Puerperium and Post partum conditions Flashcards
What changes of the reproductive tract occur during the puerperium?
Uterine involution
Elimination of bacterial contamination
Resumption of ovarian function
Lactation/suckling
When do mares come into heat after foaling?
Most mares come into heat about a week after foaling. Can be as early as 5 days or as long as 14days
What may be the consequences for a mare if she is not bred at foal heat?
Mares foaling date will slip later in the spring each year, will evntually need to take a year off to avoid producing summer foal
Foal will be born further away from Jan 1st (TB birthday), will be at a disadvantage when racing
What conditions should preclude breeding a mare at foal heat?
RFM
Dystocia
Metritis
When does the uterus of the normal cow become sterile?
6-8w post partum
What consequences are there for the cow when there is persistence of bacteria and bacterial endotoxin in the uterus?
Leads to post-partum infections: metritis, endometritis.
Subfertility caused by clinical metritis/endometritis
Reduced milk yield
What is the rationale for giving GnRH to post partum cows?
Return to cyclicity- causes ovulation, opens cervix to allow for flushing
What is the rationale for giving oestrogen to post partum cows (no longer possible under EU legilsation)
Similar effect to GnRH
Increased uterine blood flow and stimulate immune response as occurs in oestrus
What is the rationale for giving prostaglandin to to post partum cows?
- Luteolysis, so therefore reduced P4 concentrations and sends them into oestrus (Increased uterine blood flow and stimulate immune response)
- Encourages uterine involution and open cervix
What conditions can occur immediately postpartum?
Haemorrhage (vaginal/uterine artery) - common - pale mucous membranes
Nerve damage (obturator, gluteal/sciatic nerve) - -common - recumbency
Fracture (pelvis / femur / vertebral column)-rare - recumbency
Rupture (vagina, uterus, gastrocnemius muscle)
Toxaemia (puerperal metritis, retained fetal membranes) - common - recumbency
Hypocalcaemia - common- recumbency
Prolapse (uterus/cervix/vagina/bladder) - common - may be recumbent
What species does blood leak from the maternal surface occur in normally?
Carnivores- have an endothelio-chorial placenta
What are some causes of bleeding in other species?
Breakage of the umbilicus and blood leaking from the placenta
Uterine artery rupture (bleeding from uterine artery into the broad ligament may occur, in those cases external blood loss is not noted, rather collapse and death)
Vaginal artery haemorrhage in heifer after forced extraction
How would you diagnose a vaginal artery laceration in a heifer after a forced extraction?
By placing your hand in the vagina and feel the pulsing blood hemorrhaging from the side of the vaginal cavity and leak into the uterine cavity.
How would you manage a vaginal artery laceration?
place a hemostat on the artery to stop the bleeding, place 1 suture to keep the hemostat in place and return the next day to remove the clamp, blood flow in the vaginal region is then reduced and no ligature needs to be placed.
How may a uterine rupture present?
Prolapse of the dam’s intestines
What is the aetiology of uterine rupture?
May be by extremities perforating the uterus during repositioning and traction (particularly fetal monsters)
May be due to excessive vigorous retropulsion
May be by forceful movements due to asphyxia fetus
May be spontaneous with uterine torsion (friable uterus)
May be secondary to instrument perforation (fetotomy)
What is the prognosis of a uterine rupture (As well as uterine artery rupture)?
Generally very poor. Peritonitis and sepsis occurs if a perforating lesion exists. Closing the lesion intra abdominally is difficult, as is everting the uterus to suture the lesion outside the animal.
For those reasons treatment is generally not attempted.
Which animals is vaginal rupture often seen in?
Obese heifers with assisted calvings
What can prolapse into the vaginal cavity during a vaginal rupture?
Usually just peri-vaginal fat.
Can sometimes get small intestines, bladder or uterus.
What is a complication of a vaginal rupture?
Secondary infection, necrotic vaginitis (F. necrophorum & Clostridia) can be life threatening
What should you advise to a vaginal rupture case?
Clostridial vaccination preventatively and clean calving procedures.
What can you do to prevent vaginal ruptures?
Take the time and work with the abdominal contractions when the animal is in parturition to give the soft tissue in the vaginal cavity sufficient time to relax
What species are perineal injuries most common in and why?
mare as the result of a foal’s foot forceful perforating the roof of the vagina leading to a rectovaginal fistula (RVF)
When are RVF repaired?
At least 1 month after
