: The therapeutic use of oral misoprostol in the third stage of labor in second-trimester pregnancy loss does not reduce the time to complete spontaneous placental delivery.
Abortifacient Agents, Nonsteroidal↗
Bacteriological and epidemiological findings during examination of the uterine content of ewes with retention of fetal membranes.
We included 92 pairs of ewes with or without retention of fetal membranes in a cohort study of 25 flocks in Southern Greece. We obtained two uterine content samples under aseptic conditions, by introducing a swab into the uterus of these ewes, on the 2nd-4th and the 5th-9th day after lambing. We used conventional bacteriological techniques to isolate and identify bacteria and to carry out antimicrobial agents susceptibility testing. The prevalence of bacterial intrauterine contamination among ewes with retention was 24% on the first and 46% on the second sampling (P < 0.0001) and that among ewes without retention was 8 and 2% (P > 0.05), respectively. Clinical signs accompanying the retention of fetal membranes were more frequently observed among ewes with intrauterine contamination than among those without (P = 0.0007). The odds of an ewe having an intrauterine contamination increased multiplicatively by 1.06 when the median duration of retention in the flock increased by 6 h. The principal bacteria isolated from the ewes with retention were Arcanobacterium pyogenes and Escherichia coli; 21% of 73 isolates tested were found resistant to at least one antimicrobial agent.
Actinomycetaceae↗
Ethnoveterinary medicines used for ruminants in Trinidad and Tobago.
Ethnoveterinary research was conducted in Trinidad and Tobago in 1995, in order to document existing ethnoveterinary practices. This paper describes 20 medicinal plants used to treat ruminants. The main plants used were Azadirachta indica and Curcuma longa. Medicinal plants were used predominantly for endoparasites, internal and external injuries and pregnancy-related conditions. A 4-stage process was used to conduct the research and document the ethnoveterinary practices. This documentation could provide a foundation for the further scientific study and verification of those practices which merit such study.
Animals↗
Incidence risk and clinical features of retention of foetal membranes in ewes in 28 flocks in southern Greece.
In a field investigation of 28 flocks in southern Greece, 7660 lambings were monitored. Retention of foetal membranes (defined as failure to expel the foetal membranes within 6 h of lambing the last lamb) was recorded in 92 ewes. The median within-flock incidence risk was 1.25% (range: 0-1.9%). The heterogeneity of the risk among flocks was not significant (p = 0.99); no correlation was found between the incidence risk and the flock size (r(sp) = 0.33, p = 0.09). Overall, the median duration of retention was 72 h (range: 9-288 h); it did not differ among flocks (p = 0.89) and was not correlated with flock size (r(sp) = 0.24, p = 0.27). During the initial stage of retention the membranes were fleshy and humid; the cotyledons were thick and congested. Progressively, the membranes became thin, dry and stringy; the cotyledons shrunk and were pale. Finally the membranes dropped as a mass. In ewes with retention for >12 h, a variety of accompanying signs was recorded: straining (in 22% of the ewes with retention), vulval oedema and reddening (in 16%), anorexia (in 13%), recumbency (in 13%) and increased temperature (in 12%) were the most frequent ones. Overall, the median clinical score of the disorder was '2' (range: '1'-'5'); it did not differ among flocks (p = 0.98) and was not correlated with flock size (r(sp) = 0.26, p = 0.25). In 4% of the ewes with retention for <4 days accompanying signs were recorded (median clinical score: '2'), whilst in 80% of the ewes with retention for > or =4 days accompanying signs were recorded (median clinical score: '3'). This difference in the prevalence of clinical signs was significant (p < 0.0001).
Animal Husbandry↗
A matched case-control study of factors associated with retention of fetal membranes in dairy ewes in Southern Greece.
We defined retention of fetal membranes (RFM) in dairy ewes as failure to expel the placenta within 6h after lambing the last lamb and designed a matched case-control study to identify factors that affect the risk of retention. For each ewe with RFM, the next ewe in the flock that lambed and expelled the placenta in <6h after lambing the last lamb was selected as control. Data analyzed included 92 pairs of ewes from 25 flocks comprising a total of 7275 ewes (median flocksize 270 ewes). Factors investigated for associations with RFM were induction of lambing, obstetrical assistance because of dystocia, parity, the number of liveborn lambs, the occurrence of stillbirth(s), the mean weight of the litter on the third day post-lambing and the occurrence of neonatal death in the litter. Conditional logistic regression indicated (1) that the risk of RFM increased linearly with increasing number of liveborn lambs and (2) that the risk of retention was 4-fold higher in ewes that received assistance at lambing than those that lambed normally.
Animal Husbandry↗
Vesicouterine fistula after manual removal of placenta in a woman with previous cesarean section.
Vesicouterine fistula is one of the less common acquired urogenital fistula and a rare event in obstetrics. We report a case which occurred after a vaginal delivery followed by manual removal of placenta in a woman who had a previous cesarean section. The fistula was successfully repaired 5 weeks after delivery.
Adult↗
Equine reproductive pharmacology.
This article reviews therapies and strategies commonly used to treat diseases of the mare's genital tract and modulate the reproductive cycle of the mare. Many reproductive treatments are based on historical use and empirical evidence rather than well controlled clinical studies. This article attempts to present practical information in a summary form while highlighting the need for continued research documenting the efficacy and safety of reproductive therapies.
Abortion, Veterinary↗
Tongue piercing and obstetric anesthesia: is there cause for concern?
The practice of oral tissue piercing, until recently, has been limited mainly to various native tribes in Africa. However, in recent years, body piercing (including oral tissue piercing), has become increasingly popular in the United States and Europe. We present a case of an obstetric patient who presented for emergency postpartum surgery with fixated tongue jewelry in situ, which resulted in trauma to the tongue and difficult airway management. The difficult airway management consisted of tongue bleeding at the time of laryngoscopy and tongue edema at extubation. We consider these two events to be near misses of "cannot intubate" and "cannot ventilate" situations, respectively. Because the popularity of body piercing is increasing in our society, it is reasonable to expect that the incidence of oral jewelry interference with airway management will also increase. Based on this experience, we advise laboring patients with oral jewelry to remove the hardware before receiving anesthesia for safety reasons.
Adult↗
Management of the third stage of labor: an evidence-based approach.
The third stage of labor usually is eclipsed by the excitement of the birth of a baby. Evidence shows that management of this stage can directly influence important maternal outcomes such as blood loss, need for manual removal of the placenta, and postpartum hemorrhage. Most of the large trials have compared active management of the third stage to expectant management. Active management includes routine use of cord traction and uterotonins, whereas expectant management can be characterized as one of watchful waiting. The use of herbal therapies and homeopathic remedies lack study; additional factors such as site of birth and hydrotherapy also remain to be explored. However, on the basis of current evidence, if a decrease in postpartum bleeding or avoidance of manual removal is desired, an active approach to third stage is the one that should be adopted until and unless contradictory findings are published.
Adult↗
[Experience in a suburban hospital with premature termination of pregnancy in the second trimester].
The present study was performed between 1992 and 1998 and had the aim of examining the activity and side-effects of intravenously administered sulprostone for the induction of abortion in the second trimester. 160 patients were admitted to hospital. 3 were submitted to a hysterectomy; 3 underwent an abortion after cervical priming with Prostin E2 Gel (0.25 mg/ml), 154 were repeatedly treated with an infusion of sulprostone for 6 hours (500 microg Nalodor, 3 A/1000 ml 0.9% NaCl, 250 microg/h (equivalent to 4.17 microg or ca. 55 drops per min.). The mean interval for induction of abortion was 16 h 56 min; 53% of the abortions occurred within 12h; 95% of the abortions occurred within 48 h. Two inductions were unsuccessful. 12 women suffered from atonic bleeding. This study demonstrated that sulprostone infusions are suitable for the induction of abortions in the second trimester and that side-effects are rare. Particular attention must be paid to the complication of bleeding.
Abortion, Eugenic↗
Pregnancy-specific protein B (bPSPB) and progesterone monitoring of post-partum dairy cows with placental retention.
The relationship between placental retention, progesterone and pregnancy-specific protein B (bPSPB) was determined in 60 calving Holstein cows. The cows were divided into two groups with placental retention (WPR, n = 16) and no placental retention (NPR, n = 44). Every 4 days, until 60 days post-partum, blood samples were taken and the uteri were checked using ultrasonographv. The puerperal characteristics of NPR and WPR were as follows: mean days of abnormal vaginal discharge: 20.2+/-5 versus 35.6+/-7 (P < 0.01); mean intervals to uterine involution: 21.4+/-3.7 versus 27.6+/-7.6 days (P < 0.01); rate of endometritis: 25 versus 100% (P < 0.01). The mean numbers of oestrus cycles per cow were 1.75+/-0.5 versus 0.85-/+0.9 (P < 0.05) and the mean durations of the first oestrus cycle were 18+/-3.5 versus 16+/-2.1 days (P > 0.05). The mean intervals to first ovulation were 21.5+/-8.4 versus 35+/-19 days (P < 0.01). bPSPB blood concentrations were higher in the WPR group at calving with 955+/-170 versus 750+/-205 ng/ml (P < 0.01) and also during the first 32 days post-partum with 173.68+/-47.3 versus 131.0+/-29.2 ng/ml (P < 0.01). The mean bPSPB half-life was similar in the two groups: 6.9+/-2.5 versus 6.5+/-2.1 days (P > 0.05). In conclusion, it was found that placental retention was associated with a higher rate of endometritis, a lower number of cycles, longer interval to first post-partum ovulation and higher concentration of bPSPB at calving and during the post-partum period. The positive relationship between bPSPB concentrations and calf birth weight and their association with post-partum pathological events may be useful in monitoring animals presenting high concentrations at calving.
Animals↗
Placental release/retention in cows and its relation to peroxidative damage of macromolecules.
The disturbances in metabolic pathways reflected in clinical symptoms of illnesses may be connected, among others, with the imbalance between production and neutralization of reactive oxygen species. One of such illnesses may be the retention of fetal membranes in cows. The levels of reactive oxygen species can be measured directly or estimated indirectly by the determination of enzymatic and non-enzymatic antioxidative defence systems. The determination of parameters indicating the intensity of peroxidative processes of lipids, proteins and nucleic acids caused by reactive oxygen species is also useful. This review examined the available literature regarding peroxidative processes of lipids, proteins and nucleic acids caused by reactive oxygen species as well as parameters indicating its intensity. All information relates the importance of proper and improper placental release in cows.
Animals↗
Sonographic follow-up of a placenta left in situ after delivery of the fetus in an abdominal pregnancy.
A case of abdominal pregnancy was followed until 34 weeks' gestation, when rupture of the amniotic sac was noted. A live and anatomically normal female weighing 1400 g was delivered by laparotomy and the placenta was left in place. Color Doppler imaging and measurement of serum beta-human chorionic gonadotropin (beta-hCG) were successfully used to follow the placental involution after delivery. A progressive increase in the resistance index in the utero-ovarian and subplacental vessels was observed while beta-hCG disappeared 45 days after laparotomy. The mother and baby left hospital 20 days after delivery and are both doing well.
Adult↗
Placental polyp: power Doppler imaging and conservative resection.
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Adult↗
Complicated third stage of labor: time to switch on the scanner.
This Editorial chronicles the current experience in ultrasound usage during pathologic events occurring in the third stage of labor. Further improvement in the technology for carrying out clinical research will improve our knowledge so that more information can be gleaned from this modality to bestow optimal management for such potentially dangerous conditions. Awareness of the capabilities of sonography may provide the motivation for its use, and obstetricians are encouraged to scan the third stage of normal deliveries for better recognition of normal findings and improved assessment of abnormal ones. Although final decisions should be based mainly upon sound clinical judgement, we contend that complicated third stage of labor warrants turning on the scanner.
Delivery, Obstetric↗
Gray scale and color Doppler sonography in the third stage of labor for early detection of failed placental separation.
OBJECTIVE: The purpose of this study was the characterization of normal and abnormal third stage placental separation using gray scale and color Doppler sonography. METHODS: The third stage of labor was examined in 62 patients using gray scale and color Doppler sonography. After identification of placental basal plate vessels by color Doppler sonography, the placentation site was examined throughout the third stage with combined gray scale and color Doppler mode. Placental separation from the myometrium was defined clinically and correlated to cessation of color Doppler detected blood flow in basal plate vessels. RESULTS: Three sonographic phases of placental separation were: (1) latent = interval between delivery of the fetus and beginning placental separation; (2) detachment = mono- or multiphasic shearing off of the placenta and (3) expulsion = interval between completed separation and vaginal delivery of the placenta. In 57 cases with clinically normal placental separation blood flow between placenta and myometrium ceased immediately after delivery of the fetus during the latent period. In five cases manual or instrumental removal was necessary because of placenta adhaerens in one case and placenta accreta in four cases. The latter showed maternal blood flow from the myometrium deep into the placenta beyond the latent phase. CONCLUSION: Cessation of blood flow between the basal placenta and myometrium following delivery of the baby is the sonographic hallmark of normal placental separation. Persistent blood flow demonstrated by color Doppler sonography is suggestive of placenta accreta.
Adult↗