Intrauterine transmission of human T-cell leukemia virus type I in rats.

To analyze intrauterine transmission, MT-2 cells, a human T-cell line producing human T-cell leukemia virus type I (HTLV-I), were injected into eight pregnant F344 rats, and cesarean section was performed at day 23 of pregnancy. HTLV-I provirus was detected by PCR in the liver and spleen taken from one of the eight fetuses. Moreover, 71 offspring were delivered by cesarean section from the remaining seven dams and fostered by seven normal rats. HTLV-I provirus was detected in peripheral blood mononuclear cells in 2 of the 71 offspring 4 weeks after cesarean section. These results indicate for the first time the intrauterine transmission of HTLV-I. To confirm the postnatal transmission, MT-2 cells were injected into a dam within 24 h after delivery, and six offspring were fostered by this dam. HTLV-I provirus was detected in peripheral blood mononuclear cells of all six offspring. This animal model may be useful for analysis and prevention of mother-to-child transmission of HTLV-I.     

Management of respiratory complications in a western lowland gorilla (Gorilla gorilla gorilla) born by cesarean section

A female western lowland gorilla (Gorilla gorilla gorilla) infant was delivered by cesarean section (C‐section) to an 18‐year‐old primiparous dam after prolonged labor. The infant required resuscitation at birth and was hospitalized for management of pneumonia and associated respiratory distress secondary to the aspiration of meconium‐stained amniotic fluid. The infant received nine days of intensive care with respiratory support, antibiotics, intravenous fluid therapy, anti‐inflammatory drugs, bronchodilators, and chest physiotherapy. Respiratory support included nasal continuous positive airway pressure (CPAP), and supplemental oxygen. Complications included right lung atelectasis secondary to bronchial obstruction and pneumonia. Following the resolution of pneumonia, visual reintroductions with the troop were initiated. The dam was given a medical lactation supplement (metoclopramide) and her mammary glands were stimulated to increase milk production. After several days of visual and olfactory introductions, the infant was successfully physically reintroduced to her dam at 12 days of age; the dam showed appropriate maternal response and nursing of the infant. The infant had appropriate growth and development, and 4 years later, has no evidence of negative side effects of neonatal respiratory disease. This is the first reported case of management of neonatal gorilla respiratory disease associated with a C‐section, with successful reintroduction to the family group after hospitalization.     

Management of pheochromocytoma during pregnancy.

To reduce the high maternal and fetal mortality in pheochromocytoma of pregnancy, therapy is advocated with phenoxybenzamine and propranolol to obtain adequate alpha- and beta-adrenergic receptor blockade. In early pregnancy control of symptoms may be difficult, but the patient may be carried to term with such medical therapy. Delivery should be by cesarean section before the onset of labour, with, if possible, simultaneous removal of the tumour. Additional preoperative preparation with phenoxybenzamine and propranolol and careful intraoperative management are essential. During her third pregnancy a 29-year-old woman was found to have a pheochromocytoma of the left adrenal gland. After the medical therapy and preparation described, the infant was delivered by cesarean section and the mother''s left adrenal gland excised. Eight-year follow-up, including during a fourth pregnancy, showed no recurrence of tumour in the mother and only mild hypertension. The infant developed normally.     

Surgical management of canine and feline dystocia

If medical management of dystocia has failed or is inadvisable, a Cesarean section is indicated. The necessity of surgery is primarily based on the condition of the dam, progression of labor, and fetal heart rate. Timely intervention is crucial for optimal fetal and maternal survival. Surgical technique may vary, based on the needs of each individual case. There are many options for each portion of the surgery, including the choice of anesthetic protocol, abdominal approach, uterine incision location, and post-surgical pain management. Indications for surgery and some of the options for each step of the procedure are presented. Episiotomy is rarely used to treat dystocia and therefore, it is discussed only briefly.     

病种质量管理方式探讨 ——以剖宫产为例

目的 以剖宫产为例研究病种管理方式,探讨病种纳入标准。方法 采用统计学分析法,对不同指征剖宫产按照住院天数、住院费用进行分组,并对其住院费用的影响因素进行分析。结果 5组不同指征剖宫产数据根据住院费用指标可分为3组,按照住院天数指标分类则可归纳为2组,并且经分析发现,影响不同指征剖宫产术住院总费用的因素主要为药费、住院天数。结论 可以依据医疗资源消耗的相似性制定病种纳入标准,扩大病种质量控制体系范围;此外,通过控制关键影响因素来加强病种质量管理,降低患者医疗费用。     

Cesarean section: trends and morbidity.

A review of 1683 cesarean sections performed at one hospital in a 3-year period (1977-79) showed that the cesarean section rate had trebled since 1967-79, the rates being 16.9% and 5.8%. The main indications for cesarean section responsible for this rise were dystocia, breech presentation and a previous cesarean section. AFter the operation 23.3% of received antibiotics. If the cesarean section rate is to fall, the biggest impact can be made by planning vaginal delivery in selected patients with a previous cesarean section and by improving the management of nonprogressive labour.     

基于FMEA法的剖宫产风险识别与对策研究

目的 帮助医院明确剖宫产手术中的高风险环节及关键流程,切实做好产科安全管理。方法　通过FMEA法与文献研究、头脑风暴、问卷调查及专家咨询相结合的方式,对剖宫产诊疗流程中的风险进行识别。结果　共识别出剖宫产诊疗流程中10项高风险环节,即产后出血、知情同意效果不佳、会诊不及时、羊水栓塞、切口感染、尿路感染、会诊诊断及治疗错误、术前宣教效果不佳、麻醉失误、检查结果有误。结论 FMEA法是一项有效的医疗风险识别工具,能够前瞻性的检测出剖宫产高风险环节.并有针对性地实施干预。     

Commentary: "health has become secondary to a sexually attractive body"

This article focuses on the prevalence of cesarean section among upper class women for aesthetic purposes. In Latin America, the national cesarean section rate has risen to 40%, while in the early 1980s the rate was 75% in Brazil. In a survey conducted in the UK, 31% of women obstetricians would prefer to have cesarean section without any medical indication. This could perhaps be due to the obsession of maintaining a sexually appealing body. Health has then become secondary to the production of a sexually attractive body. The role of the medical profession lacks the definitive evidence on the issues regarding concerns of women and choices in childbirth particularly in some countries. The author suggests that the medical community and society should allow the women the choice between major surgery and childbirth.     

Acute fatty liver of pregnancy.

Acute fatty liver of pregnancy (AFLP) is rare and is peculiar to the latter half of pregnancy. Despite the high rates of death among affected mothers and their fetuses, early recognition of the disease and immediate delivery of the infant may improve the chances of survival. This paper describes a case of AFLP, characterized by a rapid decrease in the size of the liver, a greatly prolonged prothrombin time and minimal increases in the serum transaminase levels, in which an immediate cesarean section followed by vigorous supportive care led to survival of both mother and infant. It is clear that guidelines on treatment are necessary if the management of such cases is to be successful.     

Estimation of genetic associations between reproduction and production traits based on a sire and dam line with common ancestry

Genetic parameters for survival, reproduction and production traits were estimated for a sire and dam line, originating from one Large White breed separated more than 25 years ago. The change in parameters due to different selection pressure on reproduction and production traits in both lines was also examined. Data collected between 1990 and 2007 were available for the analysis of reproduction traits in 4713 litters (sire line) and 14836 litters (dam line) and for the production traits in 58329 pigs (sire line) and 108912 pigs (dam line). Genetic parameters were estimated using a Bayesian approach. Average phenotypic differences between lines were substantial with 1.5 more piglets born in the dam line and 1.7 mm less backfat thickness (BF) in the sire line. Based on a multiple trait analysis which included both reproduction and production traits, heritabilities for survival and litter size traits in the sire (or dam) line were estimated at 0.03 ± 0.01 (0.06 ± 0.01) for percentage of stillborn piglets (SB), 0.10 ± 0.03 (0.11 ± 0.01) for total number of piglets born (NBT) and 0.09 ± 0.03 (0.09 ± 0.01) for number of piglets born alive. Heritabilities for production traits were estimated at 0.29 ± 0.01 (0.29 ± 0.01) for average daily gain, 0.50 ± 0.01 (0.42 ± 0.01) for BF and 0.41 ± 0.01 for muscle depth. Selection pressure on litter size in the dam line resulted in a slightly unfavourable correlation for SB-NBT (0.21 ± 0.11), which was only marginally unfavourable in the sire line (0.06 ± 0.24). Selection pressure on BF in the sire line may have resulted in the moderately undesirable correlation with SB (-0.46 ± 0.15), which was not significant in the dam line (-0.08 ± 0.06). Changing the base population in the dam line to animals born since the year 2000 indicated that selection pressure on different traits has altered the heritabilities and correlations of the traits within the line. The undesirable correlations between survival at birth and reproduction traits or production traits were low so that simultaneous improvement of all traits can be achieved. Heritabilities for survival at birth and reproduction traits were low, but genetic variation was substantial and extensive pedigree information can be used to improve the accuracy of breeding values, so that genetic improvement is expected to be efficient.     

Dog Breeding in New Providence,The Bahamas,and Its Potential Impact on the Roaming Dog Population I: Planned and Accidental

This article reports the first known study on dog breeding in an Afro-Caribbean community. The study obtained the information on 517 matings through interviews with dog caregivers. Few litters (6.8%) from mongrels (potcakes) resulted from planned matings, whereas 66.5% of matings between purebred dogs were planned. Confinement of the female is often inadequate, and roaming dogs may have been responsible for 24.8% of the litters. The lack of confinement of potcakes has resulted in the perception that potcakes are “responsible” for the companion animal (pet) overpopulation problem; however, potcakes made up the minority (29.4%) of the breeding females. Until regulations concerning dog breeding are introduced, caregivers can be expected to continue exploiting their nonhuman animals to supplement their incomes from the sale of puppies. A consequence of unregulated breeding may also be inbred offspring of “purebred” dogs as few self-styled “professional” breeders appeared to use dogs who were not their own.     

Obstetrics in elephants

Obstetrics, one of the oldest fields in veterinary medicine, is well described and practiced in domestic and exotic animals. However, when providing care during elephant birth or dystocia, veterinary intervention options differ greatly from any domestic species, and are far more limited due to the dimensions and specific anatomy of the elephant reproductive tract. In addition, aging of captive elephant populations and advanced age of primiparous females make active birth management increasingly important. Intrauterine infection, uterine inertia and urogenital tract pathologies are emerging as major causes for dystocia, often leading to foetal and dam death. This paper reviews the current knowledge on elephant birth and the factors associated with dystocia. It then summarises recommendations for birth and dystocia management. As Caesarean section, the most common ultima ratio in domestic animal obstetrics, is lethal and therefore not an option in the elephant, non-invasive medical treatment, induction of the Fergusson reflex or the conscious decision to leave a retained foetus until it is expelled voluntarily, are key elements in elephant obstetrics. Surgical strategies such as episiotomy and foetotomy are sometimes inevitable in order to try to save the life of the dam, however, these interventions result in chronic post-surgical complications or even fatal outcome. Limited reliable data on serum calcium concentrations, and pharmacokinetics and effect of exogenous oestrogen, oxytocin, and prostaglandins during birth provide the scope of future research, necessary to advance scientific knowledge on obstetrics in elephants.     

Reproductive output, maternal age, and survivorship in captive common marmoset females (Callithrix jacchus)

Common marmosets (Callithrix jacchus) demonstrate significant variation in reproductive output on both a yearly and lifetime basis in comparison to other anthropoid primates. We explore the factors that may be most important in determining reproductive variation in captive common marmosets. Studies have found that maternal age, maternal condition, and dam survivorship are related to reproductive output; however, these reports are not in agreement and are far from conclusive. With the use of a large, multicolony, demographic database pooling data across five marmoset colonies, we examined litter information for 1,649 litters, and reproductive summaries for 400 dams to assess 1) how reproductive output variation (total production, total weaned production) is determined by litter size, interbirth interval (IBI), age at first birth, and dam survival age; 2) the relationship between maternal age and reproductive output variables; and 3) relationship between the reproductive output variables and survival. We used stepwise regression procedures to describe the amount of variation in lifetime reproductive output among dams, and found that mean litter size accounted for 18% of the variance in total production, survival age accounted for 10.6%, age at first birth accounted for 8.8%, and mean IBI accounted for 5%. For total (nonzero) weaned production, survival age accounted for 7.6% of variance, age at first birth accounted for 7.2%, mean IBI accounted for 2%, and mean litter size accounted for 1.6%. We identified significant effects (P<0.05) of maternal age on litter size and IBI length, but no effect of dam age on weaned litter size. Cox proportional hazards regression analyses revealed significant effects (P<0.01) of number of litters, age at first birth, and site on dam survivorship. Dams that produced more litters showed higher survivorship. Age at first birth showed a positive relationship with dam survivorship, i.e., dams that delayed first reproduction had higher survival. Our findings about reproductive variation in marmosets may have practical applications for the management of marmoset breeding colonies.     

Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients

Purpose

The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.

Methods

We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.

Results

Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05). The drainage amount over 1 hour was 500 mL (20–1200 mL) in the balloon failure group and 60 mL (5–500 mL) in the balloon success group (p<0.01).

Conclusion

Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.     

The fish community of a high mountain stream in Taiwan and its relation to dam design

Synopsis The fish community of a high mountain stream in Taiwan was studied from 1988 to 1990 in a 16 km section of Ta-chia river where a new dam is planned for construction. There were 16 species of fish belonging to 7 families; 15 genera were recorded. Six species are endemic to Taiwan. The dominant species wereZacco pachycephalus, Acrosscheileus paradoxus andRhinogobius brunneus. The composition of fish fauna was different between the eight study sites. Adjacent sites did not show a higher similarity than remote ones. AdultZ. pachycephalus andA. paradoxus showed seasonal aggregation behavior in the stream. At two distinct sites, Kukan and Tungmau, these two species had similar breeding and stock composition patterns with an intensified production period of juveniles from late autumn to early winter and a low, but continuous production period of juveniles in summer months. This information suggest that fishes in the river have special adaptations to the typhoon season in summer and benthic algal blooming in winter. The similarity of fish community and the independent breeding sites of endemic fishes in Kukan and Tungmau also suggest that these are important factors to consider for conservation when the flooding area of a high mountain dam is designed.     

Predicting the annual effective size of livestock populations

Effective population size (Ne) is an important parameter determining the genetic structure of small populations. In natural populations, the number of adults (N) is usually known and Ne can be estimated on the basis of an assumed ratio Ne/N, usually found to be close to 0.5. In farm animal populations, apart from using pedigrees or genetic marker information, Ne can be estimated from the number N of breeding animals, and a value of 1 is commonly assumed for the ratio Ne/N. The purpose of this paper is to show the relation between effective population size and breeding herd size in livestock species. With overlapping generations, Ne can be predicted knowing the number of individuals entering the population per generation and the variance of family size, the latter being directly related to the survival pattern (or replacement policy) in the breeding herd. Assuming an ideal survivorship leading to a geometric age distribution, it can be shown that the number of breeding animals tends to overestimate effective size, particularly in early-maturing species. The ratio of annual effective size to the number of breeding animals is shown to be equal to [1 + (a- 1)(1 - s)]2/(1 - s2), where a is the age at first offspring and s is the survival rate (including culling) of the parents between successive births. This expression shows to what extent inbreeding may be determined by demography or culling policy independently of the actual herd size. In many situations a fast replacement or an early culling will increase annual effective size. Consequences for the management of small populations are discussed.     

Switched identity of two Przewalski's horse mares detected by blood typing

Accurate pedigrees are of prime importance to breeders of both domestic and captive animals. Blood typing is a tool utilized to verify accuracy of pedigrees in domestic animal breeding programs that may often be directly applied to related zoo species. We describe the application of blood typing techniques developed for domestic horses to detect a switch in the identity of two Przewalski's horse mares. Before the switch detection, one of the mares had been bred to a closely related stallion, a breeding which would not have been planned had the correct identity of the mare been known.     

Long-term outcome by method of delivery of fetuses in breech presentation at term: population based follow up.

OBJECTIVE--To compare the long-term outcome of infants delivered in breech presentation at term by intended mode of delivery. DESIGN--A population based comparison of outcomes up to school age. Data obtained from maternity, health visitor, and school medical records and handicap register. SETTING--Grampian region 1981-90. SUBJECTS--1645 infants delivered alive at term after breech presentation. MAIN OUTCOME MEASURES--Handicap, developmental delay, neurological deficit, psychiatric referral. RESULTS--Elective caesarean section was performed in 590 (35.9%) cases. The remainder (1055; 64.1%) were intended vaginal deliveries. Handicap or other health problem was recorded in 269 (19.4%) of 1387 infants for whom records were available. Proportions of elective caesarean sections and intended vaginal deliveries in this group were 37.2% (100 cases) and 62.8% (169) respectively, almost the same as in the total cohort. There were no significant differences between elective caesarean section and planned vaginal delivery in terms of severe handicap or any other outcome measure. Case records were obtained for 23 of 27 infants with severe handicap. 11 (47.8%) were delivered by elective caesarean section. Of these, three had undiagnosed congenital abnormalities and seven were unexplained. Of the 12 (52.2%) planned vaginal deliveries, in only one was handicap possibly attributable to delivery and four cases were unavoidable even if elective caesarean section had been planned. CONCLUSION--In selected cases of breech presentation at term planned vaginal delivery with caesarean section if necessary remains as safe as elective caesarean section in terms of long term handicap. It was not possible to determine whether particular babies would have fared better had they been delivered by elective caesarean section.     

Late results of cesarean and vaginal delivery in cases of breech presentation.

This study compared the subsequent development of children in breech presentation according to the method of their delivery - vaginal or cesarean section. No differences were found between children born vaginally and those born by cesarean section after some labour, except for a larger variability in the outcomes of the latter group. Only 4% of the deliveries were by cesarean section without labour, and when analysed separately the data for this group frequently showed the poorest outcome. Reasons for the observations are suggested, and proposed further research is outlined.