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PubMed2001

Non-enzymatic antioxidative defence mechanisms against reactive oxygen species in bovine-retained and not-retained placenta: vitamin C and glutathione.

Vitamin C and glutathione (GSH) are water-soluble antioxidants which take part in defence mechanisms against reactive oxygen species (ROS). They may also be involved in processes of releasing/retaining bovine fetal membranes. Hence vitamin C, reduced (GSH) and oxidised (GSSG) glutathione levels were determined in retained and not-retained bovine fetal membranes in order to describe the non-enzymatic antioxidative status. Placental samples were collected immediately after spontaneous delivery or during caesarean section before term and at term, and 6 groups were formed as follows: (A) pre-term caesarean section without retained placenta; (B) pre-term caesarean section with retained placenta; (C) term caesarean section without retained placenta; (D) term caesarean section with retained placenta; (E) spontaneous delivery without retained placenta and (F) spontaneous delivery with retained placenta. Homogenates of maternal and fetal placental tissues were prepared, and vitamin C, GSH and GSSG were measured spectrophotometrically. Vitamin C levels were significantly higher in the maternal part than in the fetal part of the placenta in all groups examined. In retained placenta cases the levels were significantly lower than in control cows, except in pre-term groups. GSH concentrations were significantly higher in placentas without retention than with retention. GSSG levels showed the opposite relationship and were significantly higher in samples with retention of fetal membranes than in controls. Further experiments on antioxidative as well as oxidative status in bovine placenta are necessary.

Animals↗
PubMed1997

Retained placenta and associated risk factors.

In a retrospective study, the factors that might influence the retention of placenta such as age, parity, antenatal abnormalities, labour onset and duration, history of uterine surgery and previous retained placenta, were studied in 146 patients with retained placenta. Three hundred women who were delivered vaginally without retained placenta were similarly evaluated under the same conditions. The results showed (in descending order of significance), history of retained placenta, previous uterine surgery, preterm delivery, age above 35 years, placental weight less than 601 g, pethidine use in labour, labour induction and parity of more than five to be associated with retained placenta. The existence of some or all these risk factors in a pregnant woman should alert the obstetrician about the possibility of retained placenta in labour.

Journal Article↗
PubMed1995

[Effectiveness of local treatment using a PVP-iodine compound for retained placenta in cows].

106 cattle with retained placenta were treated either with Vetisept-bolus or Tetran-bolus (controls) after an attempt to remove fetal membranes. Uterine involution judged by rectal palpation on the 28th day was the same in both groups, but more treatments were necessary for cows of the experimental group. Cows treated with Vetisept came in heat nine days earlier than controls (p < 0.05). The pregnancy rate of the controls (91.6%) was better (p < 0.05) than in the experimental group (60.7%). No significant differences between the two groups were encountered for pregnancy index, total index, and service period. Of 82 cows after single calving 50 got pregnant again. In 18 of the remaining cattle another pregnancy was not attempted. The other 14 were bred but did not conceive. Treatment with tetracycline seems to be slightly superior and safer than the treatment with PVP-iodine. It is uncertain, whether the higher (p < 0.05) losses of animals in the experimental group than in the controls is due to the different treatment, for most of the cows had been slaughtered because of insufficient milk production. Therapy with iodine is a recommended alternative to the treatment with tracycline for certain indications.

Administration, Intravaginal↗
PubMed1998

Equine retained placenta: technique for and tolerance to umbilical artery injections of collagenase.

Under laboratory conditions and in clinical experiments, bacterial collagenase has proven to be effective in hydrolyzing placenta and detaching cotyledon from caruncle in the bovine species. Laboratory studies in which placental samples were incubated with collagenase have also demonstrated that collagenase is 3.7 times more effective in hydrolyzing equine placenta than bovine placenta. This led to the hypothesis that collagenase may be a potential treatment for mares with retained placenta. However, that collagenase may hydrolyze the uterine wall and perforate the uterus was a concern. It was the purpose of this study thus to determine any adverse effects of collagenase on the equine uterus and to develop a method for intraplacental injection of collagenase. Three normally expelled intact placentas from Arabian mares, 10 cyclic mixed-breed mares, and 4 mares of various breeds with retained placenta were used. Fluoroscein dye and latex were used to study the placental vasculature and to determine a suitable dose of collagenase; placentas were hydrolyzed by collagenase solution in vitro. Bacterial collagenase solution (40,000 units, 200 ml) was infused into the uterine lumen of each cyclic mare. Uterine biopsies were obtained from the mares before collagenase infusion and again at 16 h and 26 d after infusion. In the mares with retained placenta, each placenta was infused via its umbilical cord vessels with 200,000 units of bacterial collagenase in 1 L of saline. Results showed that none of the uteri from cyclic mares were damaged by collagenase treatment. During a 4-wk period of monitoring (including endoscopy) mares with retained placenta did not show any abnormalities. Retained placentas were expelled in less than 6 h after collagenase treatment. It was concluded that intraplacental injections of collagenase are a safe and potentially effective treatment for retained placenta in mares.

Animals↗
PubMed1997

Safety of intravenous glyceryl trinitrate in management of retained placenta.

A retrospective chart review of all anaesthesia consultations for retained placenta at 28 weeks' gestational age or more was performed to determine the safety and efficacy of intravenous glyceryl trinitrate therapy in the management of retained placenta. Of the 33 patients who received glyceryl trinitrate, 1 received a total dose of 50 micrograms and the remainder received 100 to 200 micrograms. All placentas were extracted within 4 minutes of the first bolus. The systolic and diastolic blood pressures and the haematocrit fell by a mean of 8.1 +/- 5.3 mmHg, 6.0 +/- 3.5 mmHg, and 2.6 +/- 1.7%, respectively (mean difference +/- SD, p < 0.05 for each). The pulse rose by a mean of 7.7 +/- 4.5 bpm (p < 0.001). Only 1 patient required ergometrine for continued atony. None of the patients required transfusions or operative therapy other than dilatation and curettage. The use of glyceryl trinitrate in doses of 200 micrograms or less for retained placenta appears efficacious and safe, and may obviate the need for general anaesthesia for uterine relaxation.

Adult↗
PubMed1999

Effects of twinning on gestation length, retained placenta, and dystocia.

Constraints to maximal productivity from twinning in beef cattle include increased incidence of dystocia and retained placenta, longer postpartum interval, and lower conception rate. Incidence and cause(s) of the shorter gestation length and of the increased retained placenta and dystocia associated with twinning were evaluated for 3,370 single and 1,014 twin births produced in a population of cattle selected for natural twin births. Gestation length was shorter for twin than for single pregnancies (275.6 vs. 281.3 d, P<.01) and likely contributed to the higher incidence of retained placenta associated with twin births (27.9 vs. 1.9%; P<.01). Incidence of retained placenta was also higher in the spring (March-April) than in the fall (August-September) calving season (18.3 vs. 11.4%; P<.01). The higher incidence of dystocia with twins than with singles (46.9 vs. 20.6%, P<.01) was primarily due to abnormal presentation (37.0 vs. 4.5%, respectively) of one or both twin calves at parturition. First- (40.5%) and second- (22.7%) parity dams with a single birth had more (P<.01) dystocia than older dams (13.4%), whereas dystocia was not affected (P>.10) by parity with twin births. Because of the shorter gestation length and the increased incidence of retained placenta and(or) dystocia, achievement of increased productivity with twinning in cattle necessitates intensive management of twin-producing dams and their calves during the calving season. Management of the increased dystocia can be facilitated by preparturient diagnosis of twin pregnancies, enabling timely administration of obstetrical assistance to facilitate delivery of twin calves and to increase their neonatal survival.

Animals↗
PubMed1996

Treatment of bovine retained placenta and its effects.

The literature on the treatment of retained placenta and its effects is reviewed. Manual removal, the oldest and commonest method of treatment, benefits parlour hygiene but may adversely affect the cow. The use of collagenase may allow manual removal without such side effects. Ecbolic drugs are often ineffective, both as prophylaxis and treatment for the condition. They are most effective within one hour of parturition, particularly after a caesarean section in which tocolytic drugs have been used. Endometritis is a very common sequel to retained placenta. Antibiotics and oestrogens have been used to treat, control or prevent the condition, but they are not routinely effective and may have deleterious side effects. Gonadotrophin releasing hormone and/or prostaglandins have been used to reduce the deleterious effect of retained placenta on fertility, but the results obtained have been inconsistent.

Animals↗
PubMed1980

Increased incidence of retained placenta associated with heat stress in dairy cows.

A dairy herd experienced an increased incidence of retained placenta and postpartum metritis during late spring and summer of 1977 and 1978. The incidence of retained placenta and postpartum metritis was 24.05% during the period of May through September compared to 12.24% the rest of the year. The gestation period of cows having retained placenta and postpartum metritis was an average of 5.25 days shorter than that of cows not exhibiting these symptoms. The gestation period of cows calving during the warm season was an average of 2.82 days shorter than that of the cows calving during the cool season. Heat stress resulting in early parturition was the probable cause of this increased incidence of retained placenta and postpartum metritis. The number of days open was influenced both by abnormal postpartum period and season of calving. Cows having retained placenta and metritis were open an average of 31.69 days longer than cows with normal postpartum periods. Cows that calved during the warm season were open an average of 24.42 days longer than those calving during the cool season.

Journal Article↗
PubMed1989

Early postpartum reproductive profiles in Holstein cows with retained placenta and uterine discharges.

Sixty Holstein cows were allocated to three groups. Twenty cows had retained placenta. The remaining cows were examined on d 14 postpartum and those with purulent discharges (n = 22) were assigned to one group and the remaining (n = 18) to a control group. Within each group, cows were given randomly either gonadotropin-releasing hormone (i.m., 200 micrograms) or saline on d 15 postpartum to evaluate the effect on changes in ovarian structures and plasma progesterone through 50 d postpartum and fertility. Corpora lutea were found in control cows by d 21, cows with uterine discharge by d 28, and cows with retained placenta by d 27. Maximum progesterone production during the first luteal phase was higher in control cows than in cows with purulent discharge or retained placenta (4.66 ng/ml compared with 3.23 and 3.34 ng/ml, respectively). Duration of the first corpus luteum was affected by clinical condition. Only 6.2% of cows with retained placenta had corpora lutea of normal duration (12 to 16 d), whereas 43.8 and 50.0% of cows with uterine discharge and control cows had normal postpartum luteal phases. Measures of fertility were not affected by gonadotropin-releasing hormone. Control cows had less days to conception (97) and fewer services per conception (1.6) than cows with retained placenta (134 and 2.5, respectively). Clinical group affected reproduction more than gonadotropin-releasing hormone did, possibly by altering ovarian function.

Animals↗
PubMed2003

Intravenous nitroglycerin in the management of retained placenta.

Thirty patients in the third stage of delivery complicated by retained placenta were prospectively managed with intravenous nitroglycerin. We studied the effect of nitroglycerin on the hemodynamics and characteristics of the procedure, and also analyzed labor and maternal and neonatal data. Intravenous nitroglycerin effectively aided the extraction of the retained placenta in all cases. The average procedure time was 5.3 +/- 1.1 min, and the dose range was 50-200 microg. Systolic and diastolic blood pressure fell significantly from 111 +/- 7.5 to 103 +/- 6 mm Hg and from 74 +/- 6.7 to 67 +/- 6.6 mm Hg, respectively (p<0.05). Although statistically significant, this was not evident clinically and there were no complications. Intravenous nitroglycerin at a dose of 200 microg or less is safe, effective and predictable in the management of retained placenta and could obviate the need of general anesthesia.

Adult↗
PubMed1994

Umbilical vein injection for retained placenta: clinical feasibility study of a new technique.

Intraumbilical oxytocin infusion for retained placenta is a relatively new and promising technique. We have tested the clinical feasibility of different infusion techniques in this study. Nine patients had intraumbilical infusions through a mucus aspiration catheter and 12 by an 18 gauge needle. Infusion was successful in 7(77.7%) of 9 cases following catheterisation and in 7(58.3%) of 12 cases following direct injection. Both techniques were clinically feasible, but direct injection was somewhat easier than catheterisation. The importance of non-operative management of retained placenta, particularly in areas with limited medical facilities, is discussed and an approach to the management of retained placenta proposed.

Adult↗
PubMed1998

Effects of dystocia, retained placenta, and metritis on milk yield in diary cows.

The effects of dystocia, retained placenta, and metritis on milk yield were studied in 37,776 Finnish Ayrshire cows that calved during 1993; cows were studied for one lactation. Monthly test day milk yields were treated as repeated measurements within a cow in a mixed models analysis. Index categories were created to relate the time of disease occurrence to the test dates and to capture the short-term effects of diseases on milk yield. Diseases other than dystocia, retained placenta, or metritis were categorized into two groups: diseases occurring within 42 d after calving or diseases occurring later than that. The statistical models for each parity included calving season, stage of lactation, and disease variables as fixed effects. For parities 2, 3, and 4 or higher, the cows were grouped into four categories based on previous lactation milk yield, and the disease effect was studied separately for each yield level. An autoregressive covariance structure was used to model the association among the repeated measurements. Models with a 305-d yield as the outcome were also run; the diseases were treated as binary covariates in these models. Dystocia, retained placenta, and early metritis significantly affected milk yield, as indicated by monthly test day milk yields. Late metritis was not associated with milk loss. The impact of the diseases differed across parities and also across different levels of milk yield. Using 305-d milk yield as the milk measure, no diseases were associated with reduced milk yield.

Animals↗
PubMed2001

Is there a place for intra-umbilical oxytocin for the management of retained placenta?

Intra-umbilical injection of oxytocin has been used to hasten placental separation in retained placenta. A randomised controlled trial was done on 35 consequent women who fulfilled the criteria for retained placenta at the Department of Obstetrics & Gynaecology Ipoh Hospital. Nineteen patients who were recruited into the study group received intraumbilical injection of 301U oxytocin in 27mls saline. Another 16 patients who were in the control group received 30mls of 0.9% sodium chloride (placebo). The primary outcome measured was the need for manual removal of placenta (MRP). Nine out of the 19 patients in the oxytocin group required MRP while 10/16 in the control group required MRP. There was a 24% reduction (95% C.I. 0.41 to 1.39) in the need for MRP in the study group compared to the saline group. our results indicate that intra-umbilical vein injection of oxytocin is not clinically useful for the removal of a retained placenta.

Adult↗
PubMed1996

Bovine retained placenta: aetiology, pathogenesis and economic loss.

The literature on the effects and causes of retained placenta in the cow is reviewed. On a herd basis the condition can adversely affect milk yield and fertility, but on an individual cow basis the effects are unpredictable. The aetiology of retained placenta has been extensively studied and many causal factors have been implicated, but little is known of how many of them cause the condition. As a result its prevention and prediction is uncertain, primarily because of the lack of knowledge of the normal process of placental release. Vascular changes and uterine contractions play a role in placental release, but current opinion suggests that the primary cause of retained placenta is the retention of the feto-maternal union. Release only occurs after a process of maturation, which involves hormonal and structural changes. The factors which are thought to influence these changes, and thus cause the condition, are discussed.

Animals↗
PubMed1999

Retained placenta: a cause of reproductive morbidity in Nigeria.

This study analysed the reproductive morbidity associated with 91 cases of retained placenta at the Obafemi Awolowo University Hospital in Nigeria. The incidence of retained placenta in the hospital was 1.4% of all deliveries. Over 42% of the patients were admitted in haemorrhagic shock; 56.5% were anaemic, 10.6% severely; 17% had puerperal sepsis while 67% of the women received blood transfusions. There was one maternal death (1%). Unbooked patients (74%) constituted the largest proportion of cases while inappropriate management of the third stage of labour featured in many of the patients. Retained placenta was treated with manual removal in 90% of cases. Properly supervised delivery is an important component in efforts to reduce the incidence of morbidity associated with retained placenta in Nigeria.

Journal Article↗
PubMed1995

Intraumbilical oxytocin for management of retained placenta.

OBJECTIVE: The purpose of the study was to investigate the removal of a retained placenta. METHOD: Oxytocin was injected into the vein of the umbilical cord. A total of 109 patients with retention of the placenta were randomized into two groups. Active management of the third stage of labor was carried out by giving oxytocin 5 IU intravenously and ergometrine maleate 0.2 mg intramuscularly after delivery of the fetus. Group 1, which comprised 68 patients, was allocated to receive 50 IU oxytocin diluted in 10 ml 0.9% sodium chloride solution, and the 41 patients in group 2 were given 20 ml plasma expander (dextran 70) into the umbilical vein. RESULTS: Forty-nine cases (72%) in the oxytocin group and 22 cases (54%) in the dextran 70 group required manual removal of the retained placenta. No significant differences were found between group 1 (oxytocin) and group 2 (dextran 70). CONCLUSION: Our results indicate that intraumbilical vein injection of oxytocin is not effective for removal of a retained placenta.

Adult↗