Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality globally. This study aimed to assess the efficacy of ascending uterine artery ligation (AUAL) in preventing PPH among patients undergoing cesarean section (CS) for placenta previa. A retrospective cohort study was conducted at our institution between January 2022 and December 2024, enrolling 103 patients with placenta previa who underwent CS with concurrent AUAL. A matched control group was included, comprising 134 patients with placenta previa who underwent CS with administration of specialized uterotonic agents (without AUAL). All participants in both groups received intraoperative and postoperative oxytocin administration. Demographic characteristics and clinical outcomes were compared between the two groups, including maternal age, gestational age at delivery, parity, total surgical duration, 24-hour postpartum blood loss volume, postoperative hemoglobin concentration, occurrence of puerperal fever, and rate of uterine involution. Postoperative abdominal pain intensity was assessed via the Numerical Rating Scale (NRS). No statistically significant differences were observed between the AUAL group and the control group regarding maternal age, gestational age at delivery, parity, uterine involution rate, or the incidence of puerperal fever (P > 0.05). Notably, the AUAL group had significantly lower total 24-hour postpartum blood loss (495.3 ± 159.9ml vs. 648.1 ± 246.8 ml, P < 0.001) and a smaller reduction in postoperative hemoglobin (12.8 ± 5.5g/L vs. 16.8 ± 6.8g/L, P < 0.001) compared with the control group. However, the AUAL group was associated with a significantly longer operative time (1.9 ± 0.4h vs. 1.7 ± 0.5h, P = 0.025) and more severe postoperative abdominal pain. AUAL serves as an effective intervention to reduce 24‑hour postoperative blood loss in patients undergoing cesarean section for placenta previa. Although it was associated with more severe postoperative abdominal pain, it does not compromise key clinical recovery outcomes.

To evaluate the effectiveness of a structured, nurse-led early ambulation program on postoperative pain, uterine involution, gastrointestinal recovery, and psychological outcomes among women after cesarean delivery. A cluster-randomized controlled trial was conducted in a tertiary hospital in India among post-cesarean women assigned to either a structured early ambulation program or routine care by study week (10 clusters, 1:1 ratio). The intervention began 8-10 hours after surgery and continued for 4 days under nurse supervision. Primary outcome was pain intensity; secondary outcomes included uterine involution, constipation, psychological well-being, anxiety, obstetric recovery, and global health, assessed on postoperative days 1 and 4. Sixty women were equally allocated. The intervention group showed greater pain reduction, faster uterine involution, fewer gastrointestinal symptoms, improved psychological well-being, and better perceived global health. Obstetric recovery scores were higher, and early ambulation independently predicted lower pain on day 4. A structured, nurse-delivered early ambulation program initiated within 10 hours post-cesarean reduced pain and promoted early recovery. Early ambulation is a feasible, low-cost strategy that can be integrated into routine post-cesarean care. Early nurse-led ambulation improves physical and psychological recovery after cesarean birth.

This study investigated the effect of postcalving intrauterine proteolytic enzyme therapy on uterine involution, ovarian rebound, milk yield, biochemical indices, and postpartum fertility in dystocia‐affected buffaloes. Thirty buffaloes were randomly assigned to two groups. The treatment group (Group I; n = 15) received a combination of proteolytic enzymes, that is, trypsin (16 mg), chymotrypsin (16 mg), and papain (8 mg) dissolved in 500 mL normal saline (NS) intrauterine after relief of dystocia, while the control group (Group II; n = 15) received 500 mL NS as a placebo. Average uterine involution scores on Day 20, Day 45, and combined were significantly better (p < 0.05) in treated buffaloes, with 73.33% of controls exhibiting delayed involution. Treated animals showed a significant reduction (p < 0.05) in uterine infections. Blood lactate (bLac) and creatine kinase (CK) levels were lower (p < 0.05) in the treatment group on both days, with bLac showing a strong negative correlation (p < 0.05) and CK a moderate negative correlation with uterine involution scores. Milk production was significantly higher (p < 0.05) in the treatment group on Day 20 and Day 45. The cumulative pregnancy rate by Day 250 postpartum was greater in treated buffaloes (80.0%) than controls (46.67%), with a tendency toward improvement (X2 = 3.35; p = 0.067). In conclusion, intrauterine administration of proteolytic enzymes immediately after assisted delivery accelerated uterine involution, reduced uterine infections, improved milk yield, and enhanced fertility in dystocia‐affected buffaloes. Additionally, bLac and CK were identified as potential biomarkers for monitoring uterine health in the postpartum period.

BackgroundIndia is the most populous country in the world, with over 1.4 billion people, facing significant challenges in maternal and reproductive health services. Family planning is a key strategy to prevent unintended pregnancies and optimize spacing between births. Post-placental intrauterine contraceptive device (PPIUCD) insertion is a safe, long-acting, reversible, and cost-effective method of immediate postpartum contraception. This study aimed to compare continuation rates, complications, and expulsion rates of PPIUCD insertion between preterm and term deliveries, and to explore factors influencing outcomes.Settings and designHospital-based observational study conducted at VMMC & Safdarjung Hospital, New Delhi.Materials and methodsAmong 2000 antenatal women counseled for immediate postpartum IUCD insertion, 240 (12%) consented and were enrolled. Participants were divided equally into preterm (n = 120) and term (n = 120) groups. CuT 380 A devices were inserted immediately post-placentally. Follow-up was conducted at 3, 6, and 12 months to assess continuation, satisfaction, expulsion, and complications. Counseling was provided antenatally and postnatally using standardized IEC materials, models, and checklists.Statistical analysisCategorical variables were presented as numbers and percentages. Chi-square tests and t-tests were applied where appropriate using SPSS 24.0, with p < 0.05 considered statistically significant.ResultsThe mean age of participants was 26.9 ± 3.2 years. Continuation rates at 6 and 12 months were significantly higher in term deliveries (96.6% and 85.0%) than in preterm deliveries (88.3% and 63.3%; p < 0.05). Spontaneous IUCD expulsion was higher in preterm women at 6 months (7.5% vs. 1.6%) and 12 months (15.3% vs. 6.4%; p < 0.05), potentially due to smaller uterine size, underdeveloped uterine cavity, and variations in uterine involution. Satisfaction rates were high and comparable between groups at 12 months (81% preterm vs. 85% term; p > 0.05). Acceptance rates were low overall (12%), highlighting the need for structured counseling, provider training, and peer education to improve uptake.ConclusionPost-placental IUCD insertion is safe, effective, and cost-efficient in both preterm and term deliveries. Higher expulsion rates in preterm deliveries warrant focused counseling and follow-up. Structured antenatal and postnatal counseling, combined with provider confidence and patient education, is essential to increase acceptance and continuation of PPIUCD, particularly in populations at higher risk of early postpartum fertility.

The transition period in dairy cows, covering approximately 3 weeks before and after calving, represents a physiologically demanding phase characterized by profound metabolic and endocrine adjustments that strongly influence subsequent health and fertility. This study aimed to evaluate the effects of oral calcium propionate (CP) and/or intramuscular 1,25-dihydroxyvitamin D3 (VitD3) supplementation on calving-related disorders, blood metabolites, and reproductive performance in Friesian dairy cows during this critical period. Forty multiparous cows were randomly assigned to four groups (n = 10 each): control (no supplementation), CP (125 g twice weekly, orally), VitD3 (10,000 IU once weekly, intramuscularly), and a combined CP + VitD3 group. Supplements were administered for 4 weeks before and after parturition. Compared with the control group, cows supplemented with CP and/or VitD3 exhibited a significant improvement in uterine involution rate, time of placental expulsion, and duration of lochial discharge. The combined CP + VitD3 treatment resulted in earlier placental separation, a shorter duration of uterine involution, and a lower incidence of postpartum disorders, such as dystocia, retained placenta, uterine prolapse, abnormal lochia, endometritis, hypocalcemia, and repeat breeding. Moreover, treated cows showed higher serum glucose, calcium, total protein, and immunoglobulin G concentrations, alongside lower cortisol, non-esterified fatty acids, and aspartate aminotransferase activities, indicating improved metabolic adaptation and hepatic function. Reproductive performance was markedly enhanced, as reflected by a shorter interval to first estrus, reduced days open, fewer services per conception, and a higher conception rate, particularly in cows receiving the combined treatment. In conclusion, concurrent supplementation with CP and VitD3 during the transition period effectively enhances metabolic stability, mitigates periparturient complications, and substantially improves reproductive efficiency in Friesian dairy cows.

Introduction: Puerperal sepsis is defined as an infection of the genital tract occurring within 42 days after delivery. It is characterized by symptoms such as chills, fever, foul-smelling vaginal discharge, pelvic pain, and delayed uterine involution. The condition is more prevalent in low-income countries, with Uganda among those reporting higher rates. Puerperal sepsis can be acquired either during the initial birth hospital admission or after discharge, resulting in readmission. Although the risk of infection exists during the antenatal period, it increases significantly during delivery and remains elevated throughout the postnatal period.Knowledge of self-care and use of postnatal care services are often limited in low-resource settings, increasing the risk of infection. Understanding the differences between mothers readmitted and those who acquire puerperal sepsis while hospitalized provides information for designing targeted interventions in its prevention. Therefore, we compared the magnitude, maternal characteristics, and associated factors among mothers who developed puerperal sepsis during their initial admission and those readmitted with postdischarge puerperal sepsis at Mbarara Regional Referral Hospital.Methods: A retrospective chart review was conducted on a total of 316 files from 2017 to 2024 of mothers diagnosed with puerperal sepsis who had been admitted to the maternity and gynecology wards of Mbarara Regional Referral Hospital. Information was extracted using a predesigned checklist. The data were then cleaned, entered into MS Excel (Microsoft Corporation, Redmond, Washington, United States), and imported into IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, United States) for analysis. Readmissions were summarized as proportions, and binary logistic regression was performed for both bivariate and multivariate analyses. Additionally, the Mann-Whitney U test was used to assess differences in length of hospital stay.Results: The proportion of readmissions (66.8%, n = 211) was higher than that of mothers who acquired puerperal sepsis while still hospitalized. Most readmitted mothers had delivered by cesarean section (86.5%, n = 186) and were from rural areas (67.3%, n = 142). Factors significantly associated with readmission included age 15-19 years (adjusted odds ratio (AOR): 6.815; 95% CI: 1.786-26.018) and being primiparous (AOR: 0.424; 95% CI: 0.186-0.968). There was also a significant difference in length of hospital stay between readmitted and nonreadmitted mothers (Mann-Whitney U: 7974; Z: −4.085; p < 0.001).Conclusion and recommendation: Despite the observed reduction in admissions due to puerperal sepsis, the predominance of postdischarge cases, particularly among mothers who underwent cesarean section and younger mothers, remains a significant challenge to achieving Sustainable Development Goal 3. Targeted interventions focusing on the prevention of puerperal sepsis, with emphasis on postdischarge self-care, are therefore essential.

Forceful and coordinated contractions of the uterine myometrium are essential for successful labor, delivery, and postpartum uterine involution. Failure of the uterus to generate or sustain contractile force (uterine atony) after delivery results in postpartum hemorrhage, a leading cause of maternal mortality globally. Paradoxically, uterine atony is exacerbated by prolonged oxytocin exposure used to induce or augment labor through a process of contractile desensitization. Despite its prevalent use in obstetrics, the direct impact of oxytocin desensitization on myometrial contractile force generation remains poorly defined. Current model systems are inadequate to address this gap: ex vivo myometrial tissue strips are limited by tissue availability, donor variability, and lack of genetic tractability, while existing in vitro models provide only indirect readouts of contractility without direct force quantification. Here, we introduce engineered myometrial microtissues (EMMIs), a platform enabling the direct, isometric measurement of contractile force in response to physiological agonists like oxytocin. By embedding and molding immortalized human myometrial smooth muscle cells within a collagen hydrogel, we induced significant structural and molecular maturation over six days. Upon maturation, EMMIs were characterized by circumferential cellular alignment, sustained expression of smoothelin, upregulation of connexin-43, and a transcriptomic shift toward a contractile phenotype. Mature EMMIs generated calcium-sensitive, dose-dependent contractions to oxytocin and potassium chloride. Genetic deletion of the oxytocin receptor abolished oxytocin-induced contractility, establishing receptor specificity. Finally, we utilized EMMIs to recapitulate clinical oxytocin desensitization, providing a direct link between prolonged oxytocin exposure and diminished contractile output. Together, these findings establish engineered myometrial microtissues (EMMIs) as a genetically manipulable, and reproducible system for investigating myometrial contractile physiology to improve obstetric outcomes.

Uterine involution is an important physiological process after childbirth that indicates the recovery of the uterus to its normal size and function. However, suboptimal involution can cause serious complications in postpartum mothers. Non-pharmacological approaches, specifically postpartum exercise and oxytocin massage, are recognized for their potential to facilitate uterine involution. This study aims to evaluate the efficacy of these two interventions among postpartum mothers at the Matahari Pratama Clinic. Adopting a quasi-experimental framework with a two-group pretest-posttest design, the research involved 20 participants divided equally into two intervention groups. Uterine involution progress was systematically monitored both prior to and following the administration of either postpartum exercise or oxytocin massage. The results 1showed that before the intervention, 7 respondents (70%) experienced abnormal uterine involution. After being given postpartum exercise, the number of respondents experiencing normal uterine involution increased to 7 people (70%). Meanwhile, after oxytocin massage, 6 respondents (60%) showed normal uterine involution conditions. The findings suggest that both postpartum exercise and oxytocin massage significantly facilitate the acceleration of uterine involution. This effectiveness is statistically supported by a significance value of (p &lt; 0.05), confirming that these non-pharmacological interventions are viable methods for enhancing postpartum recovery. However, postpartum gymnastics has been shown to provide more optimal results than oxytocin massage. Therefore, these two interventions are recommended to be implemented routinely in postpartum care as an effort to accelerate the process of uterine involution and prevent complications.

The responsiveness of the stress axis is fundamental for maintaining health and sustaining productive performance; however, the effect of modulating this stress axis with bovine appeasing substance and its effects on biochemical, immunological, oxidative parameters and uterine involution have not been determined, which are the objectives of this experiment. To elucidate these questions, Holstein cows, from the prepartum to lactation period in a cross-ventilation system, received an application of a bovine appeasing substance (treated group) and a 0.9% saline solution (control group) at the time of calving, and blood samples were collected on calving day and on days 3, 7, 14 and 21 postpartum for analysis. Modulation of the stress axis by bovine appeasing substance increased magnesium levels on days 7 and 14 postpartum, with a reduction in fructosamine levels on days 3, 7, 14, and 21 postpartum. A reduction in ferritin levels, an acute-phase protein, and a reduction in interleukin 1 beta and interleukin 6 were also observed, demonstrating an anti-inflammatory effect in cows of the treated group. Creatine kinase activity decreased on day 21 postpartum in cows treated with bovine appeasing substances. An increase in cholinesterase activity on day 7 and a marked decrease on day 21 postpartum in treated cows were observed compared to the control. This was accompanied by a reduction in beta-hydroxybutyrate levels on day 7 and a reduction in reactive oxygen species levels on day 14 in animals of the treated group, indicating modulation of ketogenesis and reduced oxidation through an anti-inflammatory effect. Mean uterine thickness was also affected by the bovine appeasing substance, with a lower mean thickness on day 21 postpartum in treated cows. Modulation of the stress axis by the bovine appeasing substance reduces inflammation, improving energy dynamics and reducing oxidation, thus facilitating tissue repair associated with postpartum uterine involution in dairy cows.

The uterus of postpartum cows usually becomes contaminated with bacteria. To eliminate these bacterial contaminants, during uterine involution, the endometrium initiates an innate immune response carried out by professional immune cells but also by endometrial epithelial cells (EpC) and stromal cells (StC). A better understanding of the interactions between endometrial cells and bacteria such as Escherichia coli may contribute to improving diagnostic and therapeutic strategies for uterine diseases, and thus to enhancing conception efficiency in dairy cattle. This study aimed to investigate the capacity of bovine endometrial EpC and StC to adhere to and internalize E. coli in vitro. A primary culture of bovine endometrial cells was performed and challenged with FITC-labeled E. coli. Flow cytometry demonstrated that, unlike StC (P = 0.883), EpC significantly internalized E. coli (P = 0.013). This finding was further confirmed by confocal immunofluorescence imaging. Given that E. coli is typically considered an extracellular bacterium, these findings provide the first evidence showing that bovine endometrial EpC can adhere and internalize E. coli.

Post partum mothers experience physiological changes in uterine involution. Uterine involution in post partum mothers can cause pain in the uterus called afterpains. This raises the problem of acute pain in postpartum mothers. Management that can be done to reduce postpartum pain by providing counterpressure. Post partum mothers who counterpressure will be more free from pain, can manage fear, create feelings of comfort and relaxation. The purpose of this scientific work was carried out to determine the description of post partum nursing care with acute pain nursing problems given counterpressure massage action at Mengwi I Community Health Center. Descriptive method with a case study approach to the nursing care process carried out in managing clients with acute pain including assessment, nursing diagnosis, intervention, implementation and evaluation. Patient collection was carried out using purposive sampling technique in Mengwi I Community Health Center. The final scientific work of nurses involved three patients who were given counterpressure massage for 20 minutes. Evaluation of the action of the patient who initially experienced pain with an average scale of 6 which is classified as moderate pain and after being given counterpressure acute pain nursing problems have been resolved as evidenced by patients reporting reduced pain with an average pain scale of 3 which is included in mild pain. Giving counterpressure massage can overcome acute pain in postpartum patients so it is recommended that postpartum patients be given counterpressure massage to overcome pain.

Rapid uterine involution and early resumption of ovarian cyclicity are essential for improving reproductive efficiency in postpartum buffaloes. This study evaluated the effects of different hormonal protocols administered during early postpartum on uterine involution, ovarian activity, and reproductive performance in multiparous Egyptian buffaloes. Particular attention was given to the timing of equine chorionic gonadotropin (eCG) administration, as its application around Day 14 postpartum has been relatively less explored in buffaloes despite coinciding with early uterine recovery and emerging follicular activity. Ninety buffaloes were allocated into five groups receiving gonadotropin‐releasing hormone (GnRH), eCG, or their combinations with prostaglandin F2α, in addition to a control group. Reproductive performance, ovarian activity assessed by ultrasonography, and serum progesterone concentrations were monitored during the early postpartum period.Buffaloes treated with eCG showed shorter uterine involution periods, reduced days open, and higher pregnancy rates compared with untreated controls. Hormonal treatments, particularly eCG‐based protocols, enhanced ovarian cyclicity, as reflected by improved follicular development, corpus luteum formation, and increased progesterone concentrations.In conclusion, the most favorable reproductive outcomes were achieved when eCG was administered alone or in combination with GnRH and prostaglandin F2α during the early postpartum period.

Background: Retained fetal membranes (RFM) is a common postpartum disorder in dairy cows and is associated with impaired reproductive performance, delayed uterine involution, and an increased risk of uterine infection. Hormonal imbalance during the postpartum period may contribute to the development of RFM and subsequent reproductive inefficiency. Understanding endocrine alterations and evaluating therapeutic interventions are important for improving fertility outcomes in affected cows. Objective: This controlled clinical study investigated the association between hormonal profiles and reproductive performance in dairy cows affected with retained fetal membranes and evaluated the effects of selected therapeutic protocols. Methods: A total of 88 Holstein cows were enrolled from a herd of 250 animals. Twenty-four cows that expelled fetal membranes within 24 hours postpartum served as healthy controls, while 64 cows diagnosed with RFM (&gt;24 hours postpartum) were allocated into four treatment groups (n = 16 each): intrauterine antibiotic therapy administered 24 hours postpartum, intramuscular GnRH (5 mL) on day 12 postpartum, intramuscular PGF₂α (2 mL) between days 18 and 26 postpartum, or combined GnRH and PGF₂α treatment at the same time points. Hormonal and reproductive parameters were monitored and compared among groups. Results: Cows affected with RFM exhibited significantly higher (P &lt; 0.05) progesterone and cortisol concentrations and significantly lower (P &lt; 0.01) oestradiol-17β levels compared with controls. Treatment with either GnRH or PGF₂α alone significantly reduced (P &lt; 0.05) the interval from calving to first insemination and to conception compared with other treated groups. The number of services per conception was significantly lower (P &lt; 0.05) in cows receiving combined GnRH and PGF₂α therapy. Higher conception rates at first insemination and overall conception were also observed (P &lt; 0.05) in cows treated with GnRH or PGF₂α alone relative to the remaining treatment groups. Conclusion: Cows with retained fetal membranes showed altered endocrine profiles associated with impaired reproductive performance. Therapeutic intervention with GnRH or PGF₂α was associated with improved reproductive cyclicity, while combined hormonal treatment reduced insemination frequency per conception.

Ovarian hypofunction is a major reproductive disorder in dairy cows and contributes substantially to reduced fertility, prolonged days open, and economic losses. Increasing evidence indicates that this condition is not solely an ovarian problem but part of a broader immunometabolic disturbance that also affects uterine health during the postpartum transition period. Negative energy balance after calving leads to elevated circulating metabolites such as non-esterified fatty acids and β-hydroxybutyrate, which trigger oxidative stress and inflammatory signaling. These changes impair hypothalamic-pituitary-ovarian activity, suppress steroidogenesis, and delay follicular development. At the same time, metabolic stress weakens uterine immune defense, slows uterine involution, and increases susceptibility to endometritis, creating a reciprocal cycle in which uterine inflammation further inhibits ovarian reactivation. This narrative review synthesizes current knowledge on the bidirectional interactions between ovarian function and uterine health from an immunometabolic perspective. A structured literature search of major scientific databases was conducted, focusing on peer-reviewed studies addressing postpartum metabolism, immune responses, reproductive physiology, and non-hormonal therapeutic approaches in dairy cows. The review integrates endocrine, metabolic, and inflammatory mechanisms into a unified framework explaining how immune-metabolic imbalance disrupts reproductive homeostasis. Within this framework, uterine flushing therapy is discussed as a practical non-hormonal intervention aimed at restoring uterine conditions rather than directly inducing ovulation. By removing inflammatory exudates, reducing endotoxin load, improving endometrial perfusion, and supporting immune resolution, flushing may indirectly promote normalization of hormonal signaling and ovarian activity. Field evidence suggests that, when combined with appropriate nutritional and herd management strategies, this approach can improve pregnancy outcomes and reduce reliance on repeated hormonal treatments. Overall, adopting an immunometabolic management strategy that integrates metabolic monitoring, uterine health assessment, and targeted supportive interventions offers a promising pathway to enhance reproductive efficiency and sustainability in modern dairy production systems. Further standardized field trials and biomarker-guided protocols are needed to validate these approaches and facilitate their wider on-farm implementation.

To assess the impact of Roy Adaptation Model (RAM)-based nursing on postpartum recovery in primiparous women after vaginal delivery. 258 primiparous women were randomly assigned using a computer-generated random sequence to a control group (routine nursing, n = 133) or an intervention group (routine nursing plus RAM interventions, n = 125) for 8 weeks. Outcomes included pelvic floor function (PFDI-20, nocturia frequency, vaginal dynamic pressure), pelvic floor muscle strength (vaginal contraction duration, contraction/resting EMG values), psychological status (SAS, SDS, EPDS), quality of life (QOL), and complications. Compared to the control group, the intervention group demonstrated significantly higher vaginal dynamic pressure, vaginal contraction duration, contraction EMG values, and resting EMG values (all p < 0.05). They also showed significantly lower nocturia frequency, PFDI-20 scores, breast swelling/pain scores, shorter lochia resolution and uterine involution times, and reduced incidences of stress urinary incontinence, pelvic organ prolapse, and sexual dysfunction (all p < 0.05). SAS, SDS, and EPDS scores were significantly lower (p < 0.05), while QOL scores were significantly higher (p < 0.05) in the intervention group. RAM-based nursing promotes postpartum physical recovery, alleviates psychological distress, and enhances quality of life in primiparous women after vaginal delivery.

Postnatal herbal medicine and boiled water are herbs are usually given to postpartum mothers to strengthen the body and speed up the recovery period of the uterus, speed up the cessation blood and healing perineal wounds. Method: Quasi Experimental research type Pretest-Posttest Nonequivalent Control Group Design. Held at PMB Nuripah Kubu Raya on 21-27 November 2023. Total sample was 34 respondents, the respondents were divided randomly into 2 groups, postpartum mothers in intervention group were given 1x1 multivitamin and postnatal healthy herbal medicine test ingredients at a dose of 1x1 suchet (25 grams) and Postpartum mothers in control group were given 1x1 multivitamin as a comparison, the research was carried out for 7 days. Results: The intervention group had an effect on changes in uterine involution based on anteroposterior diameter (p. 0.005), changes in uterine involution based on longitudinal length (p. 0.002), the amount of locheal discharge (p. 0.003), the smell of locheal discharge (p. 0.002), reducing the pain scale (p. 0.000) and perineal wound healing (0.003). Conclusion: Healthy postpartum herbal medicine and perineal wound fluid effective accelerating early puerperium period (uterine involution, lochea and perineal wounds) with the fastest start of action compared to the control group (multivitamin).

Background: Although thrombophilia represents a major risk factor for adverse maternal outcomes, particularly in the postpartum period, methods for its systematic screening remain costly and limited. This case–control study aimed to evaluate whether routinely available hematological inflammatory indices combined with postpartum uterine ultrasonographic assessment can predict the presence of thrombophilia in peripartum women. Methods: Eighty women with previously diagnosed and treated thrombophilia undergoing cesarean section at term were prospectively enrolled and matched by age and parity with 80 control patients without thrombophilia. Hematological inflammatory markers derived from complete blood counts obtained within 24 h before delivery and the postpartum uterine ultrasonographic score were analyzed. Multivariable logistic regression was performed to identify independent predictors of thrombophilia, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: Impaired postpartum uterine involution—defined as a postpartum uterine ultrasonographic score ic—was significantly more frequent in thrombophilia cases than in controls (OR > 1, 95% CI excluding 1; p < 0.05). Thrombophilia patients exhibited significantly higher Neutrophil-to-Lymphocyte and Platelet Ratio and Cumulative Inflammatory Index values when compared with the controls, with both emerging as independent predictors in the multivariable model (OR > 1, 95% CI excluding 1; p < 0.05). The final model demonstrated good discriminative performance, with an overall classification accuracy of 88.6% and excellent specificity for excluding thrombophilia when the postpartum uterine ultrasonographic score was 0. Conclusions: The integration of postpartum uterine ultrasonographic assessment with simple hematological inflammatory indices provides a non-invasive, cost-effective approach for identifying women at increased risk of underlying thrombophilia in the immediate postpartum period. This strategy may support targeted thromboprophylaxis and rationalize the use of specialized thrombophilia testing.

In East Asia and the Pacific region, the leading causes of maternal mortality are hemorrhage, sepsis/infections, obstructed labor, and hypertensive illnesses. To analyze the effect of a combination of warm Sitz Bath therapy and boiled taumo leaves (Blumea balsamifera) on uterine involution in postpartum mothers. This quasi-experimental study used a pre- and post-intervention group design. The population in this study was all postpartum mothers in North Konawe Regency with a sample size of 196 mothers consisting of two groups, namely mothers who were given sitz bath therapy alone and mothers who were given a combination of sitz bath and taumo leaf decoction. The intervention will be carried out for 20 min every day for 3 days, and an evaluation will be carried out every day for uterine involution. Mann–Whitney U and Wilcoxon signed-rank tests were used for the analysis. In the intervention group, there was a decrease in Uterine Fundus Height on days 1–2 and 1–3, with p-values ​​of 0.001 and 0.000, respectively. A decrease in Uterine Fundus Height also occurred in the control group on days 1 to 2 and days 1 to 3, with p-values ​​of 0.003 and 0.002, respectively. The analysis revealed significant differences in uterine fundus height during the first three days postpartum. These findings emphasize the importance of closely monitoring these parameters for optimal maternal and neonatal outcomes.

A decrease in the height of the uterine fundus is an important indicator of a normal uterine involution process after childbirth. Delayed reduction of fundal height may lead to uterine subinvolution, which increases the risk of postpartum hemorrhage, particularly in post–cesarean section mothers. Early breastfeeding and early mobilization are recommended interventions to support uterine contraction, prevent vaginal bleeding, and accelerate uterine involution. This study aimed to examine the effect of early breastfeeding and early mobilization on reducing the height of the uterine fundus in post–sectio caesarea mothers treated in the Amaryllis SMC Room at Telogorejo Hospital. The study employed a quasi-experimental design with a one-group pretest–posttest approach. The population consisted of 523 post–cesarean section mothers hospitalized at SMC Telogorejo Hospital between January and November 2023. Data were collected using structured observation sheets to measure fundal height before and after the interventions. The results showed that the average uterine fundal height before early breastfeeding and early mobilization was 19.74 cm above the symphysis, while after the interventions it decreased to an average of 12.49 cm above the symphysis. Statistical analysis indicated a significant effect of early breastfeeding and early mobilization on the reduction of uterine fundal height (p = 0.000). These findings highlight the importance of implementing early breastfeeding and mobilization as part of postpartum nursing care to support uterine involution and reduce the risk of complications in post–cesarean section mothers.

Little is known about the reproductive impacts of the GAA, creatine precursor, in ruminants. This study aimed to evaluate the effects of GAA supply during the transition period in ewes with single pregnancies on their uterine involution. Sixteen ewes with single pregnancy were allocated to two groups: one receiving a basal diet (WGAA, n = 8) and another receiving a basal diet supplemented daily with 0.6 g/kg DM diet of GAA (RUGAA, n = 8) from 100 days of gestation to 35 days postpartum (PP). The RUGAA group showed increased feed intake after delivery and modified diet selectivity. Also, at parturition, a smaller cotyledonary surface area and lower offspring weight at birth were observed. During PP, RUGAA exhibit a slight reduction in the loin depth and backfat thickness, and higher peripheral glutathione peroxidase level. Also in PP, RUGAA expressed a greater rate of uterine lumen shrinkage, more efficient mammary parenchyma growth and a higher relative lambs growth rate. We concluded that supplementation with 0.6 g of GAA in ewes with single pregnancies improved postpartum uterine involution, but also altered the mother-fetus communication system, affecting the birth weight of the offspring. Therefore, we believe further studies are necessary to efficiently align creatine demand with the distinct physiological events that occur during gestation and the postpartum period.