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Pre-term or full-term childbirth can be experienced as physically or psychologically traumatic. Cumulative and trans-generational effects of traumatic stress on both psychological and physical health indicate the ethical requirement to investigate appropriate preventative treatment for stress symptoms in women following a routine traumatic experience such as childbirth. The objective of this review was to investigate the effectiveness of early psychological interventions in reducing or preventing post-traumatic stress symptoms and post-traumatic stress disorder in post-partum women within twelve weeks of a traumatic birth. Randomised controlled trials and pilot studies of psychological interventions preventing or reducing post-traumatic stress symptoms or PTSD, that included women who had experienced a traumatic birth, were identified in a search of Cochrane Central Register of Randomised Controlled Trials, MEDLINE, Embase, Psychinfo, PILOTS, CINAHL and Proquest Dissertations databases. One author performed database searches, verified results with a subject librarian, extracted study details and data. Five authors appraised extracted data and agreed upon risk of bias. Analysis was completed with Rev Man 5 software and quality of findings were rated according to Grading of Recommendation, Assessment, Development, and Evaluation. Eleven studies were identified that evaluated the effectiveness of a range of early psychological interventions. There was firm evidence to suggest that midwifery or clinician led early psychological interventions administered within 72 hours following traumatic childbirth are more effective than usual care in reducing traumatic stress symptoms in women at 4-6 weeks. Further studies of high methodological quality that include longer follow up of 6-12 months are required in order to substantiate the evidence of the effectiveness of specific face to face and online early psychological intervention modalities in preventing the effects of stress symptoms and PTSD in women following a traumatic birth before introduction to routine care and practice.

\"Devon Burges is in the throes of a high-risk birth when she learns of her dear friend's murder. The police quickly name another friend as the chief suspect, but Devon doesn't buy it, and despite her difficult recovery, she decides to investigate. Haunted by postpartum problems that manifest as a cruel voice in her head, Devon is barely getting by. Yet her instincts are still sharp, and she's bent on proving her friend's innocence. But as Devon digs into the evidence, the voice in her head grows more insistent, the danger more intense. Each layer is darker, more disturbing, and she's not sure she, or her baby, can survive what lies at the truth\"-- Provided by publisher.

Serum indoxyl sulfate (IS) levels depend on the production of indole in the gut. The biological effects of IS in the vascular bed could be confirmed by changes in the levels of individual serum proteins during normal pregnancy and in the postpartum period as compared with non-pregnant controls. Albumin (Alb) and [alpha].sub.1 -acid glycoprotein (AGP, orosomucoid) are the most abundant serum carrier proteins with potential interrelationships with serum levels of IS. Serum levels of IS, Alb and AGP were measured in 84 pregnant women in the first, second and third trimester of pregnancy and in the postpartum period, as well as in non-pregnant controls (n = 20), using ultra-performance liquid chromatography (UPLC) coupled to mass spectrometry (IS), colorimetric assay (Alb) and immunoturbidimetric assay (AGP). The postpartum serum levels [mg/L] of IS were lower (p = 0.027) than in the second trimester (mean±SD: 0.85±0.39 vs 0.58±0.32). There were no differences in the IS to ALB ratio calculated in the three trimesters of pregnancy, the postpartum period, and in the non-pregnant controls. The IS/AGP ratio increased from the first to the second trimester (p = 0.039), and decreased in the postpartum period (p<0.05), when it was lower than in the second and third trimester. The variability of the serum IS/AGP ratio during pregnancy and in the postpartum period may reflect shared involvement in the regulation of their intravascular relationships. The link between serum levels of IS derived from the gut and AGP could serve a potential biomarkers of maternal intestinal metabolism during pregnancy and postpartum.

IntroductionWe present the case of a 23-year old woman with a history of two hospitalizations in the psychiatric ward of our hospital in the last 8 months. Prior to this age our patient had not required assistance from mental health professionals. The wide variety of symptoms shown by the patient included auditive hallucinations and persecution delusions that led to behavioral alteration and depressive symptoms.ObjectivesTo present a case report of a puerperal psychosis and to review the different kind of psyquiatric disorders that may arise in the puerperium.MethodsLiterature review of scientific papers over the last years and classic textbooks on the issue. We included references in English and Spanish languages.ResultsDuring pregnancy and the puerperium there are biochemical, hormonal, psychological and social changes that cause a vulnerability in women for the appearance of mental disorders. The differential diagnosis of puerperal psychoses must first be made with organic diseases. Once this has been discarded, several studies indicate that there is a high probability that after the onset of puerperal psychosis a cyclical mood disorder is found.Conclusions- One of the main characteristics of puerperal psychoses is the great variety of its symptomatic manifestations. They can present characteristics of both mood disorders and schizophreniform disorders. - Deep confusion and delusions are often the most prominent symptoms of psychosis in the puerperal period.DisclosureNo significant relationships.

\"Countless studies have established the efficacy of cognitive behavioral therapy (CBT) for many manifestations of depression and anxiety. In Cognitive Behavioral Therapy for Perinatal Distress, Wenzel and Kleiman discuss the benefits of CBT for pregnant and postpartum women who suffer from emotional distress. The myths of CBT as rigid and intrusive are shattered as the authors describe its flexible application for perinatal women. This text teaches practitioners how to successfully integrate CBT structure and strategy into a supportive approach in working with this population. The examples used in this book will be familiar to postpartum specialists, making this an easily comprehensive and useful resource. \"-- Provided by publisher.

Postpartum venous thromboembolism (VTE) remains a clinical challenge despite thromboprophylaxis. Low molecular weight heparin (LMWH) represents the first-line treatment, but interindividual pharmacodynamic variability complicates dose titration. This study aimed to optimize individualized anticoagulation monitoring based on anti-Xa levels, thromboelastography (TEG) parameters, and biochemical parameters. This prospective cohort study included postpartum VTE patients treated with nadroparin at Shanghai First Maternity and Infant Hospital (September 2021-July 2022). Anti-Xa levels, TEG parameters, and coagulation indices were monitored over the initial 10 doses. Patients with peak anti-Xa levels of 0.5-1.0 IU/mL following the 4th dose were classified as the therapeutic group. All participants were followed for 1 year. Efficacy endpoints included anti-Xa levels, coagulation profiles, TEG changes, thrombus resolution, hospitalization duration, and VTE recurrence. Safety endpoints included bleeding, hematoma, prolonged lochia, thrombocytopenia, and skin reactions. Fifty patients were enrolled. TEG parameters showed a biphasic response: R and K values peaked after four doses, then declined; MA, Angle, and CI exhibited inverse trends. Mean peak anti-Xa levels rose progressively from 0.05 ± 0.08 IU/mL (day 0), reaching 0.59 ± 0.19 IU/mL (day 5). Anti-Xa levels correlated positively with R (  = 7.88,  < 0.001) and K (  = 1.45,  = 0.01), and negatively with Angle (  = -18.38,  < 0.001). No significant differences were observed thrombus or adverse events between groups; but the therapeutic group demonstrated shorter hospitalization (7.54 ± 1.72 vs. 9.04 ± 3.14 days,  = 0.044). Nadroparin shows a nonlinear dose-response in postpartum VTE. Anti-Xa levels and TEG correlations may enhance individualized anticoagulation monitoring strategies. https://www.chictr.org.cn/bin/project/edit?pid=132010, ChiCTR2100051002.

Background Smoking during pregnancy (SDP) and the postpartum period has serious health outcomes for the mother and infant. Although some systematic reviews have shown the impact of maternal SDP on particular conditions, a systematic review examining the overall health outcomes has not been published. Hence, this paper aimed to conduct an umbrella review on this issue. Methods A systematic review of systematic reviews (umbrella review) was conducted according to a protocol submitted to PROSPERO ( CRD42018086350 ). CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science, CRD Database and HMIC databases were searched to include all studies published in English by 31 December 2017, except those focusing exclusively on low-income countries. Two researchers conducted the study selection and quality assessment independently. Results The review included 64 studies analysing the relationship between maternal SDP and 46 health conditions. The highest increase in risks was found for sudden infant death syndrome, asthma, stillbirth, low birth weight and obesity amongst infants. The impact of SDP was associated with the number of cigarettes consumed. According to the causal link analysis, five mother-related and ten infant-related conditions had a causal link with SDP. In addition, some studies reported protective impacts of SDP on pre-eclampsia, hyperemesis gravidarum and skin defects on infants. The review identified important gaps in the literature regarding the dose-response association, exposure window, postnatal smoking. Conclusions The review shows that maternal SDP is not only associated with short-term health conditions (e.g. preterm birth, oral clefts) but also some which can have life-long detrimental impacts (e.g. obesity, intellectual impairment). Implications This umbrella review provides a comprehensive analysis of the overall health impacts of SDP. The study findings indicate that while estimating health and cost outcomes of SDP, long-term health impacts should be considered as well as short-term effects since studies not including the long-term outcomes would underestimate the magnitude of the issue. Also, interventions for pregnant women who smoke should consider the impact of reducing smoking due to health benefits on mothers and infants, and not solely cessation.

The maternal care of cows can influence both the milk production and the performance of their calves, making this a topic of important relevance for the production industry that uses zebu cattle. The aims of this study were to 1) investigate the effects of parity on the behaviors of Gyr cows during the peripartum period; 2) characterize the maternal defensiveness of primiparous and multiparous cows towards handlers during the first handling of their calves; and 3) evaluate the relationships between cows' behaviors at the peripartum period and maternal defensiveness. Thirty-one Gyr cows (primiparous and multiparous), from Empresa de Pesquisa Agropecuária de Minas Gerais (Brazil), were used. The animals were placed in a maternity paddock monitored by video cameras. The behaviors of the animals were collected in four periods: Pre-calving, Post-calving, First handling of calf and Post-handling. Primiparous cows presented more pain signs, reflected in arched spine (P = 0.05), and tended to move more (P = 0.07) than the multiparous in the Pre-calving period. Trends were observed for both Maternal Composite Score (P = 0.06) and Maternal Protective Behavior score (P = 0.06), indicating that both primiparous and multiparous were protective, but only multiparous cows were aggressive toward the caretakers on the first handling of their calves. The most protective cows spent more time eating during the prepartum period (P = 0.03), while the least attentive cows spent more time lying down (P = 0.02) in the prepartum period. The cows who nursed and stimulated their calves more were also calmer (P = 0.02) and more attentive (P = 0.01). In conclusion, the peripartum behaviors of Gyr cows were related to maternal care and maternal defensiveness. Multiparous cows tended to be more aggressive than primiparous cows at the time of the first handling of their calves.