Uterine Palpation Research Articles

Propaedeutic and Therapeutic Practices Used for Retained Fetal Membranes by Rural European Veterinary Practitioners.

The present study aimed to monitor the practices of European veterinarians for the diagnosis and treatment of retained fetal membranes in cattle. A questionnaire was established and distributed to veterinarians from five European countries. A total of 700 veterinarians participated in the survey. A vaginal examination, general examination and uterine palpation are carried out by 71%, 38% and 23% of veterinarians, respectively. Moreover, half of the veterinarians attempt to remove the placenta manually, 70% of them administer a combined local and general treatment if the cow has a fever (more than 39.5 °C), and 50% of them only administer IU treatment if no fever is observed. Tetracyclins, cefapirin and penicillins are the most used intrauterine (IU) antibiotics, whereas penicillin is the most used parenteral one. All other European veterinarians were less likely to use cefapirin and more likely to use oxytocin, Ca perfusion and NSAID than French and Walloon veterinarians. In conclusion, our study confirms the necessity of improving and rationalizing the diagnostic and therapeutic approach of the RFM, mainly to reduce the important problem of antibiotic resistance.

Postpartum Uterine Diseases; Diagnostic Approaches and Management in Farm Animals: A Review

Postpartum uterine infections results from uterine contamination with bacteria during parturition. The postpartum environment of the uterine lumen supports the growth of a variety of aerobic and anaerobic bacteria. There are a number of risk factors for post-partum uterine disease in dairy cattle; cows having dystocia, retained placenta, twins or stillbirths and various metabolic disorders are more likely to develop uterine disease. Inflammation of the uterus slows down the process of involution in the uterus and delays the onset of activities of the ovaries leading to economic loss due to systemic illness, loss of milk and meat production and marked drop in fertility. Pyometra, metritis, clinical and subclinical endometritis are some of the most important illnesses during the postpartum period. A variety of methods such as uterine palpation, ultrasonographic features of the uterus, vaginoscopy, endometrial cytology, uterine culture, and uterine biopsy has been reported to identify postpartum diseases. Prevention of postpartum uterine disease would be better than cure, for both the animals and the economy. Thus, early diagnosis or predictions of uterine infections are important for effective postpartum management.

Postpartum Uterine Diseases; Diagnostic Approaches and Management in Farm Animals; A Review

Postpartum uterine infections result from uterine contamination with bacteria during parturition. The postpartum environment of the uterine lumen supports the growth of a variety of aerobic and anaerobic bacteria. There are a number of risk factors for post-partum uterine disease in dairy cattle; cows having dystocia, retained placenta, twins or stillbirths and various metabolic disorders are more likely to develop uterine disease. Inflammation of the uterus slows down the process of involution in the uterus and delays the onset of activities of the ovaries leading to economic loss due to systemic illness, loss of milk and meat production and marked drop in fertility. Pyometra, metritis, clinical and subclinical endometritis are some of the most important illnesses during the postpartum period. A variety of methods such as uterine palpation, ultrasonographic features of the uterus, vaginoscopy, endometrial cytology, uterine culture, and uterine biopsy has been reported to identify postpartum diseases. Prevention of postpartum uterine disease would be better than cure, for both the animals and the economy. Thus, early diagnosis or predictions of uterine infections are important for effective postpartum management.

Oxytocin infusion dose-response to maintain uterine tone in obese elective cesarean patients: a randomized controlled trial.

For cesarean delivery (CD), the 90% effective dosage (ED90) of oxytocin for a first bolus has been established. It is not yet known how much oxytocin to inject into obese women undergoing elective discectomy to keep their uterine tone (UT) appropriate. We hypothesized that patients who are overweight need a greater dose of oxytocin infusion; thus, we aimed to determine how the dose-response curve for oxytocin infusion changes following an initial 1 international unit (IU) bolus in obese women undergoing elective CD. One hundred parturients with a body mass index (BMI) greater than 30kg/m2 were randomly assigned to receive an infusion rate of 14, 18, 22, or 26 IU/h of oxytocin. When the uterine palpation is as hard as touching the forehead or tip of the nose, it is considered sufficient UT according to the criteria used by obstetricians. The median effective dose (ED50) and ED90 values were determined using probit analysis. We found the ED50 and ED90 values for the infusion dose of oxytocin were around 11.0 IU/h and 19.1 IU/h, respectively. Each group had a different number of parturients who needed rescued oxytocin: 14 IU/h for six, 18 IU/h for three, one for 22 IU/h, and none for 26 IU/h. The correlation between the frequency of rescued oxytocin administration and the amount of oxytocin infusion needed to avoid uterine atony was statistically significant (p = 0.02). The present research showed that the most effective dosage of oxytocin infusion for obese parturients undergoing elective CD is 19.1 IU/h, following an initial loading dose of 1 IU. Patients with obesity should receive a greater dosage of prophylactic oxytocin, and further studies comparing patients with and without obesity (with higher BMI) are required. https://www.chictr.org.cn/showproj.html?proj=159951, identifier ChiCTR2200059582.

8887 Hysteroscopic Intramyometrial Injection of Botulinum Toxin As Treatment for Chronic Pelvic PAIN of Uterine Origin

<h3>Study Objective</h3> to demonstrate the surgical technique of the intramyometrial application of botulinum toxin Hysteroscopic approach for the management of pelvic pain of uterine origin. <h3>Design</h3> A step-by-step description was made for the application of intramyometrial botulinum toxin via hysteroscopic. <h3>Setting</h3> Advanced gynecology laparoscopic and pelvic pain unit. <h3>Patients or Participants</h3> Patients with painful uterine syndrome who follows the diagnostic criteria: the presence of localized pain in the pelvis, colic or sensation of uterine contraction outside the cycle, dysmenorrhea, dyspareunia, physical examination findings of pain on uterine palpation as a uterine trigger. <h3>Interventions</h3> hysteroscopic Intramyometrial application of Botulinum Toxin for treatment of chronic pelvic pain of uterine origin. <h3>Measurements and Main Results</h3> Intramyometrial application of botulinum toxin under hysteroscopic guidance with general anesthesia, use of Bettochi's hysteroscope and surgical steel needle for cystoscopy (5 Fr, 30 cm) through the working channel, use of saline solution as a means of distention, vaginoscopy, entry into the endocervical canal and endometrial cavity, evaluation of the cavity, location of the ostium, injection of botulinum toxin type A dilution (200 IU in 20 cc SSN) application of 1 cc per point distributed on the anterior and posterior face of the uterine wall. <h3>Conclusion</h3> Hysteroscopic intramyometrial application of Botulinum toxin can be a treatment option in patients with chronic pelvic pain of uterine origin when conventional treatment fails. It is an easily reproducible procedure, with few side effects and effective in pain control in selected patients.

A telemedicine model for abortion in South Africa: a randomised, controlled, non-inferiority trial

Telemedicine for medical abortion increases access to safe abortion but its use has not been described in a controlled trial. We aimed to investigate the effectiveness, adherence, safety, and acceptability of a modified telemedicine protocol for abortion compared with standard care in a low-resource setting. In this randomised, controlled, non-inferiority trial we recruited women seeking medical abortion at or before 9 gestational weeks at four public health clinics in South Africa. Participants were randomly allocated (1:1) by computer-generated blocks of varying sizes to telemedicine or standard care. The telemedicine group received asynchronous online abortion consultation and instruction, self-assessed gestational duration, and had a uterine palpation as a safety measure. Participants in this group took 200 mg mifepristone and 800 μg misoprostol at home. The standard care group received in-person consultation and instruction together with an ultrasound, took 200 mg mifepristone in clinic and 800 μg misoprostol at home. Our primary outcome was complete abortion after initial treatment, assessed at a 6-week interview. Our non-inferiority margin was 4%. Group differences were assessed by modified intention-to-treat (mITT) analysis and per protocol. The trial is registered at ClinicalTrials.gov, NCT04336358, and the Pan African Clinical Trials Registry, PACTR202004661941593. Between Feb 28, 2020, and Oct 5, 2021, we enrolled 900 women, 153 (17·0%) of whom were discontinued before the abortion and were not included in the analysis. By mITT analysis, 355 (95·4%) of 372 women in the telemedicine group had a complete abortion compared with 338 (96·6%) of 350 in the standard care group (odds ratio 0·74 [95% CI 0·35 to 1·57]). The risk difference was -1·1% (-4·0 to 1·7). Among women who completed treatment as allocated (per protocol), 327 (95·6%) of 342 women in telemedicine group had complete abortion, compared with 338 (96·6%) of 350 in the standard care group (0·77 [0·36 to 1·68]), with a risk difference of -1·0% (-3·8 to 1·9). One participant (in the telemedicine group) had a ruptured ectopic pregnancy, and a further four participants were admitted to hospital (two in each group), of whom two had blood transfusions (one in each group). Asynchronous online consultation and instruction for medical abortion and home self-medication, with uterine palpation as the only in-person component, was non-inferior to standard care with respect to rates of complete abortion, and did not affect safety, adherence, or satisfaction. Grand Challenges Canada and the Swedish Research Council.

The analgesic efficacy of multimodal analgesia pathway after cesarean delivery

Background: Multimodal analgesia is a combination of analgesic methods that act on different sites of the pain pathway. The objective of this study was to evaluate the efficacy of multimodal analgesia after cesarean delivery (CD) and to investigate the adverse effects of these methods. Materials and method: A total of 180 women received spinal anesthesia for CD were divided into three groups. Group Para-TAP received paracetamol and transverse abdominis plane block (TAP block); group Para-Diclo received paracetamol and diclofenac; group Para-Diclo-TAP received paracetamol, diclofenac and TAP block. Paracetamol was given intravenously (IV) 1 g, orally 1 g every 8 h for 24 h, diclofenac was inserted rectally 1 h after surgery, TAP block were performed when uterine palpation caused a VAS score of 2 points. Pain score was measured with the visual analogue scale (VAS) at rest and on movement at 0, 2, 4, 6, 8, 12, 18 and 24 h for the first 24 h. Patient comfort and satisfaction with analgesia was evaluated at the end of 24 h. The primary outcome was VAS score and the rate of analgesic request. The secondary measures of outcome were satisfaction with the pain management and side effects. Breakthrough pain was treated with 5 mg IV morphine when the VAS at rest ≥ 4 or on movement ≥ 5. Results: The VAS score ≤ 3 at rest of the 3 groups was 76.67%, 90% and 93.33%, respectively, the VAS score on movement ≤ 3 of the 3 groups was 38.33%, 61.67% and 76.67%, respectively. The rate of analgesic request of 3 groups was 23.33%, 10% and 6.7%, respectively, group Para-Diclo-TAP did not have the second analgesic request. All 3 groups had a low rate of itch and nausea, the difference between side effects was not significant. The Para-TAP group was more effective than the Para-Diclo group during the first 6h, the Para-Diclo group was more effectiveduring 12-24 h period, the Para-Diclo-TAP group was more ffective than the Para-Diclo group for a period of 18h. Conclusion: All 3 methods are effective in pain relief after CD, in which the combination of paracetamol, diclofenac, and TAP block brings outstanding efficiency but side effects are equivalent to other methods. Key words: Cesarean delivery, multimodal analgesia, paracetamol, NSAID, TAP block.

Identifying and Treating of Uterine Infection in Cows of Basrah city

The present study was conducted from December 2015 to February 2017 on a local breeds and Holstein Friesian with 88 cows (age 4-12). Metritis was diagnosed by clinical examinations using gloved hand and rectal uterine palpation as well as by bacteriological examinations using swabs. Antibiotic therapy was applied for the treatment of metritis in cow followed by one injection of luteinizing hormone. Examined cows were randomly divided into five groups. In group A (n=15), administration of oxytetracycline was used for one day. Group B (n = 18), received lugols iodine for one day. Group C (n = 22), received penicillin with streptomaycin for one day. Group D (n=7) received intramuscular administration of gentamycin for one day. Finally, group E (n=26) received safapirin for one day . All treatment followed by one injection of luteinizing hormone. Different type of bacteria was isolated from the cow uterus including Escherichia coli (40%), Proteus vulgaris (13.63%), Corynebacterium pyogenes (6.81%), Staphylococcus pyogenes (20.45%), Pseudomonas aeruginosa (5.68%), and Streptococcus spp.(7.95%). E. coli was frequently isolated from the cow uterus (40%). Safapirin and penicillin-streptomaycin were the most effective in treating metritis as they represented 84.61% and 81.81%, respectively. Lugols iodine and oxytetracycline, were also considerably effective in treating metritis as they represented 61.11% and 60.00%, whereas gentamycin intramuscularly accounted about 28.57%.

Identifying and Treating of Uterine Infection in Cows of Basrah city

The present study was conducted from December 2015 to February 2017 on a local breeds and Holstein Friesian with 88 cows (age 4-12). Metritis was diagnosed by clinical examinations using gloved hand and rectal uterine palpation as well as by bacteriological examinations using swabs. Antibiotic therapy was applied for the treatment of metritis in cow followed by one injection of luteinizing hormone. Examined cows were randomly divided into five groups. In group A (n=15), administration of oxytetracycline was used for one day. Group B (n = 18), received lugols iodine for one day. Group C (n = 22), received penicillin with streptomaycin for one day. Group D (n=7) received intramuscular administration of gentamycin for one day. Finally, group E (n=26) received safapirin for one day . All treatment followed by one injection of luteinizing hormone. Different type of bacteria was isolated from the cow uterus including Escherichia coli (40%), Proteus vulgaris (13.63%), Corynebacterium pyogenes (6.81%), Staphylococcus pyogenes (20.45%), Pseudomonas aeruginosa (5.68%), and Streptococcus spp.(7.95%). E. coli was frequently isolated from the cow uterus (40%). Safapirin and penicillin-streptomaycin were the most effective in treating metritis as they represented 84.61% and 81.81%, respectively. Lugols iodine and oxytetracycline, were also considerably effective in treating metritis as they represented 61.11% and 60.00%, whereas gentamycin intramuscularly accounted about 28.57%.

Assessment of visceral pain associated with metritis in dairy cows

Metritis is a common disease in dairy cattle, but to our knowledge, no work has assessed pain associated with this disease. Tissue palpation is commonly used to assess pain in human and veterinary medicine. The objective of this study was to evaluate visceral pain responses during rectal palpation, with and without uterine palpation, in healthy cows and in cows diagnosed with metritis. A total of 49 Holstein dairy cows (mean ± standard deviation parity of 2.8±1.8) were subjected to systematic health checks every 3 d after parturition for 21 d, scoring for vaginal discharge (0 to 4); 13 cows showed a discharge score ≥2 during at least 1 health check and were classified as metritic, whereas 29 cows were classified as healthy and showed no sign of this or any other disease (including mastitis and lameness). Back arch and heart rate variability before examination and during palpation were recorded using video and heart rate monitors. Back arch (cm2) on the day of diagnosis was greater in metritic versus healthy cows (1,034±72 vs. 612±48cm2), and greater during rectal palpation with uterine palpation versus rectal palpation without uterine palpation (869±45 vs. 777±45cm2). Heart rate frequency domain analysis showed that the low-frequency portion was higher in cows with metritis versus healthy cows (16.5±1.2 vs. 12.9±1.0). Time domain analysis showed that the standard deviation between normal to normal interbeat intervals and the root mean square of successive differences both decreased during rectal palpation with uterine palpation versus rectal palpation without uterine palpation (1.9±0.1 vs. 2.5±0.1 and 1.3±0.1 vs. 1.7±0.1, respectively). Together, these results indicate that the inflammation associated with metritis is painful, and that the pain response can be detected during rectal palpation with and without uterine palpation. Rectal palpation with uterine palpation appears to be more aversive than rectal palpation without uterine palpation, suggesting that the former should be avoided when possible.

Five-day resynch programs in dairy cows including controlled internal drug release at two stages post-artificial insemination (2013)

Two experiments were conducted to assess pregnancy outcomes after a 5-day Ovsynch-56 Resynch (RES; gonadotropin-releasing hormone injection 5 days before [GnRH-1; d 0] and 56 hours (GnRH-2) after PGF2α [PG] injections on day 5 and 6, timed artificial insemination [TAI] on day 8) with and without a progesterone-releasing intravaginal controlled internal drug release (CIDR) 5-day insert. In Exp. 1, nonpregnant cows were enrolled on day 34 postAI: day 34 RES-CON (n = 528) or day 34 RES-CIDR (n = 503). Blood was collected for progesterone assay. Pregnancy per AI (P/AI) was diagnosed by uterine palpation per rectum at 34 and 62 days post-TAI. Only 76% of 1,031 cows had high progesterone (≥1 ng/mL) on day 34 at the nonpregnant diagnosis. No differences in P/AI were detected between treatments. The day-34 RES-CIDR cows with low (<1 ng/mL) progesterone, however, had greater (P = 0.036) P/AI than day-34 RES-CON cows (37.7 vs. 29.4%), whereas day-34 RES-CIDR cows with high progesterone had lesser P/AI than day-34 RES-CON (27.4 vs. 34.3%). In Exp. 2, cows were enrolled on day 31 post-AI after a nonpregnant diagnosis: (1) day 31 PG-3-G (n = 102): Pre-PG on day 31, Pre-GnRH on day 34, and RES on day 41 (n = 102); (2) day 41 RES-CON (n = 108) as Exp. 1, but on day 41; and (3) day 41 RES-CIDR (n = 101) as Exp. 2, but on day 41. Blood was collected for progesterone assay and ovarian structures were mapped by ultrasonography on days 31, 34, 41, 46, and 48. Pregnancy was diagnosed by ultrasonography on days 31 and 59 post-TAI. The proportion of cows with high progesterone on day 31 was 70.6%. More (P < 0.001) cows ovulated after Pre-GnRH on day 31 PG-3-G (60.4%) than for day 41 RES-CON (12.5%) or day 41 RES-CIDR (17.1%). More (P < 0.001) PG-3-G cows had luteolysis after Pre-PG on day 31 than other treatments (73.7 vs. < 11%). The proportion of cows with high progesterone on day 41 at GnRH-1 tended (P = 0.10) to be greater for PG-3-G (75.6%) than for other treatments (65 to 70%). The P/AI was greater in cows starting RES on day 41 when progesterone was low (44%) than when it was high (33%), but no treatment differences were detected 31 days after TAI (PG-3-G = 33.3%; d 41 RES-CON = 38.9%; d 41 RES-CIDR = 35.6%). We concluded that improved P/AI for cows initiating the 5-day RES on day 34 without a corpus luteum is progesterone-dependent because addition of the CIDR insert to the RES treatment improved P/AI in cows with low progesterone (Exp. 1). Although day-31 PG-3-G increased luteolysis and produced greater ovulation rates before the onset of RES, no increase in P/AI was detected compared with RES started on day 41 with or without a CIDR insert.

Using fecal progestagens and logistic regression to enhance pregnancy detection in wild ungulates: A bison case study

AbstractUngulate ecological studies often include components of reproduction because of its demographic importance and the ecological factors affecting it. Pregnancy status, in particular, is key because it represents a starting point for succeeding measurements of vital rates. Here, we present a case study using wild bison (Bison bison), in which we developed a non‐invasive method for assessing pregnancy in unmarked, non‐handled animals that improves upon existing approaches for wild ungulates. Specifically, we employed a model‐based binary logistic‐regression approach to estimate the probability of pregnancy predicted by fecal progestagen concentrations quantified from a single, late‐gestation scat sample. For 155 observations of 42 marked bison from the Jackson herd in northwest Wyoming, USA during 1997–2005, we used combinations of transrectal uterine palpation and calf status as independent measures of pregnancy to reduce the potential for error inherent in using either measure alone. We evaluated predictive success by calculating mis‐prediction rates from leave‐one‐out cross‐validation, and by calculating the percentage of 95% confidence intervals that crossed a pregnant–not‐pregnant threshold. Correct predictions, with high confidence, were obtained from a model using year‐centered, natural‐log‐transformed progestagen concentrations, resulting in an overall successful cross‐validation pregnancy prediction rate of 93.5%. Our approach will allow practitioners to consider the uncertainty associated with each prediction, thereby improving prediction interpretations. The approach should appeal to practitioners because fecal samples are easily collected and preserved, laboratory procedures are well‐documented, and logistic‐regression statistical software is readily available. Furthermore, samples can be obtained non‐invasively, which reduces cost and potential bias and increases animal safety, human safety, and social acceptability. © 2012 The Wildlife Society.

Inhibition of vascular endothelial growth factor during the postovulatory period prevents pregnancy in the marmoset

Background This study investigated the effects of inhibition of vascular endothelial growth factor (VEGF) during the first postpartum cycle in marmosets housed with a fertile male where a 90% fertility rate is normal. Methods On resumption of mating, females were treated with either 25 mg/kg aflibercept, a potent VEGF inhibitor, or control Fc protein ( n=6 per group) at the time of ovulation. Effects on timing of pregnancy were monitored by measuring plasma progesterone, chorionic gonadotropin (CG) and uterine palpation. Results In five of six Fc-treated controls, the postpartum rise in progesterone was maintained and followed by a sustained rise in CG by Day 30 posttreatment indicating pregnancy. In all six aflibercept-treated animals, progesterone secretion was suppressed in the treatment cycle and a CG rise did not occur by Day 30. Pregnancy was delayed to the next cycle, significantly extending interbirth interval compared to controls. Posttreatment deliveries and infant development were normal. Conclusion These results show that stringent pharmacological inhibition of VEGF suppresses luteal progesterone and prevents the successful establishment of pregnancy.

Analysis of myomectomy surgical technique: the importance of uterine palpation

OBJECTIVE: Myomectomy is a frequently performed fertility-sparing surgical procedure. The traditional approach for myomectomy is laparotomy, but hysteroscopy and laparoscopy are becoming increasing utilized for this procedure. One disadvantage of these less invasive approaches is that they do not allow for direct palpation of the uterus during the surgery. The purpose of this study was to determine how many uterine fibroids would be missed during myomectomy if palpation of the uterus was not used to identify fibroids not visible during the surgery. DESIGN: Prospective, observational study. Private practice, community hospital. MATERIALS AND METHODS: Women desiring future fertility who had symptomatic uterine fibroids presenting between March 2007 and April 2008 were studied. Only women with at least one visible fibroid were included for study. Preoperative evaluation of all women included physical examination and transvaginal ultrasound. Laparotomy with myomectomy was performed using standard surgical techniques. During the procedure, each fibroid was assessed as to whether it could be detected by visualization or only by palpation. Fibroids that became visible during excision of another visible fibroid were classified as visible. All fibroids detectable by visualization or palpation were removed. RESULTS: A total of 39 women (mean age 36.3 years, range 26.4-48.2 years) were studied. Median number of fibroids seen on transvaginal ultrasound was 2 (range 1-6), but the median number of fibroids identified and removed at surgery was 10 (range 1-41). The mean weight of fibroids removed was 286.9 g (range 15-1,194 g), with intraoperative blood loss averaging 233 mL (range 25-2,450 mL). Approximately 30% of fibroids removed were detectable only by palpation (SE 3.8%; range 1-90%). The total weight of visible fibroids removed (271.4 g; range 15-1,100 g) was significantly greater than fibroids detected only by palpation (19 g; range 0-94 g) (P=0.00007). CONCLUSIONS: Almost one third of uterine fibroids will be missed if palpation of the uterus is not performed during myomectomy. These fibroids are generally small. In women with symptomatic uterine fibroids, transvaginal ultrasound underestimates the number of tumors.

Comparison of three estrus detection systems during summer in a large commercial dairy herd

The objective of the study was to compare three systems for estrus detection and combinations of these systems on a large commercial dairy (1075 lactating cows) during stress of summer heat. At 37–45 days in milk (DIM), 255 cows were fitted with a HeatWatch ® device (HW; DDx Inc., Denver, CO), an activity sensor ALPRO ® (ALPRO; DeLaval Inc., Kansas City, MO), and visually observed (VO) three times daily. Pregnancy status was determined by uterine palpation per rectum 35–49 days following artificial insemination (AI). Effects of DIM, parity, standing events, inseminator, and interval between onset of estrus and AI on conception rates were determined using logistic regression. Efficiencies for detection of estrus, determined by comparing detected periods of estrus with a theoretical total of 570 periods, were 49.3% (VO), 37.2% (ALPRO), 48.0% (HW), and 80.2% for all three systems simultaneously. Conception rates (LSM ± S.E.) for cows detected by one or more of the three systems were 6.2 ± 3.9 for VO, 19.8 ± 5.6 for ALPRO, 17.3 ± 5.0 for HW, 22.8 ± 7.0 for VO + ALPRO, 26.9 ± 4.6 for VO + HW, 23.2 ± 5.2 for ALPRO + HW, and 18.4 ± 4.7 for VO + ALPRO + HW. Inseminations performed during no and mild heat stress (temperature–humidity index; THI ≤ 76) had greater conception rate ( P < 0.05; 38.8%) compared to AI performed during moderated heat stress conditions (THI > 76; 17.6%). Number of mounts were higher for primiparous versus multiparous cows ( P < 0.05). Cows over 80 DIM during estrus exhibited fewer ( P < 0.05) standing events. The highest conception rate occurred with the combination of VO + HW, which confirms the premise that combination of multiple systems enhances both the efficiency and accuracy of estrus detection.

Anoestrus in Dairy Cows: Causes, Prevalence and Clinical Forms

ContentsThis article reviews some of the recent advances in veterinary research regarding the causes, prevalence and clinical forms of pathological anoestrus in dairy cows. It is one of the few components responsible for occurrence of postpartum infertility in cattle, expressed in four clinical forms: silent heat, cystic ovarian disease, ovarian afunction and corpus luteum pseudograviditatis. The prevalence of these four forms in different herds is dependent on the managerial, environmental and nutritional status of the farm. Anything, regardless of its nature, that impedes the physiological mechanism involved in oestrus expression is liable to cause anoestrus. Nutrition (energy deficiency), interacted with other factors, is the major cause of this phenomenon (anoestrus). It has direct control of the postpartum anoestrus by negatively affecting the endocrine pathways responsible for proper functioning of the reproductive system through the blockage of pulsatile release of gonadotropin‐releasing hormone in the hypothalamus. Lack of proper training by the stockman substantially contributes to silent heat occurrence. Numerous attempts have been made to prevent or treat pathological anoestrus with exogenous hormones, or nonhormonal remedies like uterine palpation and infusion of Lugol's solution, all of which have produced variable but positive results. Specific treatment for each one of the four clinical forms is briefly outlined.

The teaching/learning process in uterine palpation and measurement: the effect of practice

The present study related to the teaching-learning process concerning the uterine measurement and palpation technique, it was intended to analyze the influence practice had on the Undergraduation Nursing students' skills acquired knowledge by the use of that technique. Applying a standard instrument previously developed for this study, the students' evaluation was carried out in two phases. The results showed a significant improvement in the students' performance skills and descriptive knowledge. Thus, this study was able to stress the importance of practice for the motor-perceptive skills in the teaching-learning process.

The relationship of the interval from breeding to uterine palpation for pregnancy diagnosis with calving outcomes in holstein cows

This study used data collected prospectively at 32 dairy herds to examine the effect of interval from breeding to uterine palpation for pregnancy diagnosis on calving interval and likelihood of calving. Multivariable statistical models were used to control for other factors that were significantly associated with the outcomes of interest. Cows diagnosed pregnant from 30 to 36 d post breeding had 2-wk longer calving intervals than cows palpated at later intervals. The interval from breeding until a cow was diagnosed open had a significant positive association with the calving interval. The interval to palpation was not associated with the probability of remaining in the herd to calve when controlling for the effects of herd, season of freshening, number of services, days to first service and mature equivalent milk production. Among cows diagnosed pregnant, 3.4% subsequently were bred and 1.5% were diagnosed open by palpation at a later date. About 5% of the cows diagnosed open calved at a time consistent with being pregnant when the diagnosis was made.

The accuracy of enzyme-linked immunosorbent assay and latex agglutination progesterone test for the validation of estrus and early pregnancy diagnosis in dairy cattle

The accuracy of the enzyme-linked immunosorbent assay (ELISA) and the latex agglutination (LA) on-farm progesterone kit for detecting estrus and diagnosing early pregnancy was investigated in this study. Italian Friesian dairy cows (n=82) from 6 dairy herds were used for the collection of foremilk samples at the time of breeding and at 19, 21, and 23 days post insemination. Pregnancy status was ascertained by uterine palpation per rectum 40 to 60 days post insemination. Progesterone levels were affected by herd, percentage of milk fat, and the day of testing × diagnosis interaction. Validation of estrus by qualitative on-farm tests was 74.6% (LA) and 100.0% (ELISA) accurate using 0.5 ng/ml of progesterone as the RIA estimate for estrus. The accuracy rate for early pregnancy diagnosis by RIA was 68.4 to 83.8% for day 19 and day 21, respectively, while the detection rate for nonpregnancy was 84.6 to 100% on day 19 and day 21, respectively, as compared with uterine palpation per rectum. The average accuracy rate for early pregnancy diagnosis ranged from 84.7 to 92.3% for the LA and ELISA tests, respectively; the nonpregnancy rate was correctly predicted 93.9% to 68.2% for the LA and ELISA tests, respectively.

Routine previous cesarean scar exploration following successful vaginal delivery. Is it necessary?

Among the 960 women who successfully delivered by vaginal route after previous cesarean section, 10 (1.04%) had complete lower segment scar rupture over a 9 year period. All were sufficiently symptomatic in order to suspect a ruptured uterus prior to scar exploration. We conclude that lower uterine segment palpation should be reserved only for symptomatic patients.