Conditions Associated with Pregnancy Flashcards
What are 3 fetal causes of abnormal pregnancy
1) fetal abnormalities
2) fetal death
3) too many fetuses
what are 5 maternal causes of abnormal pregnancy
1) viral infection
2) ascending bacterial infection
3) placental problem
4) uterine issues
5) hormonal issues
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
what is the most common cause of fetal mummification in cows
BVDV infection
what is a common cause of fetal mummification in pigs
parvovirus
T/F in litter bearing species or twin pregnancies you can have mummies born with normal fetuses
T
T/F mummification is common in mares
F
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
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
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)
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)
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 **
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
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
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
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
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 **
T/F fetal maceration is common in mares
F
is fetal maceration or mummification more common in mares
mummification, but both are very rare
what causes hydropic conditions? what can the origin be
caused by excessive accumulation of placental fluids; can be amniotic, allantoic, or both
what causes hydroallantois (2)
- abnormal placentation
- diseased uterus
hydroallantois is associated with ____________ in cows
decreased number of placentomes
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
what causes hydroamnion
abnormal fetus that cannot swallow or process amniotic fluid -> gradual increase in amniotic fluid
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
T
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
T
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
