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

Introduction

afterbirth cow tricilin treatment

Pathology of the third stage of the birth act, manifested by a violation of the separation or removal of the placenta from the birth canal. Detention of the afterbirth is said if the afterbirth is not separated in cows after 6-10 hours, in mares after 35 minutes, in sheep and goats after 5 hours, in pigs, bitches, cats and rabbits after 3 hours after the birth of the fetus. Retention of the placenta can be in animals of all species, but is more often observed in cows, which is explained by the peculiarity of the structure of the placenta and the relationship between its fetal and maternal parts. Detention of the 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 with 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 uterine horns of a non-pregnant cow are 20-30 cm long. They extend somewhat upward from the body of the uterus and pass into the oviducts. The body of the uterus ends with a neck, 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 a wide uterine ligament, which is attached to the lumbar 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 a mucous membrane; outside it is covered with two layers of smooth muscle fibers - the inner annular and the outer longitudinal. The vagina is located in the pelvic cavity under the rectum. Its length is about 35 cm. Inside it is lined with a mucous membrane. Distinguish between the actual vagina - the longer part facing the cervix and the vestibule of the vagina. On the border between these two departments on the underside of the vagina is the opening of the urethra. Outside, the vestibule of the vagina passes into the genital gap formed by the labia, in the lower corner of which is placed the clitoris - a rudiment of the penis. / 1.8 /

Figure 1 Scheme 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- vestibule of the vagina; 10-clitoris; 11-labia; 12-mesentery of the uterus, or wide uterine ligament.

C-cervix of a cow

Vagina; 2-outer opening of the neck; 3-channel neck; 4-inner opening of the neck; 5-wide ligament; 6-ovary./1/

.2 Etiology

The immediate causes of retention of the afterbirth are insufficient contractility (hypotension) or the complete absence of contractions (atony) of the uterus, adhesions (adhesions) of the uterine and fetal parts of the placenta due to pathological processes in them. After calving, the uterus of the cow is greatly reduced (postpartum attempts), the placenta gradually separates from the mucous membrane of the uterus and is pushed out of the genital tract. If there are no subsequent attempts or they are weak, then the afterbirth does not separate. The placenta does not separate even when it is fused with the uterus. Retention of the 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 afterbirth from the uterus; 2) improper diet, with a lack of minerals, vitamins, which reduces the strength of the body and predisposes to weak uterine contractions; 3) content without walks; 4) cow obesity from overfeeding and lack of walks; 5) twins and excessively large fetuses, which stretch the uterus too much, causing the force of attempts to decrease; 6) abnormal development and deformity of the fetus in the womb (dropsy of the 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 lower the strength of the body 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 straining, hunching its back and lifting its tail; sometimes reluctant to eat food, often lies down; During straining and increased contractions of the uterus, outflows from the external genital organs are observed. With complete retention of the placenta, spotting is noted. When retaining the placenta, the main clinical sign is the presence of amniotic membranes in the uterine cavity 6 hours after calving. At the same time, general clinical indicators (body temperature, pulse, respiration, scar contraction) are usually within the normal range.

With complete retention of the placenta, the disintegration of placental tissues is somewhat delayed, and with an untimely diagnosis, on the fourth or fifth day, catarrhal-purulent exudate with an admixture of fibrin crumbs begins to be released from the uterus. At the same time, the general condition of the cows changes. Complications of retention of the placenta in cows can be endometritis, vaginitis, postpartum infection, mastitis. / 3,4,5 /

.4 Diagnosis

With complete retention of the placenta, a red or gray-red cord protrudes from the external genital organs. Its surface is bumpy in a cow (placenta). Sometimes only flaps of the urinary and amniotic membranes without vessels hang outward in the form of gray-white films. With severe atony of the uterus, all membranes remain in it (they are 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.

With complete retention of the placenta, a red or gray-red cord protrudes from the external genitalia. Its surface is bumpy in a cow (placenta) and velvety in a mare. Sometimes only flaps of the urinary and amniotic membranes without vessels hang outward in the form of gray-white films. With severe atony of the uterus, all membranes remain in it (they are 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 there are indications, a microscopic and bacteriological analysis is carried out. / 2,3,4 /

The released placenta is straightened on a table or plywood. To determine whether the placenta was completely released, they are guided by the vessels of the placenta, which is a closed network surrounding the entire fetal bladder. During childbirth, the presenting portion of the membranes is torn 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 approach each other, their contours should give a matching line, and the central ends of the ruptured vessels, when they come into contact with the peripheral segments, 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 detached part of the placenta remained. In the future, with palpation of the uterine cavity by hand, it is possible to palpate the remainder of the placenta. / 6.7 /

.6 Forecast

The prognosis is cautious towards favorable. With untimely treatment, endometritis, abscesses, and general exhaustion of the body may develop. / 5 /

1.7 Treatment

Conservative methods of treatment for retained placenta:

Treatment of cows with retention of the placenta begins 6-8 hours after the birth of the calf. It provides for an increase in the tone and contractile function of the uterus, providing the most rapid and complete separation of the placenta, preventing infection of the uterus, the development of an inflammatory process in it and a common postpartum infection.

Pituitrin - Pituitrinum - preparation of the posterior lobe of the pituitary gland. Contains all the hormones produced in the gland. It is injected under the skin at a dose of 3-5 ml (25-35 IU). The action of the introduced 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 neck). / 7 /

The sensitivity of the uterus to uterine agents depends on the physiological state. So, the greatest sensitivity is stated at the time of childbirth, then it gradually decreases. Therefore, 3-5 days after birth, the dose of uterine preparations should be increased. When retaining the placenta in cows, repeated injections of pituitrin are recommended after 6-8 hours.

Estrone - (folliculin) - Oestronum - a hormone that is formed wherever there is an intensive growth and development of young cells. Released in ampoules.

The Pharmacopoeia approved a more pure 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.

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

Carbacholin - Carbacholinum - white powder, highly soluble in water. When retaining the placenta in cows, it is applied under the skin at a dose of 1-2 ml in the form of a 0.01% aqueous solution. Works 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, various minerals. In veterinary practice, fruit waters are widely used to prevent retention of the afterbirth, atony and subinvolution of the uterus.

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

Drinking colostrum for cows. Colostrum contains many proteins (albumins, globulins), minerals, fats, sugars and vitamins. Drinking 2-4 liters of colostrum to cows contributes to the separation of the placenta after 4 hours. (A.M. Tarasonov, 1979).

The use of antibiotics and sulfa drugs.

In obstetric practice, tricilin is often used, which includes penicillin, streptomycin and white soluble streptocide. The drug is used in the form of powder or suppositories. When the afterbirth is delayed, 2-4 suppositories or one bottle of powder are injected into the cow's uterus by hand. The introduction 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 the combined treatment of the retention of the afterbirth of reproaches. In the uterus four times a day, 20-25 g of white streptocide or another sulfanilamide drug is injected, and intramuscularly 2 million units of penicillin or streptomycin. Treatment is carried out for 2-3 days. /5,6,7/

In the treatment, nitrofuran preparations are also used - furazolidone sticks and suppositories. Good results were also obtained after treatment of sick animals with septimethrin, exuter, metroseptin, utersonan and other combined preparations that are introduced into the uterus.

The reproductive ability of cows treated with antibiotics in combination with sulfanilamide preparations after retention of the placenta recovers very quickly.

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

Surgical intervention with strong attempts in a cow is carried out against the background of low sacral anesthesia (introduction of 10 ml of a 1-1.5% solution of novocaine into the epidural space) or novocaine blockade of the pelvic nerve plexus according to A. D. Nozdrachev./2,3,4 ,5/

Stimulation of the defenses of a sick animal

Successful treatment of cows with retained placenta by introducing into the middle uterine artery 200 ml of a 40% glucose solution, to which 0.5 g of novocaine is added. Intravenous infusion of 200-250 ml of a 40% glucose solution significantly increases the tone of the uterus and enhances its contraction. The placenta separated on the second day.

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

After a day in summer and after 2-3 days in winter, rotting of the delayed placenta begins. The decay products are absorbed into the bloodstream and lead to a general depression of the animal, a decrease or complete loss of appetite, an increase in body temperature, hypogalactia, and severe exhaustion. After 6-8 days after intensive blocking of the detoxification function of the liver, profuse diarrhea appears. /6.7/

Thus, when retaining the placenta, it is necessary to maintain the function of the liver, which is able to neutralize the 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 a glucose solution or giving sugar or honey through the mouth is necessary.

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

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

K.P. Chepurov used intramuscular injections of antidiplococcal serum at a dose of 200 ml for the prevention of endometritis in the retention of the placenta in cows. It is known that any hyperimmune serum, in addition to a specific action, stimulates the reticuloendothelial system, increases the body's defenses, and also significantly activates the processes of phagocytosis.

Tissue therapy for retention of the 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 highly inconsistent. Most authors believe that tissue therapy cannot be used as an independent method of treating retention of the 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 at a dose of 10-25 ml with an interval of 3-4 days. /2,3/

For the treatment of retention of the placenta, a lumbar novocaine blockade is used, which causes an energetic contraction of the muscles of the uterus. Of the 34 cows with retention of the afterbirth, which V.G. Martynov made a lumbar blockade, in 25 animals the afterbirth separated spontaneously.

I.G. Morozov (1955) used perirenal lumbar block in cows with retained placenta. The injection site is determined on the right side between the second 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 Janet's syringe is attached and 300-350 ml of a 0.25% solution of novocaine is poured, which fills the perirenal space, blocking the nerve plexus. The general condition of the animal quickly improves, the motor function of the uterus increases, which contributes to the 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 at a dose of 100 ml was injected into the aorta.

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

Infusion into the uterus of solutions, emulsions. 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 infusing 500-1000 ml of fresh warm solution into the uterus, which should fall between the placenta and the mucous membrane of the uterus. The solution is re-introduced in a day. / 6.7 /

I.V. Valitov (1970) obtained a good therapeutic effect in the treatment of retained placenta in cows using a combined method: 80-100 ml of a 20% solution of ASD-2 was administered intravenously, 2-3 ml of a 0.5% prozerin - under the skin 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 the surgical separation of the placenta;

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

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

The introduction of fluid into the vessels of the umbilical cord stump. In cases where the vessels of the umbilical cord stump are intact, and also in the absence of blood clotting, 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 tied up. The placenta separates on its own after 10-20 minutes.

Infusion into the uterus of hypertonic solutions of medium salts.

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

Multiple cutting of the stump of the placenta vessels

After the birth of a calf and the rupture of the umbilical cord, a stump of vessels almost always hangs from the vulva. We repeatedly had to observe how veterinary workers, who did 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" contributes to the retention of the placenta. After all, the longer the blood flows out of the vessels, the baby placenta, the better the cotyledon villi are bled, and, consequently, the connection between the mother and baby placenta weakens. The weaker this connection, the easier the afterbirth is separated. Therefore, repeated cutting of the stump of the umbilical cord with scissors must be used to prevent retention of the placenta in cows. /7/

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

Surgical intervention with strong attempts in a cow is carried out against the background of low sacral anesthesia (introduction of 10 ml of a 1-1.5% solution of novocaine into the epidural space) or novocaine blockade of the pelvic nerve plexus according to A. D. Nozdrachev Sinestrol - Synoestrolum - 2, -1 % oily solution. Released in ampoules. Enter under the skin or intramuscularly. Dose cow 2-5 ml. The action on the uterus begins an hour after administration and lasts 8-10 hours. Sinestrol causes rhythmic vigorous contractions of the uterus in cows, helps to open 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 retained placenta in cows. After the use of this drug in high-milk cows, lactation decreases, atony of the proventriculus appears, and sexual cyclicity is sometimes disturbed.

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

In cows: if the afterbirth is not separated 6-8 hours after the birth of the fetus, you can enter sinestrol 1% 2-5 ml, pituitrin 8-10 IU per 100 kg. Body weight, oxytocin 30-60 units. or massage the uterus through the rectum. Inside give sugar 500g. Contributes to the separation of the afterbirth with atony of the uterus by tying it with a bandage to the tail, retreating 30 cm 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 induces the uterus to contract and expel the placenta. This simple technique should be used for both therapeutic and prophylactic purposes. It is possible to separate the villi and crypts by introducing pepsin with hydrochloric acid between the chorion and the mucous membrane of the uterus (pepsin 20 g, hydrochloric acid 15 ml, water 300 ml). ON THE. Phlegmatov found that amniotic fluid, administered at a dose of 1-2 liters to a cow through the mouth, already after 30 minutes increases the tone of the muscles of the uterus and speeds up its contractions. Amniotic fluid is used for prophylactic and therapeutic purposes when retaining the placenta. During the rupture of the fetal bladder and during the expulsion of the fetus, amniotic fluid is collected (8-12 liters from one cow) in a basin well washed with hot water and poured into a clean glass dish. In this form, they can be stored at a temperature not exceeding 3°C for 2-3 days. When retaining the placenta, 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 unions of the placenta, as a rule, after 2-8 hours the afterbirth is separated. Only individual animals have to be given amniotic fluid (at the same dose) up to 3-4 times at intervals of 5-6 hours. Unlike artificial preparations, amniotic fluid acts gradually, their 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 them in the required amount. 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 at a dose of 2 ml), like amniotic fluid, has a gradual and at the same time long-term effect on the uterus. Already after an hour, the activity of the uterus increases by 1.7 times, and by 6-8 hours it reaches a 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 on the basis of uterine atony and increased turgor of its tissues, a good effect is given by the use of an electric separator designed by M.P. Ryazansky, Yu.A. Lochkarev and I.A. the same cow at 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 at 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 give an effect, especially when the fetal part of the placenta is fused with the mother, then they resort to the surgical separation of the placenta. /6.7/

Manipulations in the uterine cavity are performed in an appropriate suit (sleeveless jacket and dressing gown with wide sleeves, oilcloth apron and sleeves). The sleeves of the gown are rolled up to the shoulder, 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 petroleum jelly, 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. Surgical intervention is advisable to carry out against the background of anesthesia (sacred, according to A.D. Nozdrachev, G.S. Fateev, etc.). At the end of the preparation of the right hand, they grab the protruding section of the membranes with the left hand, twist it around the axis and pull it slightly, trying not to break it off. The right hand is inserted into the uterus, where it is easy to identify areas of attachment of the fetal placenta, focusing along the strained vessels and tissues of the choroid.

The fetal part of the placenta is separated from the maternal part carefully and consistently, the index and middle fingers are brought under the chorion placenta and separated from the caruncle with a few 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 obstetrician's hand, the fingers do not reach the caruncles. Then the horn of the uterus is somewhat pulled up to the cervix, or, expanding the fingers and resting them against 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 on” the horn of the uterus on the hand, get to the placenta and, having captured it, separate it. The work is facilitated if the protruding part of the placenta is twisted around its axis; from this, its volume decreases, the hand passes more freely through the cervix and the deeply located placentas are somewhat pulled outwards. Sometimes the uterine caruncles come off and bleeding occurs, but it quickly and independently stops. With partial retention of the placenta, unseparated placentas are easily detected by palpation; caruncles are rounded and elastic in texture, while the remains of the placenta are testate or velvety. During the operation, it is necessary to monitor cleanliness, wash 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, streptocid, uterine sticks or suppositories with nitrofurans, metromax, exuterus are also used. However, it is impossible to use several antibiotics with the same organotropic toxicity at once, this causes synergism and, as a result, the development of severe complications. Consideration should be given to the sensitivity of pathogenic microflora to the antibiotics used. /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 afterbirth; in this case, no disinfectant solutions are injected 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 is restored faster.

With putrefactive decomposition of the placenta, it is necessary to douche the uterus with the obligatory subsequent removal of the solution. A good effect is given by various methods of novocaine therapy, intramuscular injection of 10-15 ml of a 7% solution of ichthyol in a 40% glucose solution, intrauterine suppositories. 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 retention of the afterbirth consists in strict observance of the whole complex of economic and veterinary measures. Particular attention is paid to the full feeding and organization of the exercise of pregnant animals, the proper conduct of childbirth and the care of the mother. Women in labor drink 3-5 liters of amniotic fluid or 1-2 liters of colostrum. / 3,6,7 /

2.Result of own research

The call was from an individual sector from a neighboring village. Red - motley suit, 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, it was very damp. Forage: hay of not very good quality, compound feed, straw. The animals were fed three times a day and given cold water. The cow calved in that barn, with difficulty, because the fetus was large. We provided childbirth.

2.1 Justification of the disease

The complete retention of this cow developed as a result of pathological childbirth. The size of the fetus did not correspond to the lumen of the pelvic cavity. Births were provided. This factor gave impetus to inflammatory processes.

The leading factors were:

• Violation of conditions of detention;
• Poor zoohygienic conditions;
• Poor feeding, unbalanced diets;
• lack of exercise;
• 2.2 Clinical picture
• The cow is anxious, often pushes, hunches her back and lifts her tail. The labia are hyperemic, edematous, bloody discharge is released from the vulva. A gray-red cord protrudes from the external genitalia.
• 2.3 Diagnosis
• The diagnosis of complete retention was made in a complex manner, based on the anamnesis, clinical findings and on the basis of a vaginal examination.
• This is a complete retention of the placenta, a red or gray-red cord protrudes from the external genitalia. Its surface is bumpy in a cow (placenta). With severe atony of the uterus, all membranes remain in it (they are 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 on the table. To determine whether the placenta was completely released, they were guided by the vessels of the placenta, which is a closed network surrounding the entire fetal bladder. During childbirth, the presenting portion of the membranes is torn 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 approach each other, their contours should give a matching line, and the central ends of the ruptured vessels, when they come into contact with the peripheral segments, 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 detached part of the placenta remained. In the future, with palpation of the uterine cavity by hand, it is possible to palpate the remainder of the placenta. / 6.7 /
• 2.5 Forecast
• After examining the animal, the veterinarian gave a conclusion. Inflammatory processes were not observed. The prognosis is favorable.
• 2.6 Rationale for treatment
• The following principles lay at the heart of the existing methods of treatment:
• 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 antimicrobials 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 medicines, their cost and accessibility.

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

Tricilin was used, which includes penicillin, streptomycin and white soluble streptocide. The drug was used in the form of a powder. During the retention of the placenta, one vial of powder was introduced into the cow's uterus by hand. The introduction 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.

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

2.7 Prevention

The reproaches of the placenta are separated 6-10 hours after birth. Retention of the placenta for more than the specified period adversely affects fertility. After a day, it is necessary to take measures to remove the placenta. Retention of the placenta may be the result of atony of the uterus due to muscle fatigue or a gross violation of the feeding and maintenance of the animal. If the placenta was separated on the first day after calving, then on the second day the animal is no different from normally calving cows.

To stimulate the 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 introduced into the uterus. At the same time, measures are taken to increase uterine contraction by introducing neurotropic aqueous solutions under the skin (corbocholine 0.1%, prozerin 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 did not give the desired result, then take measures 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 afterbirth must 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). The separation should begin with the body and the free horn. It is impossible to process the fetal 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.

At the end of the 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 separation of the placenta, as this can cause complications and the cows remain infertile for a long time.

Cows that have retained their placenta must be kept under constant observation and recorded in the gynecological journal.

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

The absence of exercise in the postpartum period has an exceptionally unfavorable 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 the 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 walks of cows on the 3rd-4th day after birth for 30-40 minutes, and then increase them every day by 10-15 minutes, bringing them to at least two hours by the 15th day after calving. Exercise must be active, that is, accompanied by muscular work. This is achieved by the continuous movement of animals during the entire time of the walk. With such a system of keeping, animals will come to the hunt in a timely manner and be fruitfully inseminated.

Of great importance in the prevention of barrenness is the proper preparation of animals for mating. The 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 walking cows. Walking contributes not to better assimilation 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 pushes, hunches her back and lifts her tail. The labia are hyperemic, edematous, bloody discharge is released from the vulva. A gray-red cord protrudes from the external genitalia.

On the basis of clinical signs and anamnesis data, a diagnosis was made - complete retention of the placenta. After vaginal examination of the cow, there was an operative separation of the placenta.

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

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

Bibliographic list

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. etc. Modern reference book of a veterinarian. - Rostov-on-Don .: "Phoenix", 2003

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

Nikitin V.Ya., Mirolyubimov V.G. Practicum 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-communicable diseases of animals. - 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-communicable diseases, obstetrics and surgery.

Course work
in obstetrics on the topic:
"Treatment and prevention of retained placenta 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 retained placenta in cows.
1.2. Classification of retention of placenta.
1.3. Disease pathogenesis
1.4. Clinical signs and course of retained placenta
1.5. Diagnosis of this disease
1.6. The prognosis for the retention of the placenta
1.7. Treatment of cows with this pathology
1.8. Prevention of retained placenta in cows
2. Own research (case history)
3. Conclusions and suggestions
Bibliography
Applications

Introduction.

The placenta is considered retained when the fetal placenta remains in the uterus in cattle for more than 6 hours.
A particular danger of retention of the 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 genital apparatus and, as a result, infertility.
This pathology is the most common of all postpartum complications in cows at large livestock enterprises. Especially often the 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 the study of etiology, pathogenesis, treatment, and especially the prevention of this disease. The economic damage in this disease consists of the culling of animals due to their infertility, lack of offspring, the cost of treatment, 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 the course work is the development of measures to prevent the retention of the placenta. It is cheaper to prevent a disease than to treat it.

1.1 Etiology of retained placenta in cows.

The immediate cause of retention of the afterbirth is insufficient contractile function (hypotension) or the complete absence of contractions (atony) of the muscles of the uterus, fusion of the uterine or fetal parts of the placenta with the formation of adhesions.
Atony and hypotension of the uterus occur as a result of inadequate feeding and violation of the conditions for the care and maintenance of pregnant females (lack of vitamins, microelements, macroelements in the diets, the same type of feeding, feeding large amounts of concentrated feed, which leads to obesity in females, as well as lack of exercise, crowded accommodation with violation of zoohygienic requirements for keeping females, etc.). The reason for the retention of the afterbirth may also be the exhaustion of the pregnant female, beriberi, ketosis of highly productive animals, a sharp violation of the mineral balance, diseases of the digestive apparatus and the cardiovascular system of the woman in labor. Hypotension of the uterus can occur with multiple pregnancy in singletons, large fetuses, dropsy of the fetus and membranes, difficult childbirth and diseases of the mother's body.
Fusion of the maternal part of the placenta with the villi of the fetal chorion, which occurs with brucellosis, vibriosis, paratyphoid, edema of the amniotic membranes and inflammatory processes in the placenta of non-infectious origin.
Mechanical obstacles in the removal of the separated placenta from the uterus, which occur with premature narrowing of the cervix, infringement of the placenta in the non-pregnant horn, wrapping part of the placenta around a large caruncle. Also, the 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 retention of placenta.

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 maintains contact with the caruncles of both uterine horns, and the allantois and amnion remain connected with the chorion.
Incomplete retention of the placenta (Retentio secundinarum incomplete) is when the chorion retains contact with the capuncles of the uterine horn where the fetus was, and separated where the fetus was not. At the same time, the amnion, allantois and part of the chorion hang down from the birth canal.
Partial retention of the placenta (Retentio secundinarum partialis) occurs when in one of the uterine horns the chorion retains contact 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 as complete - when the chorionic villi are connected to 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. The 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 that expel the afterbirth cannot ensure the removal of the membranes in a physiologically justified time frame, 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 attempts. With inflammation of the fetal part of the placenta, 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 retained placenta.

In cows, partial retention of the placenta is more often noted. In this case, the urinary and aqueous membranes partially hang from the vulva. Cows adopt a urination posture, stand hunched over, and push 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 after 12-18 hours, in winter - after 24-48 hours. It becomes flabby, acquires a gray color and an ichorous smell. In the body of a cow, an imbalance of glycolysis and oxidative phosphorylation in the uterus is created, hypoglycemia occurs, lactic acid accumulates, and acidosis occurs. The level of sodium and calcium in the blood decreases.
With the onset of decomposition of lochia and fetal membranes, signs of intoxication appear. Appetite is reduced, rumination is weakened, chewing gum is disturbed, the general body temperature is slightly increased, milk secretion is significantly reduced, the hair becomes disheveled, especially in animals of poor fatness, there is a disorder in the function of the digestive organs, manifested by profuse diarrhea. The animal stands with an arched back and a tucked up abdomen.
With complete retention of the placenta, the disintegration of placental tissues 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 with an admixture of fibrin crumbs begins to stand out from the uterus. At the same time, the general condition of the cow worsens. Detention of the placenta can be complicated by vaginitis, endometritis, postpartum infection, mastitis.
Sometimes, in such a serious condition, the placenta is completely separated spontaneously and there is a gradual improvement, but then permanent infertility may occur. Often, microbes from the uterus are absorbed into the blood, causing sepsis or pyemia with a fatal outcome.

1.5. Diagnosis of retained placenta.

The diagnosis of retained placenta in cows does not cause difficulties, since most often the fetal membranes hang from the vulva. Only with complete retention of the placenta, when all the membranes of the fetus remain in the uterus, as well as with infringement of the placenta in the birth canal, there are no external signs of this pathology of childbirth and a vaginal examination of the animal is required.
With complete retention of the placenta, a red or gray-red cord protrudes from the external genitalia. Its surface is bumpy. Sometimes flaps of the urinary and amniotic membranes without vessels hang outward in the form of gray-white films. With severe atony of the uterus, all 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, its microscopic and bacteriological analysis is carried out.
The separated placenta is straightened on the table. The normal afterbirth of a cow has a uniform color, a velvety placental and smooth allantoid surface. The entire allanto is a light gray amnion, in some places with a pearly tint.
Obliterated vessels, forming a large number of twists, contain little blood. Shells throughout the same thickness. The thickness of the membranes is easily determined by palpation.
To determine whether the placenta was completely released, they are guided by the vessels of the placenta, which is a closed network surrounding the entire fetal bladder. During childbirth, the presenting portion of the membranes is torn

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 approach each other, their contours should give a matching line, and the central ends of the ruptured 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 delayed part of the placenta, but sometimes the cause of the delay. In addition, at the same time, it is possible to detect abnormalities in the development of the placenta, degeneration and inflammation 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. With a careful examination of the released placenta, one cannot fail to notice a defect along the vessels that fed the broken part of the chorion.

1.6. The forecast at detention of an afterbirth.

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

1.7. Treatment of cows with retained placenta.

Conservative methods of treatment of retained placenta in cows should be started six hours after the birth of the fetus. In the fight against uterine atony, it is recommended to use synthetic estrogenic drugs that increase the contractility of the uterus (sinestrol, pituitrin, etc.)
Sinestrol-SYNESTROLUM-2, 1% oily solution. Released in ampoules. Enter subcutaneously or intramuscularly. Dose cow 2-5 ml. The action on the uterus begins an hour after the introduction and lasts 8-10 hours. Sinestrol causes rhythmic, vigorous uterine contractions in cows, promotes the opening of the cervical canal. Some scientists (V.S. Shilov, V.I. Rubtsov, I.F. Zayanchkovsky, and others) argue that sinestrol cannot be recommended as an independent tool in the fight against retained placenta in cows. After the use of this drug in high-milk cows, lactation decreases, atony of the proventriculus appears, and sexual cyclicity is sometimes disturbed.
Pituitrin-PITUITRINUM is a preparation of the posterior pituitary gland. Contains all the hormones produced in the gland. It is injected under the skin at a dose of 3-5 ml (25-35 IU). The action of the introduced 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 neck).
The sensitivity of the uterus to uterine agents depends on the physiological state. So, the greatest sensitivity is stated at the time of childbirth, then it gradually decreases. Therefore, 3-5 days after birth, the dose of uterine preparations should be increased. When retaining the placenta in cows, repeated injections of pituitrin are recommended after 6-8 hours.
Estrone-(folliculin)-OESTRONUM is a hormone that is formed wherever there is an intensive growth and development of young cells. Released in ampoules.
The Pharmacopoeia approved a purer hormonal estrogenic drug, estradiol dipropionate. Available in ampoules of 1 ml. The drug is administered intramuscularly to a cow at a dose of 6 ml.
Proserin-PROSERINUM is a white crystalline powder, easily soluble in water. A 0.5% solution is used at a dose of 2-2.5 ml under the skin when retaining the placenta in cows, weak attempts, acute endometritis. Its action begins 5-6 minutes after injection and lasts for an hour.
Carbocholine-CARBOCHOLIN is a white powder, highly soluble in water. When retaining the placenta in cows, it is applied under the skin at a dose of 1-2 ml in the form of a 0.01% aqueous solution. Works 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, various minerals. In veterinary practice, fetal fluids are widely used to prevent retained placenta, uterine atony, and subinvolution of the uterus.
After giving 3-6 liters of amniotic fluid, the contractility of the uterus improves significantly. The contractile function does not resume immediately, but gradually and lasts for 8 hours.
Drinking colostrum for cows. Colostrum contains many proteins (albumins, globulins), minerals, fats, sugars and vitamins. Drinking 2-4 liters of colostrum to cows contributes to the separation of the placenta after 4 hours (A.M. Tarasonov, 1979).
The use of antibiotics and sulfa drugs. In obstetric practice, tricellin is often used, which includes penicillin, streptomycin and white soluble streptocide. The drug is used in the form of powder or suppositories. When the placenta is retained in a cow, 2-4 suppositories or one bottle of powder are inserted into the uterus by hand. The introduction 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 by the combined treatment of retained placenta in cows. In the uterus 4 times a day, 20-25 grams of white streptocide or another sulfanilamide drug is injected, intramuscularly 2 million units of penicillin or streptomycin. Treatment is carried out for 2-3 days.
In the treatment, nitrofuran preparations, furazolidone sticks or suppositories, are also used. Good results were also obtained after the treatment of sick animals with septimethrin, exuter, metroseptin, utersonan and other combined preparations that are introduced into the uterus.
The reproductive ability of cows treated with antibiotics in combination with sulfanilamide preparations after retention of the placenta recovers very quickly.
Successful treatment of cows with retained placenta 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 a 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 drinking honey to cows (500 g per 2 liters of water) - the afterbirth separated on the second day.
It is known that during labor, a significant amount of glycogen in the muscles of the uterus and heart is used. Therefore, in order to quickly replenish the reserves of energy material in the body of a woman in labor, it is necessary to intravenously inject 150-200 ml of a 40% glucose solution or sugar with water (300-500 g twice a day). After a day in summer and after 2-3 days in winter, rotting of the delayed placenta begins. The decay products are absorbed into the bloodstream and lead to a general depression of the animal, a decrease or complete loss of appetite, an increase in body temperature, hypogalactia, and severe exhaustion. After 6-8 days after intensive blocking of the detoxification function of the liver, profuse diarrhea appears.
Thus, when retaining the placenta, it is necessary to maintain the function of the liver, which is able to neutralize the 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 giving sugar by mouth is necessary. Autohemotherapy well stimulates the reticulo-endothelial system. The dose of blood for the first injection to a cow is 90-100 ml, after three days 100-110 ml is administered. The third time the blood is injected after three days at a dose of 100-120 ml.
K.P. Chepurov used intramuscular injections of antidiplococcal serum at a dose of 200 ml for the retention of the placenta and for the prevention of endometritis. It is known that any hyperimmune serum, in addition to a specific action, stimulates the reticulo-endothelial system, increases the body's defenses, and also significantly activates the processes of phagocytosis.
For the treatment of retention of the placenta, a lumbar novocaine blockade is used, which causes an energetic contraction of the muscles of the uterus. Of the 34 cows with retained placenta, which V.M. Martynov made a lumbar blockade, in 25 animals the placenta separated spontaneously.
I.G. Morozov used perirenal lumbar block in cows with retained placenta. The injection site is determined on the right side between the second 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 syringe is attached to Janet and 300-500 ml is poured. 0.25% solution of novocaine, which fills the perirenal space, blocking the nerve plexus. The general condition of the animal quickly improves, the motor function of the uterus increases, which contributes to the independent separation of the placenta.
D.D. Logvinov and V.S. Gontarenko received a very good therapeutic result when a 1% solution of novocaine at a dose of 1 ml was injected into the aorta. In veterinary practice, there are quite a few methods of local conservative treatment of retention of the placenta. The question of choosing the most appropriate method always depends on a variety of specific conditions: the condition of a sick animal, the experience and qualifications of a veterinary specialist, the availability of special equipment in a veterinary institution, etc. Consider the main methods of local therapeutic effects in the retention of 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 infusing 500-1000 ml of fresh warm solution into the uterus, which should fall between the placenta and the uterine mucosa. Re-introduce the solution every other day.
I.V. Valitov (1970) obtained a good therapeutic effect in the treatment of retention of the placenta in cows using a combined method: 80-100 ml of a 20% solution of ASD-2 was administered intravenously, 2-3 ml of a 0.5% prozerin under the skin 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 the surgical separation of the placenta.
In cases where the vessels of the umbilical cord stump are intact, and also in the absence of blood clotting, 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 fluid into the second umbilical vein of the umbilical cord stump using the Bobrov apparatus. sodium chloride solution. Then all four umbilical vessels are tied up. The placenta separates on its own after 10-20 minutes.
For dehydration of the villi of the choroid and the maternal part of the placenta, it is recommended to pour 3-4 liters of a 5-10% sodium chloride solution into the uterus. Hypertonic solution (75% sodium chloride and 25% magnesium sulfate), according to Yu.I. Ivanova causes intense contractions of the muscles of the uterus and contributes to the separation of the placenta in cows.
Many methods of separation of the placenta, both conservative and operational, manual, have been proposed.
In cows, if the afterbirth has not separated 6-8 hours after the birth of the fetus, you can enter sinestrol 1% solution of 2-5 ml, pituitrin 8-10 units per 100 kg of body weight, oxytocin 30-60 units or massage the uterus through the rectum . Inside give 500g of sugar. Promotes the separation of the afterbirth with atony of the uterus by tying it with a bandage to the tail, retreating 30 cm from its root. The cow seeks to release the tail by moving it from side to side and back, which induces the uterus to contract and expel the placenta. This simple technique should be used for both therapeutic and prophylactic purposes. To separate the villi and crypts, you can introduce pepsin with hydrochloric acid between the chorion and the mucous membrane of the uterus (pepsin 20g, hydrochloric acid 15ml, water 300ml).
ON THE. Phlegmatov found that amniotic fluid, administered at a dose of 1-2 liters to a cow through the mouth, already after 30 minutes increases the tone of the muscles of the uterus and speeds up its contractions. When retaining the placenta, it is recommended to drink amniotic fluid 6-7 hours after the birth of the fetus in the amount of 3-6 liters. However, the use of amniotic fluid is associated with difficulties in obtaining and storing them in the required amount. Therefore, it is convenient to use amnistron - a drug isolated from amniotic fluid, it has tonic properties. It is administered intramuscularly at a dose of 2 ml. Already after an hour, the activity of the uterus increases by 1.7 times, and by the 6-8th hour it reaches a maximum.
Also, when the placenta is retained on the basis of atony of the uterus and increased turgor of its tissues, the use of an electric separator designed by M.P. Ryazansky, Yu.A. Lochkareva and I.A. Dolzhenko, subcutaneous injections of oxytocin or pituitrin (30-40 units), colostrum from the same cow at 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 give an effect, especially when the fetal part of the placenta is fused with the mother, then they resort to the surgical separation of the placenta.
Manipulations in the uterine cavity are performed in an appropriate suit (a sleeveless jacket and a dressing gown with wide sleeves, an oilcloth apron and sleeves). The sleeves of the dressing gown are rolled up to the shoulder, 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 petroleum jelly, 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. Surgical intervention is advisable to carry out on the background of anesthesia. At the end of the preparation of the right hand, they grab the protruding section of the membranes with the left hand, twist it around the axis and pull it slightly, trying not to break it off. The right hand is inserted into the uterus, where it is easy to identify areas of attachment of the fetal placenta, focusing along the strained vessels and tissues of the choroid. The fetal part of the placenta is separated from the maternal part carefully and consistently, the index and middle fingers are brought under the chorion placenta and separated from the caruncle with a few 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 obstetrician's hand, the fingers do not reach the caruncles. Then the horn of the uterus is somewhat pulled up to the cervix, or, expanding the fingers and resting them against 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 on” the horn of the uterus on the hand, get to the placenta and, seizing it, separate it. The work is facilitated if the protruding part of the placenta is twisted around its axis - from this its volume decreases, the hand passes more freely through the cervix and the deeply located placentas are somewhat pulled outwards. Sometimes the uterine caruncles come off and bleeding occurs, but it quickly and independently stops.

1.8. Prevention of retained placenta.

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

Conducted constantly:
Creation of a solid forage base.
Complete nutrition.
Proper maintenance and care, regular active exercise.
Carried out during pregnancy:
Timely launch.
Regular active exercise.
Abortion prevention.
Carried out during childbirth:
The correct mode in the maternity ward.
Timely assistance in difficult childbirth.

Special events:

Conducted constantly:
etc.................

Igor Nikolaev

Reading time: 5 minutes

A A

The appearance of offspring in domestic animals, which are bred for this purpose, is always expected. In cattle, this process is especially responsible. 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 atony of the uterus.

The essence of atony

The inability of the uterus to contract is called atony. She becomes paralyzed. Especially often, a slowdown in the reverse development of the uterus is found in cows, in other animals it is much less common.

Contributing factors

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

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

Thus, in the first variant, the development of pathology is promoted by insufficient labor activity, overcarriage of the fetus, 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 the harbingers of atony are subinvolution. The fact is that during the bearing of the fetus, the uterus is stretched, and after childbirth it returns to normal. This is an involution process that lasts approximately three weeks. But if the period lasts longer and slower, then this is a subinvolution. This is how it goes:

1. various inflammations associated with pathogenic microflora interfere with the natural system of returning the uterus to the prenatal state. In particular, atony of the uterine muscles develops. Muscles are in no hurry to recover. In the uterine cavity, suckers appear, which decompose over time;
2. the process is accompanied by a disgusting smell. The suckers become brown or gray in color, their particles enter the bloodstream. Against this background, a general infection of the body occurs;
3. after that, experts are already talking about the severity of the disease of the uterus. In particular, mastitis and violations of the sexual cycles are likely;
4. at this time, a bad environment for sperm is formed in the uterine cavity. And the mucosa cannot graft the germ. Perhaps a slight swelling, as with atony of the scar, in which the digestive processes are disturbed;
5. the general condition of the cow throughout the entire period of the disease is slightly disturbed. Only internal changes can become a reason for complaints from owners of personal subsidiary plots or collective farms about the lack of estrus in a cow, estrus, inability to fertilize, can help a veterinarian make a diagnosis.

Establishing diagnosis

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

IMPORTANT! In the case of accumulation of mucus in some animals, a fluctuation is noted in one of the uterine horns. The abundance of mucous secretions threatens to stop the resorption of the corpus luteum in the ovary. Ultimately, this is fraught with disabling sexual functions and even infertility.

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

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

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

Survey methodology

During the examination, the specialist uses Pankov's polystyrene obstetric-gynecological spoon. It is a round rod up to twenty-seven centimeters. Not more than half a centimeter in diameter. When administered, mucus samples are taken due to the sharp anterior edge. The device is specially designed so as not to damage the delicate walls.

A prerequisite is the following: the spoon case is filled with an antiseptic.

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

The device is accompanied by a card with multi-colored circles and inscriptions to them. Each color reflects its own process occurring in the body of the animal. In the laboratory, samples are compared and pathologies are determined.

Risk phenomena

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

Separately, it is worth stopping at a caesarean section. They resort to it with the narrowness of the pelvis, small opening of the cervix, incorrect position of the fetus, twisting of the uterus. If general anesthesia was used in such a case, uterine atony may occur. Some of these drugs relax her muscles too much.

Then the obstetrician veterinarian makes 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 be done?

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

Treatment

Proper treatment is:

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

Responsible approach

As in many cases, cattle owners must attach great importance to feeding. An unpretentious at first glance, a cow needs a responsible attitude to 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 cattle and small cattle. Decent content plays an equally important role.

Treatment of postpartum diseases of cows must be undertaken as soon as possible. Without fail, it must be comprehensive, aimed at normalizing the body's defenses and metabolic processes - the expulsion of pathological contents from the uterus, the removal of the inflammatory reaction, and the suppression of microflora activity.

Postpartum vulvitis, vestibulitis and vaginitis

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

The cavity of the vestibule of the vagina is cleaned by irrigating with disinfectant solutions: potassium permanganate, lysol, creolin. A good effect is achieved by using a 1-2% saline solution (ratio 1: 1) 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, so 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 preparations, especially those insoluble in water, do not give positive results: during urination and together 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 the bandage that protects the focus of inflammation from additional infection. With severe soreness, dikain (1-2%) should be added to conventional ointments. Ulcers, wounds and erosion after their cleaning are cauterized with lapis, a 5-10% iodine solution. As an aid, ichthyol swabs deserve attention. Tamponation should be repeated after 12-24 hours.

Treatment for postpartum vaginal eversion and uterine prolapse

It comes down to the fastest repositioning of the prolapsed organ after its thorough toilet, which is more expedient to carry out as cold as possible with a 0.1% concentration of tannin, 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 each, with a total dose of 50 IU. After repositioning the vagina or uterus, measures must be taken to securely fix them.

Fixation methods using nylon threads, rollers, metal wire are ineffective and eventually lead to rupture of the vulva at the suturing site. The most reliable and justified is the method of fixation with 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 grinding unit and use it to pierce the wall of the vulva, followed by capture with a bandage and suturing. Before suturing, one of the antiseptic preparations is injected into the uterus.

Weak contractions and pushing

This pathology causes the lengthening 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 IU of oxytocin or pituitrin. 100-120 ml of a 10% solution of calcium chloride (calcium gluconate) and 150-200 ml of a 40% glucose solution are injected intravenously. After 1.5-2 hours, it is advisable to introduce one of the preparations of prostaglandin F-2 alpha (estrofan at a dose of 2 ml or enzaprost at a dose of 5 ml).

In case of weakness of labor activity, manifested by an increase in the duration of the labor act, low-intensity laser radiation (LILI) can be used by the transrectal method in exposure modes of 3-5 minutes, pulse rate of 64-512 Hz, if the Rikta-MV apparatus is used 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 lengthening the birth act is explained by the fact that laser irradiation has mitonic and analgesic effects.

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

Furacilin - 1 g, furazolidone - 0.5 g, neomycin - 1.5 g, penicillin - 1 g, norsulfazol - 5 g or oxytetracycline - 1.5 g, neomycin - 1.5 g, polymyxin-M - 0, 15 g and norsulfazol -5 g. In the absence of these nitrofuran, antibiotic and sulfanilamide preparations, their analogues can be used in the same combination, as well as neofur, metromax, exuter, hysteroton and other preparations in the form of sticks and suppositories.

With complicated childbirth, 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 prozerin, a 0.1% solution, carbacholin at a dose of 2-2.5 ml or one of the preparations of prostaglandin F-2 alpha, as well as colostrum taken from the puerperal in the first 4- 6 hours after the birth of the fetus. Colostrum is injected subcutaneously with a sterile syringe at a dose of 20-25 ml. The cow is examined for mastitis before colostrum collection by one of the rapid mastitis tests.

Detention of the placenta

If after 6-8 hours after the birth of the calf the afterbirth has not separated, then proceed to conservative treatment for its separation.

1. Introduction 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. Perhaps intravenous administration of hellebore tincture at a dose of 2-3 ml once in order to enhance the motility of smooth muscles.

2. Parenteral administration in the first hours after calving of prostaglandin preparations: estrofan, superfan, aniprost, clatraprostin - at a dose of 2 ml or enzaprsta at a dose of 5 ml intramuscularly or subcutaneously once. The introduction is designed for resorption of the possibly delayed corpus luteum of pregnancy as a blocking link in the contractile activity of the uterus and strengthening 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, enter: subcutaneously carbacholin 0.1% or prozerin 0.5% in the form of an aqueous solution at 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 of 50 IU of oxytocin or pituitrin after 12 hours. Oxytocin is more directed and active against the background of estrogens.

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

Recently, drug-free methods of treating retained placenta in cows have been actively used. A good therapeutic and prophylactic effect is achieved when using an electronic placenta separator for cattle. The device is a compact sealed capsule. After the conventional preparation of the external genital organs of the cow, the capsule is introduced into the uterine cavity, into the horn-fetus between the uterine wall and the delayed 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 efficiency is 50-90%. The device is easy to handle, does not require special storage methods and is absolutely electrically safe.

Also noteworthy is the use of a device for electrical neurostimulation ETNS-100-1V for therapeutic and prophylactic purposes when retaining the placenta in cows. It is a fabric belt with electrodes applied to the lumbar region in the region of the 4th sacral vertebra. The device gives impulses with a frequency of 5-10 Hz and an amplitude of 50-80. Within 3-5 minutes. With proper use of the device, the service period is reduced to 45-50 days.

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

In case of non-separation of the placenta within 36-48 hours from the birth of the fetus, they proceed to the operational (manual) separation of it using the "dry" method. At the same time, special attention is paid to the thorough processing and disinfection of hands, as well as external genital organs. 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 afterbirth, in order to prevent the development of subinvolution of the uterus and endometritis, the cow is injected subcutaneously for 2-3 days with oxytocin at 40-50 units or any other myotropic agent, 150-200 ml of a 40% glucose solution and 100-120 ml are injected intravenously 10% solution of calcium chloride (calcium gluconate), intrauterine administration of broad-spectrum antimicrobials. With a belated separation and putrefactive decomposition of the placenta, a full course of complex preventive therapy is carried out as with endometritis.

Surgical intervention with strong attempts in a cow is carried out against the background of low sacral anesthesia (introduction of 10 ml of a 1-1.5% solution of novocaine into the epidural space) or novocaine blockade of the pelvic nerve plexus according to A. D. Nozdrachev.

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 decomposing lochia, preventing the development of microflora, increasing the overall tone and defenses of the animal's body. When choosing treatment regimens, it is necessary to take into account the severity of the course of the pathological process.

In the acute form of the course (5-10 days after birth), cows are injected twice with a 24-hour interval with a 1% solution of sinestrol at a dose of 4-5 ml and within 4-5 days they are injected with 40-50 IU of oxytocin or pituitrin, or 5-6 ml of a 0.02% solution of methylergometrine or a 0.05% solution of ergotal, or 2-2.5 ml of a 0.5% solution of prozerin, or a 0.1% solution of carbachol. (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.

Of the methods of novocaine therapy, suprapleural novocaine blockade of the celiac nerves and sympathetic border trunks according to V.V. Mosin or perirenal novocaine blockade (300-350 ml of a 0.25% solution of novocaine is administered), or intra-aortic or intraperitoneal administration of a 1% or 10% solution of novocaine (trimecaine), respectively, at 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 with a 48-hour interval, 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 once or twice into the uterine cavity (clause 5.4.).

In the subacute form of the course of subinvolution of the uterus, the same means and treatment regimens are used, with the only difference being that a 1% solution of sinestrol is administered only once at 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 chronic subinvolution and atony of the uterus, along with means of pathogenetic general stimulating therapy (ichthyolo-hemotherapy, tissue therapy) and myotropic drugs, prostaglandin F-2 alpha preparations and gonadotropic hormones are also prescribed. In the presence of functioning corpus luteum or luteal cysts in the ovaries, at the beginning of the course of treatment, estufalan is administered at a dose of 500 mcg or clathroprostin 2 ml. Repeated prostaglandins at the same dose are administered on day 11 in combination with a single injection of FFA gonadotropin at a dose of 2.5-3 thousand i.e. With subinvolution of the uterus, accompanied by hypofunction of the ovaries, prostaglandins (estuphalan, clathroprostin, gravoprost, gravoclatran) are administered to cows once at the beginning of the course of treatment. On the 11th day, the animals are injected with only FFA gonadotropin at a dose of 3-3.5 thousand IU.

In all cases of dysfunction of the uterus, treatment of cows should be carried out against the background of the organization of daily active exercise, rectal massage of the uterus lasting 2-3 minutes (4-5 sessions), communication of cows with probe bulls. In the presence of medical indications, vitamins (A, D, E, C, B), caiodine and other mineral preparations are prescribed.