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[牛的子宫扭转:治疗、母牛的受伤风险及犊牛的预后]

[Uterine torsion in cattle: Treatment, risk of injury for the cow and prognosis for the calf].

作者信息

Klaus-Halla Daniela, Mair Bettina, Sauter-Louis Carola, Zerbe Holm

出版信息

Tierarztl Prax Ausg G Grosstiere Nutztiere. 2018 Jun;46(3):143-149. doi: 10.15653/TPG-170680. Epub 2018 Jun 14.

Abstract

OBJECTIVE

In cows with uterine torsion, clinical parameters and different treatments were evaluated with regards to their success. The aim of the study was to investigate important factors for diagnosis and prognosis of uterine torsion and their consequences for treatment decisions.

MATERIAL AND METHODS

The study presents 114 cases of uterine torsion documented under field conditions. The cows were examined before retorsion of the uterus and immediately post partum.

RESULTS

In cases of good maternal preparation for parturition, neonatal mortality was 14.9 %, while in cases of insufficient preparation, this rose to 58.3% (p= 0.006). When uterine torsion lasted > 12 hours, only 34.8 % of the calves survived, while in cases with a duration of ˂ 6 hours or 6-12 hours, 85.7 % and 92.2 % of the calves survived, respectively (p ˂ 0.001). In 82.5 % of the cases, intravaginal manual rotation of the fetus and uterus was performed, while in 17.5 % of the cases, cows were rolled by simultaneously fixating the uterus and fetus with a plank. No statistically significant differences were found between these two treatment types regarding neonatal mortality (4.7 % vs. 18.2 %; p = 0.139) or lacerations of the dam (31.9 % vs. 42.1 %; p = 0.391). A delayed extraction of the calf after successful retorsion and waiting for widening of the cervical canal is an option in cases of insufficient dilatation of the cervical canal, even when there is a significantly higher risk for lacerations of the dam (57.2 %) compared to an immediate extraction (26.8 %; p = 0.018). As the duration of manipulation increases, the extent of injury to the dam also increases significantly (p ˂ 0.001).

CONCLUSION AND CLINICAL RELEVANCE

The quality of maternal preparation for parturition in cows with uterine torsion can be used as a prognostic factor for calf survival. Under field conditions, most of the cases of uterine torsion can be successfully treated manually. An appropriate and indication-oriented use of the rolling method with the application of a plank can be recommended. In cases of uterine torsion, proper periparturient monitoring and early intervention are of crucial importance for the course of the disease and for the prognosis of the dam and offspring.

摘要

目的

在患有子宫扭转的奶牛中,评估临床参数和不同治疗方法的成功率。本研究的目的是调查子宫扭转诊断和预后的重要因素及其对治疗决策的影响。

材料与方法

本研究呈现了114例在野外条件下记录的子宫扭转病例。在子宫复位前和产后立即对奶牛进行检查。

结果

在分娩准备良好的病例中,新生儿死亡率为14.9%,而在准备不足的病例中,这一比例升至58.3%(p = 0.006)。当子宫扭转持续时间>12小时时,只有34.8%的犊牛存活,而在持续时间<6小时或6 - 12小时的病例中,犊牛存活率分别为85.7%和92.2%(p < 0.001)。在82.5%的病例中,采用了阴道内手动旋转胎儿和子宫的方法,而在17.5%的病例中,通过用木板同时固定子宫和胎儿对奶牛进行翻滚。这两种治疗方法在新生儿死亡率(4.7%对18.2%;p = 0.139)或母体撕裂伤(31.9%对42.1%;p = 0.391)方面没有统计学上的显著差异。在子宫颈管扩张不足的情况下,成功复位后延迟取出犊牛并等待子宫颈管扩张是一种选择,即使与立即取出相比,母体撕裂伤的风险显著更高(57.2%)(26.8%;p = 0.018)。随着操作时间的增加,母体的损伤程度也显著增加(p < 0.001)。

结论与临床意义

子宫扭转奶牛的分娩准备质量可作为犊牛存活的预后因素。在野外条件下,大多数子宫扭转病例可通过手动成功治疗。可以推荐适当且根据适应症使用带有木板的翻滚方法。在子宫扭转病例中,围产期的适当监测和早期干预对于疾病的进程以及母体和后代的预后至关重要。

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