Ultrasonographic and radiological evaluation of dystocic uterus in small ruminants.
Ultrasound scan is considered to be a safe, noninvasive, accurate and cost-effective investigation of fetus in Veterinary practice. Of late, it is assuming a paramount importance as an indispensible obstetric tool and is being used not only to test early pregnancy but also to evaluate prenatal foetal health. It is also useful to rule out incidence of foetal malformations, hydramnios and oligohydramnios etc. Because of dramatic hike in prices of meat animals like sheep and goat, the number of cases of dystocic ewes which were otherwise slaughtered are now reported for evaluation and surgery. Accordingly there is pressure on the Veterinary clinician to indicate the viability of foetuses, incidence of twinning, probable postoperative complications etc.
The diagnostic ultrasound enables us to solve many of these queries which in turn are useful to decide the anaesthetic protocol to be adopted for surgery. Hence in the present study an attempt was made to evaluate the dystocic ewes and does using diagnostic ultrasound to be subjected for caesarean section.
Materials and Methods
This study was conducted on 72 referral cases of sheep and goat with history of dystocia, which could not be resolved by mutational operations.
All animals under study were subjected for real time B-mode Trans abdominal ultra-sonography with 3.5 and 5MHz transducers for diagnosing whether foetus was alive or dead. The foetal heart was located and observed for movement. In case of live fetuses, both B and M modes were used to demonstrate the dynamic activity of heart. Abnormalities of foetus if any were noted. When the information obtained from diagnostic ultrasound was inadequate, lateral and ventro dorsal radiographs of abdomen were taken.
Results and Discussion
In all the cases, diagnosis of dystocia was made mostly by history of completion of gestation period, straining, fatigue, restlessness, colicky signs in case of torsion, off feed for a couple of days, cessation of rumination, constipation etc. In cases of uterine torsion, animals had colicky pains. Clinical examination revealed stenosis of vaginal passage and difficulty in entering the birth canal. The signs were found to regress without lamb delivery. In many animals, parturition was overdue and animals looked almost normal. Diagnostic ultrasound was carried out in all the animals and was found more useful.
Ultrasonography has been used for diagnosis of several conditions in animals. Schrik and Inskeep (1993) reported ultrasonography as a rapid and accurate procedure for diagnosing viability of foetus in ewes. Alan et al. (1994) reported that, diagnostic ultrasound could be used to avoid economic losses caused by slaughter of pregnant ewes. In present study, 3.5 and 5 MHz transducers gave good resolution to diagnose fetal viability. Application of transmission gel on prepared area of ventral abdomen for transducer application provided good contact to visualize foetal parts. Garcia et al. (1993) employed 7.5 MHz transducer, while Alan et al. (1994) used 5 MHz transducer.
The accuracy of diagnosis was 100 % with dead fetuses (48 out of 48) while was 91.78% in live fetuses (19 out of 24). The viable foetus with presence of a beating heart (Fig. 1) and non viable foetus with absence of heart beat (Fig. 2) on ultrasonography were easily detected and confirmed by M mode. The higher percentage accuracy in dead fetuses due to the fact that, all fetuses diagnosed non-viable, remained dead. But relatively less accuracy observed in live fetuses might be due to some fetuses being live at time of ultrasonography should have died before surgery. The accuracy rate of 91.78% in present study was in contrast to 59.57percent reported by Dinc et al. (1994). Kuplulu et al. (2002) felt that transrectal and transabdominal ultrasonographic techniques were similar in their diagnostic effects. Kandil et al. (1997) reported ultrasonography as a simple technique with greater accuracy in animals with over due parturition, post maturity changes of placenta. Hyper echoic structures suspended in free flowing anechoic foetal fluids were confirmed as hippo manes intraoperatively (Fig. 3 and 4).
A case of foetal monster with ascites identified as an abnormal foetus during ultrasonography as extensive anechoic areas were seen in gravid horn. A few cases like stunted growth, even after crossing the complete length of gestational age were also diagnosed. In this case, the entire foetus could be seen on the monitor screen in a single projection (Fig. 5). Sarita (2006) felt, ultrasonography was useful in diagnosing foetal viability, obstetrical cases like dropsy, foetal mummification, maceration etc in sheep and goat. It can be used to rule out the possibility of foetal disorders like abdominal wall defects, omphalocele and diaphragmatic hernia etc. (Amit and Gaurav 2007). Wehrend et al. (2002) diagnosed a case of uterine torsion in ewes by observing an increase in width of uterine wall.
Twin pregnancies could not be detected in one case in present study. Kandil et al. (1997) also felt more difficult to predict twin pregnancies due to increased size of uterus. Dinc et al. (1994) observed an accuracy of 64.28 percent while diagnosing twin pregnancies. Determination of number of foetuses was more difficult due to large size of pregnant uterus which exceeded confinement of monitor screen (Varga et al., 1999).
In the present study no attempt was made to identify the sex of foetus. However, Santos et al. (2005), identified sex of foetuses in small ruminants. Identification of sex needed more time for search of genitalia of foetuses. As the fetuses were dead in many cases, in the present study, there was no movement of foetuses and their position was fixed. Moreover, the valuable time in saving the life of dam or foetus could not be spent in search of sex of foetus, as ewes were already in severe distress.
In some of cases, where certain degree of suspicion with regard to diagnosis existed, confirmation was done by plain radiography. The data elicited from history and findings of ultrasonography were mismatching and only a few hyperechoic shadows were visible. These were confirmed as foetal mummification and maceration through plain radiography (Fig. 6 and 7).
The above study confirms real time B-Mode trans-abdominal ultrasonography as an absolute diagnostic to test fetal viability. The knowledge of viability of foetus was useful in planning anaesthetic protocols, prognosis and predict salvage value to animal.
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V. Devi Prasad (1), Makkena Sreenu (2), R.V. Suresh Kumar (2) and T.S. Chandra Sekhara Rao (3)
Department of Veterinary Surgery and Radiology NTR College of Veterinary Science Sri Venkateswara Veterinary University (SVVU) Gannavaram Dist. Krishna--521101 (Andhra Pradesh)
(1.) Associate Professor, Dept of Veterinary Surgery and Radiology, CVSc, Proddatur and Corresponding author. E-mail: firstname.lastname@example.org
(3.) Dean, FVSc., Tirupati
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|Title Annotation:||Clinical Article|
|Author:||Prasad, V. Devi; Sreenu, Makkena; Kumar, R.V. Suresh; Rao, T.S. Chandra Sekhara|
|Date:||Jul 1, 2014|
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