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Diagnosis and Correction of Uterine Torsion in Cattle and Buffaloes

Diagnosis and Correction of Uterine Torsion in Cattle and Buffaloes

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Raksha Technical Review
Raksha Technical Review

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Published by: gnpoba on Jul 29, 2011
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Raksha Technical Bulletin June 2011, 2:11-17
Diagnosis and correction of uterine torsion in cattle and buffaloes
G N Purohit, Yogesh Barolia, Chandra Shekhar and Pramod Kumar Department of Veterinary Gynecology and ObstetricsCollege of Veterinary and Animal ScienceRajasthan University of Veterinary and Animal Sciences Bikaner, Rajasthan
The clinical findings, diagnostic approach and correction of uterine torsion in cattleand buffaloes are described. Retrospective analysis of uterine torsion in cattle and buffaloes at our centre is also mentioned.
Key words
: Buffaloes, cattle, cesarean section, rolling, uterine torsion.
:Uterine torsion is one of the frequent maternal causes of dystocia in river buffaloesand cows that commonly occurs near parturition and less commonly duringgestation. The entire length of the pregnant uterine horn rotates on its longitudinalaxis to the left (anti-clockwise) or right side (clockwise). The fetus and itsmembranes also rotate with the uterus; there is compression of the blood supply tothe fetus, hemorrhage or seepage of blood in the alantoic cavity and resultant deathof the fetus
in utero
. Since uterine torsion frequently occurs during parturition, the birth canal is occluded because of twisting and delivery of fetus cannot occur.Uterine torsion is a diagnostic dilemma for veterinarians and a difficult obstetric procedure for less experienced persons. The diagnostic criterion and correction procedures are mentioned here.
linical findings
hen uterine torsion occurs at the time of parturition the first clinical findingnoticed by animal owners is non-progression of labor. The animal may show signsof parturition with frequent getting up and lying down, colic pain but in most of thecases the labor does not progress and neither fetal bags, fetal fluids or fetus itself appear at the birth canal. The degree of torsion may vary from 90
to 360
.Depending upon the degree of torsion the chances of presence of fetus in the birth
Raksha Technical Bulletin June 2011, 2:11-17
canal vary. In smaller degree torsions, sometimes parts of the fetus may be presentin the birth canal and one or both water bags might have appeared at the birth canaland ruptured. However, the torsions are usually 180
or more and in these casesnothing appears at the birth canal.The parturition signs would become weak if the torsion is not correctedquickly. In mid gestation the animal would show colicky signs and signs of animpending parturition. The animal may show varying degrees of shock or toxemiathat may occur if torsion occurs after cervical dilation. Partial anorexia, dullnessand depression may be evident. Restlessness and arching of back may be evident in buffaloes.
Uterine torsion should be suspected if an animal has a history of non-progressivelabor. The point (place from which uterus rotates) of torsion could be just cranial tothe cervix (pre-cervical) or caudal to the cervix (post-cervical) and the side of torsion can be right or left. At our centre we found that torsions are generallytowards the right side and mostly pre-cervical both in cattle and buffaloes (Table1). The diagnosis of the side of torsion is extremely important as this decides theside of rolling of the animal for torsion correction.In some of the cases one or both lips of the vulva are pulled in to one side(Fig 1) because of the twisting of the uterus caudal to the cervix but this is notessential and clinicians must not rely only on this finding as this may be moreevident in higher degree post-cervical uterine torsions only and absent in pre-cervical uterine torsions.Vaginal and rectal examination helps in diagnosis. Vaginal examinationreveals twisting of the vaginal mucus membranes. The side of the twist determinesthe side of torsion. The hand cannot be passed deeper into the anterior vaginawhich has a conical end in torsions with degree of torsion being 180
or more. Inlesser degree torsions however, the fetus can sometimes be felt. Clinicians oftenconfuse such finding with cervical non-dilation. However, in such cases when thehand is passed further in the birth canal, the fetus may be found twisting to oneside along with the uterus also being felt twisted. The twisting of vaginal mucusmembranes is not always present even in post-cervical uterine torsions and hencethe most useful diagnostic parameter for uterine torsion is recto-genital palpation.By rectal palpation, the location of the broad ligaments is assessed and thisis the best diagnostic indicator of uterine torsion both in cattle and buffaloes. Atour centre 64.3% and 83.6% of cattle and buffaloes respectively evidenced pre-
Raksha Technical Bulletin June 2011, 2:11-17
cervical uterine torsion which could be diagnosed only by rectal palpation. The broad ligaments are the only holding structures of a gravid uterus on both the sidesand when a uterus rotates the broad ligaments also rotate. The broad ligaments caneasily be felt by rectal palpation. Both side ligaments are small bands of tissue feltas straight structures.
hen the pregnant uterine horn rotates to one side, the non- pregnant uterine horn which is closely attached to the gravid uterine horn by theinter-cornual ligament would also rotate to the same side (Fig 2 and 3). Thus, thelocation of both the broad ligaments is changed in uterine torsion.
hen the uterusrotates to the right side (This is ascertained by standing at the caudal side of theanimal. One should face the birth canal and determine the right or left side standinghere) the right broad ligament goes under the uterus whereas, the left ligament is pulled towards the right side and can be felt as a crossing structure (Fig 2 and 3).
hen the uterus rotates towards the left side (the side of the rumen) the left broadligament can be felt going under the uterus and the right ligament can be feltcrossing towards the left side. In every case of uterine torsion rectal palpationshould be done to ascertain the presence of torsion and the side of torsion. It isdifficult to exactly determine the degree of torsion especially in torsions greater than 90-180
by both vaginal and rectal palpation although with experienceclinicians can approximately predict the degree of uterine torsion.It is pertinent to record the general condition of the patient and the time sincetorsion as this would determine the correction options to be adopted.
orsion correction
Uterine torsion is an obstetrical emergency and hence attended on priority. It isessential to bring back a twisted uterus to its normal position (and this is known asdetorsion) when torsion occurs during mid-gestation or when it occurs at parturition and vaginal delivery is desirable. A fetus in a twisted uterus cannot livefor long because of compression of the blood supply and at times placenta and itcannot be delivered through the birth canal until the twist is very small (30-45
).Smaller degree torsions may sometimes be corrected spontaneously.The general condition of the patient must be improved before detorsion isattempted especially if the torsion is existent beyond 36 hours and the animalsuffers from shock and toxemia. Appropriate fluid replacements, antibiotics andcorticosteroids should be given to such animals.Three approaches of torsion correction are possible i) rotation of the fetus per vaginum ii) rolling the cow or buffalo and iii) laparohysterotomy.

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