-
Vol 2 No 2, P 219-222
UTERINE TORSION IN BUFFALOES: A RETROSPECTIVE ANALYSIS OF 52
CASES
GN purohit*, JS Mehta, Sunanda Sharma, Chandra Shekher, Pramod
Kumar, Amit Kumar, Sunil Raiya,Swati Ruhiland Mitesh Gaur
College ofVeterinary and Animal Sciences, RAJWAS,
Bikaner-3340Ol,Rajasthan, INDIADepartment ofvete rinary Gynecologr
and obstetrics .
*[email protected]
ABSTRACT
of uterine torsion inpreseme y Per rectal and per vmethod e
studY revealed the52) of rigfu rsion' Torsion cowithin 36 h whereas
38'460/ocondition a delivery was Posbuffaloes whereas h34.38o/o
(11132) buffaloes the fetus could r
and this can be easily corrected by rolling when buffaloes
aresection can deliver calves in uterine torsion affected
buffaloesurvival of the dam becomes difficult.
Keywords: Buftalo, cesarean section, rolling, uterine
torsion.
Uterine torsion in buffaloes commonly occufs at Materials and
Methodsparruririon; due ro rotarion of the gravid uterine horn
in
"r, ,r. like fashion over its longitudinal axis (Ghosh et
al,
2013). The rotation may involve the uterine body andcervix or
only the gravid uterine horn. uterine torsionduring pregnancy
(M,ttq' et al, 1999) and at parturition(Sh"t-" ,t ol, 1995; Prasad
et a\,2000; Matharu andprabhakar,2ool) is one of the complicated
causes ofmaternal clystocia in buffaloes culminating in death of
boththe fetus and the dam if not ffeared early. Because of
therapidity of fetal death that ensues following torsion andthe
uterine adhesions with visceral organs' uterine torsionmust be
considered an emergency. Uterine torsion isconsidered to be mofe
frequent maternal cruse of dystociain buffaloes compared to caffle
(Purohit et a\,2072) andthe incidence is more frequent in single
pregnancy; however,
rare clse of uterine torsion in t'win pregnancy has also
beenreported (Siddiquee and Mehta,the significance of the
conditionand further reproductive life ofconducted to anal\ze the
rype of urerine torsion and itsmanagement in 52 cases
(2010-2012)'RuminantScience
This study was performed in buffaloes (n=52)presented to our
referral centre at the department ofVeterinary Gynecology and
Obstetrics, College ofveterinary and Animal Science, Bikaner,
Rajasthan, Indiaberween 2010-2072. At presentarion buffaloes
receivedsupportive therapy comprising of fluid
replacement,antibiotics and corticosteroids depending uPon
theirgeneral condition. The diagnosis of uterine torsion wasbased
on trans-vaginal and trans-rectal palpation of thedirection of the
vaginal folds and broad ligaments. Thecase records were traced
rerrospectively for the type ofuterine torsion (side of torsion and
location ie. pte orposr cervical), time of presenrarion since onset
of labor,the approach adopted for correcrion of uterine torsion,the
sex of fetus and the fetal and dam survival subsequentto
correction. Rolling of the buffaloes using Schaeffer'smethod was
perfor-.d as Per ,']ethods describedpreviously (Purohit et al,
2012; Purohit, 2013). Fetuseswere delivered manually subsequent to
detorsion (rolling)if the cervix was sufficiently dilated.
Buffaloes withoutimproper cervical dilation were adminilste'red
?i}rlf;{
*[email protected]
-
Thble l. The side and location, the method of correction and the
survival of the dam and the fetus in uterinetorsion affected
buffaloes (total 52 cases) for 3 years.
YearSide of torsion Incationof torsion Damsurviral Sor of calf
Fetalviabiliw
Ift Rigtrt Preenical Post Grvical R"[t"g C-esarean Rdlo Cerean
\dale Fenrale Live Dad20t0
20tr
ND
27377t22
8
17
2l
1
3
2
7)/29 11167
72910166
8110 1010 13
18515320
Toul 6 46 4 6 32 20 n 18 2428 439
cloprostenol IM. Cesarean section was performed inbuffaloes
presented after 48 h of second stage of labor orin buffaloes in
which attempts at correction by rollingwere unsuccessful. The
duration of cases could bedetermined by case history and
obstetrical examination.A left oblique ventro-lateral approach was
adopted forcesarean section under local infiltration
anesthesia(Purohit et al, 2012; Purohit, 2013). Vicious
buffaloeswere administered xylazin (0.05mg/Kg) IM. Post-operative
care comprised of trM administration ofantibiotics and
anti-inflammatory drugs for a period of5-7 days along with
sufficient fluid replacement andcorticosteroids as required. The
data of incidence anddifferent parameters were expressed in
percentage.Results
The incidence of right sided uterine torsion was88.460/o (46152)
whereas only ll.54o/o (6152) of thecases were towards the left
side. The incidence of pre-cervical uterine torsion was 88.460/o
(46152) and onlyll.54o/o (6152) cases were of post-cervical uterine
torsion(Table 1). Only a small (8152) proportion (15.38olo)
ofbuffaloes presented were in the first or second paritieswhereas
all other (44152) bufhloes were in the third orhigher parities. The
time of presentation of buffaloes tothe referral center since onset
of second stage of laborvaried from 6-120 h. The degree of torsion
varied from90-360 degrees. Torsion could be corrected by
rollingwith 2-3 rolls using the Schaeffer's method in 61
.54o/o(32152) of the cases that were referred to the clinic
within36 h of second stage of labor. Plenry of sanguineous fluidwas
discharged from the vagina upon correction of thetorsion in cases
where cervix was dilated. Rolling failedto correct the
torsionin38.460/o (20152) of the cases. Inthese buffaloes cesarean
section was performed forRuminantScience
correction of the condition and fetal delivery. Majorityof these
cases were presented to the clinic beyond 48 hof second stage of
labor. Fetal delivery was possibleimmediately after detorsion by
rolling in 65.620/o (2ll32) buffaloes whereas in 34.38o/o (lll32)
buffaloes thefetus could not be delivered because of
insufficienqcervicaldilation. Therapy with 500 pg of cloprostenol
resultedin spontaneous fetal deliveries or deliveries with
littlemanual help 24-48 h later in these buffaloes. The damsurvival
was reasonably high in cesarean operared buffaloesand only 10.0olo
(2120) buffaloes died within 72 h ofthe operation due to
development of severe peritonitis,whereas no animal died in which
uterine torsion wascorrected by rolling. The buffaloes that died
had severeadhesions and were prese nted beyond 72 h of the
secondstage of labor. The uterus could not be brought to
theoperative site in these bufhloes and had to be incisedwithin the
abdominal cavity. A large proportion of thefetuses delivered were
male (28152; 53.84o/o) and only77.30o/o (9152) of the fetuses could
be delivered alive.Discussion
Incidence of right sided uterine torsion in thepresent study is
similar to previous reports depicting apreponderance of right sided
uterine torsion (95-98o/o)(Srinivas et al, 2007; Purohit et al,
20lla, b; Purohit rral, 2012) which is postulated to be because of
thepresence of a less wider muscular fold on right broadligament in
the buffalo (Singh l99l; Brar et al, 2008)and the presence of rumen
on the left side.
In the present study pre-cervical uterine torsionwas common.
Post cervical uterine torsion has beenobserved in some studies in
buffaloes (Srinlas et al,2007) although in our own previous study
pre cervicaltorsion was predominant (Purohit et al, 20llb).
Pre-
December 2013 1220
-
cervical uterine torsion can only be diagnosed by trans-rectal
palpation of the location of the broad ligamentsand little if any
change is found in the vaginalmusculature.
Similar to the present study previous reportsdepict that the
incidence is known to be higher inpluriparous buffaloes (Singh et
al, 1978; Sharma et al,1995; Matharu and Prabhaka 2001) with
maximumfrequency during second and third calving (Murty et
al,r999).
Torsion could be easily corrected with 2-3 rollsusing the
Schaeffer's method in the present study whenbuffaloes were referred
within 36 h or onset of secondstage of labor with high dam
survival. The fetal viabilirywas however low because of death of
fetus prior topresentation. It has been mentioned that limited
arterialperfusion and venous outflow in the rwisted uterus leadsto
ischemia, hypoxia and cell death causing irreversibledamage to the
endometrium, myometrium and fetaldeath rapidly ensues (Ghuman,
2010). Cervical dilationfailure is a common problem in buffaloes
subsequent tocorrection of uterine torsion (Prabhakat et al,
2007)especially in the presence of a dead fetus. Theadministration
of prostaglandins helped in the dilationof the cervix in such cases
subsequent to correction ofuterine torsion.
Cesarean section could successfully deliver the calfin
uncorrectable uterine torsions however, in casespresented after
sufficient delay the uterus could not bebrought to the operative
site due to development ofadhesions with the surrounding abdominal
structuresand had to be opened inside the abdomen leading
tospillage of uterine contents in the abdomen anddevelopment of
severe peritonitis in two of the buffaloesthat underwent cesarean
section. These buffaloes diedafter 72 h of the operation. Sirnilar
findings have beenpreviously documented (Dhaliwal et al, I99l;
Dhaliwalet al, 1992; Purohit et al, 20L2). It was concluded
thatbuffaloes mostly have a right sided pre-cervical uterinetorsion
and this can be easily corrected by rolling whenbuffaloes are
presented early (within 36h) to the clinician.Cesarean section can
deliver calves in uterine torsionaffected buffaloes but when the
time of presentation isbeyond 72 h the survival of the dam becomes
difficult.References
Brar PS, Saigal RB Nanda AS and Sharma RD (2008).Role of broad
ligament in the causation of uterine
RuminantScience
torsion in dairy buffaloes. Indian Journal ofAnimal Science
78:940-42.
Dhaliwal GS, Prabhakar S, Sharma RD (1992).Intestinalobstruction
in association with torsion of uterusin a buffalo. Pakistan
Veterinary Tournal 12:42-43.
Dhaliwal GS, Prabhakar S, Singh P and Sharma RD(1991). Effects
of injudicious handling of uterinetorsion on survival rate of dam
in buffalo es (Bubalisbubalis). Pakistan Veterinary Journal I 1:
LI7-19.
Ghosh SK, Singh M, Prasad JK, Kumar A and RajoriyaRS (2013).
Uterine torsion in bovines-A review.Intas Polivet 14:,16-20.
Ghuman SPS (2010). Uterine torsion in bovines: Areview. Indian
Tournal of Animal Science 80:289-305.
Matharu SS and Prabhakar S (2001). Clinicalobservations and
success of treatment of uterinetorsion in buffaloes. Indian Tournal
of AnimalReproduction 22:45 -48.
Murty KK, Prasad V and Murty PR (1999). Clinicalobservations on
uterine torsion in buffaloes. IndianVeterinary Journal 7
6:643-45.
Prabhakar S, Matharu SS, Gandotra VK and Brar PS(2007). Corpus
luteum does not contribute tohigher progesterone conce ntration
aroundparturition in buffaloes with uterine torsion.Indian Journal
of Animal Science 77:956-959.
Prasad S, Rohit K and Maurya SN (2000). Efficacy
ofLaparohysterotomy and rolling of dam to treatuterine torsion in
buffaloes. Indian VeterinaryJournal 77:784-786.
Purohit GN, Barolia Y Shekher C and Kumar P (2011a).Maternal
Dystocia in cows and buflaloes: A review.Open Journal of Animal
Science l:47-53.
Purohit GN, Barolia Y, Shekher C and Kumar (2011b).Diagnosis and
correction of uterine torsion in cattleand buffaloes. Raksha
Technical Review l:ll-I7.
Purohit GN, Kumar B Solanki K, Shekher C and YadavSP (2012).
Perspectives of fetal dystocia in cattleand buffaloes. Wterinary
Science Development2(e8): 3r-42-
o
Purohit GN (2013). Maternal dystocia and uterine torsionin
buffaloes. In: Bubaline Theriogenologr, Eds GNPurohit and A
Borghese. www.ivis.org; A5715.0113.
December 2013 l22l
-
Sharma SB Agrawal KBP and Singh DP (1995)' Torsionof gravid
uterus and laparohysterectomy in bovine
- A report on 72 clinical cases' Indian Veterinary
Journal 72:1180-82'
siddiquee GM and Mehta BM (1992). Uterine torsionin a buffalo
with viable twins. Indian veterinaryJournal 69:257-258'
S--
Singh J, Prasad B and Rathore SS (1973)' Torsio uteri
inbuffaloes(Bubalusbubatil.Ananlaysisof65cases.Ind.ian Veterinary
Journal 55 16l -165'
Srinivas M, Sreenu M, Lakshmi RN' Naidu KS and Prasad
VD (2007). Studies on dystocia in graded Murrahbuffaloes: A
retrospective study' Buffalo Bulletin26:40-45.
RuminantScienceDecember 2013 1222