ovine obstetrics

Ovine obstetrics

Embriology

(Foetal membranes)

Embryology

• Oocyte: 16-24 h

• Spermatozoa 30-48 h

• Two-cell stage Day 1

• Eight-cell stage Day 2,5

Embryology

• Morula (8-16 cells) Day 3 (uterus)

• Blastocyst Days 6 to 7

• Elongation Days 11 to 16

• Early placentation Days 14 to 18

Embriology

Senger, 2006

Embryology

• Interferon tau Interferon tau (Ovine trophoblast protein 1): Day 12– antiviral, immunosuppressive, antiproliferative

and antiluteolytic activity (stabilize P4R and/or E2ROxytocin Rno PGFCLGCLG

Interferon-tau

Senger, 2006

Embryology

• Intrauterine migration

• Binucleate giant cells: PSPB, PAGPAG

Migration of binucleate giant cells

Senger, 2006

Embryology

• Semiplacenta multiplex (cotilyca)

• Epitheliochorialis (syndesmochorialis) placenta

• Placenta dependens: Day 50

Semiplacenta cotylica

Senger, 2006

Semiplacenta cotylica

Senger, 2006

Semiplacenta cotylica

Drost, 1967

Formation of the fetal membranes

Formation of the fetal membranes

Formation of the fetal membranes

Formation of the fetal membranes

Formation of the foetal membranes

Senger, 2006

Embryology

• Termination of pregnancy: no from Day 50– ovariectomia– PGF2a

Duration of pregnancy

• Days 145 to 155

Pregnancy diagnosis

Ewe

Use of a harness and crayon on the ram

• The color of the crayon: changing every 14 to 16 days

• Interpretation:– very lights marks (can be undetected) – not all ewes are pregnant

Balottment and subjective external examination

• 12 – 24 h fasting

• Days 90 to 130 of pregnancy: 80 to 95% accurate.

• The number of fetuses cannot be determined accurately, this limits its usefulness.

Rectal abdominal palpation

– lubricated glass rod (1,5 cm and 50 cm)– fasting: 12 h– 150 ewes/day– Days 85-100: 100%

– Disadvantage:• low accuracy for fetal numbers• hazardous: rectal injury, abortion

Rectal abdominal palpation

01020

3040

5060

7080

90100

Se Sp + PV - PV

D 85-109D 60-96

n=79n=498

Vaginal biopsy

• 93 to 97% accurate after 40 days of gestation

• Nonpregnancy: 81% accurate

• 100% after 80 days of gestation

Radiology: Mobil units

• fetal skeleton: well classified by Day 80 – 400-600 ewes/day

• pregnancy diagnosis: 100%

• Fetal number: 90 % (94-100%)

• Disadvantage: cost and hazardous

Blood progesterone assay

• Pregnant: 3,7 ng/ml, non-pregnant: 1 ng/ml

• Days 18-22: 82-84%

Progesterone profiles in the ewe

Senger, 2006

P4 profil during the cycle

Senger, 2006

Ovarian artery and UOV

Senger, 2006

Ovarian artery and UOV

Senger, 2006

Accuracy of progesterone test

01020

3040

5060

7080

90100

Se Sp + PV - PV

D 16-17D 16-18D 18

N = 130 N = 22 N = 112

Progesterone test

0102030405060708090

100

Day 18

SeSp+ PV- PV

Karen et al., 2001

P4 (ng/ml)

0

0,5

1

1,5

2

2,5

3

3,5

NP Pregnant

D 0D 18

Karen et al., 2001

Estrone sulphate test:

• detectable around Day 70 (0.1-0.7 ng/ml)

• steady increase until 2 days before lambing (15-50 ng/ml)

– pregnancy: 87.9%– non-pregnancy: 44%– not reliable for prediction of fetal numbers

Ovine placental lactogen

– Day 64: 97% és 100%

Placental lactogen near term

Senger, 2006

Pregnancy proteins

-PAG

-PSPB

Binucleate giant cells

Senger, 2006

PAG (ng/ml)

0

5

10

15

20

25

30

35

D 22 D 29 D 36 D 50

NPPregnant

Karen et al., 2001)

Accuracy of P4 and PAG tests

0

10

2030

40

50

6070

80

90

100

D 18 D 22 D 29 D 36 D 50

P4 PAG

Karen et al., 2001

Pregnancy-specific proteins

• PSPBPSPB: 100% and 83% between Days 26 – 106

• single: 71%, twin: 81% between Days 60-120

Ultrasonic techniques

A-mode

• 100% after Days 60 to 70 of pregnancy

• Nonpregnancy: 80 to 90% accurate

Ultrasonic techniques

Doppler technique:

• Days 40 – 80: 60%

• Days > 80: > 90%

• Rectal examination: Days 35 to 55: 97%

Ultrasonic techniques

Real-time, B-mode ultrasonography

• Day 29: 97,7%-99,1%

• Rectal examination: from Day 25: 91%

• Twin pregnancy: /Days 45 to 50/: 98.9%

A. Transabdominal ultrasonography (3.5 or 5 MHz)

Accurate (40 to 90 after AI):

• Simple pregnancy diagnosis

• Determination of fetal numbers

Disadvantage

• Shaving the ventral abdomen (some breeds)

B. Transrectal Ultrasonography (5 MHz)

Embryonic vesicle

Days 17-19 after A1

B. Transrectal Ultrasonography

INTRODUCTION (contd)

Embryonic vesicle

Days 17-19 after A1

B. Transrectal Ultrasonography

INTRODUCTION (contd)

Embryo proper

Days 24-34 after A1

B. Transrectal Ultrasonography

INTRODUCTION (contd)

Placentome

Days 30-32 after A1

Transrectal ultrasonography (5 MHz)

01020

3040

5060

7080

90100

Se Sp + PV - PV

D 25-50D 24-26D 32-34

Transabdominal ultrasonography (3,5 MHz)

82

84

86

88

90

92

94

96

98

100

Se Sp + PV - PV

D 46 - 106D 46 - 93D 50 - 100

n=5530n=554n=516

Fetal numbers

91

92

93

94

95

96

97

98

99

100

Se Sp + PV - PV

D 46-106D 46-93D 40-100

Triplets

Smith, 2006

MATERIALS AND METHODS (contd)

Transrectal ultrasonography

• Aloka SSD-500

• 5 MHz linear

• 12 h fasting• Allantoic fluid

*P< 0.05

Fig 1. Sensitivity of transrectal ultrasonography(US) and pregnancy-associated glycoprotein (PAG) tests for detecting pregnant ewes

Sen

siti

vity

(%

)

*

0

20

40

60

80

100

Day 24 Day 29 Day 34

Days of Pregnancy

US

PAG

*P< 0.05

TTransrectal ultrasonography (US) and pregnancy-ransrectal ultrasonography (US) and pregnancy-associated glycoprotein (PAG) tests associated glycoprotein (PAG) tests S

ensi

tivi

ty (

%)

95

96

97

98

99

100

Day 24 Day 29 Day 34

US

PAG

Days of pregnancy

Sp

ecif

icit

y (%

)TTransrectal ultrasonography (US) and pregnancy-ransrectal ultrasonography (US) and pregnancy-

associated glycoprotein (PAG) tests associated glycoprotein (PAG) tests

RESULTS

Evaluation& grouping

Scanner A Scanner B

Correct positive diagnosis (a) 52 50

Incorrect positive diagnosis (b) 10 10

Correct negative diagnosis (c) 52 52

Incorrect negative diagnosis (d) 1 3

Results of pregnancy diagnosis in sheep performed transrectally by means of two B-mode ultrasound scanners

RESULTS

Evaluation& grouping

Scanner A Scanner B

Sensitivity (%) 98 94

Specificity (%) 84 84

+ PV (%) 84 83

- PV (%) 98 95

Accuracy values of the two B-mode ultrasound scanners for pregnancy diagnosis in sheep

Abortion

• Early pregnancy: • < Day 12: estrus

• Late pregnancy:– Return to estrus

– Failure to lamb

– Blood-tinged vaginal discharge: no fetus or placenta

– Abortion

– Stillborn and/or weak lamb (> 142 days)

Abortion

Drost, 2006

Abnormal placenta

Smith, 2006

Mummification

Drost, 2006

Abortion

• < 2% - < 5% (acceptable)

• 30-40%: diagnostic accuracy

• Investigation– History– Fetus and placenta– or appropriate samples – serum– Chilled sample to laboratory: as soon as possible

Infectious ovine abortion

• Placenta (placental cotyledon): fixed (10% formalin) and fresh

• Fresh fetuses - chilled if they can be delivered rapidly

• Otherwise:Otherwise:– Fetal liver and lung: fresh and fixed

– Fetal abomasum and contents: fresh

– Fetal heart blood or exudate from body cavities, or both: fresh

Infectious ovine abortion

• Whole blood from affected ewes (if in 24 hours) or sera

• Vaginal discharge from affected ewes: fresh

• (Concerning the laboratory requirements we have to consult it with them)

Abortion

• Viral causes:– Bluetongue– Border disease– Cache Valley Disease

Abortion

• Bacterial/Chlamydial/Rickettsial causes– Brucellosis– Vibriosis/Campylobacteriosis– Enzootic abortion /Chlamydiosis– Coxiellosis/Q-fever

• Parasitic causes– Toxoplasmosis gondii infection

Prolapsus vaginae

Drost, 2006

Prolapsus vaginae

Prolapse of the vagina

• protrusion of the mucus membrane of the floor

• fortnight of lambing

• severe prolapse: heavy straining– shock– exhaustion– aneorobic infection

Prolapse of the vagina

Treatment:– cleaning (antiseptic solution)– replacement (lubricant if necessary)– harness (retention of the prolapsed portion):

twine or nylon strapping– plastic retainer (tape or harnees)

Prolapse of the vagina

Prevention:– culling policy

Pregnancy toxaemia

• last 4 weeks before parturition

• fatty infiltration of liver and rise in ketone levels

• clinical symptoms: dull, without appetite, listless, disinclined to get up

Pregnancy toxaemia

• hypoglycaemia: may be present

• hypocalcaemia: injection of calcium

• acetone in the breath

• ketones in the urine: confirms the diagnosis

Pregnancy toxaemia

Treatment: – iv injections of 200 ml 40% glucose

– synthetic glucocorticoid: abortion or premature lambing

Pregnancy toxaemia

Treatment: – early caesarean section

– p.o.: glucose, electrolyte, glycine: every 4 to 8 hours

– 200 ml 50% glycerol or propilene glycol 2 times/day (max. 30 ml) or 10 ml every 2 hours

Pregnancy toxaemia

• Prophylaxis in the remainder of the flock:– 0,2-0,5 kg of cereal per head

– good hay and roots, pulped and mixed with molasses

– forced exercise twice daily

Pregnancy toxaemia

Prevention:– diagnosis of twin pregnancy

Induction of abortion or lambing

During gestationDuring gestation– Days 5 to 50: PGF2a:10 to 20 mgin 2 to 3 days– After Day 85: Dexamethanose: < Day 12: estrus

Before lambingBefore lambing: > Day 142– Dexamethanose: 16 mg i.m.– Betamethanose: 10-12 mg i.m.

• Lambing: 36-60 h

Parturition

First stage

Smith, 2006

Dystocia

Ringwomb: 15-32% of dystocia– + preparturient prolapse

– incomplete dilatation of the cervix: – after protracted restlessness: no progress to the

second stage– tight, unyielding ring: 1 or 2 fingers– 20% may open naturally– without treatment: toxaemia and death within

48 h

Dystocia

Incidence:

– dry season: less

– oestrogenic substances• red clover pasture• contaminated food with Fusarium

graminaerum

– reduced PGF2a production

Dystocia

Treatment:

– digital manipulation

– Hypocalcaemia: 60 ml Ca i.m. and Depotocin 0,5-1,0 ml ???

– Spasmotitrat (2-3 ml)

– Caesarean section

Hereditary backroundHereditary backround

Dystocia

• Torsion of the uterus

• Traction– 2% Lidocaine 2-5 ml– Xylazine 4 mg (0,2 ml) + 2 ml Lidocaine 2%

• Foetotomy

• Caesarean section

Delayed assistance

Smith, 2006

Rupture of the vagina

Smith, 2006

Postparturient prolapse of the uterus

• careful wash with desinfective solution

• hindquarters kept raised by an attendant

• epidural anaesthesia: not required– prevent straining after replacement (xylazine: 2 mg

IV, or 3-5 mg IM)

• no separation of the membranes

• replacement

• antibiotics

Postparturient prolapse of the uterus

– 3 L Ringer – lactate

infusion

Dystocia

• Treatment:– 10-20 NE oxytocin, – Penicilline: 22.000 NE/kg - 5 days– Uterine levage (foetotomy)

Third stage

• FM: within 1-2 h

• Involution: – lochia: max. until Day 21 – hystology: Day 21– complete on Day 42

Retention of the fetal membranes

• rare: passed 2 to 10 days

• if it occurs: exposed parts – apply traction from day to day

• If general ill-health: – antibiotic pressaries– parenteral injections

RFM

• RFM: after 12 h: 6,4 %– Se deficiency:

• 20 %

Acute metritis

– > 40 C – foul discharge– anorexia

Newborn lamb

Légvétel után

Smith, 2006

Newborn lamb

• Standing up: 10-30 min

• < 2 h acceptance

• 50 ml colostrum: tube

Newborn lambs

Asphyxia neonatorum:- Secondary hypothermia- Death: 0 to 1-2 days

Hypothermia and SME (Starvation-Missmothering- Exposure) complex

• Multiple etiology: up to 65% of perinatal losses

• Brown fat (perirenal, pericardinal and other sites): pinkish white at birth, or in new-born lambs (above 28 C)

Hypothermia and SME (Starvation-Missmothering- Exposure) complex

• Important sites of nonshivering thermogenesis

• Fat depletion (cold): red-brown color + subcutaneous edema

• Less than 3 kg: hypothermia: immaturity, low fetal energy reserves and a wide surface area-to-body mass ratio

Hypothermia

• Normal: 38.8 - 40 C

• Slight hypothermia: 37 - 38.8 C

• Severe hypothermia: < 37 C

Hypothermia

• Primary hypothermia: heat loss exceeds heat production

• Secondary hypothermia: because of the factors that prevent the lamb from feeding and replenishing depleted fetal energy reserves.

Hypothermia

Treatment:• by correcting hypoglycemia with intraperitoneal

20% glucose (10 ml/kg)

• by rewarming (40 C until the rectal temperature is 38 C)

• Attention to nutrition and husbandry are also critical

Hypothermia

Prevention:• Adequate feeding during gestation: to prevent

small fetuses

• Shelter for lambing

• Selection

Hyperthermia

• Severe dehidration

• Weak suckling

CAPRINE OBSTETRICS

EMBRYOLOGY

• Intrauterine migratio

• Placenta epitheliochorialis (syndesmochorialis)

• Semiplacenta cotilyca

• CL dependens

Embryology

• Interferon tau Interferon tau (Caprine trophoblast protein 1): Day 12– antiviral, immunosuppressive, antiproliferative

and antiluteolytic activity (stabilize P4R and/or E2ROxytocin Rno PGFCLG

Binucleate giant cells

-PSPB

-PAG

Binucleate giant cells

EMBRYOLOGY

• D 60: placental lactogen (prolactin)• Dry off period:

– Tetanus and < 4 w enterotoxaemia vaccine

– Vitamine E and Se

• Duration of pregancy: 150 (147 to 155)

Pregnancy diagnosis

Ultrasound technique

Doppler probe: from Day 25• Accurate: from Days 35-40

B-mode: from Day 30

Chemical methods of pregnancy diagnosis

Progesterone assay:

• Serum, milk: 21 to 24 days of gestation– > 10ng/ml pregnant, around 100%

• False positive result: – hydrometra, pseudopregnancy, or retained corpus

luteum

Cycle in the goat

Pugh, 2002

Chemical methods of pregnancy diagnosis

• Estrone sulphate assay: – milk or urine at 50 days of pregnancy

– The test does not give false-positives with hydrometra or persistent corpus luteum.

Chemical methods of pregnancy diagnosis

• Pregnancy associated glycoprotein (PAG)

Pseudopregnancy

Pseudopregnancy

Aborting before term

Kidding one life and one dead fetuses at term

Twin pregnancy until term: Day 40: mummified Day 120: decomposed

Pathology of gestation

Pathology of gestation

• Pseudopregnancy + hydrometra: 2 mg PGF2a

• Induction of abortion: 2,5-10 mg PGF2a: abortion after 5 days

• Induction of kidding: Days 145 -149– 7-8 h: PgF2a 5-10 mg: kidding 30-35 h

Pregnancy toxaemia (ketonuria)

• Prevention (last 6 weeks):– At least 0.25 kg of grain per day during the last

month.

– Any disease or condition causing loss of appetite should be treated promptly to avoid secondary ketosis.

Pregnancy toxaemia

• Treatment:– Mild cases: hand feeding, 3 mg/kg of glycerol or 60

ml of propilene glycol twice a day

Pregnancy toxaemia

• Severe case (Recumbent animal): – 200 ml 5% dextrose infusion i.v.

– antibiotics,

– 20 mg of Dexamethasone: induction

– Dehydration, acidosis: 3 L fluid + 1500 mEq of bicarbonate i.v.

– Caesarean section is indicated if the doe does not respond promptly to medical treatment.

Hypocalcaemia

• Around kidding

• 25 ml Ca i.v. and s.c.

Vaginal prolapse

• During the last month of pregnancy– Incomplete vaginal prolapse

– Complete vaginal prolapse

Treatment

• Incomplete vaginal prolapse: – confinement

– hindquarters are elevated at night

– increasing exercise

Treatment

• Complete vaginal prolapse– Vulva should be sutured

– Vaginal retainers designed for ewes

– Culling

– Lush clover or alfalfa roughage during pregnancy should be avoided

Periparturient care of the doe

• Goats need a 6 to 8-week dry period.

• Does with a history of mastitis should be dry treated.

Periparturient care of the doe

• Four weeks before parturition: tetanus, enterotoxemia vaccinations

• Prophylactic Vitamin E-, Se injections: if white muscle disease occurs.

PARTURITION

PARTURITION

• Kid is usually on its feet in 10 to 30 min.

• Licking for 5 to 10 minutes is usually adequate for acceptance.

• The first 2 hours after birth is critical.

Induction of parturition

• PGF2a on Days 144 to 149 of pregnancy: within 40 hours with a peak between 30 and 35 hours.

• No retained fetal membranes and stillbirths

• Advantage of induction: reduction of kid and doe mortality.

Dystocia

Dystocia

• Incomplete cervical dilatation:– Firm rings (usually 2 bands 0.5 to 1 cm wide)

can be felt.

– A nondilatated cervix with cool skin and ears and muscle weakness: hypocalcemia (60 ml)???

– Spasmotitrat???

– Caesarean section is indicated.

Dystocia

• Uterine torsion:– Uncommon

– Caesarean section

Dystocia

• Forced extraction:– If the cervix is well dilatated and the fetal

presentation can be corrected, forced extraction may be attempted.

Dystocia

• Fetotomy:

– Epidural anesthesia: 2% 2 to 5 ml Lidocaine

Dystocia

• Treatment following fetotomy:– Oxytocin: 10 to 20 IU to control bleeding– Penicillin: 20-40000 IU – Fluxixin: 1,1 mg/kg– Tetanus antitoxin: 1500 IU if it was not vaccinated.

– Uterine levage: Bolus or fluid antibiotics

Normal involution

• The placenta is normally passed within 1 to 2 hours after parturition.

• Lochia normally red and odourless, persists for a max. of 3 weeks.

• Uterine involution is completed by 6 weeks postpartum.

Retained placenta: 6,4%

• RFM: not passed within 12 h

• incidence: app. 6.4%

• Treatment:– Antibiotics i.u. + i.m. (3-5 days)– Oxytocin 10-20 IU/ 12 h– Tetanus prophylaxis

Retained placenta

Prevention: – adequate exercise and nutrition

Metritis

• Clinical signs: – anorexia, – dark red malodorous uterine discharge, – rectal temperature above 40 C

Metritis

Treatment: – systemic antibiotic therapy

– local treatment, if the cervix is open, by a catheter

Uterine prolapse

• Treatment:– Epidural anesthesia: Lidocaine

– Sedation: 2 mg IV or 3 to 5 mg IM of xylazine