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Results for “Placenta, Retained”

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PubMed1986

Acute renal failure in obstetric complications.

Early postpartum disseminated intravascular coagulation (DIC) was demonstrated by serial coagulation studies in 10 cases of acute renal failure (ARF) following obstetric complications (6 abruptio placentae, 3 retained placental fragments, 1 prolonged intrauterine fetal death). DIC abated within 48 hours irrespective of the therapeutic schedules employed. Renal damage was evidenced by a varying number of days of oligoanuric (6 cases) or polyuric (4 cases) ARF which always required dialytic treatment. Full renal recovery occurred in 9 cases. One patient died and no histological studies were performed. Renal damage seemed to correlate less with DIC than with the degree of anemia and shock.

Abruptio Placentae↗

PubMed1998

Effect of supplemental dietary vitamin E and zinc on reproductive performance of dairy cows and heifers fed excess iron.

We tested the hypothesis that the incidence of retained fetal membranes could be reduced by limiting oxidative stress. Sixty-four primigravid heifers (56 Holstein and 8 Jersey) and 80 multiparous cows (64 Holstein and 16 Jersey) were used. A combination of vitamin E or Zn and Fe was fed in a 2 x 2 x 2 factorial arrangement during the last 42 d prepartum. Amounts of supplements per animal were 1000 IU of vitamin E (d, l alpha-tocopheryl acetate), 0.8 g of Zn (Zn-Met and ZnSO4), and 12 g of Fe (FeSO4.7H2O) for Holsteins and 9 g for Jerseys. Neither vitamin E nor Zn directly affected the incidence of retained fetal membranes, but plasma alpha-tocopherol was lower when fetal membranes were retained > 12 h or when vitamin E was not supplemented. Iron had no direct negative effects on reproductive performance, but cows receiving additional Fe had lower unsaturated iron-binding capacity, which, in turn, was also lower in cows that retained fetal membranes. Days to first observed estrus were reduced by supplementation with either vitamin E or Zn. Vitamin E reduced days to first artificial insemination (AI) and tended to reduce days open. Supplemental Zn tended to reduce days to first AI but did not affect days open. Milk production during the first 12 wk and AI per conception were not affected by supplementation with either vitamin E or Zn. Both vitamin E and Zn reduced days to first observed estrus, indicating improved reproductive health during the early postpartum period.

Animals↗

PubMed1997

The costs of production diseases in dairy herds in England.

Economic losses due to common health problems in dairy cattle were investigated in 90 Friesian/Holstein herds (average size 152 cows), which calved in England during the 1992/1993 season with an average annual yield of about 6000 l per cow. By using only the direct costs of common production diseases and other health problems (mastitis, lameness, vulval discharge, treatments for oestrus-not-observed, retained foetal membranes, milk fever, twinning, calf mortality and aid at calving), the cost of ill health in a 100 cow herd with average rates of these problems (compared with target levels) was estimated at Pounds 6300 per year. The costs ranged from Pounds 1200 (average of the top 10%) to Pounds 13600 (average of the worst 10% of the herds). The main losses were due to mastitis and lameness (38 and 27% of health cost, respectively).

Animal Welfare↗

PubMed2005

Investigation and management of a cluster of cases of equine retained fetal membranes in Highland ponies.

Four at-risk Highland ponies on the same premises all retained their fetal membranes in the same breeding season. The ponies were treated with a combination of oxytocin, infusion and distension of the allantochorionic sac with fluid, gentle traction in one case, and supportive therapy. The possible causes of the condition were investigated with clinicopathological tests and analyses of the herbage for its species composition and fungal contamination. No obvious possible causative abnormalities were identified apart from a low total serum calcium level in one case. No fescue grass was found and no pathogenic fungi were detected.

Animals↗

PubMed1997

Treatment of dairy cows at parturition with prostaglandin F2 alpha or oxytocin for prevention of retained fetal membranes.

OBJECTIVE: To evaluate the effects of treatment at parturition with dinoprost tromethamine, fenprostalene, or oxytocin on postpartum disease and reproductive performance during the subsequent breeding season in dairy cows. DESIGN: Prospective study. ANIMALS: 1,400 Holstein cows from 5 commercial dairies. PROCEDURE: Cows were assigned within 2 hours after calving to serve as untreated control cows or to be treated with 1 mg of fenprostalene, SC; 25 mg of dinoprost tromethamine, IM; or 20 IU of oxytocin, IM. Cows were confined to treatment pens and monitored daily until fetal membranes were expelled. Cows with retained fetal membranes (RFM) were treated according to existing treatment protocols for the dairy, with the provision that intrauterine infusions were not allowed. All other disease conditions were recorded, and appropriate treatment was administered. Postpartum reproductive examinations were performed 28 to 56 days after parturition Breeding records were maintained for all cows until pregnancy was confirmed or the cow was removed from the herd. RESULTS: Fetal membranes were retained in 12.1% of all cows, and this outcome was unaffected by treatment. Compared with cows without RFM, cows with RFM had longer intervals to first insemination (76.4 vs 82.0 days), reduced first insemination conception rates (46.8 vs 28.0%), and increased number of days not pregnant (103.2 vs 127.4 days). Farm, as a variable, significantly affected development of RFM and postpartum disease conditions as well as reproductive performance during the subsequent breeding season. Fetal membranes were retained in 12.4, 15.2, 8.7, 6.3, and 16.9% of cows on farms 1, 2, 3, 4, and 5, respectively. Mean days to first insemination varied from 64.5 days (farm 3) to 91.5 days (farm 1). Mean number of days not pregnant varied from 94.8 days (farm 3) to 15.9 days (farm 4). CLINICAL IMPLICATIONS: Administration of prostaglandins or oxytocin at the time of calving does not reduce the incidence of RFM or improve reproductive performance. Farm management practices have the greatest impact on dairy cow performance.

Abortifacient Agents, Nonsteroidal↗

PubMed2004

Retained products of gestation in miscarriage: an evaluation of transvaginal ultrasound criteria for diagnosing an "empty uterus".

OBJECTIVE: The purpose of this study was to compare clinical outcomes of conservative management versus surgical evacuation of retained products of gestation after misoprostol treatment for first trimester spontaneous miscarriage using less restrictive transvaginal ultrasound criteria for diagnosing "empty uterus," which were managed conservatively. STUDY DESIGN: This was a prospective, randomized, controlled trial. RESULTS: Forty-six patients who had sonographic features previously regarded as significant retained products of gestation after misoprostol treatment, ie, homogenous intrauterine dimension of more than 11 cm 2 in combined transverse and sagittal plane, or those with heterogeneous intrauterine contents were consented to randomization. The short-term complication rates of those managed conservatively were significantly higher than surgical evacuation ([9/24] 37.5% vs [0/21] 0%, P < .05). CONCLUSION: Our previously reported transvaginal ultrasound criteria of homogenous intrauterine dimension of less than 11 cm 2 in combined transverse and sagittal planes for defining "empty uterus," which requires no further treatment, cannot be "relaxed" without incurring additional complications.

Abortifacient Agents, Nonsteroidal↗

PubMed2002

A comparison of clinical assessment with ultrasound in the management of secondary postpartum haemorrhage.

OBJECTIVE: To compare the diagnostic accuracy of clinical assessment with transabdominal ultrasound in the management of secondary postpartum haemorrhage (PPH). DESIGN: A prospective cohort study. METHODS: Fifty-three women who presented to a teaching hospital obstetric unit with secondary PPH were studied. Patients were divided into those in whom retained placental tissue was or was not the suspected cause of bleeding. This diagnosis was based on history/examination and transabdominal pelvic ultrasound scan. The definitive diagnosis was made following uterine evacuation or was assumed in women who stopped bleeding without surgical management. Likelihood ratio (LR) was used as an accuracy measure. RESULTS: The positive LR for clinical assessment was 5.5 (95% CI 2.7-12.1) compared with 2.4 (95% CI 1.5-3.7) for ultrasound. The negative LRs were 0.1 (95% CI 0.04-0.5) and 0.1 (95% CI 0.02-0.5) for clinical and ultrasound assessment, respectively. CONCLUSION: Clinical examination and ultrasound scan assessment have limited diagnostic accuracy in secondary PPH.

Anti-Bacterial Agents↗

PubMed1996

Isolation and antimicrobial susceptibility of obligate anaerobic bacteria recovered from the uteri of dairy cows with retained fetal membranes and postparturient endometritis.

The uteri of 77 postparturient dairy cows were sampled. Samples were cultured aerobically and anaerobically, and the nature of bacterial growth was identified. A mixed aerobic and anaerobic bacterial infection was found in 55% of the samples. Actinomyces pyogenes was the predominant aerobic species; it was found in 70% of the samples, whereas Bacteroides melaninogenicus was the most frequent anaerobic species isolated. Altogether, 16 species belonging to the genus Bacteroides were identified with variable frequencies. It appears that more than one Bacteroides species colonizes the uterus of a given cow postpartum. The minimal inhibitory concentrations (MICs) of clindamycin, metronidazole, tetracycline and ciprofloxacin for 83 anaerobic isolates were determined. All isolates were susceptible to clindamycin (MIC90 of 0.064 microgram/ml) and all but two to metronidazole. Susceptibility to ciprofloxacin was variable, with a bimodal distribution of MIC values. The MIC of tetracycline for 90% of the isolates was > 256 micrograms/ml.

Animals↗

PubMed1999

Randomised trial comparing expectant with medical management for first trimester miscarriages.

OBJECTIVE: To compare the efficacy of antiprogesterone (mifepristone) in combination with a synthetic prostaglandin E1 analogue (misoprostol) for outpatient treatment of miscarriages. PARTICIPANTS: One hundred and twenty-two women with first trimester miscarriages. METHODS: The women were randomised to treatment with mifepristone 400 mg orally followed by a single oral dose of 400 microg misoprostol 48 hours later (n = 60) or expectant management (n = 62). Women were re-evaluated five days later. If retained intrauterine products of conception were found with an antero-posterior diameter above 15 mm on transvaginal ultrasound, surgical evacuation was performed. RESULTS: Eighty-two percent of the women randomised to pharmacological treatment and 76% of those randomised to expectant management had an empty uterine cavity after five days. Convalescence time was 1.8 days longer for women randomised to pharmacological treatment. Pain, bleeding, complications, and satisfaction with the treatment did not differ between the groups. CONCLUSIONS: Most cases of spontaneous incomplete miscarriage will become a complete miscarriage without intervention. This study shows that outpatient treatment with a combination of antiprogesterone and a prostaglandin E1 analogue did not increase the rate of complete miscarriage, compared with expectancy alone, by a clinical important degree.

Abortifacient Agents, Steroidal↗

PubMed1996

[Manual intrauterine aspiration using a Karmann syringe. Multicenter study in Sonora and Sinaloa, Mexico].

These are the results of a prospective, multicentric study carried out in five institutional hospitals in Sonora and Sinaloa, using Karmann syringe and cannulae for manual intrauterine aspiration in cases of incomplete abortion, dead and retained ovum, hidatiform mola and endometrial biopsy. Management data in 1046 patients, are described; methodology is shown, and demonstrating that it converts uterine emptying is a simple, efficacious and economical procedure, with a very low risk and it allows these patients management in an ambulatory way. From these results, and as it is demonstrated in the study, institutions may increase their programable resources as to amount of disposable beds, for other type of patients, and the offering of attention by surgeon, anesthetist, nurse and medication, as their hospital stay is minimal, and in most of the cases active anesthetist participation is not required. In the same way, it permits the patient a better relationship with the personal of the institution, and so, a more human care and the possibility of reintegrating the patient to a familiar environment, rapidly, and in good psychical and physical conditions.

Abortion, Incomplete↗

PubMed1999

Effect of oral administration of a calcium chloride gel on blood mineral concentrations, parturient disorders, reproductive performance, and milk production of dairy cows with retained fetal membranes.

OBJECTIVE: To assess the effect of oral administration of CaCl2 gel on blood mineral concentrations, parturient disorders, reproductive performance, and milk production of dairy cows with retained fetal membranes (RFM). DESIGN: Randomized field trial. ANIMALS: 20 cows that calved normally and were not treated with CaCl2 gel (group 1), 20 cows with RFM that were treated with CaCl2 gel (group 2), and 20 cows with RFM that were not treated with CaCl2 gel (group 3). PROCEDURE: Group-2 cows were treated orally with CaCl2 gel (54 g of calcium) 24 and 48 hours after parturition. RESULTS: Administration of CaCl2 gel 24 and 48 hours after parturition did not have a significant effect on serum normalized calcium, total calcium, magnesium, or phosphorus concentrations or on incidence of metritis or left displacement of the abomasum, days to first insemination, pregnancy status after first insemination, or milk production. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of CaCl2 gel 24 and 48 hours after parturition did not have significant effect on blood mineral concentrations, parturient disorders, reproductive performance, and milk production in dairy cows with RFM.

Abomasum↗

PubMed2005

The effect of a monensin controlled-release capsule on the incidence of retained fetal membranes, milk yield and reproductive responses in Holstein cows.

The objective of this study was to determine the effect of a monensin controlled-release capsule on the incidence of retained fetal membranes (RFM), milk yield and conception rate at first service (CRFS). The study was conducted during May to August 2004 in a large dairy herd in Chihuahua, Mexico. Cows (n = 2,025) from 20 to 30 d before expected parturition were randomly assigned to either a treatment or a control group. The treated group (n = 1,010) received orally a capsule of monensin that released 335 mg/d for 95 d. Control cows (no capsule, n = 1,015) were randomly assigned and matched by parity. Outcome variables were the incidence of RFM, first three test day milk and CRFS. Monensin decreased the incidence of RFM by 3.9% only in multiparous cows. Therefore, multiparous cows treated with monensin were 0.78 times (95% C.I. = 0.71-0.86) as likely as control multiparous cows to develop RFM. Overall, milk yield was negatively affected by the RFM condition, but it was improved by monensin only in multiparous cows with RFM at test day 1. Conception rate at first service was depressed by 10.6% in multiparous cows with RFM. However, in RFM cows treated with monensin, CRFS improved to the level of treated cows without RFM.

Animals↗

PubMed1995

Evaluation of the use of intrauterine infusions of oxytetracycline, subcutaneous injections of fenprostalene, or a combination of both, for the treatment of retained fetal membranes in dairy cows.

Dairy cows (n = 207) that had retained fetal membranes for more than 8 hours after parturition were randomly assigned to 1 of 4 treatment groups (group 1, daily intrauterine infusion of oxytetracycline; group 2, daily intrauterine infusion of oxytetracycline and a single SC injection of fenprostalene; group 3, a single SC injection of fenprostalene; and group 4, untreated controls). Cows were monitored daily. Subsequent disease conditions were recorded, and appropriate treatments were initiated. Interval from parturition to expulsion of fetal membranes was unaffected by treatment regimen. The frequency of cows with high rectal temperatures (> or = 39.5 C) was significantly (P < 0.05) less in cows treated with oxytetracycline infusions; however, the frequency of displaced abomasum, ketosis, and mastitis was unaffected by treatment method. Treatment method appeared to influence the development of postpartum uterine pathologic conditions. Treatment with oxytetracycline and fenprostalene (group 2) increased (P < 0.05) the frequency of pyometra. Treatment with fenprostalene (groups 2 and 3) decreased the number of cows with a palpable uterine lumen detectable during per rectal palpation at 28 to 42 days after parturition. Reproductive efficiency, as determined on the basis of the interval from parturition to conception, was unaffected by treatment protocol.

Abortifacient Agents, Nonsteroidal↗

PubMed2006

Ceftiofur derivatives in serum, uterine tissues, cotyledons, and lochia after fetal membrane retention.

The objective of the study was to determine concentrations of ceftiofur derivatives after subcutaneous application of ceftiofur hydrochloride in cows with retained fetal membranes. Concentrations of ceftiofur derivatives detected as desfuroylceftiofuracetamide were determined in blood serum, endometrium, caruncles, cotyledons, and lochia during 72 h. After induction of parturition, 2 primiparous and 4 multiparous cows having retained fetal membranes for at least 12 h were studied. All cows received 3 consecutive injections (C1 to C3; 24 h apart) of 1-mg ceftiofur equivalents per kilogram of body weight as ceftiofur hydrochloride sterile suspension. Samples of blood, endometrium, caruncles, cotyledons, and lochia were collected immediately before each injection (0 h) and again at 4, 12, and 24 h after C1, C2, and C3. Blood samples were collected from coccygeal vessels. Caruncles were removed from the uterine lumen by manual extirpation and separated from cotyledons. Endometrial tissue (0.5 g) was collected by using Kenny's biopsy apparatus. For all samples, concentrations of potentially active ceftiofur derivatives were quantified using an HPLC assay. Within 2 h (serum), 4 h (endometrium), and 12 h (caruncles, cotyledons, lochia) after C1 and during the entire study period, mean concentration of ceftiofur derivatives exceeded the reported minimum drug concentrations required to inhibit the growth of 90% of isolates for relevant bacteria such as Escherichia coli, Fusobacterium necrophorum, and Arcanobacterium pyogenes. Only in single samples did concentrations decrease temporarily below the reported minimum drug concentrations required to inhibit the growth of 90% of isolates.

Animals↗

PubMed1990

Embryo-transfer twinning and performance efficiency in beef production.

Effects of twinning on efficiency of beef production were estimated from results of bilateral transfer of two Angus x Hereford (AxH) embryos into each of 241 heifers and 84 cows (H, A, HxA or Holstein x H) over 4 yr. Calves were weaned at 180 d and fed either 220 d in a feedlot (1977) or 170 d on forage and 140 d in a feedlot (1978 to 1980). Effects of parity, twinning and sex of calf were estimated as covariates within year-breed of dam. Pregnancy at 45 to 60 d of gestation was 68% in heifers (H) and 74% in cows (C), with 40% single (S) and 60% twin (T) births. Dystocia was 28% in H vs 10% in C (P less than .05), and tended to be less (P greater than .05) for T than S in H. More placentas were retained (P less than .05) for T than for S in both H (35 vs 12%) and C (24 vs 4%). Twin gestations averaged 3 d shorter and subsequent calving intervals 13 d longer (P less than .05), but total calf mortality was slightly higher (P greater than .05). Abortions were 4% in H only. Twinning females lost maternal weight during late gestation (P less than .05) when crowding limited voluntary feed intake, while fetal requirements were 60% higher (P less than .01). Twins increased milk output 25% (P less than .05), but 11% higher feed intake maintained cow weight during lactation. Twinning reduced birth weight 13% and weaning weight 17% (P less than .05), but 400-d feedlot weight only 9% because of compensating feedlot gain. Twins gained 18% faster than S during postweaning 170-d forage feeding, but 5% slower in feedlot to 8% lighter 490-d weight (P less than .05). Assuming 40% higher veterinary and labor costs for twins, estimated integrated herd costs per unit of age-constant output value would be lower for T than for S production by about 24% for marketing either at weaning or at 400 d.

Abortion, Veterinary↗

PubMed2003

Comparison of ceftiofur hydrochloride and estradiol cypionate for metritis prevention and reproductive performance in dairy cows affected with retained fetal membranes.

The objective of this study was to compare the effect of ceftiofur hydrochloride and estradiol cypionate (ECP) administration for metritis prevention and reproductive performance in dairy cows affected with retained fetal membranes (RFMs). After parturition, 97 dairy cows affected with RFM from a single dairy herd were randomly allocated to 1 of 3 treatment groups. Cows in-group 1 (n=31) were treated daily for 5 days with ceftiofur hydrochloride (2.2mg/kg, i.m.); cows in group 2 (n=33) were treated once with ECP (4 mg, i.m.); and cows in group 3 (n=33) were not treated. The proportion of cows with metritis, uterine involution patterns and the calving-to-conception interval were compared between groups. The proportion of cows that developed metritis was significantly different (P<0.05) in cows treated with ceftiofur hydrochloride (13%), compared with cows treated with ECP (42%) or cows that received no treatment (42%). Uterine involution patterns (i.e. median time to complete retraction of the uterus and mean diameter measure of cervix and uterine horns) were not significantly different between groups. Cows treated with ECP were 0.40 times as likely to conceive as control cows (P=0.05); median time to conception in cows treated with ECP (192 days) was longer, compared to control cows (124 days). We conclude that systemic administration of ceftioufur hydrochloride is beneficial for prevention of metritis, but its effect on reproductive performance was not significantly different to that of ECP or no treatment. In addition, administration of ECP did not have beneficial effects on metritis prevention and reproductive performance.

Animals↗

PubMed2001

Pre-parturition profile of steroids and prostaglandin in cows with or without foetal membrane retention.

Retained foetal membranes in cattle is one of the most common complications associated to the reduction in milk yield and impaired fertility in dairy cattle. In order to determine some endocrine mechanisms controlling parturition and delivery of foetal membranes, plasma concentrations of steroids and prostanoids were determined in 20 healthy Holstein cows. Samples were taken within the interval of 5 days pre-parturition to 12h after calving. Progesterone (P4) levels were similar in cows with (PR) and without (NPR) placental retention. While the estradiol-17beta (E2) peak at parturition was lower in PR than in NPR cows, cortisol levels were greater in PR cows 12 and 24h pre-parturition. The Prostaglandin F2alpha metabolite (PGFM) levels were higher at parturition in NPR compared with the PR group, but 12h later, these levels in the PR group increased so that concentrations were greater as compared with NPR cows. The Prostaglandin E2 metabolite (PGEM), 24, 48 and 72 h pre-parturition, were higher in PR cows. However, the PGFM:PGEM ratio was greater in cows up NPR at all time when included, indicating the importance of higher levels of Prostaglandin F2alpha (PGF2alpha) than Prostaglandin E2 (PGE2) for normal placental delivery. In conclusion, placental retention was related to both estrogen and PGF2alpha deficiency, which may be a consequence of metabolic stress leading to PGE2 and maternal cortisol synthesis before parturition.

Animals↗

PubMed2006

Evaluation of intrauterine antibiotic treatment of clinical metritis and retained fetal membranes in dairy cows.

Retained fetal membranes (RFM) and clinical metritis (CM) are frequently diagnosed disease conditions in dairy cows and considered of major economic impact due to negative effect on reproduction and milk production. The objective of this study was to evaluate the efficacy of i.u. tetracycline for the treatment of RFM and CM in dairy cows. Affected cows were randomly assigned to two groups; treatment group animals received i.u. 5g chlortetracycline twice weekly for 2 wks, and no treatment group. A total of 1416 cows and 804 heifers in 5 herds calved during the study period. CM was diagnosed in 18.6% (inter farm range; 15.2-23.5%) and 30% (19.4-42.3%) of cows and heifers, respectively. RFM was diagnosed in 13.1% (9.4-18.1%) and 9.2% (3.6-13.8%) of cows and heifers, respectively. Conception rates after first insemination were 38.3%, 42.5% and 18% in normal, treated and non-treated CM cows, respectively. Numbers of days open were 140.5, 136.2 and 165.5 in normal, treated and non-treated CM cows, respectively. Based on 305-d corrected milk yield, cows and heifers affected by RFM and CM produced 300-500kg less milk compared with their normal herd mates. Cows treated for CM produced 654kg more milk per 305-d corrected lactation compared to non-treated control cows. Treatment of RFM had no effect on reproductive performance or milk production. In conclusion, i.u. chlortetracycline treatment was proven to prevent the detrimental effect of CM on reproductive performance in heifers and cows and on milk production in cows only.

Age Factors↗