• Title/Summary/Keyword: retained placenta

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Clinical and Angiographic Features of Secondary Postpartum Hemorrhage and the Outcomes of Transcatheter Arterial Embolization (속발성 분만 후 출혈의 임상 및 혈관 조영술의 특징과 경도관 동맥 색전술의 결과)

  • Baek, Seung Dae;Kang, Ung Rae;Ji, Seung Woo;Kim, Young Hwan;Cha, Jung Guen
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.315-322
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    • 2018
  • Purpose: To analyze the clinical and angiographic features with outcome of transcatheter arterial embolization in patients with secondary postpartum hemorrhage. Materials and Methods: Clinical details and angiographic features with assessment of arterial embolization were reviewed in total 38 patients underwent arterial embolization at single tertiary referral center. Results: Twenty patients (53%) had Cesarean section. The major causes of bleeding were iatrogenic vascular injury, and retained placenta (55%). The patterns of vaginal bleeding were recorded as intermittent (50%), or as persistent (50%). Seven patients (18%) were hemodynamically unstable at presentation. Positive angiographic findings appeared in eighteen patients (47.3%). The frequency of pseudoaneurysm was statistically high in the Cesarean section (p < 0.001). The used embolic agents except gelfoam were N-butyl cyanoacrylate (n = 7), and microcoil (n = 7). Unilateral selective embolization (26.3%) was shown effective in superselective embolization of bleeding focus. Technical and clinical success rate were 100% and 97.4%, respectively with no complication. Sixteen resumed regular menstruation, and one pregnancy were observed in patients with available follow-up of over 6 months. Conclusion: Considerable rate of hemodynamically unstable patients was observed with high rate of positive angiography findings. Given high successful rate and few complications, early angiographic assessment with embolization should be considered.

Receiver Operating Characteristic Analysis for Prediction of Postpartum Metabolic Diseases in Dairy Cows in an Organic Farm in Korea

  • Kim, Dohee;Choi, Woojae;Ro, Younghye;Hong, Leegon;Kim, Seongdae;Yoon, Ilsu;Choe, Eunhui;Kim, Danil
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.199-206
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    • 2022
  • Postpartum diseases should be predicted to prevent productivity loss before calving especially in organic dairy farms. This study was aimed to investigate the incidence of postpartum metabolic diseases in an organic dairy farm in Korea, to confirm the association between diseases and prepartum blood biochemical parameters, and to evaluate the accuracy of these parameters with a receiver operating characteristic (ROC) analysis for identifying vulnerable cows. Data were collected from 58 Holstein cows (16 primiparous and 42 multiparous) having calved for 2 years on an organic farm. During a transition period from 4 weeks prepartum to 4 weeks postpartum, blood biochemistry was performed through blood collection every 2 weeks with a physical examination. Thirty-one (53.4%) cows (9 primiparous and 22 multiparous) were diagnosed with at least one postpartum disease. Each incidence was 27.6% for subclinical ketosis, 22.4% for subclinical hypocalcemia, 12.1% for retained placenta, 10.3% for displaced abomasum and 5.2% for clinical ketosis. Between at least one disease and no disease, there were significant differences in the prepartum levels of parameters like body condition score (BCS), non-esterified fatty acid (NEFA), total bilirubin (T-bil), direct bilirubin (D-bil) and NEFA to total cholesterol (T-chol) ratio (p < 0.05). The ROC analysis of each of these prepartum parameters had the area under the curve (AUC) <0.7. However, the ROC analysis with logistic regression including all these parameters revealed a higher AUC (0.769), sensitivity (71.0%), and specificity (77.8%). The ROC analysis with logistic regression including the prepartum BCS, NEFA, T-bil, D-bil, and NEFA to T-chol ratio can be used to identify cows that are vulnerable to postpartum diseases with moderate accuracy.

Effect of the Interval from Calving to First Insemination and Days Open on the Subsequent Reproductive Performance in Dairy Cows (젖소에서 분만 후 첫 수정 간격 및 임신 간격이 이후의 번식능력에 미치는 영향)

  • Lee, Soo-Chan;Lee, Tae-Ho;Jeong, Jae-Kwan;Kang, Hyun-Gu;Kim, Ill-Hwa
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.435-441
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    • 2013
  • This retrospective study evaluated the effects of the interval from calving to first insemination (ICFI) and days open (DO) on the reproductive performance in dairy cows. In the first analysis, data from 705 cows were grouped based on the ICFI: short (30-60 days, n=217), medium (61-90 days, n=309), and long (91-150 days, n=179). The occurrence of endometritis was greater in the long group than in short and medium groups (p<0.05). The occurrence of ovarian cysts increased with increasing ICFI (p<0.05), while body condition score (BCS) during the 5 month postpartum period was lower with increasing ICFI (p<0.01). The hazard of pregnancy by 365 days in milk (DIM) was lower (hazard ratio [HR]=0.70, p<0.0001) in the long group, but higher (HR=1.41, p<0.0001) in the short group compared with the medium group. In the second analysis, data from 436 cows were grouped based on the DO: short (30-90 days, n=154), medium (91-180 days, n=183), and long (181-360 days, n=99). The occurrence of a retained placenta was greater in the long group than in the medium group (p < 0.05). Ovarian cysts occurred more frequently in medium and long groups than in the short group (p=0.08). BCS was lower in the short group compared with medium and long groups at month 1 postpartum (p<0.05). Milk yield (kg/day) was greater in the medium group compared with the short group at months 2 to 5 postpartum (p<0.05). The hazard of first insemination by 150 DIM was lower in the long group than in the short group (HR=0.73; p<0.02). The hazard of pregnancy by 365 DIM was lower (HR=0.64, p<0.0001) in the long group than in the medium group, while the hazard did not differ between short and medium groups (p>0.05). Moreover, the culling rate was greater in the long group than in the short group (p<0.05). In conclusion, a longer ICFI and DO resulted in reduced reproductive performance in dairy cows, which was attributable to an increase in postpartum diseases, a lower BCS and a greater milk yield.

Effects of Dietary Addition of Sucrose, Propylene Glycol and Tween 80 on the Performance of Transitional Holstein Cows (Sucrose, Propylene Glycol, Tween 80의 첨가가 전환기 젖소의 생산성에 미치는 영향)

  • 이왕식;김현섭;손근남;김용국;이현준;기광석;백광수;안병석;아주말 칸;하종규
    • Journal of Animal Science and Technology
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    • v.48 no.6
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    • pp.839-846
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    • 2006
  • This study was conducted to evaluate the effects of dietary addition of sucrose, propylene glycol and Tween 80 (Polysorbate 80 : Non-ionic Surfactants) on pre-partum (21 d) and post-partum (21 d) nutrients intake, blood metabolites, occurrence of metabolic disorders, milk yield and its composition in Holstein cows. Two basal diets were formulated each for pre- and post-partum period. The diets were mixed daily and fed at ad libitum to transitional cows. Forty cows of similar parity and milk yield were randomly divided into four groups (ten animals in each). The cows in three groups were supplemented either with 280g of sucrose/day (SU), SU+64g propylene glycol/day (SUP) or SUP+50g Tween80/day (SUPT). The feed for the fourth group was not supplemented and this group served as control (C). Pre-partum DM, total digestible nutrients (TDN), and crude protein (CP) intake was similar in cows fed C, SU, SUP, and SUPT diets. Post-partum DM, TDN, and CP intakes were the highest with SUPT diet followed by SU, SUP and control diets. Pre-partum blood non-esterified fatty acids (NEFA) concentration was noticed significantly higher in cows fed control diet compared to those fed SU, SUP and SUPT diets. The concentration of NEFA was similar at calving and during post-partum period across cows fed different experimental diets. Blood glucose and Ca concentration during pre- and post-partum periods were not significantly different in cows fed C, SU, SUP and SUPT diets. Milk yield (kg/day) was similar in cows fed different experimental diets. However, milk fat percent and 4% fat corrected milk yield were higher in cows fed SU diet (p<0.05) followed by SUP, SUPT and C diets. One case of ketosis was recorded in cows fed control diet however its occurrence was not observed in cows fed other diets. Occurrence of retained placenta and mastitis was numerically higher in cows fed control diet compared with those fed SU, SUP and SUPT diets. In conclusion, the NIS and propylene glycol feeding along with sucrose could improve the 4% fat corrected milk and fat yield in early lactating cows with significant reduction in NEFA and metabolic disorders during transitional period.