Postpartum Quality of Life in Primiparous Women after Normal Vaginal Delivery versus Caesarean Section

Background: Studies on either postnatal quality of life in general or studies that compare quality of life in new mothers after different mode of delivery are limited. An investigation on health related quality of life measures in women after different type of delivery showed that women who had vaginal delivery had better health related quality of life compared to those who had caesarean section. However, the best method of delivery, vaginal or caesarean for postpartum quality of life is a difficult question as it is a matter of controversy both from professional’s perspectives and from women’s experience during childbirth. Objective: To compare postpartum quality of life in primiparous women after vaginal delivery versus caesarean section. Methods: Prospective cross-sectional study was conducted at the department of Obstetrics and Gynecology, Salmaniya medical complex in Kingdom of Bahrain. 500 primiparous women who gave birth either vaginally or by cesarean section answered a questionnaire designed to include general information, questions from short form health survey questionnaire (SF-36) and specific questions regarding postnatal related symptoms. Results: Body pain, fatigue, wound pain, headache and backache were significantly higher in cesarean section group as compared to vaginal delivery group (p-value Conclusion: Cesarean delivery has negatively affected the quality of life (QOL) of primiparous women. More studies with larger sample sizes should be conducted to examine the effects of cesarean delivery on QOL in both primiparous and multiparas within a shorter period after delivery. .

Lactation Performance of Primiparous Nubian Ewes and Yunling Black Ewes

[ Objective] To evaluate lactation performance of primiparous Nubian ewes and Yunling Black ewes. [ Method] Healthy primiparous Nubian ewes （20 ewes lambing twins and 19 ewes lambing single） and Yunling Black ewes （4 ewes lambing twins and 15 ewes lambing single） were used to study the effects of breeds and litter size on lactation performance. [Result] The total milk yield of the Nubian ewes lambing twins was 14.81% higher than that of the Nubian ewes lambing single （ P 〈 0.05） and 22.93% higher than that of the Yunling Black ewes lambing twins （ P 〈 0.05）. The total milk yield of the Yunling Black ewes lambing twins was 32.80% higher than that of the Yunling Black ewes lambing single （ P〈 0.05 ）, but the total milk yield of the Nubian ewes lambing single was 42.20% higher than that of the Yunling Black ewes lambing single （ P 〈 0.05）. The Nubian goats and the Yunling Black goats had similar lactation curves. The milk yield gradually increased during the early lactation period （5 - 15 d post partum）, and the lactation peak lasted for 20 d （15 -35 d post partum）. Then the milk yield gradually decreased. The predicted values showed the milk yield of the ewes may rapidly decrease during 80 -120 d post partum. Until Day 70 post partum, the Nubian ewes lambing twins had lost 3.06% more body weight than those lambing single had （P〈0.05）; the Yunling Black ewes lambing twins had lost 0.89% more body weight than those lambing single had （P〈0.05）. The Nubian ewes lambing lost 3.22% -5.39% more body weight than those with the same litter size did （ P 〈 0.05）. [ Conclusion] The regular pattern of primiparous lactation is similar between the Nubian ewes and the Yunling Black ewes, and their lactation performance is closely related to breeds and litter size.

Experiences of women with the support they received from their birth companions during labour and delivery in Malawi

A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qualitative data collection and analysis method on a sample of 20 primiparous women. The women were recruited from the postnatal ward of Bwaila hospital and were interviewed regarding their experiences on the support they received from their birth companions during labour and delivery using an open ended interview guide. Data was manually analyzed using content analysis. Primiparous women described the support they received from their birth companions as useful and beneficial. Birth companions provided advice, physical, emotional and spiritual support to the women during their labour and delivery. In addition, the birth companions were viewed as guardians of the women during labour and delivery. Results however, show that some women were not properly assisted by their companions because both the mothers and companions lacked knowledge on birth companionship. The results further show that birth companions play important roles during the birth and delivery of primiparous women and thereby improving birth outcomes. Therefore, there is a need to train the companions regarding support to a woman during labour and delivery. Primiparous women also need to be trained during antenatal care education so that they properly understand the roles of a birth companion as opposed to those of the midwives.

Knowledge, attitude, and practice of techniques of breastfeeding among new mothers: A survey across Delhi Region

Objective:The present study aims to evaluate aims to assess the knowledge,attitude,and practice of primiparous mothers in the immediate postpartum period regarding breastfeeding techniques which will be helpful in forming awareness and training programs.Materials and Methods:A cross-sectional survey was used.A total of 120 primiparous mothers with a mean age of 24.92 years participated in the survey and filled the questionnaire related to the knowledge,attitude,and practice of techniques of breastfeeding.Results:Results revealed that 48.3%of new mothers were not aware of the correct techniques to initiate breastfeeding,whereas 68.3%of subjects reported that during latching,the baby’s upper and lower lip should be everted.The majority of new mothers were aware of breastfeeding techniques with some misconceptions as in our culture,most of the breastfeeding information passed from generation to generation.Conclusion:The level of awareness about feeding skills among primiparous mothers can be further improved by antenatal counseling or training from health-care workers during the gestational period.This will further help new mothers to educate and will provide adequate information which will decrease the myths.

Effects of Reduced <i>in Utero</i>and Post-Weaning Nutrition on Glucose Clearance Measures and Serum Metabolites

Lowering production costs while maintaining an optimal level of production is important to producers in extensive environments. Efforts that strive to match the environment to the nutritional requirements of the grazing animal will substantially improve economic returns to the producer. Therefore, a 3-yr study was implemented that evaluated glucose clearance and serum metabolites in primiparous beef heifers (n = 48;16/yr) from two different feeding regimes. Serum metabolites and glucose clearance measures were analyzed by fitting a repeated measure mixed model using the MIXED procedure of SAS 9.4 (SAS Inst., Inc., Cary, NC). Heifers dams received adequate 1.8 (ADEQ) or marginal 1.2 (MARG) kg/d winter supplementation for approximately 80 d prior to parturition and their heifer calves were then randomly assigned to heifer development treatments that provided ad-libitum (AL) or 80% of ad-libitum (LAL) feed post weaning. Heifers that received the AL treatment during the developmental period were then assigned the 1.8 kg/d winter supplementation for life, whereas heifers that received the LAL treatment during development were assigned the 1.2 kg/d winter supplementation for life. Peak glucose concentrations in response to a bolus dose of glucose changed in magnitude between ADEQ and MARG in utero treatments and decreased further removed from parturition (P = 0.05). However, these changes did not manifest along with other glucose clearance measures (P > 0.17) indicating that regardless of in utero treatment or heifer development treatment the reduction in feed input did not greatly influence glucose clearance measures or baseline serum metabolites throughout postpartum, first parity period.

Relation between Obstetric Outcome and Parity

Objectives: To evaluate the prognosis of obstetric complications by parity in a suburban center in Dakar. Patients and Method: We conducted a retrospective and prospective, cross-sectional study that evaluated all women admitted to the Philippe Maguilen Senghor Health Center for the management of their pregnancy (childbirth, abortion, ectopic pregnancy), whether they were primiparous or multiparous. The data for this study covered a 66-month period, from January 1, 2012 to June 30, 2017. Data were entered into our E-perinatal computer database. They were then extracted and analyzed first on Microsoft Excel 2016 and then on SPSS 24, Windows version. Results: Between January 2012 and June 2017, we’ve registered 27,441 patients including 25,905 deliveries, 1415 abortions and 121 ectopic pregnancies. Direct obstetric complications involved 14.1% of our patients. 12.1% multiparous and 17.3% primiparous had at least one direct obstetric complication of World Health Organization (WHO). Antepartum haemorrhage, uterine rupture, ectopic pregnancy, and abortion complications were more common in multipara, whereas prolonged and obstructed labor, preeclampsia, and eclampsia were more common in primiparous women. Postpartum haemorrhage occurred at substantially equal frequencies in both parity groups. We had not found any case of sepsis. Conclusion: Our study confirms that primiparity is a factor that may lead to obstetric complications. However, while some complications were more common in the primiparous, others were exclusive to multiparous when we did not expect it. We also recommend continuing this work by singling out multiparas and large multiparas, in order to better understand the obstetric prognosis linked to parity.

Effectiveness of lukewarm water compress on reduction of breast pain and breast engorgement among post-cesarean section mothers

Objective:The study aimed to assess the effectiveness of lukewarm water compress on breast pain and breast engorgement among post-cesarean primiparous mothers.Materials and Methods:This quasi-experimental posttest-only design was conducted with 60 post-cesarean section primiparous mothers between October 2018 and January 2019.A simple random sampling technique was used to allocate 30 participants to both experimental and control groups.The experimental group received lukewarm water compress using a sponge cloth for 20 min twice a day on the second,third,and fourth postnatal days.The control group received routine hospital care.Breast pain and engorgement were assessed using the Visual Analog Pain Scale and Breast Engorgement Assessment Scale on the third,fourth,and fifth postnatal days.Results:Significant differences were observed between the experimental and control groups on day 1 and day 3 in terms of breast pain and engorgement scores among post-cesarean section mothers(P<0.001).In addition,no statistically significant differences were found between sociodemographic and breastfeeding parameters and breast pain and engorgement(P>0.05).Conclusion:Lukewarm water compress is effective in reducing breast pain and engorgement in post-cesarean primiparous mothers.Future research can include randomized controlled trials to evaluate the effectiveness of different therapies in treating breast pain and engorgement.

Level of Labor Pain, Level of Labor Pain Behaviors, and Cultural Pain Behaviors among First-Time Indonesian Muslim Mothers

Background: Many factors influence the expressions of pain in primiparous women aside from contractions of the uterus. Objective: This study aimed to describe the level labor pain, level of labor pain behaviors based on cultural pain behaviors at 3 - 4 cm of cervical dilation or the beginning of the active phase of labor among primiparous Muslim women in Indonesia. Methods: This was a study with 42 primiparous Muslim women who gave birth in the labor room at Bhinneka Bhakti Husada Hospital and Community Health Center Pamulang, Indonesia from June until January 2017. The women were asked to describe on a 100 mm Visual Analogue Scale the intensity of level of labor pain in their abdomen during the last contractions at 3 - 4 cm of cervical dilation, and Pain Behaviors Observation Scale to observe pain behaviors. Descriptive statistics were used to analyze the data. Results: The findings showed that the mean score of level of labor pain at 3 - 4 cm of cervical dilation was 86.38 (SD = 4.47) and most participants experienced high level of labor pain (97.6%). The expression of cultural labor pain behaviors including saying praises to Allah, Asma’aul husna, reciting the Qur’an, sholawat.

Response of primiparous and multiparous buffaloes to yeast culture supplementation during early and mid-lactation

Strains of live Saccharomyces cerevisiae yeast have exhibited probiotic effects in ruminants. This study investigated the effects of the dietary yeast supplement, S. cerevisiae(Yea-Sacc^(1026)), on primiparous(PP)and multiparous(MP) Egyptian buffaloes in early to mid-lactation. Lactating buffaloes were fed either a basal total mixed ration(TMR, control; 4 PP and 8 MP) or the basal TMR plus 10 g Yea-Sacc^(1026) per buffalo cow per day(yeast; 4 PP and 8 MP). The feeds were given from 15 days prepartum to 180 days postpartum. Feed intake, body weight, and milk yields(MY) were recorded, and milk and blood samples were collected for analyses. Feces were collected from days 45 to 47 during early lactation and from days 90 to92 during mid-lactation to determine apparent digestibility of dry matter(DM), organic matter(OM),crude protein(CP) and crude fiber(CF). Energy corrected milk yield(ECM), feed conversion, and energy and nitrogen conversion efficiency were calculated. Yeast treated MP buffaloes consumed more DM(P < 0.041) and CP than the untreated control group. Apparent digestibility of DM and OM were significantly greater at mid-lactation for treated versus control group(P = 0.001). Crude fiber digestibility was greater in MP than in PP buffaloes(P = 0.049), and yeast supplemented MP cows had a greater CF digestibility than control MP buffaloes at mid-lactation(P = 0.010). Total blood lipids decreased after yeast supplementation(P= 0.029). Milk yields, ECM, fat and protein yields increased for yeast treated MP buffaloes(P < 0.039). The study concluded that the response to yeast supplementation in buffalo cows is parity dependent. Multiparous buffaloes respond to yeast supplementation with an increased DM intake and CF digestibility without significant weight gains, allowing a greater ECM yield with less fat mobilization. Supplementing buffaloes with yeast culture may increase milk production in early lactation and results in a more persistent milk production during mid-lactation. Feed conversion and energy and nitrogen conversion efficiency may be increased with the use of yeast supplementation in Egyptian buffaloes.

Association of pre-pregnancy body mass index and gestational weight gain with labor stage

To the Editor:In recent years,as marriage and childbearing have been delayed,the ages of primiparous women have,in general,increased.In addition,with changes in the dietary habits of pregnant women,the body mass index (BMI)during pregnancy,and birth weight of newborns have also increased.A retrospective multi-center study demonstrated the effects of obstetric characteristics (increased maternal age and the BMI)and clinical treatment (labor induction and painless delivery)on labor duration:cervical dilatation was slower than that described previously,especially during cervical dilatation of 4 to 6 cm.This new information on labor duration could provide new research directions pre-pregnancy.That is, whether the BMI can become an indicator of the optimization and management of labor duration.This research aimed to assess the effects of pre-pregnancy body mass index (BMI)and gestational weight gain (GWG)on primipara duration of labor.