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Ovine obstetrics
Embriology
(Foetal membranes)
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Embryology
• Oocyte: 16-24 h
• Spermatozoa 30-48 h
• Two-cell stage Day 1
• Eight-cell stage Day 2,5
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Embryology
• Morula (8-16 cells) Day 3 (uterus)
• Blastocyst Days 6 to 7
• Elongation Days 11 to 16
• Early placentation Days 14 to 18
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Embriology
Senger, 2006
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Embryology
• Interferon tau Interferon tau (Ovine trophoblast protein 1): Day 12– antiviral, immunosuppressive, antiproliferative
and antiluteolytic activity (stabilize P4R and/or E2ROxytocin Rno PGFCLGCLG
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Interferon-tau
Senger, 2006
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Embryology
• Intrauterine migration
• Binucleate giant cells: PSPB, PAGPAG
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Migration of binucleate giant cells
Senger, 2006
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Embryology
• Semiplacenta multiplex (cotilyca)
• Epitheliochorialis (syndesmochorialis) placenta
• Placenta dependens: Day 50
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Semiplacenta cotylica
Senger, 2006
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Semiplacenta cotylica
Senger, 2006
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Semiplacenta cotylica
Drost, 1967
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Formation of the fetal membranes
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Formation of the fetal membranes
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Formation of the fetal membranes
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Formation of the fetal membranes
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Formation of the foetal membranes
Senger, 2006
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Embryology
• Termination of pregnancy: no from Day 50– ovariectomia– PGF2a
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Duration of pregnancy
• Days 145 to 155
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Pregnancy diagnosis
Ewe
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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
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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.
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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
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Rectal abdominal palpation
01020
3040
5060
7080
90100
Se Sp + PV - PV
D 85-109D 60-96
n=79n=498
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Vaginal biopsy
• 93 to 97% accurate after 40 days of gestation
• Nonpregnancy: 81% accurate
• 100% after 80 days of gestation
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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
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Blood progesterone assay
• Pregnant: 3,7 ng/ml, non-pregnant: 1 ng/ml
• Days 18-22: 82-84%
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Progesterone profiles in the ewe
Senger, 2006
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P4 profil during the cycle
Senger, 2006
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Ovarian artery and UOV
Senger, 2006
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Ovarian artery and UOV
Senger, 2006
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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
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Progesterone test
0102030405060708090
100
Day 18
SeSp+ PV- PV
Karen et al., 2001
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P4 (ng/ml)
0
0,5
1
1,5
2
2,5
3
3,5
NP Pregnant
D 0D 18
Karen et al., 2001
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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
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Ovine placental lactogen
– Day 64: 97% és 100%
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Placental lactogen near term
Senger, 2006
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Pregnancy proteins
-PAG
-PSPB
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Binucleate giant cells
Senger, 2006
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PAG (ng/ml)
0
5
10
15
20
25
30
35
D 22 D 29 D 36 D 50
NPPregnant
Karen et al., 2001)
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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
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Pregnancy-specific proteins
• PSPBPSPB: 100% and 83% between Days 26 – 106
• single: 71%, twin: 81% between Days 60-120
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Ultrasonic techniques
A-mode
• 100% after Days 60 to 70 of pregnancy
• Nonpregnancy: 80 to 90% accurate
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Ultrasonic techniques
Doppler technique:
• Days 40 – 80: 60%
• Days > 80: > 90%
• Rectal examination: Days 35 to 55: 97%
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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%
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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)
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B. Transrectal Ultrasonography (5 MHz)
Embryonic vesicle
Days 17-19 after A1
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B. Transrectal Ultrasonography
INTRODUCTION (contd)
Embryonic vesicle
Days 17-19 after A1
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B. Transrectal Ultrasonography
INTRODUCTION (contd)
Embryo proper
Days 24-34 after A1
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B. Transrectal Ultrasonography
INTRODUCTION (contd)
Placentome
Days 30-32 after A1
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Transrectal ultrasonography (5 MHz)
01020
3040
5060
7080
90100
Se Sp + PV - PV
D 25-50D 24-26D 32-34
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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
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Fetal numbers
91
92
93
94
95
96
97
98
99
100
Se Sp + PV - PV
D 46-106D 46-93D 40-100
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Triplets
Smith, 2006
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MATERIALS AND METHODS (contd)
Transrectal ultrasonography
• Aloka SSD-500
• 5 MHz linear
• 12 h fasting• Allantoic fluid
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*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 (
%)
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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
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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
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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
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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)
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Abortion
Drost, 2006
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Abnormal placenta
Smith, 2006
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Mummification
Drost, 2006
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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
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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
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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)
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Abortion
• Viral causes:– Bluetongue– Border disease– Cache Valley Disease
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Abortion
• Bacterial/Chlamydial/Rickettsial causes– Brucellosis– Vibriosis/Campylobacteriosis– Enzootic abortion /Chlamydiosis– Coxiellosis/Q-fever
• Parasitic causes– Toxoplasmosis gondii infection
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Prolapsus vaginae
Drost, 2006
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Prolapsus vaginae
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Prolapse of the vagina
• protrusion of the mucus membrane of the floor
• fortnight of lambing
• severe prolapse: heavy straining– shock– exhaustion– aneorobic infection
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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)
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Prolapse of the vagina
Prevention:– culling policy
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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
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Pregnancy toxaemia
• hypoglycaemia: may be present
• hypocalcaemia: injection of calcium
• acetone in the breath
• ketones in the urine: confirms the diagnosis
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Pregnancy toxaemia
Treatment: – iv injections of 200 ml 40% glucose
– synthetic glucocorticoid: abortion or premature lambing
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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
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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
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Pregnancy toxaemia
Prevention:– diagnosis of twin pregnancy
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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
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Parturition
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First stage
Smith, 2006
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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
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Dystocia
Incidence:
– dry season: less
– oestrogenic substances• red clover pasture• contaminated food with Fusarium
graminaerum
– reduced PGF2a production
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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
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Dystocia
• Torsion of the uterus
• Traction– 2% Lidocaine 2-5 ml– Xylazine 4 mg (0,2 ml) + 2 ml Lidocaine 2%
• Foetotomy
• Caesarean section
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Delayed assistance
Smith, 2006
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Rupture of the vagina
Smith, 2006
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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
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Postparturient prolapse of the uterus
– 3 L Ringer – lactate
infusion
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Dystocia
• Treatment:– 10-20 NE oxytocin, – Penicilline: 22.000 NE/kg - 5 days– Uterine levage (foetotomy)
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Third stage
• FM: within 1-2 h
• Involution: – lochia: max. until Day 21 – hystology: Day 21– complete on Day 42
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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
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RFM
• RFM: after 12 h: 6,4 %– Se deficiency:
• 20 %
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Acute metritis
– > 40 C – foul discharge– anorexia
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Newborn lamb
Légvétel után
Smith, 2006
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Newborn lamb
• Standing up: 10-30 min
• < 2 h acceptance
• 50 ml colostrum: tube
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Newborn lambs
Asphyxia neonatorum:- Secondary hypothermia- Death: 0 to 1-2 days
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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)
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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
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Hypothermia
• Normal: 38.8 - 40 C
• Slight hypothermia: 37 - 38.8 C
• Severe hypothermia: < 37 C
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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.
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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
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Hypothermia
Prevention:• Adequate feeding during gestation: to prevent
small fetuses
• Shelter for lambing
• Selection
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Hyperthermia
• Severe dehidration
• Weak suckling
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CAPRINE OBSTETRICS
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EMBRYOLOGY
• Intrauterine migratio
• Placenta epitheliochorialis (syndesmochorialis)
• Semiplacenta cotilyca
• CL dependens
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Embryology
• Interferon tau Interferon tau (Caprine trophoblast protein 1): Day 12– antiviral, immunosuppressive, antiproliferative
and antiluteolytic activity (stabilize P4R and/or E2ROxytocin Rno PGFCLG
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Binucleate giant cells
-PSPB
-PAG
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Binucleate giant cells
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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)
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Pregnancy diagnosis
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Ultrasound technique
Doppler probe: from Day 25• Accurate: from Days 35-40
B-mode: from Day 30
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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
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Cycle in the goat
Pugh, 2002
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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.
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Chemical methods of pregnancy diagnosis
• Pregnancy associated glycoprotein (PAG)
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Pseudopregnancy
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Pseudopregnancy
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Aborting before term
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Kidding one life and one dead fetuses at term
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Twin pregnancy until term: Day 40: mummified Day 120: decomposed
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Pathology of gestation
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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
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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.
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Pregnancy toxaemia
• Treatment:– Mild cases: hand feeding, 3 mg/kg of glycerol or 60
ml of propilene glycol twice a day
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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.
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Hypocalcaemia
• Around kidding
• 25 ml Ca i.v. and s.c.
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Vaginal prolapse
• During the last month of pregnancy– Incomplete vaginal prolapse
– Complete vaginal prolapse
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Treatment
• Incomplete vaginal prolapse: – confinement
– hindquarters are elevated at night
– increasing exercise
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Treatment
• Complete vaginal prolapse– Vulva should be sutured
– Vaginal retainers designed for ewes
– Culling
– Lush clover or alfalfa roughage during pregnancy should be avoided
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Periparturient care of the doe
• Goats need a 6 to 8-week dry period.
• Does with a history of mastitis should be dry treated.
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Periparturient care of the doe
• Four weeks before parturition: tetanus, enterotoxemia vaccinations
• Prophylactic Vitamin E-, Se injections: if white muscle disease occurs.
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PARTURITION
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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.
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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.
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Dystocia
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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.
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Dystocia
• Uterine torsion:– Uncommon
– Caesarean section
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Dystocia
• Forced extraction:– If the cervix is well dilatated and the fetal
presentation can be corrected, forced extraction may be attempted.
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Dystocia
• Fetotomy:
– Epidural anesthesia: 2% 2 to 5 ml Lidocaine
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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
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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.
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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
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Retained placenta
Prevention: – adequate exercise and nutrition
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Metritis
• Clinical signs: – anorexia, – dark red malodorous uterine discharge, – rectal temperature above 40 C
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Metritis
Treatment: – systemic antibiotic therapy
– local treatment, if the cervix is open, by a catheter
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Uterine prolapse
• Treatment:– Epidural anesthesia: Lidocaine
– Sedation: 2 mg IV or 3 to 5 mg IM of xylazine