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At least 649 records · Page 36Linked to original sources
PubMed1993

Nutrition and mastitis.

Increasing evidence presents a relationship between nutrition and mammary resistance to infection. The role of nutrition in mammary resistance has been best defined for antioxidants. To optimize this interaction, rations should be balanced and formulated for lactational stage. Although supplementation of nutrients with antioxidant function may enhance immune resistance against infections, therapeutic roles for nutritional management of clinical mastitis, as yet, are not well documented. The need to monitor herd antioxidant status as part of a mastitis control program is critical because (1) antioxidant supplementation improves mammary resistance to infectious disease during the most critical period for enhanced resistance, the dry and early postpartum periods; and (2) dry cows and heifers often are on a marginal plane of Se supplementation, particularly during periods of risk for mastitis and reproductive disorders. In areas where forages contain less than 0.1 ppm Se (dry matter) because of low soil availability, herds should be tested for Se status and, if found to be below optimum levels, increased dietary supplementation or sustained-release Se boluses should be considered. Similarly, vitamins A (or beta-carotene) and E status should be monitored in herds, especially confined herds receiving a large proportion of ensiled forages.

Animal Feed↗
PubMed1987

Evaluation of the weekly cervical examination in a preterm birth prevention program.

The efficacy of regular cervical examinations in detecting preterm labor, as well as possible risks, was studied for 133 preterm labor patients who had received regular cervical examinations as part of a preterm birth prevention program. When compared to all other patients experiencing preterm labor during the study period, the rates of preterm premature rupture of the membranes, chorioamnionitis, and postpartum endomyometritis were not increased. For 95 patients with preterm labor within 7 days of a routine cervical examination, labor onset was not temporally associated with the preceding examination. Preterm labor was diagnosed in 18 asymptomatic patients (18.2%) when the weekly examination revealed cervical change. Routine cervical exams, therefore, did not increase morbidity, and for some patients identified preterm labor before symptoms appeared.

Cervix Uteri↗
PubMed1994

Should lactating women exercise?

The safety of recreational exercise for lactating mothers has been examined in a prospective, intervention study. Thirty-three women, who were 6-8 weeks postpartum and breast-feeding exclusively were randomly chosen to join either an exercise or a control group. The exercise group took part in a program of aerobic activities averaging 4.5 sessions per week. After 12 weeks, aerobic capacity was significantly higher in the women who had exercised than in the controls, but no differences in body weight, body fatness, energy expenditure, or resting metabolic rate (RMR) were noted. The exercise program had no effect on breast milk output or composition or infant weight gain. This demonstrates that recreational exercise sufficient to improve cardiovascular fitness without substantially altering energy balance does not adversely affect lactation performance.

Body Composition↗
PubMedDate not supplied

The art and science of maintenance of normoglycemia in pregnancies complicated by insulin-dependent diabetes mellitus.

OBJECTIVE: To provide a "how-to" manual for achieving and maintaining normoglycemia in pregnant women with insulin-dependent diabetes. METHODS: We describe a detailed program that has successfully maintained normoglycemia before, during, and after diabetes-complicated pregnancies. Insulin and glucose requirements throughout pregnancy, during labor, and in the postpartum period are outlined. RESULTS: With preconception planning and careful dietary and blood glucose management during pregnancy, complications can be minimized and an optimal outcome of pregnancy can be achieved in women with diabetes. CONCLUSION: Women with type I, insulin-dependent diabetes can now have the same chances as women without diabetes to have a healthy infant. The reduction of risks associated with pregnancies complicated by diabetes can be ensured if normoglycemia is achieved before and during the pregnancy.

Journal Article↗
PubMed2005

Why pregnancy care should be an essential part of family medicine training.

Some family medicine educators are arguing to eliminate pregnancy care as a required component of family medicine training since the majority of family physicians no longer perform deliveries, and many programs are having increasing difficulties in meeting this training requirement. The primary benefit of pregnancy care training is not to produce family physicians who all perform deliveries but to produce family physicians who are competent to provide comprehensive primary care to women and girls, including routine and preventive reproductive care. The training in pregnancy care helps to differentiate family medicine residencies from other primary care training programs by facilitating competency in a wide range of reproductive health care for nonpregnant women and for the primary nonreproductive health care of pregnant and postpartum women. Residencies offering pregnancy care services also enhance their ability to train residents in child care. Family medicine should continue to strive to improve this aspect of residency training instead of abandoning it.

Curriculum↗
PubMed1984

Family planning in a healthy, married population: operationalizing the human rights approach in an Israeli health service setting.

A community health center in Israel, delivering services to a geographically defined population, attempted to formulate goals for its postpartum family planning service. Taking into account the pronatalist climate in Israel along with the good health status of the population served by this center, it was decided that the community-wide goal of the family planning program was to ensure the rights of couples to decide freely and responsibly on the number and spacing of their children. Specific process and outcome objectives were developed based on helping couples define and clarify their family planning goals, and assisting them to achieve these goals. Preliminary evaluation of the intervention based on the objectives showed that 84.0 per cent of the cohort of women who gave birth in 1980 (n = 212) had specific postpartum planning goals as opposed to 69.0 per cent of women who gave birth in 1977 (n = 242). The percentage of women experiencing unplanned pregnancies during the two years after birth was reduced by 46 per cent in the 1980 cohort (6.1 per cent of the women) as compared with the 1977 cohort (11.2 per cent).

Adult↗
PubMedDate not supplied

An early intervention program for adolescent mothers: a nursing demonstration project.

OBJECTIVE: To improve health outcomes in a vulnerable population of adolescent mothers and their infants. DESIGN: Effects of an intensive early intervention program (EIP) are compared with those of traditional public health nursing (TPHN) care. SETTING: A large California county with urban and rural communities, an ethnically diverse population, and a high teen birth rate. PARTICIPANTS: One hundred twenty-one young mothers and their children from impoverished and predominantly minority backgrounds. INTERVENTIONS: During pregnancy and through 1 year postpartum, participants (n=63) in the EIP were provided with 4 prenatal classes and approximately 17 home visits by specially trained public health nurses. Interventions addressed health issues, sexuality and family planning, life skills, the maternal role, and social support systems. Participants in TPHN (n=58) received three home visits (for intake, prenatal care, and postpartum/well-baby care information). MAIN OUTCOME MEASURES: Antepartum, intrapartum, and newborn medical records; maternal responses to written questionnaires; and nurse interviews. RESULTS: Early program outcomes indicate reduced premature birth rates for both groups compared with national data on adolescent mothers, and fewer days of infant hospitalization during the first 6 weeks postpartum for the EIP participants. CONCLUSION: Public health nurse care (both traditional and intensive) significantly improved perinatal outcomes; the intensive intervention significantly reduced the number of infant hospitalization days.

Adolescent↗
PubMed2000

Progesterone and follicular changes in postpartum noncyclic dairy cows after treatment with progesterone and estradiol or with progesterone, GnRH, PGF2alpha, and estradiol.

A previous study showed that noncyclic dairy cows treated with 10 microg of GnRH and a progesterone-releasing CIDR insert on Day 0, 25 mg of PGF2alpha and CIDR removal on Day 7, followed by 1 mg estradiol benzoate on Day 9 for those cows that still had not shown estrus (CGPE program) had higher conception rate (47% vs. 29%) than cows treated only with CIDR and estradiol benzoate as above (CE program). This study was to investigate the mechanisms by which the CGPE program improved conception rate compared with the CE program. Sixteen noncyclic Holstein-Friesian cows were randomly assigned to 2 groups balanced for the size and growth pattern of the dominant follicles, which were determined by ultrasonography over a 3-d period. One group received the above CGPE treatment, and the other group received the CE treatment. Follicular and luteal development were monitored by daily ultrasonography. Blood samples were collected daily from Day -2 to Day 11, and thereafter milk samples were collected thrice weekly for a further 24 d. Blood and milk samples were analyzed for progesterone. The GnRH treatment induced ovulation in 7 of 8 cows, resulting in elevated (P<0.05) progesterone concentrations between Days 4 and 7 for cows in the CGPE group. All induced CL underwent luteolysis by 24 h after PGF2alpha treatment. Within 5 d of CIDR removal, 7 of 8 cows in both the CE and CGPE groups ovulated. The interval from emergence of the ovulatory follicle to ovulation was similar (P=0.32) but less (P<0.05) variable for the CGPE group (9.0+/-0.3 d) compared with the CE group (10.3+/-1.2 d). Progesterone concentration in milk samples was similar between the two groups up to 10 d after ovulation. In summary, the GnRH treatment induced ovulation or turnover of dominant follicles, induced a synchronized initiation of a new follicular wave, and increased the progesterone concentration from 4 d after treatment. These could be the reasons for the increased conception rate of cows treated with the CGPE program.

Animals↗
PubMed2001

Analysis of postpartum lactational amenorrhoea in relation to breast-feeding: some methodological and practical aspects.

A large multicentre epidemiological study was carried out by WHO between 1991 and 1995 to analyse the duration of lactational amenorrhoea in relation to breast-feeding. The main results of this analysis, which used classical statistical modelling, have been already published. However, some specific aspects of the postpartum fertility amenorrhoea and breast-feeding covariates, and more specifically the observed progressive exhaustion of the breast-feeding inhibitory effect on the reproductive axis, may justify a closer look at the validity of the statistical tools. Indeed, as has already been emphasized, analysis of large longitudinal data sets in reproduction often faces three difficulties: (i) the precise determination of the event of interest, (ii) the way to handle the time evolution of both the studied variables and their effect on the event of interest and (iii) the often discrete nature of the data and the associated problem of tied events. The first objective of the present work was to give additional insights into the estimation and quantification of the dynamics of the effect of breast-feeding over time, considering this covariate either as fixed or time-dependent. The second objective was to show how to perform the analyses using corresponding adapted procedures in widely available statistical packages, without the need for acquiring particular programming skills.

Amenorrhea↗
PubMedDate not supplied

A proposal for a foster grandmother intervention program to prevent child abuse.

The incidence of child abuse and neglect is epidemic. Many abused children have sustained lifelong injuries. Often they become perpetrators of abuse, continuing the cycle into future generations. Studies have indicated that mothers who are likely to abuse their children can be identified by a predictive method during the prenatal and postpartum periods. Pilot studies have indicated that mothers who are identified by the method and who receive early intervention, consisting of home visits by registered nurses, show a significantly lower rate of verified cases of child abuse. The author proposes a strategy for early intervention to prevent child abuse and neglect and to help infants and children attain their appropriate developmental milestones. The strategy calls for training and employing women from the Foster Grandparent Program. Foster grandmothers would be a valuable resource for high-risk mothers, providing role models for parenting skills in the home setting. Participating foster grandmothers would be trained and supervised in an interdisciplinary team setting. Evaluation of the program would compare the target population of infants and children whose mothers received the proposed intervention with a similar high-risk group that received only traditional interventions.

Aged↗
PubMed1990

Maintenance of nonsmoking postpartum by women who stopped smoking during pregnancy.

This paper describes self-reported maintenance of nonsmoking at six months postpartum by women whose abstinence was verified beginning before the 20th week of pregnancy and continuing through delivery (n = 134). The overall maintenance rate of 37 percent was not related to sociodemographic characteristics, smoking and obstetric history, the time when quitting occurred, or a prenatal smoking cessation program. Although this rate is encouraging, more attention should be directed to sustaining prenatal abstinence from smoking beyond delivery.

Adult↗
PubMed1995

Do childbirth classes influence decision making about labor and postpartum issues?

This study investigated the role of childbirth education for women attending the Royal Women's Hospital Family Birth Center, Melbourne, Australia, in relation to making decisions about breastfeeding, pain medication, and length of hospital stay. Fifty-nine primiparous women completed a questionnaire after delivery about the influence of childbirth education classes on their decisions during pregnancy, birth, and the postnatal period. The results indicated that although the women enjoyed childbirth education classes, the information they received had minimal effect on their decision to breastfeed and the appropriateness of a 24-hour stay. Information gained about the use of pain medication in labor was clearly helpful when women made decisions about pain relief. Educational strategies have failed to address the tendency of nulliparous women to postpone making decisions about the postnatal period such as early discharge, and further investigation on this aspect of a childbirth education program is suggested.

Adolescent↗
PubMed1990

Management of low-grade cervical dysplasia during pregnancy.

Fifty-five pregnant patients referred to my colposcopy service from 1985 to 1990 for biopsy-proven mild dysplasia were entered into a program of serial evaluations, including Pap test, colposcopy, and directed biopsy if indicated. The evaluations were done every 12 weeks during pregnancy and at 6 weeks postpartum to rule out new or occult invasive cervical cancer. By the time the postpartum biopsy was done, no such cancer had been detected. All 55 patients had mild dysplasia or less. I conclude that pregnant patients with biopsy-proven mild cervical dysplasia who have had adequate expert colposcopy and results of Pap test consistent with biopsy require only one antepartum colposcopy prior to postpartum reevaluation and treatment. Multiple interval cytologic and colposcopic studies with or without biopsy are unnecessary. The likelihood of invasive cervical cancer developing in these patients during pregnancy is negligible.

Adolescent↗
PubMed2003

Interest in healthy diet and physical activity interventions peripartum among female partners of active duty military.

Overweight and obesity among soldiers and their dependents have increased over the last decade, mirroring rates in the general population. In general, few programs that result in sustained weight loss have been evaluated, although effective interventions could have clear health and cost benefits for the military. For women, the postpartum period represents a "teachable moment" to promote healthy diet and exercise behaviors related to weight loss, but the attitudes and preferences for weight-loss interventions in this population are unknown. With a view to developing a weight-loss intervention tailored to this population, we surveyed 161 peripartum women at a military base to assess their interests and preferences. Eighty-six percent were dependents. Despite their youth, more than one-third reported entering pregnancy overweight or obese. Interest was high for interventions that promote physical activity and facilitate social interaction. Based on these results, a postpartum exercise intervention is being designed for female partners of active duty soldiers.

Diet↗
PubMed1991

School-age mothers: predictors of long-term educational and economic outcomes.

The long-term effects of school-age pregnancy were investigated in a 20-year follow-up of a cohort of women who were pregnant adolescents in the late 1960s. Of the 149 living young black primiparas in the original cohort, 121 (81%) were located and interviewed. At follow-up the study population ranged in age from 32 to 38 years, 68% were unmarried, 71% had finished high school, 82% were completely self-supporting, and 27% reported living in public housing. Long-term success, defined as currently employed or supported by a spouse and a high school education (62%) or its equivalent, was associated with six features: having completed more school prior to becoming pregnant (odds ratio [OR] = 18; 95% confidence interval [CI] 2.3, 139.5); participating more actively in a program intervention offered to these pregnant teenagers 20 years ago (OR = 11.11; 95% CI 1.54, 79.87); being in school with no subsequent pregnancy at 26 months postpartum (OR = 10.1; 95% CI 1.64, 62.07); feeling in control of one's life (OR = 5.4; 95% CI 1.36, 21.54) and little social isolation (OR = 8.24; 95% CI 1.56, 43.50) at 26 months postpartum; and lifetime fertility control defined as one or two children after the index child (OR = 14.19; 95% CI 3.28, 61.29). It is concluded that most former teenage mothers complete a reasonable amount of education and are economically self-sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2000

[Use of modified intrauterine device (IUD) TCu 380 with chromium filaments in the immediate postpartum].

Postpartum insertion of the intrauterine device (IUD) can provide an effective and convenient means of contraception. As a result, the use of IUD's has steadily increased, and the Family Planning Program recommends it because it offers many advantages. However, a major risk associated with the use of IUD's is the possibility of its expulsion, which ranges from 4 to 60%. Furthermore, 20% of women who expelled IUD's were unaware that it occurred, thus increasing their susceptibility to unwanted pregnancies. IUD's modified by the addition of biodegradable strands of chromic suture at time of implantation are thought to be less likely to be expelled, as the sutures anchor the IUD more firmly to the endometrium, and it is possible that the use of these sutures may decrease the risk of expulsion. Therefore we determined if the chromic extension to IUD enhance retention and decreased the rate of expulsion. In one year of study, 150 women received a modified IUD (TCu 380) with chromic catgut number 0 (ccO) in the transversal arm within 10 minutes of delivery of the placenta. However, only 84 women completed the follow-up study. To evaluate IUD expulsion, exploratory examinations were conducted during the immediate postpartum, at 7 days postpartum and at 6 weeks after delivery. We determined the presence or expulsion of the IUD in these three periods postpartum. Other parameters such as parity, age and marital status were also considered. A total of 14 modified IUD's (16.6%) were expelled. This represents a similar frequency of expulsion both during the immediate postpartum and the 7 days postpartum period. There was no significant difference in the rate of expulsion between the two periods. Moreover, there was no expulsion at 6 weeks postpartum. The primiparity women had the highest percentage of expulsion (22.8%). Single mothers either living with or without their sexual partner had expulsion rates of 20.6 and 20.5%, respectively. The highest rate of expulsion when we considered age was in women younger than 30 years of age. There was only one case of expulsion where the mother was unaware of its occurrence. The results described here indicate that age, parity and civil status have no direct influence on expulsion of modified IUD's with chrome extensions. In all postpartum periods studied the p-value was greater than 0.05. Six weeks postpartum was the only time at which there was no IUD expulsion. This is most likely a consequence of decreased uterine cavity size and closure cervix. The modified IUD TCu 380 with chrome strands shows a rate of expulsion similar to other modified IUD's as evidenced in the literature. However, there is a lower rate of expulsion than in unmodified IUD's. It is an important to rote that incomplete expulsion of modified IUD's in this study was considered a total expulsion which represent loss of contraceptive effectiveness. On the contrary, if we had considered only completely expelled IUD's in this study, the percentage would have been significantly lower, as only one total expulsion was found. Further studies are necessary to investigate consecutive expulsions of the TCu 380 modified IUD.

Adolescent↗