Acta Scientific Veterinary Sciences (ISSN: 2582-3183)

Volume 4 Issue 3 March 2022

Case Report

Successful Management of Pre Partum Cervico-Vaginal Prolapse Concurrent with Dystocia

Due to Incomplete Cervical Dilatation in Surti Buffalo: A Case Report

Ruchika R Sangle, Maheshkumar V Ingawale*, S G Deshmukh and C H

Received: January 17, 2021
Pawshe
Published: February 17, 2022
Department of Animal Reproduction Gynacology and Obstetrics, Postgraduate
© All rights are reserved by Maheshkumar V
Institute of Veterinary and Animal Science, Akola, India
Ingawale., et al.
*Corresponding Author: Maheshkumar V Ingawale, Department of Animal
Reproduction Gynacology and Obstetrics, Postgraduate Institute of Veterinary and
Animal Science, Akola, India.

DOI: 10.31080/ASVS.2022.04.0330

Abstract
The present paper reports the successful treatment of cervico-vaginal prolapse and dystocia due to incomplete cervical dilation in
buffalo. Eight-year-old Surti buffalo in fourth parity was presented with history of full term gestation, unproductive straining and se-
vere degree cervico- vaginal prolapse from past 24 hrs. The cervico-vaginal prolapse was repositioned and per-vaginal examination
discovered one finger cervical dilation whereas foetus was in anterior presentation examined by per rectal examination. The buffalo
was treated for incomplete cervical dilation with dexamethasone 40 mg, cloprostenol sodium 500 μg and intravenous valethamate
bromide 80 mg with periodical fathering of cervix. There was cervical dilation and dead fetus was removed with slight traction. The
cervico-vaginal prolapse as well as incomplete cervical dilation during parturition in Surti buffalo was successfully managed.

Keywords: Cervico-Vaginal Prolapse; Dystocia; Incomplete Cervical Dilation

Abbreviation tal factors [9] and genetic predisposition [10].

ICD: Incomplete Cervical Dilatation; CVP: Cervico Vaginal Pro- Cervico-vaginal prolapse is associated with incomplete cervical
lapse; CMC: Carboxymethyl Cellulose dilatation (ICD) that leads to dystocia and the frequency of ICD in
cattle and buffaloes were 5.1% [11]. It happens because of changed
Introduction
endocrine status during birth. Cervico-vaginal prolapse (CVP) is
Buffalos are backbone for milk production contributing 49% interceded by augmented circulating attentions of estrogens and
milk produced in India (Annual Report, DAHD-2020-21). The re- relaxin during last trimester of gestation leading to relaxation and
productive concert of buffalos is underprivileged due to numerous softening of pelvic ligaments and nearby soft tissue structure [14].
diseases of reproductive system which includes genital prolapse It is intensified by the constant straining by buffalo and partial
[2,13]. Cervico-vaginal prolapse typically comprise overhang of opening of cervix. The current article reports a case of pre-partum
the portion of floor, lateral walls and roof of vagina along with cervico- vaginal prolapse complicated due to incomplete cervical
cervix and uterus [12]. It is a routine obstetrical delinquent which dilatation and leads to dystocia.
unfavorably disturbs productive and reproductive performance by
upsetting postpartum return to estrus, reducing conception rate Case history and clinical observations
and increase in calving interval. Aetiologic features of prepartum Eight years old Surti buffalo in fourth parity and in last month
cervico-vaginal prolapse in buffalos happens due to nutritional im- of gestation was initially reported with problem of intermittent
balance [1,8], hormonal disproportion [4], seasonal managemen- prolapse of vagina, with vagina protruding from vulva when animal

Citation: R R Sangle., et al. “Successful Management of Pre Partum Cervico-Vaginal Prolapse Concurrent with Dystocia Due to Incomplete Cervical Dilata-
tion in Surti Buffalo: A Case Report". Acta Scientific Veterinary Sciences 4.3 (2022): 52-55.
Successful Management of Pre Partum Cervico-Vaginal Prolapse Concurrent with Dystocia Due to Incomplete Cervical Dilatation in Surti
Buffalo: A Case Report

53

was lying down. Further it become aggravated in sequence of pe- ening of the pelvic girdle and associated soft-tissue structures in
riod with vaginal mass prolapsed through standup posture while the pelvic channel and perineum mediated by increased circulat-
trying to urinate or defecate or strain. ing concentrations of estrogens and relaxin during late gestation
[6,7]. Dystocia due to incomplete cervical dilation occurs because
After 15 days, the complete vagina prolapsed and medical in- of changes in activation of inflammatory mediators like cytokines
spection exposed inflamed, edematous and congested vaginal mu- along with different endocrinal situation during the process of
cosa with visible cervix at caudal part. After prolapsed mass origi- birth. In the current circumstance, combination of cervical massage
nated out animal had non-productive straining. Gross inspection of [5] along with use of valethamate bromide and PGF2α resulted in
buffalo displayed relaxed pelvic ligaments and developed udder. All effective dilatation of cervix as reported earlier in cattle and buffalo
vital parameters were within the standard array. [3,11]. Newly, intracervical application of misoprostol (PGE1 ana-
logue) has been stated in cattle and goat [2] with ICD. Augmented
Treatment and Discussion
concentration of estrogen because relaxation and softening of the
Buffalo was administered with epidural anaesthesia with 2% pelvic ligaments along with increased intra-abdominal heaviness
lignocaine (LOX®, Neon Labs, India) at dose rate of 1ml for 100 kg might predisposed to cervico-vaginal prolapse. The foetus might
body weight to decrease straining. Then, the prolapsed mass was be died due to long asphyxia caused by rupture of water bag and
cleaned with potassium permanganate solution (1:1000 dilution) incomplete cervical dilatation.
then icepacks, sugar solution and Popin spray was applied to reduce
edema and volume of the mass. Carboxy methyl cellulose (CMC)
solution was done over the prolapsed mass. Urine was removed us-
ing sterile stainless-steel catheter and future the prolapsed mass
was relocated and applied rope truss. Buffalo was soothed with
analgesic inj. Meloxicam 15 ml, antibiotic Amoxicilline - clavulanic
acid - 15 mg/kg body wt. along with six liters of fluid. Additionally,
calcium borogluconate 250 ml I/V was also administered [3].

After 24 hours there was no dilatation of cervix, and for incom-

plete cervical dilatation (ICD) treatment consisted of intramuscu-
lar injections of dexamethasone 40 mg. cloprostenol 500 μg. and
intravenous valethamate bromide 80mg with periodical father-
ing of cervix was carried out. Per-vaginal inspection 8hr post- Figure 1: Prolapsed Mass.
treatment exposed 4 finger dilation along with suckling reflex of
the foetus and cervical massage was repeated. About 4 hour post
therapy, chorioallantoic sac appeared at the external os of the cer-
vix through the prolapsed mass that ruptured spontaneously due
to movement of animal. Since, cervical dilation was inadequate
even after 10hour intravenous valethamate bromide 50 mg was re-
peated along with fathering of cervix. After 6hours of second treat-
ment, the buffalo delivered a dead male fetus with mild obstetri-
cal intervention. Fetal membranes were expelled after 5 - 6 hours.
Post-partum the buffalo was normal and alert and arranged with
routine antibiotics and supportive therapy [11].

Influencing factors include augmented intra-abdominal pres-

sure associated with enlarged size of pregnant uterus, intra-ab-
dominal fat or rumen distention overlaid upon relaxation and soft- Figure 2: Cleaning of Proplapsed Mass.

Citation: R R Sangle., et al. “Successful Management of Pre Partum Cervico-Vaginal Prolapse Concurrent with Dystocia Due to Incomplete Cervical Dilata-
tion in Surti Buffalo: A Case Report". Acta Scientific Veterinary Sciences 4.3 (2022): 52-55.
Successful Management of Pre Partum Cervico-Vaginal Prolapse Concurrent with Dystocia Due to Incomplete Cervical Dilatation in Surti
Buffalo: A Case Report

54

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Citation: R R Sangle., et al. “Successful Management of Pre Partum Cervico-Vaginal Prolapse Concurrent with Dystocia Due to Incomplete Cervical Dilata-
tion in Surti Buffalo: A Case Report". Acta Scientific Veterinary Sciences 4.3 (2022): 52-55.
Successful Management of Pre Partum Cervico-Vaginal Prolapse Concurrent with Dystocia Due to Incomplete Cervical Dilatation in Surti
Buffalo: A Case Report

55

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Citation: R R Sangle., et al. “Successful Management of Pre Partum Cervico-Vaginal Prolapse Concurrent with Dystocia Due to Incomplete Cervical Dilata-
tion in Surti Buffalo: A Case Report". Acta Scientific Veterinary Sciences 4.3 (2022): 52-55.