By: drh Yayuk Kholifah

Functional: (First Veterinary Medic)

Prolapse cases or uterine prolapse (broyong) are conditions where a part or the whole uterus is expelled as a common complication that occurs during the third stage of labor (after the fetus is successfully delivered). This case is more common in cattle and sheep. Prolapse cases in ruminants often result in the complete expulsion of the uterine horns, but in pigs and dogs, the organ is usually partially expelled or only one of the horns.

Cows that have given birth before have a higher risk of experiencing uterine prolapse compared to heifers. In most cases, uterine prolapse occurs a few hours after giving birth, but it can also happen a few days after.

The causative factors of uterine prolapse are not yet fully understood, but it can be said that cases often occur during the third stage of the birthing process, a few hours after the fetus is expelled and after several cotyledons detach from the mother's caruncle. The only force that can lift the heavy uterus from the cow's abdomen and out of the body is abdominal straining. Abdominal straining in cows during calving is a normal process. Abdominal straining is also synchronized with the peristaltic contractions of the uterus that occur every 3.5 to 4 minutes. The pushing force of straining, combined with other supporting factors, is believed to be the cause of uterine prolapse. The gravitational force in conditions where the barn is too sloping, along with the pressure from other organs around the uterus such as the filled bladder and the residual uterine fluid after giving birth, contribute to the increased risk of the uterus being expelled from the abdominal cavity.

The prognosis of prolapse cases depends greatly on the type of case, whether the uterus is severely damaged while outside the body, and how long the uterus remains outside before receiving treatment. However, if the condition is promptly and properly managed by a professional, the prognosis is good. Uterine prolapse cases can also lead to death due to internal bleeding from ruptured arteries when the uterus is pulled out. Additionally, the organ can become infected and the endometrium of the animal can harden.

Repositioning the organ back to its original position is a necessary intervention for animals experiencing prolapse. Ensure you seek medical assistance immediately to reposition the uterus. However, before medical help arrives, farmers should take some emergency measures. In cases of prolapse while the animal is lying down, farmers should wrap the protruding organ with a clean cloth to prevent contamination. If the cow is standing, a supporting cloth should be provided to the protruding organ to prevent internal bleeding from the arteries inside the body.

The expelled uterus should be thoroughly washed with warm normal saline solution to prevent dehydration and damage. If parts of the fetal membranes are still attached, the medical team will usually remove them completely before repositioning the uterus. If membrane detachment has not occurred and there is a risk of bleeding upon detachment, the uterus will be inserted directly without removing the membranes one by one. Animals can also be given anesthesia to reduce straining and antibiotics to prevent infections after the intervention. Animals whose organs have been repositioned should have their hindquarters elevated to prevent recurrence of prolapse cases.

References:

Noakes D.E, Parkinson T.J, England G.C.W; 2001; "Arthur's Veterinary Reproduction and Obstetrics Eight Edition"; Elsevier Limited; ISBN: 978 0 7020 2556 3