AGO1018_REDVET
Foetal maceration associated with Brucella ovis infection in a Yankassa ewe
Abstract
A ewe considered to have been pregnant but later observed to have persistent vaginal
discharge and deteriorating body condition was presented to the Ahmadu Bello
University Veterinary Teaching Hospital Zaria, Nigeria. The ewe died before a complete
physical examination was carried out and commencement of therapy. At postmortem, the
greatly asymmetric gravid uterus cut open had retained foetal bones and well – developed
freshly - looking caruncles and lots of pus. The ipsilateral ovary of the pregnant horn had
a corpus luteum (CL). Direct microscopic examination of uterine sample revealed
microorganisms suggestive of Brucella organism; and subsequent culture of same
confirmed the presence of Brucella ovis.
The foetal death and/or maceration were
therefore believed to be associated with the Brucella ovis infection.
Introduction
1
In domestic animals, pregnancy loss may occur at any stage of gestation (1). The loss
may be associated with expulsion of the dead foetus before term (abortion) or of a fully
developed but dead fetus at term (stillbirth). Sometimes, there is the failure of an aborting
foetus to be expelled due perhaps to uterine inertia and intrauterine infections resulting in
foetal emphysema and maceration (2). Under the circumstance, bacteria enter the dilated
cervix and by a combination of putrefaction and autolysis the soft tissues are digested,
leaving a mass of foetal bones within the uterus (3, 4). These bones may be embedded
within the uterine wall (5, 1) resulting in a chronic endometritis and severe damage to the
endometrium (5).
Foetal maceration can occur in any species, but it has been most frequently reported in
cattle (1). The condition has been reported in cows (4), mares (6), dogs (7, 1), cats (8),
and women (9, 10). Only few cases of foetal maceration have been reported in ewes (11,
12); and in Nigeria, to the best of the knowledge of the researchers, foetal maceration has
not been previously reported in the ewe. This report is therefore a documentation of this
condition in a ewe which was associated with Brucella ovis.
Case History
A ewe was presented to the Ahmadu Bello University Veterinary Teaching Hospital
Zaria with the complaint of persistent vaginal discharge and unthriftness condition. The
ewe was reported to have been pregnant prior to the development of this condition. On
physical examination, the vital parameters of temperature, respiratory rate and pulse were
normal. Scanty foul – smelling vaginal discharges were seen. The ewe occasionally
strained and her physical body condition was poor. Before the completion of physical
2
examination and commencement of therapy, the ewe died. At postmortem, there was a
greatly asymmetric gravid uterus with single pregnancy in the right horn (Figure 1). The
uterus was cut open and retained foetal bones and well – developed freshly - looking
caruncles were seen (Figure 2). A lot of pus material was present in the uterus. The
ipsilateral ovary of the pregnant horn had a corpus luteum (CL). An aseptic uterine swab
was taken. Direct microscopic examination of the sample revealed microorganisms
suggestive of Brucella organisms; and subsequent culture confirmed the presence of
Brucella ovis.
3
Figure 1: See attachment
4
Figure 2: See attachment
Discussion
Foetal maceration, together with foetal mummification, are considered an overall
abortion syndrome rather than separate and distinct entities, the main characteristic being
that the dead foetus remains in the uterus requiring veterinary intervention for removal
(5). When foetal death is accompanied by loss of corpus luteum, opening of the cervix
and entry of autolytic and other bacteria, there is foetal decay in the uterus, and its soft
tissues broken down and passed as a foul vaginal discharge. In most cases, the bones are
too large to be passed out and are therefore retained within the abdomen naturally
preventing subsequent conception (13). The condition can occur in full term fetuses that
fail to leave the uterus and this occurs especially in sows (13).
The retention of foetal bones in utero or in the vagina has been reported in cows (4),
mares (6), dogs (7, 1), cats (8), and women (9, 10). In the ewe, few cases have been
reported (11, 12). The incidence of foetal maceration in ewes is considered to be as low
5
as 0.13 – 1.8% (14). In Nigeria, foetal maceration has not probably been reported in the
ewe before, and thus this report may be the first to be so reported.
The clinical signs seen in foetal maceration include foul – smelling vaginal discharge in
animals that were thought to be pregnant, sharp bones in the uterus or protruding from the
cervix during rectal palpation (13), and can be used for the diagnosis of the condition.
The observation of scanty foul – smelling vaginal discharge in this case is thus in
agreement with the above observation. The presence of pus material seen in the uterus in
this case is also in agreement with the finding of Halat et al. (11). Foetal maceration is
usually associated with the loss of CL (13). In this case however, just as reported by
Halat et al. (11), there was the retention of CL.
The diagnosis of this condition was as a result of the observation of foetal bones, in the
uterus, asymmetry of the uterus, presence of caruncles. In live animals, the condition can
be detected by ultrasonography and X – ray radiography (13, 1), and the by rectal
palpation especially in large animals.
In the literature, non – specific bacteria including E.coli, streptococci, Proteus and
Pseudomonas have been associated with the foetal maceration (15). In this case, the
isolation of Brucella ovis means that either the B. ovis was in itself the cause of both the
abortion and maceration or an earlier abortion due to some other cause took place with
the entry of the organism to cause the maceration. B. ovis is associated with ovine
abortion, even though the incidence of abortion due to this organism is low (14). Due to
6
the zoonotic significance of brucellosis (16), the handling of aborting animals and their
discharges due to this organism should be done with the utmost care and precaution.
Abortions usually occur the last trimester of pregnancy. The prognosis for future fertility
and reproductive life of the affected animal is guarded.
It is possible that there are cases of foetal maceration in ewes and other livestock in the
area which go unnoticed or undiagnosed. It is therefore suggested that veterinarians pay
more attention to the possibility of this infertility condition in our livestock.
Acknowledgments
The authors are thankful to the client for reporting this case, and the management of the
Ahmadu Bello University Veterinary Teaching Hospital, Zaria Nigeria, for allowing the
publication of this case report.
References
1. Serin, G. and Parin, U. (2009). Recurrent vaginal discharge causing by foetal
bones in a bitch: a case report. Veterinarni Medicina, 54(6), 287 – 290.
2. Johnston, S. D., Kusritz, M. V. R., Olson, P. N. S. (2001): Canine Pregnancy.
In: Johnston, S. D. (ed.): Canine and Feline Theriogenology, W. B. Saunders,
Philadelphia. pp. 88.
3. Jones, T. J., Hunt, R. D., King, N. W. (1997): Genital System. In: Veterinary
Pathology. Lippincott Williams and Wilkins, Baltimore, 1149 - 1222.
4. Drost, M. (2007): Complication during gestation in the cow. Theriogenology, 68,
487 – 491.
5. Noakes, D. E., Parkinson, T. J., England, G. C. W. (2001): Abnormal
development of the conceptus and its consequences. In: Arthur’s Veterinary
Reproduction and Obstetrics. W. B. Saunders, Philadelphia. Pp138.
7
6. Burns, T. E., Card, C. (2000): Foetal maceration and retention of fetal bones in a
mare. Journal of American Veterinary Medical Association, 217, 878 – 880.
7. Gonzales – Dominguez, M. S., Maldonando – Estrada, J. G. (2006): Prolonged
pregnancy associated to an imappropriate medroxiprogesterone acetate
prescription in a bitch: Is rational and ethics the use of exogenous progestin in the
bitch? Revista Colombiana de Ciencias Pecaarias, 19, 442 – 450.
8. Nicastro, A., Walshaw, R. (2007): Chronic vaginitis associated with vaginal
foreign bodies in a cat. Journal of American Animal Hospital Association, 43, 352
– 355.
9. Graham, O., Cheng, L. C. and Parssons, J. H. (2000): The ultrasound diagnosis of
retained fetal bones in West African patients complaining of infertility. An
International Journal of Obstetrics and Gynaecology, 107, 122 – 124.
10. Samraj, S., Crawford, S., Singh, N., Patel, R., Rowen, D. (2008): An unusual case
of pelvic pain: retention of fetal bone after abortion. International Journal of STD
& AIDS, 19, 353 – 354.
11. Hailat, N. Q., Lafi, S. Q., Al – Darraji, A., Al – Ani, F., Fathalla, M. (1997):
Ovine foetal maceration. Small Ruminant Research, 25(1), 89 – 91.
12. Ortega – Pacheco, A. (1997): Maceracion fetal espontanea en una borrega:
hallazgos ultrasonicos y cambios plasmaticos en protein especifica de la prenez
ovina B y Progesterona. Rev. Biomed, 8, 33 – 36.
13. Jackson, P. G. G. (2004): Handbook of Veterinary Obstetrics. 2nd ed. Saunders,
Edinburgh. pp. 17 – 18.
14. Roberts, S. J. (1971): Veterinary Obstetrics and Genital Diseases
(Theriogenology). 2nd Ed. Published by The Author, Ithaca, New York. Pp. 298 299
15. England, G. (1998): Pregnancy diagnosis, abnormalities of pregnancy and
pregnancy termination. In: England, G. and Harvey, M. (eds.): Manual of Small
Animal Reproduction and Neonatology. BVSA Manuals, Hampshire, 118 – 119.
16. Gul, S. T. and Khan, A. (2007): Epidemiology and epizootiology of brucellosis: A
review. Pakistan Veterinary Journal, 27(3), 145 – 151.
8
9