Üç köpekte doğum sırasında ve hemen sonrasında görülen uterus prolapsusu: olgu sunumları ve literatür derlemesi

Abstract

Köpeklerde uterus prolapsusu (UPR) nadir görülen bir obstetrik acil durumdur. Genellikle köpeklerde doğumdan sonraki 48 saat içinde meydana gelir. Bu veriye zıt olarak sunulan raporda ikisi doğum sırasında ve biri postpartum 40. günde şekillenen üç UPR olgusu bildirilmiştir. Doğum sırasında şekillenen olgulardan bir tanesi uterus rupturu ile komplike olarak gelişmiştir. Kesin bir etiyolojisi olmasa da başlıca neden pelvik bağ dokularının zayıflığı gibi görünmektedir. UPR'ye katkıda bulunan faktörler arasında pelvik bağların aşırı gevşemesi, güç doğum ve aşırı zorlanma yer alır. Esas olarak kolajen ve elastinden oluşan ekstraselüler matriks (ECM) doku bütünlüğünün korunmasında çok önemlidir. Östrojen, progesteron ve relaksin gibi hormonlar, gebelik ve doğum sırasında ECM'nin yapısını önemli ölçüde etkileyerek pelvik elastikiyetini ve uterus gücünü değiştirir. Ayrıca, olgularımız zayıf vücut kondisyonu, doğum sayısı, yaş ve cins yatkınlığının da predispoze faktörler arasında olabileceğinden şüphelendirmiştir. Tüm hayvanlar cerrahi olarak tedavi edilmiştir ve elle prolabe kitle reddenin küçük ırklarda işe yaramadığı ancak büyük ırklarda bir şans yarattığı belirlenmiştir. Üç vaka da anne ve/veya yavruların zamanında ve uygun cerrahi müdahale ile kurtarılabilmiştir. Hem sağ kalım hem de korunma açısından ovariohisterektominin en iyi tedavi seçeneği olduğu görüşüne de ulaşılmıştır. Ancak bu raporda öne sürülen hem birincil faktörleri hem de yardımcı faktörleri net bir şekilde tanımlayabilmek için daha fazla araştırma yapılması gerekmektedir.

Keywords

• Köpek
• Uterus Prolapsusu
• Doğum

Uterine prolapse observed during and immediately after parturition in three dogs: case report and literature review

Abstract

Uterine prolapse (UPR) in bitches is a rare obstetric emergency. Generally, it occurs within 48 hours postpartum in bitches. Opposite this datum, in this case report three instances of UPR presented as two during parturition and one at 40 days postpartum. Besides one of them, which occurred during labor, was complicated by uterine rupture. Although no definitive etiology has been determined, it seems that the leading cause is weakness in pelvic connective tissues. Factors contributing to UPR include excessive relaxation of pelvic ligaments, difficult labor, and excessive straining. The extracellular matrix (ECM), composed mainly of collagen and elastin, is crucial in maintaining tissue integrity. Hormones like estrogen, progesterone, and relaxin significantly affect the ECM’s structure during pregnancy and parturition, influencing pelvic elasticity and uterine strength. Besides, our cases showed that poor body condition, parity, age, and breed predisposition are also suspected as contributing factors. All the animals were treated by surgery. Three cases show mothers and/or puppies may survive with timely and appropriate surgery. Besides, we believe that ovariohysterectomy is the best treatment choice with both survivor and prevention effects. However, to clearly define both the primary factors and co-factors speculated by this report, further research is required to investigate.

Keywords

• Dog
• Uterine Prolapse
• Parturition

Ethical Statement

This work involved the use of non-experimental animal only. Established internationally recognized high standards of individual veterinary clinical patient care were followed. Ethical approval from a committee was therefore not necessarily required.

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