Postparturient prolapse of the uterus Flashcards
common complication
of the third stage of labour in the cow and the
ewe.
fetal cotyledons have separated from the
maternal caruncles.
Prolapse of the uterus
prolapse of the uterus occurs less frequently in the cow and is rare in the mare and bitch t/f
f - less freq sow
e prolapse is generally a complete inversion of the gravid cornu
inversion is generally partial and comprises
one horn only
prolapse are generally partial only
ruminants
sow and the
bitch
mare
prolapse in cow: The occurrence seems to be affected by seasonal
as well as regional factors, t/f
____ (of the dairy breeds) are more
often involved than are heifers
t
multigravida
. In the majority of
instances the prolapse occurs within a few days
of an otherwise normal second-stage labour,
although in some it may be delayed several days t/f
r. Ocassionaly, where delivery is achieved by heavy
traction, the uterus prolapses immediately after
the calf is withdrawn. t/f
0f - few hours
f - rarely
The only conceivable force
that could lift the heavy uterus out of the abdomen
into the pelvis and thence propel it to the exterior
probable additional
forces:
abdominal straining
Gravity, traction
Straining occurs normally during the third
stage and is synchronous with the continuing peristaltic contractions of the uterus which occur every
3 and a half - 4 minutes
particularly apt clinical
observation that many cases of uterine prolapse
show a simultaneous hypocalcaemia or ___
which is known to be conducive to uterine _____.
milk fever
inerta
The authors believe, therefore, that uterine inversion and prolapse are associated with the onset of
uterine inertia during the third stage when a
portion of detached afterbirth occupies the birth
canal and protrudes from the vulva t/f
t
reater frequency of prolapse in heifers than cows,
in beef rather than dairy cows and in closely confined and highly fed cows rather than those at
range t/f
f - cows than heifers, dairy than beef
Vandeplassche and Spincemaille (1963) are
of the opinion that the pregnant horn does not
undergo a progressive inversion from its anterior
extremity; only the _____ invert. The
actual protrusion of this portion can occur very
quickly in one bout of straining
posterior 2/3
In Australia, uterine prolapse is a feature
of the disease seen in sheep grazed on ___ pastures containing oestrogenic substances
clover
signs of uterine prolapse in cows
recumbent, and if in
lateral recumbency rumenal tympany will be
prominent, but occasionally the cow is standing
with the everted organ hanging down almost to its
hocks
professional assistance is forthcoming within an hour or two of its occurrence, the
prognosis is
good
Patterson
et al. (1979) reported that 65% of cows became
pregnant after uterine prolapse t/f
f - 40 only
post-mortem examination in such cases it is
found that death was due to internal haemorrhage
consequent on the weight of the everted organ
having torn the ____ and the _____
artery
mesovarium and ovarian
tx procedures for uterine prolapse
wrap the prolapsed viscus in a large
towel or other suitable material to prevent further
contamination if, as is likely, the cow is recumbent; if she is standing, the organ should be supported by a large towel or sheet held by people on
either side, until professional assistance is forthcoming
Replacement of the everted organ.
Amputation of the everted organ.
It is good practice to give a preliminary
injection of _____ (as for milk
fever) and to relieve r____, if present,
by passing a stomach tube
cbg, rumenal tympany
The
cow is placed in ____ recumbency with both
hind legs pulled out behind her (weight therefore
being taken on her stifles).The assistant sits astride
the cow, facing the rear, and holds the cow’s tail up
vertically. This manoeuvre causes the slope of the
vulva to be upwards. The veterinary surgeon kneels
between the cow’s hocks and supports the weight
of the prolapsed organ on his or her thighs, prior
to replacement
sternal
give epi anesth? yes or no
wash the everted organ with
yes (helps prevent straining esp if with xylazine)
normal saline soln
(If the fetal
membranes are already partially detached and
their complete removal can be carried out easily
and without injury to the caruncles, this should be
done. But when attachment is complete or when
attempts at detachment are associated with haemorrhage, it is better that the organ be replaced
with the membranes still adherent. The subsequent management of the retained fetal membranes should be on the principles outlined on)
The prolapsed organ should be palpated in
order to detect the possible presence within it of a
distended urinary bladder; if such is the case, it
should be relieved by the use of a _____
catheter
When this has been accomplished, the cervix
should lie unoccupied at the level of the ____, and if the whole uterus has passed the
cervix it will promptly regain its normal position.
pelvic brim
To ensure complete replacement of the uterus,
_____ litres of clean warm water are delivered into
the uterus by gravity feed and immediately
removed by siphonage,
To help
restore uterine tone, and thus to prevent recurrence of the prolapse, ____ should be given plus?
9-14
oxytocin
CBG, parenteral antibiotics
a last resort in those
cases in which the uterus has undergone such severe
changes The prognosis is grave, and it is doubtful if it can be justified on welfare ground
Amputation of the everted organ
it is preferable to leave them, the caruncles to the cotykedons,
attached and return them with the uterus in ewe t/f
caudal epidural anaesthesia should also be given t/f
Anaerobic infection should
be anticipated and prophylactic antibiotic used t/f
t
t
t
The disorder is relatively uncommon in this
species
. It is likely to be related to the expulsion of
the fetal membranes which tend to separate from the endometrium much more readily in the
uterine body but seem to be more firmly attached
at the horns, particularly the
mare
tip
The continual uterine contractions, and the
subsequent straining as the mass of the fetal membranes enter the pelvis, cause the whole of the
uterus to be inverted and prolapsed t/f
t
This is the reason why,
before repairing the uterine incision during a
caesarian operation, the ____ should be
separated from the endometrium for some distanc
allantochorion
Therefore, it is suggested that in spontaneous cases of uterine
prolapse in mares are
This is also why the use of
an ______ is the preferred method of treating retained fetal membranes
weight of those portions of fetal membranes that
are dependent from the vulva and the traction
which it exerts on the uterus during the passage of
a peristaltic wave along that organ
oxytocin drip
mares need to be under
caudal epi,
or general, hindquarters raised if fractious
Before replacement, an attempt
should be made to remove the fetal membrane but
only if the allantochorion can be readily separated
from the endometrium without causing haemorrhage; if this is excessive then as much as possible
should be cut away before replacement.
If the
replacement is made under caudal epidural anaesthesia with the mare standing it is helpful to have
assistants support the everted organ; as well as
providing physical assistance, it also counteracts
the effects of passive venous congestion
uhuh
in mares, The uterus should be replaced starting at the
part adjacent to the vulva as described in the cow.
The technique is easier than in the cow because of
the absence of the _____;
carucnles
in mares, Vulval sutures
should be used. t/f
anti inflam given as there is high risk of
f - never!
laminits
unable to tolerate uterine prolapse, unless the
uterus is replaced easily and quickly;
simple
most extreme
sow
(due to fatal hemorrhage and shock)
one horn
both horn
the sow should be under caudal epi as well t/f
If the uterus is traumatised, then _____
is preferable, particularly in commercial pig units
because there will be a delay before she can be
served by the boar and become pregnant.
f - general
euthanasia
An
alternative procedure which merits a trial is to
____the uterus back into the abdomen with the
aid of water pressure. The sow is placed on her
side, head downwards, on a slope and the end of
a soft tube of rubber or plastic, of ____ diameter
and ____ long, is gently passed into the stoma
of the prolapsed viscus and eased along as far as
possible.
float
2cm x 1.5m long
By this means the whole
uterus is not only returned but completely
replaced without manipulation
In the case of
non-commercial pet sows, replacement can be
attempted under general anaesthesia via a _____ as described below for the bitch
laparotomy
in bitch and queens, 3 ways
s more
usual, however, to carry out
prognosis:
laparotomy can be performed, and with simultaneous external manipulation and abdominal
taxis replacement
‘external’ hysterectomy on the prolapsed organ.
favourable after amputation
favorable
