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BACKGROUND: Congenital arteriovenous malformations represent a rare cause of heart failure in neonates. MATERIALS: Four neonates with arteriovenous malformations (cerebral in one, hepatic in two and pulmonary in one) are reported. RESULTS: In the first three cases Color Doppler echography was able to image the arteriovenous malformations, to identify the afferent and efferent vessels and to quantify the arteriovenous shunt. In the neonate with pulmonary malformation, a cardiac cause of heart failure was excluded by echocardiography, and the diagnosis was stated by selective angiography. The neonate with cerebral great arteriovenous malformation died at 4th day of life. The two neonates with hepatic malformations improved both with medical therapy; in the last neonate, with multiple arteriovenous pulmonary fistulae, selective embolization was performed, but the child died a few months later. CONCLUSION: Congenital arteriovenous malformations are rare, and an early diagnosis is the base for a correct therapy; Color Doppler echography represents the gold standard for cerebral and hepatic malformations, while selective angiography should be reserved to patients who might profit of embolization or surgical resection.
Caesarean section delivered suckler calves and their dams from the mother cow herd were used for this investigation. Jugular venous blood samples taken immediately after delivery from the cow and the calf and in the calf at 24 hours and at 48 hours of postnatal age as well were analyzed for T4, FT4, T3 and FT3 by luminescence enzyme immunoassay. Strong correlation between the thyroid hormone values of the cow and those of the calf could be found. Higher thyroid hormone values were measured in calves increasing further at 24 hours of age and then decreasing a little at 48 hours of age with higher values in female than in male calves. A strong correlation existed between T3 and heart rate of the calves.
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Large White x Meishan F2 crossbred gilts (n = 57) were observed continuously during farrowing while the placentae of their offspring were labeled in order to examine the duration of farrowing and placenta expulsion in relation to maternal-, piglet- and placental traits and the duration of birth interval in relation to birth weight, birth order and placental traits. Independently from each other, litter size, gestation length and offspring directed aggression significantly (P 0.05) affected duration of farrowing. An increase in litter size was associated with an increase of duration of farrowing and an increase in gestation length was associated with a decrease of duration of farrowing. Aggressive gilts took longer to farrow, compared to non-aggressive ones. After taking into account litter size, gestation length and offspring directed aggression, placental thickness (i.e., placental weight corrected for placental surface area) was significantly (P < 0.05) related to duration of farrowing, i.e., litters with on average thicker placentae took longer to farrow. The latter effect is the result of the fact that individual placental thickness significantly (P < 0.01) affected individual birth interval, independent of birth weight. The piglet has to break its own membranes to be able to start its journey through the uterus towards the birth channel. Apparently, a thicker placenta offers more resistance and thus prolongs the process of birth. Independent of placental thickness, birth interval significantly (P < 0.01) decreased with an increase in birth order (first born to last born). The high variation of birth intervals for the last born piglets, caused a slight increase in average birth interval for the latter piglets. Litters with on average more areolae per placenta took significantly (P < 0.001) less time to be born than litters with on average less areolae per placenta (independent of total number of piglets born and other placental traits), while birth intervals within litters were not affected by this trait. Thus, these results are probably due to a gilt trait rather than a piglet trait. Since the number of areolae represent the number of uterine glands present, the gilt trait might be uterine development. Duration of placenta expulsion significantly (P < 0.01) increased with an increase of duration of farrowing. Furthermore, the first placenta was expelled significantly (P < 0.01) earlier relative to last piglet when duration of farrowing was protracted, while there was no relation of the time interval between first placenta and last piglet and the duration of placenta expulsion. In conclusion, the most important finding of this study is that placental thickness rather than birth weight appears to play an important role in the duration of birth intervals and as a result, of duration of parturition in gilts.
Selected more or less known risk factors of breast cancer were investigated and compared in this case-control study in Estonian and Slovak women. The results revealed that women who gave birth to the first child before the age of 20 years had one-fifth and one-third breast cancer risk in Estonia and Slovakia, respectively, in relation to nulliparous women. Concerning subsequent births, Estonian women with two children showed the lowest relative risk, while in Slovak women this risk decreased with increasing parity. Only in women from Slovakia who gave the first birth at, and after the age of 30 years, significantly elevated breast cancer risk was observed. In this study there was no evidence of an association between breast cancer risk and the age at menarche, although an increasing trend of the variable early menarche was apparent in both female populations studied. In addition, an increase in the risk was revealed among obese Estonian women, and thyroid diseases were found to be related with a twofold excess of breast cancer risk in Slovak women. The possible existence of differences in risk factors in the populations showing similar breast cancer incidence rates is discussed.
CONTEXT: Studies on postpartum mental disorders among mothers have primarily focused on either depression or psychoses and have generally not included the broader spectrum of mental disorders. A few studies have found that some men have symptoms of depression after becoming fathers, but these studies have not documented whether this exceeds the morbidity among men in general. OBJECTIVES: To estimate the risk of postpartum mental disorders necessitating hospital admission or outpatient contact for mothers as well as fathers during a 1-year postnatal follow-up period after birth of first live-born child and to investigate whether parents in general differ from nonparents in the risk of admission with a mental disorder and how this difference varies with age. DESIGN, SETTING, AND PATIENTS: Register-based cohort formed by linking information from Danish health and civil service registers. A total of 2,357,942 Danish-born persons were followed up from their 15th birthday or January 1, 1973, whichever came later, until date of onset of the disorder in question, date of death, date of emigration from Denmark, or July 1, 2005, whichever came first. From 1973 to 2005, a total of 630,373 women and 547,431 men became parents for the first time, and during the first year after childbirth, these parents contributed 1,115,639 person-years at risk. MAIN OUTCOME MEASURE: First-time psychiatric hospital admission or outpatient contact 0 to 12 months after becoming a parent. RESULTS: A total of 1171 mothers and 658 fathers were admitted with a mental disorder to a psychiatric hospital during the first 12 months after parenthood, and the corresponding prevalence of severe mental disorders through the first 3 months after childbirth was 1.03 per 1000 births for mothers and 0.37 per 1000 births for fathers. Compared with women who had given birth 11 to 12 months prior, primiparous women had an increased risk of incident hospital admission with any mental disorder through the first 3 months after childbirth, with the highest risk 10 to 19 days postpartum (relative risk [RR], 7.31; 95% confidence interval [CI], 5.44-9.81). Among mothers, risk was also increased for psychiatric outpatient contacts through the first 3 months after childbirth, also with the highest risk occurring 10 to 19 days postpartum (RR, 2.67; 95% CI, 1.99-3.59). Unlike motherhood, fatherhood was not associated with any increased risk of hospital admission or outpatient contact. CONCLUSION: In Denmark, the risk of postpartum mental disorders among primiparous mothers is increased for several months after childbirth, but among fathers there is no excess of severe mental disorders necessitating admission or outpatient contacts.
The aim of this study is to clarify the evolutional changes of the popliteal angle in low birth weight infants during the first year of life. The popliteal angle was measured at 1, 4, 8, and 12 months of corrected age on routine physical examination of 204 appropriate-for-date infants who had achieved normal psychomotor development. The popliteal angle was visually determined and categorized into two groups; tight, when it was 120 degrees or less, and wide, when it was more than 120 degrees. The infants were divided into five groups according to their birth weights; Group E, birth weight or=2500 gm. At 4 months of corrected age, the rate of a tight popliteal angle was significantly higher in Groups E + V + L1 than in Groups L2 + N. A tight popliteal angle was rare in all groups at 8 or 12 months of age. The results of this study indicate that the physiologic muscle tone of lower extremities is higher in infants with birth weights of <2000 gm at 4 months of corrected age. One should carefully interpret a tight popliteal angle in low birth weight infants during early infancy. Serial assessment of the popliteal angle is necessary before judging that a low birth weight infant has spastic cerebral palsy.
The objective of this research was to determine the effect of birth weight on perinatal mortality (PM) (alive or dead at 48 h of age) and dystocia (unassisted or assisted). Data were 4528 records of births between 1968 and 1999 from the Iowa State University research dairy farm in Ankeny. The incidence of PM was 7.1%; dystocia was 23.7%. A logistic regression model was used to predict both PM and dystocia. The PM model included effects of year of birth, season (summer or winter), dystocia, parity (first or later), birth weight (kg), ratio of calfs birth weight to dam's weight (%), and gestation length (d). Odds of PM increased by 2.1%/yr. Calves born in the winter have a 36% higher risk of PM than calves born in the summer. Difficult births tend to result in PM 2.7 times more often than unassisted births. First-parity cows have a 2.4 times higher risk of PM than cows in later parities. Probabilities of PM for birth weights of 29, 35, 40, 46, and 52 kg were 2.1, 2.5, 3.4, 5.1, and 9.6%, respectively, when other factors were set at their average value. Similarly, ratios of calf to cow weight of 4.5, 5.7, 6.9, 8.1, and 9.3% yield probabilities of PM at 8.2, 4.2, 3.1, 3.5, and 5.7%, respectively. Finally, gestation lengths of 268, 273, 279, 284, and 290 d yield probabilities of PM of 5.5, 3.9, 3.1, 3.1, and 3.6%, respectively. The dystocia model included effects of year of birth, season, sex of calf, PM, parity, birth weight, and pelvic area (externally measured). Odds for dystocia decreased by 4.7%/yr. Calves born in the winter have a 15% higher risk of dystocia than calves born in the summer. Odds of male calves needing assistance were 25% greater than female calves. If a calf died in the first 48 h, then it is 2.7 times more likely that the calf needed assistance. First-parity cows have a 4.7 times higher risk of dystocia than cows in later parities. Odds of dystocia increase by 13%/kg increase in birth weight. An 11% decrease in odds for dystocia is associated with a one square decimeter (dm2) increase in pelvic area.
Previous studies of birth certificates have not fully evaluated how accurately they identify delivery methods that have a historical component, such as repeat cesarean and vaginal birth after previous cesarean (VBAC). The authors used linked Georgia birth certificates for first and second deliveries to examine the accuracy of four reported delivery methods in the second pregnancy: vaginal (without previous cesarean), VBAC, primary cesarean, and repeat cesarean, as well as an indicator of a previous cesarean. From the immediate birth certificates, the delivery method for each of the two births was classified as vaginal (V) or cesarean section (CS), which produced possible sequences of V-V, CS-V, V-CS, and CS-CS. The delivery method for the second births to 106,049 women from 1989 through 1992 was reviewed, taking into account the historical information from the linked certificates regarding the first births. Only 42.0% of women with a CS-V sequence were correctly designated on the second birth certificate as a VBAC; 79.3% of women with a V- CS sequence were correctly designated as primary cesarean. From 1980 through 1988, birth certificates contained a check box indicating a previous cesarean (but no VBAC box). During this period, only 75.5% of 25,491 women with a previous cesarean were so designated on the birth certificate. These findings suggest that cross-sectional vital records data substantially underestimate VBAC and primary cesarean rates.
Cerebral artery Doppler ultrasound recordings, and intra-arterial pressure measurements have been made from 27 very low birth weight infants during the first week of life. These data were used to calculate Pourcelot's resistance index (RI), mean blood flow velocity, and resistance-area product (RAP), in both the anterior and middle cerebral arteries. There was a good degree of correlation between recordings from different sites on the same occasion, but absolute values were site dependent. Over the first three days of life there was a significant increase in blood flow velocity in each of the vessels, and a significant fall in RI and RAP.
Using indirect immunofluorescence on both dissociated cell cultures and frozen sections from rat sciatic nerve, dorsal root ganglion and superior cervical ganglion, we have examined the development and distribution of the peripheral myelin protein P2. It first appears in development in sciatic nerve and dorsal root ganglion on the first day of birth, at about the same time as P0 and P1. Like galactocerebroside, P0 and P1, P2 disappears gradually from dissociated Schwann cells in culture. In adult sciatic nerve, and dorsal and ventral roots, it shows an uneven distribution and is absent from some myelinated axons. In electron micrographs the onset of myelination in the sciatic nerve occurs between the day of birth (day 0) and the first day after birth (day 1). Immunofluorescence studies on freshly dissociated cell suspensions, frozen sections and dissociated cell cultures at these early time points indicate that the myelin glycolipids galactocerebroside and sulphatide are present on the surface of many schwann cells at least one day before myelination starts while the myelin proteins P0, P1 and P2 are not detected until myelination begins. This suggests that the early appearance of galactocerebroside and sulphatide is an important step preceding the formation of compact myelin.
The purpose of this follow-up study was to examine the effect of infant sex on changes in and differences between parents' reports of infant care self-efficacy and parenting and marital satisfaction from 4 months to 12 months after the birth of their first child. A convenience sample of 32 couples was selected from 44 couples who participated in a longitudinal study of the development of parenting satisfaction and infant care self-efficacy during the first 4 months after the birth of a first child (Brage Hudson, Elek, Fleck, 2001). Couples completed a demographic questionnaire, the Infant Care Survey (ICS, Froman Owen, 1989), the What Being the Parent of a New Baby is Like--Revised Questionnaire (WPBL-R, Pridham Chang, 1989), and the Dyadic Adjustment Scale (DAS, Spanier, 1976, 1989) 4 and 12 months postpartum. Infant care self-efficacy, but not parenting satisfaction, increased from 4 to 12 months; mothers reported higher infant care self-efficacy and parenting satisfaction than fathers at both times. Fathers of boys reported greater parenting satisfaction and infant care self-efficacy at 12 months than fathers of girls. Marital satisfaction decreased from 4 to 12 months for both mothers and fathers. Significant relationships existed among infant care self-efficacy, parenting satisfaction, and marital satisfaction at both 4 and 12 months postpartum. Implications for families and for nursing interventions are discussed.