Reading room. Endometritis, etiology, clinical signs, treatment of hypotension and uterine atony

Introduction

afterbirth cow treatment tricilin

Pathology of the third stage of labor, manifested by a violation of the separation or removal of the placenta from the birth canal. The placenta is said to be retained if the placenta does not separate in cows after 6-10 hours, in mares after 35 minutes, in sheep and goats after 5 hours, in pigs, bitches, cats and rabbits 3 hours after the birth of the fetus. Retention of the placenta can occur in animals of all species, but is more often observed in cows, which is explained by the unique structure of the placenta and the relationship between its fetal and maternal parts. Retention of placenta in cows can be recorded at different times of the year, but more often in winter and spring. /2,4,7/

1.Literature review

1.1 Anatomical and topographic data

In the uterus of female farm animals, horns, body and neck are distinguished. The two horns of the uterus, merging at their posterior ends, form a common cavity - the body of the uterus. The body of the uterus is small, does not exceed 5 cm in length. The horns of the uterus of a pregnant cow are 20-30 cm long. They extend slightly upward from the body of the uterus and pass into the oviducts. The body of the uterus ends at the cervix, which has a narrow canal surrounded by a thick muscular layer. In female farm animals, the uterus is located under the rectum and above the bladder; it is suspended on the broad uterine ligament, which is attached to the psoas muscles. In a cow, the uterus lies partly in the abdominal cavity, partly in the pelvic cavity.

The wall of the uterus consists of the following layers: inside it is lined with mucous membrane; on the outside it is covered by two layers of smooth muscle fibers - the inner circular and outer longitudinal. The vagina is located in the pelvic cavity under the rectum. Its length is about 35 cm. Inside it is lined with mucous membrane. There is a distinction between the vagina itself - the longer part facing the cervix and the vestibule of the vagina. At the border between these two sections on the underside of the vagina is the opening of the urethra. From the outside, the vestibule of the vagina passes into the genital slit formed by the labia, in the lower corner of which the clitoris is located - the rudiment of the penis. /1.8/

Figure 1 Diagram of reproductive organs

Ovaries; 2-oviduct; 3-horns of the uterus; 4-body of the uterus; 5-cervix; 6-hole of the cervix; 7-vagina; 8-hole of the urethra; 9-vaginal vestibule; 10-clitoris; 11-labia; 12-mesentery of the uterus, or broad uterine ligament.

B-cervix of a cow

Vagina; 2-external opening of the neck; 3-channel cervix; 4-internal opening of the neck; 5-wide ligament; 6-ovary./1/

.2 Etiology

The immediate causes of retained placenta are insufficient contractility (hypotonia) or complete absence of contractions (atony) of the uterus, fusion (adhesion) of the uterine and fetal parts of the placenta due to pathological processes in them. After calving, the cow's uterus contracts strongly (postpartum pushing), the placenta gradually separates from the uterine mucosa and is pushed out of the genital tract. If there are no afterbirth attempts or they are weak, then the afterbirth does not separate. The afterbirth does not separate even when it is fused with the uterus. Retention of placenta can be due to many predisposing reasons: 1) insufficient feeding, leading pregnant cows to exhaustion; in such cows the attempts are too weak to expel the placenta from the uterus; 2) improper diet, with a lack of minerals and vitamins, which reduces the body’s strength and predisposes to weak contractions of the uterus; 3) maintenance without walks; 4) obesity of the cow from overfeeding and lack of walks; 5) twins and overly large fetuses, which stretch the uterus too much, causing the force of pushing to decrease; 6) abnormal development and deformity of the fetus in the womb (hydrops fetus and membranes); 7) severe debilitating calving with damage to the birth canal, causing general weakness and weakness of postpartum attempts; 8) contagious and non-contagious diseases of a pregnant cow, which reduce the body’s strength and lead to weak attempts or cause fusion of the placenta with the uterus. /4.7/

1.3 Clinical signs

The animal is anxious, often strains, hunches its back and raises its tail; sometimes reluctant to eat food, often lies down; During straining and increased contractions of the uterus, discharge from the external genitalia is observed. When the placenta is completely retained, bloody discharge is noted. When the placenta is retained, the main clinical sign is the presence of amniotic membranes in the uterine cavity 6 hours after calving of cows. At the same time, general clinical indicators (body temperature, pulse, respiration, rumen contraction) are usually within normal limits.

With complete retention of the placenta, the breakdown of placental tissue is somewhat delayed, and if the diagnosis is untimely, on the fourth or fifth day, the release of catarrhal-purulent exudate mixed with fibrin crumbs begins from the uterus. At the same time, the general condition of the cows changes. Complications of retained placenta in cows can include endometritis, vaginitis, postpartum infection, mastitis./3,4,5/

.4 Diagnosis

When the placenta is completely retained, a red or gray-red strand protrudes from the external genitalia. Its surface is lumpy in a cow (placenta). Sometimes only flaps of the urinary and amniotic membranes without vessels hang out in the form of gray-white films. With severe atony of the uterus, all the membranes remain in it (detected by palpation of the uterus). /2/

.5 Differential diagnosis

Complete retention of the placenta must be differentiated from incomplete retention of the placenta. To establish incomplete retention of the placenta, it is necessary to carefully examine it.

When the placenta is completely retained, a red or gray-red strand protrudes from the external genitalia. Its surface is lumpy in a cow (placenta) and velvety in a mare. Sometimes only flaps of the urinary and amniotic membranes without vessels hang out in the form of gray-white films. With severe atony of the uterus, all the membranes remain in it (detected by palpation of the uterus).

To establish incomplete retention of the placenta, it is necessary to carefully examine it. The placenta is examined, palpated and, if indicated, a microscopic and bacteriological analysis is performed. /2,3,4/

The released afterbirth is straightened out on a table or plywood. To determine whether the placenta has been completely released, they are guided by the vessels of the placenta, which are a closed network surrounding the entire fetal bladder. During childbirth, the underlying portion of the membranes ruptures along with the vessels passing through it. The integrity of the entire membrane is judged by the breaks of the vessels: when the torn edges come together, their contours should form a matching line, and the central ends of the torn vessels, when they come into contact with the peripheral segments, should form a continuous vascular network. By the location of the defect found in the choroid, it is possible to determine in which place of the uterus the torn part of the placenta remains. Subsequently, when palpating the uterine cavity with the hand, it is possible to palpate the remainder of the placenta. /6,7/

.6 Forecast

The prognosis is cautious towards favorable. If treatment is not treated in a timely manner, endometritis, abscesses, and general exhaustion of the body may develop./5/

1.7 Treatment

Conservative treatment methods for retained placenta:

Treatment of cows with retained placenta begins 6 - 8 hours after the birth of the calf. It involves increasing the tone and contractile function of the uterus, ensuring the fastest and most complete separation of the placenta, preventing infection of the uterus, the development of an inflammatory process in it and general postpartum infection.

Pituitrinum - a preparation of the posterior lobe of the pituitary gland. Contains all the hormones produced in the gland. It is administered subcutaneously in a dose of 3-5 ml (25-35 IU). The action of the administered pituitrin begins after 10 minutes and lasts 5-6 hours. The optimal dose of pituitrin for cows is 1.5-2 ml per 100 kg of live weight. Pituitrin causes contraction of the muscles of the uterus (from the apex of the horns towards the cervix)./7/

The sensitivity of the uterus to uterine products depends on the physiological state. Thus, the greatest sensitivity is noted at the time of birth, then it gradually decreases. Therefore, 3-5 days after birth, the dose of uterine preparations needs to be increased. When the placenta is retained in cows, repeated administration of pituitrin is recommended after 6-8 hours.

Estrone - (folliculin) - Oestronum - a hormone formed wherever intensive growth and development of young cells occurs. Available in ampoules.

The Pharmacopoeia has approved a purer hormonal estrogen drug - estradiol dipropionate. Available in ampoules of 1 ml. The drug is administered intramuscularly to large animals at a dose of 6 ml.

Proserin - Proseripum - white crystalline powder, easily dissolves in water. A 0.5% solution is used in a dose of 2-2.5 ml under the skin for retained placenta in cows, weak pushing, and acute endometritis. Its action begins 5-6 minutes after injection and lasts for an hour./2,3,4,5/

Carbacholine - Carbacholinum - white powder, highly soluble in water. When retaining the placenta in cows, it is applied subcutaneously in a dose of 1-2 ml in the form of a 0.01% aqueous solution. Effective immediately after injection. The drug remains in the body for a considerable time, so it can be administered once a day.

Drinking amniotic fluid. Amniotic and urinary fluid contains folliculin, protein, acetylcholine, glycogen, sugar, and various minerals. In veterinary practice, fruit waters are widely used to prevent retention of placenta, atony and subinvolution of the uterus.

After giving 3-6 liters of amniotic fluid, the contractility of the uterus significantly improves. Contractile function does not resume immediately, but gradually and lasts for eight hours.

Feeding colostrum to cows. Colostrum contains a lot of proteins (albumin, globulins), minerals, fats, sugars and vitamins. Giving cows 2-4 liters of colostrum promotes the separation of the placenta after 4 hours. (A.M. Tarasonov, 1979).

Use of antibiotics and sulfa drugs.

In obstetric practice, tricilin is often used, which contains penicillin, streptomycin and white soluble streptocide. The drug is used in the form of powder or suppositories. When retaining the placenta, 2-4 suppositories or one bottle of powder are inserted into the cow's uterus by hand. The administration is repeated after 24 hours and then after 48 hours. Auremycin introduced into the uterus promotes the separation of the placenta and prevents the development of purulent postpartum endometritis.

Good results are obtained by combined treatment for retention of the placenta of reproaches. 20-25 g of white streptocide or another sulfonamide drug is injected into the uterus four times a day, and 2 million units of penicillin or streptomycin are injected intramuscularly. Treatment is carried out for 2-3 days. /5,6,7/

Nitrofuran drugs - furazolidone sticks and suppositories - are also used in treatment. Good results were also obtained after treating sick animals with septimethrin, exuter, metroseptin, utersonan and other combined drugs that are injected into the uterus.

The reproductive capacity of cows that were treated with antibiotics in combination with sulfonamide drugs after retaining the placenta is restored very quickly.

If conservative methods are not effective, 24 hours after the birth of the fetus they resort to surgical (manual) separation of the placenta. After separation of the placenta, bactericidal sticks on a foaming basis and subcutaneous uterine agents are introduced into the uterine cavity. /7/

Stimulating the defenses of a sick animal

Cows suffering from retained placenta have been successfully treated by injecting 200 ml of a 40% glucose solution into the middle uterine artery, to which 0.5 g of novocaine is added. Intravenous infusion of 200-250 ml of 40% glucose solution significantly increases the tone of the uterus and enhances its contraction. The afterbirth separated on the second day.

It is known that during labor a significant amount of glycogen from the muscles of the uterus and heart is used. Therefore, to quickly replenish the reserves of energy material in the mother’s body, it is necessary to administer 150-200 ml of a 40% glucose solution intravenously or give sugar with water (300-500 g twice a day).

Within 24 hours in summer and 2-3 days later in winter, the retained placenta begins to rot. Decay products are absorbed into the blood and lead to general depression of the animal, a decrease or complete loss of appetite, an increase in body temperature, hypogalactia, and severe exhaustion. 6-8 days after intensive blocking of the detoxification function of the liver, profuse diarrhea appears. /6.7/

Thus, when the placenta is retained, it is necessary to maintain the function of the liver, which is capable of neutralizing toxic substances coming from the uterus during the decomposition of the placenta. The liver can perform this function only if there is a sufficient amount of glycogen in it. That is why intravenous administration of glucose solution or oral administration of sugar and honey are necessary.

Autohemotherapy for retained placenta was used by G.V. Zverev (1943), V.D. Korshun (1946), V.I. Sachkov (1948), K.I. Turkevich (1949), E.D. Walker (1959), F.F. Muller (1957), N.I. Lobach and L.F. Zayats (1960) and many others.

It stimulates the reticuloendothelial system well. The dose of blood for the first injection into a cow is 90-100 ml, three days later 100-110 ml is administered. The third time blood is injected after three days at a dose of 100-120 ml. We injected blood not intramuscularly, but subcutaneously into two or three points in the neck. /7/

K.P. Chepurov, when retaining the placenta in cows, used intramuscular injections of anti-diplococcal serum in a dose of 200 ml to prevent endometritis. It is known that any hyperimmune serum, in addition to its specific action, stimulates the reticuloendothelial system, increases the body's defenses, and also significantly activates the processes of phagocytosis.

Tissue therapy for retained placenta was also used by V.P. Savintsev (1955), F.Ya. Sizonenko (1955), E.S. Shulyumova (1958), I.S. Nagorny (1968) and others. The results are very contradictory. Most authors believe that tissue therapy cannot be used as an independent method of treating retained placenta, but only in combination with other measures for a general stimulating effect on the sick body of the woman in labor. Tissue extracts are recommended to be administered subcutaneously to a cow in a dose of 10-25 ml with an interval of 3-4 days. /2,3/

For the treatment of placenta retention, a lumbar novocaine blockade is used, which causes vigorous contraction of the uterine muscles. Of the 34 cows with retained placenta, for which V.G. Martynov performed a lumbar blockade, in 25 animals the placenta separated spontaneously.

I.G. Morozov (1955) used a pararenal lumbar blockade in cows with retention of the placenta. The injection site is determined on the right side between the second and third lumbar processes at a palm's distance from the sagittal line. A sterile needle is inserted perpendicularly to a depth of 3-4 cm, then a Janet syringe is attached and 300-350 ml of a 0.25% novocaine solution is poured in, which fills the perinephric space, blocking the nerve plexus. The animal's general condition quickly improves, the motor function of the uterus increases, which promotes independent separation of the placenta. /2,3,4,7/

D.D. Logvinov and V.S. Gontarenko received a very good therapeutic result when a 1% solution of novocaine was injected into the aorta in a dose of 100 ml.

In veterinary practice, there are quite a few methods for local conservative treatment of retained placenta. The question of choosing the most appropriate method always depends on the variety of specific conditions: the condition of the sick animal, the experience and qualifications of the veterinary specialist, the availability of special equipment in the veterinary institution, etc. Let us consider the main methods of local therapeutic effects when retaining the placenta in cows.

Infusion of solutions and emulsions into the uterus. P.A. Voloskov (1960), I.F. Zayanchkovsky (1964) found that the use of Lugol's solution (1.0 crystalline iodine and 2.0 potassium iodide per 1000.0 distilled water) when retaining the placenta in cows gives satisfactory results with a small percentage of endometritis, which is quickly cured. The authors recommend pouring 500-1000 ml of fresh warm solution into the uterus, which should get between the placenta and the mucous membrane of the uterus. The solution is reintroduced every other day./6,7/

I.V. Valitov (1970) obtained a good therapeutic effect in the treatment of placenta retention in cows using a combined method: 80-100 ml of a 20% ASD-2 solution was administered intravenously, 2-3 ml of 0.5% proserin - subcutaneously and 250-300 ml 3% oil solution of menthol - into the uterine cavity. According to the author, this method turned out to be more effective than surgical separation of the placenta;

The Latvian Animal Husbandry and Veterinary Research Institute proposed intrauterine sticks containing 1 g of furazolidone, made without a fat base. When retaining the placenta, 3-5 sticks are inserted into the cow's uterus.

According to A.Yu. Tarasevich, infusion of oil emulsions of iodoform and xeroform into the uterine cavity gives satisfactory results in the treatment of placenta retention in cows.

Injection of fluid into the vessels of the umbilical cord stump. In cases where the vessels of the umbilical cord stump are intact, as well as in the absence of blood coagulation, it is necessary to clamp two arteries and one vein with tweezers, and pour 1-2.5 liters of warm artificial gastric juice into the second umbilical vein of the umbilical cord stump using the Bobrov apparatus. (Yu. I. Ivanov, 1940) or cold hypertonic sodium chloride solution. Then all four umbilical vessels are ligated. The afterbirth separates on its own after 10-20 minutes.

Infusion of hypertonic solutions of medium salts into the uterus.

To dehydrate the villi of the choroid and the maternal part of the placenta, it is recommended to pour 3-4 liters of a 5-10% solution of table salt into the uterus. A hypertonic solution (75% sodium chloride and 25% magnesium sulfate), according to Yu I. Ivanov, causes intense contractions of the uterine muscles and promotes the separation of placenta in cows. /2,3,4,5,7/

Repeated cutting of the stump of placenta vessels

After the calf is born and the umbilical cord ruptures, there is almost always a stump of blood vessels hanging from the vulva. We have repeatedly observed how veterinary workers, who do not have sufficient knowledge in the field of the birth process, diligently stopped the “bleeding” from the stump of the blood vessels of the placenta. Naturally, such “help” helps to delay the placenta. After all, the longer blood flows from the vessels of the baby placenta, the better the villi of the cotyledons are bled dry, and, consequently, the connection between the maternal and baby placenta weakens. The weaker this connection, the easier the afterbirth is separated. Therefore, repeated cutting of the umbilical cord stump with scissors must be used to prevent retention of the placenta in cows. /7/

Surgical intervention in case of strong pushing in a cow is carried out against the background of low sacral anesthesia (injection of 10 ml of 1-1.5% novocaine solution into the epidural space) or novocaine blockade of the pelvic nerve plexus according to A. D. Nozdrachev Synoestrolum - 2.-1 % oily solution. Available in ampoules. Injected subcutaneously or intramuscularly. The dose for a cow is 2-5 ml. The effect on the uterus begins an hour after administration and lasts 8-10 hours. Sinestrol causes rhythmic energetic contractions of the uterus in cows and promotes the opening of the cervical canal. Some scientists (V.S. Shipilov and V.I. Rubtsov, I.F. Zayanchkovsky, and others) argue that sinestrol cannot be recommended as an independent remedy in the fight against placenta retention in cows. After using this drug in high-milk cows, lactation decreases, atony of the forestomach appears, and sometimes sexual cyclicity is disrupted.

Many methods have been proposed for separating the placenta, both conservative and operative, manual. /2,3,5/

In cows: if the placenta has not separated 6-8 hours after the birth of the fetus, you can administer sinestrol 1% 2-5 ml, pituitrin 8-10 units per 100 kg. Body weight, oxytocin 30-60 units. or massage the uterus through the rectum. Sugar 500g is given inside. Promotes separation of the placenta during uterine atony by tying it with a bandage to the tail, 30 cm away from its root (M.P. Ryazansky, G.V. Gladilin). The cow seeks to release the tail by moving it from side to side and back, which encourages the uterus to contract and expel the placenta. This simple technique should be used for both therapeutic and preventive purposes. The villi and crypts can be separated by introducing pepsin with hydrochloric acid (pepsin 20 g, hydrochloric acid 15 ml, water 300 ml) between the chorion and the uterine mucosa. ON THE. Phlegmatov found that amniotic fluid, administered in a dose of 1-2 liters to a cow through the mouth, already after 30 minutes increases the tone of the uterine muscles and increases the frequency of its contractions. Amniotic fluid is used for prophylactic and therapeutic purposes when the placenta is retained. During rupture of the membranes and during expulsion of the fetus, amniotic fluid is collected (8-12 liters from one cow) into a basin well washed with hot water and drained into a clean glass container. In this form they can be stored at a temperature no higher than 3 degrees Celsius for 2-3 days. When the placenta is retained, it is recommended to drink amniotic fluid 6-7 hours after the birth of the fetus in the amount of 3-6 liters. If there are no placental fusions, as a rule, after 2-8 hours the placenta separates. Only some animals have to be given amniotic fluid (in the same dose) up to 3-4 times at intervals of 5-6 hours. Unlike artificial drugs, amniotic fluid acts gradually, its maximum effect appears after 4-5 hours and lasts up to 8 hours ( V.S. Shipilov and V.I. Rubtsov). However, the use of amniotic fluid is associated with difficulties in obtaining and storing it in the required quantity. Therefore, it is more convenient to use amnistron, a drug isolated from amniotic fluid; it has tonic properties (V.A. Klenov). Amnistron (it is administered intramuscularly in a dose of 2 ml), like amniotic fluid, has a gradual and at the same time long-lasting effect on the uterus. Within an hour, the activity of the uterus increases 1.7 times, and by the 6th -8th hour it reaches its maximum. Then the activity begins to gradually decrease, and after 13 hours only weak contractions of the uterus are noted (V.A. Onufriev). /6/

When retaining the placenta due to atony of the uterus and increased turgor of its tissues, the use of an electric separator designed by M.P. Ryazansky, Yu.A. Lochkarev and I.A. Dolzhenko, subcutaneous injections of oxytocin or pituitrin (30-40 units), colostrum from the the same cow in a dose of 20 ml, prostaglandin preparations, blockade according to V.V. Mosin And other methods of novocaine therapy. Particularly effective is the intra-aortic administration of a 1% solution of novocaine in a dose of 100 ml (2 mg per 1 kg of animal weight) with the simultaneous administration of a 30% solution of ichthyol intrauterinely in an amount of 500 ml (D.D. Logvinov). Repeated injections are carried out after 48 hours. If within 24-48 hours conservative methods of treatment do not produce an effect, especially when the fetal part of the placenta is fused with the maternal one, then surgical separation of the placenta is resorted to. /6.7/

Manipulations in the uterine cavity are performed in an appropriate suit (sleeveless vest and robe with wide sleeves, oilcloth apron and sleeves). The sleeves of the robe are rolled up to the shoulder, and the hands are treated in the same way as before the operation. Skin lesions on the hands are smeared with iodine solution and filled with collodion. Boiled Vaseline, lanolin or enveloping and disinfecting ointments are rubbed into the skin of the hand. It is advisable to use a rubber sleeve from a veterinary gynecological glove. It is advisable to carry out surgical intervention against the background of anesthesia (sacral, according to A.D. Nozdrachev, G.S. Fateev, etc.). After preparing the right hand, grab the protruding section of the membranes with your left hand, twist it around its axis and pull it slightly, being careful not to tear it. The right hand is inserted into the uterus, where it is easy to identify areas of attachment of the fetal placenta, focusing along the course of the tense vessels and tissues of the choroid.

The fetal part of the placenta is separated from the maternal part carefully and sequentially, the index and middle fingers are brought under the chorion placenta and separated from the caruncle with several short movements. Sometimes it is more convenient to grasp the edge of the fetal placenta with the thumb and forefinger and gently pull the villi out of the crypts. It is especially difficult to manipulate the placenta at the apex of the horn, since with an atonic uterus and a short arm of the obstetrician, the fingers do not reach the caruncles. Then they slightly pull the uterine horn to the cervix by the afterbirth or, spreading their fingers and resting them on the wall of the horn, carefully lift it up and then, quickly squeezing the hand, move it forward and down. By repeating the technique several times, it is possible to “put” the uterine horn on your hand, reach the placenta and, grasping it, separate it. The work is made easier if the protruding part of the placenta is twisted around its axis - this reduces its volume, the hand passes through the cervix more freely and the deeply located placentas are somewhat pulled outward. Sometimes the uterine caruncles break off and bleeding occurs, but it stops quickly and on its own. With partial retention of the placenta, unseparated placentas are easily identified by palpation - the caruncles have a round shape and elastic consistency, while the remains of the placenta are doughy or velvety. During the operation, you must ensure cleanliness, wash your hands repeatedly and rub the enveloping substance into the skin again.

After the final separation of the placenta, it is useful to introduce no more than 0.5 liters of Lugol's solution into the uterus; penicillin, streptomycin, streptocide, uterine bacilli or suppositories with nitrofurans, metromax, and exuter are also used. However, several antibiotics with the same organotropic toxicity cannot be used at once; this causes synergism and, as a result, the development of severe complications. The sensitivity of pathogenic microflora to the antibiotics used should be taken into account. /7/

In the absence of a putrefactive process in the uterus, it is considered more appropriate to use the dry method of separation of the placenta; in this case, no disinfectant solutions are introduced into the uterus either before or after the surgical separation of the placenta (V.S. Shipilov, V.I. Rubtsov). After this method, there are fewer various complications, the ability of animals to reproduce offspring and their productivity are restored faster.

In case of putrefactive decomposition of the placenta, it is necessary to syringe the uterus with the obligatory subsequent removal of the solution. Various methods of novocaine therapy, intramuscular injection of 10-15 ml of a 7% solution of ichthyol in a 40% glucose solution, and intrauterine suppositories have a good effect. All these methods should be combined with the use of natural methods of increasing the body’s resistance and postpartum activation of sexual function (active exercise, etc.). /4.5/

1.8 Prevention

Prevention of retained placenta lies in strict adherence to the entire range of economic and veterinary measures. Particular attention is paid to proper feeding and organization of exercise for pregnant animals, proper management of labor and care for the mother. Women in labor are given 3-5 liters of amniotic fluid or 1-2 liters of colostrum./3,6,7/

2.Result of our own research

The call came from an individual sector in a neighboring village. Red-motley color, 3.5 years. The cow was in a barn that did not meet veterinary and sanitary standards; there was a draft in the room, the floor was wooden and without bedding, there was a lot of dampness. Feed: not very good quality hay, feed, straw. The animals were fed three times a day and given cold water. The cow calved in that barn, with difficulty, since the fetus was large. We provided obstetric care.

2.1 Rationale for the disease

Complete confinement of this cow developed as a result of pathological birth. The size of the fetus did not correspond to the lumen of the pelvic cavity. Obstetric services were provided. This factor gave impetus to inflammatory processes.

The preceding factors were:

Violation of conditions of detention;
Poor animal hygiene conditions;
Poor feeding, unbalanced diets;
Lack of exercise;
2.2 Clinical picture
The cow is anxious, often strains, hunches her back and raises her tail. The labia are hyperemic, swollen, and bloody discharge comes from the vulva. A gray-red cord protrudes from the external genitalia.
2.3 Diagnosis
The diagnosis of complete retention was made comprehensively, based on anamnesis, clinical data and on the basis of vaginal examination.
This is complete retention of the placenta; a red or gray-red cord protrudes from the external genitalia. Its surface is lumpy in a cow (placenta). With severe atony of the uterus, all the membranes remain in it (detected by palpation of the uterus). /2/
2.4 Differential diagnosis
Complete retention of the placenta was differentiated from incomplete retention of the placenta.
Differentiation was carried out according to clinical signs. A gray-red cord protrudes from the external genitalia. A vaginal examination was also performed.
To establish incomplete retention of the placenta, it was carefully examined. The placenta was examined and palpated.
The released afterbirth was straightened out on the table. To determine whether the placenta was completely released, they were guided by the vessels of the placenta, which are a closed network surrounding the entire fetal bladder. During childbirth, the underlying portion of the membranes ruptures along with the vessels passing through it. The integrity of the entire membrane is judged by the breaks of the vessels: when the torn edges come together, their contours should form a matching line, and the central ends of the torn vessels, when they come into contact with the peripheral segments, should form a continuous vascular network. By the location of the defect found in the choroid, it is possible to determine in which place of the uterus the torn part of the placenta remains. Subsequently, when palpating the uterine cavity with the hand, it is possible to palpate the remainder of the placenta. /6,7/
2.5 Forecast
After examining the animal, the veterinarian gave an opinion. No inflammatory processes were observed. The prognosis is favorable.
2.6 Rationale for treatment
The existing treatment methods were based on the following principles:
start treatment no later than 6-8 hours after diagnosis; the impact on the pathological focus should be complex, taking into account the etiology and pathogenesis of the disease;
prescribed antimicrobial drugs should have the widest possible bactericidal spectrum;
apply the most effective therapeutic regimens lasting no more than 3 days.

In this case, the treatment was chosen based on the above points, as well as the availability of drugs, their cost and accessibility.

Infusion of oil emulsions of iodoform into the uterine cavity gave satisfactory results in treatment.

Tricilin was used, which contains penicillin, streptomycin and white soluble streptocide. The drug was used in powder form. When retaining the placenta, one bottle of powder was inserted into the cow's uterus by hand. The administration was repeated after 24 hours and then after 48 hours. Auremycin introduced into the uterus promotes the separation of the placenta and prevents the development of purulent postpartum endometritis.

Combined treatment for retaining the placenta of reproaches also gives good results. 20-25 g of white streptocide or another sulfonamide drug is injected into the uterus four times a day, and 2 million units of penicillin or streptomycin are injected intramuscularly. Treatment is carried out for 2-3 days. /5,6,7/

2.7 Prevention

Ukorov's placenta is separated 6-10 hours after birth. Detention of the placenta for more than the specified period has a detrimental effect on fertility. After 24 hours, it is necessary to take measures to remove the placenta. Retention of the placenta may be the result of uterine atony due to muscle fatigue or a gross violation of the feeding and maintenance of the animal. If the placenta is separated on the first day after calving, then on the second day the animal is no different from normally calved cows.

To stimulate removal of the placenta, you can give the animal 400-500 g of sugar, 5-6 liters of amniotic fluid, or prescribe chemotherapy drugs. To prevent decomposition of the placenta, tricillin or biomycin is injected into the uterus. At the same time, measures are taken to enhance uterine contractions by introducing under the skin aqueous solutions of neurotropic drugs (corbocholine 0.1%, proserin 0.5%, furamon 1% 2 ml every 3-4 hours). For these purposes, you can also use oxytocin and sinestrol in combination with pituitrin.

If the drugs do not give the desired result, then measures are taken to remove the placenta by hand. The technique of mechanical removal of the placenta and the procedures thereafter have an important impact on the timing of the end of the postpartum period. The placenta should be removed in one session, since repeating the intervention a day or two after the first causes endometritis. The placenta should be separated carefully, trying not to injure the uterus (caruncles). Separation should begin with the body and free horn. It is impossible to process the membranes and leave them in the uterus, as this will cause inflammatory processes. When completely removed, the surface of the caruncles will be rough and dry.

Upon completion of separation of the placenta, it is recommended to introduce 500-1000 thousand units into the uterine cavity. antibiotic and 500 thousand units. intramuscularly. There is no need to rinse the uterus with disinfectants and solutions after removing the placenta, as this can cause complications and the cows remain infertile for a long time.

Cows that have retained placenta should be closely monitored and recorded in a gynecological log.

Animals need to be monitored even after normal births. The external genitalia of cows should be washed with warm water and a disinfectant solution until the release of lochia stops, which normally stops by 15-17 days after birth, during the period when the animal is in the maternity ward.

Lack of exercise during the postpartum period has an extremely adverse effect on the involution of the reproductive system. Lack of exercise leads to stagnation in organs and tissues, which leads to a decrease in the level of all metabolic processes.

The only way to increase the function of all organs and systems of the female after childbirth is mechanical muscle work, which increases neuromuscular tone and motor function of the uterus. This accelerates the removal of postpartum cleansing from the uterine cavity and promotes the resorption of degenerated muscle fibers.

Many researchers recommend starting regular cow walks on the 3-4th day after birth, lasting 30-40 minutes, and then increasing them every day by 10-15 minutes, bringing them to at least two hours by the 15th day after calving. Exercise should be active, that is, accompanied by muscle work. This is achieved by continuous movement of the animals throughout the entire walk. With such a housing system, animals will come into heat in a timely manner and be inseminated fruitfully.

Proper preparation of animals for mating is of great importance in preventing barrenness. Timely release of animals is one of the important factors in preparing animals for mating. The dry period should be at least 45-60 days, and for weak animals - at least 70 days.

In winter, special attention should be paid to cow walks. Walking does not contribute to better absorption of feed, but also to increased sexual activity and rapid involution of the uterus. Walking animals should be active.

Conclusion

The cow was taken to the isolation ward on 04/15/2011. The animal had complete retention of the placenta. The cow is anxious, often strains, hunches her back and raises her tail. The labia are hyperemic, swollen, and bloody discharge comes from the vulva. A gray-red cord protrudes from the external genitalia.

Based on clinical signs and anamnesis, a diagnosis was made - complete retention of the placenta. After a vaginal examination of the cow, there was surgical separation of the placenta.

To prevent inflammatory reactions, antibiotic therapy was prescribed - 2 g of streptomycin and penicillin, 2,000,000 units/kg intramuscularly, once a day.

As a result of the treatment, the animal was cured. Recommendations have been written for prevention

Bibliography

Akaevsky A.I. Anatomy of domestic animals. - M.: Agropromizdat, 2000.

Valyushkin K.D., Medvedev G.F. Obstetrics, gynecology and biotechnology of animal reproduction. - Minsk: “Harvest”, 1997

Gavrin V.G., Ubiraev S.P. and others. Modern reference book for veterinarians. - Rostov-on-Don: “Phoenix”, 2003.

Kolonov G.A. Handbook of veterinary medicine. - M.: Agropromizdat, 2002.

Nikitin V.Ya., Mirolyubimov V.G. and others. Workshop on obstetrics, gynecology and biotechnology of animal reproduction. - M.: Kolos, 2004.

Studentsov A.P., Shipilov V.S. Veterinary obstetrics and biotechnology of reproduction. - M.: Agropromizdat, 1986.

Usha B.V. Clinical diagnosis of internal non-contagious animal diseases. - M.: Kolos, 2003.

Usha B.V. Workshop on clinical diagnosis of internal non-communicable diseases of farm animals. - M.: Kolos, 2005.

Khrustalev V.P. Anatomy of domestic and farm animals. - M.: Agropromizdat, 2000.

Vologda State Dairy Academy named after N.V. Vereshchagin.

Department of Internal Non-Contagious Diseases, Obstetrics and Surgery.

Course work
in obstetrics on the topic:
“Treatment and prevention of placenta retention in cows”

Done: student
741 groups
Bushmanova O.V.

Checked:
assistant Pronina O.A.

Vologda – Dairy
2009.

Content:
Introduction
1.Literature review
1.1. Etiology of placenta retention in cows.
1.2. Classification of placenta retention.
1.3. Pathogenesis of the disease
1.4. Clinical signs and course of placenta retention
1.5. Diagnosis of this disease
1.6. Prognosis for retained placenta
1.7. Treatment of cows with this pathology
1.8. Prevention of placenta retention in cows
2. Own research (medical history)
3. Conclusions and suggestions
Bibliography
Applications

Introduction.

The placenta is considered retained when the fetal placenta remains in the uterus of cattle for more than 6 hours.
A particular danger of retained placenta in cows is that it leads to the appearance of acute and chronic postpartum endometritis, various functional disorders of the ovaries and other pathological processes in the reproductive system and, as a result, infertility.
This pathology is the most common of all postpartum complications in cows at large livestock enterprises. Particularly often, retention of the placenta is recorded in the winter-autumn period. There is a reduction in the period of productive use of animals, that is, their culling, so it is necessary to pay great attention to studying the issues of etiology, pathogenesis, treatment, and especially prevention of this disease. The economic damage caused by this disease consists of the culling of animals due to their infertility, loss of offspring, treatment costs, the occurrence of other pathologies (endometritis, mastitis and others) and their treatment, a decrease in the quantitative and qualitative indicators of milk. Therefore, the main goal that I pursue in my course work is the development of measures to prevent the retention of the placenta. After all, it is cheaper to prevent a disease than to treat it.

1.1 Etiology of placenta retention in cows.

The immediate cause of retained placenta is insufficient contractile function (hypotonia) or complete absence of contractions (atony) of the uterine muscles, fusion of the uterine or fetal parts of the placenta with the formation of adhesions.
Atony and hypotension of the uterus arise as a result of inadequate feeding and violation of the conditions of care and maintenance of pregnant females (lack of vitamins, microelements, macroelements in the diet, uniform feeding, feeding large quantities of concentrated feed, which leads to obesity of females, as well as lack of exercise, crowded accommodation with violation of zoohygienic requirements for keeping females, etc.). The cause of retained placenta may also be exhaustion of the pregnant female, vitamin deficiency, ketosis of highly productive animals, a sharp disturbance in the mineral balance, diseases of the digestive system and cardiovascular system of the woman in labor. Hypotony of the uterus can occur with multiple pregnancy in singleton animals, a large fetus, hydrops of the fetus and membranes, difficult labor and diseases of the maternal body.
Fusion of the maternal part of the placenta with the chorionic villi of the fetus, which occurs with brucellosis, vibriosis, paratyphoid fever, swelling of the membranes and inflammatory processes in the placenta of non-infectious origin.
Mechanical obstacles during the removal of separated placenta from the uterus, which arise when the cervix narrows prematurely, the placenta is pinched in the non-pregnant horn, or part of the placenta wraps around the large caruncle. The same reason may be the insemination of females with sperm containing opportunistic microflora, as a complication after abortion, stressful situations, technological noise in the room, the genotype of the mother and fetus, and much more.

1.2. Classification of placenta retention.

According to I.F. Zayanchkovsky, in ruminants it is recommended to distinguish between complete, incomplete and partial retention of the placenta.
Complete retention of the placenta (Retentio secundinarum completa, S. totalis) occurs when the chorion remains connected to the caruncles of both horns of the uterus, and the allantois and amnion remain connected to the chorion.
Incomplete retention of the placenta (Retentio secundinarum incomplete) is when the chorion remains connected to the capuncles of the uterine horn where the fetus was, and separated where the fetus was not. The amnion, allantois and part of the chorion hang from the birth canal.
Partial retention of the placenta (Retentio secundinarum partialis) occurs in cases where in one of the horns of the uterus the chorion retains connection with only a few caruncles, being entirely in the uterus or hanging partially from the vulva.
G.V. Zvereva classifies the retention of the placenta into complete - when the chorionic villi are connected with the maternal placenta in both uterine horns and incomplete (partial) - when the fetal placenta is retained in certain areas of the uterine horn.

1.3. Pathogenesis of the disease.

The weakening of the contractile function of the uterus leads to the fact that the afterbirth contractions are very weak, the forces expelling the afterbirth cannot ensure the removal of the membranes within a physiologically reasonable time, and the afterbirth remains in the uterus, since the chorionic villi are not pushed out of the crypts of the uterine mucosa.
Inflammatory processes in the uterus during pregnancy lead to swelling of the mucous membrane, while the chorionic villi are tightly held in the crypts and are difficult to remove from there even in the presence of strong contractions and pushing. When the fetal part of the placenta becomes inflamed, the villi swell or even fuse with the maternal placenta, so retention of the placenta in infectious diseases (brucellosis, campylobacteriosis, etc.) is permanent.

1.4. Clinical signs and course of placenta retention.

In cows, partial retention of the placenta is more common. In this case, the urinary and aqueous membranes partially hang from the vulva. Cows take a posture characteristic of urination, stand hunched over and strain very hard, which sometimes even leads to prolapse of the uterus. Prolonged retention of the placenta leads to its decomposition under the influence of putrefactive microorganisms. In summer, under the influence of high temperature, the afterbirth decomposes within 12–18 hours, in winter – after 24–48 hours. It becomes flabby, acquires a gray color and an ichoric odor. An imbalance of glycolysis and oxidative phosphorylation in the uterus is created in the cow's body, hypoglycemia occurs, lactic acid accumulates, and acidosis occurs. The levels of sodium and calcium in the blood decrease.
With the onset of decomposition of lochia and membranes, signs of intoxication appear. Appetite decreases, rumination weakens, chewing of cud is impaired, general body temperature rises slightly, milk secretion is significantly reduced, hair becomes disheveled, especially in animals of poor nutrition, and digestive organ dysfunction occurs, manifested by profuse diarrhea. The animal stands with an arched back and a tucked belly.
With complete retention of the placenta, the breakdown of placental tissue is somewhat delayed; on the third or fourth day, necrosis of the mucous membranes of the vestibule and vagina occurs; on the fourth or fifth day, catarrhal-purulent exudate mixed with fibrin crumbs begins to be released from the uterus. At the same time, the general condition of the cow worsens. Retention of the placenta can be complicated by vaginitis, endometritis, postpartum infection, and mastitis.
Sometimes, with such a serious condition, the placenta separates completely spontaneously and gradual improvement occurs, but then permanent infertility may occur. Often, microbes from the uterus are absorbed into the blood, causing sepsis or pyemia, which can be fatal.

1.5. Diagnosis of placenta retention.

Diagnosing retained placenta in cows does not cause any difficulties, since most often the membranes hang from the vulva. Only when the placenta is completely retained, when all the membranes of the fetus remain in the uterus, as well as when the placenta is strangulated in the birth canal, there are no external signs of this birth pathology and a vaginal examination of the animal is required.
When the placenta is completely retained, a red or gray-red strand protrudes from the external genitalia. Its surface is lumpy. Sometimes flaps of the urinary and amniotic membranes without vessels hang out in the form of gray-white films. With severe atony of the uterus, all the membranes remain in it, which is detected by palpation of the uterus.
To establish incomplete retention of the placenta, it is necessary to carefully examine it. The placenta is examined, palpated, and microscopic and bacteriological analysis is performed.
The released afterbirth is straightened out on the table. A normal cow afterbirth has a uniform color, a velvety placental surface and a smooth allantoic surface. The entire allanto-amnion is light gray in color, in places with a pearlescent tint.
Obliterated vessels, forming a large number of convolutions, contain little blood. The shells are the same thickness throughout. The thickness of the membranes is easily determined by palpation.
To determine whether the placenta has been completely released, they are guided by the vessels of the placenta, which represent a closed network surrounding the entire fetal bladder. During childbirth, the presenting portion of the membranes ruptures

along with the vessels passing through it. The integrity of the entire membrane is judged by the breaks of the vessels: when the torn edges come together, their contours should form a matching line, and the central ends of the torn vessels, when they come into contact with the peripheral segments, form a continuous vascular network.
This research method makes it possible to find out not only the size of the retained part of the placenta, but sometimes also the cause of the delay. In addition, it is simultaneously possible to detect abnormalities in the development of the placenta, degeneration and inflammatory processes in the uterine mucosa and, finally, make a conclusion about the viability of the newborn, the course of the postpartum period and possible complications of pregnancy and childbirth in the future.
In cows, partial retention of the placenta is especially common, since their inflammatory processes are mostly localized in individual placentas. Upon careful examination of the released placenta, one cannot help but notice a defect along the vessels that fed the torn part of the chorion.

1.6. Prognosis for retained placenta.

With timely provision of medical care, the prognosis is usually favorable if the retention of the placenta has not yet caused a general disease of the body due to intoxication or the entry of microbes into the blood or lymph. With a general illness of the body, the prognosis is cautious.

1.7. Treatment of cows with retained placenta.

Conservative methods of treating retained placenta in cows should begin six hours after the birth of the fetus. In the fight against uterine atony, it is recommended to use synthetic estrogen drugs that increase uterine contractility (sinestrol, pituitrin, etc.)
Sinestrol-SYNESTROLUM-2, 1% oil solution. Available in ampoules. Administered subcutaneously or intramuscularly. The dose for a cow is 2-5 ml. The effect on the uterus begins an hour after administration and lasts 8-10 hours. Sinestrol causes rhythmic, energetic contractions of the uterus in cows and promotes the opening of the cervical canal. Some scientists (V.S. Shilov, V.I. Rubtsov, I.F. Zayanchkovsky, etc.) argue that sinestrol cannot be recommended as an independent remedy in the fight against placenta retention in cows. After using this drug in high-milk cows, lactation decreases, atony of the forestomach appears, and sometimes sexual cyclicity is disrupted.
Pituitrin-PITUITRINUM is a preparation of the posterior lobe of the pituitary gland. Contains all the hormones produced in the gland. It is administered subcutaneously in a dose of 3-5 ml (25-35 IU). The effect of the administered pituitrin begins after 10 minutes and lasts 5-6 hours. The optimal dose of pituitrin for cows is 1.5-2 ml per 100 kg of live weight. Pituitrin causes contraction of the muscles of the uterus (from the top of the horns towards the cervix).
The sensitivity of the uterus to uterine products depends on the physiological state. Thus, the greatest sensitivity is noted at the time of birth, then it gradually decreases. Therefore, 3-5 days after birth, the dose of uterine preparations needs to be increased. When the placenta is retained in cows, repeated administration of pituitrin is recommended after 6-8 hours.
Estrone (folliculin)-OESTRONUM is a hormone formed wherever intensive growth and development of young cells occurs. Available in ampoules.
The Pharmacopoeia has approved a purer hormonal estrogen drug, estradiol dipropionate. Available in ampoules of 1 ml. The drug is administered intramuscularly to a cow in a dose of 6 ml.
Proserin-PROSERINUM is a white crystalline powder, easily soluble in water. A 0.5% solution is used in a dose of 2-2.5 ml under the skin for retained placenta in cows, weak pushing, and acute endometritis. Its effect begins 5-6 minutes after injection and lasts for an hour.
Carbocholine-CARBOCHOLIN-white powder, highly soluble in water. When retaining the placenta in cows, it is applied subcutaneously in a dose of 1-2 ml in the form of a 0.01% aqueous solution. Effective immediately after injection. The drug remains in the body for a considerable time, so it can be administered once a day.
Drinking amniotic fluid. Amniotic and urinary fluid contain folliculin, protein, acetylcholine, glycogen, sugar, and various minerals. In veterinary practice, fetal fluid is widely used to prevent retained placenta, uterine atony and uterine subinvolution.
After giving 3-6 liters of amniotic fluid, the contractility of the uterus significantly improves. Contractile function does not resume immediately, but gradually and lasts for 8 hours.
Feeding colostrum to cows. Colostrum contains a lot of proteins (albumin, globulins), minerals, fats, sugars and vitamins. Giving cows 2-4 liters of colostrum promotes the separation of the placenta after 4 hours (A.M. Tarasonov, 1979).
Use of antibiotics and sulfa drugs. In obstetric practice, tricellin is often used, which contains penicillin, streptomycin and white soluble streptocide. The drug is used in the form of powder or suppositories. When retaining the placenta of a cow, 2-4 suppositories or one bottle of powder are inserted into the uterus by hand. The administration is repeated after 24 and then after 48 hours. Auremycin introduced into the uterus promotes the separation of the placenta and prevents the development of purulent postpartum endometritis.
Good results are obtained from combined treatment of placenta retention in cows. 20-25 grams of white streptocide or another sulfonamide drug are injected into the uterus 4 times a day, 2 million units of penicillin or streptomycin are administered intramuscularly. Treatment is carried out for 2-3 days.
Nitrofuran preparations—furazolidone sticks or suppositories—are also used in treatment. Good results were also obtained after treating sick animals with septimethrin, exuter, metroseptin, utersonan and other combination drugs that are injected into the uterus.
The reproductive ability of cows that were treated with antibiotics in combination with sulfonamide drugs after retaining the placenta is restored very quickly.
Successful treatment of cows suffering from retained placenta by introducing into the middle uterine artery 200 ml of a 40% glucose solution, to which 0.5 g of novocaine was added. Intravenous infusion of 200-250 ml of 40% glucose solution significantly increases the tone of the uterus and enhances its contraction (V.M. Voskoboynikov 1979). G.K. Iskhakov (1950) obtained good results after feeding cows honey (500 g per 2 liters of water) - the placenta separated on the second day.
It is known that during labor a significant amount of glycogen from the muscles of the uterus and heart is used. Therefore, to quickly replenish the reserves of energy material in the mother’s body, it is necessary to administer 150-200 ml of a 40% glucose solution intravenously or sugar with water (300-500 g twice a day). Within 24 hours in summer and 2-3 days later in winter, the retained placenta begins to rot. Decay products are absorbed into the blood and lead to general depression of the animal, a decrease or complete loss of appetite, an increase in body temperature, hypogalactia, and severe exhaustion. 6-8 days after intensive blocking of the detoxification function of the liver, profuse diarrhea appears.
Thus, when the placenta is retained, it is necessary to maintain the function of the liver, which is capable of neutralizing toxic substances coming from the uterus during the decomposition of the placenta. The liver can perform this function only if there is a sufficient amount of glycogen in it. This is why intravenous administration of glucose solution or giving sugar by mouth is necessary. Autohemotherapy stimulates the reticuloendothelial system well. The dose of blood for the first injection into a cow is 90-100 ml, three days later 100-110 ml is injected. The third time blood is injected after three days at a dose of 100-120 ml.
K.P. Chepurov used intramuscular injections of anti-diplococcal serum in a dose of 200 ml to retain the placenta and to prevent endometritis. It is known that any hyperimmune serum, in addition to its specific action, stimulates the reticuloendothelial system, increases the body's defenses, and also significantly activates the processes of phagocytosis.
To treat retained placenta, a lumbar novocaine blockade is used, which causes vigorous contraction of the uterine muscles. Of the 34 cows with retained placenta, which V.M. Martynov performed a lumbar block, and in 25 animals the placenta separated spontaneously.
I.G. Morozov used a pararenal lumbar blockade in cows with retention of the placenta. The injection site is determined on the right side between the second and third lumbar processes at a palm's distance from the sagittal line. A sterile needle is inserted perpendicularly to a depth of 3-4 cm, then a Janet syringe is attached and 300-500 ml is injected. A 0.25% solution of novocaine, which fills the perinephric space, blocking the nerve plexus. The animal's general condition quickly improves, the motor function of the uterus increases, which promotes independent separation of the placenta.
D.D. Logvinov and V.S. Gontarenko obtained a very good therapeutic result when a 1% solution of novocaine in a dose of 1 ml was injected into the aorta. In veterinary practice, there are quite a few methods for local conservative treatment of retained placenta. The question of choosing the most appropriate method always depends on a variety of specific conditions: the condition of the sick animal, the experience and qualifications of the veterinary specialist, the availability of special equipment in the veterinary institution, etc. Let's consider the main methods of local therapeutic effects when retaining the placenta in cows.
So P.A. Voloskov (1960), I.F. Zayanchkovsky (1964) found that the use of Lugol's solution (1.0 crystalline iodine and 2.0 potassium iodide per 1000.0 distilled water) when retaining the placenta in cows gives satisfactory results with a small percentage of endometritis, which is quickly cured. The authors recommend pouring 500-1000 ml of fresh warm solution into the uterus, which should get between the placenta and the uterine mucosa. The solution is reintroduced every other day.
I.V. Valitov (1970) obtained a good therapeutic effect in the treatment of placenta retention in cows using a combined method: 80-100 ml of a 20% ASD-2 solution was administered intravenously, 2-3 ml of 0.5% proserin under the skin and 250-300 ml 3% menthol oil solution - into the uterine cavity. According to the author, this method turned out to be more effective than surgical separation of the placenta.
In cases where the vessels of the umbilical cord stump are intact, as well as in the absence of blood coagulation, it is necessary to clamp two arteries and one vein with tweezers, and pour 1-2.5 liters of warm artificial gastric juice or cold hypertonic juice into the second umbilical vein of the umbilical cord stump using the Bobrov apparatus sodium chloride solution. Then all four umbilical vessels are ligated. The afterbirth separates on its own after 10-20 minutes.
To dehydrate the villi of the choroid and the maternal part of the placenta, it is recommended to pour 3-4 liters of a 5-10% solution of table salt into the uterus. Hypertonic solution (75% sodium chloride and 25% magnesium sulfate), according to Yu.I. Ivanova causes intense contractions of the uterine muscles and promotes the separation of the placenta in cows.
Many methods have been proposed for separating the placenta, both conservative and operative, manual.
In cows, if the placenta has not separated 6-8 hours after the birth of the fetus, you can administer sinestrol 1% solution 2-5 ml, pituitrin 8-10 units per 100 kg of body weight, oxytocin 30-60 units or massage the uterus through the rectum . Give 500g of sugar inside. Promotes separation of the placenta during uterine atony by tying it with a bandage to the tail, 30 cm away from its root. The cow seeks to release the tail by moving it from side to side and back, which encourages the uterus to contract and expel the placenta. This simple technique should be used for both therapeutic and preventive purposes. The villi and crypts can be separated by introducing pepsin with hydrochloric acid (pepsin 20g, hydrochloric acid 15ml, water 300ml) between the chorion and the uterine mucosa.
ON THE. Phlegmatov found that amniotic fluid, administered in a dose of 1-2 liters to a cow through the mouth, already after 30 minutes increases the tone of the uterine muscles and increases the frequency of its contractions. When the placenta is retained, it is recommended to drink amniotic fluid 6-7 hours after the birth of the fetus in an amount of 3-6 liters. However, the use of amniotic fluid is associated with difficulties in obtaining and storing it in the required quantity. Therefore, it is convenient to use amnistron, a drug isolated from amniotic fluid; it has tonic properties. It is administered intramuscularly in a dose of 2 ml. Within an hour, the activity of the uterus increases 1.7 times, and by the 6-8th hour it reaches its maximum.
Also, when retaining the placenta due to atony of the uterus and increased turgor of its tissues, the use of an electric separator designed by M.P. has a good effect. Ryazansky, Yu.A. Lochkarev and I.A. Dolzhenko, subcutaneous injections of oxytocin or pituitrin (30-40 units), colostrum from the same cow in a dose of 20 ml, prostaglandin preparations, blockade according to V.V. Mosin and other methods of novocaine therapy.
If within 24-48 hours conservative methods of treatment do not produce an effect, especially when the fetal part of the placenta is fused with the maternal one, then surgical separation of the placenta is resorted to.
Manipulations in the uterine cavity are performed in an appropriate suit (sleeveless vest and robe with wide sleeves, oilcloth apron and sleeves). The sleeves of the gown are rolled up to the shoulder, and the hands are treated in the same way as before the operation. Skin lesions on the hands are smeared with iodine solution and filled with collodion. Boiled Vaseline, lanolin or enveloping and disinfecting ointments are rubbed into the skin of the hand. It is advisable to use a rubber sleeve from a veterinary gynecological glove. It is advisable to perform surgery under anesthesia. After preparing the right hand, grab the protruding section of the membranes with your left hand, twist it around its axis and pull it slightly, being careful not to tear it. The right hand is inserted into the uterus, where it is easy to identify areas of attachment of the fetal placenta, focusing along the course of the tense vessels and tissues of the choroid. The fetal part of the placenta is separated from the maternal part carefully and sequentially, the index and middle fingers are brought under the chorion placenta and separated from the caruncle with several short movements. Sometimes it is more convenient to grasp the edge of the fetal placenta with the thumb and forefinger and gently pull the villi out of the crypts. It is especially difficult to manipulate the placenta at the apex of the horn, since with an atonic uterus and a short arm of the obstetrician, the fingers do not reach the caruncles. Then they slightly pull the uterine horn to the cervix by the afterbirth or, spreading their fingers and resting them on the wall of the horn, carefully lift it up and then, quickly squeezing the hand, move it forward and down. By repeating the technique several times, it is possible to “put” the uterine horn on your hand, reach the placenta and, grasping it, separate it. The work is made easier if the protruding part of the placenta is twisted around its axis - this reduces its volume, the hand passes through the cervix more freely and the deeply located placentas are somewhat pulled outward. Sometimes the uterine caruncles break off and bleeding occurs, but it stops quickly and on its own.

1.8. Prevention of placenta retention.

Prevention of placenta retention in cows includes a set of agronomic, zootechnical, organizational and economic general and special measures.
I.F. Zayanchkovsky (1982) proposes a set of measures to prevent obstetric and gynecological diseases in cows.
General activities:

Performed on a regular basis:

Creation of a strong food base.

Complete feeding.

Proper maintenance and care, regular active exercise.

Conducted during pregnancy:

Timely launch.

Regular active exercise.

Prevention of abortion.

Performed during childbirth:

The correct regime in the maternity ward.

Timely assistance during difficult childbirth.

Special Events:

Performed on a regular basis:

Igor Nikolaev

Reading time: 5 minutes

A A

The appearance of offspring in domestic animals that are bred for this purpose is always expected. In cattle, this process is especially important. The gestation period for cows lasts nine months. No more than two calves are born. Therefore, any problems with the ability to fertilize and bear a calf are fraught with financial losses and disruptions in the health of the animal. One of them is uterine atony.

The essence of atony

The inability of the uterus to contract is called atony. She becomes as if paralyzed. Slowdown of the reverse development of the uterus is especially common in cows; in other animals it is much less common.

Contributing factors

In some obstetric and gynecological diseases, an atonic phenomenon is observed. It manifests itself in two cases:

as a cause of disease;
as a sign of genital infections.

Thus, in the first option, the development of pathology is facilitated by insufficient labor, post-maturity, and prolonged leaving of the placenta in the uterine cavity.

In the second case, the cow could have suffered acute and chronic endometritis or other diseases.

Course and progression

Experts note that subinvolution is a harbinger of atony. The fact is that during gestation the uterus stretches, and after childbirth it returns to normal. This is a process of involution that lasts approximately three weeks. But if the period lasts longer and slower, then this is subinvolution. This is how it goes:

Various inflammations associated with pathogenic microflora interfere with the natural system of returning the uterus to its prenatal state. In particular, atony of the uterine muscles develops. The muscles are in no hurry to recover. Suckers appear in the uterine cavity, which decompose over time;
the process is accompanied by a disgusting smell. The suckers become brown or gray in color and their particles enter the bloodstream. Against this background, a general infection of the body occurs;
after this, experts already talk about the severity of the uterine disease. In particular, mastitis and reproductive cycle disorders are likely;
at this time, a poor environment for sperm is formed in the uterine cavity. And the mucous membrane cannot implant the embryo. There may be slight bloating, as with rumen atony, in which digestive processes are disrupted;
The general condition of the cow throughout the entire period of illness was slightly disturbed. Only internal changes can become a reason for complaints from owners of personal or collective farms about the absence of estrus in a cow, sexual heat, inability to become fertilized, which can help the veterinarian make a diagnosis.

Establishing diagnosis

In the case of atony in a cow, a rectal examination of the uterine area is mandatory. The specialist reveals her relaxed state, lack of tone. Also, the horns of the uterus appear somewhat larger, and even descend into the abdominal cavity. Uterine contractions are not observed at all.

IMPORTANT! When mucus accumulates, some animals experience a fluctuation in one of the uterine horns. An abundance of mucous secretions threatens to stop the resorption of the corpus luteum in the ovary. Ultimately, this can lead to loss of sexual function and even infertility.

In some cases, the veterinarian notices a thickened wall of the uterine horn. It becomes covered with tubercles or becomes suspiciously thin in some places. When examined, it looks like the wall of the intestine or bladder.

There are specific signs that will help establish an accurate diagnosis and prescribe timely treatment for uterine atony in cows.

prolonged discharge of lochia with a change in color;
there is no sexual arousal for a long time.

Examination technique

During the examination, the specialist uses a polystyrene obstetric-gynecological Pankov spoon. It is a round rod up to twenty-seven centimeters. No more than half a centimeter in diameter. When inserted, mucus samples are collected due to the sharp leading edge. The device is designed specifically in such a way as not to damage the delicate walls.

The prerequisite is the following: the spoon case is filled with antiseptic.

It is black in color, which helps to distinguish the presence of mucus or pus on it.

The device comes with a card with multi-colored circles and inscriptions for them. Each color reflects a different process occurring in the animal’s body. In the laboratory, samples are compared and pathologies are determined.

Risk phenomena

When symptoms of a particular disease occur, the cattle owner tries to understand the causes. This is important not only for understanding methods of combating infection or pathology. But also to prevent the situation from reoccurring. At least there are ways to avoid it. Risk factors for atony include:

Separately, it is worth dwelling on caesarean section. It is used for narrow pelvis, small dilation of the cervix, abnormal position of the fetus, and torsion of the uterus. If general anesthesia was used in this case, uterine atony may occur. Some of these medications relax her muscles too much.

Then the veterinarian-obstetrician gives special injections of oxytocin with a solution of calcium chloride and glucose. The scar remaining after this operation can also contribute to pathological processes.

What should I do?

If uterine atony occurs in cows, treatment should be started without delay. Sometimes the disease does not respond to existing methods when the processes have gone too far. Then the only option is a slaughterhouse. But if the wet nurse can be saved or she is the only one in the family, it is worth making the effort.

Treatment

Competent treatment is:

adjustment of feeding and maintenance. Additional care and creation of comfortable conditions will be required. The diet needs to be enriched with vitamins, carbohydrates and proteins. The approach in this case is similar to that for ruminal atony;
Outdoor walks are advisable. Premises for keeping cattle must meet all sanitary standards and requirements;
To restore the contractile function of the uterus, even in the presence of a scar, they resort to proven medications. Among them are oxytocin, pituitrin or mammophysin. They also secrete oxylate, which can eliminate atony. It is injected subcutaneously in the neck area once a day;
A solution of glucose, calcium chloride, calcium gluconate or Kamagsol will help to raise the tone of the body for about three days;
If complications are detected during a gynecological examination, additional medications are prescribed.

Responsible approach

As in many cases, cattle owners must attach great importance to feeding. An unpretentious cow at first glance needs a responsible attitude towards the choice of food for her. Good nutrition often becomes the prevention of many diseases.

IMPORTANT! Active and regular grazing is an integral part of an animal’s life. Walking is necessary for cows to the same extent as for other types of large and small livestock. Decent content plays an equally important role.

Treatment of postpartum diseases of cows must be undertaken as early as possible. It must be comprehensive, aimed at normalizing the body's defenses and metabolic processes - expelling pathological contents from the uterus, relieving the inflammatory reaction, suppressing the activity of microflora.

Postpartum vulvitis, vestibulitis and vaginitis

First of all, thoroughly wash the tail and external genitalia; the tail is bandaged and tied to the side to avoid unnecessary irritation of the vulva.

The cavity of the vaginal vestibule is cleaned by irrigating with disinfectant solutions: potassium permanganate, Lysol, creolin. A good effect is achieved by using a 1-2% salt-soda solution (1:1 ratio) or hypertonic sodium chloride solution. It should be remembered that irrigation can give a negative result and even contribute to the further spread of inflammation due to the mechanical movement of pathogens, therefore it is necessary to wash the vestibule of the vagina with the genital slit open, so that the solution used immediately pours out. Under no circumstances should solutions be poured under pressure.

After irrigation and cleansing, the mucous membrane is lubricated with Vishnevsky’s liniment, streptocide emulsion, iodoform, xeroform, creolin, ichthyol or other ointment. Powdered drugs, especially those insoluble in water, do not give positive results: during urination and along with exudate, they are quickly removed. The ointment prevents the fusion of surfaces exposed from the epithelial cover; located in a layer on the mucous membrane or on its damaged area, it replaces a bandage that protects the source of inflammation from additional infection. In case of severe pain, dicaine (1-2%) should be added to regular ointments. After cleaning, ulcers, wounds and erosions are cauterized with lapis, 5-10% iodine solution. Ichthyol swabs deserve attention as an auxiliary product. Tamponation should be repeated after 12-24 hours.

Treatment for postpartum vaginal inversion and uterine prolapse

It comes down to the quickest adjustment of the prolapsed organ after a thorough toilet, which is best done with the coldest possible solution of tannin of 0.1% concentration, weak solutions of potassium permanganate or furacillin. In order to reduce the volume of the uterus, before reduction, oxytocin can be used in the form of injections into the thickness of the uterus in various places, 1-2 ml with a total dose of 50 units. After repositioning the vagina or uterus, measures must be taken to ensure their secure fixation.

Fixation methods using nylon threads, rollers, and metal wire are ineffective and ultimately lead to rupture of the vulva at the site of sutures. The most reliable and justified method of fixation is using a wide bandage. To carry out fixation, it is necessary to sharpen Pean or Kocher tweezers in the form of a wide needle on a sharpening unit and use it to pierce the wall of the vulva, followed by gripping with a bandage and suturing. Before suturing, one of the antiseptic drugs is injected into the uterus.

Weak contractions and pushing

This pathology causes prolongation of the birth act. Initially, conservative treatment is carried out. The cow is injected intramuscularly with 4-5 ml of a 1% oil solution of sinestrol (1 ml per 100 kg of body weight) and subcutaneously with 30-40 units of oxytocin or pituitrin. 100-120 ml of a 10% solution of calcium chloride (calcium gluconate) and 150-200 ml of a 40% solution of glucose are administered intravenously. After 1.5-2 hours, it is advisable to administer one of the prostaglandin F-2 alpha preparations (estrophan in a dose of 2 ml or enzaprost in a dose of 5 ml).

If labor is weak, manifested by an increase in the timing of labor, low-intensity laser radiation (LILI) can be used by the transrectal method in exposure modes of 3-5 minutes, pulse frequency 64-512 Hz, if using the Rikta-MV apparatus and the same exposure time during treatment with the STP apparatus. If after 1-2 hours there is no effect, then the irradiation is repeated. The effectiveness of the laser beam in prolonging labor is explained by the fact that laser irradiation has mitonic and analgesic effects.

If there is no effect in the next 3-4 hours, they begin surgical delivery in compliance with the rules of asepsis and antiseptics. After surgery, tricillin - 18-24 g or a mixture of antimicrobial drugs in the following combinations is administered into the uterine cavity in the form of powder:

Furacilin - 1 g, furazolidone - 0.5 g, neomycin - 1.5 g, penicillin - 1 g, norsulfazole - 5 g or oxytetracycline - 1.5 g, neomycin - 1.5 g, polymyxin-M - 0, 15 g and norsulfazole -5 g. In the absence of the indicated nitrofuran, antibiotic and sulfonamide drugs, you can use their analogues in the same combination, as well as neofur, metromax, exuter, hysteroton and other drugs in the form of sticks and suppositories.

With complicated births, in order to prevent postpartum complications, cows are prescribed sinestrol in combination with oxytocin or pituitrin. You can also use a 0.5% solution of proserin, a 0.1% solution, carbacholine in a dose of 2-2.5 ml or one of the prostaglandin F-2 alpha preparations, as well as colostrum taken from a postpartum woman in the first 4- 6 hours after birth of the fetus. Colostrum is administered subcutaneously with a sterile syringe in a dose of 20-25 ml. Before taking colostrum, the cow is examined for mastitis using one of the rapid mastitis tests.

Retention of placenta

If 6-8 hours after the birth of the calf the placenta has not separated, then conservative treatment is started to separate it.

1. Injection into the uterine cavity using a Janet syringe and a rubber adapter of a solution consisting of 3 ml of hellebore tincture and 97 ml of boiled water. It is possible to administer hellebore tincture intravenously in a dose of 2-3 ml once in order to enhance smooth muscle motility.

2. Administration parenterally in the first hours after calving of prostaglandin drugs: estrofan, superfan, aniprost, clatraprostine - in a dose of 2 ml or enzaprst in a dose of 5 ml intramuscularly or subcutaneously once. The introduction is designed to resolve the possibly delayed corpus luteum of pregnancy as a blocking link in the contractile activity of the uterus and strengthen its contractions.

3. Injection of a double dose of prostaglandin with the addition of 1.5 g of polyvinylpyrrolidone. The latter prolongs the action of prostaglandin.

4. To enhance uterine motility, the following is administered subcutaneously: carbacholin 0.1% or prozerin 0.5% in the form of an aqueous solution in a dose of 2-2.5 ml every 4-6 hours; intravenously 150-200 ml of 40% glucose solution, 100-200 ml of calcium gluconate or calcium chloride.

5. Instillation of 2-3 ml of a 1% oil solution of sinestrol or folliculin, followed by the introduction after 12 hours of 50 units of oxytocin or pituitrin. Oxytocin has a more targeted and active effect against the background of estrogens.

6. Subcutaneous administration with 3-hour intervals in increasing doses (30-40-50 units) of oxytocin or pituitrin.

Recently, drug-free methods of treating placenta retention in cows have been actively used. A good therapeutic and prophylactic effect is achieved by using an electronic placenta separator for cattle. The device is a compact sealed capsule. After the generally accepted preparation of the cow's external genitalia, the capsule is introduced into the uterine cavity, into the horn-fetal receptacle between the uterine wall and the retained placenta. Upon contact with the moist surface of the uterine mucosa, amniotic fluid, the device turns on and delivers short current pulses according to a given program for about 30 minutes, after which it turns off. Therapeutic effectiveness is 50-90%. The device is easy to use, does not require special storage methods and is absolutely electrically safe.

Also worthy of attention is the use of the device for electrical neurostimulation ETNS-100-1B for therapeutic and prophylactic purposes when retaining placenta in cows. It is a fabric belt with electrodes applied to the lumbar region in the area of the 4th sacral vertebra. The device delivers pulses with a frequency of 5-10 Hz and an amplitude of 50-80. Within 3-5 minutes. When using the device correctly, the service period is reduced to 45-50 days.

If there is no effect from the techniques used, one day after the fetus is delivered, 200-300 ml of a 10% solution of ichthyol is injected into the uterine cavity (amniotic membranes), and into the aorta or abdominal cavity, respectively, 10 ml of a 10% solution or 100 ml 1 % solution of novocaine (trimecaine). You can also use suprapleural novocaine blockade according to V.V. Mosin. It is advisable to combine anesthetic injections with oxytocin or pituitrin, 40-50 units.

If the placenta does not separate within 36-48 hours from the birth of the fetus, proceed to surgical (manual) separation using the “dry” method. At the same time, special attention is paid to thorough cleaning and disinfection of hands, as well as the external genitalia. The introduction of any disinfectant solutions into the uterine cavity either before or after separation of the placenta is not allowed. After manual separation of the placenta, in order to prevent the development of subinvolution of the uterus and endometritis, the cow is injected subcutaneously for 2-3 days with oxytocin 40-50 units or any other myotropic agent, 150-200 ml of 40% glucose solution and 100-120 ml are injected intravenously 10% solution of calcium chloride (calcium gluconate), broad-spectrum antimicrobial drugs are injected intrauterinely. In case of delayed separation and putrefactive decomposition of the placenta, a full course of complex preventive therapy is carried out as for endometritis.

Subinvolution of the uterus

Treatment of cows with delayed reverse development of the uterus should be comprehensive and aimed at restoring its contractile function and retraction ability, freeing the uterine cavity from accumulated and decaying lochia, preventing the development of microflora, increasing the general tone and defenses of the animal's body. When choosing treatment regimens, it is necessary to take into account the severity of the pathological process.

In the acute form of the disease (5-10 days after birth), cows are injected twice with a 24-hour interval with a 1% solution of sinestrol in a dose of 4-5 ml and within 4-5 days they are injected with 40-50 units of oxytocin or pituitrin, or 5-6 ml of 0.02% solution of methylergometrine or 0.05% solution of ergotal, or 2-2.5 ml of 0.5% solution of prozerin, or 0.1% solution of carbacholine. (Table No. 2)

Along with this, one of the means of pathogenetic or general stimulating therapy is used: novocaine therapy, vitamin therapy, ichthyolotherapy or hemotherapy or UHF, laser therapy and laser puncture.

Among the methods of novocaine therapy, suprapleural novocaine blockade of the splanchnic nerves and sympathetic border trunks is used according to V.V. Mosin or perirenal novocaine blockade (administer 300-350 ml of 0.25% novocaine solution), or intra-aortic or intraperitoneal administration of 1% or 10% solution of novocaine (trimecaine), respectively, in a dose of 100 or 10 ml. Injections are repeated 2-3 times with an interval of 48-96 hours.

During ichthyol therapy, a 7% sterile solution of ichthyol, prepared in a 0.85% sodium chloride solution, is injected into cows six times, subcutaneously at 48-hour intervals, starting from the first day of treatment, in increasing and decreasing doses: 20, 25, 30. 35, 30, 25 ml.

To prevent the development of endometritis, it is advisable to introduce broad-spectrum antimicrobial drugs into the uterine cavity once or twice (section 5.4.).

In the subacute form of uterine subinvolution, the same means and treatment regimens are used, with the only difference that a 1% solution of sinestrol is administered only once in a dose of 3-4 ml (0.6-0.7 ml per 100 kg of body weight), and antimicrobial drugs intended for administration into the uterine cavity are not used.

In case of chronic subinvolution and uterine atony, along with pathogenetic obstimulating therapy (ichthyologemotherapy, tissue therapy) and myotropic drugs, prostaglandin F-2 alpha preparations and gonadotropic hormones are also prescribed. If there are functioning corpora lutea or luteal cysts in the ovaries, estuphalan 500 mcg or clathroprostin 2 ml is administered at the beginning of the course of treatment. Prostaglandins are administered again at the same dose on day 11 in combination with a single injection of gonadotropin FFA at a dose of 2.5-3 thousand i.e. With subinvolution of the uterus, accompanied by ovarian hypofunction, prostaglandins (estuphalan, clathroprostin, gravoprost, gravoclatran) are administered to cows once at the beginning of the course of treatment. On day 11, animals are injected with only gonadotropin FFA at a dose of 3-3.5 thousand IU.

In all cases of uterine dysfunction, treatment of cows should be carried out against the background of organizing daily active exercise, rectal massage of the uterus for 2-3 minutes (4-5 sessions), and communication between cows and test bulls. If there are medical indications, vitamins (A, D, E, C, B), calcium and other mineral preparations are prescribed.