Pathology Of The Pregnant Uterus

Front 1

What animal is a retained placenta a crisis in? What animal are retained placentas a common minor problem in?

Back 1

Crisis in horses, common minor problem in ruminants(<12 hrs=normal)

Front 2

What is the danger related to a retained placenta?

Back 2

Development of endometritis

Front 3

What leads to sloughing of a retained placenta?

Back 3

Normally decreased blood supply--> shrinkage, partial necrosis of caruncle + altered cell trophoblast cell population (apoptosis) leads to sloughing

Front 4

What causes a retained placenta?

Back 4

Multifactorial-nutrition, fetal maturity, circulatory factors, placentitis may contribute

Front 5

______ of endometrium is part of normal uterine involution post-partum.

Back 5

Dissolution

Front 6

When is lochia normally seen in cattle?

Back 6

Blood exudate is expelled as lochia at 1-2 weeks, often have some bacterial contamination bc nice environment for growth

Front 7

Subinvolution of placental sites is mainly a problem in ______.

Back 7

The bitch

Front 8

What are the clinical signs of subinvolution of placental sites?

Back 8

Bloody vaginal discharge weeks to months following delivery

Front 9

What is subinvolution of placental sites? What are the associated lesions?

Back 9

Trophoblasts in endometrium fail to die and lead to sites of hemorrhage, thrombosis and endometrial hyperplasia

Front 10

Successful implantation and fetal survival is dependent on a healthy ________.

Back 10

Endometrial lining

Front 11

Endometrial biopsies are often performed on problem breeders or as part of a pre-purchase exam for ____ and _____.

Back 11

Horses and camelids

Front 12

How and when is an endometrial biopsy performed?

Back 12

During estrus w/ alligator biopsy rod
-Fix in Bouin's or 10% formalin

Front 13

What is a grade 1 according to the endometrial biopsy grading scheme?

Back 13

Normal or mild, focal inflammation or fibrosis > 80% chance of conceiving and maintaining to term
-Don't want to see fibrosis or lots of leukocytes

Front 14

What is a Grade IIA according to the endometrial biopsy grading scheme?

Back 14

Mild to moderate change
50-50% chance of maintaining to term

Front 15

What is a grade IIB according to the endometrial biopsy grading scheme?

Back 15

10-50% chance of maintaining to term

Front 16

What does a grade III on the endometrial biopsy grading scheme mean?

Back 16

Severe inflammation and/or diffuse fibrosis
<10% chance of conceiving and maintaining till term

Front 17

The ____ must be actively maintained to prevent conceptus expulsion (EED) in cattle, goats and pigs.

Back 17

CL

Front 18

To maintain pregnancy, the blastocysts inhibit release of _____ from the endometrium.

Back 18

PGF2alpha

Front 19

The sow must have at least _____ fetuses for CL to be maintained and as long as _____ or more fetuses are viable, then pregnancy can proceed even if some feti have died.

Back 19

2 feti in each uterine horn
4 viable

Front 20

Death of the fetus results in expulsion during the next few days once in _______ in mares, ewe, and cow.

Back 20

Last trimester
-Before this may see resorption of mummification depending on whether CL is destroyed

Front 21

What happens to a fetus that dies in small animals?

Back 21

Life span of canine and feline CLs seem to be predetermined-persist whether EED occurs or not
-Autolysis, resorption or mummification is common

Front 22

You have gwendolyn a 4 yr thorobred mare present for multiple unsuccessful breedings and a copious amount of mucopurulent vaginal discharge. What diagnostic tests do you want to run?

Back 22

CBC, urinalysis, culture of discharge, endometrial biopsy
-This was Taylorella equigenitalis

Front 23

What are the 5 steps in normal parturition of an ewe and cow?

Back 23

1) mature fetus releases ACTH from pituitary gland
2) Increased cortisol from adrenal glands
3) Placental enzymes convert progesterone to estrogen, changing P: E ratio
4) PGF2alpha release from uterus
5)Uterine contractions, oxytocin release, cervical complicance, CL lysis

Front 24

What happens when a fetus experiences, hypoxia, maternal stress, toxemia, fever, or tissue damage?

Back 24

Causes fetal stress---> same hormonal cascade as parturition---> abortion or premature delivery

Front 25

What is EED? What's the final result?

Back 25

Early embryonic death
-Occurs b/w conceptino-42 d
-Resorbed or expelled

Front 26

What is the death of a bovine fetus considered stillbirth?

Back 26

260 d -term
-Theoretically viable age

Front 27

What is mummification?

Back 27

Dead fetus is retained and becomes dehydrated
May be expelled at term or sooner (CL persists)
-usually occurs in absence of bacteria

Front 28

What is the definition of maceration?

Back 28

Dead fetus contaminated by putrefactive organisms
-Common in dystocia, first trimester deaths

Front 29

What causes prolonged gestation?

Back 29

Usually some form of fetal anomaly present: hypoplastic adrenals, cephalic monsters with not properly functioning pituitary glands

Front 30

When a fetus dies in a bovine when is it considered an abortion? What happens to the fetus?

Back 30

42-260 days
-Expelled, mummified or macerated

Front 31

In general, acute acting infectious insults may cause fetal death before parturition cascade can be completed---> septic or viremic fetus are often______ by the time they are expelled.

Back 31

autolysed

Front 32

What are the 4 compartments of the placenta?

Back 32

Amnion
Yolk sac
Chorion
Allantois

Front 33

What are 4 types of placentas?

Back 33

1) Diffuse
2) Cotyledonary
3) Zonary
4) Discoid

Front 34

What animals are generally epitheliochorial or endotheliochorial placentas?

Back 34

Dog, cat

Front 35

What 3 animals have a hemochorial placenta?

Back 35

Humans, rodents, rabbit

Front 36

What kind of placenta does the horse have?

Back 36

Diffuse

Front 37

What is a placentome?

Back 37

Fetal cotyledon + maternal caruncles

Front 38

What type of placenta does a dog have?

Back 38

Zonary placenta

Front 39

What can amniotic plaques be?

Back 39

Squamous metaplasia

Front 40

What are 3 lesions that should be visible if an umbilical torsion is present?

Back 40

1) Local edema
2) Hemorrhage
3) Distension of vessels or urachus

Front 41

Where do placental calcifications occur? Are they significant?

Back 41

Allantois or amnion
-Rarely significant

Front 42

What are hippomanes? Are they normal?

Back 42

Compressed bits of waste material sometimes found in fetal membranes=allantoic calculi or Hippomanes-normal

Front 43

What are allantochorionic pouches?

Back 43

Sac like protrusions off chorion that may have fluid associated=sites where endometrial cups used to be

Front 44

What are 4 normal sites on the equine placenta that doesn't develop villi?

Back 44

Cervical star (where oviducts come in)
Along chorionic girdle-where endometrial cups tend to form
Horn tips
Twin interface

Front 45

What is hydramnios and what usually causes it?

Back 45

-Too much fluid in amnion
-Usually due to problem with fetal swallowing- skeletal, muscular neural anomalies

Front 46

What causes hydroallantois?

Back 46

Usually due to uterine disease, twins-up to 170L have been documented
-Dystocia, uterine paresis common

Front 47

What does adventitial placentation indicate in ruminants? What do you see grossly?

Back 47

Indication of placental insufficiency in ruminants
-See smaller less organized cotyledons

Front 48

What animal is usually affected by premature placental separation?

Back 48

Equine

Front 49

What are 2 possible causes of hypoplasia of chorioallantoic villi (equine & camelid)?

Back 49

Consequence from inadequacy in nutrition or endometrial lining doesn't allow things to interact properly
-Results in lack of exchange bc of lack of villi for exchange

Front 50

A placenta has thickening of the intercotyledonary area and there's an exudate, what's on your differentials?

Back 50

Placentitis

Front 51

A normal bovine placenta has ____ - ______ cotyledons with a maximum diameter of _______ (near umbilical cord attachment).

Back 51

75-120 cotyledons
Max diameter=15 cm

Front 52

What are 4 things you should look for when examining a bovine placenta?

Back 52

1) Presence of adventitial placentation
2) Relatively uniform sized cotyledons
3) Uniform rate of autolysis
4) Clarity of intercotyledonary placenta (on fresh specimen)

Front 53

The bovine placenta should weight about ____% of body weight and a lower % may reflect placental insufficiency.

Back 53

14% of body weight

Front 54

How much should the equine placenta should weight?

Back 54

10% of FETAL weight

Front 55

When examining the equine placenta you should spread it out in an f or y shape and look for abnormalities of ______, ______, ____ and ________.

Back 55

Color
Texture
Tears
Avillous sites

Front 56

When examining the equine placenta the ______ should be examined closely.

Back 56

Cervical star

Front 57

How long should the normal equine umbilical cord be? What should you check it for other than length?

Back 57

36-83 cm
Torsion?

Front 58

Hippomanes are very common in what specie?

Back 58

Equine