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NAVC Conference 2015
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vesicles that may have been too small or otherwise
escaped notice during the first examination.
Twinning
Anecdotally among seasoned practitioners, the
incidence of twins seems to be rising, perhaps due to
good management keeping those mares in the gene
pool and ovulatory agents perhaps leading to a higher
incidence of double ovulation. Numerous methods for
twin management are available, including manual
reduction, nutrient restriction, transvaginal ultrasoundguided
reduction,
craniocervical
dislocation,
transabdominal ultrasound guided reduction, and
prostaglandin F2D. Manual twin reduction prior to 17
days gestation is commonly performed and can be very
successful. Twin reduction in mares >9 years of age had
a higher incidence of pregnancy loss than age-matched
controls.9
Fetal Sexing
Although clients enjoy positive pregnancy evaluations,
fetal sexing and the associated fetal examination tend to
be crowd pleasers. Fetal sexing around 60 to 68 days
gestation, looking for the genital tubercle and performed
with transrectal ultrasonography by a skilled examiner,
can be >90% accurate. In a colt, the hyperechoic genital
tubercle can be visualized caudal to the umbilicus on the
ventral midline. In a filly, the genital tubercle is visualized
below the tail head and above the cross section of tibias
in a transverse plane of the fetus. Gonadal echogenicity
can also be used to support the findings. A second
window for transrectal ultrasonographic fetal sexing is
around 110 to 120 days of gestation when the genitalia
can be viewed. In a colt, the sheath and penis can be
visualized caudal to the umbilicus. In a filly, the teats of
the developing mammary gland are often the most
pronounced structures. Other more sophisticated and
less available methods of sex determination include sex
sorting of sperm prior to breeding, embryo biopsy for sex
determination, 3D ultrasonography and perhaps
identification of circulating cell-free fetal DNA in maternal
blood though this requires additional research.10,11
PREGNANCY
Maximum mobility of the conceptus is noted days 11
to 14, with fixation at day 16.12 This is considered the
result of increased uterine tone and an increased size of
the conceptus. Fixation usually occurs at the base of one
of the uterine horns.13,14 The migration of the equine
conceptus throughout the uterine lumen is suggested
necessary to distribute the unknown anti-luteolytic factor
over the entire surface of the endometrium to inhibit
luteolyis. Inability to contact the entire endometrium
causes failure of pregnancy establishment15 due to
luteolysis and loss of progesterone.
Once pregnancy has been established a hyperplastic
phase of embryonic and early fetal development occurs,
with tissues and organs undergoing rapid increase in cell
number following previous differentiation into developing
organs and tissues. Increasing size of the placenta to
contact the entire endometrial surface allows sufficient
nutrient absorption to fuel further growth. From day 40
the myometrium loses tone and the conceptus
elongates, with the allantochorion invading the entirety of
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