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2.
Sci Rep ; 14(1): 12673, 2024 06 03.
Article in English | MEDLINE | ID: mdl-38830990

ABSTRACT

Retained placenta is a common health issue, and appropriate prevention strategies are effective in postpartum health management. This study aimed to evaluate whether early intervention using GYS can prevent retained placenta and puerperal metritis, as well as enhance reproductive outcomes in cows. Each bovine in the GYS group (n = 591) received a single prophylactic dose of GYS (0.5 g/kg body weight) orally within 2 h after parturition, while those in the control group (n = 598) received no intervention. GYS treatment was associated with a decreased incidence of retained placenta (4.6% vs. 12.0%, P < 0.01, OR = 0.335), a lower puerperal metritis risk (8.8% vs. 20.1%, P < 0.01, OR = 0.369), and a reduced need for additional therapeutic antibiotics (11.2% vs. 26.1%, P < 0.01, OR = 0.342). We observed increases in the first service conception rate (59.7% vs. 49.1%, P < 0.01) and conception rate within 305 days postpartum (93.2% vs. 85.5%, P < 0.01) in the GYS group than in the control group. A significant decrease was observed in the number of services per conception (1.8 ± 1.1 vs. 2.1 ± 1.4, P < 0.01) and the calving-to-conception interval (83.6 ± 39.6 vs. 96.6 ± 52.5 days, P < 0.01) between the two groups. Additionally, GYS treatment increased milk yield on days 7, 14, and 28 postpartum without affecting milk fat, milk protein, somatic cell count (SCC), or milk urea nitrogen (MUN) on days 7 and 28 postpartum. Accordingly, the GYS was effective and safe in preventing retained placenta and to improve reproductive performance in cows. Therefore, it could be a prophylactic intervention for superior postpartum fertility in cows.


Subject(s)
Drugs, Chinese Herbal , Placenta, Retained , Reproduction , Animals , Female , Cattle , Pregnancy , Placenta, Retained/prevention & control , Placenta, Retained/veterinary , Drugs, Chinese Herbal/pharmacology , Drugs, Chinese Herbal/administration & dosage , Reproduction/drug effects , Cattle Diseases/prevention & control , Postpartum Period/drug effects , Lactation/drug effects
3.
Int J Mol Sci ; 25(10)2024 May 20.
Article in English | MEDLINE | ID: mdl-38791589

ABSTRACT

A genome-wide association study of resistance to retained placenta (RETP) using 632,212 Holstein cows and 74,747 SNPs identified 200 additive effects with p-values < 10-8 on thirteen chromosomes but no dominance effect was statistically significant. The regions of 87.61-88.74 Mb of Chr09 about 1.13 Mb in size had the most significant effect in LOC112448080 and other highly significant effects in CCDC170 and ESR1, and in or near RMND1 and AKAP12. Four non-ESR1 genes in this region were reported to be involved in ESR1 fusions in humans. Chr23 had the largest number of significant effects that peaked in SLC17A1, which was involved in urate metabolism and transport that could contribute to kidney disease. The PKHD1 gene contained seven significant effects and was downstream of another six significant effects. The ACOT13 gene also had a highly significant effect. Both PKHD1 and ACOT13 were associated with kidney disease. Another highly significant effect was upstream of BOLA-DQA2. The KITLG gene of Chr05 that acts in utero in germ cell and neural cell development, and hematopoiesis was upstream of a highly significant effect, contained a significant effect, and was between another two significant effects. The results of this study provided a new understanding of genetic factors underlying RETP in U.S. Holstein cows.


Subject(s)
Cattle Diseases , Genome-Wide Association Study , Placenta, Retained , Polymorphism, Single Nucleotide , Cattle , Animals , Female , Pregnancy , Placenta, Retained/genetics , Placenta, Retained/veterinary , Cattle Diseases/genetics , Disease Resistance/genetics , Genetic Predisposition to Disease , Quantitative Trait Loci
4.
Antioxidants (Basel) ; 13(4)2024 Apr 11.
Article in English | MEDLINE | ID: mdl-38671899

ABSTRACT

After delivery, the death of trophoblast cells can promote the expulsion of the placenta. Ferroptosis, an iron-dependent programmed cell death, is involved in mammalian development. Circular RNAs are associated with placental development; however, it is unclear whether circular RNAs regulate the expulsion of fetal membranes through ferroptosis. The gene expression profiles in the tail vein blood of Holstein cows with normal and retained placentas were investigated using RNA sequencing and a GSE214588 dataset. circAMN1 and SLC39A8 expression was significantly downregulated in the blood of cows with a retained placenta, whereas miR-205_R-1 expression was significantly upregulated. We validated erastin-induced ferroptosis in trophoblast cells. Transfection with si-circAMN1 and miR-205_R-1 mimic reduced intracellular total iron, Fe2+, and glutathione disulfide levels; increased intracellular glutathione levels and glutathione/glutathione disulfide; and enhanced cell viability in these cells. In contrast, transfection with pcDNA3.1 circAMN1 and an miR-205_R-1 inhibitor promoted ferroptosis. As an miR-205_R-1 sponge, circAMN1 regulated the expression of SLC39A8 to control erastin-induced ferroptosis and regulated the proliferation, invasion, and migration of trophoblast cells. Our findings provide a theoretical basis for studying the mechanism by which programmed cell death regulates fetal membrane expulsion and indicate its potential as a therapeutic target for placenta retention.

5.
Open Vet J ; 14(3): 805-813, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38682134

ABSTRACT

Background: Hypocalcemia is one of the most common transition period disorders that affects dairy cows and has been divided into clinical and subclinical types. Aim: This study aimed to investigate the relationship between postpartum serum calcium (Ca) concentrations with metabolic disorders and body condition score (BCS) in Holstein dairy cows. Methods: Two hundred and seventy-one Holstein cows were blocked from two commercial dairy herds based on parity (primiparous and multiparous) and serum Ca concentrations on calving day, 1 and 2 days postpartum were allocated to 1 of 3 groups: 1) Serum Ca concentration >8.5 mg/dl at the calving day, 1 and 2 days postpartum (normocalcemic); 2) serum Ca concentration ≤8.5 mg/dl on the calving day and 1 or 2 day postpartum (transient subclinical hypocalcemia (TSCH)); and 3) serum Ca concentration ≤8.5 mg/dl on the calving day, 1 and 2 days postpartum (persistent subclinical hypocalcemia (PSCH)). Results: The results showed that the primiparous and multiparous cows had the highest TSCH and PSCH percentages, respectively. Ca status after calving did not affect the BCS changes, incidence of milk fever, hypomagnesemia and hyperketonemia, and clinical and subclinical endometritis. The incidence of retained placenta, metritis, and subclinical mastitis was affected by Ca status after calving, so PSCH cows experienced 6.28, 6.43, and 5.9 times more retained placenta, metritis, and subclinical mastitis than normocalcemic cows, respectively. The culling rate within the first 60 days in milk for PSCH cows was 4.61 times more than for normocalcemic cows. Conclusion: Overall, the results of the study showed that cows with PSCH had a higher incidence of retained placenta; uterine infections, subclinical mastitis, and culling rate, but cows with TSCH were similar to healthy cows in terms of metabolic disorders and culling rate.


Subject(s)
Cattle Diseases , Hypocalcemia , Postpartum Period , Animals , Cattle , Hypocalcemia/veterinary , Hypocalcemia/epidemiology , Female , Cattle Diseases/epidemiology , Cattle Diseases/blood , Pregnancy , Calcium/blood , Metabolic Diseases/veterinary , Metabolic Diseases/epidemiology , Parity
6.
Animals (Basel) ; 14(6)2024 Mar 11.
Article in English | MEDLINE | ID: mdl-38539962

ABSTRACT

The aim of this study was to construct an enhanced selection index using the genomic and economic parameters of new health disorders and current production and functional traits. Genomic evaluation for the incidence of clinical mastitis (CM), three claw disease traits, retained placenta (RET), metritis (MET), and cystic ovaries (CYS) was performed using linear animal models based on producer-recorded data. Good correlations among the health disorders were found, and their heritability estimates did not exceed 7%. Economic weights (EWs) for the health disorders were EUR -132.10 for CM, EUR -128.87 for overall claw diseases, EUR -52.10 for RET, EUR -80.48 for MET, and EUR -16.16 for CYS. These EWs indicate changes in the present value of the annual profit per cow when increasing the incidence of the traits by one case per cow year. Selection using the enhanced index resulted in favourable responses for most of the new health disorders (e.g., -0.001 and -0.006 cases of RET and MET per cow year, respectively), and also in the current breeding objective traits (+49 kg of milk, -0.02% of calf losses). An index contribution of 7% for the new health disorders was assessed as acceptable for the breeders.

7.
Int J Surg Case Rep ; 114: 109121, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38061086

ABSTRACT

INTRODUCTION AND IMPORTANCE: Postpartum hemorrhage (PPH) can be defined as excessive bleeding (>500 ml) from the genital tract after the delivery of baby upto 6 weeks. PPH accounts for major cause of maternal mortality rate. Prevention and early intervention can prevent this complication of delivery. However condition like placenta accreta leads to retention of placenta and makes PPH inevitable. CASE SUMMARY: We present the case of massive postpartum hemorrhage secondary to Placenta accreta in young primigravida with RH negative pregnancy. Clinical findings and investigations were not significant during her admission. She delivered the baby via vaginal route but placenta was not expelled till 30 min. Due to failed manual removal of placenta patient was shifted to OT.Manual vacuum aspiration was done in OT setting and chunks of placenta along with blood clots were obtained.Uterine balloon tamponade was inserted. Due to persistent PV bleeding subtotal hysterectomy was carried out in line for placenta accreta. DISCUSSION: Placenta accreta being one of the life threatening obstetric condition, it should be diagnosed as early as possible and need prompt management so as to prevent maternal mortality. Due to increasing number of cesarean delivery the cases of placenta accreta has been rising but rarely in some cases can it present in young primigravida with Rh negative pregnancy. CONCLUSION: In the cases of morbidly adherent placenta it is necessary for obstetrician to early identify such conditions and timely intervene to save the mother's life. Moreover Rh negative could be a hidden risk factor.

8.
J Matern Fetal Neonatal Med ; 37(1): 2299112, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38151259

ABSTRACT

OBJECTIVES: To evaluate first-trimester ultrasound imaging of eccentric implantation in predicting the probability of retained placenta. METHODS: A total of 61 cases with gestational sac eccentrically implanted in first-trimester ultrasound imaging was selected. Demographic and obstetric data were collected through data extraction of the electronic medical record at the time of delivery admission. Baseline characteristics (including age, gestational age of first-trimester ultrasound, size of gestational sac, gestational age of delivery), delivery outcomes (mode of delivery, retained placenta or placental fragments, blood loss, postpartum hemorrhage and postpartum ultrasound imaging) were collected and analyzed. RESULTS: The risk difference for a woman with eccentric implantation to have a retained placenta was -0.18 (95% CI -0.28 to -0.08, p = 0.000) and the incidence of retained placenta in the study group was higher than in the control group (18% vs. 0%, p = 0.006). First-trimester ultrasound imaging of eccentric implantation was also found to be an independent risk factor for the incidence of inhomogeneous mass in postpartum ultrasound imaging (27.9% vs. 10.8%, adjusted OR 0.19, 95% CI 0.05 to 0.79, p = 0.012). Though 2 cases in the study group suffered postpartum hemorrhage, the risk difference for a woman with eccentric implantation to suffer postpartum hemorrhage was -0.03 (95% CI -0.08 to -0.01, not significant) and eccentric implantation did not increase postpartum hemorrhage rates (3.3% vs. 0%, not significant). CONCLUSIONS: First-trimester ultrasound imaging of eccentric implantation was associated with an increased risk of retained placenta and inhomogeneous mass in postpartum ultrasound imaging.


Subject(s)
Placenta, Retained , Postpartum Hemorrhage , Pregnancy , Female , Humans , Placenta, Retained/diagnostic imaging , Placenta, Retained/epidemiology , Pregnancy Trimester, First , Placenta/diagnostic imaging , Postpartum Hemorrhage/diagnostic imaging , Postpartum Hemorrhage/epidemiology , Postpartum Hemorrhage/etiology , Ultrasonography , Retrospective Studies
9.
Diagnostics (Basel) ; 13(23)2023 Nov 21.
Article in English | MEDLINE | ID: mdl-38066733

ABSTRACT

Angular pregnancies are rare and difficult to diagnose. Evidence suggests they are associated with a higher risk of intrauterine growth restriction and abnormal third stage of labor due to a retained placenta. The lack of standardized AP diagnostic criteria impacts on their correct identification and makes the treatment of potential complications challenging. We present a case of the successful conservative surgical management of a retained placenta after a term AP also complicated by intrauterine growth restriction. Moreover, to identify the best evidence regarding AP diagnostic criteria and retained placenta therapeutic approaches, we have realized an expert literature review.

10.
Animals (Basel) ; 13(23)2023 Nov 25.
Article in English | MEDLINE | ID: mdl-38067004

ABSTRACT

Rhinoceros species range from near threatened to critically endangered due to habitat loss and poaching. A sustainable ex situ breeding population is critically important to maintain genetic diversity and help ensure the survival of the species; however, not all populations under human care are self-sustaining. While rhinoceros reproductive physiology and pathology have been well studied, there is still a paucity of information describing the normal parameters of parturition and neonatal landmarks. Using video recordings, medical records, and keeper logs, we reviewed and compared data regarding the parturition of three rhinoceros species (black rhinoceros (BR) (Diceros bicornis), n = 4; greater one-horned rhinoceros (GOHR) (Rhinoceros unicornis), n = 21; and southern white rhinoceros (SWR) (Ceratotherium simum simum), n = 22) managed under human care in the United States. Using equine parameters as a model for comparison, we compiled the following data: the signs of impending parturition, durations of the parturition phases, calving presentation, frequency of dystocia or stillbirth, and time from birth to neonatal landmarks. Data from 47 births, including 26 videos, were examined. The durations of parturition phases I, II, and III had median lengths of 153 min (n = 18), 28 min (n = 21), and 205 min (n = 15), respectively. Anterior presentation of the calf was observed in 59% births, whereas posterior presentation occurred in 41% births. Posterior calving presentation was associated with a longer phase II of parturition (p = 0.04), although more data are needed to determine whether the posterior presentation of the calf carries a higher risk for stillbirth. Most (83%) stillbirths occurred in GOHR, indicating that this species might be at a higher risk for stillbirth compared to SWR (17%) (p = 0.07). The median time from birth to the calf standing was longer in the GOHR (64 min) compared to the SWR (30 min) (p = 0.02). Detailed descriptions of the parturition parameters and neonatal landmarks in rhinoceros will aid facilities with rhinoceros breeding programs to recognize abnormalities in the parturient or post-partum periods and guide indications for veterinary intervention.

11.
BMC Pregnancy Childbirth ; 23(1): 783, 2023 Nov 11.
Article in English | MEDLINE | ID: mdl-37951873

ABSTRACT

BACKGROUND: Retained placenta is a concern during labor and delivery. However, recent data regarding the profiles of retained placenta are scarce, especially nationwide and in minority populations. This study aimed to investigate the recent incidence of retained placenta and its associated outcomes. METHODS: We retrospectively analyzed an American population-based data from the National Inpatient Sample (NIS) 2016-2019. The outcomes of interest included the incidence of retained placenta, in-hospital mortality, length of hospital stay, and hospitalization costs. We estimated the incidence for retained placenta overall and by racial and ethnic subgroups, utilizing survey weights standardized for each subgroup. Multivariable linear or logistic regression models were employed in our study to investigate the associations between retained placenta and the impact of in-hospital mortality, duration of stay, and hospitalization expenditures for the entire population and further stratified by race and ethnicity, adjusting for potential confounders. RESULTS: Of the 13,848,131 deliveries, there were 108,035 (or 0.78%) birthing persons were identified as having retained placentas. Over time, the incidence of retained placenta increased from 730 per 100,000 (0.73%) in 2016 to 856 per 100,000 (0.86%) in 2019. Native American mothers have the highest rate of retained placenta, with a prevalence almost twice that of the general population, reaching 1,434 cases per 100,000 (1.43%). After adjusting for confounding factors, Native American mothers were more likely to have retained placenta (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.35-1.81), whereas Black (OR, 0.92; 95% CI, 0.88-0.97) and Hispanic mothers (OR, 0.84; 95% CI, 0.80-0.89) were significantly less likely to have retained placenta than White mothers. Furthermore, those who delivered with a retained placenta were significantly associated with higher in-hospital mortality, a longer duration of stay, and hospitalization expenditures, which were disproportionately varied by maternal race and ethnicity. CONCLUSIONS: The incidence of retained placenta among people undergoing vaginal delivery is exhibiting an upward trend over time, with notable variations observed across different ethnic groups by unclear mechanisms. The ramifications of these findings have the potential to impact the clinical management of maternal health care and the creation of health policies, specifically in relation to the Native American birth population.


Subject(s)
Placenta, Retained , Female , Humans , Pregnancy , Black or African American , Healthcare Disparities , Hospitalization , Incidence , Patient Acceptance of Health Care , Placenta, Retained/epidemiology , Placenta, Retained/therapy , Retrospective Studies , United States/epidemiology , White , Hispanic or Latino
12.
BMC Womens Health ; 23(1): 523, 2023 10 04.
Article in English | MEDLINE | ID: mdl-37794425

ABSTRACT

BACKGROUND: To date, the association between retained placenta and treatment success rate of misoprostol for early pregnancy failure has yet to be evaluated. The aim of this study was to evaluate this association and further investigated the connection between medical, clinical and sonographic parameters and treatment success. METHODS: We conducted a retrospective cohort study of women with early pregnancy failure treated with misoprostol from 2006 to 2021. The success rate of misoprostol treatment was compared between patients with history of retained placenta including women who underwent manual lysis of the placenta following delivery or patients who were found to have retained products of conception during their post-partum period (study group) and patients without such history (controls). Demographic, clinical, and sonographic characteristics as well as treatment outcomes were compared between the groups. RESULTS: A total of 271 women were included in the study (34 women in the study group compared to 237 women in the control group). Two-hundred and thirty-three women (86.0%) presented with missed abortion, and 38 (14.0%) with blighted ovum. Success rates of misoprostol treatment were 61.8% and 78.5% for the study and control groups, respectively (p = 0.032). Univariate analysis performed comparing successful vs. failed misoprostol treatment showed advanced age, gravidity, parity and gestational sac size (mm) on TVUS were associated with higher misoprostol treatment failure rate. Following a multivariate logistic regression model these variables did not reach statistical significance. CONCLUSION: Women who have an event of retained placenta following childbirth appear to have decreased success rate of treatment with misoprostol for early pregnancy failure. Larger studies are needed to confirm this finding.


Subject(s)
Abortifacient Agents, Nonsteroidal , Abortion, Spontaneous , Misoprostol , Placenta, Retained , Pregnancy , Humans , Female , Misoprostol/therapeutic use , Abortifacient Agents, Nonsteroidal/therapeutic use , Placenta, Retained/drug therapy , Placenta, Retained/chemically induced , Retrospective Studies , Abortion, Spontaneous/chemically induced , Treatment Outcome , Pregnancy Trimester, First
13.
Ceska Gynekol ; 88(4): 260-263, 2023.
Article in English | MEDLINE | ID: mdl-37643906

ABSTRACT

Umbilical cord drainage involves releasing the cord clam from the umbilical cord after separation of the newborn from the maternal end of the umbilical cord. Consequently, there is emptying of blood from the placenta. This procedure is part of the active management of the third stage of labor (TSL). OBJECTIVE: This study is intended to provide knowledge about the duration of TSL and the risk of retention of the placenta using umbilical cord drainage and the no-drainage procedure. MATERIALS AND METHODS: A prospective randomized study of the management of the third stage of labor in 600 patients. The patients were equally divided into two groups with umbilical cord drainage (300) and without umbilical cord drainage (300). TSL was actively managed by FIGO (the International Federation of Gynecology and Obstetrics) recommendations. We monitored the duration of TSL and retention of the placenta after a 30 min period. RESULTS: The mean duration of TSLwas 6.8 ± 0.4 min in the drainage group and 11.6 ± 0.8 min in the control group. We conclude that umbilical cord drainage significantly shortens the duration of TSL (P = 0.026) as well as reduces the risk of placental retention. In a group where we use the drainage of the umbilical cord, placental retention 30 min after delivery of the fetus occurred in four cases while the second set occurred in 14 cases (RR 3.62; 95% CI 1.18-11.14). CONCLUSION: We assume that during umbilical cord drainage, the collapse of thin-walled uteroplacental vessels occurs earlier causing bleeding from these vessels between the placenta and the uterine wall, and therefore, earlier separation of the placenta occurs. Of course, the drainage of the umbilical cord is only one step in the algorithm of active management at the third stage of labor according to FIGO.


Subject(s)
Placenta, Retained , Placenta , Pregnancy , Infant, Newborn , Humans , Female , Prospective Studies , Umbilical Cord , Fetus
14.
Cesk Patol ; 59(2): 55-59, 2023.
Article in English | MEDLINE | ID: mdl-37468323

ABSTRACT

Postpartum haemorrhage is a significant cause of maternal morbidity and mortality worldwide. The pathologist encounters only a limited spectrum of causes leading to postpartum haemorrhage. The most common causes are retained placenta and placental site subinvolution. Both of these lesions can be diagnosed from material obtained by uterine curettage. Morbidly adherent placenta (placenta accreta spectrum) is a less frequent subject of investigation, the diagnosis of which can be reliably established only on the basis of histological examination of uterine specimens after hysterectomy.


Subject(s)
Abortion, Spontaneous , Placenta Accreta , Postpartum Hemorrhage , Pregnancy , Female , Humans , Postpartum Hemorrhage/diagnosis , Postpartum Hemorrhage/etiology , Postpartum Hemorrhage/pathology , Placenta/pathology , Abortion, Spontaneous/pathology , Placenta Accreta/diagnosis , Placenta Accreta/pathology , Placenta Accreta/surgery , Hysterectomy/adverse effects
15.
Reprod Domest Anim ; 58(8): 1114-1124, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37330990

ABSTRACT

The study aimed to evaluate the effect of α-chymotrypsin on placental separation as a treatment protocol for retained placenta (RP) in dairy cows and its effect on reproductive performance after placental shedding. The study was conducted on 64 crossbred cows that suffered from retained placenta. Cows were divided into four equal groups: group I (n = 16) treated with prostaglandin F2α (PGF2α); group II (n = 16) treated with PGF2α in combination with α-chemotrypsin; group III (n = 16) treated with α-chemotrypsin only and group IV (n = 16) treated by manual removal of the RP. Cows were under observation after treatment till placental shedding. Placental samples were taken from the non-responsive cows after the course of treatment and examined to observe the histopathological changes in each group. Results revealed that the time of placental dropping showed a significant decrease in group II compared to other groups. Histopathological examination of group II shows that collagen was found as fewer fibres in scattered areas and necrosis appeared as numerous areas widespread in the foetal villi. A few inflammatory cells were infiltrated in the placental tissue and the vascular changes appear as mild vasculitis and mild oedema. Cows in group II have rapid uterine involution, decreased risk of post-partum metritis and improved reproductive performance. It is concluded that PGF2α in combination with α- chemotrypsin is the recommended treatment for RP in dairy cows. This recommendation is warranted, as this treatment was successful in achieving rapid placental shedding, rapid uterine involution, a decreased risk of post-partum metritis and improved reproductive performance.


Subject(s)
Cattle Diseases , Placenta, Retained , Pregnancy , Cattle , Female , Animals , Placenta, Retained/veterinary , Dinoprost/pharmacology , Placenta/pathology , Reproduction , Postpartum Period , Cattle Diseases/drug therapy , Cattle Diseases/pathology
16.
Int J Gynaecol Obstet ; 163(1): 194-201, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37078338

ABSTRACT

OBJECTIVE: To evaluate potential risk factors for retained placenta in a first pregnancy. METHOD: This retrospective case-control study included all primigravida with a singleton, live, vaginal birth at 24 weeks or later, at a tertiary hospital, 2014-2020. The cohort was divided into those with retained placenta versus controls. Retained placenta was defined as the need for manual extraction of the placenta or portions of it, immediately postpartum. Maternal and delivery characteristics, and obstetric and neonatal adverse outcomes, were compared between groups. Multivariable regression was performed to reveal potential risk factors for retained placenta. RESULTS: Among 10 796 women, 435 (4.0%) had retained placenta and 10 361 (96.0%) controls did not. Multivariable logistic regression revealed nine potential risk factors for retained placenta: abruption (adjusted odds ratio [aOR] 3.58, 95% confidence interval [CI] 2.36-5.43), hypertensive disorders (aOR 1.74, 95% CI 1.17-2.57), prematurity (<37 weeks, aOR 1.63, 95% CI 1.13-2.35), maternal age older than 30 years (aOR 1.55, 95% CI 1.27-1.90), intrapartum fever (aOR 1.48, 95% CI 1.03-2.11), lateral placentation (aOR 1.39, 95% CI 1.01-1.91), oxytocin administration (aOR 1.39, 95% CI 1.11-1.74), diabetes mellitus (aOR 1.35, 95% CI 1.01-1.79), and female fetus (aOR 1.26, 95% CI 1.03-1.53). CONCLUSION: Retained placentas in first deliveries are associated with obstetric risk factors, some of which could be related to abnormal placentation.


Subject(s)
Placenta, Retained , Pregnancy , Infant, Newborn , Female , Humans , Adult , Placenta, Retained/epidemiology , Retrospective Studies , Case-Control Studies , Placenta , Risk Factors
17.
J Clin Ultrasound ; 51(2): 362-372, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36785506

ABSTRACT

Postpartum hemorrhage (PPH) is the leading cause of death or severe morbidity for the mother after delivery. As a consequence healthcare staff working in the delivery room should be trained to perform a prompt diagnosis and adequate management of PPH. Uneventful outcome is induced correct identification of the underlying cause of hemorrhage. Ultrasound is a promising technique for the prompt diagnosis of PPH etiology. Indeed, it is easily available, with relatively low cost, not using ionizing radiation, and can be used in different settings including the labor room, the operating theater and at the bedside of an affected women. In order to be effective Obstetricians should have an adequate knowledge of postpartum ultrasonography. In this article, we will review the sonographic findings occurring in PPH, in the differential diagnosis of the underlying cause of hemorrhage, that include retained placenta, morbidly adherent placenta, rupture of the uterus uterine, vascular anomalies of the uterine arteries and uterine inversion. We will also provide an algorithm to manage PPH according to the ultrasonographic findings.


Subject(s)
Postpartum Hemorrhage , Uterine Balloon Tamponade , Pregnancy , Female , Humans , Postpartum Hemorrhage/diagnostic imaging , Postpartum Hemorrhage/therapy , Postpartum Hemorrhage/etiology , Uterine Balloon Tamponade/adverse effects , Uterine Balloon Tamponade/methods , Uterus/blood supply , Ultrasonography/adverse effects , Treatment Outcome
18.
Ultrasound Obstet Gynecol ; 61(2): 224-230, 2023 02.
Article in English | MEDLINE | ID: mdl-36722428

ABSTRACT

OBJECTIVES: Cerebral palsy (CP) is a group of movement disorders usually diagnosed in childhood. A substantial proportion are thought to be caused by antenatal events. Abnormalities of the umbilical cord and placenta are associated with an increased risk of adverse neonatal outcomes, but it is unclear whether these conditions also carry an increased risk of CP. We aimed to determine whether abnormalities of the umbilical cord or placenta are associated with CP and assess if these associations differ by sex of the child or gestational age at birth. METHODS: We performed a national cohort study by linking data from The Medical Birth Registry of Norway with other national registries. All liveborn singletons born between 1999 and 2017 (n = 1 087 486) were included and followed up until the end of 2019. Diagnoses of CP were provided by the Norwegian National Insurance Scheme and the Norwegian Patient Register. We used generalized estimating equations and multilevel log binomial regression to calculate relative risks (RR), adjusted for year of birth, and stratified analyses were carried out based on sex and gestational age at birth. Exposures were abnormal umbilical cord (velamentous or marginal insertion, single umbilical artery (SUA), knots and entanglement), and placental abnormalities (retained placenta, placental abruption and previa). RESULTS: A total of 2443 cases with CP (59.8% males) were identified. Velamentous cord insertion (adjusted RR (aRR), 2.11 (95% CI, 1.65-2.60)), cord knots (aRR, 1.53 (95% CI, 1.15-2.04)) and placental abnormalities (placenta previa (aRR, 3.03 (95% CI, 2.00-4.61)), placental abruption (aRR, 10.63 (95% CI, 8.57-13.18)) and retained placenta (aRR, 1.71 (95% CI, 1.32-2.22))) carried an increased risk of CP. Velamentous cord insertion was associated with CP regardless of gestational age or sex. A retained placenta was associated with a 2-fold increased risk for CP in males, while the associations of SUA and cord knot with CP were significant only among females. CONCLUSIONS: The detection of placental and umbilical cord abnormalities may help identify children at increased risk of CP. The associations between placental or umbilical cord abnormalities and the risk of CP do not vary substantially with gestational age at birth or sex of the child. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.


Subject(s)
Abruptio Placentae , Cerebral Palsy , Placenta, Retained , Single Umbilical Artery , Pregnancy , Infant, Newborn , Child , Male , Female , Humans , Placenta , Cerebral Palsy/epidemiology , Cohort Studies , Umbilical Cord
19.
Vet Q ; 43(1): 1-13, 2023 Dec.
Article in English | MEDLINE | ID: mdl-36588465

ABSTRACT

BACKGROUND: Retained placenta (RP), a quite common disorder in dairy cows, shows a high negative impact on their health status and milk production. AIM: To investigate the difference in the serum proteome between the cows with RP and the physiologic puerperium (PP). MATERIAL & METHODS: Analysis of serum samples from nine cows with RP and six with PP using high-resolution liquid chromatography-tandem mass spectrometry approach. The proteins differing in the relative abundance between the PP and RP groups were classified using the Protein Analysis Through Evolutionary Relationship tool. For the pathway enrichment analysis, the REACTOME tool, with the human genome as the background, was employed. The criterion for significance was the false discovery rate corrected P-value less than 0.05. RESULTS: In total 651 proteins were identified with altered relative abundance of ten proteins. Among them, seven had higher, and three showed lower relative abundance in RP than in the PP group. The differently abundant proteins participated in 15 pathways: six related to hemostasis, three involved in lipoprotein metabolism, and the remaining ones associated with for instance redox homeostasis, post-translational modification, and scavenging. Finally, the validation of the proteomic results showed that haptoglobin and lipopolysaccharide-binding protein levels reliably differentiated between the RP and PP groups. CONCLUSION: The pattern of serum proteome alterations in the cows with RP mirrored several interplaying mechanisms underlying the systematic response to the presence of RP, therefore representing a source to mine for predictive or prognostic biomarkers.


Subject(s)
Cattle Diseases , Placenta, Retained , Pregnancy , Female , Humans , Cattle , Animals , Placenta, Retained/veterinary , Placenta, Retained/metabolism , Proteome/analysis , Proteome/metabolism , Proteomics , Postpartum Period , Lactation/metabolism , Milk
20.
Front Vet Sci ; 9: 1037880, 2022.
Article in English | MEDLINE | ID: mdl-36325096

ABSTRACT

Retained placenta (RP) refers to reproductive disorders caused by the failure of fetal membranes to be expelled 12 h after delivery in dairy cows. Postpartum adhesion of the fetal membranes to the uterus causes diseases such as mastitis or endometritis, which threatening the profitability of the dairy industry. Emerging evidence suggests that micro RNAs (miRNAs) play crucial roles in various processes, such as the occurrence and progression of fetal membranes discharge. However, the molecular mechanisms of miRNAs in RP remain unknown. In this study, we performed RNA-sequencing to characterize the expression profiles of mRNAs and miRNAs in caudal vein blood samples of postpartum Holstein cows whose fetal membranes were discharged normally or retained to identify RP-related genes and evaluate their molecular mechanisms. We identified 44 differentially expressed miRNAs (19 upregulated and 25 downregulated) and 706 differentially expressed mRNAs (325 upregulated and 381 downregulated) in the RP group compared to the normal fetal membranes discharge group. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis revealed that differentially expressed mRNAs were mainly enriched in the extracellular matrix, cell adhesion, and autoimmunity-related biological processes or pathways. Further analyses using RNA-sequencing, a dual luciferase reporter system, quantitative reverse transcription-PCR, immunofluorescence, and western blotting verified that endothelial PAS domain protein 1 (EPAS1) is regulated by miR-150_R-1 in endometrial epithelial cells. We demonstrated the relationship between EPAS1 and RP and confirmed that EPAS1 is upregulated in the blood and placenta of cows that experience RP. Further, we proposed a model of the miRNA-mRNA negative regulatory network mediated by the HIF-1/ErbB signaling pathway to show its regulatory role in RP.

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