The foal is here, but where is the afterbirth?

In veterinary medicine, retained placenta refers to the placenta and egg membranes remaining in the uterus after the birth of the foal. This is not a separate disease, but rather a symptom of various functional disorders. It is one of the most common problems during the birth process in mares and occurs in 2 to 10% of all foal births.

INHALT
Causes and development Diagnosis and symptoms Complications Therapy Prophylaxis
Causes and development

The exact cause of retained placenta remains unclear. It is suspected that a wide variety of factors that lead to a disrupted birth process can trigger retained placenta.

When the umbilical cord is cut during birth, the blood supply to the placenta is cut off and the afterbirth is normally expelled within the first 2 hours after birth. If this does not happen, it is referred to as retained placenta. It occurs mainly in twin births, difficult births, and in very old mares. Disruptions in the contractility of the uterus, reduced oxytocin release (oxytocin = hormone produced by the body that causes the uterus to contract) or a disrupted separation of the connection between the uterus and the placenta (e.g. due to water retention or inflammation of the uterine lining) prevent the natural expulsion of the afterbirth.

Diagnosis and symptoms

Retained placenta is usually easy to recognize, as remnants or the entire placenta hang out of the mare's vagina. Under no circumstances should you try to pull it out, as it can easily tear, making further treatment much more difficult due to injuries and remnants remaining in the uterus, and can also significantly worsen the prognosis for the mare. Hanging parts of the afterbirth should be tied up so that the mare does not accidentally step on them and tear them off.

If only remnants of the afterbirth remain in the uterus and no protruding parts are visible, the veterinarian can perform a manual examination of the uterus. However, very small remnants located in the tips of the uterine horns are often not palpable. The afterbirth that has already been expelled should therefore always be checked for completeness.

If mares show fever, apathy, loss of appetite, or signs of laminitis shortly after giving birth, it can be assumed that remnants of the placenta or the egg membranes have remained in the uterus. In such cases, intensive antibiotic and anti-inflammatory treatment should be initiated immediately by a veterinarian.

Mare with foal
Retained placenta poses a major health problem for mares
Complications

If the afterbirth has not been expelled two hours after birth, treatment should be started, as the risk of complications increases rapidly with time. In many cases, germs enter the uterus through the retained placenta, where they multiply explosively and can lead to severe inflammation. Such an infection must therefore be treated as quickly as possible. If left untreated, it can quickly lead to life-threatening sepsis (the spread of pathogens in the blood).

The greatest danger of such septic uterine inflammation is laminitis, in this case referred to as puerperal laminitis. This laminitis is caused by toxins that are produced during the decomposition process of the dead tissue and bacteria.

Therapy

The aim of treatment is to support the process of detaching the afterbirth from the uterus. The veterinarian will use special medication for this purpose. If the detachment process is prolonged despite medication, repeated uterine irrigation is usually necessary to support the process and prevent infection. In this case, it is advisable to take the mare to an animal hospital for inpatient treatment.

If vaccination protection against tetanus is unclear or insufficient, adequate tetanus prophylaxis must be considered.

Prophylaxis

Particularly after difficult births or twin births, postpartum retention can be prevented by administering special infusions and medication.