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延长分娩诱导对牛胎盘滞留发生率的影响及子宫动脉血流评估作为胎盘成熟度的指标。

Effects of a protracted induction of parturition on the incidence of retained placenta and assessment of uterine artery blood flow as a measure of placental maturation in cattle.

机构信息

Clinic for Cattle, University of Verterinary Medicine, Hanover, Germany.

出版信息

Theriogenology. 2013 Aug;80(3):176-84. doi: 10.1016/j.theriogenology.2013.02.001. Epub 2013 Mar 5.

Abstract

The objectives of the present study were to compare the effects of a protracted and a conventional induction of parturition on the incidence of retained placenta, and to evaluate the suitability of transrectal Doppler sonography of the uterine arteries as a noninvasive method for the assessment of placental maturation. Protracted induction of labor (PIP) was precipitated in 13 cows by the administration of 1.3 mg dexamethasone im twice daily between Days 268 and 273 of gestation, and 40 mg dexamethasone im on Day 274 of gestation. For conventional induction of labor (SIP), 10 cows received 40 mg dexamethasone on Day 274 of gestation. A third group was not treated and served as control (SPON; N = 11). Blood flow volume (BFV) and resistance index in the uterine arteries were measured with Doppler sonography once a day from Day 268 of gestation until labor. After each ultrasonographic examination, blood samples for determination of steroid hormones were taken. Incidence of retained placenta was lower (P < 0.05) in group SPON (9%) compared with groups PIP (54%) and SIP (70%). In the last 7 days before parturition uterine BFV and resistance index did not change (P > 0.05) and did not differ between groups SPON, PIP, and SIP (P > 0.05). Resistance index was higher (P < 0.001) in cows with retained placenta compared with cows with released placenta, and BFV did not differ (P > 0.05) between them. Total estrogen concentrations increased by 283% (P < 0.001) in group PIP and by 60% (P < 0.05) in group SPON between Days -7 and -1 before parturition. They stayed constant (P > 0.05) until Day -2 in group SIP, but increased (P < 0.05) after the high dosage of dexamethasone within 1 day by 140%. Total estrogen levels were higher (P < 0.05) in cows with released placenta than in cows with retained placenta. In conclusion, a protracted compared with a short induction of labor results in higher estrogen levels before term, but does not affect incidence of placental retention. Neither alterations in placental maturation nor changes in steroid hormones influenced uterine blood supply. Therefore, Doppler sonography of uterine arteries is unsuitable to investigate the process of placental maturation induced by glucocorticoids in cows. Nevertheless, disturbances in the placental maturation process in cows with retained fetal membranes after parturition can be detected before parturition by a higher uterine blood flow resistance in the uterine arteries.

摘要

本研究的目的是比较延长和常规分娩诱导对胎盘中残留的影响,并评估经直肠超声检查子宫动脉作为评估胎盘成熟度的非侵入性方法的适用性。在妊娠第 268 至 273 天和第 274 天,13 头奶牛每天两次肌肉注射 1.3mg 地塞米松,40mg 地塞米松诱导分娩(PIP)。对于常规分娩诱导(SIP),10 头奶牛在第 274 天接受 40mg 地塞米松。第三组未接受治疗,作为对照组(SPON;N=11)。从妊娠第 268 天开始,每天用多普勒超声测量一次子宫动脉的血流容积(BFV)和阻力指数,直到分娩。每次超声检查后,采集血液样本以测定类固醇激素。与 PIP 组(54%)和 SIP 组(70%)相比,SPON 组(9%)的胎盘中残留发生率较低(P<0.05)。在分娩前的最后 7 天,子宫 BFV 和阻力指数没有变化(P>0.05),SPON、PIP 和 SIP 组之间没有差异(P>0.05)。与释放胎盘的牛相比,胎盘中残留的牛的阻力指数更高(P<0.001),BFV 没有差异(P>0.05)。PIP 组在分娩前-7 至-1 天总雌激素浓度增加 283%(P<0.001),SPON 组增加 60%(P<0.05)。SIP 组在分娩前-2 天保持不变(P>0.05),但在 1 天内接受高剂量地塞米松后增加(P<0.05)140%。释放胎盘的牛的总雌激素水平高于胎盘中残留的牛(P<0.05)。结论是,与短期诱导分娩相比,延长诱导分娩会导致足月前雌激素水平升高,但不会影响胎盘滞留的发生率。胎盘成熟度的改变或类固醇激素的变化都不会影响子宫血液供应。因此,多普勒超声检查子宫动脉不适合研究糖皮质激素诱导的牛胎盘成熟过程。然而,分娩后胎盘中残留胎儿膜的牛在分娩前可以通过子宫动脉的更高血流阻力检测到胎盘成熟过程的紊乱。

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