Timing of obstetrical assistance affects peripartal cardiac autonomic function and early maternal behavior of dairy cows.

Peripartal autonomic nervous system function and early maternal behavior were investigated in 79 multiparous Holstein-Friesian cows. Animals were allocated into four groups based on the technology of calving management: 1) unassisted calving in a group pen (UCG; N=19), 2) unassisted calving in an individual pen (UCI; N=21), 3) assisted calving with appropriately timed obstetrical assistance (ACA; N=20), and 4) assisted calving with premature obstetrical assistance (ACP; N=19). Heart rate, the high frequency (HF) component of heart rate variability (HRV) as a measure of vagal activity and the ratio between the low frequency (LF) and HF components (LF/HF ratio) as a parameter of sympathetic nervous system activity were calculated. Heart rate and HRV parameters were presented as areas under the curves (AUC) for the following periods: 1) prepartum period (between 96h before the onset of calving restlessness and the onset of restlessness), 2) parturition (between the onset calving restlessness and delivery), and 3) postpartum period (during a 48-h period after delivery). Pain-related behaviors were recorded during parturition (i.e., the occurrence of vocalization and stretching the neck towards the abdomen) and during a 2-h observation period after calving (i.e., the occurrence of vocalization, stretching the neck towards the abdomen and the duration of standing with an arched back). Early maternal behavior was observed during the first 2h following calving as follows: 1) latency and duration of sniffing calf's head/body, and 2) latency and duration of licking calf's head/body. No difference was found across groups in autonomic function before the onset of calving restlessness. Area under the heart rate curve was higher in ACP cows during parturition (39.6±2.5beats/min×h) compared to UCG, UCI and ACA animals (AUC=13.1±0.9beats/min×h, AUC=22.3±1.4beats/min×h and AUC=25.0±2.1beats/min×h, respectively). Area under the heart rate curve did not differ across the UCG, UCI and ACA groups during the postpartum period (AUC=65.2±16.7beats/min×h, AUC=58.0±14.2beats/min×h and AUC=62.9±12.1beats/min×h, respectively) but it was higher in ACP cows compared to the former groups (AUC=269.1±36.3beats/min×h). During parturition, area under the HF curve reflected a lower vagal tone (AUC=-30.5±1.6n.u.×h) in cows with premature obstetrical assistance than in animals that calved individually without farmer assistance (AUC=2.7±0.4n.u.×h) or with appropriately timed assistance (AUC=3.2±1.2n.u.×h). During parturition, LF/HF ratio showed greater sympathetic activity in ACP cows than in animals from any other group. Area under the HF curve was similar across UCG, UCI and ACA cows (AUC=-232.1±42.0n.u.×h, AUC=-163.4±35.6n.u.×h and AUC=-331.4±56.2n.u.×h, respectively) during the postpartum period and was the lowest in ACP cows (AUC=-1025.6±44.2n.u.×h) reflecting a long-term stress load in the latter group. During parturition, both vocalization and stretching the neck towards the abdomen occurred more often in UCG cows than in cows from any other groups, and the incidence of both behaviors was statistically higher in ACP cows than in UCI and ACA animals. There were no significant differences across groups in these behaviors during the 2-h postpartum observation. UCG cows had a shorter latency and a longer duration of maternal grooming during the first 2h following delivery compared to any other groups. UCI and ACA dams spent more time with licking the calf within the 2-h period after calving and had a shorter latency to sniff and lick the offspring compared to cows that received premature assistance. Group calving is less stressful for cows than calving in an individual pen either with or without obstetrical assistance. Calving in a group or with appropriately timed farmer assistance supports the expression of early maternal behavior and lead to a rapid postpartum recovery of the autonomic nervous system. Premature obstetrical assistance means stress for cows during parturition, leads to a prolonged postpartum recovery of the autonomic nervous system and inhibits the expression of early maternal behavior.

Effect of calving process on the outcomes of delivery and postpartum health of dairy cows with unassisted and assisted calvings.

Welfare aspects of obstetrical assistance were studied in multiparous Holstein-Friesian cows (n=176) with (1) unassisted calving in an individual pen (UCIP; n=42), (2) unassisted calving in a group pen (UCG; n=48), (3) assisted calving with appropriately timed obstetrical assistance (ACAP; n=50), and (4) assisted calving with inappropriately timed (premature) obstetrical assistance (ACIN; n=36). Duration of the stages of calving, the prevalence and the degree of dystocia, stillbirth ratio, newborn calf vitality, and the occurrence of postpartum health problems (i.e., retained placenta and vulvovaginal laceration) were recorded. The time from amniotic sac and hooves appearance to birth and the total duration of calving (from the onset of calving restlessness to delivery) were shorter for UCG cows than for any other groups. The overall incidence of dystocia was 31.3% in the calvings studied. The prevalence of dystocia was below 10% in cases of unassisted calvings. The proportion of severe dystocia was higher in ACIN cows than in ACAP cows (47.2 vs. 12.0%, respectively). The prevalence of stillbirths was the highest in ACIN calvings (22.2%), followed by ACAP, UCI, and UCG cows (8.0, 4.8, and 0.0%, respectively). The ACIN calves had lower vitality scores than calves born from ACAP, UCG, and UCIP dams immediately after delivery and 24h after birth. Although ACAP calves had lower vitality scores than UCG and UCIP calves at birth, a delayed recovery of vitality was mirrored by satisfactory vitality scores 24h after birth. Retained placenta and vulvovaginal laceration occurred more often with assisted dams (i.e., ACAP and ACIN animals) compared with UCIP cows with the highest prevalence in ACIN cows. In UCG cows, no injuries occurred in the vulva or vagina, and we noted only 4 cases of retained placenta (8.3%), proportions lower than in cows with unassisted calving in the maternity pen. Our results suggest that calving in a group might have benefits over calving in an individual pen in terms of calving ease, duration of the delivery process, and postpartum health of the dam vitality of her offspring. Premature obstetrical assistance leads to a high prevalence of dystocia, impairs postpartum health of the dam, and poses a potential risk to calf survival.

Práticas obstétricas adotadas na assistência ao parto segundo o partograma com linhas de alerta e ação / Obstetrical practice adopted in the labor assistance according to the partogram with alert and action lines

A utilização do partograma para o acompanhamento do trabalho de parto tem sido recomendada pela Organização Mundial da Saúde desde 1984. Esta investigação foi conduzida com a finalidade de estudar o emprego de práticas obstétricas em mulheres, cuja assistência foi prestada por enfermeiras obstetras e o trabalho de parto foi acompanhado com o auxílio do partograma com linhas de alerta e de ação. O objetivo geral foi analisar o uso de intervenções obstétricas, o tipo de parto, os diagnósticos obstétricos e os resultados perinatais, segundo as Zonas I, II e III do partograma. Foi realizado um estudo transversal com uma amostra de 233 mulheres com gestação única, apresentação cefálica, idade gestacional maior que 37 semanas atendidas em uma maternidade pública do município de Itapecerica da Serra no período de 15 de dezembro de 2004 a 15 de março de 2005. A análise comparativa foram feitas com os testes Qui-quadrado e Exato de Fischer para estudar as diferenças entre as classes das variáveis. O nível de significância adotado foi 0,05. Os resultados mostraram idade média de 24,1 anos (dp=5,8); 39,5% nulíparas; 78,5% foram internadas com dinâmica uterina presente; 69,1% com membranas íntegras; e 63,9% estavam na fase ativa do trabalho de parto. As práticas banho (71,4%) p=0,001; movimento (85,2%) p=0,001 e deambulação (85,7%) p=0,009 foram mais utilizadas na Zona III. A rotura artificial foi mais empregada na Zona II (92,4%) p=0,001, a ocitocina (45,9%) p=0,010 na Zona I. As intervenções monitorização eletrônica fetal (p=0,527), fármaco (p=0,158), posição de parto (p=0,150) e episiotomia (p=0,055) não apresentaram diferenças estaticamente significantes entre as três zonas do partograma. Quanto ao tipo de parto a cesariana ocorreu em 24,0 na zona III (p=0,001). Os resultados perinatais não apresentaram diferença estatisticamente significante entre as Zonas do partograma.

The utilization of the partogram in tracking the course of labor has been recommended by the World Health Organization ever since 1994. This investigation was conducted to study the usage of obstetrical practices in women who were assisted by nurse midwives and whose delivery was aided by the partogram with alert and action lines. The overall goal was to analyze the use of obstetrical interventions, the type of delivery, the obstetrical diagnoses and the perinatal results, according to zones I, II and III of the partogram. A cross-sectional study was carried out with a representative sample of 233 women with a single gestation, cephalic presentation, gestational age with more than 37 weeks, and assisted in a public maternity hospital in the city of Itapecerica da Serra - Brazil, in the period from December 15, 2004 to March 15, 2005. The comparative analyses were performed with the Qui-square and the Fischer's exact tests to study the differences among the classes of variables. The level of significance adopted was 0,05. The results showed the average age of 24,1 years old (standard deviation=5,8); 39,5% nuliparas; 78,5% were admitted with the presence of a uterine dynamic; 69,1% with intact membranes; and 63,9% were at the active phase of labor. The practices shower (71,4%) p=0,001, movement (85,2%) p=0,001, and deambulation (85,7%) p=o,009 were more often utilized in Zone III. The artificial rupture was more often employed in Zone II (92,4%) p=0,001; occitocin (45,9%) p=0,010, in Zone I. The interventions electronic fetal monitoring (p=0,527), pharmaco (p=0,158), delivery position (p=0,150), and episiotomy (p=0,055) did not present statistically significant differences among the three zones of the partogram. As for the type of delivery, the cesarean delivery took place in 24,0 % in Zone III (p=0.001). The perinatal results did not present statistically significant differences among the zones of the partogram.