After Birth Ebook

Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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Pregnancy Without Pounds

This proven program will get you through your pregnancy in better shape than most other women in as little as 27 minutes a day and with minimal effort. It contains all the information that I believe will Help you to look and feel like I did barefoot and beautiful! Inside you will learn Exactly how to avoid unwanted pounds, overcome your food cravings, care for your skin, dress to kill and look like one Hot Mama. Ive also put together Fifty simple, yet extremely effective pregnancy-friendly exercises and stretches to keep you and your body looking and feeling Great (includes 3 different fitness programs depending on Your fitness level)!

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Author: Michelle Moss
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Endocrinology of ageing

Reduction probably results from reduced stimulation of the liver to produce IGF1 rather than an age-related insensitivity or inability of the liver to respond to circulating GH. The predominant IGF-binding protein (IGFBP) concentration in the blood, IGFBP3, reaches maximum levels at puberty and decreases between 18 and 79 years (Corpas et al 1993). The second most abundant IGFBP, IGFBP2, decreases after birth until puberty, after which it gradually increases again, especially after the age of 60 (Clemmons 1997). At age 80 concentrations are nearly twice as high as in young adults. In agreement with this, our study in subjects aged between 73 and 94 years showed a decrease in serum IGF1 and IGFBP3 levels and an increase in both serum IGFBP1 and IGFBP2 levels.

Adult Neural Progenitor Cells in the Forebrain

Besides the SVZ and the dentate gyrus, active adult neurogenesis and or gliogenesis exist in other brain regions. The drug-affected area, striatum, is among those regions where cell proliferation and differentiation recently have been noticed (13). After BrdU injection, cell division is consistently observed in the dorsal and ventral striatum. Divided cells are scattered throughout the area. Newborn striatal cells survive beyond 60 d, with a graduate increase in their body size and processes (13,14). Although a small fraction of cells exhibit the morphological characteristics of radial glia 3 wk after birth, the vast majority of newborn cells show no obvious morphology of either projection neurons or glia. Parallel with the morphological observations, approx 10-20 of BrdU-labeled cells are immunoreactive to S100P and no BrdU cells are double labeled with NeuN even 6 wk after birth. Thus, it appears that gliogen-esis, but not neurogenesis, naturally occurs in the intact striatum at a...

Childhood Disintegrative Disorder

The etiology of childhood disintegrative disorder is unknown. It is most likely genetic in origin given the characteristic regression following an at least two-year period of normal development. Diagnosis is based on documentation of specific characteristics. As described in the DSM-IV, specific criteria include normal development for at least two years after birth. After 2 years of age, but before 10 years of age, there is significant loss in at least two areas of development such as expressive or receptive language, social skills or adaptive behavior, bowel or bladder control, play, and motor skills. In addition, similar to autism, there are abnormalities in two areas of functioning such as qualitative impairment in social interaction and communication and restricted patterns of behavior or interests. Given the developmental regression, mental retardation is often a comorbid diagnosis with childhood disintegrative disorder.

Congenital Heart Disease Introduction

Acyanotic defects include coarctation of aorta, patent ductus arteriosus, and ventricular septal defect. Coarctation of the aorta is the narrowing of the aorta proximal to the ductus arteriosus (preductal), distal to the ductus arteriosus (postductal), or level with the ductus arteriosus (auxtaductal). The position of the narrowing during fetal development determines circulation to the lower body and development of collateral circulation. Patent ductus arteriosus is the failure of the structure needed for fetal circulation to close after birth. Ventricular septal defect is the incomplete development of the septum that separates the right and left ventricles, and it often accompanies other defects.

Ambulation in the puerperium

It is now well established that early mobilization after childbirth is extremely important. Once the mother has recovered from the physical rigours of her labour, she should be encouraged to mobilize as soon as possible. The physiotherapist has an important role to play in returning the patient to normal health during the puerperium and limb exercises will be particularly important to encourage venous flow in the leg veins of any mother who has been immobilized in bed for any reason. Exercises to the abdominal and pelvic floor muscles are most valuable in restoring normal tone which may have been lost during pregnancy.

Prenatal and Late Onset CSF

Pregnant animals, thereby infecting fetuses during all stages of pregnancy. The outcome of transplacental infection depends primarily on the time of gestation and on viral virulence. Abortions and stillbirths, mummification, and malformations are observed after infection during early pregnancy. In breeding herds, this leads to a reduction in the fertility index of the affected pig herd. Infection of sows from about 50 to 70 days of pregnancy may lead to the birth of persistently viremic piglets, which may be clinically normal at birth and survive for several months. After birth, they usually show poor growth ('runt'), wasting, or occasionally congenital tremor. This course of infection is referred to as 'late onset CSF' and the outcome is fatal. During their lifetime, these animals constantly shed large amounts of virus and are dangerous virus reservoirs, spreading and maintaining the infection within the pig population. This feature of CSFV infection is comparable to cattle or sheep...

In Vitro Fertilization and Surrogacy

The birth mother (surrogate) usually signs a contract to allow the adoption of the baby upon birth. However, hormonal changes during pregnancy, especially the increased levels of oxytocin, can produce a variety of behavioral changes, often termed maternal instinct, in the pregnant woman. The woman may have been quite willing to surrender the child upon birth, but she may have become unwilling to do so after birth.

Body composition fluids and electrolyte metabolism

Table 11.2 shows the average body composition of appropriately grown infants at different gestational ages. During pregnancy total body water declines from 94 in the first trimester to about 70 at term. Extracellular fluid decreases from 65 body weight at 26 weeks to 40 at term. Administration of intravenous fluids to a mother or Caesarean section increases the infant's body water after birth.

Genetics of Eye Color

Differences in iris color have been attributed to such causes as the temperature of the brain and eyes. Some people have stressed differences between dark-eyed and light-eyed populations and have suggested that eye color is related to general traits such as temperament or intellect. But, toward the middle of the nineteenth century, it had become clear that iris color was due to iris pigment, that this pigment developed soon after birth, and that the final quantity and distribution of the pigment was a hereditary trait.

Neurological disorders

Hypoxia-ischaemia followed by resuscitation may lead to apparent recovery followed by inexorable deterioration beginning 6-8 h later and ending in severe cerebral injury. Consequently, it is frequently difficult to determine the prognosis soon after birth on clinical grounds alone. However, if asphyxia is severe or happened some time before delivery the infant will not develop spontaneous breathing therefore, if despite advance life support there is no sign of spontaneous breathing 20 min after birth the outcome is extremely poor.

Gastrointestinal disorders

In healthy infants Yes, in the first week after birth If the baby is gaining weight properly, yes This poorly understood inflammatory condition is primarily a condition of preterm infants and those with congenital heart disease. It presents as an acute abdomen in the days or weeks after birth and varies in severity from mild to fatal. Diagnosis is clinical, aided by characteristic X-ray changes such as air in the bowel wall or biliary tree. Treatment is conservative with cessation of enteral feeding and with antibiotics or surgery.

Growth Infancy Through Adolescence

After birth, the complex growth process causes the dimensions of bones in the lower limbs to continue to increase until maturity (46). The most accurate data correlating long bone length with chronological age at death originate from radiographic studies of the living. Data on long-bone growth from such studies are provided by Anderson and Green (47) Anderson, Green, and Messner, (48) Anderson, Messner, and Green (49) as well as Francis (50), Ghantus (51), Gindhart (52), Hoffman (53), Maresh (37,38), and Maresh and Deming (39).

Risk of Radiation Induced Tumors

Stewart estimated that an in utero irradiation of 10-20 mGy increases the risk of cancer in the child by 1.5-2 (Stewart 1973). Harvey et al. (1985), who studied twin pregnancies subjected or not subjected to diagnostic radiation averaging 1 cGy, evaluated the relative risk at 2.4. However, this risk continues to be debated. It is surprising to note that the risk of radiation-induced cancer is higher when the radiation is received at the end of pregnancy rather than just after birth (Miller 1995). In addition, the tumors observed in children are more of the embryonic type, which does not correspond to tumors known to be radiation-induced.

Primary Nursing Diagnosis

CL and CP are treated with a combination of surgery, speech therapy, and orthodontic work. Surgical repair of a CL is performed within the first month after birth. The repair improves the child's ability to suck. The optimal time to surgically correct a CP is controversial. Times range from 28 days of life to 18 months. Most surgeons prefer to perform the surgery at an early age, before faulty speech habits develop. The more extensive the surgery required, the later the surgery may occur. Surgical repair of CL (cheiloplasty) is usually uncomplicated with no long-term intervention, other than possible scar revision. Surgical repair of CP (palatoplasty) is more extensive and may require more than one surgery. If the infant has horseshoe defect, surgery may be impossible. A contoured speech bulb attached to the back of a denture appliance to occlude the nasopharynx may help the child speak.

Way to Test Multistage Models

In the 1960s, the importance of somatic mutations and the nature of stages in progression continued to be debated (Foulds 1969). Several authors developed the idea that cancer arises by the accumulation of genetic mutations to cell lineages. Burch (1963) noted that if a sequence of mutations drives progression, then some individuals may inherit one mutation and obtain the rest after birth by somatic mutation. Burch

Epidermolytic hyperkeratosis

Presents at birth or shortly thereafter as erythema, blistering, and or scaling marked hyperkeratosis shortly after birth scales are small, dark, with corrugated appearance scales sometimes shedand, reaccumulate keratotic skin in intertrigi-nous areas which may become macerated and foul smelling blisters occur in crops, rupturing, and leaving red, painful, denuded base bullae tend to disappear before age 20 NPS subtype - lacks severe palmoplantar involvement PS subtype -severe palmoplantar involvement no ectro-pion

Clinical Description

In symptomatic individuals, certain clinical manifestations are common. In women, menorrhagia is frequently reported and there is an increased risk of bleeding after childbirth. 9 Epistaxis may occur, whereas petechiae and bruising are rather unusual. 9 Bleeding can be excessive and frequently manifests postoperatively, in particular after surgical procedures involving tissues with high fibrinolytic activity such as dental extractions, tonsillec-tomies, prostatectomies, or urinary tract operations. For other surgical interventions such as appendectomies, orthopedic operations, cholecystectomies, or hysterectomies, the risk of severe bleeding is less pronounced. 10 Sometimes the first bleeding episode is observed after circumcision. 9 Bleeding can be immediate, 9 but typically, it is protracted or presents as persistent oozing after surgery. 10

Clinical Characteristics

As L. monocytogenes is prevalent in food for human consumption, exposure to this pathogen by the consumption of contaminated food would be considered fairly common. However clinical disease is rare and mainly occurs among the immunocompromised, the pregnant, and the elderly (age > 60 yr). Listeriosis usually manifests itself as meningoencephalitis and or septicemia. In Europe, approx 20 of clinical cases are pregnancy-associated (including neonates within the first 3 wk after birth), and the majority of the rest occur in nonpregnant immunocompromised individuals or in the elderly. The median incubation period is estimated to be 3 wk. Outbreak cases have occurred 3-70 d following a single exposure to an implicated product (13).

Transmission and Tissue TVopism

Sows usually transmit the virus to their fetuses, irrespective of the stage of pregnancy. Infected fetuses harbor virus throughout their epithelial, reticuloendothelial and lymphoidal tissues and a high-titered viremia persists until death, which may be months after birth. Immune exhaustion may develop in chronic and late-onset hog cholera.

Insulin like Growth Factor IGFI

IGF-I is a polypeptide showing high similarity to insulin. Two different forms are distinguished IGF-I and IGF-II. IGF-I circulates in blood in the form of IGF-binding protein (IGF-BP), probably inhibiting activity of free IGF. IGF-I is a pivotal growth factor secreted as a result of stimulation by human growth hormone. Both in vivo and in vitro studies indicate its anti-apoptotic and anti-inflammatory properties (Goes et al., 1996 Sukhanov et al., 2007 Sun et al., 2010). There are reports that IGF-I has protective actions in ischaemic rat kidney due to inhibition of inflammatory cytokine production (Goes et al., 1996) and anti-apoptotic in Parkinson disease via inhibition of GSK-3P signalling pathway (Sun et al., 2010). IGF-I exerts its protective actions also in central nervous system and cardiomyocytes (Sun et al., 2010). In premature babies a small concentration of IGF-I is a risk factor of retinopathy of prematurity (Perez-Munuzuri et al., 2010). IGF-I deficiency after birth may...

Hernia Introduction

A hernia results from a protrusion of abdominal contents through an opening in a weakened musculature. An umbilical hernia is the protrusion of intestine and omentum through the umbilical ring caused by a failure of complete closure after birth. Inguinal hernia is the protrusion of intestine through the inguinal ring caused by a failure of the processus vaginalis to atrophy to close before birth allowing for a hernial sac to form along the inguinal canal. Umbilical hernia usually resolves by 4 years of age those that do not by school age are corrected by surgery. Inguinal hernia becomes apparent in the infant by 2 to 3 months of age when intra-abdominal pressure increases enough to open the sac. It is usually associated with a hydrocele. Both are corrected by surgical repair (herniorrhaphy) to prevent obstruction and eventual incarceration of a loop of bowel.

Vascular Endothelial Growth Factor VEGF

The VEGFs are a family of proteins that are mitogenic for vascular endothelial cells and increase vascular permeability. VEGF is important in fetal vascular development,with VEGF levels diminishing after birth. VEGF is expressed by retinal glial cells12 and vascular endothelial cells13. VEGF is secreted by numerous ocular cell types14, and increased levels of VEGF have been detected in ocular fluids of patients with proliferative diabetic retinopathy15. In vivo, administration of neutralizing VEGF antibodies to experimental animals reverses high-glucose-induced vascular hyperpermeability16, which is an early manifestation of endothelial dysfunction in diabetic patients17.

Traditional Qualitative Views

In the fetus, the rates of hepatic P-oxidation and ketogenesis are low. However, following birth, the capacity of these metabolic pathways increases and results in a significant rise in the concentration of ketone bodies (increasing from 0.2 mM in the rat at birth to 2mM 24h later7). This physiological hyperketonaemia is maintained throughout the suckling period.8 The changes are similar to those in CPT I, where the activity, protein concentration and level of mRNA encoding CPT I are low in the fetus and increase 5fold during the first day of extrauterine life. The enzyme activity and gene expression remain high during the entire suckling period.910 Furthermore, the inhibitory effect of malonyl-CoA (an intermediate compound in the biosynthetic pathway of fatty acids and a potent physiological reversible inhibitor of CPT I11) is decreased in the first 24h following birth. However, these changes are not seen in liver CPT II and the mRNA, immunoreactive protein and activity are not...

Gestational And Neonatal Expression And Activity Of Mhmgcoa Synthase

We have hypothesized that these processes would be accompanied by the induction activation of the ketogenic enzymes such as mHMG-CoA synthase. During the fetal-neonatal transition in rats ketone body production correlates with changes in hepatic mHMG-CoA synthase.5,18 Protein expression increases from 18d gestation and doubles over the last two days to reach adult levels at term. Ketogenic capacity does not increase, however, due to increasing inhibition of the enzyme (-50 ) by succinylation. Rapid activation (desuccinylation) of the enzyme, due to the birth-stress-induced glucagon surge, occurs shortly after birth (Fig. 1.). Little is known about the control of ketogenesis during human fetal and neonatal development but, as in rat, its onset is also linked to hormonal and metabolic changes accompanying birth. In healthy (AGA) infants, transient self-limiting hypoglycaemia occurs and a counter-regulatory response to low glucose is met by increased...

Cardiac investigations in pregnancy

The amount of radiation received by the fetus during a maternal chest X-ray (CXR) is negligible and CXRs should never be withheld if clinically indicated in pregnancy. Transthoracic echocardiogram is the investigation of choice to exclude, confirm or monitor structural heart disease in pregnancy. Transoesophageal echocardiograms (TOE) are also safe with the usual precautions to avoid aspiration. Magnetic resonance imaging (MRI) and chest computerized tomography (CT) are safe in pregnancy. Routine investigation with electrophysiological studies and angiography are normally postponed until after pregnancy but angiography should not be withheld in, for example, acute coronary syndromes.

Infancy And Childhood

In rat the equivalent period would be during suckling and early weaning (between 14 and 20 days after birth). Expression of mHMG-CoA synthase increases over the neonatal period from 1-6 hours and results in a 2-3-fold increase perinatally which, with maintained activation throughout suckling, allows persistent physiological keton- However, during this transition there are significant nutritional and metabolic differences between human and rat. In rat plasma fatty acid substrates for ketogenesis come mainly from hydrolysis of maternal milk triacylglycerols, due to lack of white adipose tissue at birth. In human neonates there is significant accumulated triacylglycerol in the liver, rapidly mobilized for utilization in situ after birth. Significant amounts of fat are stored in the human fetus in white adipose tissue comprising 16-20 body mass, mainly as triacylglycerides containing high proportions of palmic (C16) and oleic (C18 1) acids. Plasma free fatty acids start to rise soon after...

Choline And Brain Development

Choline availability during embryogenesis and perinatal development are especially important for brain development. There are two sensitive periods in rat brain development during which treatment with choline (about 1 mmol d administered to the mother during a critical period during pregnancy, or 300 mg kg administered subcutaneously 2 wk after after birth) produces long-lasting enhancement of spatial memory that is lifelong (28-36). The first critical period occurs during embryonic d 12-17 (rats give birth on d 21) and the second occurs during postnatal days 16-30. Choline supplementation during these critical periods elicits a major improvement in memory performance at all stages of training on a 12-arm radial maze. The two sensitive periods for memory responsiveness to supplemental cho-line correlate with the formation of cholinergic neurons (neurogenesis prenatal) and with the formation of nerve-nerve connections (synaptogenesis prenatal and postnatal) in the hippocampus and basal...

Respiratory disorders

Pulmonary tuberculosis can present for the first time in pregnancy and the obstetrician must have a high index of suspicion when presented with symptoms of cough, malaise or weight loss in high-risk groups. Most treatment options appear to be safe including ethambutol, rifampicin, isoniazid with pyridoxine and also pyrazi-namide. Streptomycin carries risks of VIII nerve damage and should be avoided. There is no conclusive evidence that the outcome of pregnancy is adversely affected by tuberculosis providing treatment is commenced in the first half of pregnancy. After birth, the neonate should be treated with prophylactic isoniazid for 3 months and thereafter BCG vaccination should be given, although its efficacy remains questionable.

Dha Therapy For Patients With Disorders Of Peroxisome Biogenesis

The rationale for DHA therapy in PBD is simple and, at first glance, compelling DHA is important for brain and retinal function, it is deficient in PBD patients, and its level in blood and probably also in brain and retina can be increased by oral DHA administration. A serious limitation is that malformations in brain and other organs develop during fetal life and cannot be remedied by postnatal therapy. Thus, the rationale for therapy is based on the hypothesis that correction of DHA deficiency can remedy secondary ill effects that occur postnatally. Martinez has emphasized that in normal brain, DHA levels increase most rapidly during the perinatal period (Martinez, et al., 1974). Postnatally, brain DHA levels increase at a lower rate from the second month until the second year and level off thereafter (Martinez, 1992). It is postulated therefore that DHA therapy in PBD patients has the greatest chance of success if it is begun during the first 2 yr of life, and preferably shortly...

Studies In Experimental Animals

Jannsen et al. (Janssen, et al., 2000) have conducted studies in the PEX5 - - mouse model of human ZS. These animals show clinical and neuropathological abnormalities similar to those in the human disease, including the characteristic defect in neuronal migration. At birth, levels of DHA in brain were 40 less than in control littermates, but DHA levels in the liver were normal. Because the PEX5-deficient animals are incapable of synthesizing this substance, all of their DHA must have been supplied by the mother. The maternal supply appears sufficient to maintain normal DHA concentrations in the liver, but insufficient to maintain levels in the fetal brain. We have obtained similar results of our studies in the PEX2 - - mouse model of human ZS (Su, et al., 2000). The demonstration of the fetal brain DHA deficit provides the opportunity to determine whether DHA supplementation can ameliorate the neurological deficits. To test this hypothesis the diet of the mothers' of PEX5-1 -mutants...

Immune Response and Prevention

Passive immunity (maternally acquired antibodies) may protect the fetus against infection in rodents. However, immunoglobulins do not pass through the multilayer placenta (epitheliochorial) in pigs. Production of antibodies in neonatal piglets is the result of active immunity (embryos are immunocompetent from about 70 days on). After birth, pigs can contain high concentrations of PPV antibodies from colostrum while nursing seropositive dams. A similar pattern is observed for BPV second- and third-trimester fetuses yield an immunoglobulin (Ig)M response that is maximum after about 10 days and is gradually replaced by IgG with maximum titers about 5 months after infection. Calves deprived of colostrum from seropositive cows may develop severe diarrhea upon infection.

Lactational amenorrhoea method

Breastfeeding delays the resumption of fertility after childbirth and the length of the delay is related to the frequency and duration of breastfeeding episodes and the timing of the introduction of food other than breast milk (e.g. solids). Prolonged breastfeeding can postpone ovulation, and therefore the risk of pregnancy, for more than a year. A woman who is fully or nearly fully breastfeeding and who remains amenorrhoeic has less than a 2 chance of pregnancy during the first 6 months after childbirth. The lactational amenorrhoea method or LAM is an algorithm which enables a woman to determine whether or not her pattern of infant feeding combined with her pattern of menstruation, confers effective contraception.

Treatment Options and Continuing Research

Normally, the production of HbF is turned off shortly after birth. Scientists are trying to determine how to reactivate the gene for HbF so that the bone marrow of people with sickle cell disease can continually produce fetal hemoglobin without the use of medications. Other research focuses on learning how to insert normal beta chains and regulatory genes into stem cells, which are cells that develop into erythrocytes.

Discharge And Home Healthcare Guidelines

The prevalence of MG is estimated to be 5 in 100,000, and the disorder occurs primarily in a bimodal distribution. In people in the age range of 20 to 30 years, women are more often affected than men in the later years (over 50 years old), men are more likely to be affected than women. Infants and children are also at risk for MG. Neonatal MG occurs in 10 to 20 of infants with myasthenic mothers. Symptoms occur within a few days after birth and usually last about 1 to 2 weeks. This short-term form of MG in infants is associated with the circulating maternal antibodies. MG may be congenital in this case, it occurs in two forms. One form consists primarily of ocular weakness with some extremity weakness. The second form primarily involves bulbar weakness (weakness of the lips, tongue, mouth, larynx, and pharynx) with some ocular impairment it characteristically is not associated with elevated ACh antibody titers. Juvenile MG begins with symptoms in the preteen years. There are no known...

Similarities and Differences between Monozygotic Twins

The fertilized egg cell that gives rise to MZ twins begins life with a single set of genes, and so we might predict that every cell that arises from it would be exactly identical. However, small differences between daughter cells may accumulate throughout embryonic development and later in life. The earliest difference may be in the mitochondria each inherits. Mitochondria are the cell's power plants and contain a small amount of DNA. Some of the hundreds of mitochondria in a cell may contain mutations. If the cells that create the two twins carry different mitochondrial genes, even identical twins will be genetically different. Mutations can also accumulate during embryonic development, or after birth, either in the mitochondrial genes or the genes in the nucleus. Such mutations may have a significant effect Some types of cancer are due to mutations accumulated during one's lifetime, often through exposure to environmental chemicals or radiation.

Neurologic System Basic Care Plan Introduction

The neurologic system includes the central nervous system (CNS) consisting of the cerebrum, cerebellum, brain stem, and the spinal cord the peripheral nervous system consisting of the motor (efferent) and sensory (afferent) nerves and the autonomic nervous system (ANS) consisting of the sympathetic and parasympathetic systems that provide control of vital body functions. Alterations in the neurologic system affect the process of receiving, integrating, and responding to stimuli that enter the system. This results in disturbances with signs and symptoms dependent on the type and site of the impairment and the normal functioning of the system. The disturbances may be manifested by alterations in consciousness, sensation, or muscle function. Changes in the system also occur as the child develops neurologically and completes the growth and development requirements for adulthood this system is one of the last to complete development after birth.

DNA Methylation and Chromatin Remodeling

The first connection between DNA methylation and chromatin remodeling came from studies in Arabidopsis. Mutation of a gene called DDM1 (decrease in DNA methylation) yielded plants with numerous growth defects and a profound loss of genomic 5-methylcytosine. The growth defects and losses of DNA methylation became progressively greater with increasing generations of inbreeding.74 Rather than a DNA methyltransferase, DDMl is a member of the SNF2 family of ATPases. Further evidence of a connection between DNA methylation and chromatin remodeling comes from studies of a human protein called ATRX. The ATRX gene is mutated in a human genetic disease called ATR-X syndrome (a-thalassemia, mental retardation, X-linked).75 ATRX is a member of the CHD subfamily of ATPases and has been shown to associate with transcriptionally inactive heterochromatin and due to its structure, may have a role in chromatin remodeling. ATRX patients also demonstrated DNA methylation defects, although they were far...

Control Of Testicular Function

The bulk of testosterone synthesis takes place. LH restores them to normal and can produce frank hypertrophy if given in excess. Leydig cells, which are abundant in newborn baby boys, regress and die shortly after birth. Secretion of LH at the onset of puberty causes dormant Leydig cell precursors to proliferate and differentiate into mature steroidogenic cells. In the fetus, growth and development of Leydig cells depend initially on the placental hormone, chorionic gonadotropin, which is present in high concentrations and which stimulates LH receptors, and later on LH secreted by the fetal pituitary gland.

Spinal Muscular Atrophy

The differentiation of these complex disorders is increasingly being done by genetic analysis. The autosomal-recessive proximal spinal muscular atrophies have been linked to mutations or deletions in the survival motor neuron gene on chromosome 5q11.12-13.3. Variants of SMA also linked to chromosome 5q include SMA with arthrogryposis, and a very severe form with survival measured in weeks after birth.

NOC Family Normalization

Inform parents that surgery may be performed within 48 hours after birth or be delayed to age of 3 months or until further neurologic function is assessed, to allow for better epithelialization to occur, and to reduce the possibility of the development of hydrocephalus use this information as reinforcement of physician information.

Innate Signals Dictating Homeostasis

Naturally occurring Tr eg cells with suppressive properties are present in large numbers in human fetal MLNs 222 , probably as part of a peripheral tolerance to keep autoreactive effector T cells in check to avoid inflammation and tissue damage 192 . These Treg cells are apparently induced in the thymus and expanded in the periphery 223, 224 . After birth, the decision for induction of hyporesponsiveness against innocuous exogenous antigen, vs. potentially harmful systemic-type productive immunity, may be largely instructed in mucosa-draining lymph nodes such as MLNs. As discussed above, the driving force in this homeostatic mechanism appears to be the microbial impact that conditions APCs and T cells for tolerance by balancing polarizing cytokines induced via PRRs (Fig. 3.12).

The Hepatitis B Vaccines

Most countries worldwide have now introduced universal immunization of infants. Although the vaccine may be incorporated into the Expanded Programme of Immunization, it is essential that it is given as soon as possible after birth to the infants of infectious mothers, in order to break the chain of mother-to-infant transmission (see below). Immunization within 12 h of birth protects around 70 of the infants of carrier mothers and up to 90 success may be achieved when passive immunization with hepatitis B immune globulin (HBIG) also is given, at a contralateral site, to neutralize any maternal virus that reaches the newborn infant. Rarely, however, the antibody may select variants with mutations that alter the amino acid sequence of the a determinant. Such 'antibody escape' variants may also be selected in liver-transplant recipients given HBIG in an attempt to prevent HBV infection of the graft and, indeed, in the natural course of infection, with seroconversion to anti-HBs. The most...

Management of puerperium

The morbidity associated with the puerperium is underestimated and an important review (Table 10.2) shows that after childbirth mothers have high levels of post-partum problems. Thirty-one per cent of women felt that they had major problems for up to 8 weeks post-partum. In trying to reduce the impact of this morbidity there are a number of principles which need to be applied in planning post-natal care. These include Table 10.2 Proportion of mothers having major, intermediate and minor morbidity after childbirth Table 10.2 Proportion of mothers having major, intermediate and minor morbidity after childbirth 4 Emotional and physical support. Mothers require help and support after childbirth and this may come from her partner, relatives and friends. Good professional support is also important and good communication between hospital staff, community midwives, the general practitioner and health visitor is essential.

Clinical Outcomes of Congenital Hypothyroidism

Exposure to maternal hypothyroxinemia in later pregnancy is linked to an additional risk of subnormal visual skills, including impaired contrast sensitivity, slower response speeds and fine motor deficits 23 . In case that hypothyroidism occurs after birth, language and memory are brain functions predominantly affected.

Utimobranchial Complex

The appearance of Titf-1 Nkx2-1 in the thyroid anlagen coincides with the proliferation of the cells that give rise to the primitive thyroid bud. Titf-1 Nkx2-1 remains expressed in the TFC during all stages of development and in adulthood. This factor has been shown to function as a potent transcriptional activator of thyroid- and lung-specific genes 22 . In humans and rats, Titf-1 transcripts are detected during lung development. It is known to regulate the transcription of TG and TPO genes, the Tshr gene in thyroid follicular cells, and the surfactant protein B (SPB) gene in epithelial lung cells (table 3). Titf-1 Nkx2-1 mRNA was also identified in parafollicular C cells and in the epithelial cells of the ultimobranchial body. This transcription factor is first expressed in epithelial cells and becomes progressively restricted to distal branches. The absence of expression in main bronchial epithelial cells or in the proximal respiratory compartments of the fetal lung and its...

Selective Reduction in Multiple Pregnancies

Selective reduction is the process of destroying one or more fetuses with the purpose of reducing the pregnancy, usually to twins. In such a case, selective reduction could be ethically acceptable, because it is aimed at optimizing the quality of life after birth. Even so, those against selective reduction argue that it is ethically wrong and note that it may even, though rarely, result in a loss of the entire pregnancy (2 to 7 percent of cases).

Redox Modulation Of The Function Of Oligodendrocyte Precursor Cells

The ability of intracellular redox state to modulate the balance between self-renewal and differentiation in dividing progenitor cells appears to be utilized by the organism to modulate development in different regions of the CNS, as indicated by our comparative studies on O-2A OPCs isolated from different CNS regions of the developing CNS (82). We initiated studies on O-2A OPCs from different CNS regions in an attempt to understand the great variations seen in the timing of both neurogenesis and gliogenesis in different parts of the brain and spinal cord. For example, neuron production in the rat spinal cord is largely complete by the time of birth, is still ongoing in the rat cerebellum for at least several days after birth, and continues in the olfactory system and in some regions of the hippocampus of multiple species throughout life. Similarly, myelination has long been known to progress in a rostral-caudal direction, beginning in the spinal cord significantly earlier than in the...

Role Of Mitochondria In Telodendria


Glial cells outnumber neurons ten to one in many parts of the CNS. They were first identified by Virchow in 1856, who considered them to form a structural 'glue' (from which the name derives) holding together the other elements of the nervous system. We now know they have many other important roles (Figure 1.14). Moreover, unlike neurons they have not lost the ability to multiply after birth. This means that they are able to invade

Mechanisms Promoting Homeostasis

Crohn Disease Mechanism

Oral tolerance is clearly a robust adaptive immune function because even healthy adult subjects absorb substantial amounts of intact food antigens, particularly after meals - corresponding to 10-5 of the intake and reaching a circulating level of 3-10 ng ml 23 - as part of the total daily protein uptake of 130-190 g 24 . The epithelial tightness and the immunoregulatory network remain fragile for a variable period after birth 25, 26 . Importantly, animal experiments show that the postnatal

Screening for maternal complications

Chronic hypertension pre-dates pregnancy or appears in the first 20 weeks whereas pregnancy-induced hypertension develops in the pregnancy, resolves after delivery and is not associated with proteinuria. Pre-eclampsia defines hypertension that is associated with proteinuria occurring after 20 weeks and resolving after birth. Pre-eclampsia occurs in 2-10 of pregnancies and is associated with both maternal and neonatal morbidity and mortality 5 . Risk factors include nulliparity, age of 40 years and above, family history of pre-eclampsia, history of pre-eclampsia in a prior pregnancy, a body mass index greater than 35, multiple pregnancy and pre-existing diabetes or hypertension. Hypertension is often an early sign that pre-dates the development of serious maternal and fetal disease and should be assessed regularly in pregnancy. There is little evidence as to how frequently blood pressure should be checked and so it is important to identify risk factors for pre-eclampsia early in...

Self Tolerance Maintained by Thymus Produced Natural Treg Induction of Autoimmune Disease by Their Manipulation at the

Several lines of investigations suggested that T cells capable of preventing the development of autoimmune disease are present in normal animals 7 . For example, autoimmune disease spontaneously develops in mice that have received thymectomy in a critical neonatal period (day 2-4 after birth, see below) or in rats that are subjected to thymectomy in adults and several subsequent doses of X-irradiation the development of autoimmune disease in these animals can be prevented by inoculation of T cells, especially CD4+ T cells from histocompatible normal mice or rats 8,9 . Based on these findings, attempts were made to produce autoimmune disease by removing a purported autoimmune-suppressive population from normal animals, directly and not indirectly, by neonatal thymectomy (NTx) or Tx plus X-irradiation. Transfer of spleen cell suspensions depleted of particular T cell subpopulations to histocompatible T cell-deficient mice or rats elicits autoimmune disease in otherwise normal animals....

Incontinence of urine

Urinary incontinence will occur in many women immediately following delivery and approximately 15 of women will have urinary incontinence which persists for 3 months after birth 8 . However, a recent study by Glazener et al. 9 showed that three quarters of women with urinary incontinence 3 months after childbirth still have this 6 years later. Urinary incontinence is more frequently seen following instrumental delivery and least frequently seen after elective Caesarean section. Urinary fistulae are uncommon in obstetric practice today although direct injury from the obstetric forceps may occasionally occur. Complications to the ureter are most commonly seen at a complicated Caesarean section when ureteric injury may either result in a ureteric fistula or ureteric occlusion. Women with this type of urinary problem should not be managed by obstetricians but should be referred to a urological colleague for surgical management.

Examination of the newborn infant

A full examination should be carried out on every baby in the presence of the mother before discharge from hospital. Ideally it should take place 24-48 h after birth however, if discharged before this the examination should still be undertaken. It is then advisable to examine the baby again during the first week of life. Any trained practitioner can carry out the newborn examination. A history should be taken including maternal obstetric and family history to identify problems in the baby that will require further management or follow up.

Diagnostic Tools Endoanal Ultrasound

However, there are several difficulties in the use of ultrasound to evaluate fecal incontinence in women following childbirth. In one study, the prevalence of sphincter defects on ultrasound was 65 in incontinent patients however, sphincter defects were also found in 43 of continent women after childbirth 26 . Sentovich and colleagues reported that even in experienced hands and with a strict protocol of imaging and interpretation, identification of sphincter defect was falsely positive in 5-25 of cases 27 . Study of normal sphincter anatomy has revealed a natural defect anteriorly that has been suggested to complicate the interpretation of ultrasound and result in false positive anterior defects 28 .

Physiologic Effects Of Thyroid Hormones

The importance of the thyroid hormones for normal development of the nervous system is well established. Thyroid hormones and their receptors are present early in the development of the fetal brain, well before the fetal thyroid gland becomes functional. T4 and T3 present in the fetal brain at this time probably arise in the mother and readily cross the placenta to the fetus. Some evidence suggests that maternal hypothyroidism may lead to deficiencies in postnatal neural development, but direct effects of thyroid deficiency on the fetal brain have not been established. However, failure of thyroid gland development in babies born to mothers with normal thyroid function have normal brain development if properly treated with thyroid hormones after birth. Maturation of the nervous system during the perinatal period has an absolute dependence on thyroid hormone. During this critical period thyroid hormone must be present for normal development of the brain. In rats made hypothyroid at...

Approved agents

Azidothymidine (AZT, retrovir), was the first drug to show clinical efficacy and receive FDA approval. Its licensure is for first-line therapy in early- and late-stage adults and in children over 3 months of age. The 1997 DHHS guidelines recommend its use with ddl, ddC or 3TC as the two nucleoside components of a three or more drug HAART regimen. AZT is a thymidine analogue in which the 3'OH is replaced by an azido group. AZT is phosphorylated in HIV-infected cells to AZT triphosphate and is preferentially incorporated instead of the natural thymidine triphosphate into replicating viral DNA by the HIV reverse transcriptase, resulting in chain termination. Thus, it inhibits reverse transcription at two levels, substrate specificity and elongation, with selectivity resulting from its low level of utilization by cellular DNA polymerase a. The first placebo-controlled study done with AZT in patients with advanced AIDS indicated that AZT therapy might prolong survival. Therapy has also...


Blood and tissues in common maternity pens are likely vehicles for transmission. Calves are susceptible to oral exposure by colostrum or milk from birth to 3 days, but colostral antibodies usually prevent infection and can persist for 6 months after birth. During dehorning, blood can be acquired from gouges and from other treated calves in the same pen. Sniffing, coughing and sneezing can aerosolize lymphocytes, but open wounds and the avid licking behavior of cattle are probably significant routes of transmission. Sheep do not transmit BLV horizontally.

Gender and age

With age, our ability to metabolize foreign compounds reduces. Xenobiotic metabolism is low or absent in the fetus and neonates, develops rapidly after birth, and is highest in early adulthood. Before birth, the capacity for handling metabolism of foreign compounds is through the mother's metabolism. Clusters of different enzymes seem to develop rapidly during development periods, birth, weaning, and puberty. Many of the age-related differences, particularly between the young and old, can be explained by quantitative differences in detoxification processes. There is also a difference in hepatic and renal clearances of toxicants between newborn and adult animals. The necessity for dose adjustment is well recognized in pediatrics and in certain situations wherein patients have impaired kidneys. Many phase II enzymes are expressed soon after birth. Enzymes for glucuronida-tion of steroids and bilirubin develop after birth, which explains the development of neonatal jaundice. Phase I and...


In Malaysia, a decoction of the leaves or roots is drunk as a protective remedy after childbirth, and the plant is used to stimulate sexual desire and to invigorate. It is also used to promote sweating and to treat cough. The plant has not been yet investigated for pharmacology but one could suggest that the aphrodisiac and tonic properties might result from a mood elevation via inhibition of serotonin re-uptake. Note that the root of Cyathostemma argenteum contains liriodenine and discretamine (5). Liriode-nine is known to block muscarinic receptors, but knowledge on its effects on the sero-toninergic system is quite vestigial (6).

Cerebral Palsy

Cerebral palsy is a condition caused by injury to parts of the brain before, during, or after birth, which results in impaired muscle control and affects a person's ability to move and maintain balance and posture. Cerebral palsy is considered to be a static disorder that will not get progressively worse as time goes on it is characterized by damage to the brain during early periods of development, usually up to six years of age. Approximately 500,000 people in the United States have some form of cerebral palsy. In addition, 8,000 infants and 1,500 preschoolers are diagnosed with this condition each year (National Dissemination Center for Children with Disabilities NICHCY , 2003). A number of prenatal factors may contribute to the occurrence of cerebral palsy, including genetic disorders, intrauterine infections, exposure to toxins, brain malformations, birth complications, and abnormal blood flow to the brain (Myers & Shapiro, 1999). Numerous perinatal (during or shortly after...

Child Development

In conclusion a considerable increase in our appreciation of the physiology, immunology and clinical aspects of thyroid function in relation to gestation has occurred during the past decade. Important research into thyroidal influence on fetal development as well as delivery of thyroid hormones to the fetus will drive future clinical studies to improve recognition and management of thyroid disease before, during and after pregnancy.


In the term infant, the haemoglobin concentration is high, between 16 and 18 g dl. Of this 80 is fetal haemoglobin (HbF). HbF has a lower affinity for 2,3-diphosphoglycerite which shifts the haemoglobin-oxygen dissociation curve to the left, leading to maximum oxygen transfer at lower pO2 levels. The proportion of HbF falls gradually during the months after birth and by six months only 5 haemoglobin is HbF. The relatively high total haemoglobin concentration also declines after birth. Haemoglobin is removed through the formation of bilirubin which is removed by the liver hepatic immaturity frequently leads to jaundice in the

Temperature control

The placenta is a heat exchanger which transfers heat generated by metabolism from fetus to mother. After birth the newborn infant functions as a homeotherm, maintaining deep body temperature at 37 C. Heat control places a large demand on neonatal metabolism and physiology because a large surface area to volume ratio and wet skin make the newborn baby vulnerable to excessive heat loss.

Dutch Rush

(Equisetum hyemale) Dutch, because it was imported into Britain in bundles from Holland as a domestic polisher (Grigson. 1974). The American Indians used the native variety in a number of ways -the stalk decoction as a hair wash to get rid of fleas, etc., the heads to cure diarrhoea, etc., (Weiner). The Menomini used the type plant for kidney trouble, by drinking the water in which it had been boiled, while the women used the same medicine to clean up the system after childbirth (Youngken). They were used like other members of the genus (see HORSETAIL) for scouring, cleaning and polishing, hence also the


Orders very early detection and initiation of treatment will prevent health problems, often mental retardation. All newborn infants are tested for a variety of genetic disorders. Each state determines for itself for what disorders to test their newborns. Disorders are chosen based on severity, incidence, ease and accuracy of testing, cost, and benefit of early diagnosis. All states test newborns for phenylketonuria (PKU), a metabolic disorder that is almost never evident at birth. Individuals with PKU are missing an enzyme called phenylalanine hydroxylase, which results in the buildup of phenylalanine. If left untreated, severe mental retardation develops. However, infants with PKU who are placed on a diet low in phenylalanine immediately after birth are expected to develop normally, making PKU an excellent candidate for newborn screening.

Newborn Screening

The ideal time to obtain the blood spot is 3-5 days after birth to minimize the false-positive high TSH due to the physiological neonatal TSH surge that elevates TSH levels and causes dynamic T4 and T3 changes in the first 1 or 2 days after birth. Early discharge of mothers postpartum has increased the ratio of false-positive TSH elevations. The difficulty in screening for CH using cord blood samples is in the handling and transport of the samples, making it an impractical method for mass screening 22 .


Studies have also demonstrated developmental stage-dependent differences in oligopeptide transporter expression and dipeptide absorption during peri- and postnatal periods in rabbits and guinea pigs.129 130 More recently, Miyamoto et al. demonstrated a dramatically higher intestinal PepTl mRNA expression in 10-day-old rats, which rapidly decreased and then leveled off reaching a plateau at adult expression levels by day 28 after birth.131 Further investigation revealed that rat PepTl mRNA and protein levels in the duodenum, jejunum, and ileum attained maximal levels by days 3 to 5 after birth. Interestingly, these mRNA and protein levels proceeded to fall rapidly to 11 to 13 of maximal expression by day 14, but then rose again to 23 to 58 of maximal expression by day 24. Higher expression of PepT1 at weaning, especially in the ileum, may be related to an adaptive response to a reduced protein diet or nourishment at this time period.43 The age-dependent PepT1 and PepT2 expression...

Liver disorders

Liver dysfunction in pregnancy can also be caused by incidental viral or autoimmune hepatitis. Where it is unexplained, serology for acute hepatitis must be sent and medical help requested. It is often difficult to determine whether liver dysfunction is due to a pregnancy related complication or incidental liver disease, and consideration must be given to delivery when there is uncertainty. Liver failure is rare in or after pregnancy. The more common causes include paracetamol overdose, viral hepatitis, HELLP syndrome and acute fatty liver of pregnancy. Correct diagnosis is important as early referral to a liver unit with a view to transplantation may be appropriate. Delivery will not affect the natural course of a viral hepatitis, but is likely to be beneficial with the latter two diagnoses. The issue of referral to specialist liver units most commonly arises after delivery if liver function continues to deteriorate. Such decisions should be made in consultation with a specialist...


Triploidy in humans and most other animals is incompatible with life. Triploid individuals abort or fail to survive the first days of life after birth. Polyploidy is more common in plants, and polyploid forms often survive to produce much larger cells and plant organs. Ferns, which may have up to 1,500 chromosomes, are frequently polyploid, as are varieties of domesticated cereal plants. Most often, polyploids run in sets of three to eight (triploid to octoploid).

Smooth Sumach

(Rhus glabra) Much used by native Americans, mainly as a dye plant. The Ojibwa, for example used the pulp of the stalk to produce yellow (Buhler), while the Omaha and Winnebago used the roots for the same purpose (Gilmore). The Plains Indians used to dry the autumn leaves for smoking (Gilmore). They used the shrub widely, too, for medicinal purposes. One was to make a styptic wash from the boiled fruit to check bleeding (Sanford), especially to stop bleeding after childbirth (Corlett). The powdered seeds would also have been applied to wounds, and to treat piles. The juice of the fresh fruit was used for warts and for skin diseases like tetter, while the fruit decoction was taken as a gargle for quinsy, mouth and throat ulcers, and as wash for ringworm (Lloyd). It was even said that the Thompson Indians of British Columbia made a decoction that was claimed to be a powerful remedy for syphilis (Teit).


Eventually, the one-hit hypothesis gave way to other facts. If a single gene caused cancer, and it was inherited, the cancer should develop immediately after birth. However, even in cases of inherited susceptibility, inception of cancer still takes some years. This implies that at least two changes are required, leading to the two-hit hypothesis. The fact that some cancers go through a series of stages with increasing virulence, and daughter cells from each stage maintain their characteristics when transplanted, imply that for such cancers even more than two mutations occur.

Pursuing Efficacy

To novel mechanisms that might be deployed. For example, although one can speculate that the present trend to pursue curative rather than palliative treatments will continue for at least the short term, it is likely that in the longer term a growing emphasis will be placed on preventative rather than on either palliative or curative treatments.115,116 Toward this end, pharmacogenetics should become of central importance, owing to its potential to divide recipient populations into distinct treatment subgroups based on their predisposition profiles coupled with their general ADMET-related drug handling profiles, wherein both sets of criteria may eventually become accessible before or shortly after birth using gene-based assays and to a lesser extent, administration of diagnostic probe molecules.117,118 Depending on the variability of an individual's environmental exposures, it can be imagined that in the future, pharmacogenetic profiling will be done at routinely scheduled intervals...


Elsewhere, though, the yellow colour has a different meaning. On Tikopia, turmeric is daubed over mother and child soon after birth, as a mark of attention, or even of honour. It is used to single out individuals who are at the moment of special interest and importance (Firth). Yellow is a colour sacred to the gods in Samoa, so the gathering and processing of the roots became a religious ceremony, with its prescribed rites. Turmeric powder is used as a medicine, as well as a dye. Mixed with oil, it is rubbed on inflamed parts, especially over recent tattooing, to soothe the pain. It was used in Samoa as a dusting powder for babies (Buck). In the Marquesas it is used as an insect repellent, and in Java it is the commonest laxative in use (Geertz). But the best known use in medicine is pure doctrine of signatures, for it is very comonly prescribed for jaundice, and a long way from Polynesia, too. The Mano, of Liberia, for example, use it in this way. The patient has to drink daily a...

Veal Calves

Veal growers are starting with very young calves who may not have received adequate colostrum shortly after birth, and the calves have gone through a marketing system in which some calves may have been sold as many as five times before reaching the veal grower. Up through the 1980s, most veal rations were heavily medicated with antibiotics to stimulate growth and prevent high death losses. Due to public concern over the feeding of such large amounts of antibiotics, manufacturers of veal rations have stopped mixing antibiotics in their diets, leaving the administration of antibiotics up the individual vealer. At slaughter, U.S. Department of Agriculture (USDA) inspectors spot-check calf carcasses for residues of several commonly used drugs. By self-policing to ensure that vealers stop using the drugs for which the USDA tests in time for the residue of the drugs in the calves to be reduced, the veal industry has succeeded in reducing its drug-residue violation rate.

Intersex disorders

True Hermaphrodite Genitalia

The masculinized female is usually caused by CAH she may be unable to retain salt and water and die within a few weeks of birth from salt loss and dehydration if the diagnosis is not made. An important generalization concerns the age of presentation. If, as is usually the case, the patient presents at birth with sexual ambiguity it is important that full investigations be undertaken at once to choose the appropriate sex of rearing. The reasons for this are first, if the child has CAH she may die if not correctly treated, and second, whatever the diagnosis, the orientation of the child in the chosen sex of rearing will be better if she or he is placed in that gender role as soon as possible after birth and is allowed to grow up in it without further doubts about gender being expressed. Parents in these circumstances are extremely anxious to know the sex of their child and the prognosis for the future, but it is wise not to assign a gender role until all the information is available as...


Neonatal tetanus due to infection of the umbilical stump by Clostridium tetanii is the result of poor hygiene and is a distressing and severe condition with extremely high mortality. Opisthotonus and muscle spasms of the jaw and limbs are presenting features and can appear very rapidly after birth. Prevention centres on maternal vaccination during pregnancy and education to improve hygiene and change of local cultural practices.



The menstrual cycle, pregnancy and the menopause are the most significant endocrine events which may influence pelvic floor fascia. Women often declare that prolapse symptoms are worse around the time of menstruation. This is thought to be secondary to higher progesterone levels increasing fascial elasticity. Recent studies have shown that women examined at the time of menstruation will have a higher stage of prolapse than at other times of the cycle. This has important implications when deciding on treatment. During pregnancy, prolapse symptoms will be more evident in the first trimester but diminish as the pregnant uterus enlarges out of the pelvis. During pregnancy many women develop stress incontinence of urine for the first time. Research has shown that fascial elasticity increases in pregnancy 5 and this probably results in diminished pelvic floor support and a tendency to stress incontinence. Women who develop stress incontinence of urine during pregnancy are more likely to...

Vaginal delivery

Internal Podalic Version

Delivery, intervals of > 30 min are acceptable providing the CTG is satisfactory and the presenting part is descending. Uterine inertia with a longitudinal-lying second twin is corrected by oxytocin infusion. Fetal distress can be managed by ventouse delivery even if the head is high or breech extraction if podalic. The already stretched vaginal tissues after birth of the first twin allow these procedures in circumstances where they are normally contraindicated. Caesarean section for a second twin is rarely indicated for disproportion, usually only where the second twin is unexpectedly much bigger than the first, and is associated with an increased complication rate compounding the complications of vaginal and abdominal delivery 60 . An oxytocin infusion is given prophylactically in the third stage.

Cart1 Knockout

Gene targeting has been used to generate mice with a null mutation in Cartl, a homeobox-containing gene that encodes the transcription factor, cartilage homeoprotein 1 (16,17). Homozygous Cartl mutant mice develop cranial NTD and die shortly after birth. The penetrance is influenced by genetic background with a maximum NTD incidence of 100 on a 129 SvEv strain background (17). Cranial NTD result from failure of closure at the prospective forebrain midbrain boundary, so called Closure 2. Failure of neural tube closure is thought to be the result of a reduction in the number of mesenchymal cells in the forebrain of homozygous mutant embryos at embryonic day 9 (E9). This deficit appears to result from an increase in cell death and correlates with the forebrain-specific expression of Cart1 in the cranial mesenchyme. Cart1 expression is absent from the E9 midbrain mesenchyme, which is histologically normal. Interestingly, however, the neural folds do not close in the midbrain, raising the...


Some Indian peoples made a tea from the leaves of PLANTAIN-LEAVED EVERLASTING for mothers to drink for two weeks after giving birth (H H Smith. 1928). Menomini Indian women used the tea made from DUTCH RUSH, which is a Horsetail, to clean up the system after childbirth (Youngken).

Medicinal Annonaceae

In Malaysia, a paste of leaves is applied to sore legs, and a decoction of the leaves is drunk as a protective remedy given after childbirth. To date, the pharmacological potential of F. fulgens (Hk. f. et Th.) Merr. is unexplored. It would be interesting to learn whether further study on this medicinal plant disclose any aporphines of chemo-therapeutic interest. The plant is used by Malays to assuage body pains, and a decoction of roots is drunk as a protective remedy after childbirth. The pharmacological properties of this plant are unknown, but it is very probable that it elaborates aporphines and flavonoids as characterized in Oxymitra velutina (5).

Parkinsons Disease

Eating parsley seed helps to avoid drunkenness, so it is claimed (Page. 1978 Camp), and another piece of country wisdom tells that eating parsley will take away any garlic smell and taste (Browne). That is probably true, for parsley has been described as a good natural deodorant (Page. 1978). There is, or was, a limited medicinal demand for parsley seed, and a few acres were raised in Suffolk each year for the distillation of an essential oil, with apiol as its main constituent. It is the apiol that is used for kidney complaints (Clair), either in the form of this oil, or as parsley tablets that herbalists sell. The seed is also useful in the treatment of malaria (Hatfield), and they also ., open, provoke urine, dissolve the stone, break and wast away winde, are good for such as have the dropsie, draw down the menses, bring away the birth, and after birth .(Gerard) (Berkshire wise women used to prescribe plenty of parsley to recuperate quickly after childbirth). But Gerard's...

Infant Assessment Is

In early intervention, assessment serves four primary functions screening, eligibility, program planning, and program monitoring. The event that starts the process in motion is a referral. Typically the parents caregivers themselves make this referral. For example, parents may notice that their young child is not rolling over to his stomach like other infants they have seen, or their young child is not cooing when she is lying on her baby blanket. With some infants, the referral is made shortly after birth. This is especially true for infants born prematurely (i.e., younger than eight months) or who are born with definite complications caused by heart and lung defects, cerebral palsy (or other syndromes), or physical malformations or medical complications. For the latter situation, these children are already considered to be at risk for future developmental difficulties and can be automatically determined eligible for early intervention services. For infants who had no birth...

Ectromelia Virus

Antibodies generated by a primary infection protect from subsequent challenge. Newborn mice receive maternal antibody via the placenta and in the milk during the first 7 days after birth. Until titers decline to undetectable levels by the seventh week after birth, this maternal antibody confers protection against death, but not against infection, with moderate doses of ECTV. Furthermore, in the absence of functional B cells, clearance of primary

Patient Selection

Sphincter Operation

Sphincter lesions due to obstetric trauma (third- and fourth-degree tears) have traditionally been submitted electively to sphincteroplasty. This technique can be performed by edge-to-edge approximation or overlapping of the external anal sphincter (Fig. 1). Immediate repair, at the time of delivery or delayed to 24 h, has been suggested to obtain best results. However, sphincteroplasty can frequently be performed a few decades after childbirth, when the patient presents clinically with FI. Manometric parameters (squeeze pressure resting pressure anal canal length) seem not to be useful for patient selection to sphincteroplasty, whereas a pudendal neuropathy, measured by a prolonged PNTML (particularly if bilateral), should be considered as a predictor of poor outcome 20-26 . However, conflicting results are also reported 27-31 , attributable to correct definition of PNTML normality, adequate evalu