ABSTRACT
Uterine function is often compromised in cattle by bacterial contamination of the uterine lumen after parturition, and pathogenic bacteria often persist, causing uterine disease, a key cause of infertility in cattle. However, the definition or characterization of uterine disease frequently lacks precision or varies among research groups. The aim of the present paper was to provide clear clinical definitions of uterine disease that researchers could adopt. Puerperal metritis should be defined as an animal with an abnormally enlarged uterus and a fetid watery red-brown uterine discharge, associated with signs of systemic illness (decreased milk yield, dullness or other signs of toxemia) and fever > 39.5 degrees C, within 21 days after parturition. Animals that are not systemically ill, but have an abnormally enlarged uterus and a purulent uterine discharge detectable in the vagina, within 21 days post partum, may be classified as having clinical metritis. Clinical endometritis is characterised by the presence of purulent (> 50% pus) uterine discharge detectable in the vagina 21 days or more after parturition, or mucuopurulent (approximately 50% pus, 50% mucus) discharge detectable in the vagina after 26 days post partum. In the absence of clinical endometritis, a cow with subclinical endometritis is defined by > 18% neutrophils in uterine cytology samples collected 21-33 days post partum, or > 10% neutrophils at 34-47 days. Pyometra is defined as the accumulation of purulent material within the uterine lumen in the presence of a persistent corpus luteum and a closed cervix. In conclusion, we have suggested definitions for common postpartum uterine diseases, which can be readily adopted by researchers and veterinarians.
Subject(s)
Bacterial Infections/veterinary , Cattle Diseases/pathology , Puerperal Infection/veterinary , Uterine Diseases/veterinary , Vagina/pathology , Animals , Bacterial Infections/classification , Bacterial Infections/pathology , Cattle , Cattle Diseases/classification , Diagnosis, Differential , Female , Mucus , Postpartum Period , Pregnancy , Puerperal Infection/classification , Puerperal Infection/pathology , Uterine Diseases/classification , Uterine Diseases/pathology , Vagina/microbiologySubject(s)
Humans , Female , Surgical Wound Infection/diagnosis , Puerperal Infection/etiology , Pelvic Inflammatory Disease/diagnosis , Pelvic Inflammatory Disease/etiology , Pelvic Inflammatory Disease/surgery , Abortion, Septic/complications , Abortion, Septic/etiology , Anti-Bacterial Agents/therapeutic use , Drug Resistance, Microbial , Endometriosis/drug therapy , Endometriosis/etiology , Surgical Wound Infection/etiology , Surgical Wound Infection/prevention & control , Puerperal Infection/classification , Puerperal Infection/drug therapyABSTRACT
Os autores avaliaram retrospectivamente a sensibilidade e especificidade dos criterios clinicos e laboratoriais utilizados no diagnostico de infeccao puerperal em 145 pacientes, bem como as intercorrencias durante o puerperio em um grupo controle composto por 145 puerperas que nao desenvolveram infeccao puerperal. Dados sugestivos de infeccao puerperal ao exame fisico foram observados em 92,4 por cento das pacientes que desenvolveram infeccao, sendo que nas pacientes com endometrite e infeccao do trato urinario o exame fisico apresentou menos elementos do que o habitualmente descrito...
