Uterine Prolapse

Uterine prolapse is the protrusion of the uterus from the vulva with the mucosal surface exposed. This case also called Procidentia (Procidentia is from Latin procidere - to fall). A uterine prolapse is typically seen immediately following or within a few hours of parturition.

Compared to the vaginal prolapse, the uterine prolapse is larger, longer (usually hanging down to the hocks when standing), more deep red in color and covered with the “buttons” where the placenta was attached. A uterine prolapse is considered a medical emergency; therefore, this condition is life threatening.

If the affected cow is not treated quickly, she could go into shock or die from blood loss. With uterine prolapses, if a good, clean job is done replacing the uterus, it may not be necessary to cull the cow from the herd.

Potential factors that can predispose a cow to a uterine prolapse include: Difficult calving (dystocia). Injury or irritation of the external birth canal. Retained placenta. Vaginal prolapse before the parturition. Severe straining during labor or excessive pressure applied when pulling a calf. Nutrition-related problems such as low blood calcium levels. Overly thin cows that calve in poor body condition.

Treatment: – Epidural anesthesia (caudal) if that necessary. – Endometrial surface should be cleaned. – Remove placenta from maternal caruncles – Assess surface for lacerations: Suture with absorbable suture as necessary – Uterus is progressively replaced starting at the cervix – Ensure whole uterus is correctly replaced – Sew vulva. – Uterine amputation – Therapy: Fluids, Ca, Antibiotics, Oxytocin.

When this has been accomplished, the cervix should lie unoccupied at the level of the pelvic brim, and if the whole uterus has passed the cervix it will promptly regain its normal position. To ensure complete replacement of the uterus, 9–14 litres of clean warm water are delivered into the uterus by gravity feed and immediately removed by siphonage, the weight of water effacing any remaining inversion of the horn. To help restore uterine tone, and thus to prevent recurrence of the prolapse, oxytocin should be given. Preoperative treatment with oxytocin, although reducing the size of the prolapsed organ,increases the turgidity of the everted organ and makes replacement more difficult. Even if the animal shows no clinical signs of hypocalcaemia, calcium borogluconate therapy should be given, together with parenteral antibiotics