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Management of postpartum uterine eversion in a Ewe.

Introduction

Eversion of uterus is observed more commonly in cow and ewe, less common in doe. It normally occurs during third stage of labour at a time when fetus has parturated and fetal cotyledons have separated from maternal caruncles (Noakes et al., 2009). It occurs immediately after or within several hours of parturition, when cervix is open and uterus lacks tone. The etiology of uterine eversion could be poor or lack of uterine tone, increased straining caused by pain or discomfort after parturition, weight of retained fetal membranes, conditions that could increase intra-abdominal pressure like tympany and feeding on feed containing excessive estrogen.

History and Observation

A three years old pluriparous ewe was presented with complete eversion of swollen uterine mass hanging from vulva below hock region and with history of normal parturition 12 hours before and partially expelled placenta.

On clinico-gynaecological examination, ewe had tenesmus, everted uterine mass was soiled with dirt, faeces and straws. The everted uterine mass was oedematous, slight capillary bleeding with necrotic fetal membranes was noticed. The general parameters were recorded-rectal temperature was 103 F, rapid and weak pulse, rapid respiration, pale mucus membrane, animal was depressed, anorexic and restless.

Treatment and Discussion

The goal of treatment of uterine eversion was replacement of organ followed by restoration and retention. The ewe was treated under epidural anaesthesia (3 ml of 2% Lignocaine hydrochloride infilterated into first inter coccygeal space) as it reduces straining and desensitises perinium. The ice pack was applied on everted mass for reduction in size. The necrosed fetal membrane, blood clots, faeces and straws were completely removed from everted mass. The everted portion was washed thoroughly with mild antiseptic solution (Potassium permaganate) and paraffin oil was applied as lubricant for easy reposition. Hind quarter of ewe was elevated by extending hind legs backward. The everted uterine mass was repositioned initially by applying gentle palm pressure and complete uterine reposition was achieved by applying arm pressure through vagina (Kumbhar et al., 2009). Fingers were inserted to make sure that there is no remaining invagination that could incite abdominal straining and another eversion. To avoid recurrence of eversion retention sutures were applied. After reposition of everted mass, Oxytocin (Syntocinona, 5 IU/ml) 10IU was administered im to increase uterus tone. Anistamin (b) (Chlorpheniramine maleate 10mg/ml, @ 0.25-0.5 mg/kg, b.wt.), Intacefb @ 20-25mg/kg b.wt im were administered. The treatment was repeated for next 4 days and ewe showed excellent response to treatment, as eversion did not reoccur after completion of treatment. Retention sutures were removed after completion of five days of treatment.

References

Kumbhar, U. B., Suryawanshi, A. A, Mulani, J.B. and Raghuwanshi, D.S. (2009). Clinical management of Postpartum eversion of Uterus in Marathwadi Buffalo. Vet. World 2: 202.

Noakes, D.E., Perkinson, T.J. and England, G.C.W. (2009). Post Parturient Prolapse of the Uterus. Arthur's Veterinary Reproduction and Obstetrics. Saunders, p: 319-323.

A. Sahadev, B.R. Suchitra (1) and G.J. Renukaradhya (2)

Department of Veterinary Gynaecology and Obstetrics Veterinary College Karnataka Veterinary, Animal and Fisheries Sciences University (KVAFSU) Hassan--573201 (Karnataka)

(1.) Assistant Professor and Corresponding author. E-mail: suchitraraju2003@yahoo.co.in

(2.) Department of Teaching Veterinary Clinical Complex

(a)--Brand of Novartis India Ltd., Mumbai

(b)--Brand of Intas Animal Health, Ahmedabad
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Article Details
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Title Annotation:Short Communication
Author:Sahadev, A.; Suchitra, B.R.; Renukaradhya, G.J.
Publication:Intas Polivet
Article Type:Report
Geographic Code:9INDI
Date:Jul 1, 2014
Words:547
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