Partum Period Research Articles

Influence of Alteration of Dry Period Feeding Management on Body Weight and Body Measurements of Jersey Crossbred Cows at Lower Gangetic Region

Alteration during far off dry period feeding management was done to see its effect on body weight and body measurements of Jersey cross bred cows. This study was conducted on 14 healthy dairy animals which were separated into two comparable groups on the basis of almost similar age groups, parity, body weight, and body condition score. Statistically analyzed data revealed that there was significantly higher (p 0.05) difference was reported in body weight and heart girth among control and treatment group animals. The coefficients of correlation indicated high and significant (P<0.01) correlation among body condition score, tail head thickness, body length, heart girth, abdominal girth in this study. It can be concluded that alteration of feeding management practices during far-off dry period does not significantly change body weight during dry period and post partum period but can lead to significant difference in some body measurements of Jersey crossbred cows at tropical lower Gangetic region. Correlation of parameters suggested that the larger body sized animal of same breed may produce more milk.

Maternal Near Miss Obstetric Events In A Tertiary Care Hospital

Background: Maternal death in pregnancy may not reflect the scale of acute morbidities associated with pregnancy and childbirth. Studying cases of women who survived a severe complication in pregnancy, childbirth on the post partum period (Maternal near miss) is increasingly being recognized as potentially more useful then studying maternal mortality in terms of assessing healthcare needs. To determine the causes of maternal near miss. Maternal Near Miss incidence ratio. Maternal near miss to mortality ratio and mortality index.&#x0D; Materials and methods : A prospective cross sectional study was performed from January 2015- December 2015 at a tertiary care hospital in Chattogram. All women admitted to study facilities with pregnancy related complications or for birth. An adopted version of the WHO Maternal Near Miss Screening Tools was used to identify Maternal Near Miss cases. Incidence of maternal near miss, Maternal Near Miss to maternal mortality ratio and causes of and factors associated with Maternal Near Miss.&#x0D; Results : There were 3089 deliveries, 90 near miss cases during the study period. The maternal near miss incidence ratio was 31.4/1000 live births, maternal near miss to mortality ratio was 5:1 and mortality index was 16.7%. Eclampsia (35.6%) was the leading causes of near miss, followed by haemorrhage (23.3%) and ruptured uterus (11.1%).&#x0D; Conclusion : The Near Miss rate was high. Contributing factors were lack of resources, low quality of primary health care and delays in care. All Near Miss should be accepted as opportunities to improve the quality of maternity care. Health sector should address delays in conducting intervention, referral barriers and fully equipped intensive care units must be created in all facilities.&#x0D; JCMCTA 2019 ; 30 (2) : 32-35

Epidemio-Clinical, Therapeutic and Evolutive Aspects of Pulmonary Embolism in Young Subject in the Cardiology Department in Point “G” Hospital University Center Bamako

Objective: The purpose of this work was to determine the epidemiological, clinical and evolutionary aspects of the pulmonary embolism of the young person in the cardiology department of the University Hospital Center (CHU) Point G in Bamako-Mali. Methodology: This was an analytical study from January 01, 2018 to December 31, 2018 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 1379 hospitalized patients, 19 patients were concerned by pulmonary embolism of the young person. The prevalence of pulmonary embolism of the young person was 1.37%. The most affected age group was 21 - 30 (47.4%) of patients. The predominance was female (89.47%) with a gender ratio of 0.11 in favour of women. The average age in the series was 29.79 years with extremes of 16 years and 40 years. Factors predisposing to pulmonary embolism were dominated by peri partum, cardiomyopathy and obesity with 47.3%, 31.57% and 21.1%, respectively. The dominant signs were chest pain and dyspnea in 94.7% and 89.5% of cases respectively. Pulmonary embolism was unlikely in 60.52% according to the Geneva and Wells score simplified. At the thoracic angioscanner, the embolism was bilateral in 52.6% of cases and distal in 36.8% of patients; in 10 patients who performed cardiac ultrasound, pulmonary arterial hypertension (70%), dilation of the right ventricle (20%) and left ventricular dilation (40%). Hyper leucocytosis (47.4%), anemia and low prothrombin rate (TP) (22.2%) were the most found biological abnormalities. More than 2/3 (68.5%) our patients had an intermediate mortality risk according to the PESI (Pulmonary Embolism Severity Index) score. The average hospital stay was 10 days. Hospital mortality was 10.5%. Conclusion: The pulmonary embolism of the young person is a frequent, serious and multifactorial pathology and the female sex is most affected especially during peri partum periods, hence the need for preventive measures. Clinical signs are not specific and based on the assessment of clinical probability. Pulmonary angioscanner remains the confirmation review in our context.

Assessment of Protective Role of Quinoa against Sodium Fluoride Induced Skeletal Deformities in Mice Fetuses

Rajasthan has the highest number of habitations where groundwater contains fluoride specifically in the region of Thar Desert. Infact, Pan India is affected by fluoride problem, but Rajasthan is the only state where almost all the districts are affected by high fluoride. High Fluoride concentration in drinking water has been shown to cause skeletal and dental abnormalities, besides others such as osteosclerosis. It has been shown through medical research that almost all the vital systems and organs in the body including thyroid, kidney, cardiovascular, gastrointestinal, endocrine, neurological, reproductive, developmental, molecular level, immunity etc. gets affected by concentration of Fluoride when it exceeds WHO standard values. This finding facilitated us to go in further and find the effect of Sodium Fluoride (NaF) when given to pregnant mice through drinking water at various fetal developmental stages with focus on study of developmental pattern of the skeletal system of growing fetuses followed by a protective role of phytomaterials against it. In this study Quinoa seed, were selected because of its high nutritive value and latest findings indicating its antiteratogenic nature. The study was planned in such a way that females in question were subjected to fluoride treatment prior to mating, during pregnancy and post partum period when weaning process is on. The observations clearly indicates that post Sodium fluoride treatment there was a reduction in size and general body weight of fetuses. Besides this, there was an increase in the number of immature fetuses. Various skeletal anomalies were also observed, such as partially ossified ribs, reduced skull ossification, reduced sternebrae etc. Chenopodium Quinoa, also called Superfood due to its high quality of protein and wide range of minerals and vitamins was used for its protective role as mentioned earlier. In this study NaF along with Quinoa seeds were administered to treated animals. These animals showed improvement in maternal weight, increase in body weight and size of fetuses as well as bone ossification. These findings suggest that Quinoa seeds possibly have a protective effect against Sodium Fluoride induced teratogenicity.

COVID-19: Maternal and Child Health Care

In the sunset of 2019, the world encountered the beginning of a pandemic due to corona viral infection disease (COVID-19). The rapid spread via respiratory route transmission, absence of vaccine and specific anti virals is the main reason for making the situation worse. Like every aspect COVID-19 was found to be of great concerns in maternal and child health care. The objective of this short communication was to found the effects of COVID-19 in maternal and child health care. It was identified that the clinical manifestations of COVID in pregnant and non-pregnant patients have same manifestations. The mode of delivery even has no significant association with specific infection. The evidence to support inutero peripartum or postpartum transmission is also deficient. Only positive finding observed was the presence of fetal distress. So it was clinched that after birth neonates must be kept in isolation for careful evaluation of any sign of infection and hence it’s management. It was concluded that serial follow up investigations like cardiactocography, Doppler’s and amniocentesis should be done to assess fetal wellbeing in the intrauterine period. However, in post partum period both mother and baby should remain in isolation for careful monitoring of any signs of infection and hence timely management.

Recommendations and future research initiative to optimize bladder management in pregnancy and childbirth International Consultation on Incontinence - Research society 2018.

With increasing birth rates globally, obstetric bladder care and long term pelvic floor dysfunction continues to be a issue. This paper aims to provide an overview of the concerns in the antenatal, intrapartum an post partum periods and presents recommendation for the research requirements necessary and education to challenge current practice.

Cultural, Social, Religious Beliefs and Practices During Postpartum Period Among Post Natal Women in Selected Rural and Urban Health Care Settings

Belief is the state of mind in which a person thinks something to be the case, with or without there being empirical evidence to prove that something is the case with factual certainty. In developing countries, over 60% of maternal deaths occur during the postpartum period. This period is also greatly influenced by different types of socio-cultural beliefs &amp; practices that increases the risk for poor maternal and child health. A study was conducted to identify and analyse the cultural, social, religious beliefs and practices during postpartum period among postnatal women in Erashal BPHC &amp; Medical College &amp; Hospital of West Bengal. A comparative survey design was adopted in this study. A non probability purposive sampling technique was used to select 120 postnatal women from rural Erashal BPHC &amp; 160 from urban Medical college &amp; hospital as study subject. A valid &amp; reliable Structured Interview schedule(r-0.85,0.90)was used to collect data from the postnatal women who were admitted for delivery and staying postnatal ward. The findings showed that the harmful beliefs regarding maternal, baby care, breast feeding &amp; family planning aspect were present among women during postpartum period(R-75%,U-54%) Harm less beliefs regarding maternal care&amp; breast feeding aspect were present in postpartum period(R-31% U-42 %). Beneficial beliefs regarding separation aspect were present in postpartum period(R-79%,U-90%).The practices were seen in post partum period(R-52%,U-21%).There was a significant difference in belief among rural &amp; urban women as evidenced by ‘t’ test(t-11.38 at df 278 at p&lt;0.05) . There was a significant difference in practice among rural&amp; urban women (t-6.85 at df278 at 0.05 level).Significant relationship(r-0.35 , 0.28 at p&lt;0.05) was seen between beliefs &amp;practices during postpartum period in both area. There was a significant association (χ2-5.36, 10.56 at p&lt;0.05) between religion with beliefs in both area. The significant association was seen between family type with beliefs in rural (χ2-4.41 at p&lt;0.05) but not in urban. The study concluded that, a concerned matter of issue can be raised to prevent the practices contrary with harmful beliefs by counselling and evaluation of views of the mothers during reproductive period.&#x0D; &#x0D; Keywords: beliefs and practices, postpartum period, postnatal women, rural and urban settings

PENGETAHUAN DAN SIKAP IBU POST PARTUM NORMAL TENTANG TEHNIK MENYUSUI YANG BENAR DI KLINIK SUNGGAL

The correct breastfeeding technique is how to give milk to the baby by attaching and positioning the mother and baby properly. How to breastfeed greatly affect the comfort of a baby sucking milk. Midwives or nurses need to provide guidance to the mother in the first week after delivery (post partum), about the actual ways of breastfeeding so as not to cause problems. The objective of the research was know the knowledge and attitudes of normal post partum mothers about breastfeeding techniques that are correct at Klinik Sunggal Medan. The research is done by using descriptive approach of 16 samples and use primary and secondary data by distributing questionnaires. The result of the research showed that the majority of respondents have good knowledge as many as 8 people (50%), and lack of knowledge are 2 people (12.5%) and data has been obtained that the majority of positive mother attitudes are 10 people (62.5%) and the minority of respondents have negative knowledge namely 6 people (37.5%). Based on this study it was concluded that the majority of post partum mothers' knowledge of breastfeeding techniques is well-informed, and the majority of mothers have positive attitudes. Respondents are expected to seek information and ask lots of people who have done breastfeeding techniques correctly in adapting during the post partum period

Comparison of maternal milk ejection characteristics during pumping using infant-derived and 2-phase vacuum patterns

BackgroundMilk ejection characteristics remain consistent throughout 12 months of lactation in women who expressed breastmilk with an electric breast pump. In addition these characteristics appear to remain constant when women are breastfeeding or pumping suggesting that milk ejection is a robust physiological response. It is not known whether the stimulation of an infant at the breast in the early post partum period influences milk ejection patterns or whether this is a programmed event. However, as more data become available on the mechanisms involved in infant feeding, pumping patterns mimicking the infant more closely may provide enhanced results. The objective of this study was to compare milk ejection characteristics obtained when using a novel infant-derived pumping pattern with an established 2-phase pattern.MethodsA convenience sample of ten lactating mothers, 1 to 40 weeks of lactation with normal milk production were recruited in 2015. Each participated in two pumping sessions in which either a 2-phase pattern or infant-derived pattern were randomly assigned. Milk volume and milk ejection characteristics were recorded and the percentage of available milk removed (PAMR) was calculated. Statistical analysis used linear mixed effects modeling to determine any differences between breasts and pump patterns with the consideration of individual variability as a random effect.ResultsThe number of milk ejections and milk ejection characteristics did not differ between patterns. Milk volumes removed were 53.6 ± 28.5 ml (PAMR 58.2 ± 28.4) for the 2-phase pattern and and 54.2 ± 26.3 ml (PAMR 52.2 ± 22.3) for the infant derived pattern. Peak milk flow rates were positively associated with the available milk (p = 0.0003) and PAMR (p = 0.0001), as was the volume of milk removed during each milk ejection (p = 0.001 and p = 0.0001).ConclusionAn experimental pumping pattern designed to resemble infant sucking characteristics did not alter milk ejection characteristics or milk removal parameters compared with an established 2-phase pattern. Theses findings provide further evidence that milk ejection is a robust physiological response.

P5356NT-proBNP is a valuable diagnostic tool of heart failure even during post partum period

Abstract Background Post-partum period is characterized by complex haemodynamic changes that may lead to heart failure (HF) in a minority of patients. B-type natriuretic peptides inactive amino terminal fragment (NT-proBNP) is an established biomarker in the management of HF. Patients presenting with dyspnea are considered at high risk of HF if NT-proBNP is above 125 pg/ml. Higher levels of NT-proBNP in the post natal period were reported to be associated with increased risk of cardiovascular events, but there is no defined cut-off value established for prediction of HF in this setting. Purpose We conducted this study to identify an adequate cut-off value which would predict haemodynamic overload among post-partum women. Methods All women who gave informed consent during an obstetric clinical evaluation at our tertiary centre between 01/01/2018 and 30/09/2018 were included in the study. NT-proBNP was measured within 24 hours from delivery. The primary endpoint of the study was the development of signs and symptoms of heart failure (with the need of intravenous diuretics or a cardiological evaluation) within 15 days after delivery. We therefore analyzed the ability of different cut-off of NT-proBNP values in predicting the primary outcome. Confidence intervals (CI) for sensitivity and specificity were calculated with the Wilson score method. Results 252 women were included in the study. Eleven of them developed in the study timeframe signs and symptoms of HF (4.3%); all of them were treated with diuretics. Nine patients were evaluated with echocardiography and 3 of them required cardiological counseling. The cut-off value of 600 pg/mL was found to have the best sensitivity (73%, CI 95% 0.43–0.9), specificity (98%, CI 95% 0.95–0.98), positive likelihood ratio (29, CI 95% 12–69) and negative likelihood ratio (0.28, IC 95% 0.10–0.70). The diagnostic odds ratio was 104 (CI 95% 22–494, p&lt;0.001). Mean NT-proBNP was 169±121 pg/mL (cutoff &lt;600 pg/mL) versus 852±245 pg/mL. Different cut-off evaluated NT-proBNP value (pg/mL) Specificity Sensibility Diagnostic Odds ratio 125 42 81 3.4 (95% CI 0.7–16, p=0.1) 300 85 72 14 (95% CI 4–62, p&lt;0.01) 600 98 73 104 (95% CI 22–494, p&lt;0.01) 700 98 66 65 (95% CI 12–341, p&lt;0.01) Conclusion Our study suggests that NT-proBNP higher than 600 pg/mL is a high risk marker for developing HF in the post partum period. This value is slightly higher compared to the one adopted among the general population for diagnosis of HF and may reflect the peculiar haemodynamic changes of this setting.

Post Partum Cardiomyopathy Requiring Left Ventricular Assist Device Placement; Implications for Rehabilitation

To determine if patients with a Left Ventricular Assist Device placed in the post partum period can benefit from acute inpatient rehabilitation, and to identify the special considerations the rehabilitation team use in developing a rehabilitation plan.

Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort

Pregnancy and the early post partum period are widely understood as a critical period for the infant’s emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children’s social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.

Utilization of Maternal Health Care Services among Mothers Residing at Slum Area.

Appropriate utilization of maternal health care services is very important tool to reduce the maternal and child morbidity and mortality rate. This study was conducted to assess the utilization of maternal health care services by the women for their last pregnancy in one year period and to find out it's association with selected variables. Descriptive cross sectional study was conducted for one year by using semi-structured questionnaire among 285 mothers residing at slums area of Dharan sub-metropolitan city after taking written consent from them. Ethical clearance was obtained from Institutional Review Committee, BPKIHS and Dharan Sub-metropolitan city office. Simple random sampling followed by snowball sampling method was used to collect the data by interview method. Majority (95.1%) had one Antenatal visit, 60.4% had initiated antenatal visit at first trimester and 78.99% had completed 4 or more antenatal visits. Only 35.8% had taken complete dose of iron and calcium. Majority 262 (91.92%) respondents have taken Tetanus Toxoid immunization and among them only 74.42% had taken 2 dose of TT injection. Women who delivered in health facility accounted for 70.9% but only 28.8% went for postnatal visit. Majority (65.3%) received health advice during postnatal period. Nearly 40% respondents used family planning after post partum period .There was significant association between utilization of antenatal and delivery services with Educational status of respondents and their husbands and number of pregnancy and between utilization of postnatal services with occupation of husband. Utilization of maternal health care services, antenatal services utilization were satisfactory whereas postnatal services and family planning services utilization were very poor. Utilization of maternal health services should be encouraged by conducting public awareness programmes.

Exploring Beliefs and Knowledge about Maternal Health: The Case of Women in Korogocho Slums, Nairobi

Despite the fact that the government of Kenya has taken several steps to make it easier for all women to access maternal healthcare services (MHS), studies show that utilization of these services continues to be poor in the informal settlements of Nairobi, resulting in adverse pregnancy outcomes. Studies further reveal that utilization of MHS is influenced by beliefs and knowledge about maternal health. In view of the aforementioned, the purpose of this study was to investigate beliefs and knowledge about maternal among women in informal settlements. T his study, which was conducted in Korogocho slums, Nairobi, adopted a mixed method approach, which involved a survey and analysis of secondary data. Almost all of the subjects believed that some groups of women were at a greater risk of experiencing maternal morbidity than others, and that maternal health is affected by many different factors, including biophysical, socio-economic to cultural practices. The study established that 42 percent and 54 percent of the respondents were aware of danger signs during pregnancy and delivery respectively, while only 19 percent were aware of danger signs during the post-partum period. Most respondents identified blurred vision, convulsions and difficulty in breathing as the main danger signs during pregnancy. During delivery, the most commonly identified danger signs were severe bleeding, convulsions and fainting. However, during the post partum period, only two fifths of the respondents identified convulsions as a danger sign. The study recommends that the Kenyan National government and the Nairobi County government should conduct awareness campaigns with targeted messages to improve maternal knowledge, with a view to improving maternal health outcomes in informal settlements in Nairobi.

Cerebral Venous Sinus Thrombosis in Early Pregnancy : A Case Report

Cerebral Venous Sinus Thrombosis (CVST) in pregnancy is an uncommon condition and affects about 5 women per million. Actual etiology is difficult to confirm, a hypercoagulable state along with protein Sand C deficiency, hyperhomocystinaemia are the contributing factors. MRV like neuro imaging is the main stay of diagnosis. Treatment with Low molecular weight heparin throughout the pregnancy and post partum period can save the life of both mother and child.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 54-56

Oral Vs Parentral Iron Therapy among Women in Post Partum Period

Objective: To determine efficacy of oral iron therapy as compared to parentral iron therapy. Study design and duration: This is a prospective study of observational type. Study consists on the duration of 5 months. Setting: This study was conducted in Bahawal Victoria Hospital Bahawalpur. Patients and Methods: Anemic patients having Hb less than 10g/dl were included in this study. Two groups were formed group-A and group-B. Group-A was given oral iron therapy while group-B was given Intravenous iron therapy and outcome was noted after 30 days and 60 days in the form of hemoglobin level, hematochrit and MCV values. All data collected was analyzed using SPSS and Microsoft office version 2016. Results were calculated in the form of frequencies and percentages and averages. Tables and Graphs used to present data. Consent was taken from ethical committee of the study hospital and consent was also taken from all cases in study group. Results: There were total 70 cases in study group selected via randomized controlled trials. There were two groups containing 35 in each group. In group-A after 60 days of iron therapy via oral route HB value was 10.7 g/dl and after 60 days 11.8g/dl with the change of 22.4% in HB level. In Group-B after 60 days of intravenous iron therapy HB level was 12.9 g/dl with improvement of 38.8% in HB level. P- Value was 0.05. Age range of cases was 15-35 years of age with mean age of 31.4 years. Baseline characteristics of cases in group-A were age 33±4 years, BMI 23±5, HB level was 9.2±1 g/dl, Hematochrit (HCT) was 29.5±3 and MCV was 72±0.6. In group B mean age was 34±3, BMI 21±2, HB level 9.2±0.5, Hct was 28.6±3.4, MCV was 70±4. Conclusion: Parentral route of iron therapy is more effective in post partum period in women than oral route with more improvement in blood hemoglobin, hematochrit and MCV value.

RELATIONSHIP AMONG ACUTE PHASE PROTEINS IN TRANSITION PERIOD IN BUFFALOES

The objectives of this study were to record the changes in some acute phase proteins (APPs) either positive or negative during transition period and to demonstrate the correlation between different APPs in the transition period. To achieve these objectives, 29 pregnant buffaloes were selected at 2nd and 3rd milk season from Ard El -Kheir farm. The study was carried out in Assuit Governorate, Whole blood samples were collected from these buffaloes for determination of fibrinogen, blood plasma samples were collected for determination of vit. A and blood serum samples were collected for determination of serum albumin, serum total cholesterol, serum total bilirubin and serum haptoglobin). Blood samples were collected as the following: (-21d: -15d), (-14d: -8d), (-7d: -1d), calving day, 3 d P.P, 7 d P.P, 14 d P.P and 28 d P.P. The study revealed significant changes in the concentration of some acute phase proteins, whether positive or negative. The mean values of fibrinogen revealed significant changes with maximum increase at day 3 P.P. Non significant changes in the mean values of haptoglobin with maximum increase one week pre partum. Significant increase in the mean values of total bilirubin at calving day and post partum periods compared with pre partum periods, reached maximum at day 14 P.P. The mean values of albumin revealed significant changes with maximum increase one week pre partum. A significant decrease in the mean values of total cholesterol at pre partum compared with post partum reached maximum at calving day compared with pre and post partum periods. A significant decrease in the mean values of vit. A reached maximum at day 7 P.P.

Post-partum Period in Tunisian Arab Mares: Which Factors Influence the Foaling Heat?

This work aims to study the influence of some factors on the expression of the foaling heat in Arab mares. This study was held in Tunisia, from January to May 2018. For this, 59 Tunisian Arab mares were separated into 2 groups (young mares, age <15 years, n=41; and old mares, age ≥15 years, n=18), and monitored amid the post partum period. The parturition mode (eutocic, dystocic) was noted, and the onset of the foaling heat and its duration recorded. Follicular activity was monitored using ultrasonography to track the side at which the ovulation occurred. ANOVA was carried out using the software SAS (SAS Institute Inc.®) to study the effect of age and parturition mode on the onset of foaling heat and its duration. The Duncan test was used to compare the variations according to the age and the parturition mode. The onset of the foaling heat and its duration did not vary with the age class (7.5±0.2 vs 7.3±0.2 days; 5±0.5 vs 7.8±0.3 days), but had more important values in mares with dystocia (8±1.2 vs 7.4±0.2 days, p<0.05; 6±1.8 vs 5±0.5 days, p<0.05). Significantly more ovulations occurred in the left ovary than in the right one (55% vs 45%). Furthermore, silent heat occurred at the rate of 20%, while all females resumed an ovulatory function. Our results suggest that dystocia increase the onset delay of the foaling heat and its duration, and that the left ovary tends to retrieve its function faster than the right one.

Hypnobreastfeeding Dapat Menurunkan Kecemasan Pada Ibu Post Partum

Background: Post partum period is condition of a time that very influential on the psychological and social conditions for women after giving birth. The incidence of post partum blues increased in this period of time with a prevalence of 30% to 75%. Post partum blues give effect to the early cessation of breastfeeding process which is contribute to child mortality under 5 years of 11.6%. This is associated with the practice of exclusive breastfeeding that are not optimal as a result of post partum blues experienced by woman after giving birth. The purpose is to analyze the anxiety in the group given the Hypnobreastfeeding intervention treatment and which is not given the intervention treatment, held at RSUP Dr. Suradji Tirtonegoro, Klaten. Method: Research is experimental design with randomized control trial. The population is all pregnant women in Puskesmas Jogonalan I area of Klaten. A total of 60 post partum object was selected for this study by simple random sampling. This was a randomized controlled trial, conducted at RSUP Dr. Suradji Tirtonegoro, Klaten. Results: The difference of dependent variables between the two groups were tested by Mann-Whitney. Conclusion: There is a differences and significance level of result of degree of anxiety between both treatment result with p=0.002. Hypnobreastfeeding intervention treatment can relief anxiety level for post- partum mother

Comparison of placenta accreta spectrum disorders diagnosed in intrapartum and antepartum period— A three year experience in a tertiary referral unit of India

ObjectiveTo determine the frequency of placenta accreta spectrum (PAS) disorders and to study the demographic profile, risk factors and maternal and fetal outcomes in women with antepartum diagnosis of PAS as compared to women with diagnosis made in the intrapartum period. Study designRetrospective analysis over a 3-year period of all patients who delivered with PAS. The cases were divided into 2 groups. Group 1 consisted of the patients who were diagnosed during the intra partum period and Group 2 was those diagnosed as PAS by ultrasound in the antepartum period. Maternal and fetal outcomes were compared between the 2 groups. The cases that underwent conservative management were also analyzed for need of secondary hysterectomy/placental resolution ResultsThere were 81,480 deliveries conducted during the study period of which 74 were identified as PAS. Hence PAS was seen in 1:1101 deliveries (0.09%). The estimated blood loss and number of units of blood products required were significantly higher in Group 1 (2.36 ± 0.77 l vs 1.8 ± 0.91 L, p = 0.002; and 10.17 ± 5.12 vs 6.77 ± 4.22, p = 0.005) compared to Group 2. The ICU stay was also more common in Group 1 (p = 0.01). The perinatal mortality was significantly higher in Group 1(45.71% vs 23.08%, p = 0.040). 79.7% women underwent primary cesarean hysterectomy while others were managed conservatively. In conservatively managed group, placental resolution took place in 60% and 40% required secondary hysterectomy. ConclusionAntenatal diagnosis of placenta accreta spectrum disorders decreases the maternal morbidity and perinatal mortality.