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PubMed1996

The ovarian secretion of androstenedione and oestradiol during late pregnancy and the early postpartum period in sheep with an autotransplanted ovary.

During late pregnancy in the ewe, ovarian function is suppressed by placental steroids and following parturition ovarian function is restored. This experiment determined the ovarian secretion of oestradiol and androstenedione during late pregnancy and the early postpartum period in ewes. Six ewes with ovarian autotransplants were transplanted with three day 6 embryos and three gave birth on day 147. Ovarian and jugular blood sampled were collected on three different occasions. On each occasion a 4 h period of sampling was followed by a 6 or 8 h period during which the ewes were challenged with 150 ng of gonadotropin-releasing hormone (GnRH). Basal secretion of oestradiol and androstenedione was 0.3 +/- 0.1 and 10.5 +/- 3.0 ng min-1, respectively, on day 120 of pregnancy. Oestradiol secretion remained low on days 7 and 21 postpartum (0.4 +/- 0.3 and 0.3 +/- 0.1 ng min-1, respectively). Androstenedione secretion (ng min-1) on days 7 and 21 postpartum was 2.5 +/- 0.5 and 4.1 +/- 1.8, respectively. The injection of GnRH on day 121 of pregnancy produced luteinizing hormone (LH) release with a peak concentration of 0.6 +/- 0.1 ng mL-1, that did not stimulate steroid secretion. On day 8 postpartum GnRH injection induced LH release with a peak concentration of 3.9 +/- 1.1 ng mL-1 that stimulated secretion of oestradiol (0.2 +/- 0.1 to 2.1 +/- 0.9 ng min-1; P < 0.01) and androstenedione (2.3 +/- 0.6 to 17.1 +/- 6.9 ng min-1; P < 0.001). Similar effects were seen on day 22 postpartum; GnRH injection induced LH release with a peak concentration of 4.7 +/- 1.4 ng mL-1 that stimulated secretion of oestradiol (0.2 +/- 0.1 to 3.7 +/- 1.1 ng min-1; P < 0.001) and androstenedione (4.2 +/- 2.6 to 29.5 +/- 9.2 ng min-1; P < 0.01). These results suggest that the suppression of ovarian function during late pregnancy in the ewe is reversed by 7 days postpartum.

Androstenedione↗

PubMedDate not supplied

A review of research instruments for use during the postpartum period.

Locating existing instruments available to measure key variables is critical to the success of a research study. However, this process can be a time-consuming activity. In this article, selected instruments available for use in research during the postpartum period are reviewed. These instruments are divided into two categories. The first category deals with instruments that focus on mothers only. These questionnaires measure mothers' perceptions of their deliveries, their adaptation to motherhood, and their breastfeeding experiences. The second category centers on instruments that both parents can complete. These instruments measure parents' perceptions of their parenting role, sense of competence, problem-solving ability, and perceptions of their newborns. The psychometric properties of each instrument are described, and selected nursing research studies that used the instrument are reviewed.

Breast Feeding↗

PubMed1991

[Detection of Mycoplasma infection in the postpartum period].

The comparative results of microbiological and serological testing of parturients with uneventful and complicated course of the postpartum period were presented. The data justified the etiological role of M. hominis and U. urealyticum in the development of postpartum complications.

Antibodies, Bacterial↗

PubMed2000

Declining levels of erythrocyte folate during the postpartum period among Hispanic women living on the Texas-Mexico border.

Hispanic women have higher parity and shorter interbirth intervals than women of other ethnic groups. Thus, they are more likely to become pregnant relatively soon after giving birth, which may place these women at risk of low or deficient levels of specific nutrients. Folic acid is of particular concern because recent studies suggest that maternal use of folic acid supplements may be associated with better reproductive outcomes. The purpose of this study was to assess folic acid levels in postpartum Hispanic women. Using a cross-sectional design, we measured erythrocyte folate values for 188 low-income Hispanic women 1-12 months postpartum who were receiving services at the Women, Infants, and Children (WIC) clinics in El Paso, Texas. An interview was administered to collect information on diet, vitamin use, and method of infant feeding. Mean erythrocyte folate levels decreased from >1300 ng/ml during the first 4 months postpartum to a low of 1017 ng/ml by 12 months postpartum, for an overall decrease of approximately 23% (p = 0.004). Use of postpartum vitamin supplements was significantly associated with higher folate levels. However, only 35% of mothers used vitamins beyond 1 month postpartum. Study results suggest that these mothers may be at risk of developing low or deficient levels of folic acid during the postpartum period. Educational campaigns targeting these women as well as other groups of postpartum women should encourage them to comply with the U.S. Public Health Service recommendation that women of childbearing age consume 0.4 mg of folic acid daily.

Adolescent↗

PubMed2004

Mood changes during pregnancy and the postpartum period: development of a biopsychosocial model.

OBJECTIVE: Women are vulnerable to mood changes during pregnancy and the postpartum period. We set out to empirically test the hypothesis that biological and psychosocial variables interact to result in this vulnerability. METHOD: Using structural equation modeling techniques, we developed an integrative model of perinatal mood changes from clinical, psychosocial, hormone and mood data collected from 150 women in late pregnancy and at 6-weeks postpartum. RESULTS: In the prenatal model, biological variables had no direct effect on depressive symptoms. However, they did act indirectly through their significant effects on psychosocial stressors and symptoms of anxiety. The same model did not fit the postpartum data, suggesting that different causal variables may be implicated in postpartum mood. CONCLUSION: This model demonstrates the importance of considering both biological and psychosocial variables in complex health conditions such as perinatal mood disorders.

Adult↗

PubMed1993

The effect of intensive flunixin treatment during the postpartum period in the bovine.

The aim of this study was to determine the effect of flunixin meglumine (FM), a substance which inhibits the prostaglandin biosynthesis, on the uterine involution. One of the characteristics of the postpartum period in cattle is the massive and extended release of prostaglandin (PG) F2 alpha. Eleven primiparous cows, divided into three groups, were included in the study. The first group was injected with FM four times daily, the second group twice daily and the third group acted as controls. The dose was 2.2 mg/kg body weight injected intramuscularly. The treatment period was 14 days beginning at parturition. Blood samples were collected prior to calving and up to 28 days postpartum. The plasma concentrations of the main circulating PGF2 alpha metabolite, i.e. 15-keto-dihydro-PGF2 alpha, and progesterone were analysed. The involution of the uterus was assessed by rectal palpation and ultrasonography. The study showed that it was not possible to affect the time period to completed uterine involution, not even when a very intensive drug dosage was used. A statistical difference was found between the group receiving the most intensive treatment and the controls, when the areas under the prostaglandin metabolite curve (AUC) were compared. The PG synthesis and release were decreased by the treatment, but never totally suppressed. Even though the treatment with FM did not shorten the time to completed uterine involution, it was not detrimental for the process of involution. However, as the uterine involution is an inflammatory process, flunixin could, as an anti-inflammatory drug, be beneficial under certain circumstances.

Animals↗

PubMed1997

Premenstrual mood changes and maternal mental health in pregnancy and the postpartum period.

To investigate the relationship between premenstrual mood changes and maternal mental health in the perinatal period, a prospective questionnaire survey of 1,329 women was carried out. Women with a premenstrual mood changes (irritability) before pregnancy showed significantly higher Zung's Self-rating Depression Scale (SDS) scores than those without it, throughout pregnancy and the postpartum period (6 time points: early, middle, and late pregnancy, 5 days, 1 month, and 6 months after childbirth). In addition, women with premenstrual irritability had greater anxiety about pregnancy and delivery, were more reluctant to accept mother roles, and felt their babies (fetuses or neonates) were more vulnerable. These findings suggest that premenstrual mood change is correlated with unstable mental health throughout the perinatal period.

Adolescent↗

PubMed1988

Pituitary receptors for GnRH and estradiol, and pituitary content of gonadotropins in beef cows. II. Changes during the postpartum period.

Pregnant beef heifers (n = 24) were assigned randomly to four groups and slaughtered at day 1, 15, 30 or 45 postpartum. The day prior to slaughter blood samples were taken from each cow every 15 min for 8 hr. The anterior pituitary gland, preoptic area (POA) and medial basal hypothalamus (HYP) were collected from each cow. Contents of gonadotropin-releasing hormone (GnRH) in extracts of POA and HYP, and luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in extracts of anterior pituitary were quantified by radioimmunoassay. In the anterior pituitary gland, membrane receptors for GnRH were quantified by a standard curve technique and cytosolic receptors for estradiol were quantified by saturation analysis. Concentrations of LH, FSH and prolactin in serum were quantified by radioimmunoassay. Only one cow of eight had a pulse of LH during the 8 hr bleeding period on day 1 postpartum. This increased to 8 pulses in 6 cows on day 30 postpartum. Contents of GnRH in POA (15.0 +/- 3.2 ng) and HYP (14.0 +/- 2.0 ng) did not change significantly during the postpartum period. Pituitary content of LH was low following parturition (.2 +/- .1 mg/pituitary) and increased significantly through day 30 postpartum (1.2 +/- .1 mg/pituitary). Pituitary content of FSH did not change over the postpartum period. Receptors for both GnRH (.9 +/- .2 pmoles/pituitary) and estradiol (5.0 +/- .9/moles/pituitary) were elevated on day 15 postpartum, possibly increasing the sensitivity of the anterior pituitary gland to these hormones and leading to an increased rate of synthesis of LH that restored pituitary content to normal by day 30 postpartum.

Animals↗

PubMed2002

Comparison of the efficacy of continuous furosemide and low-dose dopamine infusion in preeclampsia/eclampsia-related oliguria in the immediate postpartum period.

AIM: To compare the efficacy of furosemide infusion with that of low-dose dopamine infusion in improving urine output and subsequent renal function in preeclamptic/eclamptic patients with oliguria in the immediate postpartum period. DESIGN: Prospective randomised single blind clinical trial. SETTING: Obstetric High Care Unit of King Edward VIII Hospital, a large referral tertiary hospital. METHOD: Eighty postpartum patients with severe preeclampsia/eclampsia with oliguria were enrolled. Hypovolaemia was corrected under central venous pressure (CVP) monitoring and urine output monitored for 4 hr. Patients who remained oliguric were randomly assigned to a continuous infusion of low-dose dopamine (3 microg/kg/min), or furosemide 5 mg/hr infusion, for 12 hr. In patients with no response after 12 hr, the drugs were switched and continued for a further 12 hr. A subgroup of patients who responded 4 hr after correction of hypovolaemia was observed for 12 hr. The primary outcome measured involved the comparison in urine output between the different drug regimes and the number of patients requiring haemodialysis. Secondary outcome measures involved assessment of serum urea and creatinine values in the two treatment groups. RESULTS: Of the 80 patients enrolled, 20 improved their urine outputs within the 4-hr observation period. Sixty patients were randomised to furosemide or low-dose dopamine infusion. There was no statistical significant difference in the mean hourly urine output, rate of change in urine output over time and the mean urea or creatinine levels between the treatment groups. Ten percent of patients that failed on furosemide primarily, and 8.5% of patients that failed on initial low-dose dopamine, received haemodialysis. The difference in demographic and clinic data between these groups was not statistically significant. CONCLUSION: Administration of continuous infusion of furosemide showed comparable efficacy to low-dose dopamine infusion in ameliorating oliguria in severe preeclampsia/eclampsia post delivery; there was no difference in the percentage of patients that required haemodialysis in either group.

Adult↗

PubMed1994

Exercise during pregnancy and the postpartum period. ACOG Technical Bulletin Number 189--February 1994.

In the absence of either obstetric or medical complications, pregnant women can continue to exercise and derive related benefits. Women who have achieved cardiovascular fitness prior to pregnancy should be able to safely maintain that level of fitness throughout pregnancy and the postpartum period. Depending on the individual's needs and the physiologic changes associated with pregnancy, women may have to modify their specific exercise regimens. Despite findings that suggest lower birth weights among offspring of women who continue to exercise vigorously throughout pregnancy, there currently are no data to confirm that, with the specific exceptions mentioned here, exercise during pregnancy has any deleterious effects on the fetus. While maternal fitness and sense of well-being may be enhanced by exercise, no level of exercise during pregnancy has been conclusively demonstrated to be beneficial in improving perinatal outcome.

Exercise↗

PubMed1985

C-reactive protein in pregnancy and in the postpartum period.

Serum C-reactive protein levels were measured by means of the nephelometric immunoassay technique in 215 pregnant women at various gestational ages. The results indicate a positive correlation of serum C-reactive protein levels with gestational age. In addition, we studied serum C-reactive protein concentrations in 37 pregnant women in labor and during the postpartum period. Delivery was accomplished by either the vaginal or abdominal route and was associated with significant C-reactive protein production.

C-Reactive Protein↗

PubMed1991

The effects of social support on women's health during pregnancy, labor and delivery, and the postpartum period.

This review of the literature on social support and its relationship to maternal health indicates that emotional, tangible, and informational support are positively related to mothers' mental and physical health around the time of childbirth. The importance of various types of support changes with the changing needs of women as they move from pregnancy to labor and delivery, and then to the postpartum period. During pregnancy, emotional and tangible support provided by the spouse and others is related to the expectant mother's mental well-being. In addition, informational support in the form of prenatal classes is related to decreased maternal physical complications during labor and delivery, and to improved physical and mental health postpartum. Mothers who have the support of a companion during labor and delivery experience fewer childbirth complications and less postpartum depression. Mothers' postpartum mental health is related to both the emotional support and practical help (eg, housework and child care activities) provided by the husband and others. Health care providers are in a unique position to educate prospective parents about the importance of social support around the time of childbirth and may play a critical role in mobilizing support systems for new mothers.

Delivery, Obstetric↗

PubMed2005

[Coagulation factor VIII in the early postpartum period].

OBJECTIVE: Pregnancy is accompanied by changes in the coagulation and fibrinolytic systems. There is a marked increase in some of the coagulation factors, particularly fibrinogen and factor VIII. A high plasma levels of coagulation factor VIII is an important risk factor for thrombotic complications during pregnancy and puerperium. The aim of the study was to determine changes of the VIII:C in the early postpartum period. SETTING: Dept. of Obstetrics and Gynaecology, Medical Faculty of Palacký University, Olomouc. DESIGN: A longitudinal prospective study of 197 healthy women. Primi or multigravidas whose pervious pregnancies had been uncomplicated, aged 18-41 years. All of the deliveries were spontaneous and vaginal. First samples were taken between 24-72 hours postpartum. Women whose factor VIII plasma levels were higher than 150 (percentage of standard) were tested again after 6 weeks. Factor VIII:C was investigated by the one-step coagulation method. Statistical evaluation was done by Statsoft, Inc. (2001) Statistika Cz (Software system data analysis), version 6. RESULTS: Pregnancy is associated with increased levels of VIII:C. Mean value was 194.09 percentage of standards. 119 (60.4 %) of the tested women had VIII:C higher than 150%. The post-puerperal tests were done in 59 women and showed values similar to those from formerly published data in age-matched non-pregnant group. Mean value was 139.76%. CONCLUSION: Normal pregnancy is connected with increased levels of factor VIII. However elevated plasma levels of VIII:C is not associated with poor pregnancy outcome. The highest level of the clotting factor VIII was associated with patient's blood group A. Post-puerperal data showed distinct decrease of factor VIII. There is a necessity to rule out thrombophilia, in the case of the outlasting elevation of the factor VIII.

Factor VIII↗

PubMed2002

sCD31/sPECAM-1 levels in breast milk and sera of mother-infant pairs in the early postpartum period.

Immunomediators seem to have a central role in the immune system of both human milk and newborn infants. CD31/PECAM-1 is an adhesion molecule, member of Ig gene superfamily, mediating cell-cell adhesion in both homophilic and heterophilic ways. Levels of the soluble form of PECAM-1 (sPECAM-1) were evaluated on the 2nd and 5th day postpartum in breast milk and serum paired samples from 20 lactating women as well as in time-matched serum from their single, term, healthy neonates. Concentrations of sPECAM-1 in breast milk (median, range) on both the 2nd (2.05 ng/ml, 0.0-7.2) and 5th day postpartum (0.89 ng/ml, 0.0-3.6) were about 10 and 20 times lower than those (mean +/- SD) in controls (healthy adults) (19.83 +/- 5.17, p<7 x 10(-8)), showing a significant fall from the 2nd to the 5th day postpartum (p<0.0005). Maternal serum sPECAM-1 values (mean +/- SD) were significantly lower on the 2nd day postpartum (14.21 +/- 5.15 ng/ml) than those in controls (p<0.002), but reached control values on the 5th day postpartum after a significant rise (p<0.0075). Neonatal serum sPECAM-1 values with no significant difference between the 2nd (14.4 +/- 4.11 ng/ml) and 5th day of life (14.54 +/- 4.99 ng/ml) were significantly lower than those in controls (p<0.002). Values of sPECAM-1 in milk and sera of lactating mothers and their neonates on the 2nd day postpartum depended on the mode of delivery, being significantly lower after caesarean section (p<0.034, p<0.0075 and p<0.035, respectively). In conclusion, our findings in the early postpartum period demonstrate that: (a) sPECAM-1 is present in human milk in low and decreasing concentrations; (b) the shedding of sPECAM-1 is an established component of the neonatal immune system from birth, though in lower concentrations than in adults, possibly reflecting its immaturity; and (c) the mode of delivery has a significant effect on sPECAM-1 values in milk and sera of lactating mothers and their neonates; the lower values after caesarean section may reveal a deranged endothelial homeostasis.

Adult↗

PubMed1993

Brain somatostatinergic system at late pregnancy, parturition and the early postpartum period in the rat.

During pregnancy and postpartum rats experience a wide variety of behavioural changes. Since the somatostatinergic system has been implicated in the control of some of these changes, the present study examined somatostatin (SS) content and specific binding in the frontoparietal cortex and hippocampus of non-pregnant, pregnant (17 to 18 days), parturition and postpartum (10 and 30 days) rats as well as in ovariectomized rats which were or were not treated with estradiol valerianate. The content of somatostatin-like immunoreactivity (SSLI) was increased at 17 days of pregnancy in frontoparietal cortex and decreased at parturition and 10 days postpartum in that region and the hippocampus under study when compared with SSLI levels in non-pregnant rats. At 30 days postpartum the SSLI content returned to non-pregnant values in both brain regions. Scatchard analysis showed that the decrease in [125I]Tyr11-SS binding observed at 17 days of pregnancy in the frontoparietal cortex was due to the decrease in the number of SS receptors. In contrast, on the day of delivery the number of SS receptors in the same brain region increased. The affinity of the SS receptors was consistently unchanged in pregnant and non-pregnant rats in both regions. At 10 days postpartum the value of specific binding of the tracer to SS receptors in the frontoparietal cortex was not significantly different from that in the non-pregnant rats, although the actual number of receptors was slightly higher. Pregnancy did not change SS binding in the hippocampus.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1982

Association of Enterobacteriaceae septicemia in the immediate postpartum period and asymptomatic bacteriuria.

In an 8-year period, 16 cases of parturitional septicemia due to the Enterobacteriaceae in the immediate postpartum period were identified that were not due to pyelonephritis. Fourteen of the 16 patients had more than 100,000 colonies per milliliter of urine of the same member of the Enterobacteriaceae as was present in the blood. Twelve of the 16 patients had concomitant endometrial cultures. In 11 patients the same isolate was recovered from urine and endometrium as had been recovered from the intravascular compartment. The data suggest an etiologic relationship between asymptomatic bacteriuria and septicemia due to the Enterobacteriaceae in which the maternal implantation site affords the principal portal of infection.

Bacteriuria↗

PubMed1975

Ovarian response to exogenously administered human gonadotropins during the postpartum period.

Eighteen normal puerperal women received a combined administration of human menopausal gonadotropin (HMG) and human chorionic gonadotropin (HCG) and the ovarian response to these human gonadotropins was evaluated by the daily estimation of the 24 hour urinary excretion of total estrogens. Fourteen of the 18 subjects studied were responsive to the exogenously administered gonadotropins with a rise in the urinary estrogen excretion. Moreover, plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels during the postpartum period were low compared to normal cycle gonadotropin levels. Thus, it might be concluded that puerperal anovulation and amenorrhea during lactation might be due to hypophyseal gonadotropic dysfunction rather than to ovarian refractoriness.

Amenorrhea↗

PubMed1996

Diminished mammary gland lymphocyte functions parallel shifts in trafficking patterns during the postpartum period.

Once activated, lymphocytes can regulate both specific and nonspecific immune responses. Alterations in lymphocyte function may increase the host's vulnerability to bacterial infections such as mastitis. Susceptibility to mastitis as well as diminished leukocyte functional capabilities have been shown to be influenced by lactational stage. Therefore, the present study characterized the phenotypes and functions of several bovine lymphoid populations at two points in the lactational cycle. Mononuclear cells were isolated from peripheral blood, supramammary lymph nodes, and mammary parenchyma of mid-lactating and postpartum dairy cows. The phenotypic composition, proliferative ability, cytokine secretion, and cytotoxic activity of isolated leukocytes were assessed with respect to lactational stage and tissue source. Lower percentages of T lymphocytes were consistent with diminished mitogen-stimulated proliferation and spontaneous cytotoxic activity by lymphocytes isolated from postpartum compared with mid-lactating animals. Stimulation with interleukin-2 did not enhance the cytotoxic activity or proliferative ability of lymphocytes isolated postpartum to similar levels observed for those isolated from mid-lactating animals. These data indicate that certain diminished lymphocyte functions observed during the postpartum period may result from shifts in leukocyte trafficking patterns.

Animals↗