Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding

Objectives To clarify characteristic angiographic features and clinical efficacy of selective transarterial embolization (TAE) of retained placenta with abnormal vaginal bleeding. Methods The study cohort comprised 22 patients (mean age, 33.5 years; range, 22–24 years) who underwent selective TAE for retained placenta with abnormal bleeding between January 2018 and December 2020 at our institution. Angiographic images were reviewed by two certified radiologists with consensus. Medical records were reviewed to evaluate the efficacy of TAE. Angiographic features of retained placenta, technical success (disappearance of abnormal findings on angiography), complications, clinical outcomes (hemostatic effects and recurrent bleeding) were evaluated. Results Pelvic angiography showed a dilated vascular channel mimicking arteriovenous fistulas or an aneurysm contiguous with dilated uterine arteries in the mid-arterial–capillary phase in 20 patients; it showed contrast brush in the remaining two patients. TAE technical success was achieved in all patients. No major complications were observed in any patients. Fifteen patients were followed up with expectant management after TAE; all but one patient showed no re-bleeding during the follow-up period (mean follow-up interval, 3.4 months; range, 1–17 months). One patient showed minor rebleeding, which resolved spontaneously. Seven patients underwent scheduled hysteroscopic resection within 1 week after TAE, and no excessive bleeding was observed during or after the surgical procedure in all seven patients. Conclusions The characteristic angiographic feature of retained placenta is “dilated vascular channel that mimic low flow AVM.” TAE is a safe and effective treatment to manage retained placenta with abnormal bleeding.

A Targeted Serum Metabolomics GC–MS Approach Identifies Predictive Blood Biomarkers for Retained Placenta in Holstein Dairy Cows

The retained placenta is a common pathology of dairy cows. It is associated with a significant drop in the dry matter intake, milk yield, and increased susceptibility of dairy cows to metritis, mastitis, and displaced abomasum. The objective of this study was to identify metabolic alterations that precede and are associated with the disease occurrence. Blood samples were collected from 100 dairy cows at −8 and −4 weeks prior to parturition and on the day of retained placenta, and only 16 healthy cows and 6 cows affected by retained placenta were selected to measure serum polar metabolites by a targeted gas chromatography–mass spectroscopy (GC-MS) metabolomics approach. A total of 27 metabolites were identified and quantified in the serum. There were 10, 18, and 17 metabolites identified as being significantly altered during the three time periods studied. However, only nine metabolites were identified as being shared among the three time periods including five amino acids (Asp, Glu, Ser, Thr, and Tyr), one sugar (myo-inositol), phosphoric acid, and urea. The identified metabolites can be used as predictive biomarkers for the risk of retained placenta in dairy cows and might help explain the metabolic processes that occur prior to the incidence of the disease and throw light on the pathomechanisms of the disease.

Effect of Retained Placenta And Clinical Mastitis On Reproduction Parameters, Immune Response And Steroidogenic Receptors Gene Expression In Postpartum Crossbred Crossbreed Dairy Cows

The purpose of this study was to evaluate the effect of retained placenta (RP) and clinical mastitis (CM) on the reproductive efficiency of crossbred dairy cows during the postpartum period and to investigate the effect of them in some innate immune system indicators. For this, in the first experiment a total of 232 crossbred dairy cows were evaluated and divided into three groups as: healthy control, RP and CM. The incidence of RP and CM was evaluated after parturition until 30 days postpartum (DPP) and reproductive rates were measured. In experiment 2, 30 crossbred dairy cows were divided into three groups as in Experiment 1. Between 40 and 50 DPP, clinical, gynecological examination and endometrial cytobrush were performed to evaluate subclinical endometritis and gene expression of interleukin- 1β (IL-1β), interleukin-6 (IL-6), chemokine ligand -5 (CCL5), estrogen α (ESR1) and progesterone (PGR) receptors by qRT-PCR analysis. In Experiment 1, the conception rate at 1st AI was lower in RP and CM groups and pregnancy rate at 150 days decreased in cows with CM. Calving-to-1st AI interval and days open were shorter in healthy cows. In Experiment 2 the occurrence of subclinical endometritis was 26.7% and was higher in cows with RP and CM. The expression of IL-1β was increased in RP and CM groups, while IL-6 was less expressed in RP group. The chemokine CCL5, ESR1 and PGR were similar between groups. In conclusion, cows with RP and CM had their reproductive efficiency negatively affected and had they initial pro-inflammatory response improved by the increase of IL-β, while, IL-6 was lower in animals with RP probably because it was evaluated later in the postpartum.

RELATIONSHIP BETWEEN RETAINED PLACENTA AND BODY CONDITION CHANGES DURING THE TRANSITION PERIOD IN HOLSTEIN DAIRY COWS IN NORTH-EASTERN ALGERIA

Retained placenta (RP) is a common complication of bovine parturition. It is a multifactorial reproductive disorder that predisposes to infection and hence, to infertility. The impact of body condition changes during the transition period on the risk of RP appearance was evaluated in 12 Holstein dairy cows calving from October to January in north-eastern Algeria. The animals were body condition scored (BCS) 3 weeks antepartum and two weeks postpartum to assess the peripartum body fat loss (BCS loss). The statistical analysis involving variables related to BCS and parity was performed using the principal component analysis (PCA). An RP critical occurrence of 41.66% exceeding significantly the threshold prevalence of 10% (p<0.05) was recorded. This could be related to the BCS loss that exceeded one unit over the transition period (r=0.84, p<0.01), expressing the high body fat mobilisation in response to stressor factors such as negative energy balance, feed availability and climatic condition. Scoring the body condition, particularly around the peripartum, may serve as a tool to monitor the risk factors related to the energetic status of dairy cows.

Plasma Metabolomics Reveals Pathogenesis of Retained Placenta in Dairy Cows

The complex etiology and pathogenesis of retained placenta (RP) bring huge challenges for researchers and clinical veterinarians in investigating the pathogenesis and treatment schedule. This study aims to investigate the pathogenesis of RP in dairy cows by plasma metabolomics. As subjects, 10 dairy cows with RP and 10 healthy dairy cows were enrolled according to strict enrollment criteria. Imbalanced antioxidant capacity, reduced Th1/Th2 cytokine ratio, and deregulation of total bilirubin (T-bil), alkaline phosphatase (ALP), and reproductive hormones were shown in dairy cows with RP by detecting biochemical indicators, oxidation and antioxidant markers, and cytokines in serum. Plasma metabolites were detected and analyzed by a liquid chromatography–mass spectrometry (LC–MS) system coupled with multivariate statistical analysis software. A total of 23 potential biomarkers were uncovered in the plasma of dairy cows with RP. The metabolic pathways involved in these potential biomarkers are interconnected, and the conversion, utilization, and excretion of nitrogen were disturbed in dairy cows with RP. Moreover, these potential biomarkers are involved in the regulation of antioxidant capacity, inflammation, and autocrine or paracrine hormone. All of these findings suggest that an imbalance of these potential biomarkers might be responsible for the imbalanced antioxidant capacity, reduced Th1/Th2 cytokine ratio, and deregulation of reproductive hormones in dairy cows with RP. The regulation of metabolic pathways involved in these potential biomarkers represents a promising therapeutic strategy for RP.