Bovine uterine torsion: current insights and clinical perspectives

Abstract

Bovine uterine torsion is an obstetrical emergency that affects dairy cattle and buffaloes and contributes substantially to maternal and fetal mortality. Gravid uterus rotates on its longitudinal axis (often > 180°) during the late first stage of parturition or early second stage; however, pre or postpartum occurrence is also possible. Etiopathogenesis is multifactorial, involving maternal anatomical predispositions (e.g. short and ventrolateral attachment of broad ligaments, multiparity, and environmental factors), whereas fetal characteristics include weight, position, and movement. Clinical diagnosis involves transrectal and vaginal examination; recent advances in ultrasonography and Doppler imaging (visualization of placental perfusion, uterine wall integrity, and fetal viability) have enhanced diagnostic accuracy. Severe torsion compromises uterine vascularity, resulting in ischemia, degeneration, and fetal death if untreated. Histopathological evaluations have revealed substantial alterations including necrosis, adhesion formation, reduced placental expression of estrogen receptors and vascular endothelial growth factor. Clinical management includes rolling techniques (modified Schaffer’s method) for early or mild torsion and laparotomy or cesarian surgery for advanced cases. Prognosis depends on the degree and duration of torsion and the presence of complications (e.g. adhesions or endotoxemia).