Removal by laparoscopic partial ovariohysterectomy of a uterine leiomyoma assumed to have caused fetal death in a mare

Abstract

SummaryA 13‐year‐old pluriparous Dutch Warmblood mare presented to Utrecht University's Department of Equine Sciences 4 weeks after suspected abortion at 3.5 months gestation, to investigate the nature of a uterine mass and persistent vulval discharge. Transrectal ultrasonographic examination revealed copious flocculent fluid and fetal remnants within the uterus and a 5–6 cm heterogenous mass in the uterine wall at the tip of the right horn. Expulsion of fetal parts and resolution of the coexisting endometritis were effected by a combination of repeated PGF2a analogue injections to induce oestrus, application of PGE2 gel to aid cervical relaxation, and daily uterine lavage and antibiotic instillation. The presence of the mass in the uterine wall was confirmed by hysteroscopy and the suspected tumour subsequently removed by partial laparoscopic ovariohysterectomy under standing sedation and local anaesthesia. The histological appearance of the tumour was consistent with a leiomyoma or moderately malignant leiomyosarcoma. Although a follow‐up examination 6 months post surgery revealed uncomplicated healing of the uterus, the owner decided to retire the mare from breeding. Uterine neoplasia is an extremely unusual cause of fetal death in the mare but, in the present case, laparoscopic partial ovariohysterectomy proved a promising, minimally invasive technique for salvaging sufficient uterus to make subsequent breeding a realistic proposition.