Uterine Involution Research Articles

Role of trace minerals in cow’s reproductive function and performance: a clinical theriogenology perspective*

Trace minerals (TM) have a crucial role in cattle reproduction. Although microelements are required in small amounts, their bioavailability is essential for the cow reproductive physiology, and for adequate fertility and productivity. They are particularly important for antioxidant protection against cellular damage (e.g. gametes and embryonic cells), hormone synthesis, and pregnancy maintenance. Oral TM supplementation is a common and highly recommended management practice in cattle operations. However, there is substantial variability in TM bioavailability in animals receiving oral TM supplementation. The strategic use of injectable TM supplementation (without replacing traditional oral TM supplements) before episodes of marked stress (e.g. parturition), higher metabolic demand with TM depletion (e.g. last trimester of pregnancy), active immune response (e.g. uterine involution or vaccination), and before breeding helps to maintain adequate TM and oxidative status during critical points of the reproductive program. This manuscript reviews the research-based evidence regarding the effects of TM supplementation on bovine reproduction and its impact on beef and dairy cattle reproductive performance.

Progesterone Concentrations during Uterine Involution in Sahelian Goats

Progesterone Concentrations during Uterine Involution in Sahelian Goats

Adenomyosis and fibrosis define the morphological memory of the postpartum uterus of dairy cows previously exposed to metritis.

Optimal fertility after calving in lactating dairy cows is dependent upon the successful completion of uterine involution. Invasion of pathogenic bacteria into the uterine environment within the first week postpartum can lead to uterine disease (metritis). Metritis is associated with decreased fertility and a failure or delay in establishing pregnancy. We hypothesized that early postpartum metritis would be associated with long-term changes in uterine morphology that begin within the first 30 d postpartum (dpp) and are present during a typical breeding window (2–6 mo postpartum). First parity Holstein cows were diagnosed with metritis (M) or deemed healthy (H) at 7 to 10 dpp and uterine tissues were collected and analyzed post-mortem at 30 (Exp. 1; M = 10, H = 10), or 80 and 165 (Exp. 2; M = 9, H = 10) dpp for the presence of abnormal morphology, including abnormal invasion of endometrial glands and stroma into the myometrium (adenomyosis) and endometrial fibrosis. Glands were identified using immunohistochemistry for FOXA2 (uterine gland specific marker) and fibrosis was identified using mason's trichrome stain (MTS). The severity of adenomyosis was assessed by the number and size of adenomyotic foci and the distance of foci from the endometrium-myometrium interface (EMI). The degree of fibrosis was defined by MTS intensity. Data were analyzed using a 2-way ANOVA procedure including the effect of metritis and dpp on dependent variables foci size, distance from EMI, and MTS intensity. A negative binomial regression model was utilized for the dependent variable of foci number. The presence, size, and distance from the EMI of adenomyotic foci were greater for later postpartum (Exp. 2, 80 and 165 dpp) and early postpartum cows (Exp. 1, 30 dpp) that were previously diagnosed with metritis, suggesting greater severity of adenomyosis. Endometrial fibrosis was greater at the stratum basalis (near EMI) compared with the stratum compactum endometrium (near uterine lumen) for all Exp. 2 (80 and 165 dpp) cows. Greater fibrosis (regardless of endometrial region) was observed in cows diagnosed with metritis compared with healthy controls. Taken together, these data indicate that early postpartum metritis is associated with long-term changes to postpartum uterine morphology, including increased pathological fibrogenesis, leading to the presence of late postpartum endometrial fibrosis (scar tissue), and aberrant endometrial invasion into the myometrium (adenomyosis). Additionally, increased collagen fiber at the EMI suggests a correlation between the development of adenomyosis and fibrosis, which could result from sustained endometrial inflammation caused by uterine disease.

Recovery of ovarian activity and uterine involution in postpartum primiparous Hanwoo cow

Recovery of ovarian activity and uterine involution in postpartum primiparous Hanwoo cow

Oxytocin Massage on Pain Levels and Breast Milk Production in Post Cesarean Section (Case Study)

Post cesarean section (CS) is a physiological condition that occurs in women who give birth via cesarean section or surgery. The changes include pain, uterine involution, breastfeeding (ASI) production, and psychological adjustments.. According to research, 20-80% of post CS patients experience moderate to severe pain that is inadequately managed. In Indonesia, this occurs at a rate of 30-80%. The effective breastfeeding rate in Indonesia is 55.5%, which does not yet meet the national target of 80%. Given the magnitude of these issues, the author aims to describe the influence of oxytocin massage application on pain levels and ASI production in post CS patients through this scientific work. The methodology used is a case study involving patients Mrs. L on their first day post CS. The intervention was applied from the second to the third day post CS, twice daily. The results of this application show that oxytocin massage can reduce pain from a scale of 7 to 3 and increase breast milk production, with a cumulative increase from no milk output to more than 50 cc.. It is hoped that the application of evidence-based nursing: oxytocin massage can be implemented as a standard intervention for post CS patients in hospitals.

Health risk assessment of heavy metals in Malay herbal medicine (MHM) consumed by pregnant and postpartum mothers

BackgroundMalay herbal medicine (MHM) is a popular medication and supplementation among Malaysian mothers during pregnancy and postpartum. It is expected to improve the baby’s health, increase breastmilk production, promote slimming and uterine involution, and improve the mother’s general health. Recent increases in reports of heavy metal contamination have raised safety concerns.ObjectiveThis pilot exploratory study employed a comparative cross-sectional design to investigate the types of MHM ingested during pregnancy and postpartum, their possible heavy metal contamination and associated health risks.MethodThis study involved 167 healthy postpartum Malay women.FindingsMHM consumption was significantly associated with the mother’s number of pregnancies and children (p < 0.05) as well as her pre-pregnancy weight (p < 0.05). Mothers who consume MHM were twice as likely (95% CI 1.077–3.963) to experience threatened abortion. Heavy metals were detected in the three most widely consumed MHM samples. The mean concentration of heavy metals in these samples were 47.44 ± 67.74 μg/kg for As, 25.34 ± 2.48 μg/kg for Cd, 3685.87 ± 5683.36 μg/kg for Cr and 194.33 ± 195.19 μg/kg for Pb. The calculated non-carcinogenic hazard health risks (HQ) and health index (HI) were less than one, suggesting no adverse health impacts under the exposure conditions studied.ConclusionWhile the HQ and HI values indicate no immediate health risks, the potential transfer from mother to foetus during pregnancy and from mother to infant during breastfeeding warrants further investigation. Additional studies are essential to confirm our findings and monitor the health of mothers and infants.

EFEKTIVITAS SENAM NIFAS TERHADAP INVOLUSI UTERUS PADA IBU NIFAS DI PUSKESMAS MUARA TELANG KABUPATEN BANYUASIN

One of the non-conventional therapies usually given to postpartum mothers to accelerate the reduction in uterine involution is postpartum exercise. Movements in postpartum exercises can train and tighten the abdominal muscles so that they can indirectly stimulate the uterine muscles to function optimally and prevent post-partum bleeding. The aim of this research is to determine the effectiveness of postpartum exercise on uterine involution in postpartum women at the Muara Telang Community Health Center, Banyuasin Regency. The research method used was a control group design approach. The population was all postpartum mothers totaling 40 people and a sample of 20 people, of which 10 cases and 10 controls used purposive sampling technique. The data analysis used was the Chi Square test. Research results: There was a difference in uterine involution before and after postpartum exercise, the pretest average value was 10.90 and the posttest average value was 3.50, whereas in the control cases on the first day and on the seventh day the average value was 11. 20 and an average value of 5.70, so there is a difference before and after giving postpartum exercises on uterine involution in postpartum mothers at the Muara Telang Community Health Center, Banyuasin Regency. It is hoped that postpartum mothers will increase their knowledge about the benefits of postpartum exercise.

Prevalence and risk factors of reproductive health problems in dairy cows in Southern Ethiopia

Reproductive disorders are the leading cause of economic loss in the cattle industry, as they reduce the reproductive efficiency and lifetime productivity of cows. In Ethiopian dairy, without proper preventive measures, these disorders can have a severe impact on productivity. Therefore, it is crucial to identify the extent of these issues and the factors contributing to them in order to improve the health and productivity of dairy cows. This study aimed to assess the prevalence, type, and potential risk factors for reproductive health problems in dairy farms in Hawassa city and Wolaita Sodo town. We observed 391 pregnant and postpartum cows for reproductive disorders and used a logistic regression model to identify risk factors. The study found that 165 cows (41.6%; 95% CI: 36.8-46.5%) had at least one reproductive issue. The most common disorders included retained fetal membrane (11.6%), dystocia (10.5%), metritis (7.2%), abortion (5.6%), stillbirth (2.6%), uterine/vaginal prolapse (2.3%), endometritis (2.1%), and pyometra (0.5%). The risk of dystocia significantly increased with male calf deliveries (OR=2.9; p=0.004) and larger farm sizes (OR=2.1; p=0.039). Cows experiencing dystocia were 5.3 times more likely to have retained fetal membrane (p&lt;0.001). Heifers were significantly more likely to develop metritis (OR=5.1; p=0.001), as were cows with retained fetal membrane (OR=11.6; p&lt;0.001). The incidence of abortion was significantly elevated in cows from semi-intensive farms (OR= 5.3; p&lt;0.001). The study concludes that these reproductive health issues can significantly impact future uterine health, resulting in prolonged uterine involution. It is crucial to raise awareness among dairy farmers about effective herd health management practices to minimize losses.

Effects and mechanisms of Panax notoginseng-steamed chicken on uterine involution in mice

Effects and mechanisms of <em>Panax notoginseng</em>-steamed chicken on uterine involution in mice

Determination of the impacts of supplemental dietary curcumin on post-partum uterine involution using pulsed-wave doppler ultrasonography in Zaraibi goat

This study aimed to evaluate the impacts of supplemental dietary curcumin on post-partum uterine involution using pulsed-wave Doppler ultrasonography in postpartum goats. Ten pluriparous Zaraibi goats were used and divided into two groups. Group 1 (n = 5; control) received only a base diet. Group 2 (n = 5; treated) received a base diet supplemented with curcumin (200 mg/kg diet) daily for 28 days, starting from day 1 postpartum (PP) till day 28 PP. Uterine morphometrical changes (uterine horn diameter; UHD and caruncle diameter; CD), uterine hemodynamics (resistance and pulsatility indices (RI and PI), systolic/ diastolic ratio (S/D), peak systolic velocity (PSV), end-diastolic velocity (EDV), blood flow volume (BFV), and blood flow rate (BFR)), and progesterone level were evaluated. Results revealed that the diameter of the uterine horn decreased rapidly from day 1 to day 10 PP (> 50%) but more steadily from day 14 to day 28 PP in both groups. After day 21 PP, there was nearly no reduction in UHD and CD in both groups. The treated group had lower values of the RI and PI (P < 0.05) than the control group. Regarding the BFR and BFV in the treated group, there was a significant increase (P < 0.05) on day 17 PP, then started to decrease till day 28 PP. While in the control group, there was a significant decrease (P < 0.05) in BFR and BFV from day 1 PP till day 28 PP. In conclusion, the incorporation of curcumin in the diet of PP Zaraibi goats improved reproductive performance via improvements in uterine morphometric changes as well as blood perfusion.

EFFECTIVENESS OF POSTPARTUM EXERCISE FOR POSPARTUM WOMEN ON UTERINE INVOLUTION

Postpartum exercise plays an important role in the process of uterine involution. The involution process will proceed well if uterine contractions are strong, so action must be taken to improve uterine contractions. Efforts to control bleeding from the placenta by improving strong contractions and retraction of myometrial fibers with postpartum exercises. The aim of this research is to determine the effectiveness of postpartum exercises for postpartum mothers. on Uterine Involution at the Pujud Community Health Center, Rokan Hilir Regency. This type of research is a quasi-experimental design. The population in this study were postpartum mothers, who were taken using a purposive sampling technique. Of the 17 postpartum mothers in the Pujud Community Health Center Working Area, Rokan Hilir Regency, before postpartum exercise there was a decrease in Rapid TFU of 0 (0%), a decrease in Normal TFU of 8 (47.1), a decrease in Slow TFU of 9 (52.9) and after After postpartum exercise was carried out, there was a rapid decrease in TFU in 11 people (64.7%), there was a decrease in normal TFU in 6 (35.3), there was a slow decrease in TFU in 0 (0). There was a significant influence between postpartum exercise and uterine involution as seen from the height measurement. Uterine fundus with the One-Sample Test results above show that the P value is 0.000 &lt; 0.05. So, in accordance with the basis for decision making in statistical tests, it can be concluded that postpartum exercise carried out before and after is effective in reducing the fundal height of the uterus (TFU) of postpartum mothers at the Pujud Community Health Center, Rokan Hilir Regency. It is hoped that all postpartum mothers can understand the benefits of postpartum exercise for uterine involution process. .

Профілактика ускладнень кесаревого розтину і консервативної міомектомії у вагітних із лейоміомою матки

Aim - to evaluate the effectiveness of the improved technique of cesarean section (CS) with conservative myomectomy (CME) using modern medical and instrumental means іn pregnant women with uterine leiomyoma (LM) type 3-6 by FIGO (International Federation of Gynecology and Obstetrics). Materials and methods. A fragment of a prospective study with a comprehensive examination and selection of optimal delivery tactics for pregnant women with LM at the clinical bases of the Ob/Gyn. Department No. 1 of Shupyk National Healthcare University of Ukraine for the period 2020-2023. The main group (MG, 1) of the study consisted of 37 pregnant women with LM &gt;5 cm type 3-6 according to FIGO, who underwent CS with CME according to an improved technique with the use of modern drugs: tranexamic acid, carbetocin and technical support (argon-plasma coagulation, radio-wave scalpel). The comparison group (CG, 2) included 28 pregnant women with LM &gt;5 cm type 3-6 according to FIGO with CS and CME performed according to the standard method. The control group (KG, 3) was made up of 17 pregnant women without LM, who underwent a planned CS. The reliability of the results was assessed using the Student's t-test. The difference of the obtained indicators was considered to be significant at p&lt;0.05. Results. The improved technique of CS with CME made it possible to reliably reduce the volume of blood loss in MG women compared to CG women (р1,2&lt;0.01) and was statistically insignificant with KG (р1,3&gt;0.05). A decrease in the frequency of complications during surgery and in the postpartum period in the main group was noted: a 2-fold decrease in purulent-inflammatory complications and a faster pace of uterine involution in the first 3 days of the postpartum period (р1,2&lt;0.05). Conclusions. Pregnant women with LM have an increased risk of bleeding, purulent-inflammatory complications, and the frequency of hysterectomies. The improved technique of performing CS with CME makes it possible to reduce the frequency of complications during surgery and postpartum period, preserve the organ in women of reproductive age and helps to avoid repeated surgery in the future for LM. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

The prevention of infectious complications of caesarean section in the context of the global rise of antibiotic resistance

In the context of the global rise of antibiotic resistance, optimising the prevention of infectious complications of caesarean section (CS) with a reassessment of the guidelines for ultra-short antibiotic (AB) regimens is becoming increasingly important. Given the current data on the negative consequences of the use of AB in pregnant women for the fetal microbiota, the role of antiseptics that are used locally, do not pass to the child, and are less likely to cause resistance, have a wider range of antimicrobial activity is increasing.The objective: to provide clinical evidence for the prevention of infectious complications of CS by topical application of an antiseptic with decamethoxin.Materials and methods. A comparative study of two homogeneous groups of women with low infectious risk delivered by elective CS was conducted. In the 1st group (55 women) an antiseptic with decamethoxin was used at all stages of abdominal delivery: preoperative treatment of the skin and vagina, intraoperative irrigation of the inner surface of the uterus, uterine sutures, and subcutaneous tissue. The 2nd group (55 patients) received conventional antibacterial prophylaxis. In the course of clinical and microbiological parallels, ultrasound monitoring of uterine involution, the results of the examination on the 42nd day after CS and information on the condition of the newborn child were used.Results. The absence of infectious complications of puerperium, infection of the surgical site, trends and signs of inflammatory reactions in both groups was revealed.In the 2nd group 5.5% of patients had partial skin suture separation due to seroma formation and transient infiltration of the subcutaneous tissue. The absence of such phenomena in the 1st group should be considered a consequence of the cytoprotective effect of decametoxin. The use of an antiseptic with decametoxin has pharmacoeconomic advantages over antibiotic prophylaxis regimens.Conclusions. The use of antiseptic with decametoxin in the perioperative care of caesarean section combines the possibility of safe reduction of antibiotics, effective antiinfective protection with guaranteed safety for the child.

New Insights in Uterine Involution and Ovarian Resumption in Domestic Animals

New Insights in Uterine Involution and Ovarian Resumption in Domestic Animals

Development potential of selenium in the prevention and treatment of bovine endometritis.

Endometritis is a common postpartum disease in cows. It delays uterine involution and impairs normal physiological function. This can result in long-term or even lifelong infertility and cause significant losses to the dairy farming industry. Traditional treatments like antibiotics possess certain shortcomings, such as antibiotic residues, the abuse of antibiotics, and increased antimicrobial resistance of pathogens. Alternative treatment strategies are needed to minimize the utilization of antibiotics in dairy production. As an essential trace element in animals, selenium (Se) plays a vital role in regulating immune function, the inflammatory response, and oxidative stress, affecting the speed and completeness of tissue repair. This paper reviewed previous studies to analyse the potential of Se in the prevention and treatment of bovine endometritis, aiming to provide a new direction to increase production capacity in the future.

Oxytocin, prostaglandin F2α, and scopolamine for uterine involution of dairy cows.

The aim of the study was to compare the effect of three substances with ecbolic activity, Oxytocin, Prostaglandin F2α (PGF2α) and Scopolamine, on the uterine involution process in dairy cows and on the resumption of ovarian activity. Eighty bovine were randomly divided in four groups: GROUP C: 20 cows treated, within 24 h of calving, with 5 mL/head of saline solution; GROUP PG: 20 cows treated, within 24 h of calving, with 150 μg/head of d-cloprostenol; GROUP OX: 20 cows treated, within 24 h of calving, with 50 IU/head of oxytocin acetate; GROUP S: 20 cows treated, within 24 h of calving, with 40 mg/q Scopolamine Butylbromide. Each cow was subjected to blood samples to evaluate the Hydroxyproline (HYP) levels, at T0, within 24 h after calving, and T7, T14, T28, 7, 14, and 28 days after calving, respectively. At T14 and T28, an ultrasound examination was performed to measure the diameter of ex-pregnant horn. In all cows, the reproductive indices (days to first service and number of artificial insemination for conception) were evaluated. In all groups, the HYP concentrations have been rising from T0 to T28, with the maximum levels obtained at T28 in the groups PG and S. As regard the diameter of uterine horn, the comparison among the groups showed significant differences only at T28, with lower values in the group PG and S. In group S and PG, the days to first service were less than other groups. Treatment with Scopolamine and PGF2α resulted in better outcomes, evidenced clinically by more efficient uterine involution and faster ovarian recovery.

Randomized clinical trial of ketoprofen or ceftiofur for treatment of metritis in dairy cows

Our objectives were to compare the efficacy of ketoprofen or ceftiofur for treatment of metritis in dairy cows considering subsequent health, production, and reproduction. Cows from 2 commercial dairy farms in Ontario, Canada were examined with a Metricheck device 3 times per week from 2 to 14 d in milk (DIM). Cows with metritis (fetid vaginal discharge; n = 193) were blocked by parity and fever (rectal temperature ≥39.5°C or <39.5°C) and within each block per farm, randomly assigned to receive 3 mg/kg BW of ketoprofen (KET) or 2.2 mg/kg of ceftiofur hydrochloride (CEF), once a day for 3 d. Day of enrollment was considered study d 0. Rectal temperature and attitude were evaluated in cows with metritis on study d 0, 3, 4, 7, 10, and 13, and vaginal discharge was evaluated on study d 4, 7, 10, and 13. Body condition was scored at enrollment and 35 DIM, and serum concentration of haptoglobin was measured at d 0, 2, 4, and 7. Cows with rectal temperature ≥39.5°C or a depressed attitude on d 3 were classified as clinical failure and received treatment with ceftiofur for 3 d (KET), or 2 additional days (CEF), to a maximum of 5 d of treatment with ceftiofur. At 35 ± 3 DIM cows were examined for uterine involution by transrectal palpation, purulent vaginal discharge (PVD) by Metricheck, and endometritis by endometrial cytology. Time to onset of cyclicity was assessed by serum progesterone (P4) measurements at 28, 42, and 56 DIM. Contemporary cows from the same farms without metritis (NOMET; n = 1,043) were used for comparison. Data were analyzed with mixed linear or logistic regression or Cox's proportional hazard models, including herd as a random effect. The proportion of clinical resolution of metritis on d 3 (96% vs. 92%), of cows with fever (from d 3 to d 13 after enrollment) or fetid discharge (from d 4 to d 13 after enrollment), and the number of medical treatments (3.1 vs. 3.3) were not different between CEF and KET, respectively. Cows in KET received fewer antibiotic treatments than cows in CEF (0.3 vs. 3.1). Uterine involution, the prevalence of PVD (50% vs. 47%) and subclinical endometritis (6.6% vs. 4.3%), and the proportion of cyclic cows (82% vs. 86%) did not differ between CEF and KET. Cows in KET had greater serum haptoglobin concentration from d 2 to 7 after enrollment. The incidence of mastitis, lameness, or displaced abomasum to 60 DIM and subclinical ketosis to 21 DIM did not differ among CEF, KET, and NOMET. There were no differences in median days to first AI (CEF = 68 d; 95% CI: 65-70; KET = 69 d; 95% CI: 68-72; NOMET = 69 d; 95% CI: 68-70), and median days to pregnancy (CEF = 118 d; 95% CI: 92-145; KET = 113 d; 95% CI: 90-135; NOMET = 105 d; 95% CI: 101-109), pregnancy at first AI at 33 d after insemination (CEF = 42%; KET = 41%; NOMET = 41%), pregnancy loss after first AI (CEF = 8%; KET = 11%; NOMET = 8%), hazard of pregnancy or hazard of culling up to 300 DIM. Milk yield was not different between CEF and KET during the first 10 weeks, but lesser in KET at wk 2 and 4 and CEF at wk 2, 4, and 6 than in NOMET. In this pilot-scale study, given early detection, we did not detect differences in subsequent health, milk yield, or reproductive performance in cows with metritis initially treated for 3 d with CEF or KET. Additional, larger studies are warranted.

Effect of low-intensity focused ultrasound therapy on postpartum uterine involution in puerperal women: A randomized controlled trial.

Short-term poor uterine involution manifests as uterine contraction weakness. This is one of the important causes of postpartum hemorrhage, posing a serious threat to the mother's life and safety. The study aims to investigate whether low-intensity focused ultrasound (LIFUS) can effectively shorten lochia duration, alleviate postpartum complications, and accelerate uterine involution compared with the sham treatment. A multicenter, concealed, randomized, blinded, and sham-controlled clinical trial was conducted across three medical centers involving 176 subjects, utilizing a parallel group design. Enrollment occurred between October 2019 and September 2020, with a 42-day follow-up period. Participants meeting the inclusion and exclusion criteria based on normal prenatal examinations were randomly divided into the LIFUS group or the sham operation group via computer-generated randomization. Patients in the LIFUS group received usual care with the LIFUS protocol, wherein a LIFUS signal was transmitted to the uterine site through coupling gel, or sham treatment, where no low-intensity ultrasound signal output was emitted. The primary outcome, lochia duration, was assessed via weekly telephonic follow-ups post-discharge. The involution of the uterus, measured by uterine fundus height, served as the secondary outcome. Among the 256 subjects screened for eligibility, 176 subjects were enrolled and randomly assigned to either the LIFUS group (n = 88) or the Sham group (n = 88). Data on the height of the uterine fundus were obtained from all the patients, with 696 out of 704 measurements (99%) successfully recorded. Overall, a statistically significant difference was noted in time to lochia termination (hazard ratio: 2.65; 95% confidence interval [CI]: 1.82-3.85; P < 0.001). The decline in fundal height exhibited notable discrepancies between the two groups following the second treatment session (mean difference: -1.74; 95% CI: -1.23 to -2.25; P < 0.001) and the third treatment session (mean difference: -3.26; 95% CI: -2.74 to -3.78; P < 0.001) after delivery. None of the subjects had any adverse reactions, such as skin damage or allergies during the treatment. This study found that LIFUS treatment can promote uterine involution and abbreviate the duration of postpartum lochia. Ultrasound emerges as a safe and effective intervention, poised to address further clinical inquiries in the domain of postpartum rehabilitation.

Application Of Pbm-Nir Therapy For Postpartum Mother's Discomfort In Maternity Nursing Care

Normal post partum is post partum discomfort due to uterine involution. Uterine involution in patients can cause pain in the uterus called afterpains. Discomfort caused by uterine involution requires various treatments to minimize the pain felt by the mother so that the mother's comfort can return. This can be overcome with non-pharmacological pain management strategies through innovative near infrared phototherapy or near infrared photobiomodulation (PBM NIR). The aim of this research is to analyze the results of implementing pain management with non-pharmacological PBM NIR therapy in normal post-partum mothers with post-partum discomfort nursing problems. Case study that focuses on the implementation of non-pharmacological nursing pain management techniques with PBM NIR therapy. The case study subjects were 3 normal post-partum maternal patients with the same problem, namely post-partum discomfort in the obstetrics room at the Muhammadiyah Hospital in Palembang. The results of the study showed that the implementation of non-pharmacological pain management techniques with PBM NIR therapy had an effective effect on dealing with post-partum discomfort with complaints of decreased discomfort, decreased moaning, and strong uterine contractions. Implementation of pain management can improve the comfort status of normal postpartum mothers. This study makes an important contribution to understanding of the role of nonpharmacological techniques in postpartum pain management, as well as highlighting the importance of implementing innovative therapies for labor, as well as highlighting the importance of implementing innovative therapies to improve the quality of care in postpartum mothers.

Acute puerperal uterine inversion with successful manual transvaginal repositioning: A case report.

Uterine inversion is a rare medical condition that is categorized as puerperal and nonpuerperal. Repositioning of uterine involution can be done manually or surgically, the latter of which involves abdominal manipulation and disruption of the integrity of the uterine wall, which can lead to complications for the patient in subsequent pregnancies, such as uterine rupture. We report a case of acute puerperal uterine inversion that was manually repositioned transvaginally. An ultrasonogram and reset schematic were also presented. A 23-year-old woman (gravida 1 para 0) was admitted to the hospital with a full-term pregnancy. In the postpartum period, we found placental adhesions and uterine inversion into the uterine cavity, which was confirmed by bedside ultrasound. We administered analgesic, relieving uterine spasms, and antishock therapy along with manual stripping of the placenta and ultrasound-guided uterine repositioning. After successful repositioning the patient vaginal bleeding decreased rapidly and she was discharged 3 days after delivery. Early recognition, antishock therapy and prompt repositioning are key in the management of puerperal uterine inversion. We hope that this case will enable clinicians to better visualize the ultrasound imaging of uterine inversion and the process of manual repositioning.