Equis ISSN 2398-2977

Uterus: prolapse

Contributor(s): Terry Blanchard, Graham Munroe, Philippa O'Brien, Vetstream Ltd, Elaine Watson

Introduction

  • Cause: rare condition most commonly seen following dystocia   Reproduction: dystocia  , abortion   Abortion: overview   or retained placenta   Placenta: retained  , but may occur after a normal parturition. Much lower incidence than in cows.
  • Signs: uterine tissue hanging from vulva, pain and straining.
  • Diagnosis: is by the presence of the prolapsed uterus hanging from the vulva as a soft, red mass.
  • Treatment: management - the handlers should place a warm, wet towel around the prolapsed uterus to protect it and support it until veterinary help arrives.
  • Sedation and muscle relaxants , or an epidural anesthetic to assist in replacing the organ. Tape sutures in the vulvar labia will help prevent further prolapse.
  • Tetanus antitoxin   Tetanus antitoxin  , anti-inflammatories and antibiotics.
  • Prognosis: depends on speed of replacement of uterus and extent of damage.

Pathogenesis

Etiology

  • Expulsion of the placenta appears to   →   partial eversion of the uterus, because the placenta in the non-gravid horn is more firmly attached to the uterus.
  • The weight of the placenta, and any partially prolapsed uterus, continues the process until the entire organ is prolapsed.
  • Straining by the mare, both during expulsion of the placenta and when the initial eversion is felt, accelerates the process.

Predisposing factors

General

Pathophysiology

  • Relaxation of the supporting structures of the uterus and lengthening of the broad ligament in late pregnancy allow increased mobility of the uterus in the post-partum mare.
  • Invagination of the ovarian pole of the uterus (more commonly the non-gravid horn) is probably relatively common, particularly following retention of fetal membranes where traction has been applied.

Timecourse

  • May occur at anytime within the first 48 h post-partum.

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.
  • Crabtree J (2012)Peripartum problems in mares 2. Postpartum problems.In Pract34(8), 462-471VetMedResource.
  • Hewes C Aet al(2011)Uterine prolapse in a mare leading to metritis, systemic inflammatory response syndrome, septic shock and death.Equine Vet Educ23(6), 273-278VetMedResource.
  • MacGillivray K (2011)Uterine prolapse.Equine Vet Educ23(6), 279-280WileyBlackwell
  • Causey R, Ruksznis D & Miles R (2007)Field management of equine uterine prolapse in a Thoroughbred mare.Equine Vet Educ19(5), 254-259VetMedResource.

Other sources of information

  • Spirito M A & Sprayberry K A (2011)Uterine Prolapse. In:Equine Reproduction. 2nd edn. Wiley-Blackwell. Eds: McKinnon A O, Squires E L, Vaala E W & Varner D D. pp 2431-2434.
  • Allen W E (1988)Fertility and Obstetrics in the Horse. Blackwell Scientific Publications.
  • Zent W W (1987)Postpartum Complications.In:Current Therapy in Equine Medicine.Vol 2. Ed: Robinson N E. pp 544.
  • Arthur G H, Noakes D E & Pearson H (1983)Veterinary Reproduction and Obstetrics. 4th Edition. Balliere Tindall.
  • Rossdale P D & Ricketts S W (1980)Equine Stud Farm Medicine. 2nd edn. Balliere Tindall, Eastbourne.


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