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PubMed1994

[The therapy of postpartum secretion retention (lochiometra) in high-yielding cows].

In 11 specialised dairy farms belonging to the herd book and cattle health service of the Bureau of animal health in Hannover 1134 gynaecological examinations had been accomplished during a two and a half years period every four weeks. 120 cows (approximately 10%) showed an ichorous vaginal secretion between the second and third week post partum. The treatment was conducted beginning from ten days post partum with a high antibiotical dosage (4 g Tetracycline) in shape of small-sized pessaries (UT-forte, MSD) and additionally the cows received 20 micrograms GnRH (Receptal, Hoechst) by intramuscular injection. 3-4 weeks later the cows were reexamined, 36 cows did not reveal any abnormal signs, the remainder had to be treated in accordance with the diagnosis in the sexual tract (on average 1.16 times). After a mean interval calving to first service of 93 days 85% of the cows with lochiometra needed some more than two A. l's with a six weeks' delay to get pregnant. The reasons for the differences between the results of this study and those of other investigations are explained. It requires a great deal of veterinary labor to prevent the inflammatory processes in the genital tract from getting chronic, that is why lochiometra must be looked upon as one of the most aggravating puerperal disease. The medical care of the uterus with high doses of antibiotics combined with the application of GnRH must be recognized as a good supplement to the therapy of retained placenta favoured by Götze or other puerperal disorders such as lochiometra especially in regard to compatibility and high pregnancy rates.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed2000

Mood stabilizers during breastfeeding: a review.

BACKGROUND: The postpartum period is an exceptionally high-risk time for recurrence of depression, mania, or psychosis for women with bipolar disorder. Puerperal prophylaxis with mood stabilizers decreases this risk. To allow patients and clinicians to make informed decisions about mood-stabilizer use during breastfeeding, there is a need for a critical review and analysis of the data. DATA SOURCES: A search of MEDLINE (1966-1998) and the Lithium Database, Madison Institute of Medicine, was conducted to obtain articles about lithium, valproate, carbamazepine, gabapentin, or lamotrigine use during lactation. Search terms used were pregnancy, teratogenesis, breastfeeding, lactation, breast milk levels and lithium, anticonvulsants, mood stabilizers. No other search restrictions were used. Unpublished data on gabapentin and lamotrigine were provided by the manufacturers. RESULTS: The search revealed 11 cases of lithium use during breastfeeding, 8 of which reported infant serum levels. Two cases reported symptoms consistent with lithium toxicity in the infants. Thirty-nine cases of valproate use during breastfeeding were found, 8 of which reported infant serum levels. There was 1 report of thrombocytopenia and anemia in an infant. Fifty cases of carbamazepine use during breastfeeding were found, 10 of which reported infant serum levels. Two infants experienced hepatic dysfunction. One unpublished study of gabapentin in breast milk was found. Three reports of lamotrigine use during breastfeeding were found. DISCUSSION: Available information remains limited to uncontrolled studies and case reports. Carbamazepine and valproate, but not lithium, have generally been considered compatible with breastfeeding. The overall paucity of data, data confounded by polypharmacy and infant age differences, and adverse reactions reported with all established mood stabilizers dictate a reassessment of these recommendations. We propose that a woman's historical response to medication and the clinical circumstances be the primary considerations when choosing a mood stabilizer during breastfeeding, rather than strict adherence to categorical assignments.

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