Impact of Monochorionicity and Twin to Twin Transfusion Syndrome on Prenatal Attachment,Post Traumatic Stress Disorder,Anxiety and Depressive Symptoms

Monochronioric (MC) twin pregnancies are considered as high-risk pregnancies with potential complications requiring in-utero interventions. We aimed to assess prenatal attachment, anxiety, post-traumatic stress disorder (PTSD) and depressive symptoms in MC pregnancies complicated with Twin-To-Twin-transfusion syndrome (TTTS) in comparison to uncomplicated monochorionic (UMC) and dichorionic pregnancies (DC). Auto-questionnaires were filled out at diagnosis of TTTS and at successive milestones. Prenatal attachment, PTSD, anxiety and perinatal depression were evaluated respectively by the Prenatal Attachment Inventory (PAI) completed for each twin, the Post-traumatic Checklist Scale (PCLS), the State-Trait Anxiety Inventory (STAI) and the Edinburgh Perinatal Depression Scale (EPDS). There was no significant difference in the PAI scores between the two twins. In the DC and UMC groups, PAI scores increased throughout pregnancy, whilst it didn’t for TTTS group. TTTS and DC had a similar prenatal attachment while MC mothers expressed a significantly higher attachment to their fetuses and expressed it earlier. At the announcement of TTTS, 72% of the patients present a score over the threshold at the EPDS Scale, with a higher score for TTTS than for DC (p = 0.005), and UMC (p = 0.007) at the same GA. 30% of mothers in TTTS group have PTSD during pregnancy. 50% of TTTS- patients present an anxiety score over the threshold (STAI-Scale), with a score significantly higher in TTTS than in UMC (p<0.001) or DC (p<0.001). The proportion of subject with a STAI–State over the threshold is also significantly higher in TTTS than in DC at 20 GW (p = 0.01) and at 26 GW (p<0.05). The STAI-state scores in UMC and DC increase progressively during pregnancy while they decrease significantly in TTTS. TTTS announcement constitutes a traumatic event during a pregnancy with an important risk of PTSD, high level of anxiety and an alteration of the prenatal attachment. These results should guide the psychological support provided to these patients.     

Effect of energy intake and roughage ratio on the lactation of Egyptian Nubian (Zaraibi) goats

Forty-six lactating Egyptian Nubian (Zaraibi) does were randomly assigned to four groups to investigate the effects of two energy levels at 100% (low) and 125% (high) of NRC recommended standards with rations containing two roughage ratios (20 and 40%) using a 2 × 2 factorial design. Milk yield was measured weekly after 7 days of parturition, for a 32 week period. Composite samples of milk were analyzed for fat, solids-not-fat (SNF), protein and ash contents. Rumen fluid samples were collected at 0, 2, 4 and 8 h after morning feeding to determine total and molar proportions of volatile fatty acids (VFA). Average daily milk yield was 660 g within the test period. Increasing dietary energy level was without significant effects on milk yield and fat percent, while increasing ratio of roughage significantly (P < 0.01) increased percentage of milk fat. This was concomitant with marked increases in VFA concentration in the rumen fluid and molar ratios of acetic acid rather than propionic and butyric acids. This response was more pronounced in does on high energy than in those on the low energy rations. Increasing dietary energy level resulted in significant increases in SNF (P < 0.05) and protein (P < 0.01) contents of milk, while increasing roughage ratio was without significant effect on this parameter. Neither dietary energy level nor roughage ratio affected milk ash.