Comparison of surgical and medical treatment of 49 postpartum mares with presumptive or confirmed uterine tears.
Authors: Javsicas Laura H, Giguère Steeve, Freeman David E, Rodgerson Dwayne H, Slovis Nathan M
Journal: Veterinary surgery : VS
Summary
# Uterine Tears in Postpartum Mares: Surgical Versus Medical Management Postpartum uterine tears represent a significant complication in equine reproduction, yet optimal treatment remains unclear. Researchers retrospectively analysed 49 mares presenting within seven days of foaling with confirmed or presumptive uterine tears, comparing outcomes between 15 medically managed and 34 surgically treated cases across a 17-year period, with assessment of survival, hospitalisation duration, costs, and subsequent reproductive performance. Overall survival rates were 75%, with no statistically significant difference between medical (73%) and surgical (76%) treatment groups, and similarly no differences detected in admission parameters, hospital stay length, treatment expenses, or likelihood of future conception. Notably, tears occurred significantly more frequently in the right uterine horn compared to other uterine locations (P=.018), whilst non-surviving mares displayed worse prognostic indicators including gastric reflux, elevated heart rate and anion gap, reduced total CO₂, and lower white blood cell counts. These findings suggest medical management may represent a reasonable alternative to surgery in selected cases, though the evidence base does not yet clarify which tear severity thresholds are amenable to conservative treatment, and practitioners should note that medical therapy can incur comparable costs to surgical intervention, necessitating individualised case assessment based on mare stability and tear characteristics rather than treatment modality alone.
Read the full abstract on PubMed
Practical Takeaways
- •Medical treatment can be considered as a reasonable alternative to surgery for postpartum uterine tears, achieving similar survival rates—however, the severity threshold for successful medical vs. surgical management remains unclear
- •Monitor for prognostic indicators of poor outcome: gastric reflux, elevated heart rate, metabolic derangements (high anion gap, low CO2), and low leukocyte counts may identify mares requiring more aggressive intervention
- •Be aware that right uterine horn tears occur significantly more frequently postpartum; this location-specific risk may guide clinical assessment and surveillance
Key Findings
- •Overall survival rate was 75% with no significant difference between medical (73%) and surgical (76%) treatment groups
- •Uterine tears were significantly more likely to occur in the right uterine horn (P=.018) than other uterine locations
- •Nonsurvivors had significantly higher heart rates, anion gaps, gastric reflux, and lower total CO2 and leukocyte counts compared to survivors
- •Medical and surgical treatment groups had similar hospital stay duration, treatment costs, and post-discharge breeding performance