Fetal maceration and retention of fetal bones in a mare

Abstract

A 19-year-old Quarter Horse mare was evaluated because of bloody vaginal discharge that was apparent immediately following breeding. On transrectal ultrasonography, it was evident that the uterus was filled with fluid containing echogenic particles; linear hyperechoic structures were also visible. Endoscopy was performed, which revealed a number of bones adhered to the cranial wall and floor of the right uterine horn as well as purulent fluid in both uterine horns. Bacterial endometritis and fetal maceration were diagnosed. The mare was treated with antibiotics, and the fetal bones were manually removed from the uterus. Fetal maceration with intrauterine retention of bones is rare in mares. Use of hysteroscopy supplements ultrasonography in the diagnosis of uncommon conditions of the uterus. Macerated bones may be adhered to the endometrium, thereby requiring manual removal.

Differential diagnosis for vaginal haemorrhage in the mare

“…In maiden mares, this may be associated with rupture of the hymen. In one intriguing case report, the cause of the post breeding vaginal haemorrhage was actually due to the presence of retained remnants of a macerated fetus (Burns and Card 2000). The breeding process probably facilitated expulsion of bloody fluid through the relaxed oestrual cervix.…”

Recurrent vaginal discharge causing by retained foetal bones in a bitch: a case report

“…Although foetal retention in utero has been described in the bitch, the actual incidence is unknown, but presumed to be low (Feldman and Nelson, 1996;England, 1998;Johnston et al, 2001). Retention of foetal bones in utero or in the vagina has been reported in cows (Drost, 2007), mares (Burns and Card, 2000), cats (Nicastro and Walshaw, 2007), and women (Graham et al, 2000;Samraj et al, 2008). Foetal maceration resulting from prolonged pregnancy cause by progestin injections was reported in a bitch (GonzalezDominguez and Maldonado-Estrada, 2006).…”

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

“…It is, of course, also possible that the leiomyoma was an incidental finding and that fetal death was due to some other cause. Failure to expel the fetus fully following fetal death was probably a factor of inadequate cervical dilation (Burns and Card 1998), because of equine chorionic gonadotrophin (eCG) produced by the endometrial cups prevented circulating progesterone concentrations dropping low enough for long enough to allow cervical relaxation.…”

“…Retention and maceration of the fetus within the uterus following fetal death is uncommon in the mare, but when it does occur symptoms are usually restricted to vaginal discharge without systemic complications (Vénezia et al 1975;Kennedy and Miller 1993;Lofstedt 1993;Santschi et al 1995;Barber and Troedsson 1996;Burns and Card 1998). This Case Report describes fetal retention and maceration coexistent with a moderately sized uterine leiomyoma in a mare, together with the approaches to resolve the resultant endometritis and to remove the tumour.…”