Lecture 19,20 - Pregnancy Diagnosis Flashcards
When you make a pregnancy diagnosis, is 95% chance good enough?
No - when in doubt, be absolutely uncertain. Either 100% she is pregnant or 100% she is not pregnant. Anything else, you say “I do not know”
To see if the bovine has a persistent CL, you can measure progesterone between days ____ and ___ in serum and milk.
18-23
Is measuring progesterone levels pregnancy specific?
No, but highly suggestive
Why might a progesterone measurement in the bovine result in false positive?
Was pregnant, but lost the pregnancy after maternal recognition of pregnancy.
In the bovine, you can do a transrectal palpation for pregnancy detection beginning at ___ days after insemination.
30
What are the four positive signs of pregnancy in the bovine?
Transrectal palpation of the amniotic vescile, fetal membrane slip, fetus, and/or placentomes.
When can you palpate the amniotic vesicle in the bovine?
Day 30 (35)
When can you palpate the fetal membrane slip (allanto-chorion) in a cow?
from day 35 (42)
When can you palpate the fetus in the bovine?
From day 60
When can you palpate placentomes in the bovine?
Day 75 (90)
Is palpating a fetus in the bovine trasnrectally a definitive diagnosis for pregnancy?
Yes
Upon transrectal palpation, where can you locate the pelvic floor? Is it the same in older cows who have experienced many pregnancies?
On the pelvic floor
In older cows, the caudal ring of hte cervix can be located over the brim of the pelvis, even when not pregnant.
In the bovine, assymetry of the uterine horns, CL on ovary ipsilateral to large horn, inability to retract cervix into the pelvis, and fluid inside the uterine lumen are all _____ signs of pregnancy.
Suggestive (NOT positive)
Besides a suggestive sign of pregnancy, what else can fluid inside the uterine lumen suggest?
- Pyometra
- Hydrometra
- Urinary bladder
How do you differentiate a pyometra from fetal fluid in the bovine?
In a pyometra, the uterus has thick walls, both horns are expanded, and there are NO placentomes/membrane slips/or a palpable fetus.
How do you differentiate a hydrometra from fetal fluid in the bovine?
A hydrometra is accumulation of uterine milk in the abscence of infection. The uterus has thin walls, unlike a pyometra that has thick walls. And there are no palpable placentomes/membrane slips/fetus.
What is a fremitus?
A fremitus is a palpable vibration in the middle of the uterine artery due to increased blood flow to the uterus. This can be suggestive of pregnancy, but not a positive finding.
Fremitus in a pregnant bovine can be felt from ___ months in the pregnant horn, and from ___ months in the contra-lateral horn.
5; 7
When might fremitus occur other than pregnancy?
Fremitus will be present in any condition associated with increased blood flow to the uterus, including pyometra, hydrometra, or post-partum.
In the bovine, a uterus that is not retractable is usually associated with pregnancy > __ days.
70
Differentials for a non-retractable uterus in the bovine other than pregnancy:
- Poor hand strength or technique by palpator
- Pyometra
- Hydrometra
- Fetal mummy (uterus remains enlarged with dead fetus)
- Uterine/ovarian tumor
- Adhesions (abdominal surgery leading to adhesions of the uterus)
What is the first thing you can palpate during gestation in the bovine?
Amnionic vesicle
Why is palpating the membrane slip in the bovine useful from days 35-90 of gestation?
Can first be felt on day 35 of gestation, and after day 90, other structures such as placentomes can be used to detect pregnancy.
The membrane slip can detect a pregnant horn at 35 days, and can detect in a non-pregnant horn at 70 days.
WHen palpating for a membrane slip in the bovine, compress the uterine horn immediately ____ to the cervix and allow the ______ membrane to slip between the fingers.
Cranial; chrioallantoic
Descent into the abdomen of the bovine fetus begins at ___ days of gestation.
70
The descent of the fetus is in the bovine is complete at ___ days of gestation.
150
When does the fetus start to “ascend” in the bovine, i.e. fetus starts to expand, allowing parts of him to protrude through the rectal wall?
210 days
When is the fetal “ascent” complete in hte bvoine during gestation?
240 days
By in large, it is difficult to feel the fetus during during which trimester of pregnancy? And in most cases, you can feel the fetus in which trimester?
During hte first trimester, you most likely will not feel the fetus (in some cases, as early as 70 days however). It is difficult to feel the fetus in the 2nd trimester (days 90-180). And you can usually feel the fetus easily by the third trimester until term.
In the bovine, the crown-to-nose size at 70 days is how many fingers? At 120 days?
At 70 days - 1 finger; at 120 days - Hand + thumb
In the bovine, the fetus at two months is close to the size of what animal?
Mouse
In the bovine, the fetus is close to the size of what animal at 9 months?
Small calf.
How are placentomes formed?
By union of the fetal cotyledons with the maternal caruncles.
The cow has ___ caruncles arranged in __ rows.
120; 4
Whan palpating for prengnacy , it is important to palpate at least ___ placentomes. Why?
3 - if you palpate only two, they can be mistaken for the ovaries
When palpating placentomes in the bovine, the size of hte placentomes located near the ____ is used to estimate stage of gestation.
cervix
Are placentomes in the bovine just as discrete during the third trimester or pregnancy as the second?
No, placentomes are discrete until about day 180 of gestation, where they start to become flatter and more plaque like.
The size of a placentome at 90 days of gestation? At 180 days?
90 days = 1-1.5 cm (dime)
180 days = 4-5 cm (eisonhower silver dollar)
What can you palpate in a bovine during her first trimester?
Amniotic vesicle (D30+)
Membrane slip (D35+)
Fetus (D60+)
Placentomes - BARELY palpable in late first trimester.
What can you palpate in a bovine during the second trimester?
Placentomes!
Fetus is likely out of reach, but may be found by ballottement
What canyou palpate in a bovine during the 3rd trimester?
Large fetus easily reachable in caudal abdomen
Placentomes may be hard to palpate as uterine wall becomes taut + placentomes feel thinner and less discrete
You can detect pregnancy in the cow as early as day ___ via transrectal U/S.
25
On U/S, a non-pregnant uterus is hyperechoic or hypoechoic?
Hyperechoic - ventral part of the dorsal horn and dorsal part of the ventral horn lie ontop of eachother
Using U/S, what is the earliest day that you can see placentomes in the bovine?
day 50
Using U/S, how can you tell the difference between day 33 and day 50 of gestation in the cow?
Day 33 - you see an embryo inside an amniotic vessicle (circular)
Day 50 - you can actually see a fetus elongating
To do an accurate determination of gestational age by U/S, it needs to be done in what trimester only?
First trimester only!!
Fetal sexing with transrectal U/S can be done on day 60-75 to find the location of _____, or between days 80+ to find the ____ or ____.
Genital tubercle; scrotum or teats
How can you determine the sex of the fetus by looking at the genital tubercle between 60-75 days?
The genital tubercle is in a sex-neutral position for 60 days, until which in the male fetus, it will stay in the same position, while in the female fetus, it it move to come lie underneath the tail head (will form the vulva).
Describe BioPRYN
Biochemical pregnancy test that tests for pregnancy specific protein B (PSP B) from day 30+ in cows and nannies, and from day 22+ in ewes.
It is a lab test, and cannot be done on the farm.
Describe the PAG test
PAG tests for pregnancy associated glycoprotein from day 25+ in cows.
Can be done on the farm as an ELISA.
Between BioPRYN and PAG, which test can be done on the farm vs. sent in to the lab?
BioPRYN has to be sent in to a lab, but PAG can be done on the farm.
When can you get a false positive with the PAG test?
If the cow is within the first 2-3 months of post-partum.
Describe estrone sulfate pregnancy test
Estrone sulfate is produced by the placenta, and present in the cow’s blood. The biochemical test will only detect estrone sulfate 100+ days of gestation.
It is a lab test, and cannot be done on the farm.
Confirms a live fetus, because a live fetus needs a live placenta, which is responsible for producing estrone sulfate.
It is rarely used.
In the mare, you can determine if a mare is pregnant by U/S as early as ___ days after ovulation.
10
Even though you can detect pregnancy in the mare as early as 10 days after ovulation using U/S, why is it the standard of practice to perform U/S test 14 days after ovulation?
Easier to tell that the mare has twins at 14 days than 10.
Systemic examination of the equine repro tract wiht U/S when diagnosing pregnancy is crucial - need to at least go through uterus, horns, and ovaries 3 times. Why is this?
Becuase early embryos are tiny and CHANGE location!!!
On U/S in the mare, always count the ___!!!!
CLs
Why do we always count the CLs in the mare?
A mare typically should have one CL, however, if hte mare is pregnant with twins, they almost always come from two different oocytes (meaning two separate ovulations and two separate CL formations). Therefore, two CLs can be indicative of twins.
On day ___, the embryo in the mare fixes.
16
When can you see accessory CLs in mare with U/S?
After D35
All twins in horses are ____ (dizygotic/monozygotic)
Dizygotic
In the mare, a twin pregnancy where two embryos are fixed in the same horn is called _____, and is more common with _____ ovulation.
unilateral fixation; asynchronous
T/F: All ovulations in the mare are equally fertile in the mare, even if ovulations occured asynchronously.
T
How do you differentiate an endometrial cyst from an embryo in the mare?
When you are planning to breed a mare, the first time you see her make a cyst map on her breeding record - documenting the size and location of the cyst.
What is the deprivation hypothesis?
When twins in the mare fix next to each other, they can undergo deprivation - the process of them being apposed to one another decreases endometrial contact that one or both embryos have. WIthou tthis contact, they are unable to go on and make a good placenta.
Twin pregnancies are likely to reduce to a single pregnancy on their own with ____ fixation.
Unilateral
Do bilateral fixation twins also follow the deprivation hypothesis? How?
Yes, but won’t happen until later in gestation once they notice eachother. One fetus will usually take a uterine horn and the tuerine body, and the other will get stuck in just the horn, will get stressed, and die - setting of a cascade of events, leading to premature pregnancy of the other twin.
What is the twinning tree used for?
A way of calculating what the probability that two embryos will either self-reduce to a single pregnancy or not.
What can you do to manage twin pregnancies in mares early on (before day 16)?
Examine the mare during estrus to count follicles.
Pregnancy exam at 12-15 days - include the ovaries to count CLs! and re-examine when 2 CLs, but only 1 embryo is present.
Rupture one embryo before day 16.
It is easiest to rupture one embryo in a twin pregnancy in the mare before day ___.
16
In a mare twin pregnancy, if only one embryo is fixed, which one should you reupture?
Fixed
If its been 16-32 days of a twin pregnancy in the mare, what should you do?
Wait for a spontaneous reduction
If it is day 33 of a mare twin pregnancy, what should you do?
At this point, endoemtrial cups producing eCG have developed. So if she does get rid of her pregnancy, she can be pseudopregnant, and you need to use PgF to get rid of both twins. Otherwise, you can try to do a transvaginal U/S guided puncture and asparate some allantoic fluid and hope you did not induce collateral damage into the other embryo.
Between days 36-60 of mare twin pregnancy, what can you do?
Transvaginal U/S guided puncture
Between days 60-100 of mare twin pregnancy, what can you do?
Leave it alone, difficult to do anything at this point.
At day 100-130 of mare twin pregnancy, what can you do?
Transabdominal U/S guided puncture OR transuterine decapitation via laparatomy (ethical issues)
Describe how to mannually rupture one embryo before day 16
Move the embryo to the tip of the uterine horn.
Confirm with U/S that it is at the tip of the uterine horn.
Apply pressure - and you can feel it give way. You cannot actually palpate the embryo, but you can feel pressure release when it is ruptured.
You can see anachoic fluid on U/S after rupture
Upon rectal palpation in the mare, an early bulge (on day 20) is suggestive of _____.
twins
Normally you can feel a ventral bulge in the pregnant horn of mare from days ___ to ___.
22-25
You can feel a ventral bulge and dorsal bulge in the pregnant horn of a mare from day s___ - ____.
30-35
You can feel a very high uterin tone around what days when mare is pregnant?
16-20
High tone, but no bulge upon palpation can indicate:
Early in pregnancy (day 16-20) OR pseudopregnancy type I (loss of embryo after maternal recognition of pregnancy)
You can palpate a ventral kink in the non-pregnant horn aroun ddays ____ in the pregnant mare.
18-24 days
At what day in the mare do endometrial cups start to form?
Day 35
At day 60 of pregnancy in the mare, the uterus begins to move forward and downward, and pulls the ____ closer together.
Ovaries
Can you palpate the entire reproductive tract at day 60 of gestation in the mare?
Yes
At 3-5 months of gestation, you can palpate a fluid-filled uterus, and hte fetus is identified by ______.
Ballottement
Uterine descent in the mare is completed by ___ months of gestation.
7
When does ascent of the mare fetus begin?
7 months
When is ballottement of the fetus difficult in the mare? Why?
From 7 months to term - b/c most of the fetus is in cranial presentation (head is heading towards the exist) - making it impossible to feel their feet, and you can only feel the back of their head.
Can you predict fetal dystocia due to fetal malposture?
No
When is a biochemical test indicated in the mare over an U/S?
Fractious mares and miniature mares
eCG pregnancy serum test can be done between days ___ and ___ of gestation in the mare.
Can be done on days 40-100 of gestation
Which biochemical pregnancy test can be done in the mare, but not in donkeys?
eCG
T/F: eCG serum pregnancy test is pregnancy specific.
False - will not detect fetal death after day 35 (after endometrial cups develop) resulting in pseudopregnancy type II
Do we measure estrogen in the urine to test for pregnancy in the mare anymore?
No
Estrone sulfate can detect pregnancy in the mare after ___ days of gestation in the serum.
100
T/F: Estrone sulfate pregnancy test after 100+ days in the mare is pregnancy specific test.
True
When can you sex the fetus in the mare?
Same as in the cow:
day 60-75 - for location of genital tubercle
Day 80+ - for scrotum/teats
Definitive standard for pregnancy diagnosis in ovine and caprine:
Transrectal U/S from day 25-50
How early can you see placentomes via U/S in the ovine and caprine?
Day 25
In ovine and caprine, it is important to accurately establish the number of fetuses. Why?
Sheep and goats can have a problem with not getting enough nutrition with more fetuses. Therefore, if you know the number of fetuses, you can feed and manage her differently.
When can you do a transabdominal U/S in ovine and caprine?
From 45 days on
What is the best gestational window for counting fetuses with transabdominal U/S?
45-90 days (at 90 days - fetuses are too big to know if you are seeing one fetuse or two different fetuses when comparing the R and L side.
How early can you do U/S to detect pregnancy in the sow?
As early as days 18-20, easier on day 23
Do we normally count embryos in the sow with U/S?
No, we just expect that she will have a lot
A-mode U/S vs B-mode U/S in swine:
A-mode U/S –> detects sound (headphones)
B-mode U/S –> produces 2-D image
MC detection of pregnancy in the alpaca
Behavior
If the alpaca spits off at 7 days after breeding, she might have ____. If the alpaca spits off at 14 days after breeding, you know she has ____, but you are not sure if she is _____. If the alpaca spits off 21 days after breeding, you can assume she is ____.
ovulated
ovulated
pregnant
Pregnant
You can do a serum preogesterone test at 21 days in the alpaca to confirm luteal persistence. This is > 90% correct, but why not 100%?
An alpaca can lose an embryo after maternal regonition of pregnancy - and retain a CL (“pseudopregnancy”)
Even though most clients will perform behavior tests to determine pregnancy in the alpaca, what is the standard of practice?
U/S - transrectal
T/F: Rectal perforations during U/S in the alpaca are fatal.
True
You can detect fluid in either horn of the alpaca when she is pregnant as early as day 13. However, because transporting alpacas can be very stressful, when do you want to usually wait to do the U/S?
Until you do the spit test 3 times -after day 21
In the alpaca, after day 20, all the embryos are in the ___ uterine horn, regardless of side of ovulation.
Left
In the canine, we can start to detect pregnancy by palpation beginngin ___ days after the LH surge.
25
When palpating a pregnant canine from days 25-34, you can feel a string of ____ beeds, representing conceptual swellings.
Spherical
When palpating a pregnant bitch from day 35-44, you can palpate ____ beads, instead of spherical beads.
Ovoid
Afer 45 days post LH surge in a pregnant bitch, can you palpate inividual conceptual swellings?
No, become confluent after D45
Using an U/S in the pregnant bitch, you can detect the vescicle at ___ days after LH peak, the embryo at ____ days after LH peak, and the heart beat ___ days after LH peak.
20; 23; 25
T/F: It is almost impossible to tell how far pregnant a bitch is using simple U/S. One must use a really good U/S machine.
True
You can determine the litter size via radiographs during the ______ of gestation.
Last week
You can start to see calfication of the fetuses in the bitch with radiographs at ___ days post LH surge.
45
Relaxin can be used to detect pregnancy in hte bitch by taking a serum sample on or after day ____ after LH surge.
25
Is measuring relaxin on or after day 25 after Lh surge in hte bitch pregnancy specific?
Yes
