Parturition and Postpartum Physiology
The physiological process of delivering foetuses and foetal membranes from the uterus to the external environment is called parturition or eutokia. It occurs in three stages with species-specific time duration (Table 23.17).
Table 23.17 Duration of various events of parturition (in hour)
| Species | Stage-1 | Stage-2 | Stage-3 | Parturition terminology |
| Cervical dilation and initiation of contractions | Foetal expulsion | Placental expulsion | ||
| Cattle | 2-6 (24 max) | 2-5 | 8-12 | Calving |
| Buffalo | 2-6 | 0.5-1 | 6-12 | Calving |
| Sheep | 2-5 | 0.5-2 | 0.5-8 | Lambing |
| Goat | 4-8 (12 max) | 0.5-4 | 1-8 | Kidding |
| Pig | 2-12 | 2.5-3 | 1-4 | Farrowing |
| Horse | 1-4 | 5-40 min | 1 | Foaling |
| Dog | 2-12 | 1 (24 max) | 6-12 | Whelping |
| Cat | 5-30 min (2 max) | 24 (max) | Queening | |
| Rat | 1-4.5 (2.5 avg) | 5-40 min | 1-2.5 (1.5 avg) | Parturition |
| Rabbit | 5-30 min (10 min, avg) | - | Kindling | |
| Human | 5-6 | 30-45 min | 5-30 min | Childbirth |
Source: Compiled from various sources
Max maximum, avg average
23.4.1 Foetal changes before parturition
The foetus undergoes physiological and structural changes before the parturition for the extrauterine life.
The physiological changes include1. Lung maturation and its expansion by the secretion of surfactants that reduce the alveolar surface tension.
2. Development of glycogen stored in the liver for energy supply till the initiation of suckling.
3. Increased output secretion of catecholamines and tri-iodothyronine for metabolic activity and thermoregulation.
The structural changes of the foetuses that occur before the parturition include
1. Closure of the ductus arteriosus.
2. Closure of foramen ovale within a few hours of birth.
23.4.2 Factors Responsible for the Initiation of Parturition
Throughout the gestation, the uterus remains quiescent under the influence of progesterone secreted from CL and placental. Uterine contraction initiates at the time of parturition due to decreased progesterone levels and increased oestrogen levels. Several other bio-molecules like prostacyclin, relaxin, nitric oxide and catecholamines begin the parturition process. The foetal glucocorticoid surge is the universal signal for the parturition in most domestic species. The physical,
Table 23.18 Factors responsible for the initiation of parturition
| Factors | Effects | |
| Physiological factors | Increased foetal size | Uterine irritability |
| Uterine distension | Reversal of progesterone block | |
| Placental fatty degeneration including the presence of infarcts | Interfere foetal nutrition and foetal detachment from the uterus | |
| Biochemical factors | Increase in CO2 tension in maternal blood due to foetal activity | Increase uterine contractility |
| Release of foetal serotonin | Induces collagenase activity and stasis of cotyledonary blood supply | |
| Endocrine factors | Foetal | |
| 1. Increased foetal corticotrophin-releasing hormone and ACTH | Increased foetal cortisol secretion | |
| 2. Increased cortisol secretion | Converts P4 to E2 and release of PG | |
| 3. Increased endogenous opioids | Induces ACTH secretion | |
| Maternal | ||
| 1. Reversal of progesterone block | Increased uterine contraction | |
| 2. Secretion of relaxin | ||
| 3. Increased placental oestrogens | ||
| 4. Release of pro-inflammatory cytokines | Dilation of birth canal and release of PG | |
| 5. Release of PG | Dilation of pubic symphysis and relaxation of sacro-sciatic ligaments Cervical softening of the cervix Stimulates smooth muscle contractility | |
| 6. Release of oxytocin | Induces myometrial contractility | |
biochemical and hormonal signal factors to initiate the parturition process are presented in Table 23.18.
23.4.3 Mechanism of Parturition
At the end of gestation, the foetal hypothalamic-pituitaryadrenal (HPA) matures and increases cortisol secretion (Fig. 23.9). Foetal cortisol influences the functional maturation of foetal physiological systems, particularly the lungs and the cardiovascular system requires for the newborn immediately after birth. Increased foetal cortisol up-regulates cyclooxygenase 2 (COX2) and steroidogenic key enzyme 17a-hydroxylase-C17,20-lyase (CYP17) in the trophoblast cells. COX2 increases prostaglandin production. Activation of CYP17 leads to the metabolism of pregnenolone to dehydroepiandrosterone, and the level of progesterone falls along with increased oestrogen level. The altered endocrine milieu (decreased progesterone, increased oestrogen) induces contraction associated proteins in the myometrium.
PG promotes inflammatory processes and increases blood flow to the uterus and placenta and myometrial contraction initiation. Relaxin causes the dilation of the cervix.23.4.3.1 Ferguson Reflex
Ferguson reflex is a neuroendocrine reflex induced by the distension of the cervix caused by the foetus that stimulates a series of neuroendocrine responses to expel the foetus. The uterine distension signals the nucleus tractus solitarii (NTS) through spinal and vagal afferent nerves. NTS neurons project into the magnocellular oxytocin neurons at para ventricular neurone (PVN). The neurones of NTS release nor-adrenaline that acts over the α1 receptors n PVN to activate the oxytocin neurons to release oxytocin that initiates myometrial contraction.
Melanin of the pineal gland controls the circadian rhythm through the suprachiasmatic nucleus (SCN) and stimulates the uterine contraction, determining the time of parturition. Melanin generally affects the uterus during the resting phase of the day; hence, parturition usually occurs in the daytime in the nocturnal animals like rodents (rabbits) and during late night or early morning hours in humans.
23.4.4 Inflammatory Changes During Parturition
The inflammatory process before and during the parturition is termed cervical ripening. It starts a few days before parturition with a slow progression rate but immediately before, the inflammatory reaction accelerates rapidly. The types of cytokines involved in this process are species specific. In cows, the IL-1β, IL-8 and IL-10 increase, whereas TNF-α decreases. Granulocyte colony-stimulating factor (G-CSF), leukaemia inhibitory factor (LIF) and prostaglandin (PGE2)
Fig. 23.9 Neuroendocrine mechanism of parturition. The cervical stretching induces oxytocin secretion from the posterior pituitary. Oxytocin initiates myometrial contraction. Higher secretion of PGF2α causes luteolysis and decreased progesterone secretion.
The myometrium overcomes the progesterone block to initiate contraction.are increased during stage-1 of parturition. All these bio-molecules cause neutrophils into the cervical tissues and induce the release of matrix metalloproteinases (MMPs) from the stromal cells, fibroblast and smooth muscle cells. Some of the important MMPs are MMP-1 (Fibroblast collagenase), MMP-2 (Gelatinase-A), MMP-8 (leukocyte collagenase) and MMP-9 (Gelatinase-B). MMPs cause depletion of the collagen network and loosen the interactions between the bio-molecules present in the extracellular matrix of cervical connective tissue to decrease cervical rigidity and soften it.
23.4.5 Events of Parturition
There are three events of parturition that occurs sequentially. Stage-1 of parturition is the dilation of the cervix. It is also referred to as the onset of labour. The dilation of the cervix characterises it. Initially, the dilation is occurred slowly, called the latent phase, followed by an active phase. Stage- 2 or the expulsion or delivery of the newborn commences after full dilation of the cervix and continues till the expulsion of foetuses. The first phase of expulsion is passive. The foetus moves down through the vagina, followed by a short duration of active phase with the contraction of abdominal and uterine
Relaxin causes cervical dilation. Other associated endocrine factors of parturition are prolactin (induces maternal behaviour) and melanin (causes uterine contraction). The foetal cortisol also promotes myometrial contraction
muscle contraction that push the foetus to expel out. Stage-3 is the placental shedding stage when the placenta is expelled out after delivery of the young. Pluriparous animals require less time to complete each stage than primiparous animals. The species-specific characterised events of parturition are depicted in Table 23.19.
23.4.5.1 Stage-1
The cervix remains firmly closed during the entire gestation period in the form of a cervical plug.
In stage-1, this plug is dissolved completely by the inflammatory process. The cervix becomes relaxed. The uterine peristalsis starts at the apex of the horn after getting free from the progesterone block. The foetus’s orientation changes and it rotates along the axis. During this stage, animals usually exhibit some characteristic behavioural changes, considered parturition approaching symptoms. Absolute cervical dilation denotes the completion of this stage and commencement of stage-2.Behavioural changes before parturition: Immediately before parturition is uneasiness or discomfort, anorexia, rising tail and mucous discharge from the oedematous and flaccid vulva. The softening and relaxation of the pelvic ligaments near the pin bones causing depression in the area generally occurs in domestic mammals. In a mare, the sinking
Table 23.19 Characteristic features of parturition in different animals
| Species and acts of parturition | Signs of parturition | Mechanism of initiation of parturition | Parturition process |
| Cow (calving) | 1. Distended and swollen mammary gland 2. Swollen and prominent teats with viscoid and clear secretions 3. Subcutaneous oedema of udder surrounding tissues Immediate signs 1. Kicking the abdomen, switching the tail, and frequent laying down and rising | Foetal cortisol stimulates the release of PGF2α and alterations in progesterone and oestrogen ratio | 1. Stage-I (dilation of the cervix) 2. Stage-II (expulsion or delivery of the newborn) 3. Stage-III (expulsion of placenta) |
| Mare (foaling) | 1. Oozing of colostrums from the teats 2. The secretion dries off and results in teat sealing called waxy seal 3. Swollen flange region behind the elbow Immediate signs 1. Colicky symptoms, switching of tail 2. Sweat patches on the flank a few hours before foaling | Increased oxytocin at the end of pregnancy induces the synthesis of PGF2α, and the combined effect of these two hormones facilitates uterine contraction | Stage-I: Frequency of uterine contraction increases and pushes the foetus into the cervix and pelvic canal. The rotation of the foetus occurs from a dorso-pubic to a dorso-sacral position. Mares may roll to facilitate the rotation of the foetus. Stage-II: The period between the rupturing of chorioallantois and the expulsion usually lasts 15-30 min. The cervical distension caused by the foetus initiates Ferguson’s reflex for abdominal contractions. Stage-III: It is the expulsion of the foetal membranes within 3 h after foaling |
| Bitch (whelping) | 1. Enlarged mammary gland Immediate signs 1. Digging and scratching of the floor 2. Chewing, panting 3. Copious green vaginal discharge before, during and after parturition | Foetal cortisol stimulates the release of PGF2α and alterations in progesterone and oestrogen ratio | 1. First stage of labour. It usually lasts 1-12 h. And may extend up to 36 h in primiparous bitches. Cervical dilation is completed by the end of this stage, along with the appearance of a water bag at the cervix, but it will not be visible from the outside. 2. Second stage of labour. Characterised by involuntary uterine and voluntary abdominal contractions. This stage usually lasts for 3-12 h. The first water bag appears in the vulva, and the bitch can be seen lying, standing, or crouching. The bitch breaks it by licking or biting to release allantoic fluid. Each puppy contains an intact second sac (amnion), and the bitch breaks it open and stimulates the puppy. 3. Third stage of labour. There are continuous uterine and abdominal contractions that facilitate placentas’ expulsion. |
| Queen (kittening/ kindling) | 1. Seeking of dark and dry area 2. Irritable and defensive (some queens may become hysterical) Immediate signs 1. Digging of floor 2. Defection posture 3. Vocalisation | Foetal cortisol stimulates the release of PGF2α and alterations in progesterone and oestrogen ratio | 1. Contraction phase. Abdominal and uterine muscles contract 2. Emergence phase. Litter passes through the birth canal. The amniotic sac is broken by contraction of the uterus 3. Delivery phase. Expulsion of the foetus from the vulva. The licking stimulus initiates foetal respiration 4. Placental phase. Placenta is expelled from the genital tract. Queens often eat the placental tissue. |
(continued)
Table 23.19 (continued)
| Species and acts of parturition | Signs of parturition | Mechanism of initiation of parturition | Parturition process |
| Sow (farrowing) | Isolation and nest building (48-24 h before farrowing) | The release of PGF2α from the foetoplacental unit in response to foetal cortisol triggers farrowing | 1. Stage 1 (The pre-farrowing period): It starts from 10 to 14 days before the date of farrowing and is characterised by the development of the mammary glands and swelling of the vulva 2. Stage 2 (The farrowing process): It ranges from 3 to 8 h, and each piglet is usually delivered every 10 to 20 min. In most pigs, the head is born first, but more pigs are presented backwards towards the end of the farrowing period 3. Stage 3 (Delivery of the placenta): It usually takes 1-4 h, indicating the completion of farrowing |
| Ewe (lambing) and doe (kidding) | Little changes in the mammary gland | Foetal cortisol stimulates the release of PGF2α and alterations in progesterone and oestrogen ratio | Same as cow |
of croup muscles is not so profound. Udder enlarges, becomes oedematous, and even secretion may appear from a teat in cow and litter bearing animals like the sow, bitch and queen. It occurs 2-4 weeks earlier in litter bearing animals and fourth months in the calf. Bitch and cat usually remain calm and quiet before parturition.
23.4.5.2 Stage-2
This stage begins with the entry of the foetus and foetal membrane into the pelvic canal. The allantochorion (commonly known as the water bag) is expelled first, followed by the amnion, which contains the foetus. The rapid abdominal and uterine contractions expel the foetus through the vulva. The maximum contraction occurs during the expulsion of the foetal head. This maximum straining is followed by rest, but soon after that, the foetal thorax passes the vulva. The hips and hindlimbs are expelled simultaneously. The mare and sow usually lie in lateral recumbency while cow, bitch and ewe prefer to lie on their sternum. The offspring are generally born with the intact umbilical cord, but the movement of offspring and mother ruptures the cord. It takes longer to expel the foetuses in polytocous animals, depending on the number of foetuses. The duration between two successive piglets is about 10-20 min in the pig.
A longer time to complete the delivery process occurs in some abnormal conditions like twins, monster calf and abnormal posture of the foetus. During delivery, lateral recumbency is the usual posture in most domestic animals but standing posture may also occur in pluriparous dams. The behavioural changes at this stage include licking and grooming. The licking in the nasal area facilitates the removal of mucous and placental tissues for the ease of respiration. The grooming behaviour is absent in sows, and the piglets
Table 23.20 Duration of parturition in different species
| Species | Stage-I (h) | Stage-II (h) | Stage-III (h) |
| Mare | 1-4 | 0.2-0.5 | 1 |
| Cow and buffalo | 2-6 | 0.5-1 | 6-12 |
| Ewe | 2-6 | 0.5-2 | 0.5-8 |
| Sow | 2-12 | 2.5-3 | 1-4 |
| Bitch | 6-12 | 3-6 |
often die due to respiratory obstruction. Bitches and queen nurse their offspring in recumbency while cow, ewe and doe nurse their young in standing. A strong bond between mother and foetus is developed primarily due to pheromone perceived by olfaction.
23.4.5.3 Stage-3
Occasionally, the placenta is expelled within 3-8 h after the delivery of the foetus (Table 23.20). The expulsion of the foetal membrane is facilitated by the loosening of chorionic villi from maternal crypts. The expulsion of the foetal membrane occurs in two stages. The failure of placental expulsion within 24 h after parturition leads to retained placenta.
23.4.6 Foetal Presentation During Parturition
The foetus rotates from its position throughout the entire gestation period and orients itself to the normal parturition posture for smooth delivery at stage-1. Generally, the normal foetal presentations are of two types in domestic animals. These are either anterior presentations or posterior presentations. In the anterior presentation, two forelimbs and the head are present towards the vulva parallel to the animal’s spine. In the posterior presentation, one or both of the hind limbs and tail remain towards the opening of the birth canal parallel to the animal’s spine. In polytocous animals like pigs, the foetuses are positioned about half- and-half between facing forwards and facing backwards. Different abnormal presentation leads to parturition complications.
23.4.7 Parturition Complications
Difficulty during parturition is termed dystocia. Dystocia and retained placenta are the two major complications that arise during parturition. Each foetus has an individual placenta; hence, increased litter size may lead to dystocia. Positioning of the head between forelimbs in multiple foetuses causes dystocia on many occasions. Dystocia is mainly developed due to inappropriate cervical dilation and mostly occurs in cattle, goats, sheep and humans. The cervix of cattle is generally more cartilaginous; hence, incomplete cervical dilation is more. Several gestational anomalies like twins and uterine torsion may cause incomplete cervical dilation in cattle. The weak myometrial contraction due to hypomagnesaemia, hypocalcaemia, hyposelenemia and old age predisposes to incomplete cervical dilation and dystocia. Insufficient production of certain enzymes like 5α-reductase, and increased tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) fail cervical ripening. The deficiency of 5- α-reductase causes sustained progesterone production. A large size foetus may cause a hip lock. If the placenta is not driven out within the period of stage-3 (Table 23.20), the state is termed as retention of the placenta. Low oxytocin is considered one of the causes of retention of the placenta.
23.4.8 Induction of Parturition
In some cases, parturition is induced through therapeutic and managemental interventions to release the mother from several conditions like traumatic reticulo pericarditis, bronchopneumonia, pre-partum cervical prolapse, downer cow syndrome and pregnancy toxaemia. Prolonged gestation is also required for parturition induction. The manipulation of the time of parturition is also desirable as calving in daylight facilitates better care for the newborn and the mother. The parturition can induce either through therapeutic interventions or managemental procedures.
23.4.8.1 Therapeutic Interventions for Parturition Induction
Several drugs like glucocorticoids, oxytocin and PGF2α are used alone or in combinations to induce parturitions in domestic and pet animals. The drugs’ choice and doses vary considerably among different species (Table 23.21).
23.4.8.2 Managemental Interventions
for Parturition Induction
Most parturition in cows happens in the hour of darkness. The easiest and most effective method for avoiding night calving is feeding cows at night. The exact mechanism is unknown, but it is postulated that feeding alters intra-ruminal pressure. The frequency of rumen contraction falls a few hours before parturition. Feeding increases the rumen contraction, and hence the parturition can delay night feeding.
Table 23.21 Therapeutic intervention to induce parturition in different species
| Species | Drugs | Remarks |
| Cow | Dexamethasone Betamethasone Flumethasone | • Occurrence of retained placenta in 90% of cases • Slower onset of milk production • Delayed uterine involution |
| PGF2α | • Can be used as early as 275 days of gestation • Parturition can be used within 2-3 days after administration | |
| Mare | Corticoids | • Can be applied at 24 h interval • Average induction time is 4 ± 1 days • Can be started at 321 days of gestation • Prolonged corticosteroid administration may cause immune suppression in foal |
| PGF2α | • Only synthetic forms are recommended as natural prostaglandins cause strong contraction and lead to early placental separation and foetal weakness • Foaling occurs within 4 h | |
| Oxytocin | • Doses vary with the degree of cervical relaxation • Cervical relaxation needs to be monitored | |
| Goat/ sheep | Corticoids | • Induction time varies between 30 and 35 h after administration |
| PGF2α | ||
| Swine | PGF2α | • Should not be applied till 111 days of gestation • Induction time 24-30 h after administration |
| Corticoids | • Can be applied on days 101-104 of gestation | |
| Canine | Dopamine agonist/anti-prolactin compounds (cabergoline) | • May cause hypotension and emesis |
23.4.9 Postpartum Physiology
The time between the parturition and the occurrence of the first oestrous is called postpartum period (interval) or puerperal period. The duration depends upon species, breed, nutritional status, age, parity and environmental conditions. Each species required a considerable time to exhibit the postpartum oestrus. It varies widely, only 24 h (rabbit) to 60 days (cow). The major physiological changes occur in the ovary, uterus, and mammary gland, together with behaviour changes to nourish the young.
Failure to exhibit oestrus and ovulate beyond such period after parturition is considered postpartum anestrus.
23.4.9.1 Postpartum Ovarian Changes
Pregnancy interrupts the HPO axis by secreting large quantities of the placental steroids, and resumption of ovarian cyclicity depends upon the interaction between hypothalamus-pituitary. The CL inhibits the growth of the antral follicles even 20 days after the parturition in cows and reduces the frequency of ovulation. The resumption of ovarian cyclicity occurs in three distinct phases. In the first phase, which occurs within 2-4 weeks postpartum, the pituitary LH secretion is increased. In the second phase, the sensitivity of the hypothalamus to the positive feedback of estradiol is restored. In the third phase, the HPO axis is recovered from the suckling induced suppression due to prolactin.
23.4.9.2 Uterine Involution
The restoration of uterine volume to its non-pregnant state is called uterine involution. It is characterised by decreased uterine volume, elimination of bacterial infections and regeneration of uterine epithelium. In cows, the diameter and length of the gravid uterus are reduced to half by 5 days postpartum and 15 days postpartum, respectively, and completed with 40-50 days postpartum (Table 23.22). The constriction and occlusion of caruncular blood vessels lead to
Table 23.22 Uterine involution and occurrence of postpartum oestrus in different species
| Species | Uterine involution time | Occurrence of postpartum oestrus |
| Cow | 50-60 days postpartum | - |
| Doe | 20-25 days postpartum | 25-45 days postpartum |
| Ewe | 30-25 days postpartum | 30-40 days postpartum |
| Mare | 13-25 days postpartum | 7-9 days postpartum (foal heat) |
| Bitch | 28-35 days postpartum | - |
| Sow | 20-25 days postpartum | 45-50 days postpartum |
necrotic changes in the caruncle within 48 h of parturition. The necrotic layer is spread over the stratum compactum by day 5 postpartum. Some of the necrotic materials slough off through lochia (the uterine discharge secreted during early postpartum, composed of blood, mucus, remnants of foetal membranes, and maternal tissue together with foetal fluids). The shedding of necrotic caruncles is completed by day 15 postpartum, and the smooth surface of the uterus is restored by day 19 postpartum. Other than the inter- caruncular areas, the endometrial tissues start regenerating immediately after the parturition and completely regenerate by day 8 postpartum in the cow. The caruncular re-epithelialisation starts from 25 days postpartum and heals entirely by day 40-60. The constriction of the cervix begins within 10-12 h of parturition in cow and undergoes atrophy and shrinkage. PGF2α helps in uterine involution.
The important events in the ovary during this period are regression of corpus luteum, no follicular growth, decreased ovary size and appearance as anestrus. Uterine involution and repairing of the endometrium occur. Nursing to the young is common in most mammals after parturition, except mares and rats. Copious milk secretion with a positive energy balance has been found in the mammary epithelium cells. Suckling increases opioid peptides (β-endorphin) from the hypothalamus, which inhibits gonadotropin secretion, causing to increase postpartum period. Thus, weaning favours to re-establishment of the HPO axis. It results in oestrous, and ovulation and the animal can conceive further. The oestrous after parturition is termed postpartum oestrus and can affect by light cycles, temperature and humidity. Any kind of stress negatively affects the HPO axis through cortisol, followed by a delayed postpartum period. Hot, dry and extreme weather cause delays in the postpartum period. Parturition in the non-favourable season to the seasonal breeder also delays the period. The development of anomalies during pregnancy and parturition may also cause delays in the postpartum period.
23.4.10 InitialCareofNewborn
23.4.10.1 TheOnsetofRespiration
During the parturition, PO2 and blood pH is decreased, and PCO2 is increased due to placental separation. High PCO2 stimulates chemoreceptors at the carotid sinus and initiates respiration. Tactile and thermal stimulation is also required to initiate respiration. After birth, the fluid and mucous from the upper respiration tract need to be cleared first. Brisk rubbing the chest and scrapping of nostrils are the tactile stimuli to induce sneezing and clear the upper airways. Doxapram hydrochloride can also be applied to induce breathing. In extreme cases, oxygen therapy is required.
23.4.10.2 Thermoregulation
The newborn has inadequate sub cutaneous fat insulation and poor thermoregulatory control. The initial thermoregulation is achieved by producing metabolic heat and reduction in heat loss. For adequate metabolic heat production, sufficient nutrition is essentially required. The newborn should be placed in a warm environment to minimise heat loss. Application of body coat can also reduce heat loss. The ideal temperature for the newborn puppy is 95-100 °F during the first week, 85 °F during the second week and 70-85 °F during the third week.
23.4.10.3 CareofUmbilicus
The hemostatic clamp must be removed from the umbilical cord and must ligate to prevent further haemorrhage. Cutting the umbilical cord close to the abdomen is advisable, along with proper disinfection with antiseptic.
23.4.10.4 Feeding of Colostrum
Feeding of colostrums is required to boost the newborn’s immune system by transferring immunoglobulins. Nutrients and antibodies increase the immune system. Increased level of oxytocin induced by suckling stimulus facilitates colostrum ejection. Cleaning of teats and physical assistants to a newborn is required for initial colostrum feeding. As a thumb rule, colostrum at the rate of 10% of a calf’s body weight can be fed to the newborn. Colostrums replacement therapy or colostrum from other animals should give in case of death of the dam.
23.4.11 Postpartum Reproductive Disorders
Due to stress and immune suppression around the peripartum, the animals are prone to infections. Some postpartum disorders like mastitis, metritis, retained placenta, and lameness may also occur from digestive or nutritional malfunctions directly affecting uterine development.
23.4.11.1 Mastitis
Mastitis has a direct effect on reproduction. Inflammation due to mastitis leads to stress and hyperthermia because of increased cortisol, reactive oxygen species (like NO) and cytokine (TNF-α). It affects locally and in the HPO axis, resulting in abnormalities in the oestrous cycle, ovulation, decreased oocyte competence, and failure of fertilisation. In addition, the pathogen-derived endotoxin and altered immune system cause endocrine imbalance and increased production of PGF2α, followed by luteolysis and an adverse uterine environment. It causes early embryonic mortality or abortions in dairy cattle. Mastitis affects reproduction in dogs also.
23.4.11.2 Metritis
Metritis and endometritis are uterine infections. They cause poor follicular growth and postpartum anestrus due to altering GnRH secretion, decreased responsiveness of LH to the follicular cells and lower aromatase expression followed by less oestrogen secretion. The inflammatory response in the endometrial epithelium generates TNF-α, nitric oxide synthase (NOS) and prostaglandin-endoperoxide synthase 2 (PTGS2 or COX-2). It influences more PGE production than PGF (PGF2α). Thus, luteolysis is disturbed. Endometrial immunity is also compromised through altered steroid hormone concentration, somatotrophins and local regulatory proteins due to LPS of the pathogens. Higher progesterone and IGF I, released in metritis, play an immunosuppressive role through the serine proteinase inhibitors, glycan-binding proteins (galectins) and galactose-β1,4-N-acetylglucosamine. Systemic inflammation and metabolic syndrome also affect reproductive function by a similar mechanism. Hence, metritis, endometritis and systemic inflammation directly affect the reproductive function to cause impaired fertilisation, twins, stillbirth, dystocia and retained placenta. It often occurs in cattle, sheep and dogs.
23.4.11.3 RetainedPlacenta
Retention of the placenta may occur due to certain venereal diseases and managemental and nutritional factors. It may cause chronic infection and alteration in hormonal balance and immune compromisation of the mother. It results in twin, abortion, stillbirth, dystocia, labour problem and shortened gestation. Subinvolution of the placenta after the first parturition within 3 years of age is a common problem in the dog.
23.4.11.4 Lameness
Lameness is considered chronic stress to the animal. Hence, the HPO axis is inhibited through cortisol and other stress bio-molecules. So, LH pulse frequency and oestrogen level are reduced. It causes poor oestrus signs, failure of ovulation, delayed ovulation and low progesterone production from the immature corpus luteum. Thus, oocyte maturation and the process of fertilisation are disturbed. Infertility may develop due to the formation of an anovulatory cyst. Delay postpartum oestrus has also occurred.
23.4.11.5 Digestive or Nutritional Factors
Reproductive anomalies may also occur due to nutritional deficiency and toxicity of certain chemicals during in postpartum state. It causes improper placental growth and abortion with other reproductive hazards. The deficiency of vitamin A results in thickening and erosion of the placenta, followed by abortion in late gestation. It also causes an irregular oestrous cycle. The lack of vitamin D develops silent oestrus and delays ovulation. Iodine deficiency is also a cause of abortion. Deficiency of iron, copper, cobalt and protein leads to anaemia and energy-deficient condition leads to anestrus and irregular oestrus due to disturbance in the HPO axis and ovarian activity. Magnesium and phosphorus deficiency, mostly during postpartum of high yielder animals, also causes a similar effect. Selenium and vitamin E deficiency causes metritis. Excess blood urea nitrogen (BUN) due to protein-rich ration reduces fertilisation. Toxicity of nitrites and nitrates from fertiliser and some plants during drought, excess phosphorus (from the plant’s seed), and mycotoxins from fungus caused abortion and retained placenta. Diarrhoea, bloating, bleaching, constipation, nausea, poor gut health, chronic irritation and cramping cause anxiety and stress, lead to deviation in the HPO axis and ovarian dysfunction. Gluten (a protein found in wheat, rye and barley)-rich diet may develop an autoimmune disorder called celiac disease in the genetically predisposed dog, cats, rats and mice. It causes ovulatory problems along with osteoporosis, depression and anaemia. Various oestrogenic compounds like bisphenol A, DDT, polychlorinated biphenyls, polybrominated diphenyl ethers, petroleum by-products, pesticides, herbicides and plastics disrupt the steroidogenesis process during foetal growth.
23.4.12 Diseases Related to Embryonic Mortality and Foetal Abnormality
23.4.12.1 Congenital Disorders
Congenital deformity in the reproductive tract, like malformation of the Mullerian duct, results in abnormalities in the fallopian tubes and uterine cavity. Like the Boxers breed of dog, some small animals have a small-sized uterus, causing dystocia. The ovarian bursal adhesion may occur in specific conditions due to improper ovarian manipulation by rectal palpation. It appears in large ruminants and results in inappropriate capturing of ova during ovulation and fertilisation anomalies. Other placental abnormalities include small placenta, premature placental separation and umbilical cord complications. Common defects in dog foetal developments are canine congenital sensorineural deafness (CCSD, degeneration of inner ear), canine-dilated cardiomyopathy and hypocalcaemia originated canine eclampsia (mostly in small-breed accompanying with more litter size).
Certain diseases like bovine viral diarrhoea (BVD), vibriosis, brucellosis, chronic leptospirosis and trichomoniasis cause early embryonic mortality and infertility. Different pathogens affect different modes, but in general, adhesions in the region of the ovaries, obstruction in the oviducts, and inflammation in the uterus, placenta and cervix occur. Hence, the normal reproductive function is affected.
23.4.12.2 BovineViral Diarrhoea (BVD)
BVD causes early embryonic mortality or foetal death or birth of a malformed calf in cattle according to severity and time of infection. The infection also causes ovaritis and leads to the malfunctioning of follicular cells resulting harmful environment for the embryo or foetal development. It may also cause retention of the placenta.
23.4.12.3 Vibriosis
Vibriosis is caused by the bacterium Campylobacter foetus (earlier Vibrio foetus). It is common in cattle and sheep and also in humans. It is a venereal disease and spreads by infected bulls. The bacteria cause inflammation in the trophoblasts and chronic villi, resulting in necrotic placentitis and uterine infection. Infection may continue 1-8 months of pregnancy. The consequence is abortion and infertility.
23.4.12.4 Brucellosis
Brucellosis is a venereal disease caused by the bacterium Brucella abortus. It causes infection in the endothelial cells of the capillaries and sub-chorionic tissues. The oedematous growth results in the premature termination of pregnancy and retention of the placenta. It affects cattle, sheep, goats, pigs, dogs and humans.
23.4.12.5 Leptospirosis and Trichomoniasis
Leptospirosis caused by Leptospira genus of bacteria. Transmission occurs during natural mating, where young are more susceptible and cause early embryonic mortality. Cattle, sheep, goats, pigs and dogs are affected more. Trichomoniasis is caused by a protozoon, Trichomonas foetus. The infective organism transmits through the infected animal, semen and instrument used for insemination. It causes uterine infection and abortion. It is common in cattle.
23.4.12.6 OtherPathogens
There are other organisms like streptococci, staphylococci, corynebacteria, diplococci, micrococci, and moulds that cause local infection in the reproductive tract; the consequence of this result in impaired gestation and infertility may arise in the chronic stage.
Learning Outcomes
• Fertilisation: Internal fertilisation occurs in all the primates and non-primates domestic mammals. Semen is deposited at the vagina by natural insemination and around the cervix by artificial insemination. The time of insemination depends upon the time of ovulation and it is species specific. After insemination, spermatozoa are transported to the ampulla, the site of fertilisation, through a uterine tube, and subjected to species-specific biochemicals and molecular changes known as capacitation and hyperactivation for final maturation. In most mammals, the secondary oocyte completes its maturation after ovulation in the oviduct immediately before fertilisation with the induction of spermatozoa. A series of biochemical reactions, like acrosomal reaction in the spermatozoa, cortical reaction in the oocyte, entry of sperm and initiation of meiosis and karyogamy occur to complete the fertilisation process. Several proteins and enzymes are involved in successful fertilisation or conception.
• Gestation: The period between conception and giving birth to young is the period of pregnancy or gestation. Its duration depends upon the species. Several factors like genetic, maternal, foetal, endocrines and environment control the gestation. The embryo is implanted in the uterus during its blastocyst stage and then transforms into the foetus. During gastrulation, the foetus produces three germ layers for proper attachment with the uterine wall through the placenta. Various organs are developed at the organogenesis stage. The gestation is maintained by several endocrines and growth factors like interferon Tau (IFNT). The presence of these species-specific bio-molecules in the animal confirms the maternal recognition of pregnancy.
• Placenta: The placental types are species specific. According to layer involvement, these are epitheliochorial, endotheliochorial and hemochorial. These are cotyledonary, diffuse, discoid and zonary according to shape and attachment. The placenta supports the foetus to exchange nutrients and metabolites with the mother, physical and immunological protection, thermoregulation and proper development with the influence of several endocrines and bio-molecules. Placenta itself secretes some endocrines. Foetal sex-specific placental activity has also occurred.
• Parturition: The species-specific complex physiological phenomenon occurs during the termination of pregnancy, the parturition. Interactions of several endocrines initiate the event involving various cellular and muscular activities in the female reproductive tract to generate pressure and inflammatory processes for expelling the young and the placenta. Faulty foetal presentation causes the occurrence of dystocia. Several congenital and anatomical deformities may also occur.
Exercises
Objective Questions
Q1. Why do spermatozoa reach rapidly at the site of fertilisation immediately after insemination cannot fertilise?
Q2. Which part of the female reproductive tract is considered a sperm reservoir in the cattle?
Q3. Which biological activity provides the zona penetrating ability to the spermatozoa?
Q4. Why is secondary oocyte not completely maturated before ovulation in cows?
Q5. Which stage of fertilisation causes the permanent blockage of polyspermy?
Q6. What is progesterone block?
Q7. The embryo is termed as a foetus from which morphological stage?
Q8. What is the significance of zona hatching?
Q9. What is maternal recognition of pregnancy?
Q10. Eccentric type of implantation occurs mostly in which animals?
Q11. Which kind of placenta does not involve any endometrial tissue?
Q12. What is hemotroph?
Q13. When eCG start to secret in a mare?
Q14. Why can relaxin determine pregnancy in dogs and cats, not progesterone?
Q15. In which sex the interferon tau is better expressed? Q16. What is cervical ripening?
Q17. Manipulation of which hormone is advised to correct retention of the placenta?
Q18. How many oocyte(s) are involved in the occurrence of fraternal twins?
Q19. Why dystocia mainly occurs in the Boxer breed of dog?
Q20. Why vitamin A deficiency causes abortion in late pregnancy?
Subjective Questions
Q1. Why is the concentration of spermatozoa reduced from the insemination site to the fertilisation site?
Q2. Describe the role of some bio-molecules involved in the capacitation.
Q3. Describe the process of fertilisation diagrammatically.
Q4. Describe the various factors affecting gestation.
Q5. Classify the mammalian placenta according to histological and morphological structure, shape and attachment.
Q6. Describe the endocrine role of the placenta.
Q7. Write the process of parturition in cow.
Q8. Neuroendocrine mechanism of parturition.
Answer to Objective Questions
A1. Lack of capacitation process
A2. Isthmus
A3. Hyperactivation
A4. Meiosis II is completed with the induction of spermatozoa at the oviduct
A5. Cortical reaction
A6. Reduce or block the muscular tone of the female reproductive tract in favour of gestation
A7. Gastrula
A8. The blastocyst can expand and proceed to the implantation process
A9. The state of the mother, caused by the conceptus, promotes the gestation
A10. Rat and mouse
A11. Hemochorial
A12. Substances that are directly transferred from the maternal blood by blood vessels through the placenta
A13. Around 25 days of gestation
A14. Corpus luteum persists more than during the pregnancy period in dogs, and placental progesterone can be synthesised in the cat with a luteal cyst and low progesterone in the first 2 weeks. In contrast, placental relaxin is synthesised from about 4 weeks in the dog and 3 weeks in the cat.
A15. Female
A16. The inflammatory process in parturition
A17. Oxytocin
A18. Two
A19. Small-sized uterus
A20. Due to thickening and erosion of the placenta
Keywords for the Answer to Subjective Questions
A1. Vaginal toxic environment, cervical plug, transportation through the uterus, morphological and mucus barrier at UTJ
A2. Role of ions like bicarbonate and calcium; hormones like oestrogens and progesterone; various proteins, glucose and metabolites
A3. Acrosomal reaction in the spermatozoa, cortical reaction in the oocyte, entry of sperm and initiation of meiosis, karyogamy
A4. Genetic, maternal, foetal, endocrines and environmental factors
A5. Involvement of endometrium; shape and point of attachments between foetal and endometrial tissues; structure of the chorionic membrane and contact with the endometrium; loss of maternal tissue during parturition
A6. Placental steroid, placental protein hormones, placental proteins, placental prostaglandin
A7. Stage1, stage 2 and stage 3
A8. Role of progesterone, oestrogens, oxytocin, relaxin, melanin and foetal cortisol
Further Reading
Books
Carlson BM (2019) The reproductive system (Ch. 14). In: The human body. Andre Gerhard Wolff, London, pp 373-396. https://doi.org/ 10.1016/B978-0-12-804254-0.00014-4
Das PK, Mukherjee JM (2019) Immune responses of mammary gland (Ch. 2). In: Sar TK (ed) Mastitis: symptoms, triggers and treatment. Nova Science Publisher, Inc., New York, pp 89-118. ISBN: 978-153616-124-3
Lopes SMCS, Mummery CL (2014) Differentiation in early development (Ch. 10). In: Essentials of stem cell biology, 3rd edn. Academic Press, pp 121-139
Research Articles
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Borghesi J, Mario LC, Rodrigues MN et al (2014) Immunoglobulin transport during gestation in domestic animals and humans—a review. J Anim Sci 4:323-336. https://doi.org/10.4236/ojas.2014. 45041
Chavatte-Palmer P, Tarrade A (2016) Placentation in different mammalian species. Ann Endocrinol (Paris) 77:67-74. https://doi.org/10. 1016/j.ando.2016.04.006
Conley AJ, Ball BA (2019) Steroids in the establishment and maintenance of pregnancy and at parturition in the mare. Reproduction 158(6):R197-R208. https://doi.org/10.1530/REP-19-0179
Croxatto HB (2002) Physiology of gamete and embryo transport through the fallopian tube. Reprod Biomed Online 4(2):160-169. www.rbmonline.com/Article/228
Feng Y, Zhang P, Zhang Z et al (2016) Endocrine disrupting effects of triclosan on the placenta in pregnant rats. PLoS One 11(5): e0154758. https://doi.org/10.1371/journal.pone.0154758
Ferramosca A, Zara V (2014) Bioenergetics of mammalian sperm capacitation. Biomed Res Int 2014:902953, 1-8. https://doi.org/10. 1155/2014/902953
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Garcia-Vazquez FA, Gadea J, Matas C et al (2016) Importance of sperm morphology during sperm transport and fertilisation in mammals. Asian J Androl 18(6):844-850. https://doi.org/10.4103/1008-682X. 186880
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Monroy A (2020) Fertilization. Encyclopedia Britannica. https://www. britannica.com/science/fertilization-reproduction
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