Bovis ISSN 2398-2993

Uterine rupture

Contributor(s): Jo Oultram, Mike Reynolds

Introduction

  • Cause: trauma to uterus or increased intra-uterine pressure.
  • Signs: dystocia or failure to calve; detectable tear before/after delivery of calf.
  • Diagnosis: examination per vagina or by laparotomy.
  • Treatment: surgical repair per vagina or via exploratory flank laparotomy delivery; uterine amputation; euthanasia on welfare grounds.
  • Prognosis: guarded.

Pathogenesis

Etiology

  • Uterine rupture may be spontaneous, but is more usually associated with:
    • Obstetrical technique such as excessive, forced traction Dystocia Calving aids: correct use, fetotomy Fetotomy, delivery of emphysematous fetus, or other extensive fetal manipulations.
    • Other cause of dystocia including uterine torsion Uterine torsion: correction, failure of cervical dilatation, uterine distension (twins, hydroallantois Hydrops allantois, maternal/fetal disproportion).
    • Iatrogenic:
      • Administration of an ecbolic in the presence of incomplete cervical dilation.
      • Failure to close a uterine incision successfully, or failure of integrity of suture material post operatively Cesarean section could be included in this discussion and the clinical signs and consequences are going to be consistent with those which develop post-calving where a spontaneous rupture has not been diagnosed swiftly at calving.
    • External trauma has been postulated in some case studies as the cause.

Pathophysiology

  • Vascular compromise of the uterine wall due to uterine torsion.
  • Pressure exerted upon uterus by fetus.
  • Trauma during fetal manipulations or fetotomy.
  • Failure of the integrity of a uterine suture line.

Timecourse

  • Spontaneous rupture most likely late pregnancy or during parturition.
  • Secondary rupture related to timing of the predisposing factor, most of which are associated with impending or ongoing parturition.
  • If the fetus is delivered vaginally and the tear is not palpable before or after delivery, the signs of rupture and its sequalae may take several days to become apparent.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Azawi I, Ali A J & Naoman U T (2012) Uterine rupture with alive twins in a Holstein Frisian cow: a case report. Iraqi J Vet Sci 26 (1), 27-28.
  • Pearson H & Denny H R (1975) Spontaneous uterine rupture in cattle; a review of 26 cases. Vet Rec 97 (13), 240-244 PubMed.
  • Sloss V (1974) A clinical study of dystocia in cattle. 2. Complications. Aust Vet J 50 (7), 294-297 PubMed.
  • Sloss V & Johnston D E (1967) The causes and treatment of dystocia in beef cattle in Western Victoria. II. Causes, methods of correction and maternal death rates. Aust Vet J 43 (1), 13-21 PubMed.

Other sources of information

  • Weaver D, Atkinson O, St Jean G & Steiner A (2018) Bovine Surgery and Lameness. 3rd edn. Wiley Blackwell, USA.
  • Fubini A L & Ducharme N (2016) Farm Animal Surgery. 2nd edn. Elsevier, USA.
  • Jackson P G G (2004). Handbook of Veterinary Obstetrics. 2nd edn. Elsevier, USA. pp 177-189.
  • Noakes D E, Parkinson T J, England G C W & Arthur G H (2002) Arthur's Veterinary Reproduction and Obstetrics. 8th edn, Elsevier, USA. pp 341-355.


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