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,
INDIA
Department ofvete rinary Gynecologr and obstetrics
.
*gnpobs@gmail.com
ABSTRACT
of uterine torsion in
preseme
y
Per
rectal and per v
method
e studY revealed the
52) of rigfu
rsion' Torsion co
within 36 h
whereas 38'460/o
condition a
delivery was
Pos
buffaloes whereas h34.38o/o
(11132) buffaloes the fetus could r
and this can be easily corrected by rolling when buffaloes are
section can deliver calves in uterine torsion affected buffaloe
survival of the dam becomes difficult.
Keywords: Buftalo, cesarean section, rolling, uterine torsion.
Uterine torsion in buffaloes commonly occufs at Materials and Methods
parruririon; 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 and
cervix or only the gravid uterine horn. uterine torsion
during pregnancy
(M,ttq' et al, 1999) and at parturition
(Sh"t-" ,t ol, 1995; Prasad et a\,2000; Matharu and
prabhakar,2ool) is one of the complicated
causes of
maternal clystocia in buffaloes culminating
in death of both
the fetus and the dam if not ffeared early. Because of the
rapidity of fetal death that ensues following torsion and
the uterine adhesions with visceral organs' uterine torsion
must be considered
an emergency.
Uterine torsion is
considered to be mofe frequent maternal cruse of dystocia
in buffaloes compared to caffle
(Purohit et a\,2072) and
the incidence is more frequent in single pregnancy; however,
rare clse of uterine torsion in t'win pregnancy
has also been
reported
(Siddiquee and Mehta,
the significance of the condition
and further reproductive life of
conducted to anal\ze the
rype
of urerine torsion and its
management
in 52 cases
(2010-2012)'
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This study was performed
in buffaloes
(n=52)
presented to our referral centre at the department of
Veterinary Gynecology
and Obstetrics, College of
veterinary and Animal Science, Bikaner, Rajasthan, India
berween 2010-2072. At presentarion buffaloes received
supportive therapy comprising of fluid replacement,
antibiotics and corticosteroids depending uPon their
general condition. The diagnosis of uterine torsion was
based on trans-vaginal
and trans-rectal palpation of the
direction of the vaginal folds and broad ligaments. The
case records were traced rerrospectively
for the type of
uterine torsion
(side of torsion and location ie. pte or
posr 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 subsequent
to correction. Rolling of the buffaloes using Schaeffer's
method was perfor-.d as
Per
,']ethods described
previously
(Purohit et al, 2012; Purohit, 2013). Fetuses
were delivered manually subsequent to detorsion
(rolling)
if the cervix was sufficiently dilated. Buffaloes without
improper 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 uterine
torsion affected buffaloes
(total
52 cases) for 3 years.
Year
Side of torsion Incationof torsion Damsurviral Sor of calf Fetalviabiliw
Ift Rigtrt Preenical Post Grvical R"[t"g C-esarean Rdlo Cerean \dale Fenrale Live Dad
20t0
20tr
ND
27
377
t22
8
17
2l
1
3
2
7)
/2
9 11
167
72
910
166
81
10 10
10 13
18
515
320
Toul 6 46 4 6 32 20 n 18 24 28 43 9
cloprostenol IM. Cesarean section was performed in
buffaloes presented after 48 h of second stage of labor or
in buffaloes in which attempts at correction by rolling
were unsuccessful. The duration of cases could be
determined by case history and obstetrical examination.
A left oblique ventro-lateral approach was adopted for
cesarean section under local infiltration anesthesia
(Purohit et al, 2012; Purohit, 2013). Vicious buffaloes
were administered xylazin (0.05mg/Kg) IM. Post-
operative care comprised of trM administration of
antibiotics and anti-inflammatory drugs for a period of
5-7 days along with sufficient fluid replacement and
corticosteroids as required. The data of incidence and
different parameters were expressed in percentage.
Results
The incidence of right sided uterine torsion was
88.460/o (46152) whereas only ll.54o/o (6152) of the
cases were towards the left side. The incidence of pre-
cervical uterine torsion was 88.460/o
(46152) and only
ll.54o/o (6152) cases were of post-cervical uterine torsion
(Table 1). Only a small
(8152) proportion
(15.38olo) of
buffaloes presented were in the first or second parities
whereas all other
(44152)
bufhloes were in the third or
higher parities. The time of presentation of buffaloes to
the referral center since onset of second stage of labor
varied from 6-120 h. The degree of torsion varied from
90-360 degrees. Torsion could be corrected by rolling
with 2-3 rolls using the Schaeffer's method in 61 .54o/o
(32152) of the cases that were referred to the clinic within
36 h of second stage of labor. Plenry of sanguineous fluid
was discharged from the vagina upon correction of the
torsion in cases where cervix was dilated. Rolling failed
to correct the torsionin38.460/o
(20152) of the cases. In
these buffaloes cesarean section was performed for
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correction of the condition and fetal delivery. Majority
of these cases were presented to the clinic beyond 48 h
of second stage of labor. Fetal delivery was possible
immediately after detorsion by rolling in 65.620/o
(2ll
32) buffaloes whereas in 34.38o/o
(lll32) buffaloes the
fetus could not be delivered because of insufficienqcervical
dilation. Therapy with 500 pg of cloprostenol resulted
in spontaneous fetal deliveries or deliveries with little
manual help 24-48 h later in these buffaloes. The dam
survival was reasonably high in cesarean operared buffaloes
and only 10.0olo (2120)
buffaloes died within 72 h of
the operation due to development of severe peritonitis,
whereas no animal died in which uterine torsion was
corrected by rolling. The buffaloes that died had severe
adhesions and were prese nted beyond 72 h of the second
stage of labor. The uterus could not be brought to the
operative site in these bufhloes and had to be incised
within the abdominal cavity. A large proportion of the
fetuses delivered were male (28152;
53.84o/o) and only
77.30o/o (9152)
of the fetuses could be delivered alive.
Discussion
Incidence of right sided uterine torsion in the
present study is similar to previous reports depicting a
preponderance of right sided uterine torsion
(95-98o/o)
(Srinivas et al, 2007; Purohit et al, 20lla, b; Purohit rr
al, 2012) which is postulated to be because of the
presence of a less wider muscular fold on right broad
ligament 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 torsion
was common. Post cervical uterine torsion has been
observed in some studies in buffaloes
(Srinlas et al,
2007) although in our own previous study pre cervical
torsion was predominant (Purohit et al, 20llb). Pre-
December 2013 1220
cervical uterine torsion can only be diagnosed by trans-
rectal palpation of the location of the broad ligaments
and little if any change is found in the vaginal
musculature.
Similar to the present study previous reports
depict that the incidence is known to be higher in
pluriparous buffaloes (Singh et al, 1978; Sharma et al,
1995; Matharu and Prabhaka 2001) with maximum
frequency during second and third calving (Murty et al,
r999).
Torsion could be easily corrected with 2-3 rolls
using the Schaeffer's method in the present study when
buffaloes were referred within 36 h or onset of second
stage of labor with high dam survival. The fetal viabiliry
was however low because of death of fetus prior to
presentation. It has been mentioned that limited arterial
perfusion and venous outflow in the rwisted uterus leads
to ischemia, hypoxia and cell death causing irreversible
damage to the endometrium, myometrium and fetal
death rapidly ensues (Ghuman, 2010). Cervical dilation
failure is a common problem in buffaloes subsequent to
correction of uterine torsion
(Prabhakat et al, 2007)
especially in the presence of a dead fetus. The
administration of prostaglandins helped in the dilation
of the cervix in such cases subsequent to correction of
uterine torsion.
Cesarean section could successfully deliver the calf
in uncorrectable uterine torsions however, in cases
presented after sufficient delay the uterus could not be
brought to the operative site due to development of
adhesions with the surrounding abdominal structures
and had to be opened inside the abdomen leading to
spillage of uterine contents in the abdomen and
development of severe peritonitis in two of the buffaloes
that underwent cesarean section. These buffaloes died
after 72 h of the operation. Sirnilar findings have been
previously documented
(Dhaliwal et al, I99l; Dhaliwal
et al, 1992; Purohit et al, 20L2). It was concluded that
buffaloes mostly have a right sided pre-cervical uterine
torsion and this can be easily corrected by rolling when
buffaloes are presented early
(within
36h) to the clinician.
Cesarean section can deliver calves in uterine torsion
affected buffaloes but when the time of presentation is
beyond 72 h the survival of the dam becomes difficult.
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