Postpartum Retention Research Articles

Treatment of 130 cases of postpartum retention of urine by electroacupuncture

One hundred and thirty patients with postpartum retention of urine were treated by electroacupuncture on bilateral Sanyinjiao (SP 6) and Yinlingquan (SP 9). After 1–5 treatments, 130 patients could discharge urine successfully.

Role of the small intestine in postpartum weight retention in mice

Approximately 25% of women retain 5 kg of the weight gained during pregnancy, but the physiologic factors underlying excessive postpartum weight gain are not known. The objective of the study was to determine whether pregnancy-related adaptive increases in intestinal nutrient transport are retained after parturition and therefore contribute to postpartum weight gain. We measured body weight and intestinal nutrient transport in virgin (V, control), primiparous (P, one pregnancy), and multiparous (M, 3 pregnancies) mice at parturition (day 1), during lactation (days 14 and 21), at weaning (day 28), after weaning (day 40), and during aging (days 70, 120, 200, and 300). In M and P mice, body weight and the weight and length of the small intestine were greatest during lactation; they then decreased but did not return to prepregnancy values until 300 d after parturition. Intestinal villus heights were maximal at lactation and remained high < or = 200 d after parturition. Total intestinal transport capacity for D-glucose, D-fructose, and L-proline was also greatest during lactation, and the lactation-enhanced transport capacity was retained < or = 70 d after parturition. M mice retained more body weight and intestinal transport capacity postpartum than did P mice. Aging per se had little or no effect on body weight or intestinal weight, length, and nutrient transport. The dramatic, lactation-related increases in intestinal nutrient transport capacity were due mainly to increases in intestinal mass. Postpartum retention of pregnancy- and lactation-related increases in intestinal nutrient uptake capacity may play a significant role in postpartum body weight retention. These adaptive increases may be cumulative and may result in greater weight retention in mice with multiple pregnancies.

Composition of gestational weight gain impacts maternal fat retention and infant birth weight

Objective The purpose of this study was to evaluate how changes in gestational weight and body composition affect infant birth weight and maternal fat retention after delivery in underweight, normal-weight and overweight women. Study design We assessed the body composition of 63 women (low body mass index, 17 women; normal body mass index, 34 women; and high body mass index, 12 women) on the basis of measurements of total body nitrogen by prompt-gamma activation analysis, total body potassium by whole body counting, and a multicomponent model based on total body water by deuterium dilution, body volume by densitometry, and bone mineral content by dual energy x-ray absorptiometry (DXA) before pregnancy, at 9, 22, and 36 weeks of gestation, and at 2, 6, and 27 weeks after delivery. Infant weight and length were recorded at birth; infant anthropometry and body composition by DXA were assessed at 2 and 27 weeks of age. Results Gestational weight gain was correlated significantly with gains in total body water, total body potassium, protein, fat-free mass, and fat mass ( P = .001-.003). Gains in total body water, total body potassium, protein and fat-free mass did not differ among body mass index groups; however, fat mass gain was higher in the high body mass index group ( P = .03). Birth weight was correlated positively with gain in total body water, total body potassium, and fat-free mass ( P<.01), but not fat mass. Postpartum weight and fat retention were correlated positively with gestational weight gain ( P = .001) and fat mass gain ( P = .001) but not with total body water, total body potassium, or fat-free mass gain. Conclusion Appropriate, but not excessive, gestational weight gain is needed to optimize infant birth weight and minimize maternal postpartum fat retention.

Prospective 3D ultrasonographic evaluation of immediate postpartum urine retention volume in 100 women who delivered vaginally

Our objective was to determine the reproducibility and validity of urine retention volumes measured by 3D ultrasonography (3D-US) 2 h postpartum. This was a longitudinal prospective study of 100 women who delivered vaginally. Each woman underwent five successive urine retention measurements with the Bladder Scan 2 h after vaginal delivery, followed by transurethral catheterization to determine the real volume. The reproducibility of only the last four scan values was analyzed with an intraclass correlation coefficient, and that of determinations 4 and 5 with a Bland-Altman plot. The validity of the device was similarly evaluated using the mean four-scan and real values. Pearson's correlation coefficient was calculated and a least-trimmed squares robust linear-regression model was used. All tests were two-sided with a 5% alpha risk. Results showed that 3D-US measurements were highly reproducible, with an intraclass correlation coefficient of 0.974 (95% CI:0.964-0.981). 3D-US also accurately estimated the real urine volume (intraclass correlation coefficient 0.924; 95% CI:0.888-0.949), but tended to underestimate by about 6.8%. The between-technique Pearson correlation coefficient was 0.94 (P < 0.0001) and the regression analysis gave an R2 of 0.914. Urine retention volumes exceeded 500 ml in 55 women, and 11 in 7. We concluded that 3D-US was reliably able to measure postpartum urine retention volume.

Treatment of postpartum retention of urine by electroacupuncture in 100 cases

Treatment of 100 cases of postpartum retention by electroacupuncture Sanyinjiao (SP 6), Yinlingquan (SP 9), Zigong (Ex-CA I), Liniao (Ex-CA), Zhongji (CV 3) and Hegu (LI 4), and the effective rate was 98%.

Treatment of postpartum retention of urine by needling shenshu (BL23)

●Acupoints: Shenshu (BL 23) and Sanyinjiao (SP 6) ●Manipulation: The patient was required to take a prone position. Shenshu (BL 23) was 1.5 cun lateral to the point which was below the spinous process of the second lumbar vertebra. After the skin was sterilized routinely, a filiform needle of 0.45 mm in diameter was perpendicularly inserted into skin and to a depth of 2.5 - 3 cun and the needling sensation should be required to radiate to the perineum.

Incidence and treatment of urinary retention postpartum.

The aim of this clinical study was to examine the incidence of postpartum urinary retention, to investigate the relationship between different obstetric parameters, and to find out whether our proposed treatment program fulfilled our needs. The incidence of urinary retention postpartum was 0.7%. The incidence of instrumental delivery, sphincter rupture, and larger lacerations of the perineum was significantly increased in the group with urinary retention. Our program for detecting and treating patients with postpartum urinary retention seemed to work efficiently.

An Analysis of Research on Postpartum Weight Retention

Purpose: To explain the concept of postpartum weight retention and to analyze factor effect on it. Method: A total of 20 studies related postpartum weight retention were selected in the year of 1988-2001 and analysis was done. Result: A demographic factor like parity, age, social and economic level and life style such as exercise, diet, breast feeding are influential factor on postpartum retention weight. But parts of them don't agree the same results. Meanwhile, in some studies, psychological factor like women's self esteem related to postpartum retention weight, body image change, depressing is found to be very related. As a result, postpartum overweight gain could be a bad factor of physical and mental health. In Korea, we have few studies related to them. Conclusion: It is required to do many-sided and deep studies about aspects of postpartum retention weight and the factor that effect on it. Postpartum retention weight should be approached by controling weight from the period of pregnancy. And it would rather be researched through individual approach considered women's various demographic, social-cultural and physical level than be required standardized level of weight gain.

Insulin and the "thrifty" woman: the influence of insulin during pregnancy on gestational weight gain and postpartum weight retention.

To test Neel's hypothesis among pregnant women: a high maternal insulin concentration in early pregnancy increases the risk of weight gain, overweight, and obesity among nondiabetic, low-income gravidas of racial and ethnic minority groups from Camden, New Jersey. Fasting insulin was obtained from 461 gravidas at entry to prenatal care. Insulin quartile was related to rate of gestational weight gain and excess weight gain during pregnancy (> or = 90th percentile) and to retained weight and excess weight retention at 4-6 weeks postpartum (> or = 90th percentile). The relationship between excess retained weight and excessive insulin increase (> or = 90th percentile) was also examined. Compared with gravidas with an insulin concentration in the lowest three quartiles, gravidas with the highest insulin quartile had a significantly higher rate of gestational weight gain (nonobese women only) and average weight retained postpartum (all women). Compared with an insulin concentration in the lowest three quartiles, the highest insulin quartile was associated with a 2.05-fold (95% confidence interval [CI] = 1.07-3.93) risk of an excessive rate of gestational weight gain and a 3.58-fold (95% CI = 1.87-6.84) risk of excess weight retained postpartum. Excess weight retained postpartum was linked to a 2.63-fold (95% CI = 1.00-6.89) risk of an excessive increase in insulin concentration postpartum. Our results support Neel's hypothesis and suggest that a high maternal insulin concentration is associated with increased gestational weight gain and increased weight retention postpartum. High insulin concentration may contribute to pregnancy-related changes in weight and thus may be linked to maternal overweight and obesity postpartum as well as to future risk of gestational and Type 2 diabetes mellitus.

Goal Weight Trends Among Navajo Nation Prenatal Women and Prevention of Cardiovascular Disease in Postpartum Women: A Comparison Between 1994–1996

Obstetric complications including prolonged labor, pregnancy-induced hypertension, gestational diabetes and thromboembolism can lead to long term cardiovascular disease if rate of weight gain and total weight gain is not monitored during pregnancy. The 1994 CDC Pregnancy Nutrition Surveillance System for the Navajo Nation WIC Program identified the pre-pregnancy weight status as 20% overweight and 25% very overweight in prenatal women. In 1995, the pre-pregnancy weight status was 19.5% overweight and 24.6% very overweight in prenatal women. During 1996, the pre-pregnancy weight status was 18.8% overweight and 30.6% very overweight. Within NNWIC clinics, the prevalence of overweight increased as the mother's age increased. Over the last three years. the data were as follows: 1994: age: 16–19, 22.5%; age: 20–29, 43%; age: 30–39, 60%; age: 40–49, 63.5% 1995: age: 16–19, 21.7%; age: 20–29, 43%; age: 30–39, 56.7%;age: 40–49, 68.9% 1996: age: 16–19, 8.7%; age: 20–29, 50%; age: 30–39, 36%; age: 40–49, Not Available. These percentages include overweight and very overweight categories (BMI>26). Since the baseline percentage of Native American/Alaska Natives for prevalence of overweight was between 29-75% which were estimates of different tribes, Year 2000 objective was initially set for 30% reduction. However, the NN WIC program's Year 2000 objective follows the Year 2000 objective for low-income women aged 20 and older where 1976–1989 baseline was 37% overweight prevalence with the objective for Year 2000 target <25%. Significant decreases were apparent in the 16–19 year old women as well as in the 30–39 year old women. However, significant increases were noted in the 20–29 year old women as well as the 40–49 year old women with data missing for this last age category. During 1995, Navajo specific prenatal nutrition education material promoting a healthy weight gain with appropriate dietary recommendations were developed and introduced The authors believe some of this intervention assisted in the decreases. However, since the very overweight has increased by 7% in the 20–29 year olds and 5.4% in the 40–49 year olds since 1994, more nutrition awareness and education is evident. Focused nutrition messages for the working and older prenatal and postpartum NNWIC participant were developed and introduced to the para-professionals and nutritionists. Since pre-pregnancy overweight is thought to be a risk factor for postpartum retention of prenatal gain as well as placing a postpartum woman at cardiovascular risk, heart healthy messages for a healthy weight were also developed which focused on changes in lifestyle, dietary practices, exercise habits, eating on the run and behavioral responses.

Predicting length of stay of substance-using pregnant and postpartum women in day treatment

Pregnant and postpartum substance-using women are a special population whose needs do not reflect those of the general substance-using communities. This study examined length of stay in a federally funded day treatment demonstration program in order to identify predictor variables that may help identify pregnant and postpartum substance-using women at high risk for dropping out of treatment. Variables from intake and exit questionnaires on a sample of 163 women were analyzed using multiple regression on both days in treatment and the logarithmic transformation of days in treatment. Few predictor variables were identified, although findings suggest that if a women is younger and self-referred, she may leave treatment sooner. As one of the first sets of published data on pregnant and postpartum women and retention in treatment, this study lays the groundwork for future research on the retention of pregnant and postpartum women in treatment, thereby facilitating the success of these women in overcoming their addiction.

Gestational weight gain, pregnancy outcome, and postpartum weight retention

To determine whether the risk of maternal overweight associated with an excessive rate of gestational gain needs to be balanced against the risks of impaired fetal growth associated with a low rate of gain. Rate of gestational weight gain was measured prospectively in a sample of 274 young, low-income, and primarily minority women (12-29 years old) with pregravid body mass indices (BMI) in the normal range (19.8-26.0). We defined an excessive rate of gain between 20-36 weeks' gestation as one greater than 0.68 kg/week, and a low rate of gain as one less than 0.34 kg/week. Women were followed-up at 4-6 weeks and 6 months postpartum. Rate of measured gestational gain between 20-36 weeks' gestation was associated with total weight gain based on pregravid weight, with infant birth weight and gestation duration, and with maternal overweight (BMI greater than 26) and weight retention postpartum. Infant birth weight and gestation duration were significantly reduced for women with low rates of gain, and there was no significant difference between women with excessive and moderate gains. Despite little difference in pregravid BMI, women with excessive rates of gain retained more weight overall, attained a greater postpartum BMI, and had higher levels of subcutaneous fat and overweight. Maternal anthropometric status showed little change between 4-6 weeks and 6 months postpartum. Weight gained at an excessive rate by women with a pregravid BMI in the normal range does not greatly enhance fetal growth and gestation duration, contributing instead to postpartum maternal overweight.

Changes in Adiposity Associated With Pregnancy-Reply

In Reply. —The relationship between lactation and weight retention postpartum has been raised by Dr Donnelly and Dr Thacker as one factor moderating changes in weight and adiposity among women following pregnancy. The focus of our article was not to identify determinants of weight retention postpartum, but to examine whether parous and nulliparous women differed in long-term weight gain. Therefore, we did not address lactation as a predictor of weight loss. We understand the interest in the relationship between lactation and postpartum maternal weight. In previous studies, breast-feeding has been associated with increased weight loss from 1 to 6 months postpartum, 1,2 but it was not related to the overall amount of weight lost by 1 to 2 years postpartum. 1-3 Furthermore, changes in fat distribution have been shown to be independent of breast-feeding. 4 Thus, recent reviews have concluded that lactation does not play a major role in postpartum

Chronic Urinary Retention Postpartum

Three cases of chronic urinary retention postpartum are reported. All patients were primigravidas. Unrecognized urinary retention following epidural anaesthesia in labour was the likely cause. Abdominal ultrasound may have a place in early recognition of this complication. The early use of a suprapubic catheter hastens bladder recovery.

Antler Shedding in Relation to Parturition in Female Reindeer

Observations were made on 4S individually recognized adult female reindeer ( Rangifer tarandus) as to exact date of parturition and antler shedding. Fifty percent of the cows had shed their antlers within 5 days postpartum. The maximum number of sheddings per day occurred on the sixth day after parturition. Postpartum retention of antlers varied from 1 to 11 days. No difference was found between old and young cows. The significance of antlers in female reindeer during calving season is discussed. It is supposed that possession of antlers gives the cow high social status which, combined with a high aggressive level, enables her to drive away other reindeer from the calving area, the calf thus being prevented from establishing contact with strange reindeer. It is supposed that the establishment of social mother-calf bonds would be impeded if strange reindeer were allowed to interfere. In a number of papers on reindeer and caribou (Rangifer tarandus) the shedding of antlers in females is discussed. Most authors agree that pregnant females retain their antlers until the calves are born, while barren cows cast their antlers 1-2 months earlier. There is, however, some disagreement as to the time interval between parturition and antler shedding. SemenovTyan-Shanskii ( 1948 ) reports that females drop their antlers within 3 days postpartum; Kuhmunen (unpublished data) found 24 days as the interval; Palmer (1934) gives 5-7 days; and Lent ( 1965 ), in his extensive studies on caribou, reported that no cows retained their antlers for more than 1 week after parturition. Except for Lent, the statements of the cited authors are not supported by any detailed evidence; however, Lent based his statement on several routine counts of cows with old antlers, and whether the cows were accompanied by calves. He apparently had no opportunity to relate parturition to antler shedding in 1 This work has been supported by the Swedish Natural Science Research Council. single animals because his whole study was on a population level.