Bovis ISSN 2398-2993

Uterine prolapse

Synonym(s): Calf bed out

Contributor(s): Gwen Rees, Mike Reynolds

Introduction

  • Cause: sporadic but relatively common condition usually seen immediately after calving; concurrent hypocalcemia.
  • Signs: uterine tissues protruding from the vulva, usually in a recumbent cow.
  • Diagnosis: visual diagnosis by presence of prolapsed uterus.
  • Treatment: replacement of the prolapse is possible in most instances.
  • Prognosis: studies suggest approximately 80% survival rate after replacement, with good prognosis for return to fertility.

Pathogenesis

Etiology

  • Invagination of the tip of a uterine horn from trauma Dystocia, decreased myometrial tone Milk fever, manual extraction of the fetus Calving aids: correct use or a combination of these factors.
  • Gravity and/or abdominal straining, combined with myometrial atony, leads to progressive eversion of uterine tissue until the entire uterus is fully everted.

Predisposing factors

General

Pathophysiology

  • Hypocalcemia Hypocalcemia or myometrial trauma leads to a decrease in myometrial tone in the peri-parturient period.
  • Dystocia, manual extraction of the calf or retained fetal membranes may initiate invagination of a uterine horn.
  • Reduced uterine tone combined with invagination of a uterine horn leads to rapidly progressive uterine eversion and prolapse

Timecourse

  • Occurs most commonly within 24 h of calving, often as an immediate sequela.

Epidemiology

  • Sporadic, but given the link with hypocalcemia may be over-represented in herds with a high incidence of hypocalcemia.
  • Reported incidence ranges from 0.002-0.6% of all calvings.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Rees G M (2016) Postpartum emergencies in cows. In Pract 38, 23-31 VetMedResource.
  • Miesner M D & Anderson D E (2008) Management of uterine and vaginal prolapse in the bovine. Vet Clin Food Anim Pract 24 (2), 409-419 PubMed.
  • Murphy A M & Dobson H (2002) Predisposition, subsequent fertility, and mortality of cows with uterine prolapse. Vet Rec 151 (24), 733-735 PubMed.
  • Correa M T, Erb H N & Scarlett J M (1992) A nested case-control study of uterine prolapse. Theriogenology 37 (4), 939-945 PubMed.
  • Gardner I A, Reynolds J P, Risco C A & Hird D W (1990) Patterns of uterine prolapse in dairy cows and prognosis after treatment. JAVMA 197 (8), 1021-1024 PubMed.
  • Jubb T F, Malmo J, Brightling P & Davies G M (1990) Survival and fertility after uterine prolapse in dairy cows. Aust Vet J 67 (1), 22-24 PubMed.
  • Plenderleith B (1986) Prolapse of the uterus in the cow. In Pract (1), 14-15 PubMed.
  • Risco C A, Reynolds J P & Hird D (1984) Uterine prolapse and hypocalcaemia in dairy cows. JAVMA 185 (12), 1517-1519 PubMed.
  • Roine K & Saloniemi H (1978) Incidence of some diseases in connection with parturition in dairy cows. Acta Vet Scand 19 (3), 341-353 PubMed.
  • Oedegaard S A (1977) Uterine prolapse in dairy cows. A clinical study with special reference to incidence, recovery and subsequent fertility. Acta Vet Scand Suppl 63, 1-124 PubMed.


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