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