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PubMed1992

Rat ovarian angiotensin II receptors, renin, and angiotensin I-converting enzyme during pregnancy and the postpartum period.

The ovarian renin-angiotensin system (RAS) has been studied extensively in the virgin cycling rat, but little information is available about this system in pregnant and postpartum rats. We show that renin and angiotensin I-converting enzyme (ACE)--the key enzymes involved in angiotensin II (Ang II) formation--and Ang II receptors, are present in pregnant and postpartum rat ovaries. From gestation Days 2-4 to 10-12, active ovarian renin ranged from 1.12 +/- 0.13 to 1.27 +/- 0.19 ng Ang I/h/mg and comprised between 68 and 86% of total (active+inactive) ovarian renin activity. Between Days 10-12 and Days 14-16 of pregnancy, ovarian active renin activity increased slightly, but inactive renin disappeared, suggesting its activation; the remaining active renin then decreased 62% by Days 18-20 (p < 0.05). On postpartum Day 2, both active and total ovarian renin activity exceeded that of Days 2-20 of pregnancy (p < 0.05); levels of both then declined sharply by postpartum Day 3 (p < 0.05). In pregnant rats, levels of ovarian Ang II receptors, identified by the specific binding of [125I]-[Sar1,Ile8]Ang II to ovarian membranes, were high between Days 2-4 and 10-12 of pregnancy, ranging from 12.8 +/- 1.7 to 15.7 +/- 3.4 fmol/mg, but steadily declined by 82% between gestation Days 10-12 and 18-20 (p < 0.05). Postpartum Ang II receptor levels on Days 2, 3, and 4 showed a gradual increase from low levels comparable to Days 18-20 of pregnancy. Ovarian ACE activity did not change throughout pregnancy or during the postpartum period.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1998

Effect of naloxone on serum luteinizing hormone concentration in anovulatory Holstein cows during the early postpartum period.

This experiment was conducted to investigate the effect of naloxone (NAL), an opioid receptor antagonist, on pituitary LH secretion in anovulatory Holstein cows during the early postpartum period when cows were expected to be in negative net energy balance. Twenty-three cows (11 primiparous) received either saline (n = 12) or 1 mg/kg BW NAL i.v. (n = 11) on Day 14 or 15 postpartum. Jugular blood samples were collected at 15-min intervals for 2 hr before and 2.5 hr after NAL or saline. All cows received 3 ug gonadotropin releasing hormone (GnRH) at 2.5 hr post-NAL or -saline and blood collection was continued for 1 hr. Mean serum progesterone concentration was 0.33 +/- 0.2 ng/ml. Mean net energy balance for all cows was -5.5 +/- 0.6 Mcal/day. Naloxone caused a transient increase (P < 0.05) in serum LH concentrations in both primi- and multiparous cows within 45 min after administration. In contrast, serum LH concentrations remained unchanged in saline-treated cows. GnRH increased (P < 0.05) LH and there was no effect of treatment. These results suggest that modulation of LH secretion, at least in part, may be mediated via endogenous opioids in dairy cows before first postpartum ovulation.

Animals↗
PubMed2004

Intravenous corticosteroids in the postpartum period for reduction of acute exacerbations in multiple sclerosis.

In order to assess the effectiveness of monthly intravenous corticosteroids in reducing childbirth-associated acute exacerbations in multiple sclerosis (MS), we compared pregnant patients followed up in our MS clinic. During the first period (1996-1998), 22 patients did not receive any treatment after delivery. During the second period (1999-2001), following the publication of the PRIMS study, 20 patients were treated monthly with 1 g of intravenous corticosteroids during the six months of the postpartum period. In both groups the relapse rate increased during the first trimester postpartum but it was higher in the untreated group (2+/-0.66 [mean+/-SD]) compared with the treated group (0.8+/-0.41) (P=0.018), suggesting a beneficial effect of monthly intravenous corticosteroids.

Acute Disease↗
PubMedDate not supplied

Use of the hospital postpartum period for population-based research.

A survey method was developed to conduct population-based research on behaviour in pregnancy by contacting women during the postpartum period in hospital. 85.8% of the eligible women completed the questionnaire in hospital, and follow-up measures increased the response rate to the full questionnaire to 90.8%. A shorter version of the questionnaire was completed by another 3.7% of the women for an overall response rate of 94.5%. The test-retest reliability of the questionnaire was high. This method was very acceptable to women. Non-response was due mainly to women who were missed or to lost questionnaires rather than refusal. It is important to have a high response rate on similar surveys since responders did differ from non-responders on important characteristics. This method should prove useful to other health care planners.

Data Collection↗
PubMed1986

Pleural effusions in the postpartum period.

We report on the high frequency of pleural effusions in the immediate postpartum period. Forty-four out of 45 women whom we examined within 24-48 h after delivery showed evidence of pleural fluid. Under these circumstances, this pleural abnormality should not be considered an indicator of serious cardiopulmonary disease.

Adult↗
PubMedDate not supplied

[Plasma progesterone and ovarian findings related to plasma glucose and acetoacetat in the postpartum period in the cow (author's transl)].

Ovarian function and carbohydrate status were examined in 286 dairy cows. The cows, which were at various stages of the postpartum period, had their ovaries examined by one rectal palpation. Simultaneously with the clinical examination, one blood sample was taken for determination of progesterone, glucose and acetoacetate. In the period before 24 days post partum cows not having a corpus luteum had somewhat lower plasma glucose than cows having a corpus luteum (P less than 0.05). Cows not having a corpus luteum after 40 days showed a tendency to lower plasma glucose and higher plasma acetoacetate than cows having corpus luteum (P less than 0.05). Ovarian activity, expressed through frequency of high progesterone values (greater than or equal to 2 ng/ml), increased markedly after 40 days post partum, while the lowest glucose means and highest frequencies of acetoacetate greater than or equal to 2.5 mg/100 ml occurred before 30 days post partum. It is concluded that longitudinal studies post partum will be required to clarify the possible effect of hypoglycemia on the ovarian function.

Acetoacetates↗
PubMedDate not supplied

[Psychic disturbances in the postpartum period: an increasing problem?].

Postpartum psychic disorders can be mainly divided into 3 groups: The so-called postpartum blues, the postpartum depression and the postpartum psychosis. The postpartum blues occurs 3 - 5 days postpartum in 50 - 70 % of deliveries mostly disappearing after one week without specific therapy. However, 20 - 30 % of patients will develop a depression in their further postpartum course so that a thorough evaluation concerning depression is warranted, if blues symptoms persist more than 2 weeks. Postpartum depression can be found in 10 - 15 % of deliveries and mostly occurs several weeks or months after delivery with symptoms of depressive mood, sleeping disorders, anxiety, loss of interest and accord and feelings of guilt up to suicidal ideas. In order not to misinterpret them as postpartum blues specific questions concerning the mood of the young mother during the postpartum examination - if necessary using the Edinburgh scale - are recommended. In patients with known risk factors for a postpartum depression (i. e. postpartum depression or psychosis in previous pregnancies, depression disorder, anxiety disorder, bipolar illness), a thorough survey is mandatory and - if necessary - a prophylactic treatment in cooperation with the psychiatrist. Less severe forms of postpartum depression can mostly be treated with psychotherapy and sociotherapy on an outpatient basis. In more severe cases, antidepressant drugs (selective serotonin reuptake inhibitors, SSRIs or some tricyclic drugs) are indicated. Postpartum anxiety and compulsive disorders respond well to psychotherapy; besides in anxiety disorders benzodiazepines are recommended, in compulsive disorders SSRIs. Postpartum psychoses (about 0.1 - 0.2 %) most often occur in bipolar or schizoaffective disorders or after postpartum psychosis. They require a hopitalization mainly because of the danger of suicide and homicide toward the newborn; ideally this is performed in mother-child-units.

Adult↗
PubMed2005

Pruritic urticarial papules and plaques of pregnancy presenting in the postpartum period: a case report.

BACKGROUND: Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as polymorphic eruption of pregnancy, is the most common dermatosis of pregnancy. It usually evolves in the third trimester and resolves rapidly postpartum. CASE: A 25-year-old woman complained of an intensely pruritic rash for 2 days. The rash began 10 days postpartum. It began on her abdomen and spread to her buttocks, legs and upper arms. On examination, erythematous papules and urticarial plaques were present in the striae of the abdomen and buttocks and involved the legs, arms and back. No excoriations, vesicles or pustules were present, and there was sparing of the face, palms and soles. The patient was treated with fexofenadine, hydroxyzine, oatmeal baths and cool compresses. Follow-up 2 days later revealed a worsening rash and persistence of severe pruritus. At that time the patient was placed on prednisone, which led to relief of her symptoms and clearing of the rash. DISCUSSION: PUPPP is reported to develop in 0.5% of pregnancies. MEDLINE searches of the literature from 1966 to 2003 using the keywords pruritic urticarial papules and plaques of pregnancy or polymorphic eruption of pregnancy and postpartum revealed only 2 other cases of PUPPP developing in the postpartum period. Although the clinical presentation of this patient was typical of that of PUPPP, it demonstrates an unusual time course with its postpartum presentation. CONCLUSION: Dermatoses of pregnancy should remain in the differential diagnosis of rash even weeks after a woman delivers.

Adult↗
PubMed2003

Pregnancy-associated glycoprotein concentrations during pregnancy and the postpartum period in Azawak Zebu cattle.

Specific RIA systems were developed and used to measure pregnancy-associated glycoprotein (PAG) concentrations during gestation and the postpartum period in Azawak Zebu cows. Twelve females were palpated per rectum and diagnosed as pregnant. Blood samples were taken at 5-10-day intervals from approximately Week 8 of gestation until Week 10 postpartum (pp). One Zebu cow (Z15) initially diagnosed as pregnant showed PAG concentrations lower than the assay sensitivity (<0.20 ng/ml) and did not calve. Another cow (ZSand) showed abnormally high PAG concentrations during gestation and was excluded from the general PAG profile. The 10 other Zebu cows exhibited a very similar PAG profile. In these animals, concentrations increased progressively from Week 8 to 35 of gestation (from 6.0+/-4.2 to 196.0+/-34.8 ng/ml), remaining relatively constant until Week 39 (210.8+/-74.8 ng/ml), when they increased sharply to reach their highest level (1095.6+/-607.2 ng/ml) at around parturition. After delivery, PAG concentrations declined significantly (P<0.05) until Week 2 postpartum (348.4+/-85.6 ng/ml) and slowly until Week 10 postpartum. Our results revealed that the PAG pattern in Zebu cattle was similar to those of taurine breeds during the first two trimesters of pregnancy, but differed in the peripartum period.

Animals↗
PubMed1966

The incidence of palpable liver and spleen in the postpartum period.

Abdominal examination was performed in 75 healthy women after normal delivery. The liver was palpable in 23 patients, the spleen in nine. The author believes that these organs were palpable because of ptosis rather than enlargement. Knowledge of this fact should keep the physician from attributing undue importance to the presence of a palpable liver and spleen in the postpartum period.

Abdomen↗
PubMedDate not supplied

Spontaneous coronary artery dissection as a cause of acute myocardial infarction in the postpartum period.

Spontaneous coronary dissection is an infrequent cause of acute myocardial infarction, and several cases have been presented during the peripartum period. We present a case of acute myocardial infarction resulting from spontaneous coronary artery dissection, in a 37-year-old woman during the postpartum period. Thrombolytic treatment was administered in the emergency room uneventfully but without symptom resolution. Diagnosis was subsequently established by coronary arteriography. The patient's in-hospital and long-term clinical course and prognosis are described and the potential pathogenetic mechanisms are discussed. Finally, the treatment options for this rare entity are presented.

Acute Disease↗
PubMed1990

Collagen degradation and mucosal mast cell in endometrium of mouse uterus during early postpartum period.

On the morning of the day of parturition, several parts in the endometrium showed edema in which collagen birefringence was not observed, indicating that collagen degradation occurs firstly in the endematous area. Undegradated collagen might be redistributed wholly in the endometrium on postpartum day 1 when the area of endometrium has diminished. The number of mucosal mast cells in the endometrium did not fluctuate in parallel with the endometrial collagen-degrading process, suggesting that mucosal mast cells do not participate in the collagen degradation during the early postpartum period.

Animals↗
PubMed1994

Serum level of iron and transferrin in pregnancy and postpartum period.

This study presents a composite picture of haemoglobin (Hb), serum level of iron (SI), total iron binding capacity (TIBC) and percent iron saturation of transferrin in women during different trimesters of pregnancy and postpartum period. The results were correlated with age and parity. A total of 75 subjects, 15 from each trimester and 15 postpartal, were studied and compared with 15 nonpregnant normal subjects. Signs of increased iron demand, increased iron turnover and obvious iron deficiency, were demonstrated throughout pregnancy, by decrease in haemoglobin, SI, percent iron saturation of transferrin and increased TIBC; especially in older age group and multigravidae. SI, TIBC and percent iron saturation of transferrin are more sensitive indices of iron status and provide us an opportunity to replenish iron stores of an iron deficient pregnant mother at an earlier date thus preventing anaemia.

Adolescent↗
PubMed2004

Identifying women at-risk for postpartum depression in the immediate postpartum period.

OBJECTIVE: To develop a multifactorial predictive model of depressive symptomatology in the first week postpartum in order to assist in targeted screening procedures. METHOD: As part of a longitudinal study, a population-based sample of 594 mothers in a health region near Vancouver, British Columbia completed a mailed questionnaire at 1-week postpartum that included diverse risk factors from the following domains: sociodemographic, biological, pregnancy-related, life stressors, social support, obstetric and adjustment to motherhood. Following univariate analysis, sequential regression analysis was completed to develop a multifactorial predictive model. RESULTS: In the multivariate model, the factors predictive of depressive symptomatology at 1-week postpartum included immigration within the last 5 years, history of depression independent of childbirth, diagnosis of pregnancy-induced hypertension, vulnerable personality style, stressful life events, lack of perceived support, lack of readiness for hospital discharge and dissatisfaction with infant feeding method. CONCLUSION: The findings suggest that several risk factors for depressive symptomatology in the immediate postpartum period are consistent with previously identified factors but other factors such as recent immigrant status, feeling unready for hospital discharge, dissatisfaction with their infant feeding method, and pregnancy-induced hypertension should also be examined.

Adolescent↗
PubMed1997

Non-invasive detection and monitoring of estrus, pregnancy and the postpartum period in pygmy loris (Nycticebus pygmaeus) using fecal estrogen metabolites.

Estrone-conjugates (E1C) were measured in the feces of six female pygmy lorises (Nycticebus pygmaeus) during estrus (n = 12), pregnancy (n = 4) and the postpartum period (n = 3). Noninvasive feces collection permitted frequent sampling throughout estrus and pregnancy, without disturbance of animals. The estrous period was defined as an increase in fecal E1C levels above an average of 70 ng/g feces with peaks above 100 ng/g feces obtained in consecutive fecal samples collected over a 6- to 11-day period between the end of July and the first third of October. Comparison of the periovulatory profile of E1C and the stage of labial opening of the vagina revealed a high agreement (P < 0.001). In all pregnant females, an E1C rise was found approximately 47 days postestrus, the source of which may be the growing fetal placental unit. Estimated gestation lengths ranged between 187 and 198 days (n = 4).

Animals↗
PubMed1994

Chronobiological characterization of the first estrous cycle in Brasileiro de Hipismo mares during the postpartum period.

This study was conducted on 32 mares during the first 30 d of the postpartum period to characterize the first estrous cycle, assessing ovarian cyclicity by determining plasma progesterone concentration and by transrectal palpation. The total pregnancy rate of the breeding season was 81.25%. The present results show that the incidence of estrus occurring at the beginning of the breeding season were early, long and anovulatory. The mares that did not become pregnant ovulated on average 14.5 d post partum, and those that became pregnant ovulated at 19.6 d post partum (P<0.05). On the basis of clinical and hormonal data, we divided the animals into 4 groups, all presenting signs of estrus: Group 1, animals that did not ovulate (n=7) and that presented basal P(4) levels (0.01-2.34 ng/ml) during the first 30 postpartum days; Group 2, animals that ovulated and did not become pregnant (n=13); Group 3, animals that ovulated and became pregnant (n=8). Maximal P(4) levels ranged from 4.40 to 13.50 ng/ml (Group 2) and from 3.70 to 20.50 ng/ml (Group 3). Group 4 were animals that presented high plasma P(4) levels before any clinical sign of ovulation (n=3). The absence of pregnancy could not be attributed to a failure of the corpus luteum, since the groups of mares that became pregnant exhibited similar plasma P(4) levels as the group of nonpregnant mares. Our findings demonstrated that mares exhibited differences in the timing of the first postpartum estrus, the duration of the first postpartum estrus and the timing of the first postpartum ovulation according to the month of the breeding season in which foaling occurs under tropical conditions. Furthermore, our results indicate that the foal heat may be used since its utilization did not affect the total pregnancy rate of the breeding season.

Journal Article↗
PubMed2001

Improving the number of mothers breastfeeding in the postpartum period.

The objective of this study was to review an experience at Jackson Memorial Hospital, Miami, Florida that has resulted in an increase in the percentage of mothers breastfeeding at postpartum discharge. Data was obtained from postpartum interviews in 1993, which provided the percentage of mothers breastfeeding at discharge. Staff members and personnel involved in the care of postpartum mothers and babies were educated about breastfeeding, and rounds were made to problem solve and reinforce. Patients who elected to breastfeed from April to September 1994 were followed for a duration of 3 months. These early efforts led to the implementation of a Baby-Friendly initiative and intent in 1996 and the formation of a mother-baby unit in 1997. Ten percent of mothers were breastfeeding at postpartum discharge. After implementing a program in 1994, 41% were breastfeeding at discharge. There was a decline in the number of mothers breastfeeding during the postpartum period from discharge. At 3 days postpartum, 80% of patients were breastfeeding followed by 64%, 37%, and 17% at 2 weeks, 6 weeks, and 3 months from discharge, respectively. The percentage of mothers opting not to breastfeed at 3 days after discharge was 20%, followed by 12% from 3 days to 2 weeks postdischarge, by 21% 2 weeks to 6 weeks postdischarge, and finally by 16% from 6 weeks to 3 months postdischarge. In 1998, 70% of patients were breastfeeding, and in 1999, 71% of patients were breastfeeding upon postpartum discharge. The data show that by implementing programs to promote breastfeeding, through education, encouragement, and reinforcement, one can increase the number of mothers who breastfeed at postpartum discharge. However, there is an inverse relationship between the duration of the postdischarge period and the number of mothers breastfeeding.

Journal Article↗