ET: Placental Exam, Parturition and abortion

Question 1

Equine dystocia

Answer 1

Not due to fetal: maternal disproportion
Caused by postural abnormalities

Question 2

Red bag

Answer 2

Premature placental separation
Emergency, requires immediate action

Question 3

Foaling problems of fetal origin

Answer 3

Twinning
Developmental anomalies
Wry neck/ wry nose (can remodel after birth)
Dystocia

Question 4

Uterine torsion

Answer 4

Evident @ 6-8 months and with discomfort of the dam
Discomfort secondary to vascular compromise of fetus

Question 5

Tx of uterine torsion

Answer 5

Flank sx to resolve

Question 6

Prepubic tendon rupture

Answer 6

Secondary to sever ventral edema

Question 7

Rupture of the middle uterine artery

Answer 7

Happens post-foaling within a week
Results in a rapid demise of the mar e
Secondary to uterine prolapse

Question 8

Perineal lacerations

Answer 8

Results of dystocia
First (anal sphincter and perineal body intact), second (fistula of perineal body) and third degree

Question 9

Third degree perineal lacerations

Answer 9

Acute bruising (sx repair will fail)
Thirty days later: freshen and debride, then do repair

Question 10

Gestation length

Answer 10

10.5 to 13 months (ave 11- 11.5 months)

Question 11

Abortion

Answer 11

Expulsion from the uterus of a living fetus before it’s capable to independent life or a dead fetus recognizable size at any age of gestation

Question 12

Fresh fetal death

Answer 12

Died in utero < 24 before delivery
EHV-1

Question 13

Autolytic fetal death

Answer 13

Died in utero 24-48 hours before being delivered
EVA (viral), bacterial (strept) and fungal/ mycotic

Question 14

A fetus may also be aborted __________ but nonviable from ____________-

Answer 14

1. alive
2. late term EHV-1 abortion

Question 15

Determining fetal time of death

Answer 15

6-12 hrs: corneas cloudy and gray
12-18 hrs: emphysematous degeneration
24 hrs: Kidneys soft
36 hrs: skin discoloration, subcutis, gelatinous liver soft

Question 16

Fetus is more often autolytic subsequent to ___________ in utero conditions

Answer 16

chronic

Question 17

Thickened placenta

Answer 17

Reduces the fetus’s nutrition and slow removal of its waste products → intrauterine growth retardation (IUGR)

Question 18

Twinning

Answer 18

Most common non-infectious cause of equine abortion
Insufficient placentation is the reason of loss of twin pregnancies

Question 19

Transvaginal ultrasound-guided twin reduction

Answer 19

By embryonic to fetal stabbing
Yolk sac or allantoic fluid aspiration
Early reduction preferred
>35 days

Question 20

Twin reduction: 55-150 days gestation

Answer 20

Cranio-cervical dislocation- first cervical vertebrae from the cranium, serving the SC and disrupting the ligamentous attachments

Question 21

Late gestation dx of twins

Answer 21

Majority begin between 7-8 months gestation
Premature mammary development

Question 22

Essential samples for abortion dx

Answer 22

Fetus, placenta and maternal blood

Question 23

Bacterial abortions

Answer 23

Most commonly an ascending infection
Inflammatory response that impairs the placenta’s ability to sustain the pregnancy
Overwhelmed placenta = terminated pregnancy

Question 24

B- hemolytic streptococci

Answer 24

Sporadic abortion @ any stage
Associated with dirty environment
Fetal autolysis

Question 25

E. coli

Answer 25

Second most common bacterial cause of abortion
> 6 months when fecal contamination is overwhelming

Question 26

Leptospirosis (bacterial abortion)

Answer 26

Zoonotic disease, most subclinical
Cause diffuse placentitis
CS: jaundice, recurrent uveitis, fever, Hbunira

Question 27

Nocardiofrom actinomycete

Answer 27

G+ branching actinomycete
Mucoid exudate
Placental thickness and exudate ID by ultrasound

Question 28

Equine fungal/mycotic abortions

Answer 28

Primarily ascending infections
5th-11th month of gestation
Severe, chronic placental changes
Edema, thickening skin (alligator) and necrosis,

Question 29

Chronic placentitis (thickening) leads to…

Answer 29

↓ fetal nutrition
Intrauterine growth retardation
Small fetus for its gestational age

Question 30

What causes fungal uterine infections in barren mares?

Answer 30

Excessive abx use

Question 31

Mycotic abortion

Answer 31

Submit fetal skin or stomach contents and placenta (fresh and in formalin)

Question 32

Viral abortion

Answer 32

From equine rhinopneumonitis (EHV-1), equine viral arteritis (EVA), and arterivirus (RNA)

Question 33

Another cause of viral abortions

Answer 33

Contagious equine metritis from taylorella equigenitalis (CEM)

Question 34

EHV-1 rhinopneumonitis

Answer 34

Most common
Incubation: 8 days-4 months
Abort in latter pregnancy
Abortion storm with unvx herd (>90%)

Question 35

EHV-1 aborting mare

Answer 35

No premonitory signs
Spontaneous abortion
Fetus, placenta and uterine secretion all infective

Question 36

EHV-1 Prevention

Answer 36

Vx of non-preg animals (6 m immunity)
Vx of pregnant animals @ 3,5,7, 9 m gestation
Vx immunity ↓ by 8 weeks post vx

Question 37

Key dx for EHV-1

Answer 37

Fetus (fresh)
Mild fetal icterus
Hydrothorax/ hydroperitoneum
1-2 mm grey/ necrotic foci in liver (with eosinophilic IBs)

Question 38

Equine viral arteritis (EVA)

Answer 38

Dam sick before she aborts
Abortion during or immediately after acute maternal infection (incubation 6-10 days)
Placental/ fetal autolysis
Between 5th-10th m gestation

Question 39

Dx of EVA

Answer 39

Paired titers of affected mares/ stallion
Confirm shedding by stallion

Question 40

Contagious Equine Metritis (CEM)

Answer 40

Reportable
Poor breeding efficacy, early abortion of mares, vaginal discharge
Veneral transmission

Question 41

Trypanosoma equiperdum (Dourine)

Answer 41

Sexual contact transmission
Acute: silver dollar plaques on skin
Chronic: emaciation, paresis, intermittent fever and death

Question 42

Babesia equi and B. caballi (prioplasmosis)

Answer 42

FL
Spread by blood-sucking ticks
Dx by ID organism in RBCs

Question 43

Overo lethal white syndrome

Answer 43

Paint horses
Always fatal, both parents contribute
Full- term foals, normal gestation, all white with blue eyes → few hours after birth= colic