Postpartum Mare

Question 1

Immediate postpartum mare

Answer 1

• mare and foal interaction
• placental exam
• general health assessment
• housing management
• complications

Question 2

Retained placenta

Answer 2

> 3 hrs postpartum

• 2-10% of parturitions
• increased risk after dystocia and placentitis
• usually nongravid horn
• partial or complete, always examine!

Question 3

Retained placenta can lead to ______

Answer 3

• metritis
• septicemia
• laminitis
• death

Question 4

Retained placenta - treatment

Answer 4

• ecbolics (oxytocin)
• gentle traction
• burns technique: NG tube thru vulva into allantoic space
• meijer et al: stallion catheter in longitudinal incision in vein of umbilicus

Question 5

Post-expulsion treatment

Answer 5

• antibiotics if you do not know how long placenta was retained
• uterine lavage
• exercise
• laminitis treatment

Question 6

Uterine prolapse typically occurs ______

Answer 6

Immediately postpartum

- may see post abortion or with retained fetal membranes

Question 7

Uterine prolapse - treatment

Answer 7

• sedation/anesthesia
• lift uterus to pelvic level
• cleanse
• remove placental attachements
• ligate vessels
• suture uterine tears
• catheterize bladder
• replace uterus w/ garbage bags filled with warm water
• antibiotics, ecbolics, caslick

Question 8

Invagination of uterine horn

Answer 8

Unresponsive, mild colic postpartum

• associated with retained placental tag
• intrauterine exam (dome-shaped tip projecting into uterine lumen)

Question 9

Invagination of uterine horn - treatment

Answer 9

• sedation
• manual removal of placental tag
• replace uterine invagination
• warm water infusion

Question 10

Uterine rupture

Answer 10

Occurs during stage 2 labor

• may be from dystocia
• usually at tip of previously gravid horn due to straightening of hindlimbs
• occurs during labor/manipulation or postpartum treatment
• examine placenta

Question 11

Uterine rupture - clinical signs

Answer 11

• hemorrhagic vaginal discharge
• signs of circulatory shock
• colic
• depression
• fever
• peritonitis

Question 12

Uterine rupture - treatment

Answer 12

Treat for shock and dehydration!

• surgical repair
• abdominal cavity lavage
• anti-inflammatory
• uterine massage

Question 13

Internal hemorrhage

Answer 13

Rupture of utero-ovarian or uterine artery (in broad ligament)

• at parturition or shortly postpartum
• usually >10 years old
• along with uterine prolapse or torsion

Question 14

Internal hemorrhage - clinical signs

Answer 14

• colic
• hemorrhagic shock
• may show no signs (controlled bleed)

Question 15

Internal hemorrhage - treatment

Answer 15

• dark stall and leave alone!!
• banamine
• burtorphanol
• corticosteroids
• whole blood transfusions

Question 16

Other postpartum hemorrhages

Answer 16

• trauma to birth canal or uterus
• cervical trauma
• vaginal trauma
• perineal trauma

Question 17

Acquired abnormalities can occur in:

Answer 17

• perineal trauma
• vagina
• cervix
• uterus
• oviducts

Question 18

Uterine involution and ovarian cyclicity

Answer 18

• decreasing uterine fluid
• decreasing uterine size
• histologic recovery –> occurs in 14-15 days
• postpartum estrus

Question 19

Postpartum exam

Answer 19

• 5-7 days
• palpation of genital tract
• ultrasound exam
• digital exam
• speculum exam

Question 20

First postpartum breeding

Answer 20

• foal heat estrus 5-15 days postfoaling
• foal heat pregnancy rates 10-20% lower
• first postpartum ovulation