Pathology of Puerperium Flashcards
what are 4 factors that predispose to postpartum disease
- stress of parturition
- open cervix
- placental sloughing (retained placenta)
- metabolic stress
uterine prolapse
muscle hypotony or dysrhythmia of contractions, hypocalcemia, or hyperestrogenism leading to uterus to prolapse out of the vagina
species: ruminants, pigs
predisposes to infection/sepsis; causes congestion, edema, hemorrhage, necrosis, sepsis
uterine rupture
sequela to uterine torsion, common in assisted deliveries
causes hemorrhage and hypovolemia
uterine involution
NORMAL remodeling of the pregnant uterus to resting state
occurs in all species
sloughing of attachment sites, re-epithelialization, endometrial remodeling, myometrial contraction
retained placenta
placenta that does not get expelled within 12-24 hours (ruminants) or 3 hours (horses)
can become a nidus for infection; slows down involution
postpartum endometritis
inflammation of the endometrium after parturition
caused by dystocia or assisted delivery
slows down involution
dogs - usually occurs during diestrus
ruminants - usually occurs during postpartum
subinvolution of placental sites
delayed involution; area of placental attachment do not regress
occurs in dogs
causes prolonged vaginal bleeding (beyond the normal 1-6 weeks), hemorrhage, hypovolemia
defense mechanisms of the mammary gland
- internal sphincter and wax plaque
- squamous lining of teat
- milk flow
- resident macrophages
- antibacterial secretions
developmental mammary defects
supernumerary teats, webbed/siamese teats, atresia of streak canal
only clinically significant if unable to milk/nurse
postpartum hypocalcemia
occurs in cows
high Ca demand after parturition –> hypocalcemia
can be clinical or subclinical
- clinical: paresis, slow uterine involution, reduced neutrophil function
predisposes to mastitis/metritis
eclampsia
hypocalcemia that occurs at peak lactation
occurs in dogs
tetany, tremors, ataxia, seizures, etc
galactophoritis
inflammation the ducts and sinuses
galactorrhea
inappropriate lactation
ex. pseudopregnancy, male goats
galactostasis
failure of milk letdown
caused by low OT release from fear/stress or lack of mammary stimulation
agalactia
failure of milk production
“hard udder” - caprine arthritis and encephalitis (CAEV) or maedi-visna virus in sheep
mastitis
inflammation of the gland acini
occurs in ruminants (rare in horses and small animal)
caused by an ascending bacterial infection
inflammation does NOT cause death, cytokine storm in response will cause death
obligatory mammary pathogens
staphylococcus
streptococcus agalactiae
mycoplasma
environmental contaminant pathogens
E. coli
truperella
types of mastitis
- severe necrotizing
- severe
- suppurative
- granulomatous
- subclinical
severe necrotizing mastitis
gangrenous; caused by endotoxins (gram negative) or exotoxins (gram positive) that induce cytokine storm leading to vascular necrosis and leakage –> acute phase reaction
bacteria: E. coli, clostridium, staphylococcus, streptococcus
severe mastitis
similar pathogens as necrotizing mastitis but NO clinically apparent necrosis or systemic effects
limited to mammary gland only
suppurative mastitis
cause by pus-forming bacteria
truperella, mycoplasma, strep. dysgalactiae
subclinical mastitis
higher than normal somatic cell count with no clinical signs
main significance is economic loss
cystic mammary gland dilation
non-neoplastic enlargement
occurs from downstream atresia –> forms cysts without milk production
