Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Postpartum Period”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed1995

Use of Norplant contraceptive implants in the immediate postpartum period: safety and tolerance.

OBJECTIVE: Our purpose was to determine the safety and tolerance of levonorgestrel contraceptive implants (Norplant, Wyeth-Ayerst, Philadelphia) when inserted immediately post partum, to document the effects on weight and blood pressure, and to determine the side effects. STUDY DESIGN: After vaginal delivery, 250 women were randomized to receive Norplant within 48 hours of delivery (study group) or at the 4- to 6-week postpartum visit (control group). Baseline measurements were recorded and compared with those obtained at the 4- to 6-week follow-up visit. A diary was maintained by patients who recorded bleeding and side effects. Statistical analysis was performed with t test and chi 2 analysis. RESULTS: There were no episodes of acute postpartum hemorrhage or clinically significant bleeding. Compared with the control group, the immediate group reported significantly more bleeding days (p < 0.01). There was no significant difference between the two groups in the hemoglobin values obtained at 4 to 6 weeks post partum. The immediate insertion group reported significantly more headaches (p < 0.01) and acne (p = 0.01). CONCLUSION: Norplant is well tolerated and should be available for interested patients immediately post partum.

Acne Vulgaris↗
PubMed2003

Joint SOGC/CSEP clinical practice guideline: exercise in pregnancy and the postpartum period.

OBJECTIVE: To design Canadian guidelines advising obstetric care providers of the maternal, fetal, and neonatal implications of aerobic and strength-conditioning exercises in pregnancy. OUTCOMES: Knowledge of the impact of exercise on maternal, fetal, and neonatal morbidity, and of the maternal measures of fitness. EVIDENCE: MEDLINE search from 1966 to 2002 for English-language articles related to studies of maternal aerobic and strength conditioning in a previously sedentary population, maternal aerobic and strength conditioning in a previously active population, impact of aerobic and strength conditioning on early and late pregnancy outcomes, impact of aerobic and strength conditioning on neonatal outcomes, as well as for review articles and meta-analyses related to exercise in pregnancy. VALUES: The evidence collected was reviewed by the Society of Obstetricians and Gynaecologists of Canada (SOGC Clinical Practice Obstetrics Committee) with representation from the Canadian Society for Exercise Physiology, and quantified using the evaluation of evidence guidelines developed by the Canadian Task Force on the Periodic Health Exam.

Exercise↗
PubMed1990

Sensory thresholds during the antepartum, intrapartum and postpartum periods.

The present exploratory study measured pain and tactile thresholds in response to mechanical stimulation of the hand before labor, during labor, and after parturition in women. In women who had Lamaze childbirth preparation (but not in women who did not have childbirth preparation), pain thresholds were significantly higher during labor (determined up to 8 cm cervical dilatation) than prior to labor and 24 hours postpartum. Tactile thresholds did not change during any of these conditions. These findings support earlier findings in this laboratory that vaginocervical mechanostimulation elevated pain thresholds in human and animal subjects, and more recent findings that pain thresholds increased in rats during delivery of individual young. The present findings suggest that an endogenous process that attenuates the pain of parturition is activated when the cervix dilates during labor.

Adult↗
PubMedDate not supplied

Maternal role attainment and identity in the postpartum period: stability and change.

Stability and change in maternal identity and maternal role attainment were examined in 64 medically normal, middle-class primiparous and 58 multiparous women. Using two semantic differential scales, "Myself as Mother" and "My Baby", for maternal identity and the Pharis (1978) Self-Confidence Scale for role attainment, subjects were tested at 1 to 3 days and 4 to 6 weeks postpartum. Main effects for parity and testing occasions were found for both semantic differential scales. While mothers' attitudes toward themselves became more positive over time, those toward their babies became less positive. Self-confidence showed main effects for both time of testing and parity as well as interaction effects. Although attitudes and self-confidence were stable across testing occasions, self-confidence was less related to indicators of maternal identity for multiparas than for primiparas. Sociodemographic variables demonstrated only low correlations with indicators of maternal identity and role attainment. Testing the relationship of maternal identity and role attainment to actual parenting behaviors is needed to determine the empirical and practical import of these two concepts in nursing practice.

Adolescent↗
PubMed2006

Effects of a single large dose of vitamin A, given during the postpartum period to HIV-positive women and their infants, on child HIV infection, HIV-free survival, and mortality.

BACKGROUND: Low maternal serum retinol level is a risk factor for mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). Multiple-large-dose vitamin A supplementation of HIV-positive children reduces mortality. The World Health Organization recommends single-large-dose vitamin A supplementation for postpartum women in areas of prevalent vitamin A deficiency; neonatal dosing is under consideration. We investigated the effect that single-large-dose maternal/neonatal vitamin A supplementation has on MTCT, HIV-free survival, and mortality in HIV-exposed infants. METHODS: A total of 14,110 mother-infant pairs were enrolled < or =96 h after delivery, and both mother and infant, mother only, infant only, or neither received vitamin A supplementation in a randomized, placebo-controlled trial with a 2 x 2 factorial design. All but 4 mothers initiated breast-feeding. A total of 4495 infants born to HIV-positive women were included in the present analysis. RESULTS: Neither maternal nor neonatal vitamin A supplementation significantly affected postnatal MTCT or overall mortality between baseline and 24 months. However, the timing of infant HIV infection modified the effect that supplementation had on mortality. Vitamin A supplementation had no effect in infants who were polymerase chain reaction (PCR) positive [corrected] for HIV at baseline. In infants who were PCR negative at baseline and PCR positive at 6 weeks, neonatal supplementation reduced mortality by 28% (P=.01), but maternal supplementation had no effect. In infants who were PCR negative at 6 weeks, all 3 vitamin A regimens were associated with ~2-fold higher mortality (P< or =.05). CONCLUSIONS: Targeted vitamin A supplementation of HIV-positive children prolongs their survival. However, postpartum maternal and neonatal vitamin A supplementation may hasten progression to death in breast-fed children who are PCR negative at 6 weeks. These findings raise concern about universal maternal or neonatal vitamin A supplementation in HIV-endemic areas.

Dietary Supplements↗
PubMed1994

Blood levels of the prostaglandin F2 alpha metabolite during the postpartum period in Bos indicus cows in the humid tropics.

Plasma levels of the prostaglandin F2 alpha metabolite (15-ketodihydroprostaglandin F2 alpha) were determined by radioimmunoassay in 26 postpartum multiparous Brahman cows. Variation in the concentrations of the metabolite was high among animals. 15-Ketodihydro-PGF2 alpha concentrations on day 0, 5, 10, 15 and 20 postpartum ranged from 402 to > or = 1000, from 251 to > or = 1000, from 237 to > or = 1000, from 75 to 608 and from 75 to 267 pmol l-1, respectively. The prostaglandin metabolite levels were elevated at parturition and remained elevated thereafter for periods varying up to 10 to 23 days postpartum (16.7 +/- 0.7 days, mean +/- SEM). Uterine involution (UI) was completed by 28.0 +/- 0.8 days (ranging from 20 to 36 days). A markedly linear decrease of 15-ketodihydro-PGF2 alpha levels (P < 0.001) occurred from parturition until Day 23 postpartum. A significant correlation between the duration of the elevated PGF2 alpha metabolite and the time required for completion of UI was observed (r = -0.05, P < 0.01). The effect of parity (PT) on 15-ketodihydro-PGF2 alpha levels was not significant, however the relationship between UI and PT was affected (r = -0.59, P < 0.001). Both PGF2 alpha release and PT had effects on the variability of UI (R2 = 0.62, P < 0.001). No significant relationship was found between elevated levels of 15-ketodihydro-PGF2 alpha UI and PT with postpartum anoestrous interval (PPAI).

Animals↗
PubMed1990

[Studies of the course of the postpartum period in sheep of the Polish Merino breed. III. Progesterone level in the peripheral blood 1-40 days after labor].

Progesterone concentration was determined by RIA in 24 ewes of Polish Merino Breed on 1-40th day after parturition. In most of the studied ewes (58%) 1-3 luteal phases were observed. Elevated concentration of progesterone appeared on days 6-15, but in most cases on the 20th day postpartum approximately. Luteal phases of first oestrous cycles were shortened and lasted approximately 6 days, whereas normal length of oestrous cycles and progesterone concentration illustrating the presence of cyclic corpus luteum were observed on the 25th day after postpartum.

Animals↗
PubMed1975

Is the postpartum period a time of crisis for some mothers?

This was a small descriptive study designed to discover the problems encountered by 3 primiparas and 3 multiparas during the 6 weeks following the birth of their babies. The size and type of sample allows no generalizations to larger groups. Since many problems surfaced for these few families, nurses should continue to explore this maturational period in the family's growth cycle to develop a greater understanding of their potential nursing intervention role.

Adaptation, Psychological↗
PubMed1996

Use of health services by children who were identified during the postpartum period as being at high risk of child abuse or neglect.

OBJECTIVE: To examine the rates of hospitalizations of children identified as beingat high risk of maltreatment compared with a sociodemographically similar comparison group. DESIGN: retrospective study comparing a high-risk cohort with a sociodemographically matched comparison group at Yale-New Haven Hospital (New Haven, CT). PATIENTS: One huntred fourteen children who were identified from January 1979 through December 1981 by clinicians on the postpartum ward as being at high risk of abuse or neglect and 114 sociodemographically similar comparison children who were matched according to date of birth, race, gender, and method of payment for the hospitalization. MAIN OUTCOME MEASURER: During the first 4 years of life, the number of hospitalizations, reasons for admissions, and appropriateness of days in the hospital using the Pediatric Appropriateness Evaluation Protocol. RESULTS: Significantly more high-risk children wer hospitalized (40% vs 22%; risk ratio 1.84; 95% confidence interval, 1.23-2.74). High-risk children were hospitalized for 649 (mean, 9.0) days versus 124 (mean, 3.8) days in comparison children. For admissions for medical problems, 28% of hospital days in the high-risk group were considered inappropriate by the Pediatric Appropriateness Evaluation Protocol versus 8% in the comparison group. CONCLUSIONS: There are substantial differences in the rates of hospitalizations, lengths of stay, and appropriateness of days in children identified as being at hish risk of maltreatment compared with a sociodemographically similar, non-high-risk group. Preventive programs that are aimed at reducing rates of child maltreatment in high-risk young children also should examine the program's effects on the use of hospital care.

Adult↗
PubMed1997

Fertility of fully breast-feeding women in the early postpartum period.

OBJECTIVE: To examine bleeding between 6 and 8 weeks postpartum in fully breast-feeding women and its association with fertility as assessed by hormone analysis. METHODS: Seventy-two fully breast-feeding women were followed prospectively from 42 days postpartum. Vaginal bleeding was recorded daily. Women who experienced bleeding were compared with women who did not with respect to time of ovulation and time of first menses. RESULTS: Nearly half of the women experienced some vaginal bleeding or spotting between 6 and 8 weeks postpartum. These women eventually menstruated and ovulated earlier than the women who did not bleed, but the differences were not significant. The study had 34% and 45% power to detect a 20% difference in the proportion menstruating and ovulating, respectively, at 6 months postpartum, and 10% and 16% power to detect the same differences at 1 year. Seven women experienced ovarian follicular development before day 56, but neither bleeding nor follicular development was associated with ovulation in any woman in the first 8 weeks postpartum. CONCLUSIONS: It is unlikely that vaginal bleeding in fully breast-feeding women in the first 8 weeks postpartum represents a return to fertility.

Female↗
PubMed1999

Integrated maternal and infant health care in the postpartum period in a poor neighborhood in Santiago, Chile.

An integrated postpartum health-care program was established by the Consultorio San Luis de Huechuraba (CSLH), a nongovernmental organization in a neighborhood of extreme poverty in Santiago, Chile. The main components were education, maternal and infant health care, support for the mothers, and active participation of women from the community served. The program was evaluated through indicators of contraceptive use, breastfeeding performance, infant growth and health, and a qualitative assessment of women's satisfaction. Controls were women of similar characteristics attending the nearby public clinic. Acceptability of contraceptive methods was similar but contraceptive options differed between clinics. The total number of pregnancies and of respondents lost to follow-up was significantly higher for the public clinic than for the CSLH. Breastfeeding duration was significantly longer and infant growth and health were found to be significantly better at the CSLH than at the public clinic. Women valued being treated with respect, receiving education and support, and being offered timesaving services and wider contraceptive choices at the CSLH. This study demonstrates that such interventions are possible for poor communities, providing significant advantages for women and children.

Adult↗
PubMed1983

Profile of serum estriol and its conjugates at delivery and in the immediate postpartum period in a patient with severe polycystic kidney disease: a comparison with normal pregnancy.

A patient with group C polycystic kidney disease had abnormally high concentrations of total serum estriol (E3) but low-normal urinary levels of E3 throughout the period of study (20 weeks of gestation until delivery by cesarean section at 33 weeks, 5 days). At delivery and at regular intervals until 6 hours thereafter serum specimens were analyzed for unconjugated E3 and its four major conjugates. Comparisons were made with levels in three normal volunteer subjects studied in the same way. In the 6 hours, total E3 declined 37% in the subject with polycystic kidney disease whereas in normal subjects the decline ranged from 84% to 99%. Unconjugated E3 was depleted from the serum in all subjects in about 2 hours. The major difference between the patient with polycystic kidney disease and the normal subjects was in the profile of E3 conjugates. In polycystic kidney disease, E3-3-glucosiduronate (E3-3G) and E3-3-sulfate-16-glucosiduronate (E3-SG) respectively made up 83% and 1.8% of the total serum estriol, whereas in the normal subjects the average values were 13% for E3-3G and 49% for E3-SG. There were no consistent dramatic changes in the percentage contribution of any conjugate to the total E3 level in either the patient with polycystic kidney disease or the normal subjects in the predelivery or postdelivery periods. The E3 profile in polycystic kidney disease is explainable in terms of impaired renal function coupled with normal enterohepatic metabolism of E3.

Estriol↗
PubMed1988

Changes of apolipoprotein A-IV in the human neonate: evidence for different inductions of apolipoproteins A-IV and A-I in the postpartum period.

The levels, isoforms and distribution of apolipoprotein A-IV (apo A-IV) were investigated in 127 term human umbilical cord sera. In addition, apo A-IV levels and isoforms were determined on the 3rd (n = 82) and 6th (n = 68) day following parturition and compared to apo A-I concentrations. Levels of apo A-IV were low in umbilical cord serum (5.7 +/- 1.9 mg/dl) as compared to adult serum (17.6 +/- 4.8 mg/dl). No difference was found between male and female neonates. The serum distribution of apo A-IV closely resembled that seen in the adult human. Apo A-IV concentrations dramatically increased during the first week of life reaching levels of 13.4 +/- 4.1 mg/dl on day 3 and 16.7 +/- 3.4 mg/dl on day 6 post-partum. During this time apo A-I levels did not change significantly (81.0 +/- 16.5 mg/dl in cord serum, 75.3 +/- 10.6 mg/dl and 84.2 +/- 14.5 mg/dl on day 3 and 6, respectively). Cord serum already exhibited the major serum apo A-IV isoforms seen in the adult. Isofocusing of apo A-IV also identified the known genetic polymorphism of apo A-IV. Among 127 cord sera studied we identified 109 homozygote normal patterns, apo A-IV (1-1), 16 heterozygotes, apo A-IV (1-2) and 2 individuals homozygote for the variant peptide, apo A-IV (2-2). We provide evidence that apo A-IV and apo A-I are differently induced in the human neonate during the beginning of the feeding period.(ABSTRACT TRUNCATED AT 250 WORDS)

Apolipoprotein A-I↗
PubMed2006

Influence of childhood sexual abuse on pregnancy, delivery, and the early postpartum period in adult women.

OBJECTIVE: With a prevalence of around 20%, childhood sexual abuse (CSA) is a relevant problem in obstetric care. The aim of our systematic review was to present the current knowledge on the influence of CSA on pregnancy, delivery, and early parenthood. DATA SOURCES: All English, French, or German primary and secondary literature from the reference lists found after screening the data banks Pubmed, PsycInfo, and Psyndex for publications that include the terms CSA or childhood traumatization and pregnancy, birth, delivery, labor, childbearing, breast feeding, or postpartum, and published after 1970 were reviewed for relevant data. METHODS OF STUDY SELECTION: Investigations of psychological/medical data banks and cross references revealed 43 relevant studies. Given the paucity of data on this important subject, we opted to review all of these studies. TABULATION, INTEGRATION, AND RESULTS: Although research projects on this topic are rare and the methodological quality of studies published to date is generally poor, women with a history of CSA seem to present a variety of long-term sequelae referring to pregnancy, delivery, and early parenthood. These sequelae include risk behaviors during pregnancy and disturbance of delivery by sudden memories of sexual abuse situations. Prenatal care is often complicated by the tendency to avoid situations that can trigger memories. CONCLUSIONS: As effective treatment programs to improve sequelae of CSA are available today, the question of such abuse experiences should be raised as early as possible and adequate interdisciplinary models to care for victimized patients should be established. However, to improve knowledge on the long-term effect of sexual abuse experiences in obstetrical care, methodologically well-designed research projects focusing on the kind and incidence of sequelae, mediating factors as well as prophylactic and therapeutic options are needed.

Adolescent↗