Transvaginal ultrasound-guided twin reduction in the mare

Bracher, Verena; Parlevliet, J. M.; Pieterse, M.C.; Vos, P.L.A.M.; Wiemer, P.; Taverne, MA; Colenbrander, B.

doi:10.1136/vr.133.19.478

Cited by 26 publications

(39 citation statements)

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“…Other studies reported higher success rates (46-51%) based on an examination performed 7-10 days after the TUGR procedure [3,5].…”

Section: Discussionmentioning

confidence: 93%

“…The success of TUGR has been reported to be largely dependent on operator experience [1,2], and the gestational stage (before or after day 35 of gestation [3,4]) and relative position (uni-or bilateral [3]) of the two vesicles. TUGR was first reported in mares by Bracher et al [3] who reported a viable singleton 10 days after the procedure in six of 13 (6/13; 46%) treated mares; in their study, the procedure had a higher success rate in the case of bilaterally-located twins (3/4; 75% versus 3/9; 33%) and, was more successful for unilateral twins, when performed before day 35 of gestation (2/5; 40% versus 1/4; 25%). By contrast, while Govaere et al [5] achieved a similar success rate in terms of viable singleton pregnancies 10 days after TUGR (18/35: 51%) in mares with unilateral twin pregnancies, they did not see a significant difference in success depending on whether the procedure was performed before (12/21; 57%) or after (7/17; 41%) day 35.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of transvaginal ultrasound-guided twin reduction in the mare by embryonic or fetal stabbing compared with yolk sac or allantoic fluid aspiration

et al. 2013

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Transvaginal ultrasound-guided pregnancy reduction (TUGR) is a procedure described for the management of twins post-fixation in the horse. Success rates are often disappointing but reported to be more favourable for bilaterally-situated twins, and when intervention takes place before day 35 of gestation. This study aimed to determine whether stabbing the embryo/fetus rather than aspirating conceptus fluids improved the likelihood of success, suggests that TUGR is not the method of choice for reducing > day 45 twins. Four pregnancy losses were recorded 1-7 months post-TUGR (4/38: 10.5%) and, while it is tempting to attribute the losses to TUGR, this rate of late gestation pregnancy loss is normal. We conclude that TUGR by fetal stabbing does not offer significant advantages over fluid aspiration.However, TUGR should be performed before day 35 of gestation and considered primarily a salvage procedure to be used when re-breeding is not a viable alternative.

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“…Other studies reported higher success rates (46-51%) based on an examination performed 7-10 days after the TUGR procedure [3,5].…”

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Efficacy of transvaginal ultrasound-guided twin reduction in the mare by embryonic or fetal stabbing compared with yolk sac or allantoic fluid aspiration

et al. 2013

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“…In these studies, pregnancy loss rates of 28.6 to 100% were reported. Transvaginal ultrasound-guided aspiration (TUGA) is an alternative method to MR for embryo reduction in twin-pregnant mares [13][14][15], although as far as we know, TUGA has not been used to address the problem of multiple pregnancies in high producing dairy cows. The aim of this study was to compare the effect on pregnancy maintenance of inducing embryo reduction by MR or TUGA in dairy cows with multiple pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Manual Rupture Versus Transvaginal Ultrasound-guided Aspiration of Allanto-amniotic Fluid in Multiple Pregnancies: A Clinical Approach to Embryo Reduction in Dairy Cattle

Andreu‐Vázquez

García-Ispierto

López‐Gatius

2012

Journal of Reproduction and Development

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Abstract.To avoid the problems associated with twinning in dairy cattle, one of the embryos may be eliminated. This study compares the effect on pregnancy maintenance of two embryo reduction techniques, manual rupture (MR) and transvaginal ultrasound-guided aspiration (TUGA) of allanto-amniotic fluid, in Holstein-Friesian cows with multiple pregnancies. In the first experiment, 61 lactating cows bearing unilateral twins (n=27), bilateral twins (n=30) or triplets/quadruplets (n=4) were subjected to MR (n=45) or TUGA using a 17-G neddle (n=16) on day 28-34 of gestation. In 21 and 10 cows undergoing MR and TUGA embryo reduction, respectively, pregnancy loss occurred before day 90 (46.7 vs. 62.5%, P= 0.28). Through binary logistic regression, the type of pregnancy was identified as the only variable significantly affecting pregnancy maintenance (P=0.03). Based on the odds ratio, the risk of pregnancy loss was 4.1 times higher for unilateral twins than for bilateral twins (70.4 vs. 36.7%, respectively, P=0.01). No effect was detected on pregnancy maintenance of the technique used (P=0.17) or of the interaction technique by type of pregnancy (P=0.22). In the second experiment, a 22-G needle was used to perform TUGA on 22 lactating cows. The pregnancy loss rates were 44.4% (4/9), 18.2% (2/11) and 50% (1/2) for cows bearing unilateral twins, bilateral twins and triplets, respectively. The total pregnancy loss rate following TUGA using the 22-G needle tended to be lower than that using the 17-G needle (31.8 vs. 62.5%; P=0.06). Our results suggest that TUGA using a 22-G needle could be the method of choice to perform embryo reduction in cows carrying multiple pregnancies. M ultiple pregnancies (twins or higher-order pregnancies) are undesirable in dairy herds. Whilst cows carrying triplets and quadruplets are unlikely to maintain their pregnancies to term [1], cows delivering twins are more likely to suffer peripartum diseases and to be culled [2]. Twinning increases not only the risk of pregnancy loss [3,4] but also the risks of dystocia, stillbirth and calf mortality [5][6][7][8]. Over the past 20 years, twinning rates in dairy cattle have increased alongside milk production [2,5,9]. Estimates currently run at 9%, with rates of 0.3% to 12% reported among herds [10], and it is foreseeable that this twinning rate will continue to increase.Transforming a multiple pregnancy into a singleton pregnancy by inducing embryo reduction should in theory avoid the negative effects of multiple pregnancies in dairy cattle. However, the embryo reduction technique itself may carry an additional risk of pregnancy loss. Embryo reduction by manual rupture (MR) of the amniotic vesicle during the late embryonic/early fetal period has been assessed in unilateral [11,12] and bilateral twin pregnancies [12]. In these studies, pregnancy loss rates of 28.6 to 100% were reported. Transvaginal ultrasound-guided aspiration (TUGA) is an alternative method to MR for embryo reduction in twin-pregnant mares [13][14][15], although as far as we know, TUGA...

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“…In den letzten Jahren wurde von verschiedenen Autoren die transvaginale ultrasonographisch-geleitete Aspiration (TUA) zur Reduktion unicornualer und bicornualer Zwillingsgraviditäten im fortgeschrittenen Trächtigkeitsstadium beschrieben (Bracher et al 1993, Jonker et al 1995, Morris et al 1999, MacPherson and Reimers 2000, Mari et al 2004, Becker et al 2006, Govaere et al 2008. Die am Vorhandensein eines vitalen Embryos 5-14 Tage nach der Zwillingsreduktion oder anhand von Abfohldaten ermittelten Erfolgsraten variierten in diesen Studien deutlich (9-75 %), wobei ein Einfluss der Lokalisation (Bracher et al 1993), des Trächtigkeitstages (Jonker et al 1995, Mari et al 2004, Becker et al 2006) und der Applikation eines nichtsteroidalen Antiphlogistikums (Becker et al 2006) …”

Section: Zusammenfassungunclassified

“…Die am Vorhandensein eines vitalen Embryos 5-14 Tage nach der Zwillingsreduktion oder anhand von Abfohldaten ermittelten Erfolgsraten variierten in diesen Studien deutlich (9-75 %), wobei ein Einfluss der Lokalisation (Bracher et al 1993), des Trächtigkeitstages (Jonker et al 1995, Mari et al 2004, Becker et al 2006) und der Applikation eines nichtsteroidalen Antiphlogistikums (Becker et al 2006) …”

Section: Zusammenfassungunclassified

Success rates after transvaginal ultrasound-guided aspiration and fetal puncture in the mare

Klewitz¹,

Heberling²,

Ortgies³

et al. 2010

PHK

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Transvaginal ultrasound-guided twin reduction in the mare

Cited by 26 publications

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Efficacy of transvaginal ultrasound-guided twin reduction in the mare by embryonic or fetal stabbing compared with yolk sac or allantoic fluid aspiration

Efficacy of transvaginal ultrasound-guided twin reduction in the mare by embryonic or fetal stabbing compared with yolk sac or allantoic fluid aspiration

Manual Rupture Versus Transvaginal Ultrasound-guided Aspiration of Allanto-amniotic Fluid in Multiple Pregnancies: A Clinical Approach to Embryo Reduction in Dairy Cattle

Success rates after transvaginal ultrasound-guided aspiration and fetal puncture in the mare

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