11. Postpartum period - BP | Quizlet

What does the postpartum period in mares include

- last weeks of pregnancy

- parturition

- puerperium ending with involution of the uterus

What is the first heat altering foaling called & when does it usual occur

"Foal heat"

Occurs 9th day after birth / PP

May be used for AI but success rare is not high 30-60%

What is the success rate of AI in foal heat

30-60% not high but may be up to 80%

List postpartum disorders that require immediate assistance

1. Haemorrhage in gentle organs

(Horn usually inside close, can be inside also)

2. Uterine damage / rupture of the uterus

3. Uterine horn intussception

4. Damage to the vagina leading to prolapse of intestines /injury &/or bladder

5. Uterine prolapse

6. Prolapse of rectum

7. Retained placenta

Hemorrhage in the gentle organs

1. How does it occur

2. Mortality rate

3. Who is it most likely to affect

4. Symptoms

5. Predilection site

6. Diagnosis

7. Prognosis

Hemorrhage bc dengenerative changes of the uterine arteries, rarely bc of dystocia

50% die

Occurs in mares of all ages

Colic symptoms

Occurs in pregnant horn of uterus

Diagnosis - fresh blood in abdominal cavity

Prognosis - depending on site of rupture

- good: region of broad lig & hepatoma forms

- bad: rupture of lig & intra abdominal haemorrhage

What is the main cause of hemorrhage of the genital organs

Degeneration of the uterine arteries after parturition, rarely bc of dystocia

What percentage of mares die due to hemorrhage of the uterine arteries

50%

where does hemorrhage of the uterine arteries mainly occcur

In the pregnant horn

How is hemorrhage of the uterine arteries diagnosed?

Blood in the abdominal cavity & colic symptoms

What is the prognosis for hemorrhage of the uterine arteries

Prognosis - depending on site of rupture

- good: region of broad lig & hepatoma forms

- bad: rupture of lig & intra abdominal haemorrhage

List degrees of perineal injury

1st degree perineal laceration - not bad, small wound

2nd degree perineal laceration

3rd degree perineal laceration

Recto-vaginal fistula

Can you immediately repair perineal injury?

No have to wait, bc after parturition everything this is swollen need to wait a few weeks before surgery

How long should you wait before repairing a perineal injury due to dystocia

1 weeks, to allow swelling to go down

What is the incidence rate & breed predisposition for retained placenta

2-10.6%

Cold blooded mares most often

Friesian mares!

Also occurs in warm blooded

when is placenta considered retained

30mins ->3hrs

What risk factors can predispose a mare to retaining her placenta

1. Placentitis

2. Abortion

3. Short or pro-longed gestation

4. Uterine atony

5. Dystocia

6. Advanced age

7. Previous retained placenta

8. Frisian mares - 35%

What are the consequences of retained placenta

1. Endometritis

2. Peritonitis

3. Laminitis**

4. Endotoxemia

5. Lower fertility

Possible causes of retained placenta / foetal membranes in mares

1. Physiological: transferred or twin pregnancy

2. Histological disorders of development

3. Hormonal - oxytocin def or too high

4. Biochemical - enzymes disorders & mineral def

5. Bad environment

6. Dystocia

7. Previously retained

How to manage necrotising vaginitis

Manual removal of affected tissue

General treatment - ab, NSAIDs etc.

catheterise bladder - Lesion at urethra

Consequences of cervical damage

1. Endometritis

2. Conception issues

3 issues maintaining pregnancy

Consequences of damage to vulva during foaling

Leakage

Suction of air - pneumovagine

Promoting inflammation of uterus

What is lochia?

Vaginal discharge after delivery composed of endometrial tissue blood and lymph

What is lochia retention (lochiostasis)

Retention of normal vaginal discharge after foaling

Occurrence of lochiostasis

Accounts for 8% of pp need for medical & veterinary intervention

16% of mares pp

Older mares >14yrs & Multiparous are likely to have this

What is the consequences of lochiostasis

Reduced efficiency in mating in foal heat

Cause of endometritis puerperalis

Occurs due to retention of fluid causing irritation of the uterus

Predisposing factors to uterine infections PP / endometritis puerperalis

1. Vulvular damage

2. Perineal tear

3. Cervical trauma

4. Uterine or vaginal insertion of obstetric instruments

If you leave endometritis untreated what can it lead too

Metritis

Symptoms of endometritis puerperalis

1. Various types of vaginal discharge

2. Colic

3. Reduced appetite

4. Reduced milk production (check foal)

5. May lead to laminitis

Main consequences of advanced stage of endometritis

Laminitis

What is PBIE & aim of it

Persistent / post breeding induced metritis

Inflammation of the endometrium, a physiological reaction that occurs in endometrium of mares 48hrs after breeding

Aims to expel seminal plasma, excess sperm, microorganism & debris from uterine lumen to prepare of arrival of embryo

Mostly likely to occur when everything is close together:

PP, heat, mating, persistent breeding

When does PBIE occur

48hrs after breeding

What causes increase in likelihood of PBIE

What everything occurs close together

parturition -> heat -> mating -> persistent breeding

Overview of endometrial cytokines in mares resistant & susceptible to endometritis from before to 24hrs post breeding

0hrs - IL1B, TNF-a, IL6 - susceptible mares

2hrs - increase por inflam cytokines in both resistant & susceptible

6hrs - critical time in developing susceptibility

Resistant mares have high anti-inflam cyokine IL10, 1RN, ^

12hrs - susceptible mares increases neutrophils

Initiation resolution of inflammation

24hrs - cytokines return to base level,

In suss mares - neutrophili & up reg of pro inflam cytokines

PBIE: 0hrs and 2hrs which pro inflammatory cytokines can be seen in susceptible & resistant mares

0hrs -> Susceptible - IL-1B, TNFa, IL-6, Resistant - none

2hrs -> BOTH

At what time after o sent of PBIE is the critical time for developing susceptibility

6hrs after, bc resistant mares start producing anti-inflammatory cytokines

which cytokines in resistant mares are procured 6hrs into PBIE

Anti-inflammatory cytokines - IL-10, IL1RN, IL-6

Difference in susceptible & resistant mares response to PBIE at 12hrs

Resistant - resolution of inflammation

Susceptible - neutrophilia

What occurs after 24hrs in PBIE in resistant & susceptible mares

Resistant - cytokines return to base level

Susceptible - neutrophilia & pro-inflammatory cytokines persist

What is seen in USG of PBIE

Fluid with white drops tissue or fiber cells

When does the embryo migrate from uterine tube to uterine lumen & why

Between 144-168 hrs after ovulation (6-7d) (1-2 weeks after foaling)

Bc increase progesterone, cervical tone

Side effects of prolonged PBIE

Persistent neutrophilia & excess intralumnal fluid accumuation, prolonged pro-inflammatory cytokines are all

- embryo toxic & lead to decreased fertility

- decreases the fertility of the mare