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1.4.1 Conditions Associated with Pregnancy Flashcards

1
Q

what would a mummified fetus feel like upon rectal palpation?

A
  • small uterus for stage, feel “mass” inside, uterus contracted down around it (no or little fluid)
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2
Q

Fetal Mummification etiology/pathophysiology

A
  • Fetal death and
  • Absorption of the fluids
  • Fetal retention
  • Retention of CL
  • Closed (tight) cervix
  • No ascending bacterial invasion
  • STERILE
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3
Q

what is the most common cause of fetal mummification in cows?

A

Sporadic in cows
Most common cause is BVD infection

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4
Q

when are we most likely to see fetal mummification in mares?

A

Rare in mares (Twinning; P4 supplementation)

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5
Q

when are we most likely to see fetal mummification in sows? is it common?

A

Frequently in sows (parvovirus)

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6
Q

Other than twinning, why is fetal mummification so rare in mares?

A

no CL to be retained > if fetus dies, placenta dies, endometrial cups no longer produce eCG to sustain secondary CLs…

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7
Q

pathogenesis of fetal mummification?

A

Abortion Diseases –end of 1st/beginning 2nd trimester
3‐5% rate following PGF2a to induce abortion due to failure of complete luteolysis
Genetic Factors
-Chromosomal abnormalities resulting in fetal
death
-But CL remains
In P4 supplementation – mimics the CL so dead fetus stays in uterus

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8
Q

clinical signs of fetal mummification?

A
  • Not as big as expected for stage
  • Lack of udder development
  • Ultrasound – fetus/bones but absence of fluid – placentomes absent
  • Absence of parturition as expected
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9
Q

why is there absence of parturition as expected in the case of fetal mummification?

A

no fetal stress response
dead fetus > no functional HP axis > no ACTH > no cortisol

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10
Q

how can we treat fetal mummification in cows? what is the prognosis?

A
  • PGF2a to induce luteolysis – cervix will open ‐ expel fetus
  • Two doses often required
  • Incomplete cervical relaxation can occur
    > Topical PGE2 may help
  • Prognosis: Good for cow’s future fertility
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11
Q

what is fetal maceration?

A

Decomposition of soft tissues and placenta in a septic environment leaving bones

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12
Q

what is the process that leads to fetal maceration?

A

fetal death
> relaxation of the cervix
> bacterial invasion
> retained CL
> emphysema in 24-48 hours (air filled uterus/fetus)
> maceration by 4 days (“wasting away”)

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13
Q

clinical signs of emphysematous fetus and fetal maceration

A

Emphysematous fetus:
Distended, swollen and crepitus fetus
Fetid (foul) uterine discharge
Fever, anorexia, decreased milk production
»
Maceration of fetus:
Thick uterine wall
Bones
Bones embedded in wall

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14
Q

treatment of fetal emphysema

A

PGF2α to induce luteolysis
Fetal extraction if the cervix is open
Treat metritis; Systemic antibiotics, anti‐inflammatories, fluid therapy

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15
Q

treatment of fetal maceration

A

Estrogen or topical PGE to dilate cervix
Manual bone extraction
(use lots of lubricant in the uterus)
Surgical removal

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16
Q

prognosis of fetal maceration?

A

Poor prognosis for future fertility ‐ cull

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17
Q

do we often see fetal maceration in mares?

A

no, fetal maceration is rare in mares

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18
Q

difference in clinical signs between mummification and maceration

A

both:
fail to calve; anestrus

maceration only:
+/- sick animal

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19
Q

prognosis for mummification vs maceration

A

mummification: good
maceration: poor

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20
Q

what characterizes Hydropic Conditions (Dropsy; Hydrops)?

A

Excessive accumulation of placental fluids

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21
Q

what is the origin of fluids in hydropic conditions?

A

can be:
-amniotic
-allantoic
-both

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22
Q

what is Hydroallantois? how does it arise?

A

Abnormal fluid accumulation in the allantois due to abnormal placentation or a diseased uterus
Caused by functional or structural changes that lead to excessive fluid production

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23
Q

hydroallantois can be associated with what?

A

Can be associated with decreased numbers of placentomes in cows

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24
Q

clinical signs of hydroallantois. when do we usually see it? what do we find via rectal exam and what are symptoms?

A

Usually in the last 3 months of pregnancy]
Rapid abdominal enlargement
Up to 150‐250 Litres (normal is 15‐25 L)

Rectal exam – very large, distended uterus – fetus and placentomes are NOT palpable
Round shaped abdomen
Clinical signs depend on severity:
Anorexia, weakness, reluctance to move, dyspnea, recumbancy
Potential for rupture of body wall or prepubic tendon

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25
what do the following clinical signs point to: 8 months pregnant Rapid abdominal enlargement recently Abdominal wall round and tense Anorexic, weak Rumen stasis Reluctant to move Dyspneic, tachycardic
hydroallantois
26
what do the following clinical signs point to: * 8 months gestation * Slow abdominal enlargement over last weeks * Abdominal wall is pear shaped
hydroamnion
27
what causes hydroamnion? is it common?
Due to abnormal fetus that cannot swallow or process amniotic fluid, so there is GRADUAL increase in amniotic fluid during last trimester ‐Less common
28
what is hydroamnion associated with?
‐Associated with Large Offspring Syndrome in ART calves (IVF, cloned)
29
what volume of fluid is associated with hydroamnion?
‐Up to 19 ‐ 100 L (normal is 4‐7 L)
30
what can we feel upon rectal exam in a case of hydroamnion?
Rectal exam ‐ Fetus and placentomes ARE palpable
31
shape of abdomen in hydroamnion case?
pear shaped
32
shape of abdomen in hydroamnion case?
pear shaped
33
etiology of Hydroallantois vs Hydroamnion
Hydroallantois: placental Hydroamnion: fetal
34
incidence of Hydroallantois vs Hydroamnion
Hydroallantois: 90% Hydroamnion: 10% -----sporadic------
35
prognosis of Hydroallantois vs Hydroamnion
Hydroallantois: poor Hydroamnion: good (for cow)
36
fluid character of Hydroallantois vs Hydroamnion
Hydroallantois: watery/clear Hydroamnion: viscous
37
complications of hydroallantois or hydroamnion
RFM, metritis
38
Hydrops in Cows ‐ Treatment considerations
If not severe – induce parturition to save cow Euthanasia if severe Recurrence possible if uterine/placental (hydroallantois)
39
what do these symptoms point to? 9 months pregnant with 9th foal Rapid abdominal enlargement in the last month Depressed, anorexic
hydrops in the mare
40
how common is hydrops in the mare?
rare compared to cows
41
is hydrops in the mare serious?
yes A train‐wreck waiting to happen!  Potential for loss of mare and foal
42
potential causes for hydrops in the mare
Causes can be:  Placentitis Fetal abnormality  Leptospirosis Uterine /placental insufficiency Twins Genetic – recently identified RTL1 gene expression variant (paternal in origin) – leads to decreased #s placental capillaries
43
treatment for hydrops in the mare. what should we be careful to avoid?
Terminate pregnancy to save mare prior to abdominal wall / PPT rupture -Slow drainage of hydrops in mares Beware of potential for Acute Shock in mares due to rapid loss of fluids and circulatory volume
44
how do we proceed with Slow drainage of hydrops in mares
Use of a trochar thru cervix – puncture membranes and drain thru tubing Slow Drainage - can take 2-4 hours Sedate mare Monitor mare’s heart rate etc. for signs of shock Extract fetus (malposition is common)
45
why is the outcome of hydrops in the mare usually poor?
* Outcome is usually poor as most mares have ruptured the body wall or prepubic tendon as a result of rapid abdominal wall enlargement * Often don’t know until the edema/swelling goes down weeks later * No future breeding potential (except ET)
46
if mare survives hydrops, what should we consider for the cause and for future breedings?
If mare survives, consider RTL1 gene as potential cause – do not rebreed to same stallion
47
what are these symptoms consistent with: * 18 yr old Draft X TB mare * 340 days of gestation * 6th foal * Severe ventral edema * Getting worse over last few days * Painful gait * Sweating * Tachycardia * Blood in milk * Rectal palpation – fetus alive
Prepubic Tendon Rupture
48
warning sign and common symptoms of prepubic tendon rupture in the mare
 Severe ventral edema is a warning sign  Reluctance to walk  Painful  Stretched out stance  Blood in milk  Lordosis  Udder pulled cranially  Confirm diagnosis by ultrasound
49
predisposing causes for Rupture of Prepubic Tendon and/ or Abdominal Wall
Draft mares Hydrops Twins Uterine Torsion ? Genetics Often no predisposing factor
50
treatment for Suspected Cases of Abdominal Wall Hernia or PPT Rupture
If at term and fetus is mature: induce parturition‐ be prepared to assist! If not:  Belly wrap  Pain management  Restrict exercise  Monitor Calcium/Na/K/pH of milk  And induce parturition when fetus is mature
51
Prognosis – PPT Rupture or Hernias
* Poor for future foalings/calvings * Surgical repair possible but difficult > Mesh repair > Complications – infection, failure * Embryo Transfer Donor * Pasture Pet * Euthanasia esp. in cases of PPT Rupture * Terminal C Section if fetus mature
52
why are uterine torsions very different in the cow and the mare?
‐ Differences in anatomy (attachment of broad ligaments) plus fetal positioning in mid‐ to late gestation
53
broad ligament anatomy of the cow
Broad ligaments attached caudally and along lesser curvature ‐greater curvature free ‐cervix is mobile ‐if empty rumen, heavy fetus has space to rotate
54
fetal position in late gestation for the cow
squished with feet towards caudal aspect of abdominal cavity, head up and towards vaginal opening
55
broad ligament anatomy in the mare
Broad Ligament attaches dorsally Cervix broadly attached
56
position of the equine fetus at 8 months
head towards caudal aspect of abdominal cavity, back towards ground -ie. fetus is lying on back, hind feet curled upward into 'limb horn'
57
where anatomically does uterine torsion usually occur in the mare
cranial to cervix
58
cow Uterine Torsion ‐ Clinical Signs
Late gestation / during parturition Dystocia **Failure to progress at parturition** Anorexia, rumen stasis Sometimes –dystocia, fetus upside‐down
59
mare Uterine Torsion ‐ Clinical Signs
Mid to late gestation **Colic signs** Intermittent and mild Severe (>270̊ torsion)
60
uterine torsion diagnosis in cow
Clinical sign – failure to progress during parturition Rectal palpation– rotation of uterus and broad ligament Vaginal exam – twist in the anterior vagina – cervix is included in torsion in most cases
61
uterine torsion diagnosis in the mare
Colic signs but not attributable to GIT Rectal examination (broad ligaments crossing and taught) Vaginal examination NOT usually helpful
62
Diagnosis of Uterine Torsion in the Mare - what will we feel in a rectal exam? how do we determine the side of the torsion?
Most caudal ligament felt on rectal exam is usually the side of the torsion  Ligament on *opposite side* is pulled forward in front of the uterus  If you feel the left ligament first, with the right crossing in front of it, then it is a “Left” or “Counterclockwise” torsion
63
Uterine Torsion ‐ Treatment Options‐ Cow.
-Detorsion of the fetus per vagina -Roll the cow -C‐section (flank laparotomy)
64
when and how should we detorsion a fetus in a cow per vagina
Use in Cows only (typically at term, cervix partially dilated) – good if only 90 degree Per vaginum using detorsion bar and calving chains to “roll” fetus over to de‐torse the uterus Risk that cervix will not dilate and fetus dies Risk of limb fracture to calf
65
how does “Plank in the Flank” Rolling to Detorse work in the cow? what do we do if we have a right torsion
Right torsion --- lay cow on right side ---- roll to right You are rolling the cow around the stabilized uterus
66
Uterine Torsion ‐ Treatment ‐ Mare. options and risks
Surgery: Standing flank laparotomy to detorse the uterus (cut on same side toward which the torsion occurs) Rolling the mare: Requires general anesthetic Risk of uterine rupture
67
when during gestatoin do we expect a torsion in a mare vs cow?
cow: late pregnancy mare: mid-gestation
68
Placentitis in the Mare etiology and predisposing factors
Most often ascending bacterial infection via cervix – E. Coli, Strep. zooepidemicus Simple cervix Longitudinal folds Poor perineal conformation Previous history of placentitis
69
what bacterial causes hematogenous placentitis in the mare?
Hematogenous ‐ Leptospirosis
70
clinical signs of placentitis in the mare
Usually late gestation (>240 days)  Vaginal Discharge +/‐ Premature lactation NO fever or other systemic signs
71
significance of premature lactation in the mare
Fetus is stressed! Indicates impending abortion (from any cause)
72
how to diagnose ascending placentitis?
Clinical signs Transrectal ultrasound exam >Measure: Combined Thickness of the Uterus and Placenta (CTUP) Inflammatory markers
72
how to diagnose ascending placentitis?
Clinical signs Transrectal ultrasound exam >Measure: Combined Thickness of the Uterus and Placenta (CTUP) Inflammatory markers
73
Nocardioform Placentitis (in Kentucky) caused by what?
* Bacterial organism Crossiela equi or Amycolatopsis -gram + bacteria in soil
74
Placentitis ‐ Treatment
-Broad Spectrum Combination of Antibiotics that cross placenta well - Anti‐inflammatories - Pentoxifylline -Progesterone Supplementation ??
75
prognosis of placentitis?
Prognosis – Guarded to Poor Foals born alive are often septic Likely to recur in subsequent pregnancies
76
etiology of vaginal prolapse in the ruminant
**Cause is high estrogen of late pregnancy** Inherited in Bos indicus cattle (conformational factors) Pluriparous and fat cows Edema of vagina Prolapse of swollen tissues of vaginal floor Increased abdominal pressure during recumbency – leads to external prolapse
77
what is the cycle of trauma for a vaginal prolapse?
drying --- necrosis --- more straining ---- more prolapsing– Beware!! Frostbite, predators
78
Vaginal Prolapse – Clinical Signs mild vs severe
Vaginal Prolapse – Clinical Signs Mild – slightly prolapsed during recumbency, replacing when cow stands Severe – extensive vagino‐cervical prolapse including bladder

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