Conditions Associated with Pregnancy Flashcards by Giselle Carter

What are 3 fetal causes of abnormal pregnancy

1) fetal abnormalities
2) fetal death
3) too many fetuses

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what are 5 maternal causes of abnormal pregnancy

1) viral infection
2) ascending bacterial infection
3) placental problem
4) uterine issues
5) hormonal issues

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what is the etiology/pathophysiology of mummification and what is a KEY factor

fetal death -> absorption of fluids -> fetal retention -> CL retention -> tight cervix -> no bacterial infection -> stays sterile

key factor is that it is STERILE

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what is the most common cause of fetal mummification in cows

BVDV infection

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what is a common cause of fetal mummification in pigs

parvovirus

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T/F in litter bearing species or twin pregnancies you can have mummies born with normal fetuses

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T/F mummification is common in mares

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why is fetal mummification rare in mares

they do not maintain the CL for the entire pregnancy so if the fetus dies, there are no hormones to “maintain” pregnancy and there will be no mummification

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why would P4 supplementation cause mummification

if the fetus dies, the progesterone supplementation acts to mimc the CL so the dead fetus will stay in the uterus and mummify

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what are some causes of mummification

1) abortion diseases - BVDV, parvovirus, etc.
2) single PGF2a injection given to induce abortion instead of 2
3) P4 supplementation
4) genetic factors (ex. chromosomal abnormalities)

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what are 4 clinical signs of mummification

1) fetus not as big as expected for stage
2) lack of udder development
3) lack of fluid on U/S
4) absence of expected parturition (no fetal corticosteroids being produced)

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how do we treat mummification

give 2 doses of PGF2a to induce luteolysis and open cervix; if incomplete cervical relaxation, give topical PGF2a

** good prognosis for future fertility **

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why is parturition delayed in the case of fetal mummification

dead fetus cannot undergo stress in the pelvic canal activating the HPA axis -> no fetal corticosteroids -> parturition will not proceed

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what is the pathophysiology of fetal maceration

fetal death after partially initiating HPA axis -> relaxation of cervix -> bacterial invasion -> retained CL -> emphysema by 24h -> maceration by 4 days

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what are the clinical signs of an emphysematous fetus and a macerated fetus

emphysematous:
- distended, swollen, crepitus fetus
- foul vaginal discharge
- fever, anorexia, decreased production

macerated:
- thick uterine wall
- bones
- bones in uterine wall

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how do you treat fetal emphysema

1) PGF2a to lyse CL
2) manual extraction if cervix is open
3) treat the metritis with systemic antibiotics, antiinflammatory drugs, fluids

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how do you treat fetal maceration

1) estrogen or topical PGF2a to dilate cervix
2) manual bone extraction
3) surgical removal

** poor prognosis for future fertility **

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T/F fetal maceration is common in mares

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is fetal maceration or mummification more common in mares

mummification, but both are very rare

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what causes hydropic conditions? what can the origin be

caused by excessive accumulation of placental fluids; can be amniotic, allantoic, or both

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what causes hydroallantois (2)

abnormal placentation
diseased uterus

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hydroallantois is associated with ____________ in cows

decreased number of placentomes

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what are some clinical signs of hydroallantois (6)

rapid abdominal enlargement
abdomen round
very large distended uterus and you cannot ballot the fetus or feel placentomes
last 3 months of pregnancy
varied signs in cow such as anorexia, weakness, reluctancy to move, dyspnea, tachycardia
may see rupture of body wall or prepubic tendon

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what causes hydroamnion

abnormal fetus that cannot swallow or process amniotic fluid -> gradual increase in amniotic fluid

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what can help you distinguish hydroallantois from hydroamnion on rectal palpation

hydroamnion can ballot fetus and palpate placentomes; hydroallantois cannot palpate anything

what are signs of hydroamnion

- gradual abdominal enlargement in last trimester - pear shaped abdomen

if hydrops is severe -> if hydrops is not severe ->

severe -> euthanasia not severe -> induce parturition to save cow

T/F hydroamnion commonly recurs

F; commonly recurs if placental/uterine aka hydroallantois

how does hydrops in the mare commonly present

a tremendous amount of ventral edema

what are causes of hydrops in the mare (6)

1) placentitis 2) fetal abnormality 3) leptospirosis 4) uterine/placental insufficiency 5) genetic (RTL1 gene -> decreased # placental capillaries) 6) twins

T/F hydrops in the mare is rarer compared to cows, but is much more severe, with potential to lose both the mare and foal

what is the key step after identifying hydrops in the mare

initiate parturition to save mare prior to abdominal wall or prepubic tendon rupture

what is a potential sequela of fixing hydrops in mares

acute shock due to rapid loss of fluids and circulatory volume

how do you drain hydrops in mares

pass a drain through a trochar and SLOWLY drain over 2-4 hours while monitoring the mare for signs of shock; pass the fetus after draining +/- euthanize fetus

what is the outcome of hydrops in mares

poor prognosis - many have already ruptured the body wall or prepubic tendon - no future breeding potential - consider RTL1 gene has cause and do not rebreed to same stallion in the future

what are 7 clinical signs of prepubic tendon rupture and which sign is pathognomonic

- painful - reluctant to walk - blood in milk <- PATHOGNOMONIC - lordosis - stretched out stance - ventral edema - udder pulled cranially

what are some predisposing causes of prepubic and/or abdominal wall rupture in horses

- hydrops - twins - uterine torsion - draft mares - genetics?

is prepubic tendon rupture more common in cows or horses and why

horses; cows have subpubic tendon in addition to prepubic tendon so more support

how do you treat prepubic tendon rupture in horses

1) at term and fetus is mature: induce parturition 2) not at term: belly wrap, pain management, restrict exercise, monitor electrolytes and induce when mature

what is the prognosis for PPT rupture or abdominal wall herniation

- poor for future foalings/calvings - surgical mesh repair possible but has associated complications - euthanasia especially if PPT rupture - use for embryo transfer - use as pasture pet

T/F uterine torsion presents very similarly in cows and horses

F; due to differences in anatomy and fetal positioning during mid-late gestation

where is the attachment of the broad ligament in cows and how is the cervix

attach caudally; cervix mobile

where is the attachment of the broad ligament in mares and how is the cervix

attached dorsally; cervix fixed

how is the fetus positioned in late gestation in the cow vs the horse

cow: positioned in right direction and right side up horse: positioned upside down

in the mare, torsion usually happens (cranial/caudal) to cervix

cranial

what is the biggest sign of uterine torsion in the cow vs the horse

cow: failure to progress at parturition; can also occur in late gestation horse: colic signs during mid-late gestation

severe colic signs in the horse are associated with what degree of uterine torsion

more than 270 degrees

why can a vaginal exam be helpful to diagnose a uterine torsion in the cow but not the horse

cows usually have the cervix included in the torsion, so you can feel a twist in the anterior vagina on vaginal exam horses do not include the cervix in the torsion, so the vagina appears normal on exam

how do you diagnose uterine torsion via rectal exam in the cow and in the horse

cow: rotation of uterus and broad ligament horse: crossing over of broad ligaments; broad ligaments taught

how do we diagnose uterine torsion in the mare based on what we are feeling

the most caudal ligament is usually the side of the torsion, whereas the ligament on the opposite side will be pulled forward

diagnose the uterine torsion in the horse based on the following information: 1) right ligament felt first 2) left ligament felt first

1) right or clockwise torsion 2) left or counterclockwise torsion

what are the 3 options for treating uterine torsion in the cow

1) detorsion per vagina 2) roll cow 3) C-section aka flank laparotomy

what are some risks associated with detorsion per vagina and what species is it used on

risk that cervix will not dilate, risk of limb fracture used in cows only

how does rolling the cow work

you roll the cow around the stabilized uterus left torsion: lay cow on left side and roll to the left right torsion: lay cow on right side and roll to right

if doing a surgery to detorse, where do you cut

on same side towards which the torsion occurs

what is the risk of rolling

uterine rupture

what are the 3 etiologies of placentitis in the mare

1) ascending bacterial infection through cervix 2) focal 3) hematogenous

what are examples of ways to get an ascending bacterial infection through the cervix with resultant placentitis

Infectious: E. coli, Step. zoo Poor perineal conformation

what is an example of a cause of hematogenous placentitis

leptospirosis

what is the significant of premature lactation in a mare presenting with placentitis

indicates that the fetus is stressed and abortion is impending

T/F placentitis causes systemic disease

F; no fever or systemic signs

what are two key clinical signs of placentitis

vaginal discharge and premature lactation

what measurement done transrectally on US allows diagnosis of placentitis

CTUP

what are 2 inflammatory markers of placentitis and what do we see on CBC

1) serum amyloid a 2) αfetoprotein NO changes on CBC (limited infection)

infection of horses with crossiela equi or amycolatopsis causes what

focal mucoid placentitis characterized by lesions at the base of the horns of the uterus or in the body of the uterus

what is a risk factor for focal mucoid placentitis (nocardioform placentitis)

hot, dry August and September

what is the treatment (4) and prognosis for placentitis

treatment: - broad-spectrum antibiotic - anti-inflammatories - pentoxifylline (increase blood flow, reduce cytokine production) - progesterone supplementation prognosis: guarded to poor; foals often born septic

what causes vaginal prolapse

high estrogen of late pregnancy

T/F vaginal prolapse is inherited

what are two risk factors for vaginal prolapse

pluriparous and fat cows

what is the process of vaginal prolapse

edema of vaginal floor -> prolapse -> increased abdominal pressure while recumbent leads to external prolapse

what is the cycle that produces further vaginal prolapse

prolapse -> drying -> necrosis -> more straining -> more prolapse

extensive vaginal prolapse will also include what organ

bladder

how do you treat vaginal prolapse

1) clean 2) give epidural 3) replace 4) place retention suture or perform cervicopexy or vaginopexy 5) calve her out 6) cull

what is a permanent solution to prevent vaginal prolapse

fixation to prepubic tendon or sacrosciatic ligament