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 .

*gnpobs@gmail.com

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;{

*gnpobs@gmail.com

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-

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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

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