Bovine Uterine Prolapse Study Guide

Overview and Clinical Importance

Uterine prolapse (prolapsus uteri) is a sporadic but life-threatening postpartum emergency in cattle characterized by complete eversion of the uterus through the cervix and vagina, resulting in its protrusion outside the body. The condition occurs most commonly within hours of calving when the cervix is still dilated and the uterus lacks tone. Without prompt veterinary intervention, affected cows are at significant risk of hypovolemic shock, hemorrhage, and death. Uterine prolapse represents a true veterinary emergency with reported incidence rates of 0.002% to 1% of calvings, with higher prevalence in beef cattle (1%) compared to dairy cattle (0.6%).

Etiology and Pathophysiology

Uterine prolapse occurs when the uterus undergoes complete eversion through the open cervix immediately following or within several hours of parturition. The pathophysiology involves loss of myometrial tone combined with continued straining (tenesmus), which forces the flaccid uterus through the dilated cervix. Unlike vaginal prolapse which occurs prepartum, uterine prolapse is exclusively a postpartum condition.

Predisposing Factors

Clinical Presentation

Characteristic Findings

The clinical presentation of uterine prolapse is distinctive and unmistakable. The prolapsed uterus appears as a large, heavy mass of tissue protruding from the vulva, often hanging below the level of the hocks when the cow is standing. The exposed endometrial surface displays numerous caruncles (discrete, mushroom-shaped structures that served as maternal attachment sites for the placental cotyledons). The presence of caruncles definitively distinguishes uterine prolapse from vaginal prolapse.