ISSN 2398-2977      

Cervix: trauma - repair

pequis

Introduction

  • The cervix is the last physical barrier to the uterus and has a vital role in uterine defense.
  • The cervix is made up of longitudinal muscle along its body and circular muscle at the internal and external os.
  • The shape and function of the cervix is determined by hormonal control.

Uses

  • Trauma to the cervix occurs most commonly at foaling; especially if induced, protracted, assisted or where fetotomy is performed Cervix: trauma.
  • Occasionally damage may occur at breeding.
  • Cervical damage may go undetected and result in decreased fertility with conception failure and early fetal loss Abortion: early embryonic / fetal death. Both of these causes of decreased fertility may be attributed to ascending contamination/infection tracking through an incompetent cervix.
  • Cervical tears are typically wedge-shaped with the apex pointing anteriorly.
  • Most tears occur on the dorsal cervical body.
  • Cervical lacerations which are extensive or deep must be repaired surgically.

Advantages

  • Restore a functional cervix and thus restore fertility.

Disadvantages

  • Visualization may be difficult and requires adequate retraction of the cervix and the use of a light source.
  • Repair of ventral tears is more difficult and may require general anesthesia Anesthesia: general - overview and dorsal recumbency for adequate visualization of defect.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good for small, single linear tears which don't tend to recur.
  • Guarded for future breeding in all mares with major cervical damage.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Leary J M, Rodgerson D, Spirito M & Gomez J (2013) Foaling rates after surgical repair of ventral cervical lacerations using a Trendelenburg position in 18 anesthetized mares. Vet Surg 42 (6), 716-20 PubMed.
  • K J Eastley et al (1988) Surgery for conditions causing decreased fertility in mares. Vet Clin North Am Equine Pract (3), 381-388 PubMed.
  • Brown J S, Varner D D, Hinrichs K et al (1984) Surgical repair of the lacerated cervix in the mare. Theriogenology 22, 351–359 PubMed.
  • Aanes W A (1964) Surgical repair of third degree perineal laceration and rectovaginal fistula in the mare. JAVMA 144, 485-91 PubMed.

Other sources of information

  • Pollock P J & Russell T M (2011) Cervical Surgery. In: Equine Reproduction. Eds: McKinnon A O, Squires E L, Vaala W E & Varner D D. Wiley Blackwell, UK. pp 2559-2563.
  • O’Leary J M & Rodgerson D H (2009) How to Repair Cervical Tears Using a Trendelenburg Type Positioning. In: Procs AAEP. pp 269-271. Website: www.aaep.org (pdf download).

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