Week 8- High Risk Pregnancy in the Mare Flashcards
How do Milk Electrolytes change over the course of a high-risk pregnancy?
Normal changes
* Calcium, Sodium and Potassium
* Rapid prepartum increase in calcium of more than 10mmol/ l
* Relative concentrations of sodium and potassium invert with potassium greater than sodium 3-5 days before parturition
What are the abnormal milk electrolyre changes?
premature rise in calcium of more than 10mmol/ l associated with placental abnormalities
When does premature mammary gland development occur?
- typically occurs 2-4 weeks before foaling
- usually most prominent within 2 weeks of foaling but depends on mare parity
- lactations should only develop prior to or after foaling
What is premature mammary gland development most commonly associasted with?
twin pregnancies or bacterial placentitis
What are the main clinical signs of premature mammary gland development/ placentitis?
- vaginal discharge- often subtle, better to examine for discharge via the cervix via a speculum
What are the four main diagnostic tests for premature mammary gland development?
- Blood hormone analysis
- Progesterons
- Oestrogens
- Acute phase proteins
How might you do trans-rectal ultrasonography?
- enables assesment of the chorioallantois
- high frequency probe
- Measure combined thickness of uterus and placenta
How might you do a trans-abdominal ultrasonography?
- measure CTUP
- better for assesing foetal viability in late gestation
- asessment of quality and quantity of allantoic fluid
What does CTUP stand for?
Combined thickness of the uteroplacental unit
How would you measure foetal wellbeing?
- Foetal HR and HR variability
What are the signs of foetal compromise/ stress?
- Reduced frequency of accelerations
- Increased frequency of decellerations
- Persistent brady or tachy- cardia
What is the multimodal approach to treatment?
- Treat the infection
- Control the inflammatory cascade
- Prevent early delivery
What NSAIDS are used to control the inflammatory cascade?
- Flunixin meglumine
- Phenylbutazone
- Firocoxib
What would you use to promote uterine quiescence?
Synthetic progesterones
* Inhibit oxytocin receptors
* Prevents prostaglandin induced abortion
* Altrenogest
What would you use to maintain uteroplacental perfusion?
Pentoxyfylline (Aspirin)
What is ‘red bag delivery’ ?
- Emergency
foal is oxygen deprived, chorioallantois fails to rupture at the cervical start - owner should intervene immediately
What are the causes of infectious abortion?
- Bacterial infection
- Viral infection
- Fungal/ Parasitic Infection
What are the causes of non-infectious abortion?
- foetal appendice abnormalities
- gestation abnormalities
- maternal origins
- foetal origins
How would you diagnose vaginal varicose veins?
- speculum exam of vagina
- dilated veins on dorsal vaginal wall
How would you treat vaginal varicose veins
- laser cautery or topical treatments
What reproductive issues may cause colic in mares?
- Foetal movements
- First stage of labour
- Uterine torsion
- Uterine rupture
What are the clinical signs of colic in mares?
- low grade and intermittent
- severe if GI involvement
How would you diagnose colic in mares?
- speculum exam via the vagina
- palpation via rectum of broad ligaments
- transbadominal ultrasound
- ultrasound guided abdominocentesis
How would you treat a colicky mare?
- Rolling of anaesthetised mare
- Surgical correction
- Transcervical manipulation
What is the prognosis of a colic mare?
Good if <320 days gestation
Concurrent GI problems affect the prognosis
When does uterine rupture most commonly occur?
In Stage II labour
What are the causes of uterine rupture?
colic mare
- Hydrops
- Uterine torsion
- Foetal trauma
- Dystocia
What are the clinical signs of uterine rupture?
Colic + peritonitis signs
What is the treatment of uterine rupture?
- Surgical correction
- Agressive peritonitis therapy
What are the clincial signs of prepubic tendon rupture?
- Pelvic tilt
Elevated tail head
lordosis
udder shifts cranially
What are the two considerations in prepubic tendon rupture?
- Terminate pregnancy
- Maintain Pregnancy
What is the prognosis for prepubic tendon rupture?
- Poor as repair is difficult
- euthanaesia is considered
What is acute abdominal enlargement herniation?
Body wall hernia involving the internal and external abdomianl oblique and transverse abdominal muscles
What are the clinical signs of acute abdominal enlargement?
- Presents close to foaling
- severe painful oedema up to and including the mammary gland
- distorted abdominal shape
- reluctance to walk
- colic
What is hydrops?
- excessive accumulation of fluid within the allantoic compartment
- occurs in last preg trimester
- multiparous mares
- foetal abnormalities
What are the clinical signs of hydrops?
- sudden change in abdomianl size
anorexia, depression - difficulty walking
- uterine rupture or herniation
How would you diagnose hydrops?
- Grossly enlarged uterus via the rectum
- ultrasound to confirm diagnosis
What is the treatment for hydrops?
- Terminantion f pregnancy to save mare
- slow and gradual removal of foetal fluids
- dystocia/ retained foetal membranesv
What is considered to be a high risk pregnnacy?
Mares at risk of pregnancy loss
