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PubMed2003

[The incidence of cervical dystocia and disorders of cervical involution in the post partum cow].

The aim of this study was to obtain information on the frequency of cervical dystocia and involution disorders of the canalis cervicalis after difficult dystocia and to characterise factors possibly influencing these pathological conditions. Therefore 317 difficult births in the cow (extraction: 123; foetotomy: 82; caesarean section: 112) and the involution of the cervical canal were documented during the first ten days post partum. In total a cervical dystocia could be diagnosed 53 times (16.7% related to the total number of births). This kind of birth disorder is regularly followed by a caesarean section (p < 0.001). Animals who show a narrowness in the cervix were older than the cows without cervical dystocia (p < 0.05). The same correlation could be detected for the number of births. Animals with delivery problems associated with the cervix had already given birth to more calves than cows who were not affected by cervical disorders (p < 0.01). 58 cows developed a disorder of the cervical involution (18.3% related to the total number of deliveries). This puerperal disorder can be frequently observed after foetotomy (p < 0.001). A correlation between the incidence of disorders of cervical involution and the age or the parity of the animals could not be detected. In the same way, cows with a diagnosis of a cervical dystocia did not develop more frequently disorders of cervical involution than animals who showed a physiological dilation of the cervical canal intra partum.

Age Factors↗
PubMed1991

Bacterial flora of the uterus of cows after calving on two hygienically contrasting farms.

Intrauterine swabs were obtained from cows after calving on two commercial dairy herds with contrasting hygienic environments and incidence of leucorrhea, and cultured aerobically and anaerobically. Of 26 cows with a normal calving and puerperium, eight of 14 (57 per cent) were sterile on farm B where hygiene was poor, compared with five of 12 (42 per cent) on farm A where hygiene was better. Two cows on farm B retained their placentas and subsequently developed metritis/endometritis. Actinomyces pyogenes was the commonest bacterial isolate and Fusobacterium nucleatum, Proteus mirabilis and Bacteroides melaninogenicus were also frequently observed. Similar isolates were obtained from cows on farm B with parturient or puerperal disorders. The contrasting hygienic environments had no influence on either the quantitative or qualitative uterine bacterial flora. Thus, the difference in the incidence of endometritis must have been due to factors other than hygiene.

Actinomyces↗
PubMed1978

[Acute renal failure and consumption coagulopathy in the puerperium].

Disseminated intravascular coagulation accompanied 18% of cases of acute renal failure during puerperal disorders. We studied in particular 31 cases of disseminated intravascular coagulation with renal failure due to obstetric disorders : 12 post-abortion infections, 3 retentions of a dead foetus, 5 infections, 6 cases of toxemia, 2 retroplacental hemorrhages, two hemorrhages during the third stage, one uremohemolytic syndrome. For diagnosis one relies on the clinical data (bleeding, purpura, shock, hemolysis, visceral involvement) and laboratory data, (coagulation should be supervised throughout the course). The renal lesions are either cortical necrosis, or interstitial nephritis. The analogies with experimental phenomena suggest a human equivalent of the Schwartzmann-Sanarelli syndrome.

Acute Kidney Injury↗
PubMed2007

Incidence of hospitalization for postpartum psychotic and bipolar episodes in women with and without prior prepregnancy or prenatal psychiatric hospitalizations.

CONTEXT: Postpartum psychosis occurs in 1 to 2 cases per 1000 live births. Most studies have not distinguished postpartum psychosis from bipolar disorder or the proportion of the incidence attributable to prepregnancy psychiatric morbidity. OBJECTIVE: To determine the incidence of postpartum psychosis and bipolar disorder attributable to previous psychiatric hospitalization. DESIGN: Population-based study using linked registry data to determine postpartum onset of psychotic and bipolar episodes within 90 days after the first birth, by women with and without prepregnancy or prenatal psychiatric hospitalization. We assessed the type, number, and recency of previous hospitalizations on the incidence of hospitalization for postpartum psychotic and bipolar episodes. SETTING: Nationwide Swedish Hospital Discharge and Medical Birth registers. PATIENTS: Swedish women delivering a first live infant between January 1, 1987, and December 31, 2001. MAIN OUTCOME MEASURES: Postpartum hospitalization for psychosis or bipolar disorder. RESULTS: The cumulative incidences for postpartum psychotic and bipolar episodes (adjusted for age at first birth) were 0.07% and 0.03%, respectively. The incidence of psychiatric hospitalizations for postpartum psychotic or bipolar episodes among women without previous psychiatric hospitalizations was 0.04% and 0.01% of first births, respectively; for women with any psychiatric hospitalization before delivery, the incidence was 9.24% and 4.48%, respectively. For postpartum psychotic and bipolar episodes, the risk increased significantly with the recency of prepregnancy hospitalizations, number of previous hospitalizations, and length of most recent hospitalization. More than 40% of women hospitalized during the prenatal period for a bipolar or a psychotic condition were hospitalized again during the postpartum period. Approximately 90% of all postpartum psychotic and bipolar episodes occurred within the first 4 weeks after delivery. CONCLUSIONS: Almost 10% of women hospitalized for psychiatric morbidity before delivery develop postpartum psychosis after their first birth. This underscores the need for obstetricians to assess history of psychiatric symptoms and, with pediatric and psychiatric colleagues, to optimize the treatment of mothers with psychiatric diagnoses through childbirth.

Adult↗
PubMedDate not supplied

Classification of CSF samples from normal and post-partum psychotic women using chromatographic profiles with bilinear projections: a multivariate approach.

This paper demonstrates how chromatographic profiles of cerebrospinal fluid (CSF) have been subjected to multivariate data analysis to discriminate between CSF samples from women with post-partum psychosis and those from healthy women. Instead of peak-heights or areas, digitally defined chromatographic profiles were examined using principal component analysis (PCA). In accordance with the diagnosis, we have found a complex profile pattern of at least ten composite peaks that discriminates between these groups. Two of these peaks were for the discrimination particularly clearly between the two groups. We speculate that these findings can be useful in the diagnosis of post-partum psychosis, increasing diagnostic precision and having both clinical and prognostic implications.

Chromatography, High Pressure Liquid↗
PubMed2004

Antipsychotic drugs for non-affective psychosis during pregnancy and postpartum.

BACKGROUND: Antipsychotics are commonly prescribed for women suffering psychotic illnesses during pregnancy and the postpartum period. The potential adverse consequences of these different options are multiple and complex, impacting on the foetus, neonate, infant and early development of the child as well as the woman herself. OBJECTIVES: To establish whether the benefits of taking antipsychotic drugs outweigh the risks for pregnant or post partum women. SEARCH STRATEGY: The Cochrane Schizophrenia Group's Register (January 2003) was searched in order to identify all published trials of women during pregnancy or the postpartum period. We inspected all references of all identified studies. If any studies had been found, the first authors of each included study would have been contacted. SELECTION CRITERIA: Randomised controlled clinical trials investigating the effects of any type of antipsychotic drug compared with any other treatment option (including standard psychosocial care, any other antipsychotic drug, or an alternative therapy such as electro-convulsive therapy or cognitive behavioural therapy) and involving pregnant women and/or women during the postpartum period diagnosed with a non-affective psychotic disorder. DATA COLLECTION AND ANALYSIS: Citations, and where possible, abstracts were independently inspected by reviewers and the papers ordered were scrutinised and quality assessed. Data would have been extracted independently by at least two reviewers. Binary outcomes were to have been analysed using Relative Risks (RR) and their 95% Confidence Intervals (CI). MAIN RESULTS: We found no trials that met the broad inclusion criteria. REVIEWERS' CONCLUSIONS: Current guidelines and clinical practice for the use of antipsychotic drugs in women with non-affective disorders during pregnancy and postpartum are not based on evidence from randomised controlled trials. Although ethical concerns have to date precluded the use of randomised controlled trials to address this research topic, the continued use of antipsychotic drugs in this group of women in itself poses significant clinical and ethical problems. Evidence is required from large pragmatic trials that reflect routine clinical practice, examine a broad range of outcomes and accurately quantify risks and benefits to both mothers and their offspring, so that comparison between different treatment options can be made.

Antipsychotic Agents↗
PubMed1979

An explication of 'wind illness' in northern Thailand.

'Wind illness' is a very common complaint among the Northern Thai, yet is rarely recognized by Thai physicians trained in biomedicine. Persons most susceptible to 'wind illness' are adult women who have ever borne a child. Consequently, data were obtained from 415 everparous women, 43% of whom reported ever having had 'wind illness' and 57%. never having had it. In addition, 20 individuals who had ever had the syndrome were followed for case study, and 13 indigenous healers who traditionally treat clients suffering 'wind illness' were interviewed. Their perceptions of the etiology, symptomatology and treatment of 'wind illness' are reported in Part I. Part II is an attempt to define 'wind illness' in terms of biomedicine and as a consequence of fertility. Part III synthesized the emic and etic accounts with explanations for the perdurance of 'wind illness' despite the advances of biomedicine and the recent fertility decline in Northern Thailand.

Adult↗
PubMed1984

Presence of chlorprothixene and its metabolites in breast milk.

Chlorprothixene (CPX) and CPX sulphoxide were demonstrated in breast milk from two psychotic mothers taking 200 mg CPX daily. The milk concentrations of CPX were 120 to 260% greater than in plasma. The estimated amounts of drug administered in breast milk to one of the infants were 15 and 26 micrograms/day for CPX and CPX sulphoxide, respectively. Accordingly, the infant dose of the parent compound would be only 0.1% of the maternal dose/kg body weight. It is not likely that CPX or its metabolite would exert any immediate pharmacological effects in the nursing infant. However, the long term effect of low doses of neuroleptic drugs in the developing infants is not yet known.

Adult↗