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Wolfgang Kahn

Veterinary Reproductive
Ultrasonography
Horse Cattle Sheep Goat
Pig Dog Cat
English Translation and Revision
Dietrich Volkmann Robert Kenney
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by Dr.Stator & Saraajka
,
,
I
I
I
Wolfgang Kahn
VETERINARY REPRODUCTIVE
ULTRASONOGRAPHY
Horse CaltJe
Sheep Goat Pig
Dog Cal
Th.l._ one
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by Dr.Stator & Saraajka
VETE NAltY
PRODUCTIVE
I J I Til ASONOGIl APHY
Horse Cattle
Sheep Goat Pig
Dog Cat
Dr Wolfgang Kahn
Ellglish Trallslatioll alld Revisiol1
Professor Dietrich Volkmann
College of Veterinary Medicine
Cornell University, USA
Professor Robert M Kenney
School of Veterinary Meclicine
University of Pennsylvania, USA
schlutersche
Avk:lrSko L a s ~ tellO gradivo
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by Dr.Stator & Saraajka
Wolfgang Kahn. Dr. Dr. habil.
Professor
Cli nic of Reproductive Medicine. Veterinary Facuhy
Uni versi ty of ZUrich. Switzerland
English Translation and Revision
Robert M Kenney. DVM, PhD
Professor
School of Veterinary Medicine
University of Pennsylvania. USA
Dietrich Volkmann, BVSc. MMed Vet (Gyn)
Associate Professor
College of Veterinary Medicine
Cornell University. USA
0 2004. SchlUtersche Verlagsgesellschaft mbH & Co. KG, HansBOc:klcrAllee 7, 30173 Hannover
E-mail: info@schluetersche.de
Printed in Germany
ISBN 3-89993-005-3
Special edi tion. Reprint from 1994.
Bibliographic Inronnallon published by Die DeutKbe Blbllothck
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available in the Intemetllt http://dnb.ddb.de.
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shall not be held responsible for any damages that might be incurred by the recommended use of drugs or dosages con-
tained within this textbook. In many cases controlled research concerning the use of a given drug in animals is lacking.
This book makes no attempt 10 validnle claims made by nuthors of reports for off-label use of drugs. Practitioners are
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Contents
Preface 10 fi rsl edit jon
Preface 10 current cdilj on
J
1.1
J 2
1.2.1
Ultrasono in the mare ............................................................................................. .
Techni ue of ultrason in the mare

Ovarian slOIct ures in the mare "" """ "" . " " """ "" """ " """ "". "". """""" " "" " " " " .
Eollicies .. ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,, ,,,,,,,,,,, ,,, ,,,,,,,,,,,,,,""""""""''''''''''''''''''' ,",
,'".,2, .,',.,', ______________ ,So ,',0, es of follicles ......................................................... ............................. .
:'".,2, .,',.,2, _______________ ,Dcve "",,', follicles ..........................................................................
:'".:2, .,',.,3, ___________ " __ .T" m, ,osv , c,a, inal son uncture of follicles ............................................................. .
1.2.2 lutea ......................................................................................................................... .
:'".,2, .,2 ".,', ______________ , SO " . hie ima es of co fa lutca ............................................................................ .
1.2.2.2 Dcvelopmcni of corpora IUl ea during the estrous cycle and in earty pregnan9' h .. h, .. .
1.2.3 Anovulato luteinized follicles ............................................................................................. .
124
1.2.5
1.3
1.3.1
1.3.2
1.3.2.1
1.3.2.2
1.3.2.3
1.3.2.4
1.3.2.5
Fallio d!!r a nd ovarian he malOmas
Ovarian tumors and IS .............................................. ........................................................ .
l llenne Slruct ures in I be mare"", ,"' ", ,,,,, W h ." "h'" ""." ,,, . ,,, , ,,,, ., "" ' ",,, "' ,,, . ,",, . ,', . ,,, .,"",,, " "",
ant uterus . " "" ... ".""" .. h .. " ..... "" .. ",,, .... ,, .. ,," ........ ,,h" ........ ,, ..... "h" .. "" ... h".
ant uterus ..... " ..... " .... " ............ " .......................... " ..................... , ..... , ........................... .
Da
Da
Da
Da
9 to l 30f
14t0200f
21 to 40 of
.. " ............. " ...... " ... " " .. " ...... " ...... " ...... " .... " " ........................ ..
...... " .............. " ..... " .... " ............... h .. "" .... " ....... " .. " .. " ...... ",,.
..................... " ...... " ... "."h" .. h" .... h."" ... " ..... " ... h" .. "" .... ""
.. " ................................. , ..... , .................... ' .. , .................... " ... .



1.3.3. 1.1 Head, neck and inal column ................ " ...... " .... " ............. " ................... " ........... ..
1.3.3.1 .2 lborax nnd heart "' ..... " .. ".; ......................... "' .......... "'''' " ... '" ' ..... " ... " .. ""'. " .... "' ... .
1.3.3.1.3 Abdomen and lvic re on ....... " ..... " ..... " .... " .... " ................................................. .
1.3.3.2 Accessibili of e uine fetuses lransrcctal son .. " ............. " ..... , " .. "" , ... " .. " ..... "".
felomel in horse.c; ................... " ..... " ..... " ..... " ........................... " ................... .
_____________ and braincase ........ " ................... " ........... " ..... " .................... " " .... " ... " ...... " ............ ..
1.3.3.3. 2 Ribs, trunk and stomach."" ... "" .. ,.""""",,,,,,,.,,,,,,,,.,,,, ... ,.,, .... " .. " ... , .... " .. " .. " .. " .. " ...... ,.


1.3.4.2 ......................... " ........................ " ............... , ..... , ...... , , ..... , ............. .



.. ..

..

.. ..

..
"

.. ..

" " "
"

"

1.3.4,5 muco- and urometra .. " .................................. " ................... " .... " .... " .................... ..
_____ , _____ ,c __ .E " 0,d,,0, m ,,e,,',n",ai " IS", .. "" ... "" .... ",.".", ... ",., ... ", .... ", ... ," ... "",.""", .. "", ... ", ...... , .... "",."""
reface., .. , .. ",.,. , ... ,., ................... ,.,." , ..... , ................. , ... ,'.,.,." .... " ... , .. , .. ,., .. " .. ",, .. ", .. , .. , .... "", .... ,."
2
2.1
22
2 2 J
2.2.1.1

Ultrasono in the cow ... " ..... " ... " ... "hh .. " .. .... .. ...... ..... "" .. """ .. "" . .... " .... " ..... """ .. ""
Teehni ue of ultrason in the caw ............. " ..... " ............................................................. .
Ovarian Slmctllres in tbe rIl!.V " " """, " . " " . " . " "
Follicles
Sooo es of follicles " ............... " ..... " .. " ..... " .. h." "" ......... ", ".". "h ..... """ .. ""
"
"
15
15
'5
' 9
23
25
25
27
33
35
37
41
4'
43
43
43
49
5'
53
6'
61
63
65
65
65
67
7'
5
77
79
80
83
83
89
89
89
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by Dr.Stator & Saraajka
2.2.1.2
22 13
2.2.2
23
2.3. 1
Co
Follicular developmem during the estrous cycle
and in earl
Estrous foll jcles
...................................... ...............................................................
ra IUlea ......................................................................................................................... .

.. ..
IUlea during the estrous 9'cle and in early pregnancy ................................................. ...
.. .. ..

..
I llerine Slnldures in the CCttN
..................................................................................................... .........
.. .. .. .. ..
.. . .
2.3.2.2 Day 21 to 24 of pregnancy ..................................................................... ............. ......... ...
____ 25 to 30 of
2.3.2.4 Da 31 to 400f
..............................................................................................
............................................................................................
2 "."' 3.,, 25 "'--____ -' D"' a 41 to 90 of re nan ....................................................................... ....... .... ......... ...
2.3.2.6 2nd and 3rd trimester of pregnancy ......................................... ............. ......................... .
2.3.2.7 Twin and multi Ie nanctes ...................................................................................... .
2.3.3 Uterine ........................................................................................................... ........
2.3.3. 1 ok death

23.3.2
2.3.3.3
2.3.3.4
2.3.35
2.3.3.6
Eetal mummification .. .. .. . .. .. ..
Ectal macemtion ... .. . .... .. . .... .... .. . .... .. . .. . .. . .. . .. . ..
Po.<'
artum uterus
Endometriti s
..... ... ...... .... .. .... .... .. ...................... ........ ...............................................
.. . .. . .... .. . .. .. .. .. .. ..
-ometra ......................................................................................................................... .
2.4
2.4. 1
2.4. !.I
Ultral;Qnography of the bovine fetus ........................................................................................... .
2.4.1.2
2.4.1 .3
2.4.1.4
2.4.1.5
2.4.1 6
2.4. 1.7
2 41 8
2.4.1.9
2.4.2
2.4.3. 1
2.4.4.2
2.4.4.3
2.4.4.4
References to cha
Imaging of fetal organs .......................................................................................................... .
Head ... ... " ......... . ... .... .. ................... ............... . " ................... .... ... .... " .... .. " .. .. " ..... . " ... .
Spinal col umn ................................................................................................................ ..
Neck ... .................. ...... ........... ............. ............. ................. ....... ................... "" ..... .......... ...
Thorall ..... ..... ...... ...... .. ...... .. " ........ ..... ............. .. " ................ .... ....... . .... ... . . ... " ... .... .... ... . .

Abdomen . " ... . " .. " ... ......... .. .. .. .. ... " .... " ........ " .... .... .... .... .. . .... .. . .. .
Pelvis ... "
" .. .
.......... .. . .. .. .. .. . . . .. ..... .... .... .... .... .... . .. . .. . .. . .. . ...
From limb ....... ...... ......... .. " ............. ............. ... .. ... . ..... " . .. ...... . .... .. .
"" .
. ... .. " .. .. ....... .
.. "
Hind limb
Umbilical cord amnion and allantois

Sex dctcnnjoarjon jn the bovine fetll S .. . .... . .... " .... . ........ . .... ... " .... " ..... .... .... . ............
.. .. .. .. .. ..
and their intraulerine rcsemations durin .......................................................
arts ........................... ....................... .. ...... .......................... .. .
.. .. .. .. .. .. .. .. .. ..
.. .. ..

.. .. .. .. .. .. ..
.. .. .. .. .. .. ..

.. .. ..
Heart frequcn9'. crown-rump-Iength, diameters of
stomach trunk JOCrOtum and umbilical cord ................................. " ...... ............ .. . ....
Cervical. thoracic, lumbar, coccygeal vertebrae and ribs .............................................. .
FroD! and bind limbs ..... ...... ..................... .... ................... ..... ... ... ................... ....... .... ..... ..
ter2 ......................................................................................................................................
93
9S
95
103
113
113
121
123
127
129
133
135
137
137
117
137
139
) 41
141
143
143
145
153
157
157
159
163
163
165
169
173
J73
179
181
184
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3.1
3. 1.1
3.1.2
3.3.2.3
3.3.2.4
3.3.2.5
3.3.3

Techni ue of ultrasono c:I<I l.'I
Transcutaneoll.'I son ............ ,." ........................ -.-...................................................
Transrectal son




.

.

.

Oa)'4O lo lOOofpregnancy ............. ....... ....................................................................... .
Day 100 to 150 ofprcgnancy ......................................................................................... .
Accuracy of sonographic pregnancy diagnosis ...............................................................
Uterine thol ... .................................. ..............................................................................
References to cha te r 3 ......................................................... ............................................................................. .
4 Ultrasono

........................................................................... ..............................




..





cysts ........................................................................ .................................................. .
187
187
189
201
205
207
209
210
213
4.3 Uterine structures in .... .......................................................................................................... 219
_____________ ,N:eo""' - : a "", ' " ."I,e, ,,, , , ,', .".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,.,.,.".,.,.,.,.".,. ____
4.3.2 Pre ant uterus...................................................................................................................... 219
4.3.2. 1 ............................................................................................ 219
5. 1
5.3.1.5
5.3. 1.6
Sub'ect index

...............................................................


a"d
cats ...........................................................................

. .
.


.


.............................................................................................
Obstet ric diagnostics ...................................................................................................... . .
Postpanum uterus .......................................................................................................... .
.
.
.



.......................................................................................................................................................
227
245
245
253
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Preface to fIrst edition
In 1980 it was reported for the first lime that the
ultrasound imaging system sonogrnphy or B-sean-rcal-
time cchogmphy pcnnittcd a rel iable carll' pregnancy
diagnosis in mares (Palmer and Driancoun). This reo
pon triggered a de'o'elopment during the course of
which sonogr.lphy bcaamc an important 1001 for the
management of reproductive problems.
Si nce then sonography provided signifICant contribu-
tions to our better understandi ng of the carty embryonic
phase and has contri buted significantly to new discov-
cries concerning the function of the uterus and ovaries
(Chevalier and Palmer 1982. Ginther 1983. Gint her
and Pierson 1984).
Veterinary sonography has gained significant value
in the gynecological examination of mares. In contrast
to traditional methods. ult rasonography permits a much
earlier and more accurate diagnosis of pregnancy and
provides rel evant practical information about many
other conditions of the genital trdct (Si mpson et a\.
1982. Valan et al. 1982. l..eidl and Kiihn 1984, Kahn
and l..eidl 1987).
Today ultrdsonography is applicd in the reproduc-
tive and obstetrical examination of numerous other spe-
cies. Initial publications have appeared on virtually all
domestic species. II has been shown that sonography
can be applied "''Cry successfully in the diagnostic v.'Ork-
up on the bovine utcm" and ovary (Chaffaux et al. J 982,
Pierson and Ginther 1984 a and b, Reeves et al. 1984,
Kiihn 1985, Taveme et aI. 1985, White et aI. 1985). In
countries where sheep and goots are bred intensively,
ultrasonography spread surprisingJy rapidJy as a means
of diagnosing pregnancy and cstablishing fetal numbers
(Tainturier et al. 1983 a and b, De Bois and Ta\'Cme
1984. Fowler and Wilkins 1984, White et al. 1984). In
the pig ultrasonography is also very useful in diagnosing
pregnancy (Inaba et al. 1983, Botero et al. 1984, lrie ct
al. 1984). In the bitch and queen it is used to diagnose
pregnancy at a much earlier stage than is possible by any
other method (Mailhae et al. 1980, Boulet 1982, Laiblin
et al. 1982. Legrand et a\. 1982). In obstetrical cases
fetal viabili ty can be detcrmincd allowing a more ra-
tional decision to be made whcn choosing betwecn
mediad or surgical interventions. Also in othcr vet
erinary discipli nes thc application of ultrasonography is
gaining more importance.
It is thus becoming apparent that ultrasound diag-
nostics in veterinary medicine may experience the same
kind of dC\'CIopment as it has in human medicine where
it was first applied in gynecology at the end of the fifties
(Donald et al. 1958) lind since then has expanded into
vi rtually all fields of diagnostics.
Alt hough the technique currently only stands at the
beginning of its development in veterinary medicine it is
ObVKH.L" that ultrasound imaging provides a valuable ad-
ditional diagnostic tcchnique in gynecological and 0b-
stetrical examinations. In the few years of its application
this tcchnique has already providcd several new indica-
tions for diagnostic examinations in normal and patho-
logical conditions of the genital tract of domest ic ani-
mals. When compared to conventional methods the
diagnostic accuracy has improved significantly. too.
The sonographic progress provided the stimulus for
writing this book so as to ill ustrate the possibilities and
li mitations of the application of ultrasonogmphy to the
examination of the reproduct ive systems in horses, cat-
tle, sheep, gool.., pigs, dogs and cats.
I thank my teacher and mentor, Professor Dr. DDr.
he W. Leidl, for his support and creative guidance of my
scientific studies over many years. His influence has
been a significam factor in the development of Ihis
book.
I wish to thank the following people for kindly
providing illustrations and contributions to this book:
Dr. C. Bouabid, Dr. J. Fraunholz, Dr. B. Kahn, Dr. T.
Pyczak and Dr. K.. Will.
I acknowledge the work of the staff of Schlutersche
in the production of this edi tion.
Kaufungen, June 1994 WOLFGANG KAl iN
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Preface to current edition
In 1994, when the firs t edition of Veterinary Repro-
ducti ve Ultrnsonogrnphy was publi shed. ultrasound ima-
ging was considered to be just a supplementary diagno-
sti c 100\. The technique was nOI widely used althal time
and was orten only employed when more convcnlional
diagnostic 1001s were considered to be inadequllte. In the
meantime. diagnostic medical sonography has advanced
to being II basic 1001 used in a variety of physiological
and pathological reproducti ve conditions in the horse.
cow. small rumi nantS. pig. dog and cat. Ultrasound ima-
ging has found its way inlo routine veterinary practise for
early pregnancy recognition in domest ic animal s. for
improved ovarian diagnosis. and for II better detection of
pathological changes in the uterus.
The extensive impiemcnllllion of diagnostic medical
sonography brought with it a great need for specialist
literature and as a consequence, the first edition of this
book was qui ckly sold out. Both veterinary surgeons and
students have frequently requested that it should be
reprinted or a new edi tion published. Looking through
the first edition. it could be recogni sed that the book's
cont ents have remained up-t(}-date. Evcn though there
has been an enormous increase in knowledge about
reproducti ve processes duri ng the more than two decades
of ult rasound imagi ng. the pen.inent basic scienti fic
knowledge had already been included in the first editi on.
and this has retained its validity. Therefore. the publi sher
and author have mutuall y decided to reprint the fi rst edi-
ti on without changing any of its contents.
Zurich. Deccmber 2003 WOLFGANG KAHN
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10 Ultrasollography ill the m(ln!
Flg. 1.1 : Schematic presentation of the tr;msTl.:ctal ultrasono-
graphy of the: uterus and ovaries of a marc.
"' ig. 1.2: DorR1VCntral sagi llul section through the neck of the
urinary bladder (U) of a marc. The bladder lies on the hypcr-
echoic pelvic floor widening as it extends crnnially. The urine
is slightly l'ChQic. Ultrasonogr;lm luken wil h Ii 5 MHz linear
5alnnerl.
t Moo in this \)001; laken in ' ivo. Some phol()-
graplt<i ... -en:: made afler Canning the excised org:tns in a WDleibath
and the Icgt'nds m:ut.ro lK't'OftIingly.
Fig. 1.3: Oor5O\'cntrnl sagitt al section through the body of the
urinary bladder (arrows) of a marc, The urine is int ensely
echoic, UltrdSOnogram taken with a 5 MHz sector .scanner.
elQ radlVo
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Uilf'QU}//ogrtlIHIY in lite marc 11
1 Ultrasonography in the mare
1.1 Technique of
u1trasonogJ aphy in the mare
In mares the uterus and ovaries are examined by
tr.msrcctal ultrasonography. For this pUiposc the ultra-
sound probe is imroduccd into the caudal rectum.
In order to keep the probe hygienic and to protect it
from moist ure it is preferable to pull a plastic slccve
over the probe. The space between the scanning win-
dow of Ihe probe and the plastic sleeve must be filled
with gel 10 exclude any ai r bubbles which cause undesi-
rable reflect ions and thus affect the image quality. It is
not necessary to apply any coupling gel tx:twcen the
plastic sleeve and the rectum, since he rectum's natural
contractility and moist contents both provide favorable
conditions for the exclusion of air betv.'een the probe's
scanning surface and the rectal wall . Many veterinarians
introduce the unprotected probe into the rectum.
The procedure of ultrasound examination of the ute-
rus and ovaries is simil ar to that of a rectal examination
(Fig. I.J). Control and handling of the mare arc also the
same. Before the genital organs are scanned they are
palpated in the usual manner thereby facilitating the
speedy location of the organs and the correct position-
ing of the probe to ensure a swift and accurate examin-
ation. During the leaming period of ultrasound examin
ations it is also helpful to compare the familiar palpable
structures to the "new" images seen on the screen. This
aUows for the recognition and identirlcation of the
geni tal organs and their characteristic ultrasonic pat-
tems.
Feces and fecal ga<; bubbles hinder the transmission
of ultrasound wavcs. The absorption of sound wa\!CS by
fecal mailer lying tx: twcen the probe's scanning window
and the rectal wall will result in the appearance of black
stri pes in the depth of the image, The rectum must
therefore be evacuated and the probe then introduced
through the anus. Thl! probe's scanning window is di-
rected vcntrally while it slides cr.mially along the rectal
floor. During the examination the probe is covered dor-
sally by the examiner's hand and manipulated with the
fingers. With increasing experience it is frequently
possible 10 determine the position of organs nnd the
probe's orientat ion inside the pelvis by recognizing
typical images on the screen. It is usually not necessary
to manually position the organs in preparation for an
ultrasound examination.
The urinary bladder is the f i ~ t ullrasoniC'..a lly striking
organ encountered after passing the probe through the
anus. The neck of the bladder widens over the cr..anial
pelvic edge to join the body of the bladder (Fig. 1.2).
The echogcnicity of mares' urine can vary greatly. The
ultrasonic image varies from almost anechoic to
strongly echoic in the case of very viscous urine
(Fig. 1.3), Turbulently moving reflexions can frequently
be detected inside the bladder's fluid content.
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12 Ultmsonogmph), in tile mUn!
HI . 1.4: section through a uterine hom of a marc.
1lIc peritoneal bordelS are indicated by anu ..... s. Analogous to
the sc..'Ction represented by A in Fig. 1.5.
fig. 1.6: longitudinal section through the uterine body of a
marc equivnlcnt to the section illustrated by B in Fig. 1.5. The
OO/S3J and ventral uterine bordclS arc demarcated by large
arrows. The opposing surfaces of the endometrium form an
echoic line (small 3rf01.\"S).
A
B
fig. 1.5: Schematic presentation of a traflSVCrse section
throogh a uteri ne hom (A) and a longitudinal section through
thc utcrine body (8).
.' Ig. 1.7: Trans\"ersesection through a utcrinc hom (aITO'l'o"S) of
a nonpregnant mare. The uterus is posi tioned ahlJ\1: 3 arched
sacculations of the left dorsal colon. The difference in impcd-
aocc bc",,'cen the intestinal wall and the feces cau...-.e total
rcfkction of the ultrasound \\'lln':S along the echoic saccula
tions of the oolon.
10 ra 0
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After visualization of the urinary bladder the ultra
sound probe is advanced cranially until the uterus ap-
pears on the screen. The probe is placed dorsally on the
uterus at the level of the bifurcation. From here the
ventrally directed probe is rotated laterally along the
uterine hom until the ovary is visualized and then back
to the opposite side to the second ovary. In this manner
the uterine horns are scanned slice by slkc. Each slice
represents a sagittally oriented cross section through the
uterine hom (Fig. 1.4 and 1.5). After the two horns the
uterine body is imaged on the screen. Starting at the bi-
furcation the probe is withdrawn along the midline up
to the level of the cervix. In the process one sees a sagit-
tal longitudinal section of the uterine bexly (Fig. 1.5 and
1.6). During the course of an examination the probe
should be moved rather slowly so as to ensure that the
entire uterine tract as well as the ovaries and their func-
tional structures can be assessed. It is important to be
aware that only a minor rotation of the probe results in
a significant shift of the scanning plane in the depth of
the field. A 30 degree rotation of the probe results in a
5 em movement of the scanning plane at a depth of IO
em. Fast probe movements and motility of the targeted
organs can be additive with the result that important
features are passed too quickJy or even missed.
Organs closely associated with the internal genitalia
can be used as reference points to improve one's topo-
graphical orientation. Very echoic arches in the left ab-
Techlliqlle of IIltrasOIlOgraphy t 3
domen, usually ventral to the left uterine hom, repre-
sent the sacculations of the left dorsal colon. The drastic
change in impedance betv,.een the gut wall and the gas
conlaining feces underneath it cause the total reflection
of the ultrasound waves. The thin wall of the colon thus
appears as a wavy structure of high cchogenicity. The
deeper areas are not reached by enough ultrasound
waves and therefore remain almost tot ally dark. The
bony pelvic floor also presents as a hypcrechoie struc-
ture (Fig. 1.2). It is recognizable as anechoic line caudal
and ventral to the uterus and the urinary bladder.
In addit ion to transrectal ultrasonography, trans-
cutaneous ult rasonography can be applied in mares.
The transcutaneous approach is less established for rou-
line gynecological diagnostics than the transrectal
method. One valuable indicati on is the visualization of
the fetus and its ut erine environment during the second
and third trimesters of pregnancy (ADAMS-BRENDE-
MUEHL and PIPERS 1987). Since the hair on the abdomi-
nal wall prevents the penetration of the ultrasound
waves, the mare's \-entral abdominal hair must be
thoroughly clipped very well before perfonning the
ultrasound examination. The majority of mares tolerate
the transcutaneous examination less well than the trans-
rectal procedure.
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14 U/lr(lSollography ill the ilia"
rel."vt: echo
rnhanccmcnt (E)
$hadows (S)
rag. 1.8: Schematic illuslnttion of the ultrasonogmphy of a
nuid fi llt.'tI \'csicle. A oblique W'd\'1,: impact. b perpendic.
ular wave imp.'1Cl . c tangential wave impact. D - hyper
echoic distal wall, E relalr.'C echo enhllllCCffiCnt , S shad
ow
1.9: Ult rasonogram of an estrous follicle in a man: anaJo..
gous to the schematic representation shown in Fig I.S. C
tangential ...... d\'e cntl)'. D - h)'percchoic distal wall with
specular reflection. E - relative echo enhancc:mcnl. S - shad-
ow
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1.2 Ovarian .II uctures in the mare
1.2.1 Follicles
1.2. 1.1 Sonographk images .rrollieles
. The ultrasonic image of follicles exhibits features
characteristic for fluid filled vesicles.
Some of the components of the image can be rel ated
to the presence of real morphological structures of the
follicle (KAliN and UIDL 1987 b), while some ultrasonic
image patterns typical for follicles are induced by phys-
ical phenomena when ult rasound waves impact onto
vesicles and their fluid contents. They are thus seen as
principal features whieh are referred to a. .. artifacts.
These image components which result from the inter-
action between ultrasound waves and fluid filled ves-
icles frequently do not reflect the presence of actual
tissue components and should be viewed as art ificial
products. An understanding of their origin helps to
a\'Oid misinterpretations and permits proper concl u-
sions about the nature of a vesicle.
When ultrasound waves impact vertically onto a
smooth reflection surface. some waves are reflected
back to the transducer and are depicted as an intense
echo on the screen (Fig 1.8). 1he echogenicity is strong-
est where the ultrasound waves fall perpendicularly
onto the front and baek "''ails of the vesicle (Fig t .9)
which result in specular reflections. In the area where
the ultrasound waves fall obliquely onto the follicle wall
a smal1er amount of the energy is reflected, the remain-
der being deflected away from the transducer and nol
received. At these sites the follicular W'dlJ is less echoic
and thus dllrker. If the sound waves were to fall Db-
Follicles 15
liquely onto a perfectly level border surface they would
all be deflected and no signals ,,"'Ould be received
(HAssLER 1984). Bordering layers in the body are, how-
C\'Cr. irregular and a varying number of sound waves are
always reflected back to the transducer. Where the
sound waves hit the follicular wallo; at a tangent, they are
largely deflected (Fig 1.8 and 1.9) wi th hardly any echo
signals reaching the probe from such sites. Very few
sound waves continue to progress in a straight line from
these si tes into deeper tissues. The vast bulk of the
ultrasound energy is dellected laterally from here. The
result is that narrow. sometimes slightly widening, echo
shadows fonn below such areas of tangential ..'iOund
wave impact
Amplified echoes or brighter images arc seen behind
larger fluid filled vesicles (Fig 1.8 and 1.9). Ult rll<iQund
is much less attenuatcd by fluid thiln by ot her body tis-
sues. When sound wa,'CS penetrate larger fluid bodies
they reach the deeper lyi ng tissues with more energy
and cast a much more intense l'Cho than neighboring
waves thilt folloYt'cd a longer path through layers of tis-
sue with more wave absorbency. Also on its p.1th back
towards the transducer the reflected ult rasound penet-
rating through fluid looses less energy :md is ilbsorbed
to a lesser extent. This creates the impression of an
echogenkity behind a fluid filled vesiclc. the so C".lIled
enhancement artifact. The width of the enhancement
area is detennincd by the diameter of the fluid filled
body. laterally. the rlCld of echo enhancement is usually
demarcated by the narrow ultrasonic shadows which
originate from where the .sound W'dVCS impaCl tangen-
tially onto the latcral walls of the fluid body.
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16 UltrosOilogrophy ill the mare
Fig. 1.10: Ovary of an estrous mare .... ith follidcs of varying
shapes. Four small round folliclcs and one large polygonal fol-
lide of estrus can be diSlinguislu:d.
f1&. 1. /1: Ovarian rallKles of a mare. A small follicle is indent-
ing the .... 1\11 of a larger estrous follicle.
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The ultrasonic image of a follicle in cross section is
seen as an anechoic area on the monitor. The lalter can
be delineated by a narrow brighter line which follows
the outline of the follicle. The anechoic nature of the
follicle is caused by the lack of reflection of sound waves
as they travel through the relatively cell free, clear folli-
cular l1uid. Occasionally, and partkularly in larger fol-
licles, there will be clumps of reflexions visible close to
the follicular ",-all. The shupe of follicles varies (rom
circular to oval to irregularly polygonal to nearly angu-
lar (Fig. 1.10). These variations in shape arc the result
of differences in pressure between neighboring folli-
cles, corpora lutea or even the ovarian stroma itself
(GINTHER and PtERSON 1984 a). When adjacent fol-
licles are of equal pressure their adjoining walls are
often completely slmighl. In contrdSt. small follicles of
high inner pressure may clearly bulge into the lumen of
larger. softer follicl es (Fig. 1.11 ). When the ovary
contai ns numerous small . tense follicles its ult rasound
image may resemble a honeycomb.
The follicular W"d ll is hypcrcchoic and thin. A narrow
hypcreehoic line is often visible where the ultmsound
Poflicles 17
WiWes imp<lct vertically onlO the front and back walls of
the follicle (Fi g. 1.9 and 1.10). Laterally to this line the
echogenici ty is reduced along the obliquely oriented
w:llls. The echo intensity in Ihis area is comparable 10
that of moderately dense tissue and is hardly distinguiSh-
able from the surrounding stroma. In the region of lan-
gential wave impact the follicular wall is usually not visi
ble. TIlCSC areas arc frequent ly marked by the origins of
the shadow art if:lcts that begi n here and stret ch into the
depth of the image.
The echo enhancement of the tissul.'S behind larger
follicles is one of thei r typical features. The size of this
enhancement area is correlated wilh the size of the fol
licle.
Using ult rasound at a frequency of 3.5 MHz one can
relatively reliably detect follicles that are 6 to 8 mm in
size, but with ult rasound at 5.0 MHz follicles of 3 10
5 mm are delectable with relative ease (PAL\IER and
DRIANCOURT 1980, GINTIIER and PI ERSON 1984 b).
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18 Ultrasonography ill the marc
Largest follicle
+
'0 30 Ovulation

r rf'l n III I-I I I I III
Q 10 5eeond l:ugest follicle
o
-192 168 _]44 . ]2(1 -96 n -48 24 0 Hours
I ' I I S 14 I S I S I ., I , I 0.,.
Time before ovulation
Fig. 1. 12: GfUI.\1h of the eSITous follicle and Ihe second largest
foll icle during the prroo.uJUlory period in mares (meun:j; SD:
adapted from WIt.!.et aI.1988).
80
10
00
0
" Round follicles
-0- " (}"al foJliclc$
" Irrtgulnrfollicles
,
,
1 1 1 1
120 108 96 ... n
..,
4 8 .S6
I
4
I

I
s
I
.,
Time before o\'ulalion
Ovulation
1

."
,
Houn
I
,
I
0.,.
1-". 1.14: Omngcs in shape of estrous follicles during the
preowl:ltory period in mares (adapted from WIl.l. et al.
1988).
.' ig. 1.13: Two estrous foll icles in a mare shortly prior 10
double ovulation. Theirdiameters arc bct .... -een 35 and 37 mm.
rig. 1. 15: Irregularly shaped estrous follicle in a mare shonly
before ovulation. Its largest diameter measuR.'5 53 mm (be
.....CCII markings).
d
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1.2.1.2 Developmenl of preovulmory follicles
Approximately J 92 hours before ovulation (Day -7:
Dayofovulation OayOorDayOoftheCycle)domi-
nant estrous follicles hu\'C a mean diameter of about 25
mm (Fig. 1.12). They lhen grow al 2 10 2.5 mm per day
and rtuch their maximum diameter of 41 1045 mm al
24 to 48 hours before ovulation ( PIERSON and Gtllol1 tER
1985 b. WIll. et al. 1988). In mosl cases no further
growth occurs during the lasl I 10 2 days before ovu-
lution ( PAU1ER and DRIANOOURT 1980). The diameter
of the preovulatory follicle often remuins Slatic; some-
limes even a reduction in the diameter can be measured
on the day of ovulation.
AI the time of ovulation of a single follicle it will
usually hm'c a diameter of 40 mm or more. Only occa-
sionally will follicles be smaller althe lime of ovulation.
The upper li mit of the size of normnl ovulatory folliclcs
lies between 55 and 58 mOl .
When doublc ovulations occur the diameter of the
preovulatory foll icles muy be smaller than those of
single follicles (Fig. 1.13). In these C'.tSCS ovulntion of
follicles with diameters of between 35 and 40 mOl are
nOI unoommon.
Po/licles 19
In many of the more mature preovulutory follicles
one can see a change in shape during the days preceding
ovulation (WIU_ el at 1988). The majorily of dominant
follicles are distinctly round 3 or more da)'5 before ovu-
lation (Fig. 1.14). During the days until ovulation the
estrous follicle will change to a more oval or irregular
shape (Fig. 1.15). On the day of ovulation only about
one third of the estrous follicles will be round in shape.
Apart from the palpable feature of follicular coll.'iis-
tenC)'. the ultr.lSOnic shape nnd size of a follicle can be
ut ilized to help predict the time of an impending ovulll -
tion. Other pammeters. such as the thickness of the fol-
liculnr wall or the I..'chogenicity of the follicular contenlS
have been shown to be of li ttle value. If the largcst fol-
!icle shows an irregulnr shupe. is til lea.'>t 40 mm in size
and has possibly been shown to hu\'C stopped growing
for some time one should ~ p e c t ovulation to occur very
soon. Although sonography hlL'i contributed meaning-
fully 10 the prediction of the timc of ovulation its val ue
wi th regard to the aCCUnlC)' of such predictions must not
be O'o'ercstimated. When manual criteria are combined
with those of ultm.sonogmphy it is possible to correctly
predict about one third of the ovulations that will occur
during Ihe next 0 to 12 hours (WILL et at 1988).

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20 UJtrasollograpl,y ill the man:
Fig. 1.16: Collapsed follicle immediately after ovulat ion. The
follicle still conlains small amounlS of residual fluid (bctv.'eCn
the cros.scs).
.-130 1.17: Collapsed follicle on the day of ovulation slloYiing a
bro.1d echoic scam (arrows) in the area of the original follicu-
lar w.1l1. The center contains anechoic fluid.
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An ovulation can be recognized ultrasonically when
a folliclc that was still present a short time ago cannot be
found at a subsequent examination. Ovulation itself
usually only lakes second<; to minutes (CARNEVAlE el al.
1988 b). The actual collapsing of the ovulating follicle
can only be demonstrated by chance if the nlare is ex-
amincd \!CI)' frequenlly (Fig. 1.16 and 1.17). The wall of
the follicle appears to fold iny.-ards, the follicular cavity
i<; irregular in shape and sometimes contains small
Follicles 21
quantit ies of residual fluid. Whet her the anechoic fluid
in the lumen of the follicle consists of follicular fluid or
blood, which acrumulates inside the follicular lumen
after ovulation, or a mixture of both, is unclear.
in many cases immediately after ovulation a large
echogenicity is detectable near the collapsed follicular
wall and may fill the ent ire area of the original follicle
(sec also Chapter 1,2.2.2).
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22 UilroSOllugroIJI'),;/1 (he ImllY'
)Ol g. 1.18: 'iOnogr.lphic puncture of lin CStrous
folliclc of a mare follo\.\cd by the aspiration of the follicular
Ouid. lbc puncture needle enn be secn bc",-ccn the two guid
mg linC!> and llppruximlltely J on into thl: follK:Ular
tmtrum.
Jolg. 1.20: Corpus lutcum (:lrTOYo"S) which dC\elopcd at thc si te
of B follicle th:u had been puncturt.'tl -I days pn.'"ViousIy.
.-ig. 1.19: depK.1ing the hcmorrhagc (be.
"''Ccn the into a foll icle 3 minutes after a puncture had
been performed. The real time image dearly turbu-
IeIKCS (arTOYo) inside the accumulated blood iIIusU"ating the
inflow of more blood.
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1.2_1.3 Transvaginal sonographic
puncture of foll icles
Tranwaginal follide punctures can be used to collect
nuid from preovulatory folli cles or to attempt the
collection of OOC)'Ics. The same instrumentation that
was designed for tr,lnsvaginal concept us punctures was
applied for this purpose (see Chapter 1.3.2.6) using a
similar technique. The automated puncture device. cov-
ered by a protective plastic sleeve, was introduced into
the anterior vagina where it was gently pushed ag.1i nst
the vaginal wall. Using II rectally introduced hand. the
ovary was then brought towards the lip of the ultra-
sound prolx:. When it was evident on the monitor that
the follicle was aligned in the direction of and for the
correct depth of the puncture needle the automatic
puncture device could be triggered (Fig. 1.18).
Using thi.<; technique it was jX)S.<;ibl e to aspirate folli-
cular nuid. Using a double barreled needle it wa.<; pos.<;-
ible to continuously nush a follicle; with a singl e bar-
reled needle follicles could be filled and the nushing
fluid aspirated repeatedly.
Immediately after a follicle had been punctured it
was evident that intmfollicular hemorrhage occurred
Follicles 23
(Fig. 1.19). Within only a few minutes the follicular cav-
ity filled with blood whieh exhibited intensive echoge-
nicity. Within this hemorrhage. turbulences, indicative
of the streaming of blood into the follicle, ..... ere seen on
the TCIII-time ultrasound imllge. The extent of hemor-
rhage was similar to thllt seen lit the si te of the future
corpus lutcum after spontaneous ovulations (sec Chap-
ter 1.2.2.2). Thus far no disorders have been observed
in mares after follicle puncture.
When the puncture si te was examined ultrasonically
during the next few days, the formation of a structure
not unlike that of a corpus Imeum could be obselYCd
(Fig. 1.20). A single puncture of a follicle shonly before
its anticipated ovul3lion did not affect the development
of a normal corpus luteum thereafter (CARNEVALE et
al. 1988 a). In some mares whose follicles were punctu
red, lower plasma progesterone concentrations were
measured during the first 3 to 5 days after punc-
ture than in mares that ovulated without interference.
This difference in progesterone secretion was, however,
not evident after Day 8 of the cycle. Cycle length and
the ensuing estrus of mares .... 'eTC nOl affected by follicle
puncture.
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24 Ultrasollography ill the man!
."!g. 1.21: Solid corpus I"tcum (dots) b c ~ ' C C n SC\ICraJ small
follicles on the ovary (arro ... ;s) of a mare. A hypocchoic bor-
der zone scfXIrdtcs the corpus lutcum from the surrounding
ovarian fXIrench)ma.
fig. 1.2.2: Ultrnsonogrnm of a regressing corpus luteum (ar-
1"tJ\II"S) next to an estrous follicle. Analogous to the sectioned
ovary in Fig. 1.23. The inner diameter of the foll icle is ap-
proximately]S mm.
FiI. 1.23: Section through an OVllry that was rerTlO\-..-d by
()'I,'aricctomy from an estrous mare. A small remnant of
hemorrhage is still "isible in the center of the regressi ng cor-
pus lmeum (arT"OYl"S). To the left of the corpus Imeum lies the
antrum of ttt.! estrous follicle.
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1.2.2 Corpora lutea
1.2.2. J Sonographic images
of corpora lutea
Useful ult rasonic features in identifying a corpus
luteum are its characteristic echogenicity, its size and
shape, as well as a thin hypocchoic border zone which
sepamtes it [rom the surrounding ovarian parenchyma
(Fig. 1.21). On ultrasound, luteal tissue shOW'S up in
varying gray tones which are typical of the reflections
received from loose, moderately dense tissue. The sur
rounding ovarian parenchyma is more echogenic, due
to its higher density and it contains many anechoic fol-
licles. The shape of a corpus luteum is irregular in many
Corpora lutea 25
cases, someti mes even cubical. It is often narrower ncar
its cent er, resulting in a pear shape. Frequently. vesicles
which lie adjacent to the corpus luteum are the cause of
these indentations to the outline of the corpus luteum.
When 5 MHz scanners are used corpora lutea are
relatively reliably detectable from thei r formation unt il
middiestrus around Day 12 of the cycle (PIERSON and
GINll-t ER 1985 a). Thereafter they become less distinct.
AI the time of luteolysis., approximately 14 to 16 days
after ovulation, they are still detectable in many
instances. Only rarely can the regressing corpus IUleum
be identified with certainty at the time of the followi ng
ovulation or even a few days later (GIl\'1l-fER and PI ER
SON 1984 b). By this time it will have become signif
icanlly smaller (Fig. 1.22 and 1.23).
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26 Ultrasonography in lite mare
t-1g. 1.24: Int ense echogenicity (alTOYo'S) at the site of the est
rous fol licle one day after ovulation. The bright cchogenic:ity is
caused by the hemorrhage into the follicular antrum afterovu-
lation.
Fig. 1.25: Sectioned w.IIY J days afler ovulation !;hov-ing a
young corpus luteum in its center.
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1.2.2.2 Development of corpora lutea during
the estrous cycle and in early pregnancy
The site of the development of a oorpus luteum can
already be recognized by its intense ultrasonic cchogen-
icity within the first 24 hours after ovulation (Fig. 1.24).
In some rases this site can even be detected within
minutes after ovulation (GINTIIER and PI ERSON 1984 a,
KAHN and LEIDL 1987 b). These intense reflections
originate from the hemorrhage into the follicular lumen
which occurs after ovulation (All EN el al. 1987). The
development of such hyperechoie areas at the sites of
Corpora Ilt/ea 27
fonner follicles can also be secn after iatrogenically
induced hemorrhages during follicular punctures (see
Chapter 1.2. 1.3 and FIG. 1.19).
The hemorrhagic area of young oorpora lutea re-
mains vcry echoic for the first 3 to 4 days following ovu-
lation (PAL\IER and DRIANCOURT 1980). This hyper-
echogenicity is only detectable for a short lime after
ovulation, because with the increasing proliferation of
luteal cells in the area of the blood clot it beoomes less
echoic. This process of luteinization usually
so rapidly, that large areas of the blood clot are taken
over by Imeal tissue (Fig. 1.25).
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28 Ultrasonography in ti,e mare
f'II. 1.26: A solid corpus tUleum (arruv.'S) in a mare 8 days post
ovulation. To ics right is a follicle (between crosses) wi th a dia
meIer of 24 mm.
f'II. 1.28: Sectioned ovary of a mare contammg a corpus
hemorrhagicum. The luteinization progresses from the
periphery IOwards the ccmer of the blood dot.
Fig. 1.27: Hemorrhagic corpus lmeum (alTOYo'S) of a marc 3
days post ovul!llion. The narrow, h)pcrt.'Choic edge of luteal
ti.<sue surrounds the large. hypocchoic ccntral area of the
blood dol.
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Two kinds of corpora lutea can be distinguished
during the diestrus in mares: Compact corpora lutea
and hemorrhagic oorpora lulea (PIERSON and GtNlliER
1985 a). A solid corpus luteum develops in about half of
all mares after ovulation while in the other half a corpus
hemorrhagicum fonns. No functional difference ap-
pears to exist between the t .... ,o types of corpora lutea
(TOWNSON et al. 1989). Both, progesterone concentra
tions and cyclic events, are the same in mares with a cor
pus luteum or a oorpus hemorrhagicum. Knowledge of
the typical appearance of a corpus luteum is, however.
imponant for its correct ultrasonic identification.
Solid oorpora lutea have a homogenous echogenicity
and structure acrms their entire cross sectional surface
when viewed by ultrasonography (Fig. 1.26). The entire
compact corpus luteum seems to consist of tissue of
equal echogenici ty throughout. They retain the same
echogenicity for the duration of diestrus.
The second form of corpora lutea, the corpus hem
orrhagicum, consists of two distinct zones of differing
Corpora flliea 29
appearance: A hypcrechoic peripheral edge and a cen
tral. less echoic core arca (Fig. 1.27). In the lattcr the
echoes vary from hypocchoic to almost anechoic and
nol infrequently they form trabecular, web like patterns.
These two zones of corpora hemorrhagica result from
the echoic peripheral zone of luteinized tissue and the
hypocchoic central zone of the blood clOI, respectively
(Fig. 1.28). The blood clot reflects ultrasound less
strongly than the luteinized wall and is sometimes
traversed by a nel\"'Ork of fibrin.
After ovulation, the entire cross sections of almost
all hemorrhagic oorpora lutea are echoic (PIERSON and
Gll'm-l.ER 1985 a). Only after a few days can the hypo-
echoic central area be distinguished from the more
echoic peripheral area. On the third day of the cycle of
ten less Ihan half of the cross sectional surface area of a
oorpus IUleum consists of echoic luteinized tissue (Fig.
1.27). As the cycle progresses the echoic areas enlarge;
by Day 9 of the cycle they make up about 70 %, by the
end of the cycle usually 100 %, of the corpus luteum.
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30 UllrllsonogrtllJhy in the mare
fig. 1.29: Corpus IlIl eum of prcgnalK)' in a marc on
Day 17 of gCSlalion. 'be corpus Imeum is surrounded by sev
eral follicles.
"'g. 1.31: Corpus hcmorrhagkum (arrows) in II marc on Day
53 of gC!llation.
fig. 1.30: Two rorporn IuIca on Ihc ovary of a marc
on Day 25 of gC5talion. Dclow Ihc corpora IUlca lies a follicle.
"1g. 1.32: Two oorpora lulea in II marc on 1>.1)' 116 of
gcslal ion.
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Once conception has occurred the primary corpus
luteum of pregnancy remains detectable during the
cour.;c of early gestation (Fig. 1.29). The same two
forms of corpora lutea that are seen in diestrus can be
found during the finit two ","'Ceks of pregnancy. When
the corpus luteum of pregnancy reaches a few weeks of
age it usually has the same homogenous cchogenicity as
is typical of the solid corpus luteum of the cycle.
After a double ovulalion has laken place, both oor-
pora lutea can be depicted. Also in the case of an early
twin pregnancy it is possible to depict both corpora lu-
tea (Fig. 1.30).
Corpora {Idea 31
Also Ihe accessory corpora lutea of prcgnllncy which
develop between Days 40 and 60 of gcstation can be
demonstrated by ultrasonography. Among these acces-
sory corpora lutea of pregnancy are some that have the
same appearance as the corpora hemorrhagkn whieh
occur during the nonpregnant cycle (Fig. 1.27). In the
beginning these show a narrow peripheral edge which
surrounds the trabecular hypocchoie central area (Fig.
1.3 1). During the further cour.;c of pregnancy the cen-
tral, less echoic area becomes smaller while the hyper-
echoic luteinized wall grows thicker (Fig. 1.32).
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32 Ultruso/logrophy in the mare
tia. I.J3: Anovulillory. lutei nizing foll icle (between the cr0s-
ses) wi th a ner.o'ork of internal echoes and a thin luteinized
wall (arrows). TIle size of the follicle W.IS 81 x 81 mm and the
plasma progesterone ronccntrntion in the marc was 5.1 nglml.
"1;. 1.34: Anovulatory. lutei nizing foll icle (arrows) from Fig.
1.33 seven days later. TIle lutei nized pcriphernl area sur-
rounding the hypocchoic center has become subsllinlially
wider. The plasma progesterone ronccntr.lt ion of the murc
was 1.6 nglml.
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1.2.3 Anovulatol)lluteinized follicles
Occasionally during an estrus a \'l'sicle will develop
into a dominanl follicle. but will not ovulate. Such ano-
vulatory folliclcs sometimcs have the same size as that
of normal. mlllurc preovulatory follicles (WIU. et al.
1988). Orten they grow to larger diametcn> of 6 to 10
centimete"" and rarely even larger. Some of these ano-
vulatory follicles seem to develop into hemorrhagic fol
licles, whereas others show clear signs of lutcinizatK>O
(SoUIRES et at J 988, LEIDL and KAHN 1989).
During cstrus. the sonographic appcaronce of ano-
vulatory follicles correlates v.'ell with that of normal fol-
liclc.'i. In those follicles that will later develop signs of
luteinization. reflections will appear with increasing fre-
quency at a lime shonly arter ovulation would have
normally taken place (Fig 1.33). These lr.werse the
hypocchoic follicular lumen in the form of I1occulation
and/or networks of hypcrechoic reflections. These
echoes may originate from the bloody follicular con-
tents such as occur.; in hemorrhagic follicles or they may
represent the onset of luteinization. At the time when
the follicular contents stans to show this echogenitilY
the mure's bchavioml estrus usually ends.
Arter the scattered inner echoes first become visible
inside an anovulatory luteinizing follicle the narrow,
hypcrcchoic W'JII will progressively become wider and
AIIOI'II/OIOf)' follicles 33
wider (Fig. 1.34). The funher dc-."CIopment of these
structUI'CS resemble that normal ly seen in hemorrhagic
corpor.. lutea during the course of diestrus. The lutein
ized wall that sUlTOUnds the hemorrhagic center be
comes wider while the central. hypocchoic area shrinks.
Some of the anovulatory follicles therefore seem to lute-
inize to develop into slructures similar to carpor.! lutea.
This obscrvlItion is supponed by the plasmll pro-
gesterone conccnlrotions in these mares. In some indi-
vidual cases it has been possible to demoll5lmte rising
plasma progesterone conccnlrat ions at the time when
the fir.;t hYJX!rechoic foci appeared in the follicle.
Ouring lhe course of the development of the luteinized
structure the plasma progesterone concentrations
rellched the expected levels and the ensuing estn.LS
occurred at the normal lime.
Similar pictures as have been described for anovula
tory. luteinizing follicles during the estrous cycle could
also be seen during early pregnancy (Fig. 1.31). At 40 10
50 days of gcstation. at the lime when the development
of accessory COrpom lutea can be expected. large ''CS-
ides which contained I10ccular echoes were found on
the OV"J.ries of martS. 11lc lumina of these vcsicles then
filled up with tissue that showed the sano-
graphic features of corporn lutea. 11 could thus be as-
sumed that these st ructures were. in fact. accessory
corpora lutea.
Avtl 0 I
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34 U/lfasollographY ;1/ the mare
FIg. 1.35: Anovulatory rollicular hemll toma in a marc. Wit hin
the roll iculll. r lumen the st1O\\)' echogenicity ruuscd by hemor-
rhage i<; ... "Viden!.
Flg. 1.J6: Ovarian hcmatom;J in a mll.rc. The hcm;Jtoma hlld IJ
dilJrneter or 2{) em and weighed 3.8 kg..
Ave ,ko Z'lSC no rad 0
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1.2.4 Follicular and ovarian hematomas
In addition to the luteinizing, anovulalory follicles
described above, there are also anovulatory follicles
which develop inlo hemorrhagic follicles or follicular
hematomas (SoUIRES cl al. 1988. LEIDL and KAliN
1989). In the case of the anovulatory. hemorrhagic fol-
licles the hemorrhage lakes place by diapedesis into the
follicular lumen. In Ihis type of anovullliory follicle no
ultrasonically apparent luteinization occur.; in the
follicular wall. When only the follicle fills with blood it is
referred 10 as II hemorrbagK:: follicle or II follicular
hematoma. Where the surrounding ovarian tissue is
largely atrophic and the hematoma encompasses vir-
tually the entire ovary it is called II ovarian hematoma.
UltrolSOnically, follicular hematomas do not show a
widening. hyperechoic edge indicative of progress.r.'C lu-
teinization (Fig. 1.35). Instead, the wall of these anovu-
latory vcsicJc remains hyperechoic and thin and appears
to remain unchanged for a long period of time. even
beyond the end of a particular estrous period. The mesh
Follicular and ol'Qrian hematomru 35
of rcneCiions that typically develops in the lumen of a
lutcinizing, anoorolatory follicle fails to dcvdop in this
type of anovulatory follicle. In most follicular hema-
tomas the initially hypocchoic lumen will only develop
regularly 5Callered noccular rencclions at II Illter stage.
These can become more prominent as time passes.
Only rnrely will a few echoic lines become evident inside
the follicular lumen. They are interpreted as being
fi brin strands inside the hematoma as the Illner is
becoming more organized.
The diameters of anovulatory follicles which develop
into follicular hematomas are OCtOasionally only a little
larger than those of mature preovulatory follicles. Folli-
cular hematomas somet imes expand considembly even
after the end of est rus.
In rare cases ovarian hematomas with n diameter
of 20 em and more and II .... -cight of scveml kilogmms
are encountered (Fig. 1.36). On ultrasound such hema
lomas can appear ali CYSlic struct ures with evenly
scattered sOQY.']jke echoes in their lumina.

AvtJ 0 =1! I
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36 Ultrasollography j ll the marc
Hg. 1.37: Granulosa cell tumor in a marc. The tumor consists
of numerous cyst ic structures.
fig. 1.39: Homogenoously echoic granulosa cell tumor. Nar-
row echo shadows originatc from small foci of mineralization
in the IUmor tissue. Ultr.lsooogram takcn in a waterbath.
Iolg. 1.38: Sectioned ovary with the granulo!.a ccll tumor from
Fig. 1.37 arter O\Iaricctomy of the marc.
Fig. 1.40: Sectioned ovarywi lh granulosa cell tumor from Fig.
1.39. The cut surface has a solid. waxy appearance.
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1.2.5 Ovarian tumors and cysts
The ult rasonic images of ovarian neoplasms can vary
considerubly. Among the most commonly encounlered
grnnulosa cell tumors the predominant fonn i.o; charnc-
terizcd by a multicystic partitioning of the tumor
(WIIITE and AlLEN 1985, KAHN and LEtDL 1987 b.
lElDL and KAliN 1989). More vesicular structures can
usually be counted in such tumors than .... 'Quld be expec-
led in normal. intact ovaries. On a normal ovary 5 to 10
follicles with a diameter of more than 10 mm each ..... iIl
physiologically be found during an estrous cycle (PIER-
SON and GtN11 IER 1987). In cases of ult rasonically ex-
amined granulosa cell tumors and in excised spximens
many more cystic structures ,",,-etC found. In single OV"d-
ries 50 to 60 cystic structures ..... cre identified.
The diameters of individual vesiclc.o; in granulosa cell
tumors vary from a few millimeters to several ccntime-
ters. A normal ovary is charactcrized by the presence of
many follicles of differing sizes in the same organ. It is
rare to find more Ihan 2 10 3 foll icles with a diameter of
30 to 50 mm on a normal ovary, the majority of visible
foll icles ranging in size between 5 and 20 mm. The ul
trasonic images of granulosa ccll tumors usually differ
from this pattern. Sometimes single. c:<tremely large
\'CSicies are seen within a tumor or the entire image of
(Jl'tJriOI/ Illmor.r and C}'l'LS 37
the tumor consists of numerous small, lightly JXlekcd
vesicles (Fig. 1.37 and 1.38). On cross sectional image
of GC tumors the proportion taken up by vesicular
structures is mostly greater than that occupied by solid
tumor tissue.
AP.1rt from the multicystie grnnulOS:I cell tumors
there arc also those that are virtually solid on cross
section (Fig. 1.39 and 1.40). Their uhrJSOnog.rnms
depict a relatively homogenous image free of hypo-
echoic vcsicles. In some tumors there were llreas of
hypcrcchogenicity which were interpreted as areas
of mineralized tumor tissue, which produced sound
shadows beyond these foci.
Ovarian tumors consisting of a single large vcsicle
with moderately echoic contents have also been found.
Their walls sho ..... ed histopathologiC' dl ehanges consistent
with those seen in granulosa ccll tumors.
The taking of aa:urate measurements of an {)\Iary is
an imp.)rtanl application of ult rasonography during the
examination of ovarilln neoplasms. Measurements of
the ovary taken at regular lime intervals make it p0s-
sible to cakulate the ~ 1 h rate of the tumor. and to
confinn the diagnosis. In addition. koov.'icdge of the
ovary's exact size lIid in the decision whether the ovari
ectomy should be performed by laparotomy or truns-
vaginally.
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38 Ultrasollography itl the lIIan!
. ig. 1.41: Ovarian (.)'Stadenoma in a mare. The ultr,iSOllOgl1lm
depicts numerous small , cystic structures.
t . 1.43: Large O\'arian e)'SI in a mare. The ronlents of lhe
cyst were largely anechoic. Other cysts or follicles \\''CTC nOI
prescnt. Ult rusonogrllJll taken in II W3terbath.
.". 1.42: 5t<:tioned O\'lIry wi th C)'S'adenoma from Fig. 1.41
after O\'lIriectomy of the marc.
.1g. 1.44: Sectioned O\'lIry from Fig. 1.43. The O'o-ari;m cyst
measured approximately 12 em in diameter.
Av SkO zasc 10 radivo
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Cystadenomas arc much less frequent ly encountered
ovarian neoplasms in the mare than granul osa cell tu-
mors. In the cystadenoma. .. examined ult rasonically thus
fa r. the tumor tissue varied in echogenidty and con-
tained numerous cystic structures (Fig. 1.41 and 1.42).
The vesicles with hypocchoi c content .. measured only a
few millimeters in diameter.
Ovarian cysts occur only very rarely in mares. The ul -
traS(mic image of macrocysl ic ovarian degeneration fea-
tures a few. very large cyst ic structUTCS (LEIDL and
KAl iN 1989). The cyst walls """eTC echoic and remarkab-
ly thin (Fig. 1.43 to 1.46). The cysts were polygonal in
Fig. 1.45: Macrocystic CMl rian degeneration in a marc. Mul
tiple. thin walled cysts wi th anechoic contents arc prescnt on
the ovary.
(A'aria" t u m o ~ ami C)'SIS 39
cross scctiolt ... The ultrasonograms showed hardly any
islands of ovarian parenchyma bet"""ecn the cystic struc-
tures. The diagnoses of macrocyst ic ovarian degenera
tion were based on histopathological examinations of
the organ after ovariectomy.
Ultimately, it can be stated that the ultrasonic ap-
peamncc of ovarian tumors and cysts can vary consider-
ably. An accurate diagnosis of thc ovarian changes.
based on ult rasonography alonc. is not possiblc in cvery
case. In many inslanccs. however. ultrasonogmphy con-
tributes meaningfully to the establi .. hment of a correct
therapeutic conchl .. ion.
fig. 1.46: Mncroc),stic degeneration and atrophy of the func
tional ovarian tissue in the scctioned ovary from Fig. 1.45.
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40 UltroSOllogropilY ill the mare
Fig. 1.47: Sugi ttal cross section through the uterine hom of a
mare in diestrus. The hypocd1oil; peri toneal bord<::r (large ar
ruw:s) and the trnnsition from myomet ri um to endometrium
(small :!1"I't)\\'S) can be seen.
Fig. 1.49: Prominent spol;e.whccl pattern of the uterus during
A I"I't)\\':S indic:lle the peritoneal border of the uterus.
rig. 1.48: Cross SCdion through merine hom during
Due to the endometrial edema alternming areas of hypo
echoic and more echoic tissues can be seen. This muses the
typical spol;e ...... hl'Cl appc:lr:mcc of the uteri ne hom during
estrus. Arrt:M'S indicate the truns;tion from myo- to endo-
metrium.
"'\g. 1.50: Euensn.-c edema of the endometrial during
1lie endometrial folds wi th their echoic base. hypo-
t'Choic edematous tXntrnl area and hypel'l'Choic surface bulge
inc o the uteri ne lumen (L) fi lled with secretions.
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1.3 Uterine structures in the mare
1.3.1 Non-pregnant uterus
A sagittal eros.. .. section of a physiologic, nonpregnant
utcrine hom is sonographically secn as round to oval
image (Fig. 1.47 to 1.49). The utcrine wall appears as a
gray st ructure of moderate cchogenicity. The peritoneal
border of the uterus can be seen as a thi n, hypocchoic
line. ConcentriC'Jlly posit ioned to this li nc, another line
can Ql)"1!sionally be identified in the middle of thc uter-
ine wall (KAli N and I..cIOL 1985). This hypocehoic zone
represents the transition from endometrium to myo-
metrium (Fig. 1.47 and 1.48). In the centcr of the utcrus
a small area of high cchogcnicity can sometimes be
found. It is caused by reflections from the echoic surface
of opposing laycrs of the endometrium which lie in close
apposition in the empty uterus and project as an echoic
spot when seen in ~ section or as anechoic line when
viewed longitudi nally (Fig 1.6).
The struct ure of the uterine wall is homogenous dur-
ing anestrus and diestrus (Fig. 1.47). A distinct layeri ng
cannot be recognizcd. Around the time of estrus a clear
UtenLS 41
distinction between areas of differing echogenicity can
bcobscrvcd in the tmnsversc view of the uterus of mnny
mares (Fig. 1.48 to 1.50).The ri ng like structure in the
area between endo- and myometri um which lies con-
centrically oriented to the outer, peritoneal wall of the
uterus is now very prominent. From this zone hypo-
echoic stripes run towards the center of the lumen
where they meet to fonn a star (spoke-wheel) pattern.
Hypcrcchoic segments lie between these areas of low
echogenicity. This pattern is caused by the endomctrial
folds which bulge towards the center of the uterine
lumen and consist of an echoic base, the hypocchoic,
strongly edematous adl uminal pan and the hypercchoic
lumi nal epithelium. This wagon wheel pattern of the
uterus is typical of estrus and can clearly be secn in
about 50% of all estrous mares (GINTlIER and PIERSON
1984 c). It is associated wi th thc cstrogenisation during
estrus and becomes apparent 6 to 10 days before ovula-
tion (HAYES el al. 1985). The pattern is best developed
about I to 4 days before ovulation and thcn graduatty
and progressively \\'Cakcns unt il it disappears 2 to 6 days
after ovulation.
Avto 0 zasc elO gradivo
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42 UltrasQnography in ' he mare
FIg. 1.51: Uterus (arJ'O\.\'S) of a mare immL"CIiately after mat
ing. The uterine lumen contains hypoechoic scoren whidl is
speckled with floccular rcncctions.
FiR. 1.53: Conceptus on Day I I of pregnancy. The anechoic
embryonic vcsicle shows the typical specular refkt1ions where
the sound Yo'll\1CS impact vcnicaJlyonto its front and bock walls.
Its diameter measures 9 mm.
rag. 1.52: Uterus on Day9 of pregnancy (DayD - Dayof ovu-
lation). The anechoic. embryonic\1CSicJe has a diameter of 4 to
5 mm and lies centrally in the hom (al'TOY>'S).
Ag. 1.54: Conceptus on D:IY 14 of pregnancy. The spherical
embryonic vesicle lies ccnlmlly in the uterine hom and meas-
ures 15 mm in diameter.
e 10 ;JradlVo
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Larger fluid 3ccumula(ions of a physiological origin
will not be found in the nonpregnant uterus. Sono-
graphically evident secretions in the lumen of the dies.
lrous uterus can be seen as a indieation of endometritis
(ADAMS et al. \987, SQUIRES et al. 1988). During estrus
small amounts of free fluid may be seen as physiologie,
but larger ones as pathologic (Fig. 1.50). Immediately
after mating, the ejaculate can be secn in the uterine lu-
men (Gl!'o'11IER and PIERSON 1984 e). Mares whose uter-
ine lumina were initially closed, show fluid accumula-
tions containing scattered echoes after service (Fig.
1.51 ).
The uterine cervix is depicted relatively poorly. Its ul
trasonic image is more echoic during diestrus and preg-
nancy and is therefore easier to recognize than in estrus.
1.3.2 Pregnant uterus
1.3.2.1 Day 9 to 13 of pregnancy
The young conceptus fi rst becomes visible when it
forms a fluid filled vesicle, large enough to be recog-
nized as a round, anechoic sphere on the ultrasound
monitor (Fig. 1.52). Depending upon the quality of the
sc.1nner, this is first possible, with a variation of only a
Pregnancy 43
few days, between Days 9 and 13 of pregnancy (Day 0 -
Day of ovulation or last day of service). When using
high resolution ultrnsonography \\; Ih a frequency of 5
MHz, 3 to 5 mm large conceptuses can be detected as
early as on Day 9 of gestation. On Day) 0 the blastocyst
measures 4 to 7 mm and will be detectable in as many as
about 70% of the mares (GINTHER ) 986). On the Day
11 it reaches 6 to 9 mm and will be visiblc in nearly all
mares (Fig. 1.53 and 1.55). Around Day 12 the concep-
tus has a diameter of 10 to 12 mm and can now be de-
tccted evcn with scanncrs of lesser resolution usi ng 3 10
3.5 MHz frequcncies (GINlliER 1983 b).
1.3.2.2 Day 14 to 20 of pregnancy
By Day 14 the embryonic vc. .. icle has a diameter of
14 to 19 mm (Fig. 1.54 and 1.55). The embryonic vesicle
is now large enough to make accurate and reliable posi-
tive as well as negative diagnoses under field condition
of general veterinary practice. provided 5 MHz ultra-
sonography is used (Kiihn and Lcidl t 984). Using ultra-
sound of lower frequcncy, this date may be postponed
by a few days (Q-!EVAUER and PAI.MER 1982). The
shape of the embryonic vesicle is spherical and the
embryo proper is not yel visible.
Avlo ozasc
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44 Ultmsonography ill tire marl!
60
,.
"
"
..
20
16
12

4
o
.,. -, ,
.. - -
.j. , ,.
, .,
-,. ,-
"
.-.' ..
-,- - . -,--
... -- '.-- ..
-,- .. ". , -,
,
-,-.,

. '.
,
10 15 W n ]5 45
Days of pregnancy
60
,.
J6
20
16
12

o
Fig. 1.55: Groo1h of the diameter of equine embl)'Onic \.cs-
iclcs during emly pregnancy (ad3pted from GIN'IlIl;K 1986).
"-'g. 1.56: Pregnancy on Day 16. The embf)'Onic \"CSicic h:1S an
ovoid shape. measuring 26 x 2fl mm. '11e largcst diameter is
marked by the 2 Cf'O!;Ij(:s below the \'CSic\c.
fig, 1.57: I'regnancy on Day 18. 1bc embl)'Onic \"CSiclc. lo-
co.ned in the ute rine hom (UI"f"O\Io'S), is pear shaped.
Av s 0
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The embryonic \'csicle grows at an a\'emgc rate of 3
to 4 mm per day during the second week of gcstation
until the beginning of the third week to reach a diame-
ter of20 to 25 mm by Day 16 (Fig. 1.55). After this date
the growth curve nallens considembly. The diameter of
the conceptus appears to increase only marginally and
seems 10 rest on a plateau between the 17th and 25th
days of pregnancy (PAU,1ER and DRIANCOURT 1980.
YAWN et a!. 1982, GtNTIlER 1983 b). Breed related
differences in the size of embryonic vesicles are negli-
gible during the first three weeks of pregnancy. Even
the growth curvcs of pony and large horse breed
embryos are vinually identical (Gtl'm-lER 1986).
A remarkable phenomenon in the horse is its em-
bryonic mobility which can be observed by ultrasono-
graphy from the time the conceptus first becomes visi-
ble until Day 17 of gcstation (GtNl1tER 1983 a). The
conceptus movcs from one hom to the other. and
through the uterine body seveml times every day and
may be found in different positions within thc uterus
during successive ex'lminations (GI/\'11IER 1984a). This
movement of the embryo can sometimes even be 0b-
served if a mare is scanned continuously for a number of
minutes. The mobility is particularly strong from Day II
to 14 and comes 10 a halt on Days 15 to 17. It has been
shown through frequent examinations in 5 minute inter-
vals that the embryo moved from one hom to the other
or into the uterine body an avemge of 7 times within 2
hours during the period of maximal embryonic mobility
between Days II and 14 (Leml and GIl\'11 IER 1984).
From Days 9 to 11 the embryo was found in the uterine
body in 60 % of the cases, from Day t 2 to 14 in 30 % of
cases and thereafter only rarely. The positional changes
of the conceptus appear to be caused by contractions of
the uterine wall and can be controlled by the conceptus
iL'iClf (GIN11lER 1984 b. urnl and GIN11IER 1985). The
careful sonographie examination of the corpus uteri
during this stage of early pregnancy is of particular
diagnostic importance. Duc to its intense mobility the
conceptus frequently lies in the uterine body. If only the
uterine horns are seanned by ultrdSOund the further
caudally positioned conceptus may remain undetected
insi de the uterine body. This is one of the most common
reasons for not detecting or overlooking a conceptus or
twin pregnancy. The intra-uteri ne positional changes of
the equine conceptus can lead to, among other things,
implantation not only in the hom ipsilateral to the ovu-
lating ovary. but. in about half the cases. in the con-
PregnallCY 45
trahlleml horn. Increases in Ul eri ne tone and size of the
conceptus seem to be the ColUse for the cessation of con-
ceptus mobility. The preferred site of implantation lies
just next to the bifurcation in one of the uterine horns.
In the horse the early conceptus has a strict ly spheri -
cal shape until Day 15 of gestation. thereafter first be-
coming ovoid until d"y 17 <Ind. between Days 18 lind
21 it is usually pear shaped, after which it assumes an
irregular shape (Fig. 1.56 to 1.59).
From the time the conceptus is first detected until
Day 18 the uterine .... -all is 10 to 15 mm thick. It becomes
thinnerovc rthe nexi few weeks and ranges from 5 to iO
mm. Initially, the uterine wall is of uniforn} thickness
around the entire concept us (Fig. 1.52 and 1.54); from
Day 18 to 20 on its thickness decreases. particularly vcn-
trollly to the conceptus (Fig. 1.58).
There nre numerous criteria which can be used to
differentiate the enrly embryonic vcsicle fronl patho-
logicnl condi tions such as endomel rinl cysts. the secre-
tions in cases of endometritis or embryonic death. At
Ihis sl:lge the intact conceptus is a round spheric.'l1 vcs
icle clearly visible and contrasted :lgainslthe echoic utero
ine wall. There :lTC no renections inside the vesicle so
that its nuid coments appear bl .. ck. I f the probe is
swept across the vesicle the increasing and decreasing
diameter reveals the spherical shape of the conceptus.
At the front and back sections of the conceptus. whcre
the sound waves imp..'lct \'Cr1ically onto the wall. a shor1
hypcrechoic line c:ln be seen :lnd PAU,IER
1982). These bright lines are the result of the specul:lr
rcnections of the ultrasound wavcs from the wol ll of
the tense embryonic vesicle and should nOi be mis-
interpreted as the embryonic disc (Fig. 1.53).
In veterinary practice there exists concern about the
optimal time for early sonographic pregnancy det ec-
tion. For several reasons the time from Days 15 to 18
cm be considered most appropriate. At this stage it is
no longer difficult to demonstrat e the early embryonic
vesicle. Not only lire twi n pregnllllcie!l easy to rerognizc
at this time period but it is quite ftwomble for a timely
intervemion where indic lled. In C'dSC of detection of
non-pregnancy the ultra .... ound examination C'oln be u.'iCd
to assess follicular development. becau."oC the following
estrus should be imminem.
Once ,Ill early pregnancy has been diagnosed in a
mare during the first few .... eeks of gcstation. it is useful
to reexamine the mare at about Day 30 of prcgnnncy so
that .1 possibl e e:lrly embryonic death can be detected.
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46 Ultmsollogmpily ill the mare
nl. 1.58: Pregnancy on Day 20. The shape of the embr)Unic
vesicle is triangular. The embryo (E) can be seen at the floor
of the vcsicle. Below the vesicle the uterine .... -all is rclati\'ely
thin.
"lg. 1.60; Ultrasound image of the rubber balloon of a bal
Iooned catheter wi thin the uterus. In order to an
embl)tmic "cside the bal loon ..... filled with 20 ml ..... mer and
then depicted by ultrn.o;onogrnphy. The catheter (arrow) is
shown in SI,.'CIion at the ccnterof the balloon.
" . 1.59; Pregnancy on Day 21. The embl)unic \'CSicle is ir-
regular in shape. The embl)'O (E) lies on the floor of the
vcsicle .
Ayrs OZ C 10
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By this time the majority of embl)'Onic deaths will have
taken pl ace or will be in progress (GIl'ffHER 1985.
WOODS et al. 1985). The successful induction of an-
other estrus is still poss.ible and valuable time will not ix:
wasted. Since embryonic deaths can also occur after
Day 30 of gestation anot her examination is recom-
mended bcty,'Ccn Days 50 and 60 so that all embryonic
losses can be detectcd.
In the conten of carly pregnancy diagnoses. a train-
ing method for the detection of early pregnancies by
ultrasonography should be mentioned. In the absence
of a sui table training mare, a water fil led rubber balloon
can be introduced into the uterus to simulate an early
pregnancy (Fig. 1.60). A ballooned catheter (e.g. Foley
cathetcr) which is introduced through the cervix into
Pregnanc), 47
the uterus is suitable for this purpose. Once the tip of
the catheter is positioned inside a uterine hom the in-
sumation channel is used to fill thc cuff wi th liquid
making sure not to include any ai r in the nuid. In this
manner the injection of 5 or 15 ml water into the cuff
wi ll result in a balloon diamcter of 20 or 30 mm. These
diamcters would be equivalent to the sizes of an em-
bl)'Onic vesicle on Days 15 or Days 25 to 30. For trai n-
ing purposes a balloon introduced in this manncr can
now be sought using ultrasonography and then depicted
on thc monitor. Sco.cral features of the image of such a
balloon are similar to those of an early conceptus. After
the training examination thc balloon can be emptied
and removed without problcms.
Avlorsko zast" eno cr'ldi '0
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48 Ultrasonogmphy ill the mare
Ectoderm
Endoderm
Mesodenn
Yolk sac
Allantoic sac
rig. 1.61 : Schematic presentation of a Day 30 embl)'Onic
\-esiclc in the norse. Due to shrinkage of the yolk sac and the
fi lling of the allantois the cmbl)'O ascends from the floor and
rises within the vesicle (adaptcd from GI1'o"JlIER (986).
Fig. 1.63: Pregnuney on Day 29. The embryo is suspended in
the center of the embl)'Onic \1:sicle. The appositioned memo
branes of the yolk sac (Y) and the allantoic !Ole (A) form a
hyperechoic structure which extends from thcembryo lowartls
the lateral walls of the \'C:Sklc (sec also Fig. 1.62 to 1.67).
Fig. 1.62: Pregnancy on Day 27. The Masccnt" of the embl)'O
(arrow) has begun. The ventrally positioned 311:mtOO starts 10
filJ up.
FIg. 1.64: Pregnancy on Day 30. 1be embl)'O is suspended in
the upper ponion of the vesicle.
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I
1.3.2.3 Day 21 to 40 of pregnancy
On about Day 21 the embryo is deu.:ctable for the
first time ncar the floor of thc vesicle (GINlli ER 1983 b,
KAHN and lElol. 1984). It is initially visible as a hyper-
cchoic spot on thc floor of the embr),onic vcsicle and
not yet scpar,lIcd from the endomctrium (Fig. 1.58 and
1.59).
From Day 21 to 40 the embl)"O follCM'S a character-
istic ascent within itsvcsicle (VAWN et al. 1982). Ven
tmlto the embr),o the allantois starts to fill up, lirting the
embtyO (Fig. 1.61 to 1.(6). Whi le the yolk sac above the
embtyO initially occupied the bulk of the early concep-
tu. .. it now shrinks over the next few days. The mlio be
tween the sizes of the t\\'O embryonic structures gradu
ally moves in favor of the allantois until the yolk SOIC has
virtually disappeared by Day 40. The embryo appears to
Ix: suspended by the hypcrcchoic membrane formed by
allantois and yolk sac and floats insi de the anechoic em-
bryonic fluid. The majority of embryos commence their
ascent between Days 22 and 25. On Day 27 they are still
suspended in the bottom third of the vesicle (Fig 1.62),
PregllallCY 49
by Day 30 in the t'ent er (Fig. 1.63) and by Day 33 in the
top third of the vesicle (Fig. 1.64 and 1.65).
On Day 25 the emhl)'O is ilbout 5 mm long (GIN-
THER 1986). It gf'OVllS by about I mm per day to reilch 12
mm by Day 30. 17 mm by Day 35 and 22 mm by about
Day 40.
The embl)'OS hcart beat can be detcc1ed around day
26 which is only a few days after the embryo can be first
detected. The hellrt bcilt is illl import ant criterion for
the assessment of embl)'Onic viability :lIld for the exclu-
sion of a JXl thological pregnancy.
After the suspended growth period of the conceptus
from Day 19 unt il Day 25 there is a renewed growth
(Fig. 1.55). The gTCMt h r.Jte until Day 50 of gestation is
i1bout 2 mm per day. From the fourth week of gestiltion
a difference in the growth rate bct\\'ccn fetuses of differ-
ent breeds becomes evidcnt ; hence the diameter of the
cmbl)'Onic "cside of heavy dmught horses betwcen
Days 20 and 40 of gestation will be I to 4 mm larger
than that observed in lighter horse breeds (OmvAu ER
and PAU,tER 1982).
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50 UltTOSOllogmplJy in the "'lin!
Fig. 1.65: PrcgmHK)' on Day 32. The embryo floa ts in the up-
per third of the embryonic \csicle. The )Ulk sac (Y) has reo
ceded considcrnbly. The all antoic sac (A) is
fig. 1.67: Pregnancy on lJ:ly 40. The cmbl)'O (3I"l"00') de-
scends bOlck tow:mls thc floor of the vesiclc while it hangs
from thc umbil ical cord which still shows remnants of the yolk

rig. 1.66: I'regnancy on Day 35. The cmbryo is suspended
vcryhigh in the cmbl)'Onic \'CSiclc. Thc )'Ol k sac has alman dis-
appeared.
tlg. 1.68: Pregnancy on Day 37. The embl)'Onic vesicle is dis-
oriented. The all anloic il.1C (A) lies at the top and thc )Ulk sac
(Y) al the bottom. In Ihis mare the - asccnt - of Ihe embryo
within its \'e5ick: ",.'as from the top to the bot tom.
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1.3.2.4 Day 41 to 60 of pregnancy
Around Day 40 the embryo reaehes it<; highest posi-
tion within the embryonic vesicle (Fig. 1.66 and 1.67).
From here it gradually sinks, suspended by its umbilical
cord. back down to the floor of the vesicle (KAliN and
l.J:JDL 1984). After this time movements of the fetus can
be observed frequently (Al.l.EN and GODDARD 1984).
The umbilical cord normally attaches to the dorsal
pole of the allantochorion. Very rarely it attaches lat-
erally or ventrally. Cases have been observed where the
yolk sac was positioned ventrally and the allantois dor-
saUy to the embryo leading to an embryonic migration
from top to bottom within the vesicle (Fig. 1.68). It is as-
sumed that this kind of disorientation of the embryo is a
sequel to an eurlicr twin conception (GtNTIIER 1984c).
In singleton pregnancies there seems to be a mechanism
FIg. 1.69: Pregnancy on O:ly 46. 1bc fcms lies on its buek on
the floor of the \csidc. Its crown rump length measures 33
mm.1bc head with the eyes (E) lies to lhe left.
Pregnancy 5 J
which ensures that the conceptus is oriented with the
embryonic disc al its vcnl.r.:al aspect at the time of ftX.1 -
tion between Days 16 and 20. This also leads to the em-
bl)'o rising from ventral to dorsal during its ascent be-
tween Days 20 and 40 and to the attachment of the
umbil icus to the dors.11 aspect of the allantochorion.
This procc. ... <; sometimes appears to be dist urbed in twin
pregnancies when the two vcsicles int erfere "-i th one
another's orient ation "-i thin the uterus.
The fetus has a crown rump length of25 mm on Day
45 of gestat ion (Fig. 1.69) and grows to a length of 40
mm by Day 60. The placental vesicle reaches a diameter
of 6 em bclY .. cen Days 45 and 50. Subsequently it cx-
ceeds the scanning width of the 5 MHz scanner and can
onlybc depicted in sections (Fig. 1.70). From Day 50 [0
60 a penetration depth of 10 em is also inadequate [0
show the vesicle in its entirety.
fl&. 1.70: Pregnaocy on Day 54. 1be dia.meter of the COIK'CP-
[US exceeds the scanning width of the ult rasound probe. The
head (H) of the fetus lies to the left . The umbilical cord runs
3 o'clock out of the pict ure.
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52 U1/rflsollogrophy ill /he mare
r ig. 1.71: T .... in prcgn:mcyon Day 13. The two \'csiclcs are bi-
[aternl, one in each hom (arro .... s).
1.73: Twin pregnancy on Day ]4. Only one embryonic
\"CSide seems to be visible. In relation to the Inst service date
this vesicle is 100 large. 11lc opposi ng w,dls or the two vesiclcs
are hidden (rom view.
t-lg. 1,72: Twin prcgnan(.)' on Day ] 6. The two \'csidcs are uni-
lateral nnd close tl)h'Cther.
f1g. 1.74: Single pregnancy on Day 22. Due to the unravorable
posi tioni ng or the ultrasound probe the common membrane
or allantois :lOd yolk (alTO'W) is depicted without the em-
bryo. A misinterpretation as a twin pregnant)' is possible.
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1.3.2.5 Twin pregnancy
An imponant indication for the use of ultmsonogm
phy is the timely diagnosis of a twi n pregnancy. The fre
quency with which twin pregnancies are diagnosed de
pends on the time of the eltamination as well as the
breed of the horse involved. It has been reponed that
the incidence of twi n pregnancies diagnosed between
Days 13 and 21 is 15 % in pregnant Thoroughbred
mares and only 6 % in pregnant Standardbred mares
(BoWMAN 1986). If the examination is performed later
and Wannblocx:ls and dmught horses are included. this
percentage may drop to I to 3 % (OIEVAUER and
PAU,1ER 1982). The detection of twins during the early
stage of gestation requires a very carefully executed
ull rasonographic exami nation of the uterus. The diag
nosis is possible wi th relative ease betv.'Cen Days 12 and
16 (Fig. 1.71).Bilaterally positioned twin conceptuses
are not difflCll lI to recognize, provided the exami nation
is carried out conscientiously (MERKT el al. 1983).
Difficul ties are encountered in cases of ipsilateral twin
pregnancies where both conceptusc." lie close together
in the same hom (Fig. 1.72 to 1.74).
Many factors C' dn contribute to the fai lure of recog
nizing a twin pregnancy. When two embryonic vesicles
lie close together the positioning of the scanning probe
may make it impossible to see the thin. echoic memo
brane fonned by the two closely apposit ioned SCts of
vesicle walls (Fig. 1.73). The presence of twins should
be suspected when an embryonic vesicle is too large for
its age as detennined by the last service date ofthc mare.
Twill pregllallc), 53
If the fi rst examination is perfonned after Day 20 the
ascent of the embryo wit h the development of its char
acteristic septum across the middle of the vesicle will
have already st aned. This membrane whieh is fonned
jointly by all antois and yolk sac can lead to the mis-
interpretat ion of a singleton embryo a. .. a twin (Fig.
1.74). Equally, a twi n with closely appositioned memo
branes of the two vesicles which arc misinterpreted as
being the all ant ois yolk sac membrane of a singlelOn is
possible. The hypcrcchoic line fonned by the apposition
of t .... -o chorionic membranes usually runs stmight and in
a venical di rection, whereas the allantois yolk sac mcm
brdne commonly lies horizontally (SIMPSON et al. 1982).
A ' 'Cry significant source of error is the examiner being
satisfied with the detection of one embryonic vesicle
and neglects to examine the remaining sections of the
uterus for another vesicle. Duri ng the phase of em
bryonic mobility until Day 16 of gestalion the embryos
frequently li e in the uterine body where they are ea .. ily
overlooked. At the time when a singleton embryo i. .. de
tected on Day 14 or IS. another embryo from a second.
asynchronous ovulation days later may still be too small
to be found by ul trasonography. Sincc asynchronous
double ovulation. .. with a time interval of 48 to 96 h o u ~
between ovulations can still lead to the conception of a
twin pregnancy, the younger of the two embT)'Onic ves-
icles will be 2 to 4 days less advanced than the older and
thereby have a diameter smaller than can be detected by
ul trasound (Gtl"lrHER 1986). Endometrial cysts may
also lead to a faulty diagnosis of a twin pregnancy
(SIMPSON el al. 1982).
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54 Ultrasollography in the m(lre
Fils:. 1.75: Twin pregnanqo on Day 28. Don.ally. a duster of
multiple endometrial cysts (C) can be secn. Thcye-.m generale
difflClJhics in diagnosing a I",,; n pregnanqo. To enMire an ac-
curate diagnosis the two embl)'OS (E) ..... ith the beating heart in
each should be dcpicloo.
fig. 1.77: T""1n prcgnanqo on Day 15. The vcsicle on lhe left
has the appropriate size in relation to the service dale. where
as the one on the right is too small.
,,,. 1.76: Twin prcgnanqo on Day 37. The two embryonic
\"CSidcs nppear to be fused. '-""'0 embl)'OS arc visible.
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There arc rn<lrcs with rnuhiple endometrial cystS
which c.1n make the search and detection of twin ves
icles in the uterus particularly difficult (Fig. 1.75). Oc
casionally it is difficult to find the membrane that di
vides the two vesicles of a twin pregnancy (Fig. 1.76).
Where uncertainty the final decision should be
postponed until the time when the detection of lWO
hean beats can be expected.
The individual embryonic vesicles of a normal twin
pregnancy often show the same growth rate as that seen
in singleton pregnancies (GtNll-lER 1984 b. PtPERS et 31.
1984).
In spite of that the sizes of individual vesicles in cases
of twin pregnancies can differ (Fig. 1.77). This may in
dicate that the smaller member of a twin is retarded and
is in the proces.<; of undergoing an embryonic death.
However, in cases where twin vesicles of unequal size
are detected the categorical oonclusion that the smaller
embryo must be dyi ng. will often prove wrong. Asyn-
chronous double ovulations with an interval of 48 to 96
hours between ovulations can lead to twin pregnancies.
The two oonceptuses will show differences in their
stages of development, but can both continue to persist
and grow into the fetal stage of pregnancy.
In unilmeralty rlXed adjacent twins an embl)'Onie
mortality is likely between Days 17 and 29
1984 c). Prior to this, during the phase of mobility, re
sorptions are r.lre and after this until Day 45 onlY, k'W
mortalitics will occur. The resorption of one member of
a twin is morc likely than that of both. Bilaterally rued
twins oontinue [0 develop in the majority of cases and
Twin prt"8,wllcy 55
lead to abortion during the advanced stages of preg-
nancy.
The following approach is reoommended for vet
erinary practice: Where twins of clearly differing sizes
are diagnosed until Day 16 of gcstation, the possibility
of a spontaneous resorption should be considered. In-
tervention may be postponed until 2 to 3 days later
when it is evident from the follow-up examination that
both embryos ha\'e continued to develop since the pre-
vious examination, Where twins are found before Day
16 and both vcsicles appear to be intact it is useful to
attempt the reduction of the pregnancy to a singleton
pregnancy by manually crushing of either of the t .... ,o ves-
iclcs. Since both vesicles are still mobile at this stage,
repeated examinations can be performed until the two
vesicles are found to be far enough apart so that the one
can be crushed without harmi ng the second one. If a
bilaterally rued twin pregnancy is first detl'C\ed after
Day 16 an intervention is indicated, because it is likely
that both embryos will persist. Since a sponulOcous
resorption is more likely in unilaterally rlXed twins after
Day 16 an intervention can be poslponed for some
time.
Once a twin pregnancy has been reduced by crushi ng
of one vesicle the successful elimination of the one and
the further development of the other vesicle should be
monitored ultrasonically. Where an embryo has been
eliminated by crushing it before Day 20 the survival
chance for the second conceptus is good, but in later
cases one must expect the second embl)'O 10 die
(BoWMAN 1986).
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56 Ultrasonography ill the mare
Hg. 1.78: Twin pregnancy on D' JY 39. 1be t ..... o cmbryonic
\'i.!Sick:s lie next 10 each other and lire ... isible on the same
ul trasonogram.
Fig. 1.79: Twin pregnancy on Day 129. 111(: trunks of 1\\'0 fe-
tuses lie next to each other. 'The L"Choes produced by the
5Cdions of the nbs (arrows) of both fetuses am be seen.
10cm
Fig. 1.80: Instrument lllion for tmm;vagi nal sonogmphy. including the automated punctun: device (LAtl(Jt'CT. GOlllngen. Ger-
many). l)(.'Vlces for adjustment and triggcring oft ne automated punctun: an: .'litU3tL-d on tne left of the handle. The scan
ning head (arrow) of the vaginal probe Erlangen. Gcnnany) is pushed up to the cranial V' .J.ginal wall . J\OOo.e the tube
for the probe is the ch:mnel with the puncture needle.

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From Day 40 even in unilater.ll twin pregnancies the
two fetuses may be so far apart that it may be difficult to
capture both on a single ultrasound image (Fig. 1.78).
In advanced gcstation (2nd and 3rd trimesters) it is
difftCUlt to diagnose twin pregnancies by tr.lnsrcctal ul-
tr.lsonogr.lphy. Sometimes it is possible to see two fe-
tuses (Fig. 1.79). Where this is possible the existence of
a twin pregnancy can be confirmed. Should only one
fetus be detectable making a diagnosis of a confirmed
singleton should be approached with caution.
1.3.2.6 Transvaginal sonographic puncture
of the conceptus
Since the manual reduction of a twin pregnancy is
usually not successful after Day 20 to 25, the possibility
of eliminating one conceptus by controlled puncture
was consi dered. It appeared promising to puncture one
conceptus undcr visual control of a vaginally introduced
ultrasound probe.
For this purpose a pistol-like instrument was de-
signed. The barrel of the instrument accommodates the
ultrasound probe and on the handle is a trigger for the
Tro/lSWlgil/al sol/agraphic pUllcture 57
automated puncture device (Fig. 1.80). The handle of
the vaginal sector probe is fIXed within the tip of the bar-
rel. A spring mechanism is used to drive the puncturing
needle and an adjusting screw is used to set the depth to
which the needle can he shot beyond the tip of the
probe. The depth and direction of the puncture can be
determined aiming with two puncture guide lines on the
ultrasound monitor (Fig. 1.82). The total length of the
instrument is nbout 80 COl .
The punctures arc performed after the vestibulum
and vagina are prepared aseptically and the mare is se-
dated. For the sake of sterility the instrumentation is
covered in a sterile plastic sleevc. The tube of the in-
strument with the attached puncturing device is intro-
duced into the vagina in the same manner as a tubul ar
speculum. It is pushed against the anterior vaginal wall
and one hand introduced into the rectum to hold the
uterus caudally and fIX it against the ultrasound probe.
Once the image of the conceptus is aligned with the
puncture direction of the needle the trigger mechanism
is activated. The plastic sleeve is penetr.lted by the
puncture needle when the trigger is pulled. It is possible
to aspirate fetal fluid through the needle.
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58 UltrosollogmfJhy ill the lIIure
rIG. 1.81: Tral1SVllginal puncture of an embl),tmic vcsicle on
Day 29 of gestation. The purn.1ure necdle (arrow) has pene
truled about 2 em into Ihe vesicle. Within the conceptus the
dctaehing embr)'Onic mcmbrant'5 can be '\Cen. The
..... as subsequently rc..-.orbed.
l'lg. 1.83: Trnnsvaginal puncture of a conceptuS on Day Sol of
gl'5tation. The puncture needle runs Oct .... een the two guide
lintos to a depth of 3 em. Thc prcgnarn;y cont inued to dC\oclop
after the puncture.
I-'Ig. 1.82: TrJnsv.tginal puncture of a ronttptus on Day 50 uf
gestation. The puncture nt'Cdle lit:s between the two guide
li ncs. A section through Ihe feluscan be secn in the
upper left of the \'C'iick. TIIC oorn..'cptUl> subsequently
resorbed.
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Experiences with tmnsvaginal punct ures of concep-
tuses in the hOf5C are still limited, In the punctures per-
formed thus far one could usually observe a change in
the typical features of the embryo or fetus immediately
followi ng penetmtkm of the vesicle by the puncture
needle (Fig, 1.81 and 1.82). Within the vesicle echoes
reminiscent of floating parts of membranes became evi-
dent. These were assumed to have been freed placental
membmncs. Immediately after the puncture the em-
bryo changed its position. coming to rest on the floor of
the vesicl e,
To date six punctures on singleton pregnancies have
been performed between Days 19 and 75 with the aim
of aspirating small quantities of placent al fluid, In 4
pregnancies which were perfonned between Days 19
Trorm'ogillol sollogrophic pWlcfllre 59
and 50 the conceptus died after the puncture, One con-
ceptus which had been punctured on Day 54. and from
which 7 ml allantoic fluid had been collected, continued
to develop (Fig, 1,83), This pregnancy W.JS purposefully
interrupted on Day 75 by the collection of a large vol -
ume of fetal fluid.
Only one conceptus was punctured in each of two
twin pregnancies on Days 29 and 44 of gestation. re-
spectively. The remaining member of the twin pregnan-
cy was intended to pcl1iist and develop as a si ngleton
pregnancy. In both cases, however. both conceptuses
died. In all cases the death of the conceptus was ap-
parent within days of the puncture. Usually, a heart
beat could oot be detected by ult rasonography on the
day following the puncture.
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60 UltmsOllogm/JI,)' ill lite morc
Fig. 1.84: Tmnsrcctal image of the eye :md braincase of a fe-
tus on Day 151 of gestation. In the anterior aspt.-ct of the eye
the caudal wall of the lens (arrows) is depit.1ed.
c
0-
E
OJ
-
"

'"
rig. 1.86: Horizontal section through the thorax of a fetus on
Day 134 of gestation. The echoes fomlCd by the sections
through Ihe ribs of bolh ha ... es of the chest run in (Wo lines to-
wards each ot her. Between Ihe 11,1,'0 lines three e:ardiac cham-
bers (1. 2. 3) are visible.
'"
,.,
,.,
,.,
'"
""
'co
'"
t"!g. 1.85: Longillldinal section through the neck of a fetus on
Day 154 of preg.nancy. 11H: arches and lxxIies of three verte
brae delineate the spinal e:anal (S). Behind them shadow ani-
faCl$ into the depth of the imag.e.
,.38
Y _ 189.3 - 0.44:l
r 0.$9
p s 0.01
.,0
,
.,
..
''''
UO 180 110 :uo no )00 ):10
Days of pregnancy
Fag. 1.87: The heart rate of equine fe tuses (Thoroughbred and
Standl1rdbn.:d) during pregnaocy (adapted from KAII:-/ and
LEIOI. 198711).
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1.3.3 Ultrasonography of the equine fetus
After Day 60 of pregnancy, significance of transree
tal ultrasonography for merely diagnosing pregnancies
in the decreases. At this stage the emphasis of the
value of the ultrasound examinat ion shifts towards fe tal
diagnostics. Through sonographic observation of the fe-
tus in utero, the depiction of its IxxIy parts and organs
as well as taking fetal measurements - the so called feto-
metry -, fetal development can be monitored and a ...
sesscd (KAHN and LEIDL 1987 a). Import ant conclu-
sions for abnonnal pregnancies can be made in this
manner. Sizes determined by fetometry can be used to
assess gestational age in cases were uncertainty exists
aboulthe exact service date. Transcutaneous ultrasono-
graphy through the dam's ventral abdominal wall may
prove useful in some cases in order to visualize the fetus
(AoAMS-BRENDEMUEHL and PIPERS 1987).
1.3.3.1 Imaging of fetal organs
The ult msonic appearance of the various organs of
equine fetuses generally resembles that of bovine fe-
tuses (Sec Chapter 2.4. 1). In the latter species the ultra
sonography of the fetus ha<; been well studied. Below
follows a descri ption of particularly characteristic ul tra-
sonic images of equine fetuses.
1.3.3.1.1 Head, neck and spinal column
Prominent structures on the head of the equine fet us
are the eye and the cranial cavity (Fig. 1.84). The vito
reous body of the eye is anechoic and surrounded by the
hypercchoic orbit. In the anterior portion of the eye ball
Arch shaped structures become visible. The t ... ,'o convex
lincs that lie opposi te one another represent the front
and back wall of the lens.
The roof of the scull ilnd the b;lsal portion of the
brain cavity form a hypcrechoic, oval outline that is a
Equine/ellis 61
few millimeters thick (Fig. 1.84). The oval outline of the
brdin cavity can be depicted until about the 8th month
of gestation. After that the OAAi fication of the bones of
the cranium ha,<; progre<:scd so fa r that only the bony
parts in proximity of the tr.msducer can be imaged.
The most apparent struct ure in the neck is the cervi-
cal spi ne (Fig. 1.85). The ossificil tion centers of the ver
tebral bodies "nd arches produce disc like echoes. Due
to the absorption of the sound wavcs, ultrasonic shad-
ows ilre seen beyond the vertebrae.
When the probe is positioned favorably the spine
Qln also be detected by ultrasonography in the thoracic,
lumb.lT, sacral and even cocg.'geal regions. Usuatty the
typic,,1 double row of hypcrechoic discs is apparent.
Only the tail vertebrae pTlXlucc a si ngle row of solid
echoes.
1.3.3,1.2 Thorax and heart
The COnic.1tty tapering images of the two halves of
the chest cavity arc obvious in the thoracic region (Fig.
1.86). Similar to the \'enebme, the cross sectional im
ages of the ribs produce echoic circles. Ult rao,onic shad
ows li e behind the ribs that produce them.
The heart will be evident in the apex of the thorax
(Fig. 1.86).The echoic wall of the heart surrounds the
hypocchoic lumina of the ventricles ;lIld i1tri a which arc
separated from one another by bright val\'cs and septa.
The action of the heart c.1n be demonslr;lted qui te im
prcs.<; ively if the probe is oriented properly.
The m<;al heart rate of equine fetuses is 150 to 190
bealS per minute in the 3rd month of gestation and
decreases slowly as pregnancy progresses (Fig. 1.87). In
Month 7 the basal hean rate will vary from 100 to 110,
and near term 60 to 80 beats per minute (CoU..E.S and
PARKES 1978, PIPERS and ADAMSBRIONIlEMUEIII. 1984,
MATSUI et at. 1985. ADAMS BRENDEMUEHL and PI PERS
1987). Generally. however, the heart rate is mther "'Ir
iable and can rise well above the basal val ues during
short periods of observalion.
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62 Ultrasollogmplly ill tile mare
FIg.. 1.88: Tral\S\'ersc section through the trunk of II fetus on
Day 148 of pregnancy. At the bonom lies the stomach (S), al
the lOp lies the coarsely granular, moderately echoic (L),
and between them runs the caudal caval vein to the right of
which is a cross section of II vertebra with II ultrasonic shadow
originating below it.
Fig. 1.89: Cross section through the umbilical cord with the
two lumina of the umbilical arteries Lind that of the umbilie:tl
vein in a fetus on Day 185 of gcstatKm.
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1.3.3.1.3 Abdomen and pelvic ngjon
The abdominal organ easiest to depict by ultrasono-
graphy is the stomach (Fig. 1.88). II fills a hypoechoie
oval area in the background of the last few ribs and
shows the typical features of an equine stomach. namely
the dorsal cul-de-sac and the ventral body.
Next to thc stomach lies the coarsely granular,
moderately echoic liver which is passed by the black
cords of the large abdominal blood vessels (Fig. 1.88).
Under optimal conditions it may be possible to de-
termine the sex of equine fetuses by means of ultra-
sonography (CURRAN and GtNTHER 1989). For this pur-
pose the location of the geni tal tubercle between the
hind legs must be determined. The embryonic geni tal
bud differentiates into penis and prepuce in the male
fetus and into clitoris and vulva in the female fetus. Dur-
ing fetal development the genital tubercle migrates
from its origin between the hind l e ~ cr ... nially towards
the umbilicus in the male and caudally towards the tail
in the female. By determining its position from about
Day 60 of gestation the sex of the fetus can be diag-
nosed. In both sexes the genital tubercle consists of a
Equine Jews 63
bilobular, hypcrcchoic structure. The optimal lime for
transrcctal uJtrasonographic sex determination in
equine feluses appears 10 lie between Days 60 lind 70
of gestation. The sex determination is possible at later
stages too. but then the more cranio\'cntral position and
the larger size of the fetus may make the optimlll depic-
tion of the C'Judal body region difficult and not possible
in C\'CI)' examination.
In contrast to lhe situation in bovine fetuses (see
Cllapter 2.4.2). it has not been possible to determine
the sex of equine fetuses by sonographic imaging of the
scrotum (PlrERS and AOAMS- BREf'lOEMUEHI. 1984).
One reason for this is that the testes descend much laler
into the scrotum in the equine fetus than in the bovine
fetus. Therefore. the depiction of the scrotum and
testes cannot be used to differentiate between the sexes
of equine fetuses.
Occasionally. the umbilical cord which noats around
within the placental fluids can be seen (Fig. 1.89). A
trarm'Crse section through the umbilical cord shows the
typical arrangement of two umbilical anerics and one
,'Cin in the equine fetus.
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64 Ultrasonography ill IIII! mare
90
80
70
60
% 50
40
30
= Fetus inaccessible
o = Head accessible
o = Thorax accessible
= Abdomen accessible
3 4 5 6+7 8+9 10+11
folg. 1.90: The rrequency with
\\"hich the head, thorn.'( and abOO-
men of equine fe(uses (Thorough-
bn:d and Standardbred) were 3C-
tcS-\lblc by sonogr ... phy
during pregnancy (adapted from
!U.II.'J and WOI. 1987 a).
90
"
SO
"
7.
"
60
"
50
Months of pregnancy
Estimation of the age of equine felulieS and pn:gnallC)'
throuGh $OOOgr:lphic fetometry,
,
I
.
.
:
i Tnmr
i
, II
I -/
Braincase
:
=tl
,
-

/
,
I
90
"
80
"
70
"
60
"
50
45
o
Stomach
-
i
/'
45
40 40
"
JO
"
20
"
10
,
I
I

-
;-j

I-I---t
/ 1
VEyt

,
f
;
-H
, ,
,
,
,
f
Rib diameter \\'iLh
one intc:TCO:l11l spa
,
,
,
.
!
,
"
3'
"
20
"
10
,
o 0
I
,
60 90 120 150 ISO 210 24{) 270 300 330
Days of pregnancy
Fig. 1.9 1: Growt h (regressions) of Ihe largcsi diameters or the
trunk. braincase. stomach. eye :and one rib cross SI.'Ction with
one inlercoSial space in equine retuses (Thoroughbred and
Standardbred) during pregnancy (adapted from KAlIN and
1..101. 1987 a).
Fig. 1.92: Example of IlIking measurcmenls of the diamclers
of cye and braincase in a fClus on Day 159 of pregnancy,
Ay S ozas 10
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1.3.3.2 Accessibility of equine fetuses by
transrectal sonography
During onc st udy involving 162 Thoroughbred and
Trollcr mares which 3 to 11 mont hs pregnant it
was possiblc to reach thc fc tus by transrectal sono-
grdphy at all stages of gestat ion (KAHN and LEIDL 1987
a). For these examinations a 5 MHz lincar ull iJ.SOund
probe wi th a penctration dcpth of to em was used. The
technical difficullics associatcd wi th the ullrasonic ex-
amination of cquine fC\l!scs very much depend on the
stage of gestation. In about one half of thc mares ex-
amincd between Days 80 and 100 of gestation the fe-
tuses lay outside the range of the ultrd!iOund Wolves (Fig.
1.90). At this stage the relatively small fetus had often
descended cranioventrally into the uteru.<;; bulging far
beyond thc pelvic bri m. In this position it was too far
away to be detectable by the ultrasound waves. From
the 4th month it became increasingly ca<;;ier to reach
some parts of the fetus so that only to to 20 % of aU
fe tuses betwecn the 5th and 11 th months of gestation
remained beyond reach.
The availability of individUltl fe tal body parts for ul-
trasonic examination also depends heavi ly on the stage
of gestation. The head will move closer to the maternal
pelvis as pregnancy progresses and was visible in 74 to
83 % of all 6 to 11 month old fetuses in thc above mcn-
tioned study (Fig. 1.90). In contrast. the thorax. abdo-
men and pelvis generally move Cl.'cr furthcr away. The
chest and abdominal regions were accessible in 25 to 50
% of fetuses duri ng the 3rd. 4t h and 5th months and on-
ly in isolated cases thcreafter.
The above mcntioned rcsull<; reflect tendencies and
can be impl'O\'Cd significantly through the development
of beller ultrasound technology. Wi th impTO\'ed tech-
nology equine fc tuses and their body parts will then
become even more available for sonogrnphic examin-
ations. It has also been demonstrated that thc shon-
comings of trdnsrcctal sonogmphy could be com-
pensated for in many cases by the tmnscutancous appti-
Equine Jews 65
Clition of thc ultmsound probe (O'GRADY et al. 1981 .
PIPERS and ADM1S- BRENDEMUEI U_ 1984). By"pplying
the probe in thc area between the maternal udder :md
na\-cI fetal structures in the proximity of the abdominal
wall can be visualized from the outside during the 2nd
and 3rd tri mesters of gestation. Using this tt.ochnique the
trunk of thc fctus remains acressiblc until binh.
1.3.3.3 Sonographic fetometry in horses
Through fet ometry. ultmsonogmphy offcrs the p0s-
sibi lity of dctermining fetal agc and to lLSSC'iS the dcvel-
opment of the fetus and pregnancy (KAliN and LElDl
1987 a). The best apPfO<tch for measuring a fe tus de
pends on the approxi mately suspected stage of preg
nancy. In principal it is expected that the combi nation of
measurements from as many parameters as possible will
result in the most accumte estimation. Until Month 6
the diameter of the trunk and the size of any additional-
ly accessible organs should be determined. From the 6th
month especially thc head should be fetometrically cval-
uatcd. On thc procedures for fc tometry sec also Chap-
ter 2.4.4.
1.3.3.3. 1 Eye and braincase
The cye is the fetal organ which is most frequently
avai lable for fctometrical assessment during thc entire
course of gestation (Fig. 1.90 and 1.92). The largest di-
ameter of the eye increao;cs approximately in a linear
fashion as pregnancy progres.o;cs (Fig. 1.91).
The expansion of the inner diameter of the crdnial
cavi ty increases vcI)' mpidly (Fig. 1.91 and 1.92) and is
well correlated with the stage of pregnancy. The brain-
case can only be measured until the 8th mont h of gesta-
tion. because thereafter the sound "''aves are too at-
tenuated by the cranial bones and thc imaging field of
conventional SC'dnners is too small to allow the crdnium
to be depicted in toto.
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66 U1ffflSonogmphy in fhe mare
"'ig. 1.93: Exnmple of taking measurements of 3 nb cross sec-
tions ..... ith their rom.-sponding intercostal spaces in a fetus on
Day 188 of pregnant),. TIIC length of one nb cross St:clion with
its corresponding inlcn.v.;tal spao.: i ~ 12.5 mm (37.5 divided
by 3).
Ag. 1.94: Example of measuring the dill meter of the lruolo: of
a fetus on Day 88 of gestation.
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1.3.3.3.2 Ribs, trunk and stomach
In order 10 determine the increase in the size of the
tmnsvcrsc scClions through the ribs, one must obtain a
horo..ontal sonogmphic plane through the chest thereby
making it will be pos..c.ible to count the number of ribs
and imeroostal spaces per unit length (Fig. 1.93). In or
der to reduce the errors in measurements to a mini-
mum, scvcml ribs and thcir intclcostal SlXICCS (3 to 5)
should be used for this assessmcnt. The di.<; tance be
tween the edges on the same si de of the cross sections of
two distant ribs is del emlined. When this dist:mcc is di-
vided by the number of rib cross sections included, Ihe
result will be the length of one rib cross seCi ion with its
:ldjoining intercostal space.
The size of the stomach can be measured by orien-
tat ing Inc ultrwiound probe to show the image wi th the
Equille/ems 67
greatest length of the stomach. Now the largcst inner
diameter of the hypocchoic lumen of the siomach can
be measured.
The largest diameter of the trunk is delennincd al
Ihe level of Ihe stomach :md liver. The direct distance
bet\\\.'Cn the opposing body walls on a sonogmphic
planc Ihal is vcnic-..ally oriented to Ihe lrunk is measured
(Fig. 1.94), On avcmge. the diameter of the trunk grows
from 25 mm on Day 60 to 80 to 100 mm on 300ut Day
150 (Fig. 1.91). During the Momh 6 thc size of the
trunk exceeds the penetration depth of the ulll'll.<;()und
probe and can no longer be used for fClometrical pur-
poses. Umil thc 5th momh of gestation thcre is noml al-
ly very lillic variation in the trunk diameter of different
fetuses. making this a reliable parameter for the assess-
ment of fetal dcvclopmem.
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68 Ultrarollogmphy ill the mare
Fig. 1.95: Onset of embryonic mortality on Day 17 of gesta
tion. Signs of abnormality are the iocreasc:d cchogenicity of
t h ~ embryonic nuid as " "ell as the vaguena<i of the interface
bet .... -ecn the embr),onicvcsicJc and the uterine wall. Four days
laler the ronccptus \V35 largely resortx:d .
.... ig. 1.97: Abnormal pregnancy from Fig. 1.96 on Day 33. The
embryo had continued to grow Ilnd still had 8 beating hew.
Signs of cmbl)"Onic mortality are the uncharacteristic orienta-
tion and disorganization of the placental membranes (arrow),
the echoes visible inside the nuid and the small size and nat
shape of the vesicle.
F"tg. 1.96: Abnormal pregnancy on Day 27. The embryo still
exhibited heart beats. Signs of the impending embl)"OT1ic
death were the irregular outline of the embryonic vesicle and
the smaller than expected size of the vesicle ", .. hen rompared
to the last service date.
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1.3.4 Uterine pathology
1.3.4.1 Embryonic death
In the horse embryonic death occurs in 4 to 15% of
all pregnancies becwcen Days 10 and 50 (OIEVAUER
and PALMER 1982, SIMPSON et a1. 1982, VALON et al.
1982. SoUIRES et al. 1988).
There are numerous ultrasonic signs that can be
used to predict an impending embryonic mortali ty. In
pri nciple, all findings that indicate a devi ation from the
normal should be interpreted as suspicious. Certain fea-
tures are, hO\\--evcr, more characteristic and occur quite
regul arly.
An important feature indiCl.ting the viability of a
concept us is the anechoic nature of the placent al fluid.
In the case of a resorption slight to moderate reflections
will appear relatively soon within the fluid of the em-
bryonic vesicle (Fig. 1.95). They are a sign of the in-
creasing cellular content of the embryonic fluid and of
the disorganization of the pl acental membranes.
The interface between the embryonic \-csicle and its
surrounding endomet rium is smooth in the C1se of
intact pregnancies. When this line becomes wavy it may
serve as an indication that an embryonic death is immi-
nent (Fig. 1.96). Occasionally, the interface appears tor-
IUOUS in which case the resorption will have already pro-
gressed somewhat. The reason for this is the lack of in-
ner tension in the vesicle which is Cl.uscd by cessation of
embryonic fluid production and by its increased resorp-
tion. The endometrial folds are no longer stretched
smooth by the conceptus , but rather protrude into it
(SoUIRES et al. 1988).
Ulerine 69
In the case of a disrupted pregnancy the loss of the
embryonic vesicle's tension is associated with a loss of its
typical shape. In the intact pregnancy the conceptus re-
mains strictly spherical until Day 15 of gestation. If the
embryonic vesicle assumes any other shape before this
day it should be suspected to die. During later stages a
change of shape can no longer be used as a reliable in-
dicator since physiological changes in shape occur sub-
sequently. In some C3SC'i of embryonic mortali ty a disor-
ganization of the embryonic membranes have been 0b-
served (Fig. 1.97). Deviations from the typical
arrangement of the allantoic yolk sac membrane occur
in some cases of embryonic death during the ascendi ng
phase of the embryo (GI1-.TIlER et al. 1985).
The lack of a heart beat is the most reliable sign for
embryonic death. Shortly before death a bradycardia
can be seen in somc embryos. In the intact embryo the
heart rate is usually above 150 beats per minute.
Another indiCl.tion that an embryonic death might
be in is the inadequate size of the vesicle
(small -for-date) due to the subnormal vol ume of em-
bryonic fluid (G1NrnER el al. 1985). An embryonic re-
sorption occurring duri ng the fi rst 3 weeks of gestation
usually runs a rapid course. It only takes a few days from
noticing the fi rst signs of a disorder untilthc embryonic
vesicle has disappeared. After the 3rd week some re-
sorptions run a protracted course (Fig. 1.96 and 1.97).
In mares that loose their embryo at a hiler stage, a pre-
ceding subnormal vesicular size ponends impending
dcath. The involved embryonic struct ures somctimes
continue to grow for several days and rarely for a few
weeks (DARDII US et al. 1988) yet do not obtain a
normal growth rate and eventually die.
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70 UI/rrlwllogroplly ill 'he mare
Fig.. 1.98: Uterus 4 days aCler the death of the fetus on aboul
Day 70 of pregnancy. At this time the fetal fluids had largely
disappeared. Uypcrcchoic fe tal remnants (arrows) .... 'Cre still
dctt.'Clabl e b)' ullr.l.sonogrJphy for another 2 weeks.
1.100: Uterus (arrows) of a mare with a normal postp.u-
tum period 84 (3.5 da)'S) after p.lr1urition. Within the
uterus the ant.'Chok: lochial secretion over a few
can be seen.
Fig. 1.99: Hydrops of the placental membrJnes in a mllre al
day 230 of gestation. The c.V'CUio.'C aCCllmulation of fluid can
be secn to extend beyond thc ma:umal penclrnlion dcpth of I
the sound w-.. wcs. Thc fetus could not be detected by transl'l'C-
tal uhra'iOnography .
. 'Ig. 1. 101: Normal involution of the in a mllre IS hours
fJOSt panum. The uterine lumen is largely closed. A small
amount of h)'JXlCchoic fluid is visible between the endome-
trial folds.
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1.3.4.2 Abnormal pregnancy
There can be many signs of abnonnal events during
advanced pregnancy. The shape and size of the fetal sac
can no longer be assessed. because it has become too
large. Ultrasound ex...minations at this stage ameen-
trate on the fetus (see also Chapter 1.3.3). In cases of
imminent abortion it has been not ed that the fetus had
a heart rate beyond the outer limi ts observed in intact
pregnanCIes.
Often the fetus is not immediately expelled after it
has died. A steady decline in the amount of placental
fluid can be obser .... ed by ultrasonography in such cases.
The sonoanatomy of the fetus also changes. Many struc-
tures that can be seen in live fetuses become less clear
(Fig. 1.98) . Parenchymatous organs in particular. which
undergo rapid postmortem changes and are nonnally
traven;cd by a rich supply of blood vessels change their
typical appearance (STAUDAa-t 1986). The hypocehoic
appearance of blood vessels changes to look like the
surrounding tissues. because of intravascular roagul a-
tion of blood. Soft tissues may loose their typical struc-
ture and look much less different iated. Ossified bone
segments retain their eehogenicity and will therefore re
main visible for a much longer period of time. Even
once the placental fluids have totally disappeared fetal
echoes can usually be found for several more ..... eeks
(GINrnER et al. 1985).
In hydrallantois and hydramnion cases the most 0b-
vious finding is the extensive amount of fluid in the uter-
us. There is an excessive aceumulation of placental
fluids between the uterine wall and the fetus. In some
instances this is so extensive that it exceeds the scanning
depth of 20 to 30 em of low frequency ultrasound (Fig.
1. 99) and the fetus can not be reached transrcctally.
During transcut aneous examination it might be detect a-
ble in the vicinity of the maternal navel.
A bllonnai pregnanc),. POSI paT1l1f11 /IIems 71
1.3.4.3 Post partum uterus
During the fi rst k-w days of the post partum period
the uterus of most mares contains some lochi 'll secre
tions. The depth of the fluid accumul;ltion can re,lch
several centimeters, even in normal postpartum mares
(Fig. 1. 1 (0). It somet imes happens that on the basis of
an ultrasound ex..mination a uterus is found to be frcc
of fluid during the fi rst few days after parturition (Fig.
1.101); not infrequently, however. lochial Ouid may be
found in the same uterus during a followup examina
tion Ito 2 days later (MCKINNON et al. 1988). The pro-
portion of mares that do not have any Ouid left in thei r
uterine lumina increases significantly after Day 7 post
partum. At the time of foal heat only 25 % of mares
have lochial secretions in their uterus. In the case of an
abnormal postpartum period with Ihe retention of
lochia the resultant nuid accumulat ion in the uterus can
be strikingly extensive and many centimeters deep (Fig.
Flg. 1.102: l.ochiomelr:l in a marc 45 days poslpanum. 1hc
fluid pool in Ihe ulerus (arrows) exlends nmn)' cenlimclCf'j
dccp. lbc same day 1.5 1 of fluid \.\'CTC drained rrom this ul erus.
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72 UilfflSOllography ill the mil rl!
Fig. 1. 103: Pa<itpanum uterus (alTOllo'S) 3 days lifter panuri-
tion. There is hypercchoic lochial fluid in the uterine lumen.
The hyperechoic structurcs brJnch out O\wthe surfaccsof the
cndometrial folds.
J.1g. 1.104: Conspicuous accumulation of hypercchoic SCCTC'
lions (betwecn the CfOOiSCS) in a uterus with abnormal in\ulu
lion in 1\ mll re 8 days postpilnum. Malin&" during foal heal
and the next heat did not result in 1\ pregnancy.
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1.102). The cchogenici ty of lochia slowly decreases over
the fi rst few weeks of the postpartum period. Immedi
ately after panurition the tissue componenlS and in
fl ammatory products cont ained in lochial secretions
cause the lattcr to contain floccular cchoes. These reo
flections can becomc vcry int cnsive in cases of viscous.
purulent lochia. Sometimes the luminal epitheli um also
produces hypcrcchoic reflections (Fig. 1.103). The
superficiallaycr of the uterine wall forms a nnlTOW I to
2 mm, 'o'ery hypoechoic seam which li nes the uteri ne
lumen and spreads behlleen the endometrial folds.
Post partl/It! lIIems 73
Only few of the puerpcml mares which have seere
lions in thcir utcri duri ng foal hcat m the time of mating
conceive (Fig. 1.1(4). In cont r.l..St, murcs that have a
solid uterine image at the same time huvc a much bener
prognosis (McK1NN01'l ct al. 1988). In tcrms of pnlctical
stud management this means that only mares which do
nol show any ultnlsonic evidence of int rauteri ne fluid
should be bred at foal heal.
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74 UIlrrlsollq.'T"llpily ill the mllfl!
Fig. I.I OS; Trunwcf';C section through the mcrine hom (II r
rows) of a Illare wit h chronic endometritis. 1bc lumen oon
tains a modciJlc IlmoUn! of C'CUdaIC.
Fig. 1.107: Uterus (affU\\"i) wi lh an inflammlllOf)' kcrl.'lion as
u result of II chronic endometritis. The increased cdlulur exm-
Icm or lhc cxud:lle Ooocular echoes.
Fig. 1.106; of a marc wi th large accumulation or exu-
dale II result of Il chronic The cndumctrial
folds bulge into the lumen.
folg. 1.108; Uterus (a/TOYo'S) of a marc after the instillation of I
I physiologic:ll s.aline -.olution for Oushing. The ai r bubbb in
the Oushing solution produce intense floccular echoes.
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1.3.4.4 Endometritis
Accumulations of fluid inside the uterine lumen arc
very typical of mares suffering from chronic endomctri
tis. The amount of fluid in Cll" of uterine infections
varies from marc to marc (Fig. 1.105 to 1.101). The
amount of the secretions in the same marc can also vary
from day to day. This is dependent on the stage of the
cycle. Auid accumulations found during estrus may be
physiologic, but may also be an early indication of en-
dometritis in many cases (ADAMS et al. 1981). When-
ever fluid secretions arc found in the uterus during di -
estrus they should be regarded as abnormal. Sometimes
the secretions arc concentrated in a panicular area of
the ut erus and at other times they can be detected along
the entire uterine lumen.
The outline of the fluid accumulations in endometri-
tis cascs is typically stcllate shaped (UlDl and KAHN
1984) in a tmnsvcrse section of a fluid fill ed uterine
hom in which the endometrial folds bulge into the uter-
ine lumen (Fig. 1.1 06). The interface bet .... 'een the
secretion and thc surrounding uterine wall is wary.
Quite frequently the 6 to 8 cndometrial folds that are
normally prescnt in the uterus of a mare can be seen.
The fluid distention of the uterus causes fluid to also
penetrate in between the longitudinal folds, separating
them from onc anothcr whereas in the absence of any
fluid they normally lie in tight apposition.
The stellate shaped appearance of the sonographie
cross section of a free intm uteri nc fluid accumulation
in cases of endometritis cannot be secn in fluid accumu-
Ialions of ot her origins such as in inlact pregnancies or
with endometrial cysts. Due to the inner tension of the
placental membranes or endometrial cysts these form
rclattvcly tightly filled vcsicles which stretch the fold .. of
the endomctrium [ 0 form smoot h lines. The interfllce
between the uterine contents and the endometrium
thus fomls a smooth line. In rare individual cases a stel-
Urcn'lIc pml/Ology 75
late shaped protrusion of the endometrial folds into the
pl acental membranes can be found even in intact preg-
nancies. The cases thus far identified all occurred in ol-
der. multiparous mares. The irregular interface be-
tween Ihe embl)'Onic fluid and Ihe surrounding uterine
wall appears 10 be a consistenl finding in all cases of em-
bl)'Onic death.
A typical feature of the uterine secretion in Ihe case
of endometritis is the increased echogenicity of Ihe
fluid. Clear fluids usually produce an anechoic. black
image on ult rasonography. In contrast, the secretions of
endometritis mares always contain echoes of varyi ng in-
tensity. Depending on the degree of change thc.'OC can
vary from occasional floccular echoic spots to echo pat-
terns that can be more echoic than the surrounding
uterine wall. Small air bubbles ins.i de fluid accumulations
can also produce noccular reflections. These are particu-
larly evident after uterine infusions or flushes (Fig. 1. 1(8).
From a differential diagnosis point of view it should
be pointed out that amniotic nuid can also be echoic
during Ihe 2nd and 3rd trimesters of gcstation. Due to
the increase in cellular components it is first floccular
and later the amniotic nuid will have snowy reflections.
This also applies to the allantoic fluid during the last
trimester of pregnancy. The sonogrnphic differentiation
belWCen the secretion of an endometritis and other
fluid types in the uterus such as placental fluid or thai
contained in endomelrial cysts. must be undertaken in
conjunction with the aw-ssrncnt of other criteria. Im-
portant criteria in this regard are the (."chogcnicity of the
fl uid. its intra-uterine position and its shape. The most
suitable time for the ultmsonic diagnosis of an endo-
metritis appears to be during the mid to latc diestrous
period (ADAMS et al. 1981). At this stage of the cycle,
pathologic fluid secretions seem to be most prominent
and can stj]) be diffcrentiated from the possibly physio-
logic secretions that may appear during estrus.
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76 Ultrasonography ill the m(lre
Fig. 1.109: Pyomet ra in a marc. The uterus is severely dis-
tended by a large ilnlOunt offluid. Due 10 the large number of
leukocyte the purulent exudate contains very snow}' refll'C'
tions.
'g. 1. 111: TmnwcI"SC Sl'Ction of both uterine hams ( a ~ ' S )
of a mare suffering from muoomctra. The hypocchoic Sl'CfC
tion is sUlTOUnded by the thickened ut erine walL A persistent
hymen in this 2 year old mare caused the retention of fluid in
her uterus and vagina.
.lg. 1.110: Uterus and urinary bladder (all'UYo'S) of a mare suf
fering from SC\'ere endometri tis. The ut erus. with its endome
trial folds bulging inlO the lumen. lies cranial to the urinary
bluddcr .
.' !g. 1. 112: Urometra in a mare. The uterus ClItends cranially.
The intrauterine fluid contains snlMY refl ections such as can
be also \)p ical for equine urine.
Ave 0 Z C "lO ClC "
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1.3.4.5 Pyo-, muco- and uromctra
Pyometra represents a particularly SC\-ocre form of
endometritis. Its ultrasonic image features an extreme
dilatation of the uterus (Fig. 1.109). Through this the
endometrial folds are stretched and the interface be-
tween the uterine contents and the .... 'all is smoolh.
Within the secretions of pyometra there are usually
intensive renCClions which increase in density ventrally.
This is caused by the sedimentation of increased
amounts of cellular components as .... 1:11 as the increa
sing consistency of the pyometra nuid in the uterus.
The ultrasound image of the urinary bladder can
look much like that of a pyometra (Fig. 1.110). Due to
the high viscosi ty of equine urine the luminal contents
of the urinary bladder show an echo pattern wi th inten
sive rencctions which can be confused with that seen in
a pyometra. The appcamncc of the bladder can also be
confused with a slightly cmnially dilated uterus. Since
this can lead to misinterpretations. a pyometra should
only be diagnosed if two completely separate, closely
opposed hollow organs can be demonstrated. It is im
portant to dcpictlhe entire bladder wall without any in-
terruption so as to ensure that there: is no oonncction to
the more cranially positioned hollow organ.
If difficulties are experienced in differentiating be
tween a pyometra and a pregnant uterus effons should
Ulerine palllolOf{)' 77
be made 10 find floating segments of the amniotic mem-
brane or other fetal struct ures such the umbilkal
cord or paJ'lS of the fetus itself.
The ult rasonic diagnoses of muco- and urometra are
based on similar criteria as are used for a pyometra.
Mucomctrd is occ'sionally diagnosed in mares with an
imperfomte hymen. Most oommonly the diagnosis is
made in young fillies. After the onset of ovarian and
uterine cyclic activity during puberty, the usual outfloy,
of secretions from the genitaltmct is prevented by the
persistent hymen. This then leads to the accumulation
of the mucous secretions in the vagina and uterus.
Apart from typical clinical signs. such as the protrusion
of the hymen from the vulva or the rect ally palpable en
largement of the uterus. the ret .. ined fluid can also be
demonstruted sonogrnphiclllly in severnl seClions of the
uterus (Fig. 1. 111 ).
AnatomiC'dl changes of the genitalia. such as the
craniovcntml displacement of vagina and uterus in the
presence of an open cervix, can cause urine to flow
crJnially into the uterus and establish a ummetra.
Ultrasonically such a uterus appears nuidfilled and
widely dilated (Fig. 1. 112). The charncteristic echogen-
icily of equine urine often also leads to noccular renee-
tions in the uterine as in cases of urometra.
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78 UltrusollogrulJ"Y in the mare
Fig. 1.113: Endosropic Vk..-W of a multilocular endometrial cyst
in the uteri ne hom of a marc. In front of the cyst is some I'rcc
fluid. indicating that the mare also has an endometrit is.
f1g. I.I IS: Large endometrial wi th multiple scpta in the
uterus of a mare. The cysts were opened using a biopsy punch
nnd thc marc conceived three weeks Imer.
Fi3. 1.114: Two enoomclriaJ cysts (C) within the uterus (ar
rows) of a marc. Both c),sts produce an image which could be
confused \\ith an cmbl)'Onic vesicle during an ullnlSOund ex
ami nation.
t1g. 1.116: Endometrial cyst (C) and conceptus on D-.I} 29 of
pregnancy. The cyst bulges into the cmbl)'Onic \1:sicle oon-
taining the embryo (E). The pregnancy continued 10 dc\'C1op
unt. ... entfully.
e a ;I(
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1.3.4.6 Endometrial CYSlS
Endometrial cysl<; are typically found in mares O\ICr
10 years of age (KENNEY and GANJAM 1975, KAsPAR et
al. 1987. LEtDl et al. 1987). In this age group cysts can
be found in 20 to 25 % of all mares. The 'l'SlS can be of
lymphatic or glandular origin. Endometrial 'l'Sts can be
single or multiple (Fig. 1.1 13 and 1.11 4). They can oc-
cur in both. the uterine body and the uterine horns. It
seems possible that the cysts can affect the fertility of
the mare. They do not. however. prescnt an absolute
obstacle to the establishment of a pregnancy, because
many pregnancies ha\'e been seen to develop quite nor-
mally in the presence of endomet rial cyst<; (Fig. 1. 11 6).
In isolated cases, where the cysl<; arc particularly large
or numerous, they appear 10 cause embryonic mal-
development by interfering wi th the normal implanta-
tion process of the embryo (AOAMS et al. 1987).
UltrJSOnic.llly. cysts look like fluid filled vesicles with
a sh.lpe that can vaT)' from spheriC'.l1 to long and oval.
Their lumen can consist of a single cavity or can be di-
vided into severnl C'.lvi tics (Fig 1.11 5). The outer .... '3115
and possible inner septa of endometrial cysts possess
the same cchogcnicity as that of the uterine wall . The
rront and back walls of the cysts which are oriented vcr-
tically to sound wa\'CS C'.ln show intensive, specular re-
flections. The cyst fluid, which is lymphatic fluid, is an-
echoic and looks virtually black on ultrasonography.
The size of these cysts can vary from a few millimeters
to SC\ICrnl centimeters.
Some C)'Sts f'.lnging in size from 10 to 30 mm can at
times be difficult to distinguish from Day 10 to Day 25
pregnancics {OIEVAUER and PALMER 1982. SIMI'SON ct
al. 1982, LElDl et al. 1987). From Week 4 or pregnancy
thc differentiation is easier, because thc cmbryo exhib-
itc; a beating heart (Fig. 1. 116). Evcn at this stage con-
fusion can arise whcn there are twin embryonic vesicles
or simultaneously occurring cysls and a conceptus.
Paying particular aUention to the recognition of
their typical, specific features makes the distinction be-
tween a conceptus and a cyst easier. A spherical shape,
UlerillC JHllholOf:D! 79
a diameter consistent with the last reported service date
and a centrnl position in the uterine lumen are all symp-
toms favoring the diagnosis of a conceptu.c;. Mobility of
the vcsicle or the detectable presence of a heart beat in-
side the embl)1) will both confirm a pregnancy. The m0-
bility of the embl)'O is usually evident until Day 15 or 16
and can be observed in most cases by scanning the ves-
icle for a few minutes (lml and GINTHER 1985).
Indications of a cyst include an irregular or oval
shape. the presence of scvernl compartments within
their lumen. or their multiple occurrence in the uterus.
Vesicles that lie eccentrically or intrnmurally in the
uterus should also be vie ..... cd as cyst ... Further indica-
that a detC(.'1ed vesicle may be a cyst include a
discrepancy bet ..... een the observed and the expected
diameter (based on the 1.lst service dale) of the vts--
icle or it .. failure to grow in size as dcmonstnlted by
repeated examinations at of a few d:lYS.
If there is still doubt about the identity of a \,t.'Sicle.
other pammelcrs than Ihose established by uitf'.lSOIlO-
graphy must be relied on. These include the nssessment
by rectal palpation of uterine and cervical lone as well
as the site and shape of a possible bulge in the uterus as
well as progesterone detcrmination. If even this cannot
provide clnrity, a repealed examination after a few days
is indicated. If the mare is pregnant there will be a de-
tectable increase in the size of the embryonic vesicle by
the time of the next examination.
In order to avoid later confu.c;ion in differentiating
betwcen cysts and embryonic vcsicles il has been found
useful to look for the presence of 'l'Sts during a breed-
ing soundness examination which is performcd at the
beginning of the breeding season . ..... ell before the mare
is bred for the IiDt time. During this cxamimltion the
presence, locality. number and size of all endometri al
cysts should be recorded. Should a new vesicle of the
appropriate size appear during the lirst 3 weeks after
SCrvK:c il ,"'Quid be most likely to be an embryo. Endo-
metrial cysts grow much slower than embl)'OS ;md the}'
tend to remain sonogmphically unchanged for much
longer than embl)'OS.
Allt>rsk a t n 1
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80 References
Refere nces 10 preface
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8out.Er. D. (1982) : Application de l'6chol'Iphie III diq;nostic de
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I K .... ND. J. 1. B. C.o.wu:. I. BEJrrlAND d P. F. Vl.UD (1982) ;
lmagc:t 6chognplUques de 1'anaIomic iIbdominaJc del dol, ...
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LElDL W. and W. KJ.HN (t984): Diffen:nti I Ldi l anostitr.:hc Befu.nde bei
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MAlUlAt:. 1. M . S. CHAI'FAlllI. 1. 1. lalilANll. B. Cuuu. d F. HEm.:
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PAl.lIU:. E. and M. A. DalANCOI./U (1980); Use ol ultruonic 110-
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PrElSON. R. A. and Q 1. G,:ffl(U: (1984b): UIUUOIIOCl1Iphy 01 the
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RUVES. 1. J .. N. W. RANTANE.'I and M. HAUSER (1984) : Transrectal
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noIogy 21. 485-49-4.
StNI'SON. D. I .. R. E. S. S. W. RJcurrn. P. D. Ross.
/.Io\U!. M. S.o.NDEa5ON and W. R. AJ..L.V< (1982): Use 01 uhruound
echoeraphy for early diq:1ID$.i.I. of l ingle and twin prqnancy in the 11111...,.
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TAlNT\JRlu. D .. L. 1..I.Iooa. M. CHMIU. K. W. d B. D&Ils
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(1983b): Diagno5lic de I. acstation cht:z I. chh..., par 6chotomo&raphic.
Revue Mt<! . 134. S97- S99.
TAVf.l.'II!. M. A. M .. a SZENCI. J. SWAQ and A. Pi_ (198.5) :
Piq;tW>C)' diqnc:.sis in o;oQ wilh lineIIr-anay real-time ulll1l5OUnd
lK'IMioa; tx*. The 'tt:rilwy Qtw1erly 1. 264-ro
VALOtI . F .. F. SEGAao CI .51: . CHAfflWX (198:2) : &hcMomoJraphie en
IC:llIpS 16::1 de J'ultrw chc:z Ia jument . BIIIl . Acad. vh:. Fr. S$. 1B7-211.
WHITl!. I. R .. A. J. F. RUSSEL and D. G. FowU!l (r984) : Real-time
ul1t'UOllie scanning in the diqnc:.sis ol and the due, ",;nation
01 fetal numben in iheep. \let. Rt;c. 11.5. 14{)-143.
WHITl!. I. R . A. J. F. RII5SEl.. I. A. WlOOHT and T. K. WHYnI (1985):
ReaI ' lime 1I11t'U011ic scanning in the dil;gnosil 01 prcpatKY and die
estimation ol, ,mional.,e in eattle.. Vet . h<:. In .s-s.
Rcferences to chaptcr 1
A/.Io\MS. G. P .. I. P. K.o.srEuc, D. R. BEfIGfRT and Q 1. OtN'THU:
(198'7) ; EIJc,;t ol ull::rinc: inflammation and IIltrasonic:a1Jy-dcIcdod ute-
rine phlthoIogy on fenility in the mare. I. Rt;prod. Fe" .. Suppl . 3.5.
445-454.
A\lO.",s BIE.'IOEMUElIL. c.. and F. S. PiI'EllJ (l9!7): Anlt:pl.rtum c:vaIua-
Iion$ 01 the equine fctw, . I. Rt;pood. .. SIIppI . 3$. 56!i- .573.
AI.I..tI . w. E. and P. J. (loot>O.ao (1984): Serial inYes(iptions 01 carly
p<qnancy in pony U$i", iUlt;me IIltrasound I('anni",. Equine
vet. 1. 16. .509-.514.
Aunl . W. E . P. E. AUfJD. K. KOOIOS and 1. F. PtCOt.." (J98'7) ;
Ul\JU:lllic oldie equine haelllOl,I""ic\im. Vet . Roc.
Ill . 422-4U
BowMMi . T. (1986): UIlllSOOic diq;n05is and 01 early
twillS in the mare. Proc:. Am. Au. Equine Pracutr. 32. 35-U
CAitIIl!VAU!, E. M .. A. O. MCKif/NOl'f and E. L. SQtnIU (t988 .):
EITttt 01 JIIllWIllatory IOllicular fluid aspiration upan luEal tur..-Uon
in the TlI'''lcFnoIogy 29. 231.
C.o.aNEVALI!. E. M .. A. a McKltl_ and E. L. SQuJau (t988 b):
UltraIOnic uf the ....-ut.tory follicle dlrocdy piUC:C:V
ding and dun .. ovulation in the mare. 29. 232.
CHEVAUU. F. and E. PALMU (1982): Uhl1llOllk ochosraphy in die
mare. I. Rt;piod. .. SIIppI. 32. 423 ...... 30.
COl, ft, c.. M. and R. D. p ",UI'S (1978) : Foo:taI cic<.:trocardqraphy
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CullAN. S. and a 1 G,IffllU (1989); Ul\JU:lllic dilgllOlil ol equine
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a 1. (t983 I): Mobili!}' oldie early equillt ,oe4pcus.. The-
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n 1. (1983 b): n lion and oricnwion ol the early equine
UX4pi1l1. Tbc:fioaenoIos.y 19. 61)-623.
Avto zasc C 10 gradivo
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0"<1'1101. 0. 1. (1984 I): inlnIurrrine ItIIM:mrnt 01 early roncq>IU.I
in bamn .00 po6!p'"um mvt:I. Therqc:noiogy 21. 633-6'4.
ClI1<T1l". 0. J. (1984 h) : Mobility 01 !Wid _i<1<:o In mamo.
Theri0l<'"olagy 22, 8J-9S.
ClIl'ITlI". 0. J. (\984 t) : P\)QrLWioa ell1bt)o redI.IctioII in unilaleral
.00 bilaw:ral !wiM in ThcrioFnoIosY 22. 21l-211
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mm. Yerllc EqU.lKrvica. CIOSI PW .... Wisconsin, USA. .
ClI1<TI\u. 0. J. and R. A. Pw.UOl< (19S4 I) : UI\r.uonif;: ..... 01
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FnoIocY 24, 73-16-
!-tow r_, D. (19S4): Physik WId ThduIik dtr
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10. .. 1<, W. ulld W. UJoc. (19SI) : 0;. UluuduJld"-ik (Et/q.ra
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Nc:, dcl.,ilkundr: I. 239- 246-
IUHs. w. WId W. ' fAA (1987 I) : Die: uttrudlall-Bionw:tric: _ Prer
ddtltn in UI!em WId die 1Oi ....... phisdw:: iII..,r Orpne:.
DlKb. tiefln:1l . w.dIr. 94 .109-Su.
IUHs, W. IIIId W. I O"ll (1987 b): IIdi.tndt 1/1 o-itn
_ SUiIen. TIefiJUI. Unudo. 42. 2S7- 266.
K.o.S!\U:. B. . W. "" .. 1'1. C. l..IrGl<CI WId W. lnDL (1987) : Enoolllcmum
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LEloc.. W. ulld W. 1U1II< ( 19S'): DillemlliaJdiapootixlw: IIcfundr:
bti dtr Frilhuicht.ipr:itsunlt"""""llI '00II SUiIl:n mit dtm UluudWl.
..m.hn:n (EcIqrap/Iic). V ....... die,,,,. ok. TIjddor. S)' 1-
n .
l..fJoc.. W . .00 W. IUHS (19119) : Ult..,.,.,i< dwxItlistic$ of
Iital conditions .. tIoe equine UItfUIi and (MInes. In: Ulua
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cine.oo Anilllll Science 51. 21 - 35. Eds. : M. A. M. A.
H. WillclMi:. Verlq KlU_B Aado:mic Publilloon. DonIrecht. aow....
.......
lnDL. W . Ii ItosIout WId W. 1U1II< (1987): EndometriWllZ)"Jlrn lIti
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lnm, (l. S. and Q J. O ....... u (J98(), Ouol"Olaeri ... jnn 01 ifttrautcrlne
mobil;!)' 01 tho:: eady eqIIitw: Cotoccpws. 22. 401 108.
RejtTl'lIces 81
lDnI. 0 . S. and Q I. (ir:ml1Jl (19M): Mobili!)' 01 tile COIICCjAlIJ and
uoeri:w: a'lIIlrIICtions in tho: man:. 11k' """,ooioc 24. n - 711.
MAnrn, K . S. Suo:woo and I . M!.su ......... (1983): Cha:oFs in tho:: &:cal
he_" ralt 01 Thorouthbrtd t.or.c ohmotJh tho: gtSlI! ..... . lap. I. vet . Sci .
47. m-601.
McKrsSOl<. A. Q . E. L. 5Quw3. L. A . H"IImON. E. L. 1kx1l..,.;l
R. K. SII,,,,,, E. ( 198!1): UliJMlWllraphic: lNdirs on tho:: ..,pmducliw:
trlC! oI .... M Ifler p'ltIuitioa: EtJca 01 ilM>lution and IIICrine Auld
... poq1WIC)' me. in .... M with normal ..,.;l rilll IQlponum
(MIlany qo<le$. I. Am .a. mcd. Au. 192,
MEHt, H .. A. R. G<lr<zu.. W. A!lf.LWId R. M"nos (198J): Eo::ho&>a.
phic - rine ElJinzu .. dtr UiiItnIidounpmetJooden
zur Zyklul"" und TTictlIilkc:ilidiapostili: lItim !'kid. DlKb. tierlml .
Wrlr. \lO, 22.5-230-
OGum, 1. P. . C H. YI'..IEJo. L. FtSIll.J!lOl'l. J. B-..I<.oo 0 . E5aA
(19111) : In vi$uaJi>Mion .. tho:: feul hone: by uluuoni< KMni",.
Equillt I'ract . 3. 4S-49.
P"L/oIEJo. E ..,.;l M. A. Daw<cooIlT (1980): Us.:: 01 ultruonlc echo-
Jl'lpIo)' in equine IYnecaIosY. Tlw:riotcnoloc U. 203- 216..
PrEMOf<l. R. A . ..,.;l a. J. OtJmlO; (19U I ): Ultraooni< .....JIIII ..... of
tilt corpus lult\lm of tho: ......... 23. ?J}-806.
PrEJt3Ol'l. R. A. and Q J. On<rnEJo (1985 h): Ulrruonic e>'IJllllion 01
tho:: prc<MI!atory IOIlil;lc in tho:: ......... Theliop:noI"I)' 24. 3S9-368.
PrE.UON. R. A . .00 Q J. GI)(f1l1J1 (1987) : Follicular populalion dy ....
micIo oIurin& tho:: e:ltroool q<:1e 01 tho: man:. Anim. Re!"vd. Sci . 14,
2t9-231.
Prrw. F. s. and C S. An.ws BI!a<IlE.WVEHL (19114): Techniquesilld
:tppIimioRJ 01 tllllSllbolominaJ ultRlOliOJraplo)' in I'ft'&IW'l mare..
I. Am vet . mcd. Au. Iss. 766-nl .
Prrw, F. S., W. Zarr , R. HOI u;'.oo A. ASMJrr (1984): UIuuorIo-
atapIo)r as 1/1 "juncc 10 prqlIIIlC)' WOWIiltnU in tho:: man:. J. Am Yet .
!toed. Au. 1114. 328-334.
SlwI'5Ofi. [). J.. R. E. S. CiltEDo"\llUlD. S. W. RlnETn. P. D. Ross
... tAl. M. and W. R. AlllI< (19112): Us.:: 01 ulrmound
ecbo&:raph)' for early diapolil oIli"lIe.oo t .... in pn:gnI/IC)' in tho:: man:.
I. RI:prod. Fat . Suppa. 32, 431-4)9.
5Quw3. E. L . . A. Q McKrs_ and R. K. SH'DIl.f" (1988): Us.::
01 ul!ruonoJraph)' in "'produaiw: 1I'III\I#n'k1ll 01 ""'"' . Therqc: ......
lo&Y 29, SS-;U
StAIJtW:H, A. (1986): FtWe AtllIOmic im Uhnsc:hall , Sptinp:r Ye,-
1q, lI<r1in, Nc-w York, t.ondooI, Thtyo.
Tcoo'IlH, D. H .. R. A. PrElUOf< and Q J. (ir)(f1lEJo (l989) : Ouo.--
oiutioo 01 plas ... JIIC' Jilt""'" for !'NO diSlill(t 11111:101
ill TherioFnoIoc 32. 191- 204.
V"WI<, F. , F. SoouD rI .51. C ..... fflIUX (1982): en
rrrror- t&1de l'om!ntS rna la junoenl. Bull . Iw::td. V<!I. Fr. S5. 11fl"- 211 .
WIlIT1I. R. A. S. and W. R. Aun< ( 1985): Ug oIuJllUOOnd ecl ... ra
ph)' lOr tho: ditkrollliaJ diapoIis of I ...... 1_ oo:lJ ru""",r in I "",",.
"""iN: Yet. 1. 17, 401-402 .
K .. W. WId W. LEloc. (19118) : Sono&raPhifClit U""' ....
thun;c:n Ubcr die prbulatorisclw: FoIllkc:lclllwi<tJllIII bt; der sw....
DucI>. Ilcotml . Wkhr. 9S. J62- l6S.
WOODS. 0 . L. . C. Ii B.o.n:/t. R. Ii and [). H.
(19ILS): Recent >Ndirs relat;", 10 carty cnoboJOiii< oIeIIh in tho:: .........
"""ine vet. I., Suppa. 3, I14-IJ7.
Avtl 'o:.:a

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82 UfftriWllogrophy ill 'lte CDII'
Fig. 2.1: Schemntic presentation of an ultr.1sound examination
of the internal genital trdCl of a cow. usi ng a linear scanner.
The ultrasound probe lies longi tudinally inside the n."ctum,
just dorsal to the Ulerine hom.
rIC, 2.3: Schematic presentation of an ullrasound examination
of the int ernal genital tmet of a cow, usi ng a sector scanner.
Crdnial vi<:w of the pelvic canal. The tmnS\'CI'scly oriel\1ed ul
trasound plane produces a cross SCC1ion of the uterus ( I) and
urinary bladder (2),
.' ig. 2.2: Sagillalscction through a non-pregnant uterus analo--
gollS 10 the cxamination plane in Fig. 2.1. The larger curva
ture of tbe uterus is demarcatcd by a ~ ' S .
rig, 2.4: Tmnsvcrsc seet ion through a non-pregnant uterus
analogous to the scanning plane in Fig. 2.3 and 2.63. The 4
trdnS\'CT'SC SL'CtiollS through the uterine horns are demarcuted
byal'1'Olo\'S.
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2 Ultrasonography in the cow
2.1 Technique of ultrasonography
in the cow
The ultrasonographic examination of uterus and
ovaries in cows is performed by transrcctal sonography.
The technical aspects of the procedure arc largcly thc
same as those applied in the mare (see OIaptcr 1.1). In
the cow, too, the cxami nation is performed in a way
similar to that of thc rectal palpation (Fig. 2. 1 to 2.4).
After thc rectum has been cvacuated and thc intcmal
genit alia have been palpated in the usual manner. the
handheld ultrasound probe is introduced through the
anus and thcn advanced cranially along thc rectal floor.
Gencrally, all commonly avail ablc ultrasound scan
ners ( lincar, sector and convex) can be used for trans-
rectal sonography in callie. The only condition for their
usc is that one must be ablc to manipulate thc chosen
Technique of ultrasonography 83
ul lrd.o:;ound probes inside the rectum without call.'>ing
damage. Experience has shown that the use of linear
probes holds advantages over the other types when
organs in the ncar fi eld are examined. Examples of such
situations arc when the probe held close to an ovary
or very closely above the uterus. It is difficult, however.
to tum a linear probe a .... -ay from the longitudinal axis
and hold it more in a Ir.msvcrse plane of the animal.
They are thLL'> best suitcd to examine parnllcl to
the longitudinal axis of the body (Fig. 2.2). In contrast,
sector probes offer advantages when more distant
areas, such as the fctll.'> in advanced pregnancy, are to be
examined. Provided it is suitably constructcd, a sector
probe can be turned far enough in.'>ide the rectum to
allow tmosvcrsc views through the uterus to be dcpicted
(Fig. 2.4).
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84 Ultrosollogropl,y ill the COli'
f.'ig. 2.5: Crnnial half of the urimu), bladder (fundus and
body); u!lO\'c the fundus of the bladder is a mature corpus
luteum (demarcated by a/TOlOl'S) .
.. -", 2.7: Pammcdian section through the pek'ic floor (ar.
rows); parallel 10 the initial echo. and into the
depth of the image, arc a of echoes whil;h arc caused by
multiple rcflections (rc\'crtx:rotion artifacts) bctwl.:cn the
sound probe and the pelvic floor.
"']g, 2.6: Caudal half of the urinal)' bladder (U) wit h its neck
(Cc,,<bc \'CSiC:le) and part of its body (Corpus \'Csicac). Vcntml
to the bladdl.:r lies the horizontally positioned. hypercehoic
pelvic floor (a/TOlOl'S).
Fig. 2.S: Saginal section through the uterine cc"i,.; ventrally
to the cclVi."lics the urinal)' bladder (U). Se\'CraJ rings
(a/TOlOl'S) can be rcOOt,;niZt. --d. In the center of the cervix is the
hori1.ontaUy posi tioned. bright linear echo of the cclVic:J1 CJ
nal.
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I
Arter passing through the anus the caudal structures
in the pelvis. such as vcstibulum and vagina, are only
poorly recognizable. Moving funher fOlW'drd, the easily
recognized neck of the urinal)' bladder will come into
view (Fig. 2.6), II produces the typical image of a hollow
organ cont<li ning hypoechoic Ouid and expands cranio-
vcntrnlly to fonn the body of the bladder (Fig. 2.5).
Ventral to the bladder, especially in the area of the neck
of the bladder, the petvic floor can be secn. Its bony
components are evident as vel)' bright, a few millimeter
thick. struct urc.. ... The Ooor of the pelvis fonned by por-
tions of the ischium and pubis, lies vinually horizont ally
in its cranial ponion and rises sl ightly in a C'dudal di rec-
tion (N1CKELct al. 1984). Deep to the echo of the pelvic
Ooor one can often see further echoes which run paral-
lel to it (Fig. 2.7). These are reverberation artifacts.
created by the multiple reOections of sound wavcs be-
tween the hypcrechoic bony surface and the ultrasound
probe.
The cervix of the non-pregnant caw can be found at
the level of the urinary bladder (Fig. 2.8). The cervical
structures that can be identified include the cervical
rings and a central. hypcrechoic line which represents
the cervical canal. Immediat ely cranial to the cervix.
usually in the midline, appear the body and homs of the
Techniq/le of lIf1rosOIlOgraphy 85
uterus. Occasionally, the utero. .. can also be found lat-
eral to the urinary bladder. When the uterus has been
recognized. the probe is positioned above the intercor-
nua] space. In the case of a linear array SC"dnner with
craniocaudal and dorsoventral sound be' lm the probe is
swiveled from side to side to produce longitudimll im-
[Igcs of the uterus (Fig. 2.2). When using a sector scan-
ner. the operator can tum the beam through 90 degrecs
and thus change the scanning plane from longitudi nal to
transverse in relation to the body axis. In this manner
transverse sections of the uterus can be obtained (Fig.
2.4).
After SC' dnning the uterus, the probe can be rotated
further late rally in order to visualize the ovaric. ... In their
nonnal position they can usually be reached by the
sound beam and any additional digital fixation or re-
positioning of the ovaries is nOl necessary. C:lre should
be taken to allocate each identified ovary to the correct
side. Since the exact scanning direction during an
examination is nOl always clear to the operator and the
both ovaries may be posi tioned rat her close to one
another it may happen that the ovary found first is
allocated to the wrong side. Only after both ovaries can
be identified in succession should they be llppropriately
allocated as belongi ng to either the left or right side.
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86 Ultmsollography ill the cow
Fig. 2.9: Comparison of the image qualilY between lower and
higher fn!quency ultrasound. Ult rasonogr.lm of a conceptus
on Day 45 of prcgnarx.y at a frequency of 5.0 The cm-
bryo (E) lics on the floor ofthc uterus and is surrounded by its
amnion (A).
Fla. 2.11: Comp;trison of image quality bcf'A'ccn kM'er and
higher frequcncy ult rasound. Ultrnsonogrnm of a corpus lutc-
urn with a cavi ty imaged li t a frequency of 5.0 MHz. The out-
lillC of the corpus ]uteum is indic'dted by arrows.
2.10: The S.1mc pregnancy as in Fig. 2.9 imaged al a fre-
quency of 3.5 MHz. Details are less wcll rcrogni7.ab1e than at
5.0 MHz.
Fla. 2.12: The same corpus luteum M in Fig. 2.1 I imaged al a
frequency of 3.5 MHz. Size of the corpus Juteum: 36.5 x 26
mm: size uf cavity: 25 x 18 mm.
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When cow genit alia are exami ned sonographically
the imagi ng of small structures, such as the embryo and
its thin embryonic vcsicle, intra-ut erine fl uid accumula-
tions as well as follicles and corpora lutea, is of primary
importance. The image quality generated by ultrasound
at a frequency of 3 to 3.5 MHz is not adequate to relia-
bly depict early embryonic structures or small functional
structures on the O\I3rics (Fig. 2.9 to 2. 12). For these,
the use of sound waves of a higher frequency is essen-
ti al. The resolution of ultra<;Qund at a frequency of 5.0
MHz is high enough to identify vesicular struct ures with
a diameter of 3 to 5 mm (DoBRINSKI and KREMER
1982). At the lo ...... er frequencies of 3 to 3.5 MHz vesicles
of 6 to 8 mm can be seen. To further increase image
Technique of IIltrasonography 87
quality 7.5 MHz ult rasonography can be used. Sound
waves at this frequency provide a marginally better
resolution than that obtained with 5 MHz.
The penetration depth of sound waves at 7.5 MHz is,
however, only 4 to 5 em (HAssLER 1984). For this
reason the use of high frequency ultrasonography is
restricted to the examination of st ruct ures Ihat arc
extremely close to the probe. Sound waves at 5 MHz
penetrate about 8 to 10 em, thus allowi ng the examina-
tion of the O\Iarics and uterus duri ng early gestat ion.
Since ultrasound at 3.5 MHz penetrates 12 to 15 em or
deeper it can be vcry usefully applied in the later stages
of gestation or in cows with pathologically enlarged
gcnitalia.
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88 Ultrosonognl/)IIy ill tile cow
ng. 2.13: Follicle (F) in 3 row on the day of The di
ameter of the follicular ant rum is 17 mm. the thickness of Ihe
follicular ..... ;111 is I to 2 nlnl . Iklow the foll ick lies the urinary
bl:ldder (U).
.'g. 2. IS: ComP'lrlson of inl<lge quality between lo ..... er and
higher frequency ultrasound. Ultm .. o;;cmogmnl of an est rous fol-
licle (Fa) at 5 MHz.
Fig. 2. 14: o.'ary (large :UTO\.\"S) with an estrus foll iclc on Ibe
dlly of ovulat ion. There is a echoic spot (small alTQW) li t Ihe
floor oflhe follicle. Ultrasonogrum laken with a 5 MIlz SCt"lor
scanner.
2. ((i: The samc follicle (Fb) :I. " in Fig. 2.15 secn at 3.5
MUz. 'be diameter of the follicle is 16 mm.
o zas d
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,
,
2.2 Ovarian structures in the cow
2.2.1 Follicles
2.2. 1.1 Sonographic images of follicles
The sonogmphic image of bovine ovarian foll icles is
char.acterizcd by the anechoic. circular areu of the folli
cular lumen (Fig. 2.13 to 2.20). During real time scan
ning the sphcrical shape of the follicles can be demon
stmled by moving the sound probe back and fonh over
the ovary. Their fluid contcnt usually cont:li ns no re-
flections ( PIERSON and Glr..'11IER 1984 b. REEVES el :ll.
1984). Only in ;t few individual cases the lumina of
follicles near ovulation will contain echoic spots close to
the fol1iculur w.all (Fig. 2.1 4). Whether these spots
possibly represent the cumulus oophorus or structures
of iI different kind is nOI clellr }'CI. Where IwO vesicles
Omriull Sin/Ctl/res 89
arc found to lie next to cach other a dividing mem-
brane. consisting of the apposi lioned follicular walls.
can bc dctccted. The wall of a follicle which is sur-
rounded by the hypcrcchoic ovari'lIl stroma can I'llrely be
ident ified (Fig. 2. 13 and 2.19). Thc thin follicular wall is
OCC-.o.lSionally scpar.Jted from the OV;lrian p.1I'cnchyma by
a \'ery narrow. hypocchoic li ne.
The shape of follicles is usually round ( PIEKSON and
GINnmR 1984 b). The dividing walls of two neigh-
bouri ng follicles of equal prcs.<;ure oflen fonn a stmight
line. Sm:lller folliclc.<; often bulge into the lumen of a
larger follicle.
The limi t of resolution of 3.5 MHz uhrasound lies at
6to 8 mm (PmRSON and GII\'11IER 1984 b) and cannot
be used to reliably identify vesicular structures of less
than 10 mm (Fig. 2. 15 and 2. 16). low frequency ul tm-
sound therefore only has very limited v:l lue for the pre-
cise ex.amimlt ion of follicles on the ovary.
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90 U/trosollogmpll)' ill the cow
fig. 2.17: Bcwine oval)' during metestrus. Se.era) vesicles of
varying sizes (from left to right : 4, 6. 8 ,md I J mm). AfTOI,\'S in
dicate the outl ine of the ovary.
Fig. 2.19: (}.tary ~ i t h 4 dC\'cloping follicles (I. 2. 3. 4) 5 days
after the stan of a supcrovulatory F'SH trclltmen!. The row
was gh.'Cn I\I-;ce daily injcdions of F'SI! (6. 5, 4, 3 mg) for rour
d:ar.>- The thin follicular wall surrounding the \'CSicies can be
rt!cog.nized in some of the follicles (No. I and 4).
fig. 2.18: (}.tary containing a cystic oorpus luteum (arrows)
and a diestrous follicle 8 days after the last Q\'UL'llion. The
cavity of the corpus luteum is surrounded by a .... "llll of luteal
tissue. Dorsal and to the lefl of it is the diestrous follicle (inner
diameter: 17 x 13 mm).
FIg. 2.20: Multiple follicles on an ovary9 days after the stan of
ECG induced superovulation. The cow received 3000 IU
ECG 9 days earlier and 05 mg eloprostcnol 7 days earl ier.
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I
I

Follicular vesicles with diamctcrs of more than 10
mm can be easily dctectcd using 5 MHz ult rasound
(KAHN and LEIOL 1986). The accurate recogniti on of
vesicles with diamctcrs of only a few millimctcrs de-
pends mostly on the image quality gcneratcd by the
scanner and on the experience of the operator. If the
examination is conducted carefully. follicles in the size
range of 5 to 10 mm can still be identified reasonably
accuratcly (Fig. 2.17). Under less favorablc conditions
the differentiation betv."Ccn several small, neighbouring
follicl es may not be possible in every case.
When counting ovarian follicles by ultrasonography
there is a tendency to count 10 to 30 % fewer follicles in
thc size order of 3 to 10 mm than are actually present .
Vesicles with a diameter of less than 2 to 3 mm are too
small to be detectable. even al the highest resolution of
5 MHz ultrasonogmphy.
When carefully petfonned the ultrdSOnic detennina-
tion of the inner diameters of follicl es corresponds
quite cxactly to the real sizes of the follicular cavity
(QUIRK et al. 1986). The total outer diameter of the
same follicle, including its wall. L" then 2to 3 mm larger.
From a di fferential diagnostic point of view one must
be able to separate the cavities of cystic corpora lutea
from follicles (Fig. 2. 18). The sonographic images of the
Follicles 91
cavities in cystic corpora lutea resembl e those of fol -
licles. In cont rast to the ancchoic follicular nuid. how-
ever, the .mechoic fl uid content of the corpus luteum
cavity is surrounded by a modcrately echoic wall of
luteal tissue. which is a few millimeters thick.
Follicular development can also be monitored ult ra-
sonically in honnone induced superovulation (Fig. 2.19
and 2.20). In this way the number of developing follicles
can be assessed reasonably accurately and their ovula-
tion with subsequent corpus luteum fonnal ion can be
confinned (DRIANCOURT et al. 1988). The ultrasound
image of the individual FSH or ECG induced follicle is
not differenl from that of a spontaneously developed
follicle. Only the overall picture consisting of several.
equally large vesicles is characteristic.
Afler ovulation has taken place. the ovulation de-
pression. or any ot her sign of ovulation, cannot be de-
tected. During early metest rus the echographic image
of the ovary corresponds 10 that of an ovary without any
significant functional structures. An ovulation can only
be detected in a cow that was examined by ultrasound
on the days preceding the ovulation, In such a case, the
absence of a large vesicle, which had recently been
present. indicates that an ovulalion has occurred.
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92 Ulrrowllogmphy ill rhe cow
"
U 14
. -
-
-
S 12

o 10
E ,
E
6
.!i
o
E
" 2
.-
" 0

17
-
u
"
.-
- -
.

Ll
0

E
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"
,
.-
"
\7

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-
U
\,
.-
-
-
.
\,

0

E
E


" 0
7
-0
E

.-
,
"
,
1,1 1.)- ...........
L...argesl follicl es
Second lugesl
follicles -,.-
o 1 2 1 4 S 6 7 8 9 10 11 12 Il 14 IS 16 17 18 19 20
Days afler ovulati on
2 follicular waves per estrous cycle
Ovulation
Ovulation
+

. ,
.. ..-."
.' '.
" .
.' ' .
. ' .
.' ,
.' ,

...
.'

+
\"
'.
' .
...
' . ' .
\7
<:>
_.

3

R
-

I I 3
2-
,
\ 7 19 21 0 1 3 S 7 9 11 13 15 17 0 I 2 1 4
Days after ovul ation
3 follicular waves per estrous cycle
Ovulati on
+
Ovulation
..... ....
r---" .. ..
,
"
I
./

,
+


17 19 0 1 3 S 7 9 II 13 IS 17 19 0 J 2 3 .j
Days after ovulation
tlg. 2.21: The dc\-clopmeru of
the diamelers of Ihc largest
and second largest foll icles in
heifers duri ng the estrous cycle
(from KAliN 198IJc).
Ag. 2.22: The dcI.'Clopmcnt of
indr.idual foll icles in a hei fer
wi th two fonicular wa\"CS duro
ing the estrous l)'CIc (adapted
from SIROIS and FORTUNE
1988).
Fig. 2.23: 'The development of
individual follicles in a hcircr
with three foll icular waves dur-
ing the l)'C1c (adapted
from SIROIS and FORTUI"E
1988).
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2.2. 1.2 Follicular development during the
estrus cycle and in early pregnancy
Follicles grow on the ovaries :It regular intervals of
several dnys. The development of the largest follicle in
each case is usually inversely correlated to the diameter
of the second largcst follicle and to the number of all
Olher follicles (Fig. 2.21). During the first 3 days after
an ovulation the largest follicle on a pair of ovaries
usually only has a medium diameter of 5 to 8 mm. After
thnt it develops rather rapidly to rench it .. maximum di
ameter of 12 to 14 mm berwcen Days 7 and 10 and then
becomes smaller again. While the dominant follicle
grows, the second one becomes smaller, and visa versa.
Also the number of the smaller, sonogrnphically visible
vesicles is inversely correlated to the development of the
dominant follicle. The highest numbers of small follicles
are found during the days following an ovulation, i.e. in
metestru5 (MAlTON et al. 1981. Pt ERSON and Gll"'fH.ER
1984 b, KAliN 1989 c). When a diestrous follicle begins
to dcveklp thereafter. the number of smaller follicles
rnpidly declines. This rontrasting pattern of the devel
opment of dominant and remaining follicles W'olS found
in cyclic as well a. .. early pregnant heifers (PI ERSON and
GINTHER 1984 band 1986).
The growth nile of the largest follicle from the time
it becomc. .. dominant until the day it reaches its maxi
mum diameter is, on average, 1.5 10 2.5 mm per day
(DRIANOOURT et al. 1988). This growth rate is the same
for dominant follicles during the luteal phase, for cst
rous follicles during the last few days before ovulation
and for those follicles that develop after induced super
ovulation.
Follicular growth in cattle occurs in wavc like pat-
terns. At the time of ovulation another vc. .. icle i. .. grow
ing to develop into the dominant follicle, to grow
further during metestru5 and to reach its maximum
diameter during the early luteal phase between Days 4
and 10 of thc cycle. Shonly after this dicstrous follicle
has reached its maximum diameter, the second follico-
Poifides 93
lar wavc stans and another dominant follicle dC'oelops.
In the case of a 2-phasc follkular cycle this onc will ter
minat e in ovultltion (Fig. 2.22). Some C:ltlle show tI
2-phasc, others a 3-phase pilttern of d<. ... 'CIopment (IRE,
LAND 1987, SIROIS lind FORTUNE 1988. GIN111ER et 011.
1989 a). A follicul:.r growth pattern where 4 dominant
follicles develop in succession during a single cycle is a
rarity. In 3phasc follicular development the second
dominant follicle also regrCSSN. and a third follicle
develops into the estrous follicle (Fig. 2.23). The time
intervnl between the onsel of gTO\\1h of suctCMive
dominant follicles seems si milar in 2- and 3phasic
cycles, namely 7 to 10 days (GIl'mIER ct aL 1989 a). The
tot al length of cycles with 3 follicular waves is.
on a\enlge. 2 to 3 days longer. A third wnve of follicles
L .. most commonly observed in heifers having .. 2 to 3
day del ay in the regrc. ..... ion of their corpus luteum.
During the first few .... -ceks of pregnancy this hasic
pattern of follicular gTO\\1h, with its contrasts in the de
velopment betwccn the dominant follicle on the one
hand and the second largest follicle and the remainder
of follicles on the other. persists (SoINEEBEU 1984.
PI ERSON and GIN11 IER 1986). This wave-like succession
of dominunt follicles at intervals of 9 to 10 days can be
obscn-cd during the first two months of gc. .. tation
(GIN11IER el al. 1989 b).
Except for the days during metc. .. trus. there is usu-
ally a vesicle with a diameter of 10 or more millimeters
prescnt on one of the ovaries C\-cry day of the estrous
cyde (CtIOUDARY et al. 1968, IRELAND et al. 1979,
SrAIGMILLER and ENGlAND 1981). Most foll icles have a
diametcr of Ics. .. than 14 mm during met-, di - and pro--
est rus. In a few cases. ho\.\'cver, follicles with a diameter
of 14 to 20 mm can be detected during diestrus or the
first few weeks of pregnancy at the same time, the
diametcr of some estrous follicles can be smaller thun
14 mm. It C' .ln be concluded that in vcteri nary practice
the diameterof a follicle alone cannot be relied on to in
diC'.lte the sttlgc of Ihe reproductivc cycle of n row.
AVT)( KlZ
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94 Ultrasonogrtl/HI), in the cow
Animals Estrous folli- Dial!leter of estrous follicles (mm)
studi ed cles studied
d,
smallest
12 heifers
54 14.7 2.6 12.0
in 51 cycles
45 cows
45 15. 3 2.9 10.0
before AI
I-lg. 2.25: Q\'llrywith a mature. compact corpus lut cum. Com-
pared 10 lhe surrounding (Mlrian pareoch)ma Ihe t"Orpus lu-
tcum (al1'OW!i) is less echoic. UJ/rnsooogram t3kcn in 3 water
b3th .
lg. 2.21: Corpus luteum (al1'OW!i) wilh o.:nlral ClIvity. The
t'(:hoic lU1cll1 WIlli of Sr.."Vc rnl mill imeters thiclo:nC!ioS surrounds
thc anechoic cavity. Ultrasonogram taken in waler bath.
largest
20. 0
20.0
f.tg. 2.24: The int ernal diamClCrs of ~ I r o u s
foll icles in heifers and COY>"S prior 10 AI (from
KA" s 1989 c).
FIg. 2.26: Cross section through the solid corpus lot eom ana-
logous 10 the sectional plane in Fig. 2.25.
FIg. 2.28: Cross section through Ihe COrpu. .. luleum "ilh ClI\icy
analogous to the !iCClional plane in Fig. 2.27.
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2.2.1.3 Estrous follicles
The avcr.lge diameter of the cavity of the estrous fol-
liclc at the time of standing heal is 15 mm (PI ERSON and
GIIfflIER 1984 b, KAHN and UIDL 1986). When its wall
I is incl uded Ihis means that a preovulatory follicle has a
total size of 18 mm (QUIRK et al. 1986). The range of
I
the inner diameter of estrous follicles on the day of
standing estrus is JO to 20 mm (Fig. 2.24). It is note-
.... 'Orthy that pregnancies can result from large follicles of
I 20 mm as well as from small foll icles of 10 mm.
The daily increase in the size of the estrous follicle
during the days preceding ovulation is 1.5 to 2.5 mm.
I Most estrous follicles that have been studied by ultrn.so-
nography rcuched their maximum size on thc penulti-
mate duy before ovulation and did not grow largcr dur-
ing the 36 hours prior to ovulation.
2.2.2 Corpora lutea
2.2.2. 1 Sonographic image of corpora lutea
Corpora lutca are rcrognizcd by their size and shape
I as well as thei r charactcristic cchographic appearance
(PIERSON and GINTHER 1984 b. KAHN and 1EI0L 1986).
I

I
I
I
I
COI]HJm IlIlea 95
The sonogrnphic section of luteal tissue appears as a
roughly granular. gray-structured oval area on the
monitor (Fig. 2.25 to 2.28). It can be delineated from
thc remaining ovarian t ~ u e orother functional Slruetu-
res that may be on the ovary. The relat ively hypoecho-
genidty of thc aetr.'C corpus luteum is in distinct con-
trast to the brighter gray of the ovarian parenchyma.
The Jalter usually contains SC\'Cml \'CSicular Slrueturcs
of v"dI)'ing sizes. whereas the lutcal tissue contains no
fluid. except in the case where it oo'Cloped a cavi ty dur-
ing its devc1opmcnl. The .... 'Cak cchogcnici ty of lutcal tis-
sue corresponds to reflect ions typically produced by
loose, less dcnse. highly vascular soft tissues. The highcr
echogcnicity of thc ovarian stroma. in cont rast. reflects
its solid cons.istcncy and higher tis. .. uc density.
Corpora lutca with cavitic. ... so called cystic corpora
lutea. can also be diagnosed by ultrasonogmphy (PI EH--
SON and G II\"f1!ER 1984 b, REEVES et III. 1984, KAHN
and UIDL 1986. Krro ct al. 1986). In a corpus lutcum
with a cavity an echoic rim of tissue, a few millimeters
thick, surrounds a central. anechoic fluid accumulation
(Fig. 2.27). The ecOOgenici ty of the rim of tissue is the
same as that of luteal tissue and thus corresponds to
that of solid corpora lulea.
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96 U/tnlsoflogrophy ill tile CDII'
Fig. 2.29: A solid corpus JuteunI or the C)'tk (size: 28.5 " 18
mOl) wilh a hyperc<:hoic. centrnl line. Ultrn5000grnm laken
wilh a 7.5 MHzlincarscunncr.
Fig. 2031: A mmpacl corpus ]ulcum on Day 9 or Ihe cycle.
Length: 29 mOl. widlh: 23.5 mm.
FIg. 2.JO: A corpus lulcum of [he cycle (arroo'S) 3 day.; afler
O\'Ulmion. I l ~ size is. 19)( 16 0101. At ils center there is a cavi ty
or 6.5 0101 and to its left is a follicle of about 8 01m.
Fig. 2032: Regl'CS.'iing corpus lulcum (arrows) one day before
Ihe nC)(1 t'SIf\l$; lenglh: 19.5 0101. width: 15.5 0101. A ~ the
corpus lutcum arc N'O procstrous follicles (diamcter about 14
mm).
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Frequently, the cross section of a corpus lutcum con-
tains a narrow, hyperechoic zone in its center (Fig. 2.29
and 2.33). This site corresponds to a similar onc that
can be identified on the sectioned corpus luteum. It
consists of branching connective tissue which, starting
from the center, compartmentalizes the wavy, densely
packcd layers of luteinized tissuc. A hypcrcchoic central
zonc can always be seen aftcr thc closure of a central
cavity in a corpus luteum. This pattcrn can be found in
corpora lutca of thc cycle as well as those of pregnancy.
Immediately following ovulation the developing lu
teal tissue cannot yet be recognized. The young corpus
lutcum only becomes sonographically detectable 2 to 4
days post-ovulation (Fig. 2.30). Corpora lutea have a
mean width of 14 mm and a mean length of between
Corpora Imeo 97
18 and 21 mm when they first hcrome detectable on
the third day arter ovulation (PIERSON and Gtl'mlER
1984 b, KAli N 1986).
They then grow I mm in width and 2 mm in length
per day, and reach their maximum size of about 20" 30
mm by Day 8 to 10 post ovulation (Fig. 2.31). After lu-
tcolysis has begun or PGF2a has been injected the
largest diameter of the corpus luteum rapidly falls to be-
I()\.V 23 mm (QUIRK et at 1986). At a frequency of
5 MHz, corpora lutea are reliably detectable from their
early development to the end of diestrus, and nearly all
of them arc still identifiable aI the time of next
ovulation (Fig. 2.32). In some c 1ses they C"".ln still be
identifiable as corpora albicans for several days aft er the
onset of the next C)oclc.
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98 Ultrnsollogmphy i1l the co"'
t-lg. 2.33: A solid corpus lu[cum of pregnancy (Size: 26 x 195
mm) ..... il h a hypcn."Choic line in its CClilcr. Day 21 of pn:gnun
"I.
t-lg. 1:.35: DJrpus lutcum (arrtM'S) on Day 8 of the cycle.
The cavity lies ccccnlric:llly :and has an irregular outline.
Fig. 2.34: C)'stic oorpus IUleum (arrtJ\.\'S) on Day 11 of the cy.
cle. TIle corpus lut eum measures 31 x 20 mrn: the cavity
measures 17 x 105 mm.
Fig. 2.36: Cystic corpus lutcum (UIT(J\o\'S) on Day II of lhe cy.
cle. 'Ibc diameler of Ihe cavilY is 22 x 19 mm. 1bc eslrous C).
de of the cow 23 days kmg. Slight rcnl"Ctions can be secn
within [he nuid of the wity.
----------------------------------------.
SkO z. 10 ad a
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OAlpBJ5 oueW SBZ O)jSJOJflV
The gray scales of the corpora lutea of different ages
vary very lillie and cannot be employed for diagnostic
purposes. At the same time, corpora lutea of pregnancy
canllOt be distinguished on the basis of thcir cchogenic-
ity from those of the cycle (Fig. 2.33). The dimensions
(length and width) of corpora lutea of pregnancy are
much the same as those of corpom luteil of the cycle.
The cavities inside corpora lutea are usuaUy oval, oc-
casionally round ilnd nearly alW'.I)'S cent mlly posi tioned
inside the gland (Fig. 2.34). Only in exceptional case."
are they eccentrically positioned or ha\'C they an irregu
Corpom luletl 99
lar shape (Fig. 2.35). The largcst diameters of the cavi
tic. .. usually vary from a few millimeters to 1.5 em.
Rarely, they can reach 20 mm or more (Fig. 2.36).
The cchogenioty of thc C'.Ivi tics is similar to thai of
follicles. Slight reflections C'.In occasionally be seen in
side the cavity's fluid (Fig. 2.36).The luteinv-.cd wall is
used to differentiate cystic corpom lutea from ovllrian
follicles. Whereas follicles are seen to lie embedded in
the hypcrechoic ovarian parenchyma, the cavity of the
cystic corptt'l luteum is scp<tr.ued from the bright ovari-
an IL'lSUe by its slightly Ics. .. echoic w.lII of luteal tissue.
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,
100 UltruSOllogrtlfJlly in ,he COli'
Fig. 2.37: CorpU!i Illleum of pll:gnalK')' with a ccntmJ C"JviIY
(diameter 16 x 10 mm). This corpus IUleum found in a
00Y0' on Day 28 of gcsl:llion (sec Fig. 2.38).
fig. 2.39: Four torpor.! IUlea ( I. 2, 3 and 4) on a
single ovary after superovulation. Their length ranges from 24
to 25 mm: their width from 1310 J 7 mm.
fig. 2.J8: Uterus (IIrTO\.\'S) "" it h a conceptus (C) on Day 28
IOoith a simult aneously prescnt t)'SIic corpus luleum (sec Fig.
2.37).
tlg. 2.40: A non<)'Stic and a cysIic corpus IUleum (Jefl) on the
0\'ary6daysbcforc the onset orllle next cycle. 111c rorporn lu-
lea arc indicated by arroYo's.
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,
OAlpEJ5 auaW SEZ O)jSJO\,.,V
As during the estrous cycle, cystic corpora lutea can
also be found during the first weeks of pregnancy (Fig.
2.37 and 2.38). After the third \.\'Cek of pregnancy they
lire seen infrequently. The fertility of a n i m a l ~ with a
cysti c corpus luteum is the same a ~ that of cows with the
solid type of corpo. .. luteum.
With the aid of uJtra.o;onogl".Iphy the number of cor
porn lutea on ;In ovary can be dctennined quite accu
r,lIcly (DRIANCOUKT et al. 1988). In thi. .. manner the
success of a superovulation att empt C'" JIl be t1 sscsscd and
the number of embryos that could possibly be harvcsted
can be l.'Stimated. Where se\'Cral corpora IUlea lie dose
Iy together they arc u. .. ually only separated by thin,
Corpom IlIlea 101
hypocchoic 1i,<;SUC lines (Fig. 2.39). The bulk of the
OVllry then consists of the hypol."Choic echo patterns
which arc typical for lut eal lis.<; uc. The size and echo-
genicily encount ered in multiple corpora lutell is nOi
different from the piclure observed in single luteal
glands.
When mUltiple corpora IUlea :Ire present in a cow
they can be of both. the compaet llnd the cystic type.. ..
(Fig. 2.40). Cases can be found in which only solid cor
porn IUl ea arc present allhe same lime; sometimes the
comp:let and cystic fomlS occur in adjacent corpora
Julea and in other animals only the CYSlic fomls can be
visualized.
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102 Ultrasonography in lite COW
100
'"
80
70
60
%'"
40
30
20
10
o
100
'"
80
70
60
%'"
40
30
20
10
o
'" 12
30
28
26
e "
e "
20
" 16
"
"
Estrous cycle D '" C. I. with cavity mm
D = C. I. with cavi ty mm
3 4 5 6 7 8 9 10 I I 12 13 14 15 16 17 18 19 20 21
Days after ovulation
Early prrgnancy
D = C. I. wi th cavity mm
= C. I. wi th cavit y mm
4 5 6 7 8 9 10 II 12 13 14 15 16 17 18 19 20 21
Days after ovulation
-0- = C. I. with cavity
Estrous cycle = C. J. without cavi ty
10 ., " __ ,--,-, __ ., __ .,-,, __ '--'-' __ __ +-"' __ .' __
r -
3 ,
,
7 8 9 10 1 I 12 13 14 IS
Days after ovulation
t6 17 18 19 20 21
t1g. 2.41: The: percentage of corpora
lutea with a cavity mm or
<!: 7 mm) during the estrous cycle in
heifers (from KAHN 1989 a).
tlg. 2.42: }11c percentage of corpora
lutea with a cavity mm or
7 mm) during early pregnancy in
heifers (from KAliN 1989 a).
Fig. 2.43: The! length of oon.cystic and
cystic corpor.alutea during the estrous
t)'C1c in heifers (mean % SO; from
KAliN 1989 a).
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I
I
I
2.2.2.2 I ncidcncc and development or cystic
and non-cystic corpora lutea during the est
rous cycle and in early pregnancy
In caule corpora lutea with or without a cavi ty occur
during the cycle and early pregnancy. The non-cystie
and cystic forms of corpora lutea can be seen as nonnal
vari ations of luteal ghands in caule. Compact and cystic
corpora lutea occur alternately in caule. The type of the
luteal gland had no effect on cycle length, endocrine
pattern or fertility in call ie (KAliN and LEIDL 1988.
KAHN 1989 a).
The incidence and the size of IUleal glunds. wilh or
without .1 cavity, were st udied in a lllie during Ihe cycle
and in the firslthree weeks of pregmmcy. It was shown
that the C'dvity in cystic CI reachcd its lurgcst diameter
between Days 8 and 10 of the cycle (KAI-IN 1986). AI
this time cavilies occurred most frequently and reached
their largest size. Afterwards they decreased in inci-
dence and size with time.
Until Day 10. one third to a half of ull corpora lulea
in normal cycles contained a sonographically detectable
cavity (Fig. 2.41). After this day the incidence of cystic
corpora 100ea decreased by 3 to 4 % per day so Ihat
fewer than one third of all luteal glands contained cavi
ties by day 13.
Non<ySlic and cystic Cl<i could be found with equal
frequency during nonnal cycles and in early pregnancy
(Fig. 2.42). If cows with a cystic corpus luteum ,",,'Cre less
fertile than rows with compact luteal glands, the ina-
Corport/llllea 103
dcnce of the former type should be lower in early preg-
nant cows. The OOscI'\'Cd ralios do not. howC\'Cr. sup-
pon this hypothesis. In contmst. in pregnant cows cystic
corpora lutea were found at least as frequently lIS during
the cycle. This indicates that the pregnancy rates in
cows with the two types of luteal glands are the same
(Krro et al. 1986).
When cystic and non-cystie corpora lutea .... -cre fin;t
detected on Day 3 of the cycle they had a mean lengt h
of 17 mm (Fig. 2.43). Thereafter the increase in the
lengt h of Ihe two types of corpora lutea differed. with
the cystic type being longer than the compact type at all
timcs. The cystic and compact tYf.K!S reached thei r maxi-
mum lengt h of28lmd 24.5 mm on Day 8 and Day lOaf
diestrus. rcspccti\'Cly. They then slowly decreased in
size. The length of cystic forms decrea'iCd faster than
that of compact fomls. From Day 6 10 17 of the cycle
the cystic Os .... -cre consistently 2 to 4 mOl longer than
their compact counterpans.
The cystic forms of luteal g 1 a n d ~ were also I to 3 mm
longer than the compact forms from Day 9 until Day 21
of early geslation (Fig. 2.44). A comparison between lu-
teal glands of the cycle and those of pregnancy revealed
that both, compact and cystic corpora lutea were a
li ule longer in pregnancy than during the cycle (KAHN
1989 a). By Day 18 of the cycle and early pregnancy the
sizes of compact corpora lutea varied bet,",,'Cen 22 and
24 mOl. and bet .... 'Ccn 24 and 26 mm. rcspccth'C1y.
34
J2
JO
28
Early preganey
fi&. 2..44: The kngt h or OOfl<)'SIic and
C)'SIic corpora lutea during early preg-
nancy in heifers (mc:m :t: SO: rrom
KAt"" 1989 a).
"
e"
e "
,.
"
"
"
12
j Ij ~ I :: __ ~ A
I "'f-- -+- I
-:- : C. I. with cavity
I : C. I. without cavi ty
10 'I I I I I I I I I I I I I I I I I I
;/ 3 4 , 6 7 8 9 10 II 12 13 14 I' 16 17 18 19 20 21
Days after ovulation
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104 Ultrasonography in IIII! cow
"
14
12
\0
8
,

"
14
12
10
=
= 8
,

2
I
9000
8000
7000
,., 6000
5000
<000
JOOO
2000
1000
o

= Longi tudinal di ameter of cavi ties
Estrous cycle

= Transverse diameter of cavities
d
~
1
, , , , , , , , , , , , , , , , , , ,
5 6 7 8 9 10 II 12 13 14 15 16 17 18 19 20 2]
Days after ovulation
Early pregnancy
I
,
, 7 8
Estrous cycle
= Longitudinal diameter of cavities
a '"' Transverse diameter of cavities
I I
,
9 to II 12 13 14 IS
Days after ovulation
16 17 18 19 20 2 t
= Volume of caviti es
o :IZ Luteal tissue of cystic CIs
o :: Luteal tissue of non-cystic Cis
fo-Ig. 2.45: The longitudinal and trans-
\'ersc di:lmetcrs of the cavities in cyst-
ic corpom !Ulea during the CSlfOUS
cycle in heifers (mean % SO; from
KAHN 1989 a).
Hg. 2.46: The longitudinal and trans-
verse diameters of the cavities in cyst-
ic corpora lutea during early preg-
nancy in heifers (mean :t SO; from
KAHN 1989 a) .
rig. 2.47: The \'Olumes of non-cyslic
and cystic corpora lutca and their
5 6 1 8 9 10 11 12 13 ]4 IS 16 17 18 19 20 21 cavities during the C5trous tyde in
Days after ovulation heifers (mean; from KAHN 1989 a).
Avklrsko L a s ~ lane cradi '0
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The 10ngilUdinai di ameters of the cavities of cyclic
Os and of Os of pregnancy increased until about Day
10 post ovulation when they measured approximately
II mm (Fig. 2,45 and 2,46). After that the longitudinal
diameters of the cavi ties decreased by about 0.5 mm per
day and measured only 5 mm at the lime of Ihe nexl
estrus or on Day 21 of gestation.
Similar increases and dccn:a
scs
were recorded for
the tranS\'Cf'SC diameters of Ihe cavities of luteal glands
of the cycle and of pregnancy. These were, hQY,cver.
consistently a few millimeters shorter than those of the
10ngilUdinai diameters. From these observations it is
clear that the cavi ties in corpora lutea have a predomi-
nantly oval shape which largcly follows thc outer con-
tours of the glands.
Since the cavi ties can reaeh a considerable size dur-
ing the first 14 days post ovulalion, it was suspected that
cystic corpora lutea might cont ain less luteal tissue than
their compact counterparts, and that they may thus
secrete less progesterone.
The total volume of cystic and non-cystie luteal
glands increased during the est rous cycle from a mean
of 1984 mm
3
and 1329 mm
3
on Ihe third day afler ovu-
lation to a mean of 6000 to 7000 mm
J
and 4000 mm
J

respectively, in the middle of diestrus around Day 8 10
13 of the cycle (Fig. 2,47). At the same time the cavities
within the CIs grcw from a mean of 170 to 400 mm
J
. Af-
ter subtracting the cavi ty's volume from the total \"01-
ume of Ihe cystie corpus luteum. il became surprisingly
clear thai the cystic glands conlained more luteal lissuc
than compact glands. The difference in the amount of
Co/porn I//Ieo 105
luteal tissue bcty..een the Iwo form.;; vmied from 100010
3000 mm3 in the period from the 6th 10 Ihe 20t h day of
diestrus (OKUDA 1982).
A comparison of the de\'Clopment of luteal glands
between those of normal diestrous and those of early
pregnancy shQY,'Cd no signifiC"<tnl differences. Over.llI.
luteal gland.;; of pregnancy " .. ere gener.llIy a little larger
than those of normal diestrus. Similar to the OOscrv..J-
tions during the cycle, it was ulso shown that during
early gestation cystic corpora lutea contained more
luteal tissue than compact ones (Fig. 2.48). Even in
their development of cavit ies cystic corpora lutea of
pregnancy and of nonnal diestrus did nOl differ mark-
edly. They also grew to a mean size of II mm by Day 8
to 10 and then continuously became smaller (KnD et al.
1986). After Day 30 of gestation in cattle it is vel)' rare
to find a corpus luteum with a cavi ty, The dis..'I ppear-
ancc of the cavi ties can be explained by the increase in
thickness of the luteal walls of the Cis (LEtDL et al.
1983). Very few cystic corpora lutea are found in the
fourth ..... eek of pregnancy.
Studies completed thus fa r on the endocrine status
of cattle with either a cystic or a solid corpus luteum
have shown no deficiency in the progesterone secretion
of the luteal glands with cavities (KAHN 1986. Krro et al.
1986). The mean plasma progcslerone concent ration
O\'cr the ent ire cycle in cows with a cystic corpus luteunl
was maint ai ned at the same IC\'el as that of cov.s with a
compact gland. The adequacy of progesterone secretion
by cystie luteal glands was also dcmonstnttcd by using
hCG stimulation .
= Volume of cavities
9000
l1OOO
7000
Early pregnancy 0 = Luteal tissue of cystic Cis
Fig. 2.48: 11Ie volumes of non<yslic
and cystic corpora lutca and their
cavities during early pregnalk.)' in
hci(crs (mean; from KAHN 1989 a).
'" ""'"
E
ElOOO
4000
3000
2000
1000
o
J
, 6 7 8 9 10 II 12 13 14 1.5
Days after ovulation
./
16 11 18 19 20 2-;
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106 U1trrlsollosruphy ill the CDII'
Fig. 2."9: Ovm)' containing three theca-follicular l)'StS. Two
share a straight dividing wall ; on the right a smaller t)'St
bulges into the middle one. Ultmsooognlm taken in a Wllter-
bath.
Fig. 2.51: contai ning a luteinized follicular C)'St (ar-
rows). The inner cavity sl}O\Oo'S a network of echoes. The .... -all
mea.QJrcs several millimeters in thickness.
t1g. 2.50: Section through the same OV"Jry analogous to tile
sectional plane in Fig. 2.49.
rig. 2.52: Ovary containing a thecal follicular cyst. lhe diame-
ter of the C)'St is about 5 em.
Ay S ozas
10
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In some C'.JSCS progesterone secretion of g.'St ic luteal
glands even exceeded the levels found in cows with
compact corpom lutca. Thc tendency for higher plasma
progesterone levels in CCM'S with cystic iuteni ghmds is
likely explaincd by the fact that they have larger
amounts of IUleallissuc.
In conclusion. the studic.ct completed thus far on thc
incidence, development and endocrinc function of cyst
ic corpora lutca of the cycle and of pregnancy, with
cavity diamcters ranging from a few millimcters to
2 centimeters, have no indication that they are endocri
nologically dysfunctional. This conclusion is supponed
by the fact thaI the pregnancy rates of cattle with cystic
corpora lutea are not decreased.
2.2.3 Ovarian cysts
In their sonographic appearance ovarian cysts re
semble large follicles (Fig. 2.49 and 2.50). One distin
guishing feature is their larger size. In the casc of a lu
teinized follicular cyst its wall thickness can also assist in
its identification. The sectional images of ovarian cysts
Ch'ana" C)'SLS 107
are characterized by large anechoic areas. Thc dark
nuid content of thecal follicular cysts hardly e"er con
tains any renections (Fig. 2.52). Thc lumina of lutein
ized cysts OCC'dSionally contain a network of echocs (Fig.
2.5 1 ).
Among the sonogmphically visible OV'"d ri an cysts two
distinct forms can be recognized. The one fonn hns such
a thin wall that its structure cannot be aswsscd (Fig.
2.52). Most of Ihese structures are likely 10 be thecal fol
licular cysts. The second kind are ovarian cysts wilh a
thicker wall. The laller is a few millimeters thick and
usually hypocchoic (Fig. 2.5 1). ILct cchogenicity is simi
lar to that of luteal tissue. The adjaccnt ovnrian tissue
usually appears mther hypcrechoic in comparison to the
cyst wall. These vesicular structures are likcly to fall in
to the category of luteinized follicular cysts. If thecal
and lutcinized follicular cysts appear in thei r vcI)' char
acteristic forms, i.c. with eithcr a vel)' thin or a vel)'
thick wnll . respect ively. thei r differentiation should pre
sent little difficully. In the mixed or transitional forms it
.... ,ould. however be rather more difficult to reliably dig.
tinguish between the I""O types on their ult rasonic ap-
pearance alone.
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108 U1troSOllognlplly ill file cow
Fq;;. 2.53: Q\rJI)' containing multiple cysts after honnonal
superovulation tTCa tment of the row. 'Ibe row had received
dllily trealmcntsof FSI-I from Days II 107 before and a single
dose of PGI- "'2a on Day 8 before uhrJsonogr.lm was
taken.
"Ig. 2.55: Foll icular cyst in (I row on Day 59 of gcsuuion (sec
Fig. 2.56).
Fig. 2.54: Follicular cyst and corpus luteum of the cycle (1Ir-
lOWS) on the ovary of a COW 13 dB)'!' after she had been in-
jected with GnRI-I (20 g Ouscrelin i. m.) for the Ircalmcnl of
ovari(lO t)'StS. Progesterone W"JS elevated on the day of this
ullrasound examination and the COYo WIDi trcatl-d with PGF2a.
The insemination performed 4 days later resulted in II
pregnancy .
-ig. 2..56: I'regllam wilh fetus on Day 59 of pregnancy
ill a CfHI with an OYlI rian cyst (sec Fig. 2.55). The fe tal head
(1-1) lies t()\\-:trds the right . the rump the left. and
above the nose there is a front fOOl.
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The shupe of cysts mnges from round to oval to p0-
lygonal , sometimes even angular. When they occur as
single structures on an ovary they are usually round.
When more than one cyst appeal1; on the same ovary
their shapes are determined by the relative tensions in
s.ide adjacent cysts (Fig. 2.53). Their common, scpam-
ting walls are often straight. Cysts wi th higher inner
pressure will bulge into the lumen of cysts with lower
pressure. Commonly. sm:.Uer vesicles bulge into lurger
cysts.
Not ull foll icular cysts thut c-.m be seen sonogmph-
ically on ovaries of cows can be considered to have a
pathological effect. Such cysts have been found duri ng
ult rasound cxaminlltions where iI distinct corpus [utcum
of the cycle was present simultaneously (Fig. 2.54). In
such cases the corpus luteum is usually the structure
that determines cyclic events. which can be normal wit h
pregnancies resulti ng from an im'Olved estrus. Ovllrian
Ag. 2.S7: Cystic corpusluteum (am,",s) with a ''Cry large cav
ity 14 days after ovulation. The next estrus of this cow oc-
curred at the nomlal time. Mi ld I'l;'ncctions arc visible inside
the lumen of the corpus luteum.
Omlinll cyrts 109
cysts can ulsa be found in the presence of an intact preg-
nancy (Fig. 2.55 and 2.56). III single cases O\',.rillll cysts
have been detected as laIC as the third month of gesta-
tion.
A<; a result of their extensive fluid content and their
resul tant typical sollogr.lphic appcaTuncc ovarian cysts
are easy to diagnose. Thecill follicular cysts are recog-
nized by their thin, hypcrechoic wOIlis. Lut einized (.)'Sts
can be diagnosed if they are more than 40 mm in
dill,meler, their walls arc thinner than 5 mm OInd they
persist unchmlged for a protmctcd period of time. The
images of small luteinized cystS with thick walls can
sometimes appcOlr similar to those of large cystic
corpora lutea (Fig. 2.5 1. 2.57 and 2.58). In the few ClISL'S
where a structure with a p..1Tticularly large inner cavity
and a relatively thick wall are found it may not be
possible to differentiate reliably between 01 cystic corpus
luteum ilnd a luteinized follicular cyst.
Fig. 2.58: Largc CYSlic corpus IUlcum (bcl\\'Cen thc C'I'OMCS) 8
days after O\'Ulation.llIC co'l'us lut cum measures 36 x 27 111m
and its C' o.lyity I ) x 9 mm.
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11 0 Ultrasonography ill 'he cow
.".2.59: Oval}' with :1 granulosa cell tumor (arrO\\'5). Duri ng
[he 11l.\t 3 .... ~ k s prior to ovariectomy. the row hlld a plasma
progesterone concentrat ion or ( 1.0 nglml. 1llcrc arc nUlllcr
ous hn ...... choic CI'O!i."i .scaions through blood ~ I s in the
dorsal pan orthc tumor. 1bc \'Cntral pan orthc tumor shIJ.,.,'S
the L'Chogcnicity typical or solid t ~ .
F". 2.60: Cross Sl.'Ction through the sallie ovarinn tumor mUI
logous to the examination plane as in Fig. 2.59.
Av 0
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2.2.4 Ovarian tumor>
Ov-.uian tumors are rare in a utle. The case de-
scribed here concerned a three and half year old row.
Nothing conspicuous was nOl iced about the row during
the fi rst 1 .... '0 months post partum. Once the cow showed
estrus she was to be inseminated. Whcn Ihi5 WdS tried a
struct ure twice as large as a ehil d's head was palpatcd in
the area of the k ft ovary. The right ovary was also en-
larged. During an observation period of another 3
.... 'Ccks the cow developed signs of nymphomania and re-
pe.ned plasma hormone determinat ions rcvealcd pm-
gesterone concentrat ions of less than 1.0 nglm!.
The sonographk image of the tumor cont ained !'A'O
distinct regions (Fig. 2.59). Hypoc..'Choic trarID'Crse sec-
tions through numerous vessels were seen in the dorsal
section of the tumor. The remai nde r of the tumor oon-
tained a coarsely granul ar echogenici ty. producing an
image of mixed tissuc which was trdvcrsed by numerous
sections of smaller \ 'CMCls. The adjacent areas of
brighter and Ics.<i bright echoes reJ1cded the compact
nat ure of the tumor intcrspersed with islets of ...... .tX}' tis-
sue (Fig. 2.60). The outli ne of the tumor could be St..'Cn
and measured.
Ol'Uriflll lumor.r I II
Bot h ovaries .... 'CTC rell)()'\'ed by ovariectomy. On
pat hological examination the left ovary WdS diagnosed
to cont ain a socccrb.111 -sizcd granulosa cell tumor with
a few :area. .. of hypcrvascularity. The right oviary also hlld
Changes consistent with a granulosa cell tumor.
The described ult ra.o;onic pict ure of a granulosa cell
tumor is not typical of this t)'pC of ovari an tu
mors in canle, In thi5 single C<tsC the tumor was very
compact and its echoic sectional image was only inter-
rupt ed by hypocchoic lumina of blood vessels. Other
case<.; of granulosa cell tumors have been described a. ..
being more polycystic (Andresen et al. 1986). This type:
of granulas.1 cell tumor should then result in a sonogra
phic image which is more commonty seen in cascsofthe
same tumor in horses (WHITE and AIJ.EN 1985. KAl iN
and U' 1I)1. 1987). These often ha\'C a strong capsule of
connective tissue underneath which lies a labyri nth con
taining numerous cystic structures (sec chaptcr 1.2.5).
The contents of the cysts may be serous or hcmorrhagic
and therefore generate an anechoic or moderately
cchoic image on ult rasound examination.
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112 Ullrosollogroplly ill IIIl' cow
.' ig. 2.61: 5.1ginal section through the non-pregnant uterus of
a aM' in diestrus. The large arrtJ\lo'S indicate the grt::lter cul'va-
ture. the arrow'S the lesser rurvalUre.
I'1g. 2.63: Schcmatic presentation of an ultmsound examina
tion of thc uteru. in trJlb-"Cr..c din.'Clion w.ing a scun-
ncr. The .;;.amc .;cuming pl'lllc in Fig. 2.6-1.
Fig, 2,62: Sagillal '>t.'Clion through :I uterus during T\\'o
scp.1mte sections of the same uterine hom mn be rerognil.cd,
Auid Ilccumulations arc \'isiblc inside the uterine lumen. Ar
rtJ\Io'<\ demarcate the outer \\'all of the uterus. Uhl'll'iOnogmm
W31. produced with a 5CCIor scanner at 5 MI tz.
.1g. TmllS\'CTSC scctionthmugh the on the day uf-
ter ovul:lIion, TIle tr.Hlwersc SI..'<.1ions through the lefl dorsal
(Id) and right duMI (rei) of the are on lop, wilh
the cross through the left n:ntml (Iv) and right vcntrul
(rv) pouts of the horus I: .. eolily alld below the dorsal 'i(.'ClON.
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2.3 Uterine structures in the cow
2.3.1 Non-pregnant uterus
When a linear ultrasound probe is posi tioned dorsal-
ly above the uterus and the sound beam is directed
dor.;o-ventrd.lly. a longitudinal section of the organ is 00.
tained (Fig. 2.61). Rotating the probe slightly to the left
and right brings the ut erus with its horns into view. Its
outline with the lnrger uterine curvature becomes clear-
ly visible. The latter is a distinct narrow, hypocchoic line
which separates the uterine wall from the usually some-
what more echoic surrounding tissue. The lesser curva-
ture - the mesometrial edge of the uterus - is usually less
obvious with a variable intensi ty. When the uterine tone
is high. such a . ~ in /,:strus. it has, as with the larger curva-
ture. a U-shaped, arched appearance. The dorsal and
ventml sections of the same hom arc at other times of-
ten so close to one another that they are separated by
only a single. hypercchoic line, or diverge at a very acute
angle.
The entire length of the spiraling uteri ne hom codn
usually only be depicted in a single image if the uterus is
optimally positioned and the probe is directed al an
acute angle in relation 10 the longi tudinal axis of the
cow. In addition, the ult msound beam must be rotated
slighlly from dorsoventml to dorsolateml. In the major-
ity of C;ISl:S it is impossible to depict the entire curvature
of a hom in a single image. Instead, by vinue of its cur-
vature. the ulerus can be sectioned at several places
(Fig. 2.62), Using a linear scanner, bet\\,'Cen two and
four sections through Ihe uterine hom can often be
visualized in a single image (f AVERNE et al. 1985). Also
UlI!ntS 11 3
in the case of a pregnant ut erus. its wall and the em-
bryonic vcsicle in its lumen will be sectioned II I various
levels. Only very rarely is it possible to depict the whole
length of an embl)'Onic vesicle (see chapter 2. 3.2.5).
When using a suit .. ble sector sc .. nner, its grcuter
maneuverability inside the rectum permils the operntor
to project a greater variety of sections through the ut er-
us (Fig. 2.63 and 2.64). The fan shaped ul tmsound
plane can be rotated from the longitudinal axis of the
animal. through "'Mious steps all the way 10 a perfectly
transvel1iC position. In this manner il is possibl e. with
the sound W.l\'CS directed dorsoventrally and transverse-
ly to the animal, to project a cross section through the
uterus. In this plane of examination, a lotal of 4 trans-
verse sections through the left and right ut erine horns
can be depicted simultancoLL .. ly. These include 2 sec-
tions through the dorsal p a r t ~ of the uterine homs and
latemlly below them 2 cros. .. sections of the vcntral parts
of the ut eri ne horns.
Wilh the probe guided appropriately along a suitable
path. the wi nding of the ut crine horns from medial to
lateml com be followed. Doing this create. .. the impres-
sion that the tips of the uterine horns curl more dorso-
caudally during the luteal phase than during the days
jLL<; t before and just after cstruS' (Pt ERSON and GINmEIl.
1987). During the pcriovulatory period the hom ends
are directed more hori zontally in the c:ludolateml di-
rect ion without rolling up in the dorsal direct k>n. The
lesse r culVdture describes a larger radi o.<; during this
lime thom during dicstrus. The spimli ng shape of the
ut erus is therefor most pronounced during the phase of
elevated progesterone conccntrations.
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114 UllrrlSQllogrtlpbY;1I life cow
Fig. 2.65: Uterus of a fX1N during estrus. In thc ' cntnll pan of
the. hom the hyper, ..choic line representing the appositioncd
surfaces of the endometrium (E). Large arrows indicate the.
greater curv.llure. small arrOYo'S the lesser curvature.
~ 1 g . 2.67: Sagi ttal section through 0 ut erus during estrus.
There is a few millimeter thick. hypocchoic area. representing
estrous SI.. "CfCtions (5). in the ,e.ntra] pan of thc hom. Arrows
demarclte the greater CUlv.lture.
Fig. 2.66: Uterus of 0 fX1N during diestrus 8 da)'S post O\--ula-
tion. In the vent ral SCCIor of the. hom a fluid accumulation can
be rccogni7.cd (small arrow). Large arrows dermrcalc the
greater curvature.
.'\g. 2.68: Sagitlol SCCIion through a uterine hom during
est rus. A prominent accumulation of secretions is present in
the tip of the hom (arrOYo'S).
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The section through the uterine w;all contains gr,mu-
lar. variably structured shades of cchogcnieity. In the
center of the organ the <lppositioned surfaces of the lu-
minal epi thelium often produce a hypcrechoic line (Fig.
2.65). This runs along the middle of the uterine section,
from the tip of the horns up to and through the cervix,
Large, coherent and anechoic fluid acrumulations are
not nonnally seen during diestrus. Depending on the
Utems 115
stage of the cycle. smaller, thread like C'Jvi lies:L few mil-
limeters thick can be found in the ut eri ne lumen (Fig.
2.66 10 2.68). These are usually seen during estrus, but
can also occur during di estrus. They are free of echoes
and can be seen in various of ut erine sections (PIERSON
and GIi"fTllER 1984 a). During estrus the amount of :ac-
cumulated secrelions in the ut erine lumen varies con-
siderablyand may reach several centimeters (Fig. 2.68).
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116 UltrtlSOllogrtlIJII), ill/he CDII'
tlg. 2.69: of Ihe dorsal . "mnial and \"Cn
Iml diamc' ers of :1 ulerine hom
t1g. 2.72: Ewmplc of an heterogenous ulerine wotll . Apan
from 'he 'hin fluid accumulmions there are arc:iS of grealer
and lesser I.:ehogenidty in the uterine wall . Arrows demarcate
the greater curvature.
'00
90
80
70
.,
%'"
.,
30
'"
,.

" mm
ventrnl 0
cranial 0
dorsal 0
__ +--+-; __ +--+-;, __ ., __ __
o t 2 J 4 S 6 7 8 9 10 II t2 13 14 15 16 11 III .9 20
Days after ovulation
2J)
" l
"
"-
"

,
2
,
1.
"
4
,
.l
"

17 12.l. ...L ...L 10
S 8 14 Jl...ll Jl. ..ll
10 10119
6 7 B 9 10 II 12 Il 14 U 16 17 18 19 20
Tage nach Ovulation
Fig. 2.70: Mean ooThaJ, cnmial and
\'Cnt rotJ diameters of non-pregnant
uterine horns during tbe estrous
cycle in heifers_
Fig. 2.71: The percentage or cows
in which a sonogrnphiGally delect-
able fluid !lcrumul:ilion could be
found during .he estrous cycle_
SkO z. l: 10 ad 0
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I
Sc"eml invcstigation.<; were conducted to test
whether any correl ations between the stage of the cow's
cycle and the ult rasonic image of her ut erus existed. For
this purpose the diameter of the uteri ne homs, intra-
uterine fluid accumul ations and the sonogrdphic ap-
pearance of the ut erine wall were determined in a total
of 51 estrous cycles of 12 heifen;.
The thickness of the uterine homs could be moni
tored by measuring the changes in the dorsal, cranial
and ventrJ.1 diameters of the uterine horns (Fig. 2.69).
All three diameters were largcst at the time of cstrus
(Fig. 2.70). They decreased significantly during met-
estrus until the beginning of diestrus. The uterine
hams then became thicker again to reach their widest
diestrous diameter during the middle of cycle, between
Days 9 and 14. On, or about Day 16 a subst antial
decrease in the uterine hom diameters occurred. The
thickness of the homs increased again until the next
estrus. o.'cmll, a cycle dependent change in the thick
ness of the uterine horns could be dcmonstmted (Vou..-
MERIIAUS 1957. PI ERSON and GII'mIER 1987). Through
out the cycle their thickest portion was the ventral,
cuNed sectlon of the hom. At the cranial and dorsal
measuring sites the diameters \.\'Cre approxi mately I to
4 mOl thinner.
In a large proportion of cows fluid accumulations are
sonogmphically visible in the ut erus at the time of estrus
(PI ERSON and GIl'I{Tli ER 1984 a). They are detected in
about half the heifers on the day of estrus and in about
one third of the heifers during the few days just prior or
after est rus (Fig. 2.71). It is interesting that fluid accu-
mulations can also occasionally be demonstrated during
the early and mid luteal phase. The most frequent site
of the fluid accumulat ion lies just distal to the larger
cuNature of the uterine hom in the part that winds cau-
dolatemlly. Fairly frequently, however, hypocchoic
areas can also be found in other pans of the uterus. The
size of the fluid accumul ations can vary markedly in
nonpregnant uteri. During estrus and diestrus fluid ae-
Utents 117
cumulations measuring 30 to 40 mOl in length :md 5 to
10 mm in width can occur.
The fact that fl uid Cdn also be found in the nonpreg-
nant uterus is of considemble importance for the sona--
gmphic diagnosis of early pregnancy. Since secretions
can be present in the uterus at any stage of the ent ire
estrous C}'Cle, even if no conception has taken place, the
mere detect ion of a fluid accumulation should not be in-
terprded as a reli:lble sign of pregnancy. Pregnancy can
only be diagnosed when embryonic components can be
identifi ed with certainty.
Particularly during proestrus, estrus and metestrus a
layering of the ut erine wall into a hypocchoic, adluminal
zone :lnd a more echoic peripheml zone is recognizable
(Fig. 2.72). During this period one third to 11 half of all
cows have a heterogeneously structured uterine wall. In
about one half of those cows in which the structure of
the uterine wall was e:tamined ultrasonically during nor-
mal estrous cycles, a heterogenous structuring of the
ut eri ne wall could be recognized on the day of estrus. In
the ot her half of the cows the uterine wall appeared to
Ix! homogeneously struct ured. During metestrus be-
tween 28 and 53 % of the cows slill had heterogenous
ut erine walls. Laminated uterine walls could only be
secn in a few cows during diestrus but in the majority of
cases the uterine wall was homogeneously structured.
During the days preceding the following estrus the per-
ce ntage of heterogeneously structured uterine walls in-
creased again to reach 50 %.
As a result of the edema of its more superficiall a)'Crs
and the accumulat ion of secretions, the inner areas of
the uterine wall will become less echoic during the es-
trogen dominated stagc.<; of the estrous cycle. This leads
to the layered image of the uterine wall. This seems to
be a similar phenomenon to that observed in estrous
mares where the edematous endometrium is distinct
from the more dense tissue of the myometrium
(GINHIER and PI ERSON 1984. KAliN and LEIDL 1985).
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I
I
11 8 U1fmSOllogropirY ;1I fil e COli'
. . . . . . . . . . . . . . . .
Jo1g. 2.73: Embryonic \'CSidc with embryo (E) from il cow on
Day 26 of gestation (rell1O\'Cd from the uterine lumen). The
al1antochorionic vesicle stretches thread like from the tip of
one uterine hom to the other. In the pregmull hom the in-
crca<;e in embryonic nuid leads to an enlargement in the
\'e1Se diameter of the vesicle.
I-lg. 2.7S: Bovine uterus on Day 12 of pregn:ml)'. A Uypo-
echoic section (large arrow) Ihrough Ihe embryonic \'csicle is
... iliible in Ihc \cntr.d pan orthe ut erine hom. The greater and
lesser are dcmllll.' lIed by small allU\\'S. Ul lr,isono-
gmm produces ... sector scmncr :ll 5
1-1g. Z. 74: Uterus on Day 12 of pregnancy. H),poechoic sec-
tions (small allU\\'S) through the embl)'{mic \'CSic1c are \'isibJc
in several places. The outline of the ulerine horn is demar-
ruted by Ihe larger 31"fO\\.'S. Ultrasonogram produced with So..'C-
l or scmncr al 5 MHl.
Avk; 'SkO'
,
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2.3.2 Pregnant uterus
From Day 15 of pregnancy the embryonic vesicle of
the bovine will be a thin, thread like tube in the ut erine
lumen (BEI IERIDGE et al. 1980). By Day 20 it will
stretch from the tip of one ut erine hom to the other and
have a total length of up to I meter (WINTERS et al.
1942, OlAFFAUX et al. 1982). Until Day 25 the cross
sectional diameter of the allantochorionic and amniotic
is still so small that a fluid filled embryonic
can only be detected by using higher frequency
ultrasonogmphy of 5 MHz or more (KMIN 1985). From
around Day 25 the amount of fluid in the allantocho-
rionic vesicle increases mpidly so that aL..a the embryo
onic \lCsicle's transverse diameter becomes considerably
gremer (Fig. 2.73).
2.3.2. 1 Day 10 to 20 of pregnancy
If cows ilre examined sonographically every dny after
insemination a minute fluid accumulation may become
apparent between Days 10 and 17 of the cycle (Fig. 2.74
and 2.75). The fluid will lie in the hom ipsilateml to the
corpus lut eum (CURRAN et al. 1986 a). It will appear as
thin, anechoic areas that are round in shape in three
quarters of all cows and measure 2 to 4 mm in size
(PIERSON :md GINll/ER 1984 a). In approximately one
third of the pregnant cows they will be elongated and
are 2 mm thick and 3to 7 mm long. The diameter of the
embryonic vesicle i1PPCilrs to remain constant from Day
l'regnQncy 119
10 unti l Day 18, only its lengt h incrc:ISCS. Betwecn Days
17 and 20 of gestation, sometimes even earlier, hypo-
t.'Choic sections through the embl)'Onic \lCs.icle are vis-
ible in various sectors of the pregnant hom of the utero
us. In most !';1St'S these minute fluid accumulations are
sections through the chorionic vesicle. At this stnge it
lies thread like in thc uterine lumen :md contains vcry
little fluid nnd FOLEY 1958). Around day
19 the embryonic vesicle will fonn a slight distention
usually near the middle of the pregnant hom, in the
same aren where the fluid first became visible.
Sonogrdphic imaging of the embryonj(; vesicle at this
early stage is difficult and thus unreliable. For example
experience was made that a nuid fill ed vcsicle could be
detected in some oows betv.'(;en Days II and 13. but not
between Days 14 and 17, although the cows ,"lere later
found to be pregnant. The maximum diameter of the
fluid accumulmion in early prcgnancy before Day 20
reaches not more than 2 to 3 mm (BI, I IERIDGE et al.
1980). The largest diameter of the embryonic vesicle
therefore lics at the lower limit of resolution a(;hicvcd
even by high performance ultrasound equipment. While
it seems feasible that uitmsonDgmphy can be applied
successfully for research pul")XtSCs 10 sludy early preg
nancy, it is not possibl e to usc ultTllSOnography as a tool
for the reliable pregnancy diagnosis before Day 20
(KASTEUC et al. 1989). From a differential diagnostic
point of view the hypoechoic fluid accumul at ions can
not be distinguished reliably from similar images seen
during estrus, diestrus or in certain pathological condi
tions.
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120 U/trnsollogrnpll)' ill the cow
FIg. 2.76: Uterus on Day 21 of pregnancy. The hypocchoic
area of the embryonic \'i;side (V) has a size of 9.5 ..: 4 111m.
Ultr.lsonogmm produced wi th a st"CIor scanner ;11 5 MHz.
fig. 2.78: Uterus on Day 23 of pregnancy. The embl)'O (E) lies
at the I1oor ofthe vesicle. During real time scanning pulsation
W' .IS detectable in the area of the dc\'i;loping hean. Ultrasono-
gram produa..--d with Sl..'CIor scanner al 5 MHz.
Fig. 2.77: Uterus on Day 22 of pregnancy. 1bc l a r g ~ 1 fluid
collection inside the embl)"Onic vcsicle (V) is located in the
\'i; nt ral portion of the uterine hom. Arrows dcm31"C3te the
grc3ler CUIY.llUre.
rig. 2.79: Uterus on O:lY 24 of pregnancy. 'r1lc :lllllntoic memo
brane (arrow) fl oats inside the embl)"Onic vcsicle.
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2.3.2.2 Day 21 to 24 of pregnancy
Between Days 21 li nd 24 of gcstation the :Imount of
fluid inside the cmbl)'Onic \'(."Sicle hns usually increased
to such an CJC\em that it becomes easier to visuli lize by
ultr.:oonogmphy (Fig. 2.76). At the Site of its greatcst
expansion, usually in the .. rca of the amnion, the em-
bryonic vesicle reaches .. diameter of between 3 and 5
mm and a length of .. bout I em on Day 22 of gestation
(KAli N 1985). The largest fluid accumulat ion is most
frequently seen for the first lime distal to the cutvature
of the uterine hom, in its free, winding section (Fig.
2.77). This is also the si te where the embryo .. nd its sur-
rounding amnion become delectable for the first time.
Before Day 25 of pregnancy it can often be difficult
\0 fi nd the embryo itself. Sometime.'i its presence can be
suspcc1ed, but it is difflCUlt to differentiate it from other
echoic struct ura;. Rat her frequemly, though. it can be
ident ified wi thout doubt (Fig. 2.78). The lcngth of the
embryo between D .. ys 21 and 24 is about 5 mm (CuR-
RAN' et al. 1986 a). Occasionally it is even possible .. tthis
time to see a heart be .. , in the form of flickering echoic
points.
The non-pregnant status of a cow can, under certain
circumstances, be diagnosed around Day 20 to 23 post
insemination. In these C"dSCS one ,,'Ould base the nega-
li"e pregnancy diagnosis on the small size of the corpus
luteum (largest diameter ( 20 mm) and the absence of
fl uid in the ut erus (KAsn:uc et al. 1989). A positive
pregnancy diagnosis can only be made with certainty
once an embryo has been idemi fied.
A thin, hyperechoic and !(}\O,'ards the ti p of the hom
bulgi ng membrane can someti mes be seen insi de the
embryonic fl uid .. t .. bout this stage of pregnancy (Fig.
2.79). Based on its posi tion and the lime of its appear-
ance it is .. s,<;umed thm it represents the allamois (CuR-
RAN et al. 1986 b). This thin, slightly floating membrane
is only visible for .. few days. According to experiences
m .. de thus f .. r it is most frequently det ectable on D .. ys
23 to 26 of gcstation. In some C<ISCS it may still be seen
IWgnallc)' 121
on Day 30 (Fig. 2.80). In the bovine. the all ,mtoic vcs-
icle undergoes paniculurly ntpid growt h in length
:u'Ound the 23rd day of pregnancy ( SAIJSBURY et al.
1978). By Day 32 to 37 the allantois will line the cntire
inner surface or the chorion.
During this phase of the sonogntphic preg-
nancy diagnosis particular att ent ion must be paid to
confirm that the obscn'cd fl uid accumuhlt ion is intrd-
uteri nc. There is nlW' d)'s the pitf:tll of confusing the
blood vessels that run on the surface of the uterus with
nuid accumulations within the ut erine lumen (T AVERNE
et nl . 1985). Findi ng the concept us with certainty li t this
stage requires a thorough sonographic ex.amination of
the ut eru.s. To establish an nccuml e diagnosis can some-
times take SC\'Cral mi nutes.
Fig. 2.80: Uterus on Day 28 of prcgnanc;y. The membrane of
the allantoic \'CSicle bulges towards the tip orlhe uteri ne horn.
In Ihe area where the sound W'J\'\!S impact w rtic"JUy onto the
allantoic membrane an intenSive echo (arrow) visi
b<.
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122 Ultrasonography in the cow
Fig. 2.81: Embr),onic ,cside (Y) and embryo (E) on Day 25 of
pregnanl)'. The cmbryonic"esiclc along the rurvat ure
(arrows) into thc dorsal ponion of the utcrine hom.
Fig. 2.113: Nuclear magnetic resonance image of a utcrus on
Day 26 of pregnarK.j'. In the pregnant hom three of the
uterine Willi protrude into lumen latcrally (small arrows)
:lnd one from dorsal to \'cntrol (large arrow). Latcrol lo the
homs arc the In-arics (OY).
FIg. 2.82: Embryonicves.icle on D3Y 26 of pregn3rK.j'. Twosee
tions through the embryonic \"CSic1e arc vislble. Thq' appear
to be separated by a ponion of the echoic uterine \00'11 11.
rig. 2.84: Vesicle and embryo (E) on D3Y 29 of pn:g.nancy.
Ponions of the uterine "'-all which lie in the SCUl nmg pl3ne
and the embryo divide the embryonic vesicle illlO pscudoam
pullar sectors (I. 2 and 3). Arro ..... s demarcate the outline of
the uterus.
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2.3.2.3 Day 25 to 30 of pregnancy
On Day 2S of pregnancy the embryonic vesicle of the
Ix:Mne reachcs a diameter of 10 mm at the point of its
Iargesl expansion. By slight rotat ions of the ultrasound
probe the course of the embryonic \'csicle can be fol
JooA'Cd into much funher areas of the free segment of
the pregnant uterine horn at this stage. It also stretches
through the curvature of the hom into the pan where
the two uterine horns are fused to form the uterine
body (Fig. 2.81). Until Day 30 the diameter of the em
bryonic vesicle increases to 18 to 20 mm and is then al
SO visible in the contral ateral hom (CHAFFAUX et al.
1982, OJRRAN et :11. 1986 b). In the cont ralateral hom
is much narrower with a diameter of 4 to 8 mm.
The course of the pregnant uterine hom with its
dorsal segmelli. the ... enlml bend and the caudally direc
ted )XInion - is best demoll5tnlled if the probe is posi-
tioned above the uterus wi th its sound plane oriented
along the longitudinal axis of the cow's body and the
Pregnanc), 123
beam directed donio\,cntr:t lly with a slight lateral devia
tion. This produces a sagittal section through the uter
ine hom which is chamcterizcd by the echoic, curved
uterine ""'all surrounding the anechoic embryonic \cs
icle. It is usually nOI possible to position the sonographic
plane in such a way that the embryonic vesicle is
simultaneously visible in all parts of the hom. More of
ten. only \'3rious segments of the embryonic vesicle will
be depicted (Fig. 2.82 to 2.84). The nuid sac of the em-
brytmic vcsicle is interrupted in places by folds of the
ut erus which project into the lumen. This creatcs a
pseudo-ampullar image (KAl iN et al. 1989). These folds
and their spatial ammgemcnt can be demonstrated \'el)'
well on NMR scan pictures (Fig. 2.83). Typically. 2to 3
anechoic sections through the chorionic \'csicle are vis-
ible on a single ult rdSOund im3ge al Day 25 of gcstalion
(Fig. 2.82). More sections through the emhl)'Onic ves-
icle will become visible during the next few days so that
4 to 6 sections can often be seen by Day 30 (Fig. 2.84).
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124 Ultrtlsollography in Ihe CDII'
"li:. Z.H5: VesICle emhl)lJ (E) on Day 26 of pregnancy.
' 111: embl)lJ tiC!! aUJaccnt to the uterine wall.
"'g. 2.87: Comparison ur the pregnant), dingnosis
at 5 Vesicle and emblYo (E) on Day 32 ofprcgmtO(}'.
"'g. Z.K6: Vesicle lind emblYo (l!.) on Day 31 of prcgnancy.
lbc cmbl)'O is stllrting to nKM: IlWIlY from lhe ulerine wall .
Fig. l.88: Comparison orthe sonogmphic pregnuncydiagnosis
lit 3.5 MHz. Vesicle wit h embl)'O (E) 00 Day 32 ofprcgnancy.
The \'CSiclc and the embryo II rc difficult to recognize.
A .... t> sl(o Z'lsc' 10 .... c
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The use of a high resolution scanner will ensure that
the embryo can be detect ed in all cases of bovine preg-
nancy between Days 25 and 30 (PIERSON and GINTHER
1984 a). The embryo's echogcnicity is a little more in-
tense than that of the neighbouring endometrium (Fig.
2.85 to 2.87). Since the embryo lies very close to the
ut eri ne wall for the first month of pregnancy, it may
prove difficult to find (Fig. 2.85). It projects from the
wall into the anechoic ut erine lumen and can be identi-
fied by the presence of a heart beat. The embryo s t a r t ~
to moves away from the wall during the next few days
and by Day 30 it is completely surrounded by fluid (Fig.
2.86). To identify the embryo accurately its echo must
be examined C'd.rcfully to differentiate it from the reflec-
tions of other structures. Especially in the area where
the sound W".avcs impact vertically other structures may
produce very intense echoes. Such areas include the
sites where the allantoic membrane is exposed to veni-
cally imp' lcting sound wuves which then generate vcry
bright echoes. More ultrasound is returned from the re-
flective surface vertically oriented to thc transducer,
thcrcby creating thc impression of a \lcl)' intensely
echoic structure (HAssLER 1984).
On average. the length of the embryo increases
from 5 to 12 mm in the period from Days 25 to the 30
of pregnancy (PIERSON and GIN11lER 1984 a, REEVES
et at 1984, CURRAN ct al. 1986 b). If it is clearly visible
its heart beat should also be detectable. The heart is thc
first organ of the bovine embryo that can be identified
by ultrasonography. It can be detected only a few days
after the vcry fi rst cardiac contractions occur during the
course of organogenesis. Around Day 20 the heart
PregllulICY 125
starts cont racting rhythmically (SAUSIIURY ct al. 1978.
NOI>EN and DE lAll UNTA 1985 b)
The earliest time at which pregnancy c:m be diag-
nosed depends very much on the sound frequency ,lI1d
the quality of the scanner used (Fig. 2.87 and 2.88).
Using a 5 MHz sc:mner it should be possible under
practical conditions to demonstrute the embryonic ves-
icle with relative ease by Day 25. From this Day the ab-
sence of fluid from the ut erus indicates wit h reasonable
certainty that the cow is non-pregnant. If. in addition to
the embryonic fluid. the embryo is visible u posi tive con-
finnation of pregnancy has been obtained. Under cer-
lain conditions the delection of an allamoic membrane
a few days prior 10 the detection of the embryo is pos-
sible and may be laken as 1I positive confi nnation of
pregnancy.
While it is possible with u 5 MHz SCimner under
field conditions to deliver a reliable pregnancy diagnosis
betYlCen Days 25 and 30. this is only possible at a later
stagc if lowcr frcqucncy probes are used, due to thcir
poorer resolution (TAVERNE et al. 1985. aMFFAUX
et al. 1986. HANZEN and DELSAUX 1987). With a fre-
quency of 3 to 3.5 MHz, the demonstration of the em-
bryonic vesicle and the embryo is usually delayed by
about 5 days. At a frequency of 3 MHz the embryonic
vesicle is visible after Day 25 and the cmbryo after Day
30 (T AltmJRIER et al. 1983). Studies on thc accuracy of
ultrasonic pregnancy diagnoses indicated that at low
frequencies of 3 or 3.5 MHz an accurate negative
diagnosis could be made by Day 35 to 40 and a positive
diagnosis not earlier than from Day 45 (TAVERNE et al.
1985, CHAFl--AUX et al. 1986).
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126 UlrrtlSQllogmphy ill tlte cow
fol g. 2.89: COIlCI:ptUS wilh cmbryo (ind amnion (2 1lIT(J\\'S) on
D:ly 33 of pregnancy. Thc amnion a thin mcmbr.Ulc
which surround\ the embl)'O. Uhrasonogrum produced \\ilh
sector sc::mncr at 5 MI
"' il(. 2.91: Conceptus with cmbl)'O and amnion CA) on Day 40
of pregna .. The head of the cmbryo ..... ith the ;mcchoK:
round area of thc dc\'cloping cye (arrow) lie.:. tOwards the left.
The c:tl:M11rump- lcngth (CRL) is 2U mm. Ultrasonogram
produt'Cd wilh ..ector sciinner lit 5 Mi ll.
Hg. 2.90: PholOgrnph of lin embryo wi th surrounding amnion
and 3djoining 311:ulIochorion (AI) on Day 37 of pregnallC)'
(specimen rcmO\'Cd from the ulerus).
foig. 2.92: UltmsonogrJm of (I oooccplus wit h embryo (E) and
a single placcntome (P) on Day 33 of pregnancy. The plOlccn
tome budlike into the lumen.
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2.3.2.4 Day 31 1040 of pregnancy
The crown-rump-Icngth (CRL) of the embl)'O
reaches 12 mm around Day 30. 15 mm by Day 35 and
20 mm by Day 40 (PIERSON and GINTImR 1984 a).
Qmlsiomilly around Day 30, but usually around Day 35
the amniotic vesicle becomes apparent (Fig. 2.89 and
2.90). A few millimeters away from the embryo it forms
:1 .... cry thin. arched, hypercchoic line which surrounds
the embryo.
Around Day 40 the mean diameter of the embryonic
vesicle is about 2.5 em and the CRL of the cmbf)'O
about 2 em (Fig. 2.91). The sizes ofcmhryonic vesicles
vary, h<M'cycr (MOLLER CI al. 1986). Sometimes the
Pregnant:)' 127
diameter varies between different scdQI'S of the vcsicle
and there arc also differences bctv.-ccn individuals.
Even during an examination the embryonic vcsicle may
undergo changes in diameter due 10 intestinal imd
uterine movements. It is thus not mrc 10 find variable
vesicle diameters when Ihese arc measured during a
single ultrdSOund examination.
The placcnlomes also become visible for the first
time between Days 30 and 40 (Fig. 2.92). On average,
the first apJX:arnncc of knob like protrusions can be
around Day 35 (CURRAN 1986 b). The first
signs of placcnlomcs are usually noticeable in the area
near the embryo.
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.... ""D:o)'57ufprqn.ul<).("Jbo.'ious
""'f ..... uuna:nlt,,;(O) .... vt<Hcoolhohead.l' ... .....t>ilo;:aIwnI(U)
"'''' In I don.al d,reo;1iun and 'hen fr>lk"" I ,,>u1>e .k"", II><! "'crin< ....
=:""""'. TO' ... rigbttA""'_OOd<nnl .... rhca:tooa.uf.
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2.3.2.5 Day 41 to 90 of pregnancy
From the first day of de\(.'Ction between Days 20 and
30 until Day 50 the embryo grows at a rate of approxi
mately I mm per dny (Pt ERSON and G1NTIlER 1984 a,
KAHN 1985). By Day 50 it ..... ould thus have a CRL of
about 35 mm (Fig. 2.93). The cross sectional diameter
of the placental vesicle also increases appreciably be
tween Days 30 and 70 of pregnancy. It reaches 2S mm
by Day 40, 35 to 40 mm by Day 50 and 50 to 60 mm by
Day 70 (KAuN 1985, CURRAN et al. 1986 b). The largest
dilation of the uterus usually occurs in the area of the
embryo, whi le the embryonic vesicle in the contralateral
hom can be substantially narrower.
Around Day 40 ,\ stage is reached when the sonogra-
phic examination of the pregnancy can be extended to
l'n'8l1(lIIc), 129
include the demonstration of embl}'Onic or fetnl struc
tures, respectively. From the dingnostic point of view
the only organ that is available at this stage of pregnan-
cy is the beating heart. In contrast, aft er Day 40 the out-
line of the fetus with its head, extremities and umbilical
cord become visible (fig. 2.94). From Day 35 to Day 45
the sonogmphically visible changes that transfonn the
undifferentiated, primitive embl}'O into a fetus with a
distinct body fonn. take placc(WINTERS et a!. 1942). At
this time. first ossifICat ion centers can be noticed in the
vcrtebrae, ribs and pelvic bones, on the upper and lower
jaws, on the femur and humerus as .... 'CII as on the radi -
us, ulna and tibia.
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130 Ultrasollography j ll the cow
.1g. 2.95: Sagi ual section through a pregnant uterine hom on
Day 41 of pregnancy. The anechoic conceptual \csidc ap-
pears to be divided by folds of the uterine wall into 4 ( I. 2. J.
4) companmcnts.
Fig. 2.97: Nuclear magnctic resonance image of a uterus on
Day 55 of pregnancy. Inside the pregnant hom are folds (ar-
TOI'o"S) that reach venically into the lumen, as well a ~ placen-
tomcs (P). On the right is the ovury (Ov) with a a; oilihe left
is the non-pregnant hom (oph). The head ( H) . spinal column
(S) and the bright echo of the liver can be n:cugnU:t.'d.
Fig. 2.96: Photogroph of a sagittally opened uterine hom on
Day 55 of pregnancy. The folds of the uterine w-oIUlead to the
wmpanmentali:altion orthe pregnant uterine hom.
FIg. 2.98: Photograph of II sagittally opened. pregnant uteri ne
hom on Day 78 of pregnancy. The folds of the uterine wall
stroightcn out as the pregnancy progresses.
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The pseudo-ampullary appearance of the pregnant
uterus is particularly pronounced during the 2nd month
of pregnancy (Fig. 2.95). Atlhis time numerous well de-
veloped ut erine folds bulge into the lumen and divide
the early pregnant uterus into compartments (KAli N et
al. 1989). In a sagittal section through the uterus the
folds run vinUlllly in lrnig.ht lines between the larger
and lesser curvatures of the pregnant hom. lhey arc
sic1de shaped and project often 2 to 3 em high into the
uterine lumen (Fig. 2.96). They stand almost vert ically
10 the outer surface of the ulerus and are ammged
in the fonn of circular folds, in relat ion 10
the longitudinal axis of the uterine lumen (Fig. 2.97).
Their regular spacing and their prominent infolding
fonn a pscudo-compartmentillization of the ut erine
horns.
As pregnancy cont inuc,<; these circular folds of the
uterine wall grnduil lly retract so that by Day 70 the com-
partmcntaliz;ttion becomes less prominent (Fig. 2.98).
If a linear scanner is used for the sonogr.l phic exami -
nation of the conceptus a 5 MHz probe will give goOO
17egIlQllcy 13 1
result<; unt il Week 6 of pregmmcy. At this frequency the
resolution is high enough to detect even small fluid
accumulations as well as the still smilli embl)'onic struc-
tures. In addition. the SCo'tnning width of about 5 em of
the 5 MHz probe and it<; scanning depth of about 9 an
are adequate to rather completely depict the conceptll.<;
which is still quite small.
The lower frequency ultrasound .... i th its deeper
SC<l nning depth has import ant adv.lntagcs during the
more advanced stages of pregnancy. As a result of the
deeper field of view, larger parts of organs and wider
segments of the pregnant uterus can be depicted. When
a 5 MHz probe is used the CRL of a fetus may not be
measurable after Day 60. Around this time the CRL
reaches 6 em which is the maximum scanning width
of most 5 MHz linear probes (WUI1"E et al. 1985). If a
k,." .. er frequency probe is selected the fe tus mlly sti ll be
SC<l nned in tOIO unti l Day 90.
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132 UI/rrISOIllI8rtlpl!y ill rlrl' co ....
2.99: Pn:gn:ml Ulcrus wilh a plao::nlOmc (P) on Day 102
of pn. .. gn:tOC)'. 111e hypefC<"hoic membrane of the nliantlXho-
rion (nrrow) runs ncross the pla(:cmomc.
2. 101: tightly packed plaocntomcs in a uterus
on Day 191 of pregnallC). Ikt\l,'l..'Cn the a ,,"'dion
through the nmniotil; vc..;dc (Am) with it\ more l,.'Choil; am
niock fluid c;:an be Sl,:cn. The allantoic "uid (AI) is mue-h more
hypot."Choic.
Fig. 2. 100: Placcntomc with its hyperechoic border in a preg-
nancy on D:ty 162.
Hg. 2. 102: Uterus with the h)'pcrechoic amniotic membrnnc
(alTlM') IOohich scpar:ucs the echoic umniolic nuid from the
hypocchoic allantoIC nuid. l"NgnallC)'Oll Day 191.
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..3.2.62ndand3rdlrimcslcrofprcgllant)'



'The pbttnlOlDe' l>ulge 1010 lhe u\Crine lumen in
'!-W aPl"'arano:: (lIg. 2.9':1). During the

,...1Iy<urrourkk:dbyJ I . ....,ryhypcr.

... 'Cnmlhcll'ccnlcr.;. lnm"ny

he >een <K1 a Slngk: :IO.JIIOgf'lIph..: 1m.
.. 111..:n: ....


...

:w.ome "ppeanmccand lurbulen<.n
rhe
allanl(l;'" fluid for many month<.. Only
duriog the si>(\h nlOl1lh ofpn:g.nallC)' 00 a few ochoc.
<larttoappearini,,,hichlhenincn:a<jCrapidlyin<kn.
wty.l'rumM<K1,h8umdsbonlybcforehirththeect...-
alLamoi(:f1uidmaybevcrysimilarl(}INII
mtM amniOhcfluid. thin echo line:
of 1M amnion Ctln nearly aNo'aysbe T'tOOgfIl7.ed as II

flud..
rhe=lI1"hi<hthektw.e<c;mnothcrcachedhy
lrnnsr=al..........,..phyou;urdurinalhc """ trirnc.tcr
ofpregnancy( ...
I100I''' conduo.i<>n<can be d ... by ima&Jng tho:
rdJed ..
..

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134 Ultrasollography ill the cow
"'ig. 2.103: Twi ns. which resulted from insemination and oont ralateral
embl)'O tmosfer, in a CC10II on Day 41 ofprcgnancy, The transverse sec-
tion through the uterus shows one fet us. surrounded by its amnion
(arrow), in the lert uterine hom and another fe tus (F) in the right
uterine hom,
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2.3.2.7 Twin and multiple pregnancies
The sonographic diagnosis of a twin or mUltiple
pregnancy can be justified if tv.'O or more embryos Of fe-
tuses .... 'Cre dearly visible. If two conceptuses can be
depicted simultaneously on the monitor a sonographic
diagnosis of a twin pregnancy is reliable (Fig. 2. (03). If
the two conceptuses lie in opposite uterine horns they
can only be seen in one pict ure if the sound probe is
turned into a virt ually transverse position. A probe
which allows mult iple scanning planes during intrarectal
applicmions is pankularly suitable in sueh cases. So, for
example. the use of a linear probe which is held length-
wise insi de the rectum produces mostly sagi ttal sections
through the ut erus while trunsvcrse images through the
Mllitiple pregnancies 135
organ are difficult to obtai n. To diagnose a twin preg-
nancy the fe tuses then have to be found one after the
othef. This can lead to di llgnostic uncertai nties. because
it is not always clear during the course of an examina
tion whether the second fetus that is found is not
perhaps another view of the fi rst one which has mi
grated back into the picture.
The second month of pregnancy appears to be the
most suitable period for diagnosing [lAins. This period
encompas"cs the stage at which from the embryos are
first easily visible at around Day 28 to the stage when
the adYanccd growth in the size of the fe tuses prohibits
them from being depicted simultaneously.
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F"," 2.JI).I, AooomWI"O&fW'C)'38a.y.ofto,;"",mi",,'..,.,
[""""' .....

bryu(t)
!.I""', 1.1"-_"""" of r .. 1Il moovrufo<a'.,., ill. \lOll"
ar,O' ;n",m",","", _ n..: nwmm;.'< "",r""" ch.c to

p<>noefI .. __ 'ft'h"'
""'. """"n"thc<kpo:l.,., <'Alk"'l't,ktal >InK1u_
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2.3.3 Uterine pathology
2.3.3.1 Embryonic death
First signs of an impending embryonic de:nh are an
undersized embryo and a reduced amount of embl)'Onie
fluid. The death of a w nceptus can be reliably diag-
nosed once the embryonic hean beat has stopped.
In cases where embl)'onic death have been observed
between Days 25 and 40 of pregnancy the hean beal
persisted for several days after a retardation in growt h
had been detected (Fig. 2.104). Sometimes the hean
beat did not cease until several days after first suspicions
of an impending embryonic death, based on retarded
embl)'Onic growth, were raised (Fig. 2.105). Shortly be
fore the heart wmes to a complete standstill, one can
often notice a markedly reduced pulse rate (KAs"rEuc
et al. 1988). The nonnal embryo at this slage ,,'Ould
have a heart rate of about 150 per minute (KAt IN 1989
b). A .. the resorption progresses the amount of embry-
onic fluid will decrcase, while its (.'Chogenicity will in-
crca<;e. What started a .. floccular reflections al the be-
ginni ng of the resorption will develop into a mas.. .. of
snowy echoes. The embryo then looses its typic .. 1 out
line and becomes very indistinct.
2.3.3.2 Fetal mummification
In caSC$ of pregnancy failure in the form of fetal
mummification the uterine ultrasonogrdms usually con
tain vcry little conclu. .. ive infonn:nion. Immediately be-
low the utcrine wall hypcrechoic foci can be detected
(Fig. 2. 106). No fetal body parts have been identified in
the mummies examined by trdnsrectal ultrdSOnography
thus far. The sound waves only penetrated a few cenli
Ulerillepmhology 137
meters into the fetus so that only:l narrow, hypcrechoic
peripheral area could be identified. The tissues that lay
deep to the fetus did not reflect any ultrasound echoes
and remained anechoic (FISSORE el at 1986).
Iy, the mummification process lelad to tissue changes
which c .. used an increased absorption of sound waves in
the superficial tissue layers.
Between the surflacc of the mummified fetus and the
uterine waU werc no hypoechoie area .. that could be
seen as accumulations of fetal fluid.
2.3.3.3 Fetal maceration
Apart from the well known clinical features some
sonographic signs of fetal maceration were seen in a
case of this foml of a pathological pregnancy. 11lCre was
a very disti nCi difference between the echogcnicity of
the allantoic fluid and that of the amnion (Fig. 2.1 07).
Due to its lack of reflCClmns the allantoic fluid appeared
vi rtually black, while hypcrechoic. regularly distributed
echoes whirled around inside the amniotic fluid. These
were interpreted to ha\'C been caused by the increased
ccllular content of the amniotic fluid resulting from the
disintcgratmn of the fetal tissues.
Within the echoic amniotic fluid, fetal component ..
were identifiable. The fetus and its organs were, how-
ever. much less distinCi than in viable pregnancies. Due
to the increased echogenicity of the amniotic fluid the
fetal outlines contrasted less than nonnal. Structures
wi thin the fetus .... -ere only vaguely recognizable. This
wa. .. assumed to have been the result of the onset of
post-mortem changes. As a rcsull of their hypcrechoic
echoes only bony p<1rtS could be differentiated from soft
tis.. .. ue components (F1SSORE et al. 1986).
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2.3.3.4 Postpartum uterus
After birth the most obvious sonographie struct ures
in the uterine lumen are the caruncles (Fig. 2. 108 to
2. 110). Depending on the direction of the sonographie
scanning, a variety of sections through the carunclcs can
be produced. Areus of differing eehogenicity can be
secn on the round or oval cross sections of caruncles.
The most superficial hlycr is depicted as a hypcrechoic
layer. The deeper tissues of the placentome are rela-
tively less echoic. resembling the image generated by
loose tissue. From the site of it .. uterine attachment
hypcrcchoic lines often radiate into the depth of the
caruncle (Fig. 2.1 OS).
The uterine lumen often appears to be virt ual ly 0b-
li terated, even as early as the fi rst day after calving wi th
no larger accumulations of fluid recognizable (Fig.
2.108). In many cases. hov.'CVCr. lochial secretions C'dn
be seen inside the ut erine lumen (Fig. 2.109). They
show the floccular eehogenicitics which are typical of
flui ds that contai n cell ular comp:ments. In such CIISCS
the cilruncles protrude like mushrooms into the rel a-
tively hypocehoie ut erine secretions. Even by two weeks
post partum the normlll postpartum uterus can still be
Postpartllm menu 139
distended by fl uid several cent imeters in diameter
(OKANO and TOM1ZUKA 1987). At this ti me a distinct
reduction in the size of the caruncles can be demon-
strated ul trasonically (Fig. 2.110). Smaller fl uid accu-
mul ations can sometimes persist unt il the end of ut erine
iO\'Olut ion.
When the uterine involut ion runs a pathological
course in the form of a lochiometm the uterus can be-
come extremely di. .. tendcd (Fig. 2. 11 1). In such cases
the placcntomes often ean not be seen. A hypcrechoic
area can sometimes be seen at the floor of the uterus.
This is caused by the sedimentation of tissue break-
down-products and cell ular clements in the lochial fl ui d.
Certai n sonographic features of the postpartum
uterus are also detectable in pathological si tuations
such as endometrit is. For example, the lochia can show
the same echogenicity as is seen in many cases of
endometritis (Fig. 2.112 to 2. 11 5). The caruncles are
then used as characteristic distinguishing features. The
regressing caruncles usually remain detectable unti l the
end of the postpartum period. Apart from this - lind the
usual clinical features - the diameter and the asymmetry
in the size of the pregnant and non-pregnant uterine
horns usually indicate a postpartum uterus.
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140
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2.3.3.5 Endometritis
Auid accumulations which are detectable inside the
lumen of a nonpregnant uterus can be indico.lt ivc for
chronic cndomctritis. The amount of the secretion can
vary considerably (Fig. 2. 112 and 2.1 13). In many cases
a fluid filled lumen can only be detected in short seg-
ments of the uterus. In scvere endometritis cases, how-
ever. both uterine horns can be distended to several
centimeters along their entire length. In mild fonns of
endometritis no lumen may be evident ull rasoniC'o.llly.
Their echogenicity distinguishes the endometritic
secretions from other uterine secretions as are seen dur-
ing estrus or pregnancy (FISSORE ct al. 1986). Anechoic
fluids usually only occur under physiological conditions
(Piel1iOn and Ginther 1987). The fluid causcd by in-
flammation contains floccular echoes. The cchogenicil}'
of the fluid can develop to snow-stann-like images and
can become so scvere that it appears nearly white. Dur-
ing observation periods of some minutes of extensive
fluid accumulations it is usually possible to see turbu-
lence within the fluid.
The value of transrectal ultrasonography in diag-
nosing endometritis in the cow must be judged wi th cau-
tion. Unless endometritis is accompanied by the accu-
mulation of fluid inside the uterine lumen the usc of
ultrasonography will usually not detect pathological
changes of endometri tis. If the uterine lumen is, how-
ever, distended with fluid sonographic diagnosis may be
possible.
A noteworthy phenomenon has been obscr.'Cd in
cases of endometritis after intra-uterine treatment.
After an iodine solution had been instilled into the uter-
ine lumen the luminal surface of the endometrium be-
came hypcrechoic (Fig. 2.114). The hypcrechogenicil}'
de"eloped immediately after the iodine infusion and
Uterine !)(JlllOlogy 141
persistcd for a long time thcreafter. The development
of this increased echogenici ty was also tested in excised
uteri. In this manner it coul d be shown that the in
creased echogenicil}' did not originate from the iodine.
but from the endometrium itself. After flushing the
iodine solution out of the excised uteri the increased
echogenicity persisted.
2.3.3.6 Pyometra
The most extreme fonn of endometritis. the pyome-
tra, is sonographically characterized by a uterus which is
considerably distended by an accumulation of fluid. The
secretion inside the uterus contains unifonnly and dif-
fascly dispersed floccular reflections (Fig. 2.1 15). The
echogenicity of the reflections depends on the consis-
tency of the pyometra fluid. If the secretion is very thick
and contains many cell ul ar clements its echogenicity
may be the same as that of the uterine wall, whereas a
more liquid contents will appear much darker than the
surrounding wall of the uterus.
The thickness of the uterine wall in the pyometra
cascs examined thus far varied considembly. Thick- and
thin-walled pyometras can be found. Only when the wall
is se\'Crely thickened can th is be used to distinguish a
pyometm from a pregnancy. The diagnosis of a pyome-
tm on the basis of its ultrasonic image must be made
with appropriate care. In advanced pregnancy the
uterus is also distended and its fluid contents can be
considerably echoic. For a reliable sonographic diag-
nosis of a pyometra an effon should be made to depict
the entire course of the uterine lumen with its abnonna1
contents and 10 ensure that no fetal pans or struct ures
can be found inside the fl uid.
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."l.ll ' : SdIIIIN' ..

_uol!lOC!'<>n,C) ,fII"...,,,,,,or ....... ...:tioo
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in !he ""'" of an cmhryoOl1Iy ils inlra
. positionandlheoutlilkof it,bodycanbca ..
bylransrectal uhrasonography. a greal number
macm-anatomi""n)'di.ainguishableslructurescanbe
the SIlJnC proccdun: in the Ix:r>inc
"J990j.Gcn<:mlly.lhccmircfclusC<lfIbcc""m-
sonogt"aphkall). 191'\9 b). The SllCCeSSwith
indr.'idualorgansrnnbedepkled, ... riesconsid
"ndd<:pcndso" the Slage of the pn:gnancy. Ihc
"terinc position of the fetus and its mohilily (scc
cr2.4.3).lndividualorgansorbodj.' parts""nbc
tifiNlwhenlheyhav",reachedal leasla,izethale:<-
lhe minimal rcsolOlion capabil ily of t he scanner
and;fll!cyh,,,"cachar,,,-1cnsticllOnogrnphicap-
anccthalaliowsthcmtoood;;tingoi,hcdfromad-
It",,,,,", Theearliesltimeat which ,..,rtainorgarui
vi,ible i, dosel).' connecl"d with the typical

Rased on cxp..'1icncc thu, far the impK"SSion has
g<lincd thm """1or .... nners"re bcttcr suited for



n.. lbismakcstl!cimagingofllugcrpansofthc
po!<Sibk, Jnaddition.lhebcttcrmancuvcrabililyof
small sector probe:'l imide the rectum ma/;;es il
' rtodepictvariou<sectionalplanesthroughthe
Ius, Doc 10 the l-shapc it isdiffoculllOlumlhe
oftbclincar,,;ann.:rfrumibUMl,,1 kmgitudinal
.. n inside the rectum to a more traru,ve"", JlO"i
Blj .. 143

scanncn..Thc"ariou'IClpOgrJphical JlO"iliomofthc fe-
tal organs can thus 00 traced irre.pc<.1ive oftl!c rdativc
positioning of the fetu' in<ide the uterm.
In mosIC3.<;csthe"""t limiting foctor in depicting
the oomplclc fClus is tnc limiled pcnclrati<:m oflhe
soond waves.lfthefelUSIK."Swryncarlotheprol>ca5
MHz '!ector tmnsducer can be u",d for bctter imagl."
quality. For the imagingnf.lructu=that arefurthcr
away from the prol>c it i, fa,maIlle to switch to a 3.5
MHztmmduccr.
Fetuses can ""'lJ=vanabie positioru;insidc thc
uteru . A "andardized"""",nclatu",.tmuIdbe adop-
tedsothatilWmhcpos.,ibietode.crihethep<ll'ilionnf
t hcfctus.Inc sonographicexamiMlionplane' and lhe
"hm.ouod images in unambiguous terms. 'Ibe
usedbelowtodescribethediffe",ntsooogJ'aphic
examinalion plane. thmngh the felu, a", based on the

forms of Iongillldinal sections all: lk:scribed. A!oOt1O-
gmphicpJancJlO"itioncdc""'1IybclW ...... nthclinca"lm.
aodthespinalcolumnt<;caIJedamediansection;ifitts
moved to the .id<: it referred to a, paramedian or
sagiual .... -ction; ifil is dircctcdvcrtically act'OII' the body
axi.il;"illcd a irJIDVCn;corcIl.."6SSCCIion; if il is
directed lalcru--latcmU}';t is a horizontal SC<.1ion. ln

path of the soond ... avcs through the fetal body.hould
he d<:scribcd. If the calf lies wilh ilS spinal column

sound w"ve,dir1ed fwm the spi!lllJ column to Ih<:
linea aibawe'pca1:ofa oo""""ntral sound beam, and
nfavenlrodorsal <Qund hcam in tr.e "PJ">'titc direction
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144 Ultrusol1ogrophY ;1/ the cow
fig. 2.11 7: Ventrodorsal s.1gittal section through a fetus on Day 48ofprcg.
nancy. The head lies on the left. The hypocchoic developing eye (E) can be
reoognizcd.
Fig. 2. 11 8: Transverse section through the head of.1 felUs .1t the le ... eI of the
e)"CS on Day 102 of pregnancy. In the emnial aspects of the C)"CS the oval
lenses (:HTOIII"S) can be secn. Below the eyes is the spherical ccrcbnll cr.lni-
urn (C).
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2.4.1.1 Head
Next to the extremities. the head belongs to those
body pans of the embl)'O that can be recognizcd rela-
tively early. The obvious difference in impedance be-
tween its p.uts llnd that of the surrounding fetal fluids.
its characteristic profile and a marked narrowing in the
region of the neck allow for a dear differentiation be-
tween head and body from about the fifth \\-'Cek of preg-
nancy.
Apan from the facial skull the dark area of the devel-
opi ng eyc wi thin the head can be recognized on about
Day 40 of pregnancy (Fig. 2. 11 7). Initially, the embry-
onic eyc i. .. free of echoes and no ocular structures enn be
differentiated. From Day 70 of pregnancy echoic struc-
FIg. 2.119: Saginal section through the L')'C of a fet us on Day
197 of pregnancy. The head lies dorsal ly against a pl:tccntomc
(1'). The split (arrow) bct\\,'CCn thc cyc lids is open. The pos.
terior curvature of the lens (L) can be secn.
Bodl//! /efltJ 145
tures become visibl e wi thin the eye (Fig. 2.1 HI). These
consist of arched. echoic lines which originate from the
llnterior and posterior ....... 1115 of the lens. With II hori7..on
tal section through the heud the eye balls hnvc perfIX"!ly
ci rcular cross scctions. In saginal sections (in ophthal
mology also referred to as \'enical scctions) they arc
slightly oval. Wi th the 5:lgittal beam the interpalpcpr;tl
space becomes visible from about Month 6 of pregnan-
cy (Fig. 2.1 19 and 2. 120). At times the eyelids are clear-
ly open and bli nking movements of the lids can be ob-
scrved. The relative echo enhancement by the hypo-
echoic eye ball makes the retrobulbar nrca uppear more
echoic than the neighbouring 1 i . ~ u c s at the 5:lme depth.
rig. 2.120: Sagittal section through the L')'e of a fetus on Day
205 of pregnancy. An C)\! lid projects from abo-.'C the eye to
lhe left. 1bc retrobulbar arc;1 slJoy.'!l rclatr.c ccho enhance-
ment (E).
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146 UllrrJSQlI()8rt11Jhy ill Ille cow
Fig. 2. 121: SagiuaJ St."Clion through a fetus on Day 61 of preg'
nancy. In the head hypcll.'choic ossiflC3tion centers can be
seen in the mandible. maxilla and facilll bontS
.lg. l . I2J: Tangential sagiual section through II fetus on Day
127 of pregnancy. The fetus f:I('cs to the left , The e)'c with the
Jens (L) and the ecrebml e .... lIlium are dcpicled.
.". 2. 122: SCdion through the crnnium on Day
with the cervical area on the right llnd the nose on the Idt.
Cranially 10 the C\Jrvcd reTCh ..... ! roof lies the "PhcnoitJ bone
(S). Inside the brain are the two Illteral ventricle.<! (tv) with the
falx ccrcbri between them
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The development of ossification centers provide the
basis for the sonogrnphic depiction of bones. Ossifica
tion centers that develop e"fly on in the skull bones re
suit in the depiction of hypcrrcnective structures in the
head from the end of the second month of pregnancy
(GJESOAI. 1969). The first large hypcrcchoic structure is
found in the region of the mouth (Fig. 2.121). It is
found at the site of the mandible and depicts its charac-
teristic future shape. At the end of Month 3 of pregnan-
cy the ossification processes have progressed so far thnt
individual skull bones can be recognized by their typical
shapes (Fig. 2.122).
DoI'if/ere/lI! 147
From Day 50 to 60 of pregnancy the bones of the
cranium fonn a nearly closed, hypcrechoic 0\':11. A
transvcr.;c section through the cranium shows a round
cmnial cavity (Fig. 2.118). A sagittal section through the
cranium results in the depiction of an oval cranial cavity
the longest diameter of which lies in the frontooccipital
direction (Fig. 2.123). The cr,mial cavity can be seen in
toto until Month 7. During the last two months of preg-
nancy the bones in the roof of the skull absorb so much
ultr.!SOund that the energy renectcd from the bones at
the base of the cmnium is not sufficient for the produc-
tion of an image on the monitor.
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148 UllrrlSOllography ill tile cow
FIg. 2.124: Horizontal section through a fetus on Day 93 of pregnancy. The
forehead points towards I o'doek, thorn)[ and rump towards 7 odock.. In-
side the cmnium the laterul ventricles (alTOYo"5). falx c:crebri and the third
Vl.'ntricle (.-an be secn.
HI
.' Ig. 2. 125: Schematic presentation analogoUli to the sc:tnning
plane in Fig. 2.126. Cross st:ction through the anterior brain at
the level of the mamillary body and the pituit ary (P). li t hypo-
thalamus, IIv left lateral \'Cntricle, rIv right lateral \'Cotriclc. I
Corpus mamillare. 2 Falx o:rcbri. 3 Sulcus splenialis. Ill. third
ventricle (adapted from SElFEII.LE 1984),
FIg. 2. 126: Tmnsvcrsc S(.'Ctioo through the cmnium of a fetus
on Day 147 of pregnancy at the level of the mamillary body
and the pituitary analogous to the diagram in Fig. 2.125. The
inner cavity is panitioned by the echoes of the \'Cntriclc and
the Falx c:crcbri.
----------------------------------------.
o zas 10 radIVO
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Tbc;nnerraviryoflhi:cr.tnium;'clearlyk!l6echoic
its surrwnding bonl.--s. Al a rclalJVCiy early


tllruugh the CflInillm inproUmitytoilllrool"rc-
... stripe like, II\nliahI edIo .. hidt ruMcemllilly
crani.1 to caudal (Fig.2.122and2,124). Ilwxarc

nthel'o.uhernk.pbe=oflhebn.inanddMdeol
cnuuuminll)l'MlS)'I1UIIctricaJhal\'l'S.ikl'o.ccndli<

ct'Ilni/l1 roof a "'-'<:tion through the crani.
ll:\'Cals two round ecOOe. on eilher of lbe ccn
line. 1llCY!cd>Qe5otiginate frum lhe laler.tl """.

/W"'III'/ttw' 149
ll1f;yronlrastagain>llhercmaJningh)'lXlCchoicparlSol



nial cavity. The hlroem:tauicstnoctUfeSUl tbc>ianlryuf
lhehr.oinoriginalC flQl11 the mcnirt:gC$",ith the chorioid
plC1 ... aoolhelater.tl",mricies.where.flllchrainti!l-

[ntheareaoltbcmouthandllOilemoMoftheJlroc
fUrail)picaloflhlSl'ilrtoflhefaceanbciOCnlifoed.A
oection lhmugh the IU1tenor pan of the
moulh show!; the lateral na. .... lwalls oswell a<lhe en-
!ranee to lhe nll.'\IIl pa'iSa&" (Fig. 2.(27). lInwmcath

opIlIg tccdl 01 the matilla can be !ittn .
.
nooulh 00 Day 2.1'1 of prep"')'. flc:h,.. tbc na .. 1 ""fIlum;"
Ibtll)pen:doui<ln:.IIottbehardpoLue{l'j.U ..... m<1Ilhlhil
Ibt"""k""",lo1tW,.;pttrclh(n",thcmmDo.cube
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150 Ultmsonogmphy ill the mw
.' Ig. 2. 128: Tmns\'crse SI.--ction through the mouth and nose of
a fetus on Day 161 of pfl!gnflnCY. Staning from both edge., of
the hypcrcchoic hard palate (I') the dc.;eloping tcelh arc pro-
ducing long !>had!)w anifacls. l\ boo.'C them arc be
longing 10 the !JliSal lurbinOltcs. Whisker hair.! project a"""JY
from the muzzle at II and 3 o'clock
.' ig. 2. 130: Tangent ial sagitl.lll section throogh the nose and
mouth of a fe tus on DlY 185 of pfl!gnal'lC)'. The mouth points
the OInd nostrils (N) lie on the right and the
mandible on the Jeft. 'Ille longue (T) .slicks out of the mouth
and is dcn .. "Ctcd in the direction of a nostril.
I-1g.2.129: I':lmmedian sc..'Clion through the facial skull of a fe
IuS on DOIY 100 of prcgnOlOC)'. The nose (N) pomb upwllrds.
The lies on the left. the mandible (M) on the right.
' 11e tongue (J) projects from the mouth.
f'1g. 2.UI : Paramedian scaion through nose and mouth ora
fetus on Day 184 of pregnancy. The nasal Clivity is defined by
the nasal bone (N) tJorsaUy and the maxilla (M) \'Cnlrally. At
2 o'clock is the tongue (11. projecting from the mouth in the
din.'CI.ion of the IUlSIII entrance. 'Ilte mouth is .."ide open.
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sectl()[ltl\e are more_clearly


2..131)
From the timc which facial Slruc1Un!$ r,"i become
.... rlyidcntifLablcnumemusoignsolfclal viability a""
e\'idenl.Wilhoplimal probe pOSilioning lhoc fC\l1'lcan-
notonlybcsoxnlobiinkil .,.eliOs,buIDOleliding ..
Ulhcr forms of pI")'ing wilh itJ \onguc can beub!;c"""d



.lCClioned appropriately, the em be oIRrol.-d (F'!-
2.132).
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152 UllTUSOllogrophy ill the COIl'

Fig. 1.1]1: Image of an car in a fetus on D:,y 199 ofprcgnan-
cy. Thl" tip of the car points at 2 oclock. The face to the
Icft. off the image.
b
c
f'ig. l . IJ.l: Schematic presentation of the ultrasound c.'Wmina-
tion of\cnebrac. Depending on the angle al which thc sound
impat1 onto thc vcncbrn different ossification centers
may be depicted. a and b; double of echoes; c: si ngle TOW
of echoes.
1-'4;. l.I 33: Ventrodorsa.1 sagiuBI section through a fetus on
Da) 61 of pregnancy. 111e head wil h the eye (E)
lies on the righl. In the areas of thc m:tolla and mandible
bright ossirlCil tion tenters can be recognized. The spinal
column (arrow) is h)l)CI'(.'Choic.
.-ig. l .135: Tmnsvcrse <;cajon through the thora .. :u the Icvel
of tile stomach and the Ii-ocr in a fems on Day 114 of pregnan
cy. Caudal view. Three OAAil'icalion centers (armlli'S) of a tOO-
mcic"cncbrd can besccn. curved ribs (R) stretch around
the trunk. The stomach (S) lies Illx)\.-c with Ihc livc
(l) underneath il.
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;L4.i.2 Spinal column
lbc first tdJoi,cilructUM in thc arca of thc !<pine



I!.t;;"""""'bewrncs cvidentinlhebactrqionoftht
roo,?",(FllI.2. 133j. Individual ilructur; in the form of




11)"rA 1985 a ). OssiflC&lIonoilhe.-cnr:il""' .........


i--lIinuousstringufh}perechmcvertebnM.'canbcs..'Cn
... hichthe!lOUnd...","",
I-cr the felU!;, dirre",m 'IL'Cliom of the spinal cnlumn
fc- bc dct*tedCl-'t;.2.114). It .. go;ocrallypnv.ible
10 iCe 3 o..sir>ealion ocnlen in cach ,-cncbnl. lbcse
incluo.ieoncOlilloir>eatioorentcrincachoflhe..-endJr.1
arrlIe5anda.mgk:oncinlhemiddlcoltlleYCflebntl
hody.
Ulnonlybcvi<ualin:,j ina P<'rfCCllyhorizontai...:lion
throu&h the.o;pinalmlumn (f"i&.2.135). l bcc;:m<s.a:-
tion of the abdomo:n isalmollcomplctclyroorulinlhis
vicw.lfthc fClm in anyJoogiludinal ",:<:linn
at_t-..uO&lirlClltiunrentcl1lpcr...,nehrucanbcsccn
... anyoncim:ogc. lftbcexarniootionplancis""""'-"<l
siigl\llyfmmmedianl .... -anlspanuncdianthtUloSifo;:a..
tion centcrinonc an:hasweli asthat atthc rentcr oilhe
...,ncl!racanocsecnllJl!Cther.Tlll)'aresitualwdorsaJ-
lyand vemrnlly 10 thtspinal canal.. The narrow. hyp.>-
echoic band of th.!'l'inal<nal .... rln

brighl echocs can onIybc !<ftn on slightlyparame<.lian
sectiun$oJ!l..-fctU5.
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154 U1urlSollogmplzy III IIII! COIl'
.' Ii:' 2.136: Median ..celion through the cervical on Day
161 ofprcgn:mcy. The spin31 cord (S) and thc \'Crtebral bodies
below it arc depicted. Shadow 3rtifacb appear in the
background or the \crtcbrae.
I-'i:. 2. 138: Sacral and coccygeal n:rtebrne in a on Day
165 of pregnaIlC)'. ' Ille sacrJI vertebrne lie on the right and arc
individually n..t:ognw-Ible. n,e tail (f) 10 Ihe kft.
Fig. 1.131: Horizontal SI.'CIion through the head, neck and
trunk of a felus on Day 11 of prcgn:ltlcy. The head (H) points
to the right. A double fO',I.' of echoic discs of the o;pinul column
wilh :1 CClllrnl. hypocchoil;: t.'tn:d (arrow) runs through the
middle of the ned: a.nd trunk.
.lg. 2.139: Vcnlrodorsal median.;;ection through the neck and
anterior tip of Ihe thorax in a fetus on Day 101 of prcgnanqr.
TIIC head (out o(view) lies on Ihe lefl, lhe ccrvical spine (CS)
with the first lhorncic venebrae \'Cnlrally. From the tip of
the thorax the (51) runs 10 the din..-ction of" ockxk.
A .... e 0 Z"ISC
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When the sectional plane lies exactly in the median it
passes bel,",,'Cen the ossification centers of the left and
right vertebral arches without producing any reflections.
but it docs strike the ossification center in the middle of
the vertebral body (Fig. 2.136). After that only a row of
disc shaped eehoes can be seen. The same h a ~ n s
when the examination plane is mO\'Cd to the parame
dian or if it is rotated from the sagi ttal towards a more
horizontal plane. In these cases thc single row of echoes
may originate either from the ossification centers in the
vert ebral arches or from those in the vertebral lxxIies.
Further rotation of the probe around the longi tudi
nal axis produces the horizont al section with the sound
beam directed latero-Iaterally. lfthe examination plane
lies at the level of thc vertebral arches. tv..'O parallel rO\\'s
of eehoe.'i are again produced (Fig. 2. 137). These repre
sent the ossification centers of the left and right verte-
bral arches, respectively. Due to the natural curve of the
spi ne a horizontal section through it will pass through
individual vertebrae at different heighl'i and therefore
no rows of echoes from the same structure of the dif
ferent \'Crtebrae can be seen. Commonly therefore. for
example, a short section of the thoracic spine may be
seen as a double row of echoes, be continued caudally
as a single row and fonn a double row again in the lum
bar region.
On the exact horizontal section through the spinal
column of the trunk one can sometimes see, apart from
the reflections of the \'Crtebrallxxlies. on bmh sides a
further row of disc shaped echoes. These represent the
sonographic images of the transvcn;e processes. In this
manncr the horizontal section through the fetus can oc-
casionally depict three parallel rows of echoes in the re-
gion of the spinal column.
Ikwiflcfems 155
The caudally extending tail of the fetus is character
ized by the large numbcr oflined up, discshuped echoes
of the vertebral bodies (Fig. 2.138). The image of the
tail is very similar to that of the ot her pans of the spinal
column. A double row of echoes or a clcar spinal canal
arc. hov.'C\'Cr. not evident. Not infrequently, mm'cmenlS
of the tail can be observed.
Early on already, the \'Crtcbral echoes are very
bright, and towards thc end of pregnancy they can be
described as hyperrcflective. As the ossification of the
vcrtebrae prog.rcsses. the typical image of shadowi ng
becomes evident in their background(Fig. 2.1 36, 2. 143,
2. 144). From below the vertebrae hypocchoic Shlldows
stretch into the depth of the image. llle width of each
shadow is approximately the same as that of the bony
structure in the foreground. The shadowing effect is
caused by the absorption of sound waves by the bony tis-
sue which then causes very li ttle sound to reach the tis-
sues immediately behind the bone.
If areas behind the vertebral column are to be ex-
amined sonographk-,tlly it is useful to mO\'e the probe to
a point where the spinal col umn is no longer positioned
in the path of the sound waves. In this manner the
sound shadows. which originate behind the echoes of
the vertebrae and run as parallel stripes th rough the
cntire image, can be avoided.
llle spinal cord is best depicted on an exact median
section (Fig. 2.136). This approach allCM'S the sound
W3\'CS to pass between the ossification centers of the
\'Crtebral arches on ei ther si de without generating any
rcnect ions. The spinal cord can then be examined with-
out any shadows interfering with the image quality.
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156 Ultrasollography ill the COli'
F". 1. 140: 1lori1.Ontal so::ction through the neck of a retus on
O:ty 209 of pregnancy. The anechoic inner lumen of the tra
chea (T) is bordered by the two ro, .... s of trnnsversc1y sectioned
trncheal rings. TI,e head (OUI ofvitw) liC!l on thc left.
rq;. 2. 142: HorU.ontal '\CeIion through 3 fetus on 0 3)' 10 of
pregna!X.)'. The head (U) lics on the right. The two hyper-
echoic ro'\'S of no cross scC1ions (mTI)I.\'S) produce a conical
shape of Ihe lhora.'(.
Flg. 2. 141 : Horizonlal section through the head neck junction
in a fetus on Day 183 of pregnancy. Allhc cenler the lal}l1.,(
(t). to the left a pulsating blood \'csscl (arrow).
Fig. 2. 143: Ilorizootal section through the thorax on Day 126
of pregnancy. The thorncic inlet i ~ positioned at 7o'cklck.
From the rib CJ'mS sections Sh.1doo.\" are cast across the hean
(II). Lung tissue lies bctYo-een the hean and the diaphrugm
(llf1'l)Y,'S). Hcpalic ' cins Cflll be seen brunching from the cau-
dal (",lV',d vein (V).
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2.4.1.3 Neck
Apart from the typic-J.I image of the spine (Fig. 2. 136
and 2.139) the trachea appears as a dominating struc-
ture on the sonogram of the neck (Fig. 2.140). Its longi-
tudinal section features a prominent string of hyper-
echoic cartilaginous rings which Slmo und the anechoic
lumen of the trachcaltubc. In comparison to the blood
vessels that run in the cervical area the trachea has a
much wider diameter. This is particularly evident on
transverse sections through the neck which show the
wide, hypocchoic tracheal pipe in about the middle of
the neck just ventral to the spi ne. In the region of the
head-neck junction the \arymc can be secn (Fig. 2. 141).
Occ.1Sionally. swallowing movements can be observed
he re. On horizonllli sections the common carotid artery
can occasionlilly be traced on either side of the trachea
and lal)'TlX. Ils pronounced pulsation is slriking.
2.4.1.4 Thorax
The ribs can be differentiated almost at the same
lime as the vertebrae. The nbs. thoracic \'cnebrae and
sternum are all charactcnzcd by hyperrcncaivc cross
Dorine fetlls 157
sectional images. The thoracic skeleton can be recog-
nized by thc strings of numerous hyperechoic disc
shaped echoes and their typical topographic amange-
men!. On horizontal sections the rows of rib cross
sections of both halves of the thorax form a cone (Fig.
2.142 and 2. 143). The previously described phenome-
non of shadow ani faClS behind the spinal column can
also be OOscrved in the background of ribs and thoracic
venebrae. When the thorax i .. examined by longitudinal
sections its image is obscured by pamllel shadows (Fig.
2. 143). This applies for horizont al sections with latera--
lateral and sections with sagittal. dorsoventral beam
directions. The distances between shadows correspond
to the widths of the intercostal spaces. In advanced
pregnancy the increased ubsorption of sound waves by
the bones can scriously restrict the examination of
organs lying behind the ribs. Under such circumstances
it is possible to rotat e the probe through 90 degree. thus
allowing the examination of the thoracic contents
through the int ercostal spaces wi thout any interference
from the rib shadov.-s.
The sternum docs not produce the image of a single.
coherent bone. but consists of a single row of discs (Fig.
2.139).
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158 Ulfrosonogroplly ill file cow
Fig. 2.144: Ventrodorsal sagittal section through a fetus on
Day 91 of pregnancy. 11Jc lied; is on the right. 1leart cham-
bers ( H) and the aorta which runs \'entrally of Ihe vertebral
column (VC) in a caudal direction can be identifIed.
rig. 2.146: em;.,<; So..--ction through the omasum with its charac-
teristic folds (afTOYo'S) in a fe tus on Day 157 of pregnancy.
Fig. 2.145: Horizontal section through the thor-.ax and abdo-
men of the fetus depicted in Fig. 2.143. The fet us is stilll)ing
in the same posi tion on its Icrt side. The heart (H) is on the
left . Caudally to the dorsaUy positioned nbs is the liver (L)
.....ith severnl vessel cross sections. Cranially to the Ir.'er is the
diaphragm (arl'OO"S) and below it is the slom<l(;h (S).
fig. 2.147: Left parnmedian section through the stomach of a
fe llls on Day 166 of pregnancy. The stomach contains snO\ll)"
renections which. during IongerobscMl lion periods. will show
obvious. turbulent mOllemcnts. 1llc dorsal and ventral sacs of
the rumen communicate through the ostium int raruminalc
(Oi).
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The cmnial. apical sector of the thordcic cone is
filled by the heart (Fig. 2.143 to 2. 145). The laner is
very striking wi th L<; obvious pul'lation, its hypocchoic
heart chambers which are surrounded by the echoic
myocardial walls and sulxlivided by the bright septa and
valvcs. The pulsation is clearly noticeable by the move-
ments of the valvcs. In order to obtain a favorable
image of the heart it is advisable to rotnte the sound
plane far enough until a window is found between the
ribs that allows the sonographic examination to be per-
formed without the interference of any rib shadows.
This may be difficult and em oc achi eved if the fetus li es
in the optimal position of having its front limbs in close
proximity to the transducer. If the transducer can be
posi tioned favorably it is sometimes to produce
a 4-chamocr section through the heart (Fig. 2.144).
When an image of 2 or more chambers C'.m oc gener-
ated the functioning of the heart and its larger valves
can be observed. By choosi ng the correct section
through the thonuc one can see the blood vessels leaving
the heart.
The space octween the heart and the diaphragm is
filled by the echo of the lung. The lung echo is comscly
granular, very si milar to that of the liver. The dia-
phragm itself cannot be illustrated sonographically. Its
position can, however, oc determined by subtle dif-
ferences in the echogenicity octween liver and lung
(Fig. 2.143 and 2.145).
2.4.1.5 Abdomen
The developing stomach and the liver can oc seen in
the background of the last few ribs (Fig. 2.145). The
liver can be recognized by its coarsely granular echo
which is traversed by scvcmllarge vessels in the center.
The sonographically obvious stomach lies octween the
liver and the contralateral ribs. The stomach become.<;
BOL,jne Jews 159
ultrasonically visible shortly later than the heart and at
about the same lime (around Day 40 of pregnancy) as
the developing eyes. It constitute.<; the anechoic
are;1 in the abdomen of the fetus, produces the typical
image of a fluid fill ed, hollow organ and permits the
idenlifiClltion of its typi c-dl shape and different anatom-
ical regions (Fig. 2.146 and 2. 147). As pregnancy
progresses, the echogenicity of the stomllch's contents
will increase. At about Month 5 of pregnancy there will
be al rellCiy obvious cchogenicity in the stomach. These
will become more intense as time p.. ,sses. Sometimes
they wi ll even develop into snow storm like reflections.
If the stomach can then be observed over time one will
often be able to observe turbulence within its fluid con-
tents.
The position of the slQm:lch ClIO give an indication of
the posture of the fetus. If the rumen lies dot"S.., lIy next
to the transducer the fetus will be lying on its right side;
if the fetus lies on its left side the rumen will be on the
side furthest from the transducer (Fig. 2. 145 and
2.152). The description of the position of the fetus rela-
tive to that of the dam then depends on its prescntation.
In the case of a crani al presentation with the rumen
found dorsally the fetus is in II left lateral position;
where the presentation is caudal with the rumen still
found dorsally the felUS is in a right lateral position. The
same contrasts between presentation rInd position arc
valid for the vcntf'<l l1y situated rumen, I.n this case the
eranilll and caudal presentations imply a right and left
lateml posit ion. respectively.
In a median section through the fetus the abdominal
aorta is scen as a hypocchoic band running just under-
neath the many bright echoes of the spinal column (Fig.
2.144). When OOscrvat ion periods over time are possi-
ble the aorta's pulsation can be seen. The wall of the
\'CSSCI is hypercchoic.
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160 UltrtlsonogrtJp/,y in fhe cow
Fig. 2.148: Scctionlhrough the kidney of a fetllS on Day 1960f
pregnancy. Se"cr.d rcnallobcs with conical and medullary re-
gions are visible.
F!g. 2.150: Tr.lIlS':erse section through the caudal abdomen of
a fetus on Day 62 of pregnancy. The fe lus lies on its side and
is sunoundcd by ils amnion (A). 111e two Clud'li limbs point
to the righl. Bet"'Cen the limbs is the small . anechoic urinary
bladder.
Fi&. 2.14\1: DofSO\cntr.Jltransverse section through the region
of the lumbar \'Crtebrole on Day 166 of pregnancy. Dorsally a
lumbar vcrtebra (L) with both transveI'SC processes. Above
thc laller Ihe two Mm. Iongisliimi. Below them: Left kidney
(lk). right kidney (r\::) and in bcrv.'Ccn Ihose Ihe caudal
vein and the abdominal aorta.
Fig. 2.15: Tr.lItS\crse section through lhe caudal abdomen of
a on o-oly 86 of pregnan<.),. The scanning plane is lilted
slightly 10 run from to auniovl; ntrnl. The urinary
bladder (U)with ilS dar\:: lumen and cchoicW'.dl lics in the cen-
ter. To the left of the bladder arc pelvic bones (arrow).
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The kidncys can also be dcpictcd ultrasonographi-
cally. In the horizontal section they can be seen between
thc ili ac bonc and thc last rib (Fig. 2.148). In a trans-
verse section with the beam di rectcd dOJ'SO\'Cnt r.tlly thcy
can be found at thc level of the lumbar \'Crtcbrae. im-
mcdiately vcnt ral and latcral to thc spinc. With thc
transducer skillfully positioned. both kidncys can be
shown on thc same imagc (Fig. 2.149). Thcy are rela-
tively hypocchoic and prescnt thcir typical anatomical
structure. including multiple papilla dividcd by dcep fis-
sures. Bettcr than in thc tr.tnsversc section, the longit u-
dinal section permits the identi fication of numerous re-
nal lobes which collectively fonn the ki dney. On each of
the renallobcs a more hypercchoic outer cort ical and a
less echoic central medullary region can be recognized.
The next smallcr organ with an anechoic lumen be-
side the stomach is thc urinary bladder. Fi nding thc
BOl'ille fews 161
urinary bladder is somctimes difficult - /"'VCn wit h a wcll
exposed pelvis. Although it is sometimes visible at an
carly stage of pregnancy (Fig. 2.150), its accurate iden-
tiflCation may pfO\.'C vcry difficult. The degree of filling
of the bladder appears to vary. Thc urinary bladder pre-
sents with its anechoic, nuid filled lumcn and lies in thc
midlinc of the vcnt ral abdomen. just li t the pclvic inlet
(Fig. 2.151). On cithcr sidc of the bladder thc umbilical
artcrics which run in the direction of the can
be found. These can be relatively thick and must be dif-
fcrentiatcd from the uri nary blllddcr. The difficulty in
fi ndi ng the fe tal uri nary bladder by ult rasonography
may be caused by presumed ability of the fetus to regu-
larly empty the bladder from an early stagc of pregnan-
cy on. Shortly after urination it may thus be ,"cry difficult
to recognize the fe lal bladdcr.
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162 UllrtlSOllogmph)' ill tlte COli'
"i g. 2.152: Horizontal section through the thora)!.
abdomen and pelviS of Il fetus on [)oJ)' 95 of preg-
nancy. 111e :Ipc.'( of the thor.u: points to'l'o'llrds 8
oclock. the ... tomach (5) lies vCnlr:llly. 111e IWO
halvcs of the bony pehi ... with hypcrechoic ischi al
and ileal bones (atr(JYo'S). form a cone, the apex of
y,hich is directed 10000Irds 2oclock.
Fig. 2. 153: Oblique hori7.ontal section through the pelvis of II
fetus OIl Day 21 1 of pregnancy. The cunnection between the
ileal (0 il) and ischial (0 isch) bones. in the! area of the ace-
tabulum. is not yet ossiflCd. Ultrasound penetrates t h i ~ point
(arrow).
Fig. 2.154: Tangential sagi ltal section through the fronllimh
of II fe tus on Day 75 of pregnancy. 'Ine back of the fetus lies
vcntrnlly lind the head on the right (of( the image). The front
leg ..... ith scapula (5). humerus (H), radius lind ulna ( RU) and
metacarpus (M) is visible.
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2.4.1.6 Pelvis
During e:trly pregnancy bolh halves of the bony pel-
vis can be depictcd simultaneously on a horizontal sec-
tion (Fig. 2.152). On each side the ilium and ischium
can be seen. They prescnt as four rod shaped, hyper-
echoic structures. In horizontal section the ischium is
slightly shorter than the il ium. The 2 bones lie one be-
hind the other, parallel to the longi tudinal axis of the
body and form, with their wunterparts on the othcr
side, the blunted wne shape of the bony pelvis. The lal-
ter n a ~ slightly towards its caudal opening. When
thc ultmsound beam is directed [atero-laterally, the de-
monstration of bot h halves of the pelvis is only possible
in the first half of pregnancy. Thereafter, the nearer h:M
of the bony pelvis absorbs so much ult rasound that the
other half cannot be seen (Fig. 2.153). At this stage on-
ly the ilium and ischium nearest to the transducer can
still be depicted.
The pelvic region can be recognized tQWard .. thc end
of the second month of pregnancy when its ()S';ification
centers become visible. The iliac and ischiac bones can
then be seen as individual struct ures around week 11 to
12 of pregnancy. The bones of the pclvis are well suited
to aid the search for the ge nitalia, the urinary bladder
and the hind limb.
Fig. 2. 15S: Sagi ttal section through a front fOOl on Day 135 of
pregnaocy. The a",ices of the metacarpus (M). proximal (I).
middle (2) and distal (3) phalanl:cs are so well 05SiflCd that on-
ly the foreground is visible. The two C:lRil:lginous epiphyses
(E) of the metacarpus can be seen clearly.
BOI'ine/erus 163
2.4.1.7 Front limb
The sonographic visualization of the extremit ies is
based on the depiction of thei r bony and cart ilagi nous
components. Due to the large difference in impedance
between bony tissue and the surroundi ng soft tissues the
former :Ire easy to recognize by their intensive refl ec-
tions.
On the front limb the larger long bones, such as hu-
merus. radius, ulna and met:lC<! rpus C<! n be ident ified
for the lir.;t time around ..... eeks 10 to 12 of pregnancy
(Fig. 2.154). At this stage the ()S';ification proccs.s has
obviously progressed far enough to produce continuous,
rod shaped echoes in the regions of the diaphyses. Aft er
this time the length measurements of the bones are
taken bern'cen the rn'O ends of their hypcrechoic
diaphyses. Prior to this the measurements are 1:lken
from the edge of each limb segment to its point of an-
gulat ion. They therefore refl ect not only the length of
the main bone. but include the joint and soft tissue com-
ponents of each segment. At the end of the 4th month
of pregnancy il is still possible 10 depict the full thick-
ness of the long bones of the front limb. Due to the ad-
vanced perichondrial ossification at about Month 5 it i . ~
only possible to see those sides of the bone cortex of the
humcrus. radius and ulna ...... well as melacarpus and
phalanxes that are nearest to the tr..msduccr (Fig.
2.155). The sound reflcction from. and absorption on
Ihe compact bone arc so strong that the background is
no longer accc.'>Sible. It rent ai ns black.
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164 Ultmsollogm/Jhy ill the caw
Transverse section through the front foot of a on Day 91
of pregnancy. The 1\\00 hypcrcchoic claws (C) point to the left . To the right
of the cl;IY.'S an.: the two bright spotS of the d .. :wcla .... 'S. Thc front limb is
epicted up to ils carpal joint.
t-ig. 2. 157: Palmar \;cw of the cla .... 'S of bot h front feet in a fe-
tus on Day 164 of prcgn:mcy. [n Ihe centers oflhe cla ..... s (le) of
the [eft fool [ie the hypcn:choic digital bones. " b e image of
the right claws (rc) sho ..... s only the hoo\'cs,
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Apart from the bony parts, the horny parts at the tip
of the extremities can also be shown. Main and dew-
claws can be seen (Fig. 2. 156). The horny wnll of the
main hooves can be recognized from Mont h 4 (Fig.
2.157). Its echogenicity increases over the following
months and the hoof wall as well as distal phalangeal
Ixme can be identified.
FIg. 2. 158: Pl anlodorsal sagi ttal section through the hind limb
of a fet us on Day 11 0 of pregnancy. The !I1!'S:l1 joinllics on lop
and is ncxcd. The bright diaph)'Sis of the metatarsus (M)
poinl5 to 8 o'clock. the tibia 10 5 o'clock.
HOI ';ne JelIIs 165
2.4.1.8 Hind limb
The chronological order in which the bones of the
hind limb can be depicted are very simi lar to that seen
in the front limb. Although individUll1 ossifiC<ltion cen-
ters can be detected by Day 60, specific long bones such
as femur, tibia and metatarsus can only be identified re-
liably stnning Week 10 of pregnancy. A few weeks laler
the entire thickness of the diaphysis of the bone can be
illustrated (Fig. 2.158). The diaphyses of the femur,
tibia and metatarsus produce very bright ecOOcs, Dur-
ing Month 5the ossification is so pronounced that only
those walis of the diaphyses that arc neaTeSt to the
transducer can be depided (Fig. 2.159).
Fig. 2.159: longitudinal scdion through the melatan.us (M)
of a fetus on Day 171 of pregnancy. One side of the bony
diaph)'Sis produces a hypcrcchoic rencction. Distal 10 Ihe
diaphysis lies a cunilugi nous epiphysis (al1'O\\). nlere arc two
pl3<'l.' nl omcs (P) in t he right half of the picture.
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166 Ultrosollogrophy ill Ihe COli'
t-"ill. 1.160: Uterus ..... ith fetus in il5 amnion (Al on D".lY 63 of
pregnancy. The umbilical cord (U) runs dor...111y from the fe-
tUS 10 the :lnlimcsomctriaJ edb'C of the uterus.
~ l g . 2. 162: Longitudinal Sl.'CIion through the ino;cnion of the
umbilic<LI cord (al'fO'llo) in a fetus on 1)001), 110 of pregnanc),.
The hypocehoic lumina of ""IQ umbilicll \cs..<iels arc scp .. mLted
by thc vessel \\11US.
FIg. 2.161 : Tl'llnsversc section through the umbiticusof a fC111S
on Day J 10 of pregnancy. The 4 lumina of the umbilical ar-
teries !lnd veins C'oin be recognized.
1-11=..2. 163: The hypocchoic allantoic nuid (AI) lind the $I\O'oOoy
amniOlic nuid (Am) nrc separated by the llmniotic membrane.
Inside the amniotic nuid lie the left (k) and right (re) cial'.'Sof
a felLlS 011 Day 206 of pregnancy. I'almanricw.
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2.4.1.9 Umbilical cord, amnion and allantois
The umbilical cord can be seen early on the uhra-
sound monitor. At the time when the outline of the em-
bryo becomes visible and the head and neck can be dif-
ferentiated the umbilical cord can also be identified. It
runs from the embryo in a dorsal direct ion to the site of
its division at the antimcsometrial wall of the ut erus
(Fig. 2.160). From Month 3 of pregnancy the two um-
bilical art eries and veins can be seen inside the umbilical
cord. They are particularly impressive when seen in a
cross section through the umbilical cord (Fig. 2. 161). In
this view the four vessels are arranged in a square.
Where the umbilical cord enters into the abdomen the
1 .... '0 umbilical arteries can be traced caudally in the
direction of the urinary bladder. The umbilical vein can
be traced crani ally to the liver.
In a longitudinal section through the umbilical cord
only two vessels can be seen (Fig. 2.162). If the section
BMine fellls 167
runs tangentially through the umbilical cord one will not
necessarily see a vcsscl lumen. In this case the umbilical
cord appears solid and may be confused with the more
caudally situated scrotum.
The amnion can be recognized as a very thin hyper-
echoic membrane by Day 30 of pregnancy (see Chapter
2.3.2.4). Without signifiC<lOtly changing its thickness it
remains visible until the end of pregnancy. The nuid
contained inside the amnion is hypocchoic, almost
black, for the first few months of pregnancy. First re-
nections appear at about the end of the 2nd month of
pregnancy. They rapidly become denser and soon crc-
ate the image of a snow storm. The echoes become so
intense during the third trimester of pregnancy that the
term "'snow storm appearance" seems justified (Fig.
2. 163). Echoic particles also appear inside the allantoic
nuid during the course of pregnancy.
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168 U1muOIwgmphy in the co'"
1"". 2.164: Medi an sect ion through a male fe lus allhe level of
the pelvis on Day 92 of pregnancy. The spine stretches from
10 o'd ock to 12 oclock. The scrolum (arrows) points IOwards
4 o'dod;, Ult rasonogram produced in I'o"dlert)al h.
FIg. 2.166: }-lo07.nntal section through a female felus al the
Ie"el of the mammal)' glands on OilY 101 of pregnancy. Be
twe<.: n the left (IH) and the right (rH) hi nd ClItremit ies tic the
four briglll l'Chocs ort he cross Sl'Clions ofille !Cats (1'). Ult ra
sonogram produced in a wJ!emalh.
FIg. 2. 165: Section through the snme fetus annlogous to the
examination plane in Fig, 2. 164, On the \-entml abdomen are
the scrotum and genitnll ubcrc1e.
fig. 2. 167: Section through the same fetus analogous to the
scanning plane in Fig. 2.166,
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2.4.2 Sex determination in the bovine
fetus
2.4.2.1 Scrotum, teats and genital tubercle
The scrotum of the male fetus COd.n be depicted by ul-
trasonography (Fig. 2.164 and 2.165). Based on exJX:ri-
encc to dale it seems possible to detennine fetal sex by
the detection of the scrotum from the Month 3 of preg-
nancy. First fctal se.'( detenninations may be possible
between Days 50 and 60, but the scrotum cannot, how-
ever, be identified with certainty at this stage. After Day
60 the scrotum can then be identified more clearly (Fig.
2.168 to 2.171). In positive cases the male gender can
now be diagnosed with certainty (MOUR and WITT-
KOWSKI 1986).
In female fetuses the developing teats can be depiet-
ed (Fig. 2. 166 and 2. 167). As a result of their intense
8m 'ille fetla 169
cchogcnicity the teats become evident as four hyper-
reflective dots which are arranged in a square. They are
best identified on horizontal sections.
Another way of detennining the fetal sex is based on
the determination of the relative position of the genital
tuberde (Curran et a!. 1989). The genital tubercle will
give rise to the penis and prepuce in the case of malc. ..
and to the vulva and clitoris in the case of females.
Initially the genital tubercle will be positioned between
the hind legs in both sexes, bUI between the Day 40 and
60 of pregnancy it will migrate towards the umbilicus in
male fetuses and the tail root in female fetuses.
The genital tubercle will prescnt as a bilobular. ovoid
structure, a few mi11imeters in size and of intense echo-
genicity. On the basis of the relative position of the gen-
ital tubercle it becomes possible to predict the felal sex
[rom about Day 55 of pregnancy.
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170 Ultmsollogmph)' in tile COli'
""Ig. 2. 168: lll1erolllleral UlIflS\'CNC <;Cction through the pel.,is
of II fetllSon Day 860r pregnancy. TIle upper portions ofbolh
hind extremities point to the right. Oc(\\"Cen them lies the scm.
tum (s). 111e base of the tail m be secn ataboUI 9 o'clock (ar.
row).
tlg. l .170: Il orimntal St.'ClKln distal to the pel\,", through the
knee joinr of a fetus on Day 129 of pregnancy. Inside the
tnms'o'erscly imaged scrotum (5) the ""u hypocchoic tcsticular
structures can be <;Cen. To the left of the scrotum an 0VIl1
c:rm.s section through the musclcs of the upper thigh.
t'4;. 2.169: Trnn!'o'o'Crsc SCCIion through the pel\'js of a fetus on
D"oI)' 99 of pregnant),. The fetm; lies on its back. Bc",,'cen the
t .... ,o hind limbs (H) the scrotum (5) pointing to\lo'ards 12
oclock.
tlg. 2. 171: Median section through the scrotum of 11 fctus on
Day 170 of pregnancy. The head of the fe tus lay on the right.
the scrotum the testicle (amw,,') am be St.'Cn. J3clow the
scrotum the umbilical cord (U) with 2 \'C.W!ls can be rcoog.

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Depending on the position of the and the ori-
entation of the probe the fetal scrotum can be detected
betv,lcen the hind legs on median, transvelSC or hori-
zontal sections (Fig. 2.168 to 2.171). The biggest threat
of misdiagnosing the presence of a scrotum comes from
structures in the vicinity of the scrotum. In this context
the umbilical cord and any parts of the tail that may
have been drawn in between the hind limbs should be
mentioned first. In order to avoid confusing the scrotum
with the base of the umbilical cord, should
always be made to demonstrate, apart from the suspect
ed scrotum, the umbilical cord. Only if the COUISC of the
umbilical cord can be followed all the way to its origin
on the abdomi nal wall, and if, in addition, to it the scr0-
tum can be identilled as a separate st ructure a definitive
diagnosis can be made.
From Month 4 of pregnancy may re
veal testicular structures inside the scrotum (Fig. 2.171)
which are less echoic than the scrotum proper. Testicu-
lar descent starts during the 3rd month in the bovine fe-
tus and is completed in the 5th month of pregnancy
( H UWNGER and WENSING 1985, Sctl UMMER and
VOU .. MERIIAUS 1987).
According to experiences made thus far the positive
recognition of the female sex by depicting the devel-
Boville JelIIs I 71
oping teats appears to be rather difficult during the ear-
ly stages of pregnancy. The teats arc occasionally con-
fused with other echoic spots in the region of the pelvis.
Structures often misdiagnosed as teats include the
hypcrcchoic images of IransvclSC sections through
pelvic bones or the femur. The determination of fetal
sex using the posi tion of the genit al tubercle appears to
yield more aCCUT',lIe results in the female fetus.
The period from 55 to 60 days of pregnancy to
be particularly well suited for the determination of the
position of the genital tubercle, and thus the sex of the
fetus (CuRRAN et al. 1989). If the sex is to be deter-
mined by detecting the scrotum or the teats the period
between Days 70 and 120 seems to be better suited for
the examination. If both criteria, position of the genital
tubercle as well as the depiction of either scrotum or
arc used in conjunction a relatively high accuracy
in the determination of the sex of the fetus can be at-
tained between Days 55 and 120 (WIDEMAN et al.
1989). It must be emphasized that much opemtor expe-
rience is needed, and that the sex of the fetus cannot be
determined in every ca.<;c during a single sonogmphic
examination. Occasionally, only follow-up
allow the sex of the fetus to be determined accurately.
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172 Ultrasonography in the cow
100
90
80
70
60
% 50
40
30
20
10
0
2 3 4
B
'" Head accessible
'" Thora", accessible
iii '" Abdomen accessible
'" Pelvi s accessible
5 6 7 8 9 10
Mont hs of pregnancy
t1g. 2.172: Frequency with which retal body parts were :lCCe$J.blc by transrcctal ul tr.1
sonogrnphy during pregnancy in hcifel5 (adapted from Kti hn 1989 b).
100
90
80
70
60
% 50
40
30
20
10
0
2
o = Anteri or presentation
Posterior presentation
'" Transverse presentation
3 4 5 6 7
Months of pregnancy
8 9 10
tlg. 2.173: The intm-uteri ne presentations of bovine fetuses during pregnancy (adapt-
ed rrom Kahn 1989 b).
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2.4.3 Accessibility of bovine fetuses
for transrecta] sonograpby and their
intra-uterine presentations during
pregnancy
2.4.3.1 Accessibility of fetal body parts
The specific intra-uterine positioning of the fetus
during the course of pregnancy has a direct effect on the
ability 10 depict fetal body parts by ultrasonography.
This means that the accessibility of cert ai n struct ures is
limited by the typical intra-uterine presentations of the
fetus at the different stages of pregnancy and by thei r
growth rales. Duc to these factors. for example. the
scrotum and developing teats, the thoracic and lumbar
vertebrae. the ribs. the size of the stomach or the lengt h
of the li mb bones often cannot be accessed for sonogra-
phic fetometry during the last trimester of pregnancy.
During onc study the fetuses of 19 pregnant cows
were ultrasonically examined 485 times at int ervals of a
few days from the 2nd to the 10th months ofprcgnancy
(KAliN 1989 b). Duri ng the second mOnlh of pregnancy
the enl ire fetllS could be depicted regularly at every ex-
aminati on (Fig. 2.172). In the third mont h the head,
thorax, abdomen and pelvis were within reach of the
penetration depth of the ultrasound waves in 95 % of
' ses. During the following months the accessibili ty of
the individual body parts decreased. In MOnlh 5 the
thorax, abdomen and pelvis could still be depicted in
one half of the cases. In these cases the cardiac activi ty
could also be demonstrated ultrasonically. The trunk of
the fetuses could only be seen in 25 % of C-dSCS in the 6th
and 7th months of pregnancy and was only visible in
isolated ("uses from the 8th mont h. The head was the
body component that could be depicted in 87 % of
uhrasonograms duri ng the entire lengt h of pregnancy.
If certai n body parts are reachable by transrectal so-
nography their prominent organs can also be examined
and sUI"-'Cyed regul arly on the ultrasound monitor.
2.4.3.2 Fetal intra uterine presentations
The frequency with which the various body parts of
bovine fet uses can be reached by sonography is signifi-
cantly determi ned by their posi tion wi thin the dam's
uterus. Until the end of the fourt h month anterior and
posterior presentations of the fetus occur with equal fre-
quency (Fig. 2.173). From Month 5 the antcrior pre-
sentations occur more frequently. BcI .... 'Ccn the fifth and
sc\'enlh months of pregnancy about 25 % of fet uses are
still in posterior presentation. The final positioni ng inlo
an anlerior prcscnl ation appears 10 be achiC\'Cd pre-
dominanl ly during the transi tion from the 7th to the 8th
month, by Days 220 of pregnancy. Thereafter posterior
presentation can only be observed in isolated cases
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174 U/rrasollogroplly in Ihe cow
FiK- 2.174: Example of measuring the largest diameter of the
eye. Sagitt al section through the skull of a fetus on Day 157 of
pregnancy.
FIg. 2.175: Example of measuring the largest diameters of the
cerebral Cfllni um and Ihe eye. 5.1gillal section through the
skull of a fe lllSon Day 141 ofprcgnancy.
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2.4.4 Sonographic fetometry in cattle
The size and stage of development of a bovine fetus
C'.m be determined in vivo by using intmuterine sono-
graphic survey, that is ultrasonic fetometry (WUITE et
at 1985. KAliN 1989 b). There are nUmefOlL'i useful ap-
plicltions of fetometry in vctcrinary practice. Wherc
disturbances set in during a pregnancy the extent of
their affect on the fctus can be assessed by felal sono-
graphy. Whcre doubts exist with regard to thc limc of
impregnation in pregnant ~ fetal sonographic
measurements can be used to establish the real age of
the calf with reasonable accuracy.
In order to obtain concJtL';ive results it i ~ important to
conduct the fetometrie survey as precisely as possible.
Before uny mcasurenlcnts of any fetal p<IMS arc tuken
the probe should be rOiated and swiveled gcntly until
the largest possible section of the organ is depicted on
the monitor. Measurements of all sizes are taken ahng
a straight line between IWO points. In this manner, for
example. the crown-rump-Iength (CRL) is determined
along the direct linc berv.'Cen the crown and the &hi
urn, and not along the curvature of the neck und back.
2.4.4.1 Eye and braincase
The eye is the organ that is most frequently av-.I ilable
for fetometry by transrectal sonography during all
stages of pregnancy. By optimally positioning the ultra
sound probe a section which sh<Jl.\'S the largest diameter
of the eye should be obtained (Fig. 2. 174 and 2.175). In
doing so it is not alw.l)'S possible to determine the exact
direct ion of the section through the organ. This means
BOI'ine fetus 175
that transverse, sagittal and horizontal sections, as ..... ell
as transitional sections between these. may end up
being chosen for assessment. In order 10 obtain thc
highest possible degree of accuracy the largest diu meter
should be measured between the two furthcst removed
points on the border between the anechoic eyeball und
the hypcrcchoic, surrounding orbit in all ca-;cs. The
largest diameter increases from around 4 mm on Day
60. 10 10 mm on Day 90 and to 30 mm at the end of
pregnancy (Fig. 2.187 and Tab. 2.1).
Apart from the eye Ihe cranial cavity is another
structure of the head that is easy to find and to identify.
It is thus .... 'CII suited for fetometric assessment. The
bones of the roof of the skull and the bas:.ll parts of the
crani um form an oval shape which surrounds the brain
and is sharply contmstcd against the hypocchoic bmin
cortex. lllis clear border is used for the determinntion
of the largest inner diametcr of the cranial cavity (Fig.
2. 175). The largcst dist ance between the outer surfaces
of the cranial bones is seen as the oUler diametcr of the
brain cavity. The cranial cavity can be biomctrically
evaluated until the end of the 7th month of pregnancy.
During the last two months of pregnancy so much ultra-
sound is absorbed by the bones oflhe cranial roof that it
becomes impossible to depict a complcte section
through thc cranial cavity and thus to obtain its largest
diameter, On Day 60 the largcst inner diameter of the
cranial cavity is 10 mm and the largest outer diameter is
17 mm on average (Fig. 2.188 and Tab. 2.1). Both
pamJ1leters increase linearly O\'Cr the following months
to reach 63 to 76 mm and 80 to 96 mm. respcctr.'Cly.
during the seventh month of pregnancy.
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176 UllJ1JSO<\QjJTUphyinlhecow
(0/"mrn)
BraiOlCMeinlaDal (w-) , ,, -16.18+0..433 . (61-1'16)
ero.. ... .. 0,0199 . 1 (11-&3)
E,e (Wmm) y,, -13,20.0.31', (110-268)
_Q.OOCl6I.
1
(l<n&lMmnl,,,-0.1 0.001f7.2 (6I}-201)
(\>eIl>IraioI} ,_1,.96.0.609,
O.ooISl ,1

(Iao&IMmIly ,,- U)+o.ooIM.2
(Ionzthlmrn)y._O.Sl+O.ool(l6,l (61_1110)
.. o.ooj)5,l(6'_201)
(!ms<Mom)y o.OOW.0.OOU19.2(60-111)
(Ic>&IMnm)y,,_j,32+0,OOIB1.
2
(63-206)
(0frnm,) y .. - S.21:" 0. Hl'l. (61-2011)
(\eI>JIMnrn) Y" _2.11+0,00215 , 2 (63--201)
(Wmm) y. 7.7&.0.191. (61-211)
,. -29_1O.0.62:h (60-211)
(l<r\a!Mm1)y . -1.01.0.00108.2 (63-201)
(WmnI) y .. -U7 + 0.06.'i. (172.S2)
(WmmJ , (1l-l63)
+O.lXlln.
2
(WmnI) ' " 2.2. +0.00121.
2
(60-206)
(Wmm) p - 5.1l+0, 14h (6I}-201)
(Wmm) y o. 6,49 .. 0.099. (M-20I)
0,97 104
0.96 W!I
0,')9107
0.91249
0.99 108
0.70 261
0.96 78
0.98 108
0.96 Sol
0,9S"
0.97 50
0,96 toJ
0.96189
0.97 M
0.92 S)
0.961Sl
0.98 56
O.BI S8
0.97 ISS
0.97 223
...
0,9) 150'
,,, - 5..40 .0. 106.
, ,, -'.15+0.099.
, ........ Q.(9).
y. -3.$) +0,08I,
(61.246) 0.9' 137
(1Ia-191) 0.99 7
(62-U2) 0.91 II
(&4-211) 0.9l 21

Days of pregnancy

.. )
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2.4.4.2 Heart frequency, crown-rump-Iength,
diameters of stomach, trunk, scrotum and
umbilical cord
The movements of the heart can fi rst be seen very
early at the end of the fi rst month of pregnancy. Due to
the rel ative ease with which the thorax can be: depicted
through the following few months the cardiac action can
be monitored without much difficulty (sec Chapter
2.4.1.4 and Fig. 2.181). In fetuses which lie in anterior
presentation the heart can often be monitored even
during the last month of pregnancy.
The heart (,.Ite of young fetuses is very high. occa-
sionally reaching a value of 180 to 204 bealS per minute
during the third month of pregnancy (CURRAN el a1.
1986 b). The mean heart rate decreases as pregnancy
progresses and lies around 160 beats per minute at Day
60. 150 around Day 90 and 130 to 140 between the fifth
and ninth months of pregnancy (Fig. 2. 176 and Tab.
2. 1). Generally. the variations in the heart rate arc con-
siderable. In fetuses examined repeatedly at wcckly in-
tervals it was possible, in many of them. to detect signif-
icantly different heart rates at successive examination
times.
The crown-rump-Iength (CRL) of bovine fetuses c.1n
only be detennined over a relatively shon period. Due
10 the li mit ed size of the image of most ult rasound scan-
ners it is hardly ever possible to still depict fetuses in
toto once they have reached a length of more than 10
Fl. 2.177: Measuring the largest di ameter or the stomach.
Horizontal SCCIion through thi! abdomen of a retus on Day
107 or pregnancy.
/WI'ille Jews 177
em. The CRL (measured betwecn the occi pi tal tx.lOe
and the first vertebra of the tail) reltches 12 em IOwards
the end of the third month of pregnancy (Fig. 2. 187 and
Tab. 2. 1). The daily increase in CRL is about J.4 mm at
the beginning of the second month and increases to 2.5
to 3 mm during the third month. The determinat ion of
the CRL is one of the most accurme me:msof deciding
on the age of a fetus (HACKEt.oER. J 984, WtllTE et al.
1985).
The anechoic lumen of the stomach com be reli ably
recognizcd and surveyed tow.lrds the end of the second
month of pregnancy (Fig. 2. 177, 2. 187 ,md Tab. 2. 1). At
this time the largest diameter orthe stomach lies around
8 mm. It increases linearly during the following months.
The stomach can regul arly be: depicted in its tot ali ty lmd
its diameter determined until the sixth month, there-
after only in individual cases.
The scrotum can also be evaluated fe tometrically.
From Day 60 it forms an echoic struct ure which projects
from the abdominal \\'311. The scrotal width can be de-
tennined on a traOS\'ersc section through the pelvic re-
gion. From the founh month of pregnancy an exact
transverse section through the scrotum can be recog-
nized on the basis that both testes are depicted next 10
eaeh other (Fig. 2.178). The largest width of the scr0-
tum increases linearly until the seventh month of preg-
nancy and reaches an ;!verage of 30 mOl (Fig. 2.188 and
Tab. 2. 1).
Fig. 2.178: Measuring the .... idth of the scrotum. Tr .. m. ... ersc
sect ion through the pcl\,M::: region of a fetus on Day lS I or
pregnancy.
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178 UllrtJSOllography ill Ihe cow
."Ig. 2.1 79: MClL'ruring the trunk diameter on a tmnsversc sec-
tion through the atxlomcn of a k lll ll on Day 81 of pregnancy.
At about I I o'clock is the anechoic stomach and at 2 o'clock a
cross section through the umbilical cort!.
Fig. 2,181: Example of observing the pulsating heart in the
apex of the thomx as well as ITlCllllUring the length of 4 ribs and
their associated intercostal sp.'K'CS. Horizontal SCC1ion through
the thord;( of a fetus on Day 166 of pregnancy.
Fig. 2.180: Measuring the largest trunk diameter on a trans-
vcrsc section through a fetus on Day 62 of pregnancy. The rer
viel! spine and the cone shaped thard;( are hypcrcchoic.
tlg. 2.182: Measuring the length of 6 lumbar vcrtebme and
their associated intervcrtebrul spaces. Horizontal St.'CIion
through the thorax lind abdomen ofa f e l U . ~ on Day920f preg
nancy. Ult rasonogram of an excised fetus in a .... '3terbiilh.
~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - .
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Mea,ure"...,n"of l helrun\:shouldhelakenal iI'
. Slpoint, inlheregionof(ilC la<.lrib<\.atlheb<:lof
livcTandSlomach.ForthispuIpObCatmn""rscscc-
throughlhe abdornen ,hould be oblai ned ( Fig.
179). fly examining a scction rtlfloingvcrtical to tne
al ",alb it is JlOS' ible to obtain a rounci m""
ion through the l runk. Longitudinal 'lection,
ghlhemiddlcofrhcrnlflk inlhcfonnofsagil1al
horiwnml Sl. ... 1ions can also be (Fig.
!KJ) ,lnlhesecase'lheheighlOft helrunk oril!;widlh
Iongil udinal!oCC1ionsoorrcspomlswilSdiaJJli:ler in
'rsc sox1io", al the samc place. For=ralc
rement, il is importarll 10 produ"" a Iran"",,,,,,
orienledexactly9()"rothelongiludinal axisof
bodyor.lrmgilUdinal"""ioncMlt1Jythroughthc
cofthebody. Jfthe l r.nwerse"-"'.'1iQnarerolaled
yfmm lhe vertical plane towanislnc lo"gi l<,<i i",,1
of lite hoJy ni<JTC 0,",,1 mJSO Sl."<.1ional imab'Oiofthc
arc c1\:alcd. Th""" result in inaccurale mea,ure
I' , 'The .... me is l rue for sagil1al sccliollS Ihat arc
cd from Ihc rn.:dian towurili a paraIIIl...Jian pbnc.
On DayW 1o 70 Ihe lrunk diameler of bovine fe-
measu=bel\\"cn 20 and J.O mm (Fig. 2.187 and
1.2).hlhcnincrcascsbyO.9mrnpcrd"ylorca"h
mmaround Day 150 ofpregnanq(WlllTEetaJ
). Al thi.poinl il rcadlCSthcsi", cqualslhe
imum imaging Ikplh and widlh of c'Ilm:nUy
Ioycd ultrdSOund equipment. Thi' prohibit< Ihe
plete<iepirtionoflheetllirclrunkdianlClerinlhe
ingmomhsofpregnan.:y
TIIC umbilical oord is easy to find in many instance,
ilslarge.'ldiamelercanbcdelermined (Fig.2.161
Tah. 2.1). Il< wry lort,oou, oour.;e u",aU}'makcsil
10producc a Irdnsvcrsdyuriented seClion through
umbilical cord.
It seem, inocrurale 10 take sooographic nlCa'ure_
\J5of indi.;d""lvcTlchmcoroftbccTUS/;"-,,-tloru;,,f
Ductolhcirinte nseechogenicil)'lhesehonyslruc
are easily recognizcdal an carly>lagcofprcgn"TI '

bc<:auscofthclimiledresolutLonofcon''entional
1I1Ira<ound<o;;anne"'-TIleirhordersarealsonOlclcarly
(icrnaTCalcd and. paTli.:ularly duringcariy pregnancy.
tocywrrcspondto lhebone,'ossifocalion""ntersTalhcr
IhanlO l heiractualoul lines.
Howe,,,r. il is p<.lS'ihle 10 measure thc length of a
",holesecrion oflhevertebraJrolumnwl1 ich includes
severalvertebrae(F'ig. 2.182). Thl:$wouldlheO)'icldlhc
"umbcrOfvcrtcbmc pcr unillength, from Ihis pammc-
Icrthenumhcrofvertebraeina particularseCiion os
",,,11a'lheirindivid, ... l sUcandlhatoflhcintcTYcncbral
sp;=canbe<lcdoctcd, Forlhi'purposcme"'lIreasec-
tion of the ""nebral column a, long"' p"",ihle and
dr.ide il,1cngthhylnenumocrof,'crtchmcindu<kd
During the s.;-oond half ofprcgnml<.Y lhis measuremenl
"ften indude'< oot more Ihan" to 4 ,,,nehrae on a
'ingle image. ,,'hereas7Io 8vr:r:hmc can be secn
simuhanwusJy01l imagc,lai:n during the fiThi third of
pregnanq'.
A,imilararproach;'suilahlcfo'JJli:a,uringrih<",-""
<;cc1ion& and inlm.u;tal"""""" (rig. 2.I.sl).A horiwn-
laJsc>ctionlhroughlhefetallhoraxis"'qui",dforlhi.<
nle""''''menl lntheSlOOJCw"ya&rbc,izcofindividual
vertcbTacwa,dckrmincd. lhe,;"'of,ing\eribcross
intercostal o;pacescan
11l<: ccTY;""lvcTlcbmc arecasicst to reach and are
usually delectable umil the end of pregnancy. TIle
le nglhofonecervicalvcrtchmandilsadjoininginlcr.
,,,nehral>j=incrcascs{rom2Io4mminthcthird
monlhlO2SmminllH:.ighlh IIlO1lth (Fig. 2.1l\7and
Tab. 2.1)
...
lic in thc same r.mge (Tab. 2.J).'Theyare,IIO\\""'er,le",
ea,ilymeasure<iand. byvinueoflheinlra.U\crinep<ll'i-
lioningofthcfcllL,.lhey.reina=il>lchysonograpny
duringlbcl<lSilhirdofprcgnancy.
TIlesi:reoflherihcrr,.;i\CClion'andlhelrin\cn::0'<tal
<paCCSCOTTI!>j>Ondlolhe lcnglhoflhc,,,nchrncand
locirintcTVCTlcbmlspaccs(Fig.2,ISl!andTab,2.l).As
Iooga,thethorax""l il1withinreac;hoflhesoundwa,'eS
lheycanhe<kpicted,Mcasuri"glhclcngthofarib is
imposlilhlc.becauscitssizeusuall).e:<",e<is l haloflhe
ultrasound scanner's image. and hecausc of il< CI!I'\'cd
sI1ap<:ilcan11OIhepm;ccrcdinasing,k;irnagLngplanc
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180 Uf'rrlsollDgrrlplly ill ,IIe COli'
Fig. 2.183: Measuring the length of the diaphysis of a fetal
(M) on a sectIOn through a fore limb showing also
the S('COnd and third ph:I!:Ht.\CS (I. 2. 3) on OJ)' 125 of
pregnancy.
Fig. 2. 184: Measuring the lengths of the ilium and ischium in
a sagillaJ KCtion through the peM!; of a feltlS on Day 189 of
presnan')'.
t' ig. 2. 185: Mcasllring the length of a femur in a horizontal SCClion through
the pclvic port ion of a fetus on [)oJY 1().l of pregnancy.
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2.4.4.4 Front and hind limbs
The fetometry of the limb bones invol\'CS the meas-
uring of the lengths of their hypcrtthoic regions. These
regions reprcscntthe ossified sections of their diaphyses
(Fig. 2.1 83. 2.185, 2.186). The ossificat K)O centers are
characterized by their \'Cry intense reflect ions. Their
echoic pans end relatively abruptly at the transitions to
the canilaginous romponents of the bones. When meas-
uring the length of bones the ultrasound beam should
imp..1ct venically onto the bone. In the front limb the 0s-
sified pans of the scapula. humerus, mdius and ulna. as
well as metacarpus can be evaluated by fetometry. Since
the radius and ulna are dirrlCUlt 10 differenti ate ultra-
sonically, their echoes arc usually seen as a single one.
The bonc.o; of the pelvic limb that are avai lable for feto-
metric purposes are the il ium. ischium, femur. tibia and
metatarsus (Fig. 2.184 to 2.186 and Tab. 2.1).
The long bones of front and hind limb have approxi -
mately the same length nnd show similar growth mtes
(Fig. 2. 187, 2. I 88 and Tab. 2.1). The ossified diaphyses
of scapula, humerus, mdius and ulna. metacarpus. fe-
mur, tibia, and metatarsus ha\'C an average length of 12
to 16 mm on Day 90 and grow to 5510 65 mm in length
by Day 180.
Among the bonesofthc front limb the metacarpus is
the easiest to reaeh by ultrasonography and can, in cases
of anterior prcsentnl ion. still be depicted in advanced
pregnancy (Fig. 2.183). When the metacarpal bones lie
close to the mat emal pelvis. the optimal rotation of the
ultrasound prolx: will often allow them 10 be brought in-
to the optimal plane relative to the sound beam and
thus greatly facilitat e the taking of reliable measure-
ments. Generally, all bones of the from and hind limbs
can be cvalunlcd fetometrically unti l about the seventh
month of pregnancy. Arter this siage they are too large
to be depicted rompletely on a single ultrasound imagc.
Bm'inc {Cl/IS 181
The optimal 3pprooeh for the fetomelric age deter-
mination of bovine fetuses depends on the stage of the
pregnancy and on the or the fClal body
parts. When the head C'oln be re3ched the biomelry of
the C)'C 3nd the skull cavi ty should tx: ronsidered relia-
ble parameters. The e)'CS lind skull C'olvity col n tx: meas-
ured very accur.ttcly and are usually accessible through-
out the rourse of the pregnancy. Apan from these there
are numerous suitable body pans thul can be used
during Ihe first half of pregnancy. The accuracy of the
fetal age esti mation can be enhanced by the rombined
assessment of as m3ny mensurements as pos."ible.
t ... 2. IM: Measuring the lengt h of the diaphysis of the mela
tarsus in a sc..'CIion through the melacarpus of a fetus on Day
175 of pregnancy.
www.vet4arab.co.cc
by Dr.Stator & Saraajka
182 Ultrasonography in the cow
120
100
80
40
20
o
o
Estimation of the age of bovine feluses and pregnancy
through sonographic retometry.
................... , ..... . ... , ...................................................................... .
CRL

,




SlOmach




120
......... .......... ) .. . > > .......... , ........ .
,) 100








Trunk





Tibia


............... ... ......... -... ...... -........ ......... ........ -:- ......... ; ............... 80



,


... ... ... _ ........ _ ...... .



......... ..... .





.. ..... ...
........ . ,. . ....
30 60
,


90

. ..... .



120
. ... ..

,

.. .


.. ...

,








..... -:- ......... _ .. ....... _ .... .




........ . ......... ............... .
Eye

.. , ......... + ........ + ...... . .


Cervica vertebrae with
one intervertebral space
-1-
150 180 210 270
Days of pregnancy
40
o
Fla. 2.187: Regressions of the gtOY>1h rutes of the CI'O"l1. rump-lcngth (CRL). the largest
diameters of the trunk, and eye, the Icnglhs of tibia and metacarpus. aswctl as that
of one cervical Vl: ncbra with its intcIVcrl ebral space in bovine fetuses during pregnancy.
AvtlrSKO e'lO cradi '0
www.vet4arab.co.cc
by Dr.Stator & Saraajka
120
100
80
40
20
Bow'fle feills
Estimation of the age of bovine fetuses and pregnancy
through sonographic fetometry.
............................................................................................ ......


.... ..... . ; ......... .







. . .
.................... , ................................ , .... .

Braincase



external






........ \ .......... : .......... : .................... \ .................... ~ ......... . .... ...... .....




........ 1 ........ \ .. .. ..................... .





,
.. \ . ....... ..

,
................................... ........ .. ,1,1







Femur



Metatarsus
.......... ~ ........................ ..
Scrotum
..........................


Os ischii




........ ; ........ .. ............................. ; .......... ; ... ..


120
100
80
40
20
Fig. 2.188: Regressions of the gn:w.1h rat es of the external diameter of the braincase. the
length of the femur, metatarsus and ischiac bone. the cross sectional diameter of the scr0-
tum. as well as one rib cross section with its corresponding intercostal space In bovi ne
fetuses during pregnancy.
183
Avtorsko z a s ~ eno C'radi '0
www.vet4arab.co.cc
by Dr.Stator & Saraajka
184 References
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Avtorsko C'lO gradrvo
www.vet4arab.co.cc
by Dr.Stator & Saraajka
186 Ultrasonography ii, s/, eep ami goats
"ig. 3.1: Schem:llic prcsentalion of Ihe transcutaneous ultra-
sound CXllminalion of a cwc. The probe is applied in the hai r-
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Ave 0 Z C "lO gradrvo
www.vet4arab.co.cc
by Dr.Stator & Saraajka
Tec:hniqut of ultrosonogmphy 187
3 Ultrasonography in sheep and goats
For many years various ultrasound u:chniques ha'"C
been used to pregnancy in shccp and goats.
The A - mode and Doppler tcchniques used in the past
are considered non-imaging systems (UNOAHL 1969).
Neither techniquc is able to produce an image of the
o::ona:ptlts. but mther illustrates its presence by detec-
tion of a characteristic pattern of amplitudes or through
an audible or optically detectable frequency modula-
lion. Today, the imaging ultrasound te<:hniquc, the real
lime B - mode ultl"a$OrlOgmphy, is used in small rumi-
nants (FoWl.El'l and WIUINS 1980. el al.
1983 a and b). In oounlries wllere intensive sheep fann-
ing is practiced the $I:mographic c.amination of these
animal.<; for pregnallC)' detection and the detenninalion
offelal numbers is applied routinely (FOWLER and WIL-
KINS 1984. WHrrE el al. 1984. DAVEY 1986). 1lle im
aging sonogrnphy is superior to the non-imaging
methods. because it is more lICCUmte and enables the
operalor 10 detect Ihe number and viability of the fe-
tuses (BUCKREU. 1988. JAll.OON 1988).
3.1 Technique of ultrasooography in
sheep and goats
llIe ultrasound c.amination of sheep and goalS can
be performed in two different ways. 1lle internal geni
talia can be depicted by applying the ultrasound probe
10 the veOlml abdomen the transcutar>OOUS ultrasono-
graphy - or by inlroducing the probe into the rectum -
the transrectal ullrasonography (Flg. 3.1 and 3.2). Bolh
melhods have been shown to be useful in sheep and
goalS (FOWLII and WIUII,S 1985. KAsPAR 1988.
KAspAII. 1989). 'The choice of which lechnique 10 use
depends on the diagnosis Ihat is to be made, Ihe type of
lhe available ultrasound probe. as weU as the ..mking
conditions during the examination of large flocks.
Based on CIIm:nt experience the trallSrectal examina-
tion is more accurale than lhe transcutaneous method
until Day 35 of pregnancy. Between Days 35 and 70
both methods appear to be equally accura!e.1lle tmns-
cutaneous approach is preferred during tile second half
of pregnallC)'. because it allows a larger ponion of tile
pregnant uterus to be visualized and it is much more
practical.
Generally. scanners with sector. linear and convex
probes at frequcnOes of 3.5 to 5.0 MHz can be used for
both approaches. In practice the frequency of 5 MH.z is
versatile. Linear probes appear beller suited for tile
transredal examinations, whereas sector probes are
preferred for transcutaneous examinations.
3. 1.1 Transcutaneous sonography
For transcutaneous sooogrdphy the probe is applied
to the groin area immediately CT"dnialto the udder (Flg.
3.1). In the majority ofshecp and goat breeds this area
is relatively free ofwool or hair. allowing for good cou-
pling of the probe wilhout prior dipping of Ihe hair in
Ihe area. In addition. Ihe nonpregnant 3IId early preg-
nant uteri are best visualized from this site. Only during
the last trimester does Ihe pregnant uterus extend so faf
forv.-ard thallhe probe has to be moved cranially in or-
der to permit a complele examination of the fetltsCS. In
these C<lSCS some wool or hair needs to be reITllJl."Cd be-
fore the examination can be performed. In order 10 ac-
curately count the number of fet uses after Day 100 of
pregnancy an area of 20 to 40 ern arournl the udder
must be dipped 3IId both sides of the abdomen have to
be scanned. For a simple pregnancy diagnosis. in other
words a mere distinction between pregnant and non-
pregnant. the probe can be positionedjust cranial to the
udder and 00 dipping of hair or wool is required even
in late pregnancy (FOWLER and WtLKINS 1985).
1lle transcutaneous can be per-
fanned "" hile the C\Io"t is standing. $illing or lying down.
Practical experience has shown that the examination
vt:l?S d
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188 UllrrJsD/lOgraphy itl sheep alld goats
Fig. 3.J: TrJJl5CUlanl'Ous image oflhe urinary bladder (U) and
the non prcgnam uterus (arrows) of a in a sagittal sect ion
with venlrodorsally directed beam.
fig. 3.4: TrnnsrcctaJ image uf lbe urinal)' bladder (U) and Ihe
non-pregnant uterus indiclte Ihe grc:lt er culVa, urc)
in a nanny goo, in a saginal section wilh dONlVCntrJl1y di
rCClcd beam.
Ay S 0 zas eno
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should stan on the right hand side of the animal. In
most cases the full rumen pushes the pregnant uterus to
the right side where it is found with greater reliability
and speed. The transcutaneous sonographic examina
tion is greatly facilitated if a helper, standing on the left
side of the sheep, bends over the animal and pulls up its
right hind leg.
The probe is applied 10 the hairless area in front of
the udder, immediately cranial to the sebum filled in
guinal gland. The sound waves are directed dOfS.1tty and
slightly caudomediaUy. The probe is then pressed mod
erately against the abdomen in the direction of the uri
nary bladder. When large flocks are examined working
ronditions should be optimized as far as possible. It has
proven most useful to chase the sheep on to a 80 to
100 em high mmp where a standing examiner can scan
the sheep withoul too much discomfon. The number of
shccp that can be scanned in a given period of time
depends on the experience of the examiner, the pre-
dominant stage of pregnancy of the sheep in the flock
and the prevailing working ronditions. Where the pur-
!X>SC of the examination is merely to distinguish be-
t,",'Cen pregnant and non-pregnant sheep up to 100 ewes
can be scanned in one hour (DE BoiS and TAVERNE
1984). If the number of fetuses in each pregnant e,",'C
must also be determined the e:<amination speed will be
slD"'Cr and may take up to I to 2 min. per ewe in some
oases.
The above mentioned information on sonogmphic
examinations of shccp relate to small to medium sized
flocks 500 sheep). More intense experience on large
flocks in prominent sheep farming rountries has shown
that the diagnostic accuracy and the speed of the exam-
ination can both be enhanced by the introduction of
improved techniques. Such techniques include, for
example, the usc of clamps that allow the C\\'C to be
placed in a special position for the exami nation. In this
regard it has been shown that fetal numbers can most
accumtely be determined when the c" .. e is in dorsal
Trtlllsreclal sofogroplly 189
recumbency or in a hanging posi tion (FOWLER and
WILKtNS 1985).
In order to obtain the best possible image quality it is
necessary to apply a roupling gcl between the skin sur
face and the ult rasound probe. When scanning standing
animals the gel is applied onto the scanning surface of
the probe before the latter is placed against the skin.
When the animal is scanned in the recumbent position
the gel is distributed onto the skin surface. In prepara-
tion for the scanning exercise it is very uscfulto starve the
animals by removing their feed for 12 hours during the
preceding night. This precaution often helps to obtain a
better image quality and thus leads to increased speed
and accuracy during the examination (BUCKREtJ.. 1988).
In order to ensure accurate results during the preg-
nancy diagnosis a systematic approach is essential. First.
the urinary bladder should be found and depicted. It is
easily recognized by its anechoic lumen and typical
shape (Fig. 3.3). The nonpregnant ulerus appears in
the area of the apex of the bladder. The nonpregnant
ulerine horns are usually found cranially and ventrally.
sometimes also laterally. to the urinary bladder. Also in
the presence of a pregnancy. the uterus can be found in
the vicinity of the apex of the bladder. Depending on
the stage of pregnancy one would then follow the ex-
panded pregnant uterus in a cranial direction.
3.1.2 Transrectal sonography
A prerequisite for the tr..ansreClal sonogr..aphy is the
availability of II probe that can be introduced into the
rect um and whose scanning surface can be rotated ,en
trally and laterally. Probes with oUler dimensions of 10
em length, 3 em height and 2 em width can be intro-
duced without any difficulty inlo the rectums of sheep
and goalS (KAsPAR 1988).
Prior to a transrectal sonographic examinalion the
animal must be properly TCStrained. This will help to
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190 U/Jraso/l agrapllY ill sheep and goafS
FIg. 3.5: Waterbath image of an excised OV' .uy of a L'We. The
'\\'0 corpor.! lutca s.how the moderate echogenicity of luteal
tissue. The ovarian parenchyma is more echoic.
Fig. 3.7: Transrcctal imllge of a foll icle (diamctcr - 7 mm) on
the o ... ary of a nanny goat . The ovary lies ventral to the non
pregnant ut erus. Small UlTUYo"S demarcat e the outline of the
ovary. large alTUYo"S that of Ihe utcrus.
.;lg. 3.6: Photograph of the same ovary sectioned through the
scanning plane in Fig. 3.5 and showing the 2 corpora lutea. A
small cavity is present in the center of the left corpus luteum.
fig. 3.8: Transrectal image of [y,'O large vcsiclc$ on the ovary
of a e\l,e with suspected cystic follicul ar degcnerlllion. 1lie
OV'dry lies cranioventrally of the urinary bladder (U) and yen
tr.1l1y of the non pregnant u t c r u ~ (alTUYo-s).
A v ~ SkO z. ~ Ii a adlVo
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avoid injuries that may result from the animal's defen-
sive struggling. Advancing and steering the probe inside
the rectum of a sheep or goat is achieved from the out-
side (Fig. 3,2), If the ultrasound probe is attached to a
sufficiently stiff cable the laller can be used to advance
the probe into the rectum and then to further manipu-
late it there. Where the cable of thc probe is flexible a
pipe: or rod can be used to stiffcn thc connection to the
",abe (Fig. 4.3).
The ultrasound probe is first lubricated and then
introduced through the anus inio the rectum. It is thcn
pushed cranially for about 15 011 where the urinary
bladder should become visiblc. Removal of the feces
from the rectum or the application of a coupling gcl be-
fore the introduction of the probe into the rectum nrc
not necesSllry for the transrectal sonography in shecp
and goats. Once the bladder has becn identified. thc
probe - with the sound beam directed ventrally - is ad-
vanced slowly while it is also swiveled latcrally through
45 degrees in both directions untilthc utcrus comes in-
to view (Fig. 3.4). Occasionally. fcces that lie bew,cen
thc probe and the gut wall may obscure the imagc. By
moving thc probe hack and fonh a lillie. or by reintro-
ducing it. this hindrance can be removed. When sheep
in thcir second or third trimester of pregnancy are
scanned it may be hclpful to clevate thcir abdominal
wal1 a little in ordcr to better visualize parts of the preg-
nant uterus. Tnl.llsrectal sonographk examinalions takc
a littlc more time to perform than the trnnSCUlancous
ones. When many animals are to be checked an exam-
OIurian stnlCfll1rS ill slleep 191
inalion time of I to 2 minutes per animal should be ex-
pectcd (BUCKREU et a!. 1986). Provided the probe is
handlcd skillfully inside the rectum serious injuries do
not occur. Irritation of thc rectal mucosa may Icad to
mild hemorrhagc which is gencrally harmless.
3.2 Ovarian structures in sheep
and goats
3.2.1 Follicles and corpora lutea
Based on thc findings of examinations on excised
ovaries in a watcrbath, follicles and corpora lutca of thc
small ruminants produce echo patterns similar to tho!ic
obscl'\'Cd in C<l ulc (see chaptcr 2.2). Corpora lutCil pro-
duce rcfloctions vety Iypical of thc low dcnsity of luteal
tissuc (Fig. 3.5 nnd 3.6). A cavity of a few millimetcrs
can be seen at the centcrs of many corpor.t lutca. Fol-
licles arc charnctcrizcd by the prcscl"lQ! of anechoic
nuid in their antrum.
A routinc diagnostic visualization of the ovaries by
means of ultrasonogrnphy is not )'Ct possiblc at all stages
of the cycle in shcep and goats (BuoaI.EU_ 1988). Fol
licles nnd corpom lutca of shcep and goats can be so
smalllhllt they cannot reliably be detected by the U.'iC of
currently employed ultmsonographic cquipment. In
sheep with unknown cyclic activity, for example, most
follicles ha\'C a diameter of only a few.millimeters which
is below the resolution capacity at which reliable inter-
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192 U/lrrlSollogmphy ill sheep (ifill goats
t1g. 3.9: OV'olI)' of a CYo'C afler supell)\'Ulalory treatment. On
the left of the ovary !k..'VcraJ corpora lutca (arrows) and on the
right 3 follicles (diamelcrli bctwl,.'Cn 5 to 6 mm). (Ul trasono-
gram from Nov. 22, 15:00. Thc sheep was treated as r o l ~ :
Nov. 9. PGF2a; Nov. 1922, FSH bid and Nov. 21. 18:00,
PGF2a. Estrus occurred on Nov. 23).
Ag. 3.10: Ovary (cntnial lo the urinary bladder. U) in a f,.'\";C on
the day of esuus after supell)\'Ulatol)' treatment. Eight to ten
foll icles with diamelerliof 4 to 8 mm can be seen on the ovary.
(Ultmsonogram from Nov. 23. 18:00. The sheep ..... as treated
as follows: Nov. 9: PGF2a; Nov. 19: ECG sid and Nov. 21.
18:00, PGF2a).
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pretations of the image can still be made. At times fol-
licles of 5 mm diameteror more can be identified on the
ovaries of proestrom e ..... cs (Fig. 3.7). Large, anechoic
vesicles can also be found on the ovaries of animals suf-
fering from the relati>.'Cly mfC condition of cystic de-
genemtion of follicles (Fig. 3.8). The cavities insi de hol-
low corpom lutea of sheep and goats CJn be confused
with small foil ides. The reason for this is that the echoic
wull of the hollow corjXlm lutea may be as thin as I to 2
mm and thus frequently overlooked.
B.1SCd on the as yet limited experiences it can be con-
cluded that transrectal ultrasonography may be useful
in assessing ovll ri an features in spcciflC ovine and cap-
rine cases, for example detennining follicular develop-
ment after supcrovul atory treatment. Studies on goats
have shown that the ovaries with their developi ng fol-
licles could only be identified in some animals during
the first few days of supcrovulatory treatment (DaRN et
al. 1989). Only prior to ovulation, when some of the fol-
licles reached an inner diameter of up to 10 mm. could
the ovaries be found with ccrtainty.
In studies conducted by the author the follicular
dcvclopmenl in superovulated sheep was observed. By
Follicles 193
tmnsrectal sonography the oV'Jries were reliably de-
tectable - if they had responded to the honnonalthem-
py with follicular activity. The image result ing from
many adj acent. anechoic follicles was so typical that the
ovaries could be ident ified without difficulty. The hlrg-
est follicles of sheep had a diameter of 5 to 6 mm on the
d:ly of prostaglandin treatment and 6 to 8 mm on the
day of ovulation (Fig. 3.9 and 3. 10). Ultrasonography
made it possible to aSsess whether a ewe had responded
wi th the development of mult iple follicles 10 the hormo-
naltreatment. The exact number of follicles oould only
be estimated. Some of the sheep ,",,'CTC examined by
tmnscutancous endoscopy after they had been exam-
ined by transrectal ult rasonography. This revealed that
the sonographic examination enabled the investigator
to correctly establish the tendency in follicle numbers.
but that counling the exact number of follicles was im-
possible.
Occ-'.asionally. and only with difficulty, could ovaries
be ident ified that had not, or only inadequately. re-
sponded to the supcrovulatory treatment by the devel-
opment of multiple follides.
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194 U/frrJSOllogtTlpll)' i1l sheep o1ld goafS
Fig. 3. 11 : Sagittal section through the non-pregnant utcrus of
a ewe. The greater CUN'JlUre of the ulerus is marked by
arrows. Tmnsrectal ultrasonogram.
Fig. 3. 12: Sagittal section through the utcrus of a .. we on the
day of estrus follov.ing supcrovul:nory treat ment. Mul tiple,
small nuid rollcctions (al"TOYo"5) arc visible inside the lumen of
the uterus. Tr-.msrectal ultrasonogrJm.
Av s 0 Z " ' l ~ 10 ra vo
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3.3 Uterine structures in sheep
and goats
Generally. the findings on the non-pregnant uterus
as well as the uterus and conceptus during pregnancy
arc similar in sheep and goats (T AINIlJRIER el al. 1983 a
and b).
3.3.1 Non-pregnant uterus
The non-pregnant uterus of sheep and goats can be
found inside the pelvis in the vicinity of the apex of the
urinary bladder. It can be depicted by transrcct al. as
.... 1:11 as transcutaneous sonography (Fig. 3.3 and 3.4).
Uterine Stmctlll1!$ 195
During a transrcctal examination, a sagittal section
through the uterus is produced if the probe is held
dorsally above the uterus, and iL'i scanning pl ane is
directed ventrally and parallel to the longitudinal ru:is of
the body (Fig. 3. 11 ). The cranial border of the uteru.'i, in
the form of its larger curvature. can be seen as a com1:X
structure. The lesser curvature of the non-pregnant
ut erus can only be recognized with difficulty. On section
the uteri ne wall produces a homogenous. coarsely
granular echo. The uterine lumen or any fluid ilccumu-
lations inside the uterus can usual ly not be detected
in the normal. non-pregnant uterus. Only during pro-
estrus and estrus of ewes treated for superovulation did
the uterus regularly contain fluid accumulations (Fig.
3. 12) .
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.... .....
.... nt..'''''nju>t
.....,WI)IOth<urioIDyblacidct(U).'Tkirl .. nwe""'dwn-
... ..
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3.3.2 Pregnant uterus
3.3.2.1 Before Day 20 of pregnancy
The carlicst indication of the presence of a pregnan-
cy is thc dcmonslrl.llion of embryoni c fluid inside the
ut erus. The trophoblast of the ewe and goat begins to
elongate ronsiderably from the Day II of pregnancy
(KING et al. 1982). By Day 13 to 14 thc embryonic ' 'CS-
icle lies as a 10 em long tube in the utcrine hom ipsilat-
eral to the corpus luteum of pregnancy. By Day 16 to 18
it extends into the contralateral hom ( RO\\'SON and
MOOR 1966). Around Day 20 of pregnancy the narrow
embryonic vesicle extcnds from the tip of the pregnant
hom 10 the tip of the contralateral hom of the uterus.
TransreClal sonogruphy OCC'dSionally allows the visu-
alization of anechoic sections Ihrough the emb.yonic
vesicle between Days 14 and 19 of pregnancy (BUCK-
REU.. 1988). During this period the demonstrat ion of an
anechoic lumen is, howC\'Cr. unreliable and cannoc be
used to positively diagnose pregnancy. The chorionic
and amniotic vesicles rontain so little fluid at this stage
that the embryonic vesicle of only a few millimeten can
only sporadically be visualized (Fig. 3.13). Small fl uid
accumulat ions in the ut erus can also originate from
causes other than pregnancy.
Pregllullf //tents 197
Prior to Day 20 lrnnsrcClal sooography may be lL<;C-
rul as a research tool to slUcIy. for example. embryonic
death: it docs not ronsti lUl e a practical means of relia-
bly ditlgnosing pregnancy III this stage.
3.3.2.2 Day 20 to 40 of pregnancy
From Day 20 to 25 of pregnancy the dcmonstmt ion
of embr)'Onic fl uid is regularly possible in sheep and
goats examined by transrcctal sonogrnphy (BUCKKEU.
1988). At this stagc of pregnancy anechoic embr)'Onic
fluid accumul ntions occur inside the lumen of the early
pregnant uterus - frequently C'o'cn in scvcml places
which appear as a series of vesicles (Fig. 3.14). "1lley C"".t n
usually be found immediately cranial or cmniovenlrully
10 the urinary bllldder ( Il UCKRElJ... el al. 1986. GEAR'
HART et al. 1988). The amount of embr)'Onic fl uid in-
creases rather mpidly over the following few days so
thai ever larger port ions of the embryonic vcsiclc be-
rome visible. The largest cross sections through the ,.cs-
icle increase from around 10 mm on Day 20. to 15 mm
on Day 25 and to 20 mm on Day 30 (Fig. 3.14to 3.16).
It is often not possible to s(''C the ronncctions be-
tv,cen Iocules of embr)'Onic fluid which ..... ,ould demon-
stratc that they are aU parts of a single embr)'Onic ves-
icle. More oft en. an inlllgc consisting of apparent ly
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198 UllfWOllogrophy in sheet) alld goalS
Fig. 3. 16: Utcrus of on Day 29 of prcgn:mcy. Three an
echoic sections through embryonic vesicles are visible. Trans-
rectal ultrasonogram.
fo1g. 3.1 8: Uterus of II nanny goot on Day 24 of pregnancy. The
echoic embl)"O (E) lies. surrounded by anechoic embryonic
fluid. in the vcntr:ll section of the uterine hom. ul-
trasonogmro.
Fig .. 1 17: Photograph after a sagittal section through the right
uterine hom of a C\Io' C on Day 29 of pregnancy. The uterine lu-
men is part itioned into Sl.'Vtrnl compart ments by vertical folds
of thc uterine wall. 8oIo.lshapcd carunclcs (small arrows) are
recognizable. The greater curvature is marked by large ar-
rows. the cervix (C; partly CUI 01T) lies on the left.
fole. 3. 19: Uterus of a nanny goat on Day 25. The uterus lies
cranial to the urinary bladder (U). In the ventral sect jon of the
uterine hom 2 placenlomes can be seen bullon like protru-
!>ions. Transrcctal ultrasonogram.
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lantochorionicYC5idelbt-rcbyprodudngtllemul!i!ocu,
wdlea,

and 3O of prcgnarot)",uccasionallycarlicr(F>g. 3.1S). If
the..-m/lryo!lareclcarly>-NbictheirheanbeatOU1be

cmhryo!l ...

cntOllll."S .ndtbe embr)ol{iJlJckK>J.l. ctai.l98ti). ' llw,:
pia<:entO!l1<-"Srorsl!)ewmcappllrcntonlheutcri"" .... ull
fromahoutDaylS. Atthislol.theyappcarasbotioo


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r-""J.lt:\I ""of
_(A) .... mlUnd<lheembr)oo ... lh'" ""ool>ay35ofl""lI"""')'.Too".ml>lyoJ(L)1U>Il4 ....
I"nIAIII.....w ........... -.gnm.
.. U:'T"'n'm . ... "OfIu.y40"'I'''."'''''nt)'.(""m<o.'''''''" ' ..... :uJ,llorihlnllll""""'''''h''''''''.n". ..... fC1 .... ''''
lions .hl"llllJl>'W<l k'I1";:F) .... .-..illIe. .. u1tr""-... 4Oofprtllllnt)'. Tho. """""'-f'WTlp-Icnll"h mo ......... 4 an.
rq",m h<:aJ (H) "",I crooo """""''' U""""".he 1,,,,,1""'-

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3.3.2.3 Dtly40 to IOOofprcgnanC)'
From Day 40 Qfpn:gna1l()'counUngof the fCIU=
bca.>mr$ incrcasin&IY more fca. .. l* (l'ig. 3.22). 11.:
cdlOic felu.w. an: $Urmundc<J by larte of

alv>",,"Uk"P3raledfrumoneanothcrlUldcanthusbc
distingui.<hed with Cfl'.(. During this period thc fet ......

ahoul 4cmU'OUnd Oay40, 7anby

lengthofovi""andcaprioefcl u."", ...
10 <:m {EvA.'15 and SJ.cx.\\l7J) ... ilich .. the \i miluf
5 MHI pmbcs W .. 3,24). For lhc oompkte im:tgingof
fC1U."", the of lower ultrllSO\lIld
holds advIIntagcs fmm this time onwartb.
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202 UllrtlSOllogrtlpl,)' ill sheep alld COO's
tlg. 3.l4: Trnnsrectal horizontal section through 3n ()\line fe-
tUSOfl D3y60of pregnancy. In Ihe apex of the IhotaX (arT\)\o\'S)
lies the hean. to the left of that the modcrnlelycchoic liver (l )
with sections Ihrough some large hepatic blood vcsscls.
FIg. 3.26: Trnnsrectal horizonlal section through the abdomen
of an ovine fetus on Day 96 of pregnuncy. The h)'JXlCChoic lu-
men of the rumen (R) lies at the top. the liver (l) at the bot-
tom, an l'Choic \'Cnebru on the right.
FIg. 3.25: Transcutaneous horizontal section through the skull
of an ovinc fe lus on Day 65 of pregnancy. One eye (af'l'O'W)
with its lens lies at the top. the other eye (arrow) at the bot-
tom. To the right of the !auer lies the h)'pcrcchoic of the
cranial wily. TlK: bip.lrictlll diameter (nPD) 23.5
mm.
fig. 3.27: Trnnsrectal horizontal section through the thorax of
an mine fetus on Day 96 of pregnancy. Shadow anifactsorigi-
nale from 11K: conically ummged rib cross seclions and run in-
to the tJcpth of the image.
Ay S OZ 10
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During the second and third trimesters of pregnancy
numerous organs of ovine and caprine fetuses can be
depicted sonographically (DE. BoiS and TAVERNE.
1984). In general, the different organs and body parts
produce images similar to those described for bovine fe-
tuses (Chapter 2.4). The cranial cavity and eyes, heart ,
stomach, kidneys and umbilical cord can be depicted
with particular clarity (Fig. 3.24 to 3.30). As a result of
thei r intense cchogenicity the bony parts, such as the
skull , spinal column, ribs and the extremities, can be
identified without difficulty. The fe tuses show intensive
mobility at this stage, resulting in frequent positional
changes (SoIEERBOOM and TAVERNE 1985).
Pregnant /Items 203
By taking fetal measurements the age of a pregnan-
cy can be estimated or, in the case of a known service
date, the developmental status of the conceptuses can
be assessed. Next to many other body parts, the bipari-
etal diameter (BPD) of ovine and caprine fetuses is
particularly ,,"'CII suited for fetometric evu.luation (Fig.
3.25). The biparietal diameter of ovi nc and caprine fe-
tuses increases nearly linearly duri ng the course of preg-
nancy (HAIBEL and PERKtNS 1989, HAma el a1. 1989).
On average, the biparietal diameter grows from 7.5 to
10 mm on Day 40, to 23 10 26 mm around Day 70 and
to 40 to 45 mm al about Day 100.
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During lhe ""cond half of pregllancy the placen
\OmI..'S.apant'romthefe!u ... dominaICtOCsonogmphi<'
image(Fig,3,2Iltn3.31).Thi;isduewtheirlargenum-
..
tm:cnindj..idualpiacentomcs. TIlcyareoflcnthcfmt
posili.-e,ignnfpregna",:ythalbccome,evidentduring
an ultrasound =tminatKJn. The demonstration of 'ncir

i; sofflCiemmmakca di"Snc.;isuf"prcgnam".

cru.ra<:lcri,tic""""&,,,phicimagc.lniliallylhcyare nat
andbun"""'apcd.bulaspn:gnam)'progr .. """'theybe.
rome more (Fig, 3.29 and 3.30). The pc.
riphcral edge of the carunde lrulge.; up wilh thc ron-
Cl'.ilj-'direcroot"",aJ'(i<;thcfel",,))cpcndingonthe
IllgleoflhcSCCIioo.I""'l}picaJ imasesofplaccntomcs

IionslhrOllghplaccn(orncsMUltin'lickle,hape',
... -he",a, horiwmal SC<.1ions produce ring "'aped im
ilgt!'i.The lalterh."" an echoicperiphcral mnc and a
bypocchoicrenter.ShccpuwallyhavcbetWl.>cnWand

19S4).1bcdiffcre"""innumlx:r<;O;SOIlClgruphicallynot
ob-.-ious.
Manag<'l'l'of)arb""hccpflurtsoftena,ktileques-
Iion:WhcnisthetimeatwhichsoOOSraphOcpregnancy
examinations yield thc higltCSl possibleaccumcywhi!e
at the same timcproviding the """'""",oomicallyrcle.
.... nl informalion'l Transrulaneou, examinations wilh
.... apprupriate Ix:pcrfofTI\(;d al high speed
., large floc .. still )'icld reliable pregnancy diag
"""'-'S[rom lJay35 to4Uofp"'gllancy.TlJeoptimaJ
time for an acrumte diagnos;" and .unul
Ianeou'lly O)U,,( ing the numlxr"fft:tuses i, hetween
Da)"l453TldS5(BlJCKRElll<)I*l),AcruralepreSJlaOC)'
diagnoses caII still he made lhe lalerf>fagc:. ufprcg
I'regnammmlS 2115
naoc)'. As pregnancy progrc&SCS. lhe corooom
ical hetlCfil derived from applyingdifferentlal feeding
regimes for c"'e, or multiple fctuses
Jiminil;hc". WhereearlypregnaOC)'diagnoscsbetwttn
20 and 40 arc 1o be made. the mm.-rectal
approach should be chosen (Blioaun el aL 1986). AI
Ih;"timetheindividualexaminalionblIlOTCtimcoon
.... mingand lhe diagoc,,;is lc" ",-,-'Urmc panly due 10 the

3.3.2.4 Day 100 to 150 of pregnancy
Due tu it, heiter image quality, ullrao;oo.m(1 al 5 MHz
b best .... iled for p"'gnancy diagoco;cs JUIlof
pregnancy. TlJercaflcr, lhc use of 3.5 MHz ullrasono-
gmplty may Ix pr.,[erred, because it offers a larger
S<<lnning field wnich facilitatcs lhc.-isualizationofthc
largeroo",-,,-,pluscs. Al this stage the
all)'dispiaecdpart,ofthefelU'I,a'wcllasO)Unlingklal
numoo", "'" po<sible if thc animal, an: cxamin, .. <.l
transcutaneousiy. Even .... ilh ""nogm-
phyilmayoodiffll'Ulltoreliablyestahli'hthcoumhcrof
fetu"",afierDaylWofpregnancy.Thcfctus<,',arcnow
so large and lie"-OcloS<.'locach other thaI ithero=s
rathcrdirr ... 'UitloJ;stinguishhetweenthem
Ouringthe last trimeslerofprcgna!tcyonlythccau
dal ponion.of Ihc pregnant examinedb)-'
tmns!CClal "-""Waphy. DemolLslration of
;s possible in all ca",-,so Ihat lhe prcscro:coh prcgnan
he allh;"f>fab'C. Fctal body paru;
are,h<'N.-ever.r!Cqucnllyimpossibletodepictbylrans-
rectal sonogmphy. The latter prohlem oflcnlx:
"'l\-ed by elevating lhe ahdominal .... ali. but the depic

mainimpoo.sible.
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206 U1lmsollogrophy it! sheep ami goalS
Fig. 3.31: TrnnsreClal ultrnsonogrnm of Ihree placenlOmes of
a nasmy gool on D'JY 63 of pregnancy. Depending on the
dircclion of the SCdional plane the cup-shape of the p ~ n
lomes l'.iJl produce a vaneI}' of images.
Av s 0 Z " l ~
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3.3.2.5 Accuracy of sonogrdphic pregnancy
diagnosis
ThcultrdliOOndteclmiqucsprcviouslyw:o.ItQo.Ii.otg

<mlyyicklco.lsatisfacMy results
from
1981. Ho:sCllct ill. 1981. WAITet.l. 1984). Both



91\3, I .... NGiOKIJctal. 191>4). Undc:rfteldrondition.,
powl"VCr. it Ita:; bo.,.,n"oo...l1 thaI the IlOCum"), of the

:ty:I:!;U!
.... "}'

O"VIV 198Ii).ln manyca..:s tile application of





gnatot animals is wry high if the operator is;ode



nlifted during thc cxaminalion. This pmblem occu'"

lhe tno'l';n,ctai tcdmiquc the acruracy of the


Ikl\>-ccn [);I)'lI 40 and SO of pn.-gnaO<."}' Lhe aa:u1'llC)'
nfthc:pn!'ittvetnsn"""YdiagnoM!;(prediaiYev-..luellf

examinationslit:slUO<lnd<J5%.Af!crVay5(lLherc
liahilityin<:rca<;C510ovcr9'l%{fuVt"'1-MandWII-xn ......
l<J!I4. Tr.v(RNl!cI al. 1'J!l5.GE"ARlLARTtlul. 19S8.JAIl-
'ION 19A8).
Oncrca-;orlM"",aUmunbcrufl""l"1"lJllo<l\Jdiaj.;lLOiCS

vcrycarly pregnancycan:IUlJcrcmbryonit: Ior!f;and later
be counted II!< a !aLoe pooitr..: diagn05is. Additional
faI'JICp08itivcdiagnoscsmaybcmado: ... henpalho1ogical
lluidaccumulatiomintbeuterm,!-UdILrl<lC'."Urinp)\>'
01<:11"3, hydrometra and hydrallamrm (\C . are wrongly
im"rpr"ICd ofprqpIUOK.-Y. vcn n"id ll(X:umula-
tiom in tbe gul or in tbe atxlonten can lead 10 fuke
Equally. ""huic (any may
f:mclybeidentifoedMft:tal<lruc1.ures..
llJo.,5I;nsiti-.i lyofthcmcthodin<.>.lmXltyn:cognizing
allprqruonlanimakandtberteptiYepdict;"'VlIluc
arc.\OrTlCl'll\at Iowcr (80-90 %), bcca,* happ:n.
oa:asionallythat P"'gnant "mn",lollire idcntif ... -..t ;is
l1Ol1prcgnanl(fi',"-':K .. JJ etaI.1986).
Diffcrc!11iUlingbylran,,::ularn."1JUSiiOIlOgraphybc-
tVt-ecn singleton and mulliple pn:snancie; i5 ,..,tiably
poMiblcbo;lwccnl)ays45andlOOaOOllCCUI'lIC)'can
,..,adt 90 to 9S % {DI!BotsaodT"VONll 19114, WlIITE
cl al. I984. I'owlHlandWll.Kl!'CSI984. 1'ov;' -"Kand
WIUUNS 1'lSS, T"\"ElI..'<Ectai. DJI\"I!Y 1986.
l..or.t1E el al. 19S7). EITOI""S OOCUr ",ilh mtJ1' .... ing
frcqucncybcforc Day 45 and aflcr Day 100. 11 is\-.:ry
easy to make a mistake in dc:tennining whether an
animal;' CIt")";ng twins. lripk:ls or

lTaMm:la1 .. not well .ruled
fur OJUntingthe
0Ul usually only be attained from the 5th totbe 7th
-..-ccU of prcgnancy. lbcrcaficr. doc 10 tbe cranio\-en-
traldi<placcmentoftMute"",elTOl""Sllcrurmorefre..

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3.3.3 Uterine pathology
Pathological conditions of the Ulerus, such as py0-
metra, hydromctra and mucometra. and in case .. of
abnormal pregnancies, such as embryonic deaths, fetal
mummification. hydmllantois and hydramnion can all
be diagnosed by ultrasonography (BUCKRELL 1988.
GEARIIART et at. 1988).
Pyometra in the cwe is chamcterizcd by an int ra-
ut erine fluid accumulation which contains obvious re-
flections (Fig. 3.32). The echogcnicity of the fluid de-
pends on the rdllive llmount of cellular nmterial in thc
secretion. A snow-storm-like image is typical.
lbe tenn hydrometra in goalS signifies the accumu-
lation of large :lmounts of sterile fluid inside the uterus
in the presence of a persistent corpus [uteum and the
failure of the doc to cycle (PIEll!RSE and T,WERNE
1986). The ult rasound image in a case of hydrometr.t is
characterized by the large, hypoechoic fluid ,1C:rumulll -
tions insidc the utcrus (Fig. 3.33). Frequently, seveml
closely adjllccnt fluid filled cavities scpanncd by sec-
tions of thin uterine wall can be seen. This image origi-
nates from the coiling and kinking of the ut erine horns
which are filled with secretions and portions of which
fonn tightly lIppositioned loculcs. No fetlll echoes or
Uterine patholQfff 209
placcntomcs are present. Treatment with PGF2a usu-
ally leads to the prompt emptying of the uterus, but
small amounts of sonognlphicalty de\l.'CIable fluid may
remain for some time (Fig, 3.34).
Early C3.'iCS of hydrometra, where the amount of
fluid is nlIher small. can be confused with pregnancy
during sonographic examinations. In doubtful cases the
doc should be reexamined at least 40 days aftcr the last
service date. At this time a fetus should be dctectablc in
a pregnant doc and an accurate di agnosis can be estab-
lished (PnTIcRSE and TAVERNE 1986).
Dropsy of the fetal membranes includes those condi
tions in which there is a pathologiC'..I1 increase in the
amount of fetal fluids. as in hydrallantois and hydmm-
nion. In a C'.tSC of hydrallantois the sonogmphic exami-
mllion will rcvcal a uterus that is filled to the extreme
with anechoic fluid (Fig. 3.35). A ~ is the case in hydro-
metra. hypcrechoic sections of thc thin utcrine wall will
travcrse thc allantoic fluid. In order to diITercnti:l te be-
tween hydrallantois and hydmmnion on one h:lnd and
disturbances in non-pregnant animals (pyo- :lnd hydro-
metra) on the other onc should look for fewl structures.
Typically. in cases of dropsy of the fctlll membmncs.
placentomes and/or fetuses can be depictcd whereas
these :lrc not prescnt in cas(''S of pyo- and hydrometro.l.
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I
210 References
References to chapter 3
Bucu.w.., B. C (t9S8): Applications d in ,eptodllC-
tion in IhcqI am.! ptI. Thc:rlcsell!llocY 29, 71-84.
Bucuu., B. C , B. N. 8or< .. lTTand W. H. JOONJON (!986): The use
d lUItime uJlm.oond =WI, b urly prqnam:y in V p
n .. l ioJF", .... 1oQ 2$, 66' 673.
D..wu. C G. (1986): An C\'ahwion d prqnIIK)' _illl in shttp
Ulilll 1U1-ti_ ultl1llOUJld Autl . vet. J. 63, 347- J.4.!.
DEAl, D. W. (1977): P'rcJnant'y diqnosis in the ewe by ." uJtr1l1O" ic:
poobe. Roe.. 101, Ill-US.
Of: Bocs, C. H. W. en M. A. M. TAVW'lfI Dnl:hliJb:idoondc:f-
md; bij lid Khup D. M. V. echclsBfoe. Vlums
d>e1ccr E' Ik. TIjdscht. '3. 240-252.
00. ... C. G., B. A. WOLI'!I. E. BIiSSOIJDO and D. C. KAAEMEII (1989):
FoIliculu delection in goau by ulti'ltliqraphy. 1'herioJenoI0cy 31,
"'.
EYoVIs, H. E. and W. 0. SIO. (W1J) : PrmalallkYclopiiltl'll of dune-
Itic and IabonoIDf)' 1I\IIIUl1ab: Growth CIIrYeI, a1ml&l b lUm! and
5Cko:d .dbeuoe::., Zembl . \lei. Me<! . Reihe C 2. 11 ...... 5-
Fowt..u, D. G. and 1. F. W(U(JNS (1980): The identi(1Wion d linalc
and multiple bcarin& _ by ullrQOnic irrlaJina. Proc.. Aust. Soc.
Anim. Prod. IJ, 492 .
Fowt.Ea, D. G. and 1. P. WILKINS ( t98oi) : 0iqn0I.is d and
nwnbcr ol roctulel in abcqI by rcaItime ulllUOClk imqil1a. I. Effu
d number oll'ocnaKl. stIiC d gWMion. opc:nwr and ." I: , d_
on xtUl'k')' of Uvestock Production Science II , 437--450.
Fowwt , D. O. and J. F. Wlwm (1985) : DeYeIopina. rlCld IOCbnique
for liner ralmbcr durina prqnancy in 1Ihcc:p. Miscc:llancoo.lI
Bulktin 10. Ikp. of New South w.1c:s.
M. A. , W. E. WII'IGFlI!I.D. A. P. I(Jo,'l(lHT. J. A. SMmt, 0.
A. OUCIAtt. l . A. BooH aDd C. A. SroKf.s (1988): R".I-lime ufuuo.
qraphy for .. pIqllUIt)' IWuI and viabk kill numbm in
cwc:a. Ther;""""""", Xl. 323-337.
HAJau, O. K. aDd N. R. PJtxoo (1989): RuI time uluuonjc, biparic.-
1&1 diamclCr of talNid Suffolk ud FiM Ii:'fIIses aDd
prediction of Je$tlUonaI .. TMriq; idIocY 32, 86J 869.
HAIBEL. O. K., N. R. PEulss and O. M. lml. (1989): Breed differen
tU in biparinaJ diamd ... s ofsccOid trimester 1bgenburg. Nubian aDd
AnJOn. 10111 rctu.ea. 32. m-8J4.
IAlOON, C. (1988): Utiliu, ion Kt\IeIE .... de,. It' itN\, en
dIa Ia brdIis. R.tcl. Mid. v4!t. t.c. Aim 164, I35-MO.
JV,s ..... , B. (1988): Bc:iuq: tIIr Sonograp/lie in del" Cnlk""'livben
Diapostik, mr p, ' grIN" del" Orwvidilit bei SdJaf und
ncunpberichl . KrankJx:ilen del" kkincn W"ledertluer. der
DYQ, Oit&n n.6.1988.
K.url\l. B.. (1989) : UluuchlUwtlSllChu"l bei Ziqcn: Eine m __ lb-
Nee Methode :cur TrkhliPc
ius
nnelhlJ\&. lkt" Ziep:>wlchlCr ,.
I-U.
Klloa. O. 1., B. A. ATlUIOOf< and H. A. (1982) : ImpIanIa
lion and early pIai;e,ulion in donw::stic: u"",I*,. 1. Repioe!. Fa1.,
StIpp!. 31, 17-30.
u.."'<lfOlD. O. A J. N. B. P. S. FISD: . L. 0.
P. HEAHEY ud O. I. MAlCUS (t984) : impi ooeci diagnostic 1ttII/'IC)'
by rqJelilivc uilluonic: p.qnanc:y testi .. in sheep. Theriosmolol:Y ZI,
691-
UJoIMHL, I. L. (1969): ComparUon ofuilruonic IiedIniquea: for the
d' I: ' Iion of preJIWIC)' In C"o1lt1 J. Repn:d. Fer! . \8, 117-120.
Um:too.HL, I. L. (1971) : Prqnancy d.iaJnoW in the ewe by in!raR!CUI
Duy;Acr. J. Anim. Sci . 3Z. 922-9U
LooUII, D. N .. 1. T. HAu, S. McRoiem and A. WATUItOUSII (19!1) :
RuI-time ullfUOnic: in Wep: The of the lirst )UI"
of its appIicalion 011 farms in IOUth ... d Srolli nd. \Itt. R.tc. 121.
I46- W9.
Orr, R. s., W. F. BlAiJN. T. F. I..oCJc, M. A. MEMOIfaDd J. L.$'n::MIA-
TEll; (1981): A of intmt:aai Doppler aDd =1aI abdominaJ
for lCSIilll in pili. J. Am. n. mc:d. All. I7&.
7JO-73i.
o.."F.IQ, J. L. and 1. R. (198'): [)iq:nosis d IbeuJ number
in prolifIC 1Ihcc:p. Proc. N. Z. Soc. Anim. Prod. 4'. US-U7.
Ptero.se, M. C. aDd M. A. M. TAVDN! (1986): H)'drometrl in JOIIS:
witb real-time ullruoulld aDd lrtatmenl witb proscaatandins
lIT Olt)1Ocin. Theriogenology 26. 81l-821.
RrEaA, G. S. (1984): Somc: limilariticll aDd clitkrenc:a in female aDd
pi reproducIion. Proc. ll" 1111 . Conar. Anim. &. A. I. IV,
VIl- i - VIl-4.
RowsoN. L. E. A. and R. M. Mooa (\966) : DeYClopiikUI dthe Wep
oonotplWl .... ri .. the fi.- bil'lflen d.ys. J. AMI. 100, m _78S.
ROSCH, P. , M. BDIcInow lind L. Eoor.a (1981) : Du EdIoIoIverc.b-
mI mm beim SdJaf Un tur Ulln.
JdWI DoppIcrTc:dmik. TimmI. Umsd! . 36. 180-18&.
ScHnuooM, J. E. M. aDd M. A. M. TAVU1fl! (19"): A Uudy of the:
pregn&IIl liIerUI of the ewe and the: plllli .. real-time IlIIlUOUnd 1I:aII'
nina: aDd 'kI. Rca. Com. 9. 4S-j6,
ScHEPlE, K. M., O. EMEWtO lind L. MAAsHAu.. (1986): VaJIcic:bende
UnlCl1UChuna: lIIr TficlKi&Ice,lMIi,,1IOK beim Schlr. Mh. Mee!.
41, 158-160&.
TAll'I1lIlIflt, D.. L. 1..tJolJa. M. CHAAlIl. K. W. SAlIWAI'IA et B. DeNIs
(1983 a): de ]a rwm dIa ]a brebil pal" 6c:1JcJIomopphie.
Rrvue MM. 134. ,23-,26.
TAlImIalflt , D . L. 1IIOIIl, M. CHMlI, K. W. et J. L. U!
NIIT (l9!3b): OiaeooIIic de ]a i' a im dIa Ia chhre pal" 6cl ...... ,.,.
,rapIUe. Rrvue M6i. vtt . 134. m-m.
TAVfltNE, M. A. M .. M. C. LA'oOtN, R. V/lN OilD aDd O. C. \c\N oae
WR'o'OEN Accuncy of pqnano;:y and prediction d
foetal numbers in Wep with linear amy reaI--lime Ulll7HNnd JCaMinc-
The \bcriewy Quanc:ly 1, lS6-Z61
b"uop, M. J. and A. L. $l..YTElI (198J) : Pqnanc:y di .... is in the:
CWC'. 1. Anim. Sci . 57. 1-'.
WATT. B.. R., O. A. AADEUOII aDd I. P. CANI'8EU. (1984) ; A CIN,,,*"'
I0Il of m mcthocb; UKd for deliXl'na: prea:nancy in Jhco:p. AIm. n.
J. 61, )77- 38:2.
Wllrte, I. R. , A. 1. F. RIIS.5I. and 0. O. I'oWull (1984): RuI--lime
ultn_ic: seannina: in the ofprqnancy and the:
of fttIl numbers in sheep. 'kI. R.tc. IB. WO- W1
ellO (' adi '0
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212 U11rosollogrophy inpigs
FIg. 4. 1: Transcutaneous ultrasound examination ir, a pig. TIle
probe is applied just above the last three mammal)' glands.
fig. 4.3: For transrectal ul trasound examinations in pig1 the
linear probe and itscablc can be stiffened by a metal or
rod.
r ig. 4.2: Transrectal ultrasound examination in a pig. The
probe is diredcd from the outside by a guide rod (see
Fig. 43). introduced into the rectum and mtllled back and
forth O\'er the uterus and the ovaries.
SkO z. 10 ;I(
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4 Ultrasonography in pigs
In pigs pregnancy diagnosis by ultrasound tech-
niques have been utilized for many yeaffi. As in sheep
and goalS the non-imaging techniques, such as the ultra-
sound-Doppler (FRAsER et al. t 971,ISAKOv 1974) and
A-mode techniques (UNDAHL et al. 1975, O'REIUY
1976, PEJSAK and WIERZCIiOS 1981, BAL.KE and EL-
MORE 1982) were used for this purpose .

In recent years the imaging ultrasonography has
been used more frequently to di agnose pregnancies
(lNABA et al. 1983. BoTERO et al. 1984, IRtE et al. 1984,
CARTEE el al. 1985, TAVERNE et aJ. 1985, TAINTURIER
and MOYSAN 1985. JACKSON 1986).
4.1 Technique of ultrasOnography
in pigs
The imaging ultrasound technique can be used in the
pig by applying the probe to the skin of the ventral ab-
domen (transcutaneous' sonography) or by introduci ng
the probe into the rect um (transrectal sonography)
(CARTEE et aI. 1985, FRAUNHOlZ et al. 1989).
4.1.1 Transcutaneous sonography
For the transcutaneous sonographic scanning of the
SfJW the probe is held against the skin surface of the ven-
tral abdomen, just dorsal to the last three mammary
complexes. in the area from the attachments of the
mammary glands to 15 em funher dorsally (Fig. 4.1 ).
The probe is held in such a way that the sound plane lies
leve l and impacts perpendicularly onto the abdominal
wall and an area of about 20 by 15 em is scanned. Imag-
ing the pregnant uterus is achieved fastest if the hori -
zontally oriented scanning plane is rotated up and down
through the abdomen. Should the uterus not be detect-
Technique of u/lrasonography 213
ed init ially, the same procedure is repeated after mov-
ing the probe several centimeters in a cranial or caudal
direction. In order to depict the lert and right compo-
nents of the uterus and ovaries of pigs both sides of the
abdomen must be scanned. In doing this it is often pos-
sible to find both halves of the uterus, but it is often not
possible to differentiate between the left and the right
uteri ne horns. The full stomach and spiral colon often
push the uterus towards the right side of the abdomen
where it L ~ then usually easier to find.
Restrai ning methods or sedation of sows arc usually
unnecessary during either the transcutaneous or the
transrcctal scanning procedures. It is also not necess-1ry
to remove the hair in the area where the ul trasound
probe is held against the skin. The sows should be tied
up or held in a tight chute during the exami nation. Of-
fering them some feed may distract and calm them.
4.1.2 Transrectal sonography
During the transrcctal sonographic examination of
sows the probe is best manipulated from outside the
rectum after advancing it into the rectum and then r0-
tated O\'Cr the uterus (Fig. 4.2). Manipulating the probe
with one hand inside the rectum is often difficult and
can Stress the animals considembly. In order to be able
to manipulate the ultrasound probe from the outside.
the probe and its connecting cable must be stiffened.
For this purpose the probe and the cable arc tied to a 80
em long guide-rod made from a non-twisting material,
such as metal or plastic (Fig. 4.3). The rod encloses the
cable and the probe on 3 sides. leavi ng only the scan-
ning surface open. With the ai d of this rod the probe
can then be advanced and wi thdrawn or rotated in the
desired di rection inside the rectum (FRAUNI-tOLZ ct al.
1989).
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fill, 4.4: Multiple "'''l'''"' IUlea on an ">c';"':d """'1)' of a,.,.,..',
UllraJ<)O"'IP"m pmdOC<'d on , wa'crba,h


... T!1I.....aai

...
t>.um''''''''''''J'Of1lu\<.o
. .. .......

dcdinlhc""""h)pcrcdIoicOO'W18flpan:nrn,TnlLT ..........
Uluaillnognrn,
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Prior to the trnnsrcctal examination as much of the
feces as possible should be manually relllO'o'Cd from the
rectum. then the probe introduced and pu.<ohcd fOIVo'3rd
along the rect ill floor. If the probe becomes trnpped in a
rt.'dil l fold it may be helpful to initilllly guide it int o the
rectum for iI shon distance by enclosing it in a hand.
Depending on the size of the sow thut is to be examined.
its reproductive status and the organ that is targeted the
probe is advanced to a depth of about 30 to 40 em. The
dimensions of the probe used for this c.umination
should not exceed a .... idt h or height of 2 to 3 em and a
lenglh of 10 em. Provided the pl Ottdure is conducted
skillfully there is no need to be afraid of serious injuries
duri ng the examinil tion.
4.2 Ovarian structures in pigs
Using tr.msrcctal examinations it is frequcnt ly possi-
ble to sonographic-J.lly depict the porcine ovaries
(FRAUl'lIlOtZ 1988). The O\'3ricscan also be sc:mncd by
transcutaneous ult rasonography (MADEC et al. 1988.
WEITZE el al. 1989). The ()V"dries of both, non-pregnant
and pregnant sows can be depicted. Based on current
experience. it may sometimes be difficult and take lime
to find the ovaries on both sides of the body. In addi-
tion. when 50 ...... 5 are scanned transcutaneously. it is
necessal)' to ehange sides.
In general, follicles. corpora lulea and ovarian cyslS
can be sonographically depicted. The exact idcntifK:a'
tion and counting of the different functional structures
on the 0\131)' requires pract ice and may oft en bc possible
only to a limited extent.
Omriall stnlClIIres 215
4.2.1 Follicles and corpora lutea
Follicles are chumcterized by the anechoic follicular
fluid. Normally there are numerous follicles wi th diam
eters bct .... 'Ccn 1 :md 6 mm on the ovaries of so ..... s at all
stages of the estrous (:ycle (ScUNUIUUlUSCJI el ill. 1981).
A few days prior to ovulation larger follicles become vis
ible, so that during proestrus and estrus SC\'Crnl follicles
with diameters of 5 to II mm can be found (Fig. 4.6).
Confusion can be caused by the presence of hemor-
rhagic corpom luteD and Ihe larger blood vessels in the
vicinilY or the OV'dries. Cross sections through blood ves-
sels need to be sonogmphleal1y differentiated rrom fol
licles.
Usual1y most follicles in the pig reach ovula
tion. Only occasionally do large follicles and corpora lu
tea occur simultaneously. This may h:Lppcn during the
cycle as wel1 us in pregnancy.
Corpom lutea produce the echo typleal of luteal tis
sue (Fig. 4.4 and 4.5). Their sonographic cross section is
hypocchoic. The surrounding ovarian stroma is a li tt le
brighter. They are more difficult to recognize than fol-
licles. Since the)' lie \'cry close together on the owries
their numbers can usually only be estimated (Fig 4.7).
Luteinized and hemolThagic corpora lut ea can occur
simultaneously (MADEC et al. 1988). The size or cyclic
corporn lutea varies between 5 and 10 mm (SaINURR-
BUSCH et al. 198 1. MADEC et al. 1988). Corpora lutea of
pregnilncy can be I to 2 mm larger.
A,VI><
,
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by Dr.Stator & Saraajka
..... lllruughth<"",ry"'a"", ..... h tl&-U:Mu"opIe",,"UiiuI<)*,iaa., ...

..... 4 . 0:'. uh>(>lo',..,.' .. n<y<ina'O",Tbe<l>am<1cBOI .... 4.1I: 0',"',"'<)," .. ,1II1II"' ..... !_I)("'I)1"&_
",Ie< in a __ . pI\J<luu:<J In" ....
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4.2.2 Ovarian
In the larvr than 12 to 15 rnm on the
..... ..... 'arian
dcgt'lICmlionoccun;ina.ignirlCanlpcn"'Cnlugt:ofoider
"""""AnincldeOCl:()fhetv.-eenl(landI5%hM"'ptal.
Ily bccnfouml (V""'OOI'lA5SCI!E

... ilhlnorn.luccnl
walls and dear "uid cy.<ts "';Ih a Iu"';n--
i1rowal1that ilia fcwmillimc:tcn thiclc; and hcmor-
.... aJlandbloodyruntcnt:s
(Sc..."UkKlIIJStllClal.l981}.Oiariant)'$UOInbc
found in 1M presence of other follicle! rorpora
lutea. Iflheyan:si nglclhcyan:11Qt 'le<:(e',Mriiyron.
sidcrc<ltobcintcrfcringwithnurmalfc"iUt),undlht..-y

comidenobk size and oa:ur in the ab!lcna: uf>my
nnrmalfurlC'lionalOirucrul'e'<onlheowrie:'lthcyal'e


i7,c<l by their hypo or iRoe. splICe And hy the

f""" shout 15 mm 10 lO:v.:ral a.:nlimetcn
{f"ig.UI04.11}.ThcedJogenidlyofthenuilliJNdc
10 thaI !ll:Cn in normal follicle:!.-

mntain inneredloc!;(Fig. 4_1 I). 'The uhJ8!lOWld ,mage
from a kw

originatclromflbrinandroUu!,'l:n ... hi<:florg<.ni:tcsthc
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tll. 4. 12: r>.()l\i',ogn.m of'....,.,. Due I" ," t,\&.4.I.l:Cc" ... ul.,.,.. in flif,lnl
lOtI""", ""'U"' _ "" ... "'11It\1 ...... thmugh tbo t>om are d< "nc "".""d. l"!1c """u1 'IIIII' au," I .... """".1 QI'IIo
p;c.od il'lllSll-alwlr2O ... "",m (.rrooIUNII ... 'ndIngoou...-.lml.J\-.;1a1uk.,..,..."....
f" .. ..... ....
nail<)' lh<<1IIbr><>, .. ..,b" ....

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4.3 Uterine structures in pigs
4.3.1 Non-pregnant uterus
The non-pregnant uterus of the pig is difficult to rec-
ognizc with cenainty_ The uterine wall produces a fi ne-
ly granular, homogenous echo p..1t1ern (Fig_ 4.12). Due
to the lonuous nature of the ut erine horns their ultra-
sound images usually consist of several cross sections
through the horns. As long as the ut erus contains no
fluid it may be difficult to reliably identify it amongst the
loops of intestine.
Occasionally the cervix can be seen (Fig. 4. 13). The
cervical mucosa appears as an echoic line which follows
a winding or even zigzag course. This image is caused by
the typical pulvi ni cervicalisorthe pig's cervix. If the rer-
vieli canal is slightly open and contains some fluid a
curvy, poorly echoic band. surrounded by the more
echoic ccrvical wall will be visualized.
4.3.2 Pregnant uterus
4.3.2. 1 Before Day 20 of pregnancy
The earliest sonographie indicat ion for the presence
of pregmmt)' is the detection of embryonic fluid inside
the uterus. On the ultrasound image the fluid contents
Uterine stmclIIm 219
of the early conceptus will appear as anechoic areas in-
si de the ut erine lumen, and they will be surrounded by
the echoic ut eri ne W'III . If conception has taken pl ace,
one may occasionally sec the first signs of fluid accumu-
lations between Days 12 and 14 post insemination. De-
pending on the posi tion of the uterine horns, the direc-
tion of the sonographic plane and the number of con-
ceptuses, varying numbers of dark sections through
embryonic fluid may be detectable (BoTERO et al. 1984.
CARllOE et al. 1985. FRAUl"1I 0LZ et al. 1989). Between
Days 15 and 20 these anechoic areas reach di ameters of
10 to 20 mm (Fig. 4. 14). At the end of the third week of
pregnant)' echoic structures become evident inside the
anechoic fluid. These echoes originate from the em-
bryos and their surrounding amniotic membranes.
Ihe applic-dtion of ult rasonography for pregnant)'
diagnoses before Day 20 of pregnancy is not pr..actical.
False diagnoses cannot be avoided at thi .. stage. because
it may be impossible to detect any embryonic fluid in the
ut erus of pregnant sows at this lime ( INAUA et al. 1983).
4.3.2.2 Day 20 to 11 5 of pregnancy
The embryos l l ~ u a l l y become l\."'COgni1.able around
Day 20 of pregnant)' (Fig. 4.15) and Iheir hean beats
detectable a few days later (BoTERO et al. 1984, CAR-
TEE el a!. 1985, FRAUNIIOLZ et a!. 1989).
AvlC ~ o zasc ClO oradi ~ o
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220 Ultmsmrogmpl,y ill pigs
Fig. 4.16: Ulcrus of a sow on Day 26 of pregnancy. Thc cm
bl)'O is surrounded by ils amniotic sac (arrow). Its crown
rump-lengt h (CRL) measures 22 mm. TmnsrectaJ uhrnsono-
gr.tm.
1- 4.18: Ulcrus of a sow on Day 35 of pregnancy. The CRL
of Ihe fClus mell5urcs 31 mm. 1llC head (1-1 ) w;th bot h cyes.
front (a/TO'NS) :md the trunk can be identified.
Trnnscut:moous uhrnsonogram.

Fig. 4.17: Uterus of a sow on Day 27 of preg/Ulncy. A hyper
echoic pl accnml membrnne (a/TO'NS) is dri fling inside the an
echoic placental fluid. Tmnsrt.'C{al ultr.tSOnogrnm.
Fig. 4.19: Uorizontul section through the thorax of a porcil"lC
fc tuson Day 65 of prcgnancy.1llC h)'pcrecooie discs or the rib
cross sc.'Ctions fonn Ii cone. 1bc hean (marked by the crnsses)
lies in the apex of the oonc. Tmnscutanoous ult rasonogram.
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The crown-romp-length (CRL) of the embryos
measures approximately 8 to 10 mm around Day 20.
20 mm around Day 28 and 30 to 35 mm around Day 35
(Fig. 4.16 and 4.18). Thei r trunk diameter increases
from approximately 10 to 20 mm between Days 25 and
35 (MARTINAT-BOI rEet al. 1988).
During this period hypcrcchoic ponions of the felal
membranes can be seen drifting in Ihe embryonic nuid
(Fig. 4.17). During the funher course of the pregnancy
Ihe embryos show a veT)' rapid increase in size (Fig.
?regl/alll !Items 221
4.19). Thcy reach a CRL of 50 mm around Day 40 and
100 mm around Day 50 (Ull-REY et a!. 1%5, EVANS
imd SACK 1973).
Around Day 30 the contours of the embryos become
evident and the head. alxlomen and the extremities can
be differcmimed. In the weeks that follow several de-
veloping imemal organs can be idemified. The hypo-
echoic areas of lhe orbit and Slomach, the pulsating hean
and the echoic reflections of the rib cross sections and
Ihe venebrae are panicularly st riking (Fig, 4,)9to 4.2 1),
AvID ozasc
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222 UilfOSOllogmlJhy ill pigs
)o.g. 4.20: Horizont :.1 sect ion through the thorax of a porcine
fetus on Day 93 of pregnancy. IJchind Ihe hypcrcchoic rib
cross st"CIionslic the stom:lch (S) aud the heltn (1-1). Tronsrec-
tlil uhrolsonogram.
% SO j
5.0 MHz
trnnsrectal
Total 1-J
3.5 MHz

transcutaneous
4 S-8 9- 12
Weeks after insemination
)o.g. 4.21: Transrcctal ultrnsonogrdm of the head in a porciuc
fetus on Day 99 of pregnancy. The nose points to the left. the
eye (E) lies dorsally and to its right is the 0\'"011 cerebral cra-
nium. Tmnsrcctal ultmsonogrJm.
O
. 5.0 MHz
tranSCutaneous
13-16 not
inseminated
)oig. 4.22: The accul"lK1' ( . number of correct di .. gooscslnumber of di:.gnoses made)
of tr:msrcctal (5 MHz) and transcutaneous (3.5 and 5 MHz) ultr.iSOflography for
pregnancy diagnosis in pigs (adapted from FIL\UNHOlZ el aJ. 1989).
Ave 0 Z
'10 grad t
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4.3.23 Accuracy or sonogr.iphic pregnancy
diagnOOs
In<XJmp"rIsonlolhepre.iouslyu-.edullt3o;oond
lhe Amode and Doppler OIetllnd< lhe
imaging sonographic examinatkm pcrolilS An earlier
r.:liatlk:
'.:J;rtal. 1985.TAVERI'<'Eelai. 1'185).

l""&""ncydiagr'lCl'>isinbn;OO.
"'II iIOoS n:;.oealed that the method off.,r.;
more during......,o 3 and 4 of pregnancy
duc to ill hi&her3(nl""'Y (R,. 4.21). Thc accur .... )'ur
aU e.<tahlW>ed hy
during Week 4 c=<kxl 90 % el al
19119). II .... .." u!soshoJo,o,n that tUghcr fn:quency ultra_



lwI nosiptifw;anl efi"ecI on the IttIJracy of lhe 1""'-

irrespec!io...,of ... "hethcrtbc ap-
pruach"'a,lransrec.olortnMCUllu.e(l<6andthcfre
q""ncy ... 1982.

nant"' frum Week 4 ofpregnan-
<)' and the conclusion "pn:gnam" front Wed S. An
e...rt determi""'lkm of the rctl$."1 ill not
poMibk hy ultmonograpby (rl\lST\lRIt:J. and MoYSi\l<
1985).
' Ill<: diagno!.llC awriau.'d .. ith ullruono-
paphic eumination during early pn.1:JUI1k), largely de-
pend!lon the c.".pc"""",, oftbc aanllller. ror ",,,,,ral
pig pn ... 1iw il can be roncluded that

from Day JfI after troc lao;( in,."mi"',loo.

n.""'lbt..: .... -eenl);a)'!<22and24(I" ... IIA1.'1a1.1983.IN'IO
etal.I'Jll.4. T"'''''''Nh1.'1a1.1985. Hcm:ROcLaI.I986.
M"'knS"'T-nOt"!l!1.'1a1.1988).
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224 Rt'{tm.'lIca
Rererences to chapter 4
SALn, J. M. E . ..... It o. E' ...... ' (t982): Prqnatq di4'" in
swiM: A 1:1 the 1eChnique 1:1 m:tal palpMion ..... ulna
1OWId. Therklp:JIOklsy n. 231-236.
Bol'uo. 0 .. F. MAmNAY'Borrt et. F. (1984):
pr6:Ixc Ik p:lQlion par kho&raPhie d'ultra$O!U.. Journla Reeh. Fur
dM cn Francc. 16. 181-188.
BamIo, Q . F. MAmllAY Borrt ..... F. 8AAfT1!AU (1986): UK l:Iulll'll'
IOWId iaMi,. ialWlne bdt' : :Iioa and IOI'l1C patboIos).
cal eondiIkIns. TlCiiop:nnIncY 26.. 267- m
c...aru. R, E .. T, A, PowJ ..... R, L Ana (191$):
dncaioa 1:1 prqn&DC)' ill __ Mod. vet, Pnct. 66. 23-26,
famf. W, (1984): Die lysa06c: DcFtc.aion dai o.v. aIs 1eil dai
AnIIstn"."p\':7es tcim Schein. \te. mal, DiIt- , OXflc:e.
E""..,. H, Ii, ..... W. Q SIo: (W13) : PmIaaI dc-..:IOPliiuKI:I ebu.::-
Ilk and IabonIDr)' nwnmab; Growth C\l1'\U, alUilal t;:.b'reI .....
Kle+cled mC:lulCU. Zcntb/ , Vel. Med. Reihe C 2. 11-'15,
Fa.uu. A. F .. V, N,:!(IA .... nw.c and R. 8, CAUXXI, , (!97l): The com-
pithcllllvc UM: ulin ..... !! .. 1 in farm animal reprod\lc1iorl . \\:C.
Ree. 8& 202- 205.
Fa.o.tmoou, J. (1988): ZIit Il'&n$ftktalc:n und ItWISbllancn Sonosn
pIIie inde:r &ynlkoIn&iv'xn O,bl".,it \te. rrcd. Dia. ,
Milnden.
FiAuNHCU, I . W. KAHN WId W. l.lDL (19S9): in \\:lJle:ich lW;-
IriIm dt:t tranmktale:ll ulld traM""" lUI SOIqnphie lUI' TrI+::hti&-
keit!d
i
., .... - brim SdI.Cin. Mil . \te. Mcd, 44.
bI.u>.. T . Y. N. MATStIf and T. I ...... , (1983): Early prq.
na.q di4_i in IOWIby u.Ib II "'K citronic 1!CUIIIinI. The-
rkrnolOI.,., lO. 97- 0i.
I .. ! . M .. K. 0ttMar0 and S. KvMliOA (1984): OiaanoIis 1:1 prcpancy
in pip IJy lUI timc: ultrasonic 8-modc JeaII. Jap. J. ZOOIOClon. Sci . 55.
381- 388.
IsAKCW, D. (1m): Application de la ICCIIniquc uJuuoniquc (Doppler)
pour un diq:nottie P"!lOl.l Ik ,rwvidili! dai tnliea. Sen-a, An:h. Tier
hcUk. 1J6. lAS-1.5l
O. H. (1986); Prqnanty di..,...;. in die ",i,. lUI time
uIuuonk vannm,. \t"I . Roe. 119.
l..iNOM{l. I. L .. J. P. TO'5OI. P. A. and P. J. DzruK (!975):
Early di4i'C'til rt pcqnanty inlOWlby ultJuonic: llinpIinLd dejAb 1tIIi-
lysis. l . Anim. Sci. 40. 220-222.
MADEC, F . F. M.unllAT Borrt. Y. 1'-oM;arr, M. UI DMMAY et l,-c.
V AUtII!l.JIT (1988): UliliJIIlion de J'6choiornosraploie en
k l. Mid. &. Alfon Wi4. 117- 133.
MA ..... IIUI. A. W. and R. R. AsHOCJIIIiI'I (1967): QuanLitatlYe 01+: ....
lioN Oil pia: Cllob,)OI knoa'n ... J .,ric. Sci .. Carob.
">-<41.
MunMAT-Ilon 1, F . F. BAarnAu. M. l..utxO. Y. et To-
QUi (1988): Outil dcdi.,......it de .''Mim
Ia 1f\Iic. Reel. M6d .-fl, t.c. Allon 164. 119- 126.
O' Rm.LY. P. J. (miS): dh, __ " in pip by u/tratonit ampii
tilde dep;h anatyIis. A field co.alilMim. It . vet. 1. 1O, 16.S-161.
f'rN.K. l . and E. (1981): All early dJa&noW 1:1 pcqnanty
in IOWI by mcaI\J ulirUOiUcs. Mcd)q-r\l wei . 11. 139-1-41.
SoiHtlJ.UlJ5CH. U .. 1. BEIIGfEUl. K.- P' BaOssow .. lid U. KAu ..... f.JII
(1981): Schcmii Dlf OYattieutl+:i1uns tcim Schwcin, Mh. Med. 36.
811 - 8l5.
TAnmllJEa, D. et. F. MO\'$AIC (1985): Oiapoaic de: Ja I' ,"'ion par
Ja tnIie. Revue MM . .-fl. IJ6" 219-293.
T,,\VEa.ICll . M. A. M .. L. 0vtH0. M. \AM LfflsHour and A, H, WII,.
'IMS! (1915) : Pqnmty in pip: I roeld II1Idy
lincar-.nay lUI time ulm ..... ,nd V'lmli,. and ampl itude: dqItIo-'Y-
As. The VeteriJwy Quanmy 1. 17I-V&.
UuaIY. D. E . J. I. SPw.AoIJI!. Q E. Bean and E. R. M,u.u,
(1965): GiuwtII I:I the _inc Ii:h" J. AAim. Sci . lA, U6- 1I&.
M . J. SftHCDl"D" WId R. Bounu (1971): Die
zyA6Ie EieMIXbOqmmtion bcidu' SaIl . DlIc:h. ticdrUl . Wxhr. 78.

WEiTZI. K. P . Q HMilCii: . T. and D, RATH (1989):
lion 1:1 IMlIation in the lOW tII:ina Ir'lMcutanoouJ: JOnOSraphy. luehI
hyJienc 2-4. 40-42.
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by Dr.Stator & Saraajka
226 UlITUsollogmphy ill ,logs will etJ/s
t'lg, 5. 1: Sooogrnphy in a standing bitch U!iing a sector scan-
ner. The ute rus lies donial to the urinary bladder (U),
-
o
" ~ a g . 5.2: Sonography in 3 pregnant bitch in lateral recumben-
cy using a linear scanner. The uterus, in the lubular stage, lies
cranial to the urinary bladder (U).
Avlorsko zasl!:" eno gradivo
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Techlliqlle of IIlImsollogropi/)' 227
5 Ultrasonography in dogs and cats
The application of sonography during rcproductr.'C
and obstetric examinations is enjoying increasing popu-
larity in small animal pl1lctice. Imaging ultrasonography
frequently offers a suitable alternative to nadiologie-dl
examinations. It can thus contribute to a reduction in
the technical efforts and safety risks that are as<iOCiated
with radiogmphic examinations. In addition, sono-
graphy makes early pregnancy detection JX>SSiblc and
usually permits an assessment of the viability of the con-
ceptuses, Also in its applie-dtion to diagnose other
pathological conditions of the genital tract ultrasono-
graphy can be considered equally, or even more effec-
tive than other diagnostic techniques (PFoFFENBARGER
and FEENEY 1986).
5.1 Technique of ultrasonography in
dogs and cats
For reproductive and obstetric examinations in dogs
and cats transcutaneous sonography is used. The ultra-
sound probe is positioned externally against the abdo-
minal wall (Fig. 5.1 and 5. 2). A transrectal approach,
using small rectal probes adapted from human medi-
cine, appears feasible in larger bitches, but has not been
tested adequately in vcterinary pl1lctice.
Linear, sector and convex scanners are all sui table
for transcutaneous sonogmphy in dogs and cats. The
usc of 5 MHz scanners in small animals presents a use-
ful compromise between image quality and scanning
depth.
Of critical importance for optimal image quality is
the air-free coupling between the probe and the pa-
tient' s skin because hair is very disruptive. Before dogs
and cats are to be scanned a 5 to 8 em path should be
clipped betwecn the two rows of mammary glands, ex-
tending from the pubis to cranial of the umbilicus. Even
in dogs with few hairs clipping will improve the image
quality. Although one could omit the clipping of dogs
with a spanc coat, this may have disadvantages. If the
hair was not removed prior to the examination, in order
to achieve high image quality, the probe has to be
pressed more finnly against the skin and more coupling
gel needs to be applied. The coupling gel is
then more difficult to remO\'C after the examination. It
is also much more diffICUlt to handle probes with large
contact surfaces, mostly linear probes, on unclipped
dogs. Based on current experience dog owners tolerate
the clipping of hair between their dogs. mammary
glands quite well. Obese .mimais, even if their hair is
clipped, tend to provide unsat isfactory ultrasound im-
ages (TA VERNE et aJ. 1985). In lactating bitches as well
as those with inflammatory or neoplastic changes in the
mammary gland the approach through the linea alba
may be difficult. In such animals it will be beneficial to
position the probe above the mammary glands.
The sonogr.l.phic examination can be perfonned on
the standing or recumbent bitch without sedation (Fig.
5. 1 and 5. 2). Larger dogs should be ex..1mined while
they are standing. In this position the uterus will lie clos-
est 10 the ventral abdominal .... '3I1. it cannot easily escape
to a more lal eml position and is thus easiest to re:lch.
Also, animals that arc sick or in late pregnancy experi-
ence the least amount of stress and discomfort in this
position. Small dogs and cms arc easily exami ned in lat-
eral or dorsal recumbency (GONZEL and LONtNG 1983).
In pregnant females in dorsal recumbcncy it should be
borne in mind that the pressure of the feluses onto the
larger abdominal can interfere with circulation.
Forced respiration or panting can seriously affect the
stillness of the image and thus make its interprctalion
much more difficuh. Temporarily closing either the
mouth or the nostrils of the dog can reduce the di.<; luro.
ing eITect or respimtory movements, or momentarily
remove them.
AvlC zasc e 10 madi
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by Dr.Stator & Saraajka
228 Ultrasonognlphy in (logs ami ems
fo1g. S.J: Urinary blad&.! r (U) and nonpregnant uterus nt the
le.rel of the (amJl.\'S) in a bi tch. Using tl1l lL';(:lIlancous
sonography ""i th the beam directed \1:nlrodorsally wit h the
probe npplied to the \1:ntml abdomen, the nm:choic urimlry
bladder will be imaged close 10 the transducer and the uterus
will lie in the depth of the image.
Ag. 5.4: Trnnscut:ml'Ous viI::'>'.' of the urinal)' bladckr (U) and
the uterus in a bitch examined with!l !'CC\or SC3nncron D'ly 28
of pregnancy. Cranial to the bladder is a conceptus
AvlO sko zast 010 d
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In order to produce an image of the uterus the probe
is positioned tx:twecn the two rows of mammary glands.
Its beam is directed ventro-dors .. dly and it is placed
directly in front of the pubic bone. Following this tech-
nique it must be remembered that the image closest to
the probe originate from the ventml part of the abdo-
men, while the portion of the image furthest removed
from the probe corresponds to the tissues in the dorsal
abdomen. In contrast to the si tuation as it is seen during
transrectal scanning of cows and mares the images seen
in the trnnscutaneous examination appear to be upside-
down. During transrect al sonographic examinations the
ut erus usually lies dose to the probe and the urinary
bladder somewhat deeper. In contrast, during the tmns-
cutaneous sonographic ex<'lmination of the dog and cat
the urinary bladder will be dosest to the transducer with
the uterus in the depth of the image (Fig. 5.3). A sys-
tematic approach is essential if a thorough examination
L<; 10 be obtained. The sonographic examination of the
internal genitalia should proceed from C'cludaJ to crani-
al. First, the urinary bladder is identified inside the pel-
vis. It produces the typical image of a hollow. hypo-
Techniqlle of IIltrasonography 229
echoic organ and servcs as the reference point for the
examination. A full urinary bladder is preferred for
ultmsound examinations. The bladder is easier to find
when it is full and it acts 3.<; an .acoustic window, because
its fluid contents will cause the rel3live amplification of
the ultrasound passing through it and this faci litates the
im[lging of structures behind it. Dorsal to the urinary
bladder lies the rectum. In transverse section it pro-
duces [I round cross section with the surface dosest to
the transducer producing a bright and conVCl( image.
Due to the absorption of the sound waves by the rectal
contenL<;, an acoustic shadow usually origi nates behind
the rectum and runs into the depth of the image.
One should attempt to find the pregnant or path-
ological uterus in the area of the fundus of the urimuy
bl adder (Fig. 5.4). Using the bladder as reference point
this is usually possible by moving the scanning plane
from si de to side. In C'clts, and occasionnlly in dogs, in
dorsal recumbency the uterine horns C'cln lie fa r Intcml-
Iy. They can then be moved into the image by moderate
finger pressure onto the abdominal wall.
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230 Uilrasollogroph), in (logs ami eOiS
tig. 5.5: Sonogmm of a cani ne ovary with cystic disorder.
1be oval)' measures 10 by 8 by 7 em and contains numerous
\'CSirular structures of v"drying sizes.
rag. 5.7: Sonogr.Jm or an O'VlI rian tumor in a cal. 1lIc enlarged
oval)' (afTU',\"s) exhibits the heterogenous t.'Cq'Cnici ty of
mL"(ed tumor tissue.
.,1 . 1., . ., " .. "
FI3. 5.6: Photograph oflhc sectioned ovary from Fig. 55 after
the bitch was O'VlIriCClomized.
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5.2 Ovarian structures in dogs and cats
With currently available ult rasound equipment.
diagnostic ult rasonography of the canine and feline
ovary is largely limited to the detection of pathological
conditions. Follicles and corpora lutea which are
normally only a few millimeters in diameters arc too
small to be detect ed reliably by convent ional ult rasono-
graphy (ScHMIDT et al. 1986, PVCZAK 1990).
5.2.1 Ovarian tumors and cysts
Some palhological changes on the ovaries of dogs
and cats are sonographiC'd.lIy recognizable. Suitable indi-
Ol.'tuiall S(n/ctures 231
cations for the usc of sonography include ovarian tu-
mors and cysts (PJ:OFFENBARGER and FEENEY 1986,
$atMIDTet al. 1986).
Cystic ovaries in the bitch can produce ult rasono-
grams which appear honeycombed in struct ure and con-
tain numerous anechoic cavi ties (Fig. 5.5 and 5.6). The
cysts vary in size. are fluid filled and separated from one
another by thin. echoic walls. Some cysts may have a
polygonal shape.
In one case of an ovari an tumor in a cat the enlarged
ovary of heterogenous echogenicity was striking (Fig.
5.7). Large parts of the ovarian tumor were made up of
hypoechoic, solid tissue. In places anechoic. fluid-filled
struct ures were embedded in the tumor.
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232 U//f'(/IDllagrolH1), ill dogs wzd ems
J.1g. 5.8: Uterus of a bitch around Day 18 of pregnancy. "' be
ulerine wall in Ihe vicinilY of the cooccptus (arrows) appears
thkkcncd and surrounds a sm:11I anechoic fluid accumulalion
(to the right in this picture) of the urinary blad
der (U).
J.1g. 5. IU: Photograph of the c.xcised uterus of a C:lI around
Day 21 of pregnarK:Y. FIVe spherical bulges. eaeh containing
an embryo. are pl\."SCnt .
t1g. 5.9: Uterus of a bizch around Day 22 of pregnancy. Two
COOCCpluses (!llTo", .. s) lie dorsally and cranially (10 .he right
:lt1d below in the picture) or the urinal)' bladder. The uterine
wall surrounds anechoic fluid in which embryonic st nlctures
can be seen.
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5.3 Uterine structures in dogs and cats
Important indications for sonographic examinat ions
of dogs and cats include pregnancy diagnoses and the
recognition of pathologic-dl changcs of the uterus. The
non pregnant, inconspicuous uterus of the dog and cat
C'dnnot reliably be depicted with the image quality of
currently employed ult rasound equipmelll (INAI!A et al.
1984, ScHMIDT el al. 1986). Oa:asionally its sonogra-
phic image may be recognizable, but then it is difficult
to distinguish with confidence between the uterine
horns and the surrounding int estinal loops (DAVIDSON
et aJ. 1986). One exception is the postpartum uterus im-
mediately after parturition. It can be recognized on the
basis of its size and the identification of its characteristic
placent al wncs.
The sonographic features of the pregnant uterus of
the dog and cat are largely the same. For that reason
they will be discussed together in the follO\Ying section.
Particular mention will be made where important dif-
ferences between the species occur.
5.3.1 Pregnant uterus
5.3.1.1 Before Day 20 of pregnancy
If high resolution ultrasound is used it may occa-
sionally be possible to detect signs of pregnancy on the
ultrasonograms of the dog and cat before Day 20 of
pregnancy (Fig. 5.8). The sonographic basis for preg-
nancy hO\Yever, difficult and'relatively inac-
curate at stage, and is therefore not consi dered
worthwhile in general practice (MAIUlAC et aJ. 1980.
H et al. 1986). It been reported that hypocchoic
Uierine stn/Cll/res 233
areas of a fcw millimeters in diu meter could be found in
the regions of the developing conceptuses as early as
the second week of pregnancy (BoULET 1982, CARTEE
and ROWLES 1984). It is still being debated as 10
whether these areas represent the lrophoblasts them-
selves or whether they are areus of edematous swellings
(HOLST and 197 1). Also in the cat it was
reported that 2 to 3 mm anechoic areas of embryonic
fluid could be seen in the uterine lumen by Day 11 1014
of pregnancy and that the echoes of the developing
embr),os were detectable betwee n Days 15 and 20
(DAVIDSON ct al. 1986).
5.3. 1.2 Day 20 10 30 of pregnancy
From Day 20 of gestation I it beromes possible. un-
der practical conditions. to diagnose a pregnancy by so-
nography in the bi tch and the queen (MAIUlAC et a!.
1980. LAIBUN et al. 1982, MAI UIAC 1982, SIIlI.LE and
GOI\'TAREK 1985, FLOCKIGER et a!. 1988).
The conceptuses which arc filled with hypoechoic
embryonic fluid C'..In be seen on the ultrasound monilor
(Legrand et al. 1982). They arc surrounded by the
echoic uteri ne w..I1I (Fig. 5.9). The development of am-
pul1ae is characteristic for the stage bet .... 'Ccn Days 20
and 30. At this time the ampulhle of the bitch are ovoid
in shape. On a longitudinal vicw they produce an oval
image and a circular one in a tr.msvcrsc view. In the cat
the ampullae are spherical at this stage (Fig. 5.10).
When the ampullae fi rst become visible they often do
not contain any internal embryonic echoes. Usually the
more caudally positioned ampul1ae (nearer the urinary
bladder) arc easier to find than those Ihm lie in the cr.1-
nial abdomen.
I In this chllp1<:r all tllc data on lhe !;Iagc: of prrgnancy "-crr ba!.cd on
.he day of panurition. IIli far IIli Ihis " 'as "1100"11. Day 0 - Day of panus
minus 63. For the: dog th" approach pmo.ido.he IOO:'it accumlc
lion of the aact gatDtional under pn>l.'licil conditions.. If it ....... im.
\0 baddulC. lhe day of the filSl !!C,,'icc or ill!!Cmination ... -as
takcn Dar O.
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234 U1tfTUo/logmplt)' ill dogs and cars
14()
12 0
100
E 8
E
0
60
40
20
o
20
Longiludinal

K
Transverse diameler
25 30 3l 40 45 50 55
Days of pregnancy
60
"
.. Ig. S. I1: 11lc incrca.'iC:S in the longitudinal and trdrn.verse diameters of
embryonic and fe t:11 \-,:sicles during pn;gnancy in bitehes
adapted from p.,.CL.AJ( \990).
tlg. 5.12: Tmnsvcr.;c SCCIion through a bitchs urinary bladder
two bkxxl \'CMCIs (arroo-s) running dorsally to it . Cross
sections through blood vessels can be confused .... i th concep-
tuses. Examination in three dimensions makes the differen-
tiation easier by n.. ... 'Caling the longitudinal course of blood
vessels; see Fig. 5.13.
rzg. 5. 13: Longi tudinal SCCIion through a bitchs urinary blad-
der wit h a blood \"eSSe1 dors.-.11y to it (see also Fig.
5. 12).
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On Day 20 the conceptuses have an inner diameter
of 10 to 20 mm. In bitches they grow to a mean size of
20 by 40 mm by about Day 30 (Fig. 5. 11 ). These sizes
are meant to serve as guidelines and may vary consider-
ably between bitches of different breeds. The concep-
tuses of cats have approximately the same sizes as those
of bitches (MA1LHAC et al. 1980).
Under practice oonditions a reliable pregnancy diag-
nosis using 5 MHz uhrnsound is possible in most cases
from Day 25 of gestation (TAVERNE et al. 1985, Fl.OCKI-
GER et al. 1988, PVCZAK 1990). A1lhough it appears
possible at an earlier stage in some cases it must be TC-
membered that the breeding date in dogs can differ
considerably from the ovulation date and it is thus diffi -
cult to accurately establish gestational age in dogs.
Matings performed several days prior to ovulation can
result in pregnancies. When examined ultrasonographi-
cally the conceptuses in such cases will be less developed
and will not have attained the size expected based on
PregllOnlllfenlS 235
the breeding date. This can lead to fal<;c negative diag-
noses in cases where the pregnancy diagnosis is pe:r-
fonned very early. Use of the 1cw.'CT frequency of
3.5 MHz or less may mean the time of the earliest
possible pregnancy diagnosis can be delayed by a few
days (GONzELand LONING 1983).
In order to avoid misdiagnoses, other nuid fi lled
bodies must be differentiated from conceptuses. In par-
ticular, blood vessels and loops of intestine that run in
the vicinity of the urinary bladder must be considered.
The cross sections through larger blood vessels adjacent
to the uterus can appear very similar to young concep-
tuses (Fig. 5. 12). Questionable images should be depict-
ed in 3 dimensions in order to identify them correctly.
Rotation of the transducer will reveal the longitudinal
shape of a blood vessel (Fig. 5.1 3) and the spherical
shape of a conceptus (Fig. 5. 14). The pulsation of a
blood vessel and the pcri"taitic movements in a gut loop
will also aid the difrcrentiation.
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236 UilmSOllograplJy ill dogs and cats
t1g. 5. 14: U l c m ~ of a bllch around Day 24 of pregnancy.
Mcmbr:mcs of (he yolk s,'1CS can be seen insldc the two em
bryonic \'csiclcs (llrTOl'o'S) which lie dol'Sll llo the urinal)' blad
der (below (he urinal)' bladder In the picture).
Fig. 5.1 5: Concept us of a bitch around D-JY 27 of pregnancy.
A longitudinal S1ion of Ihe elnbryo with its head (H) and its
yolk sac (Y) can be secn inside the vesicle. Ultrnsonogrnm
producW in a watcrbath.
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A dar" aflcr the amccpluscs bcoxne!WlOO-

side the cmhryouic ,;,:side.. will happen
octween Days 20 and 25 of prcgn""'-y (Fig. 5.9 ind
5. 14). "Thcsr.:ec/>oMrnnn;pl\SCnttheembtyooro:Jm_
poncnlSuflheyoiksac(fig. S. IS). lrNdethccmbryonic:
/'1rgtummmu 237
cclJo.:saheanl'lcal,.ilJbecomedelCCtllblcb.,t""",n
Oayo;28and30(llQsocsr""'clal.]\III1). Theklcation
OflhcpulsalingheartCMuidinlhediffereolialioooc-
l ....... ..,n yolk sac aoo cmhryo.
"Thf.:char ..... 1cm.ic:cresttnl.n.rpeuflhecmhryoand
its longitudinal hodyaxillcan be r=lV'ilcd oc"",..,n
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I
238 Ullrasonography in (logs (/lid CQts
f1&. 5.16: Fel ine ronccptus around Day 25 of pregnancy. The
embryo. in longitudinal SCCIion, lies with its hClld (arrow) 10-
wurds the right insKk: the ' "<:side. Measuring litc CTl:Mll-rump-
length (CRt) is poMiblc.
180
160
140
120
E 100
E
80
60
40
20
0
20 25
AU
Bitches
>20kg
Bitches
S 20"
30 35 40 45 SO !is
Days of pregnancy
60 .,
fig. 5.1 7: 1bc increase in crown-romp-lengths of canine fetuses in bi tches
of different body weights (regressions: adapted from PYC2.AK 1990).
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Days 25 and 30. In dog.o; and cats onc can now slart 10
measure thc crownrump-l ength of the fetuses (Fig.
5. 16 and 5. 17). Caninc fctuses will have a CRL of be-
tween 20 and 25 mm at about Day 30 (CARTEE nnd
RO ..... 1.ES 1984). Felinc fetuses will also reach a size of
20-25 mm belv.'Ccn Days 25 and 30 (DAVIDSON ct at
1986).
5.3.1.3 Day 31 1050 of pregnancy
At around Day 30 the fetal vesicles start to elongatc
and become more ovoid and elongated, both in the
bitch and cat (PVClAK 1990). The ampullary shape of
the uterus starts to diminish from Day 35 -40 and
changcs 10 a morc tubular shape (Fig. 5.18). This will
bring aboul noticeable changcs in thc sonographic
FIg. 5.18: Photograph or the excised uterus of a bitch around
Day 35 of pregnancy. At about this time the ampullar appear-
ance of the uterus precedes the tubular stage.
Preg1l011f ute",s 239
fe:ltures of the pregnant uterus. From now on it will be
difficult. if nOI impossible, to follow the string of neigh-
bouring conceptuses on a longi tudinal section of a
si ngle uterine hom. Due to the strong coili ng of the
uterine homs the conceptuses of bot h horns can now lie
next to one another in unpredictable ways. Also the ex
pansion of the individual fetal vesicles shows that their
ampullary shape is disappearing (Fig. 5.1 9). The an-
echoic fluid collections around individual fetuses in-
creases more rJpidly in the longitudinal direction as
compared 10 the cross section (Fig. 5.1 1). By Day 35 to
40 they reach inner trdnsverse dinmelcn; of 25 to 35 mm
and inner longitudinal diameters of 60 to 80 mm
(SHIUE and GONTAREK 1985).
f1. 5.19: Uterus of a bitch around Day 34 of pregnancy. The
fetus. surrounded by the amniotic mcmbr.mc (alT(J\Ol"s) lies
with its head tOW<lrtis the right inside the fetal \-csicle. The
concept uses assume an OV"".t1 shape at this stage.
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240 Ultrasonography in dogs ami cats

. . . , . . .. . . . .. .
5.20: l'OOtogroph of a conceptus that was removed from
the uterus of li bitch at around Day 4\ of pregnancy. The fe
tus. cnn:lopcd by its allantoic sac (A). is surrounded by the fe
lal component of the zonal)' pl acenta,
rig. S.12: Concept us of a bitch in week 5 of pregnancy. En-
closed in the zonal)' placenta (arrov.'S) is the fetus (sagiual
section) with its head towards the right; below itl ics the yolk
sac (Y).
.lg. S.2 1: Conceptus of a bi tch around Day 35 of prcgnarlC)',
1bc fetus lies with its head the left within the zonary
placenta. The edges of the placenta arc curlcd on their mar-
gins (arrows) to l"C'iult in their bowl like shapes. UltmsollO-
Ilf'JIT1 produced in a ""'lItemlth.
"

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Along with the longitudinal expansion of the fetal
SICS the zonal)' pl acenta become apparent (fig. 5.20).
In the middle of the vesicle the zonary placenta forms a
cylinder surrounding the embryo or fetus. It i. .. secn as a
finely granular structure of moderate cchogenidty (Fig.
5.21). While the placenta occupies virtually the entire
surface area of the fetal membranes during the early
ampullary stage it IlOYI only covers the central area of
each conceptus afler Day 30. Through their elongation
the vesicles' ends remain free of pl acent a. In these areas
the uterine wall appears thin. Over almost its whole
width the zonary placenta lies closely adherent to the
endometrium. Only ncar their edges the zonal)' placen.
ta curl away from the endometrium and project slightly
into the uterine lumen. On longi tudinal ultrasound im
ages of the uterine horns the zonary pl acenta with their
bowlshaped edges can be rcrog.nized. The pl acenta is
thicker than the uterine wall.
Pn.'gnallf menu 241
The fetuses are suspended inside their surrounding
zonal)' plllccnta (Fig. 5.22). The yolk sac also lies within
the 7.on:(1)' placenta. It is ,",,'CII de\'Clopcd in the dog and
remains present until the end of pregnancy. On longitu
dinal sections through the uterus it can be seen as an ex
tended, echoic tube. It extends over almost the entire
length of the conceptus and thus reaches beyond the
end .. of the pl acental bands.
From Day 30 of gestation the contours of the fetuses
become discernible (Fig. 5.22). The head and rump can
be distinguished and the limbs are visible as echoic
buds. If it is possible \0 obscn'C individual fetuses for
some time one will already be able to sec some active fc
tal movements (GONZEL and LONL:-:G 1983, C\R1'EE
and R OWlS 1984).
From Day 35 to 40 organogenesis in canine and
feline fetuses has progressed so far that one can rccog
ni7.c deve loping organs insi de their bodies. Inside the
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242 Ultrasonography ill dogs (/lid et/fs
fig . .5.23: ]']orizonla] section through a fetus of a bitch around
Day 41 ofprcgnancy. The head ]icson the left. Caudal ly to the
hypcrechoic nb cross sections of the left thoracic waill ics the
anechoic lumen of the stomach (arrow).
Fig. 5.25: Horizontal section through a canine fetus around
Day 46 of gestation. The hypercchoic rib cross sections of the
two halves of the form a cone shaped plI t1cm. An
echoic heart chambers can be seen in the apex of the
.-11' 5.24: Horizontal se<:tion through a canine fetus around
Day 46 of pregnancy. The curved echo of the diaphragm OUI-
lines Ihat of Ihe liver. The anechoic area in the caudal abdo-
men repfCSCnts the urinary bladder. Ult rnsonogrJ.m produced
in (I watcroat h.
, ,
, ,
E"
E
, ,
,
0
,
0
T-
t runk
l
71
II

Rib with one
intercostal space
w .3 w
Days of pregnancy
Fig. 5.26: The incrca.'iCS in trunk. bipllricla] and cardiac
diameters as well as the length of one rib cross section and one
intercost:IJ sp.1ce in cani ne fetuses during pregnancy (regres-
sions; ,Icmptcd from P'!O ...... '" 1990).
SkO z. 10 ad 0
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abdomen the large dark area of the stomach easily
identified (BoNDa TAM et al. 1983, I NAIl;\. et al. 1984,
NOMURA 1984). The liquid gastric contents are largely
anechoic (Fig. 5.23). Next to it lies the modcrdtely
echoic area of the liver. The next, smaller anechoic area
in the caudal abdomen is that of the urinary bl<ldder
(Fig. 5.24). The onset of mineralization of the bones in-
creases their cchogenicity from Day 35 to 45. The facial
bones (Fig. 5.19, 5.21, 5.22) and the discs of the verte-
brae and rib cross sections (Fig. 5.25) are the first to be-
come visible. Initi ally the sound absorption by the devel-
oping bones is so minor that no echo shadows are cre-
ated in their backgrounds.
Both Ixxly halves need 10 be scanned very carefully
if the litter size of a bilch is 10 be determined by ultra-
sonography. Counting the number of fet uses <lnd as-
signing each fetus to <I specific uterine hom is difficult
on a sagittal CXllmination plane. The transverse section
is more suitable to ensure , 10 optimal orientation and a
clear distinction between the uterine horns. By tipping
the transducer from the left to the right si de and back it
is possible to view bolh si des virtually simultaneously. If
the transverse view L'I maintained and the transducer is
rotated [rom cranial 10 caudal, the number of fetuses
can be counted most accurately. By continuously, yet
slowly, moving the transducer one fetus after the next
will come into view. Even with this procedure errors oc-
cur. The number of expected pups can only be deter-
mined with reasonable accuracy in small liners (BoN-
OESTAM et al. 1984). In geneml , the accumcy of the
fetal count decreases with increasing litter size (BoN-
Pregl/alll /Items 243
OESTAM et al. 1983, SIIIU.E and GONTAREK 1985, TOAI.
et al. 1986).
In dogs it is also possible to as..'iCS.'I the development
of the conceptuses and the gestational age by fetometry
(Fig. 5.26). Thus far data have been collected for the
following pardmeters: Crown-rump-l ength and bipari-
ctlli. abdominal and cardiac di ameters, as ..... cll as the
size of one rib cross section with one intercostal space
(CARTEE and ROWLES 1984, PvCZAK 1990). The ultm-
sonogmphically measured crown-rump-lengths largely
correspond to those obtained after removal of the fetus-
es from the uterus (EVANS and SACK 1973). The estab-
lished v:t1ues represent average sizes for different breeds
of dogs. They are intended as guide line values and
can vary considerably with the breed of the individual
bitch. Separating the data for large (> 20 kg) and small
(20 kg) bitches shows distinct differencc.'I with regard to
the growth in Icngt h of the fetuses. For examplc, the
Icngth of fctuses of large breeds will be about 70 mm on
the Day 40 of gestation which is 15 mm more than the
corresponding value of 55 mm for small dogs. As the
use of ultmsonography spreads, it is anticipated that
more exact data on the felal growth of dogs and of
the various breeds will become available. Fetal diag-
nostics, and wit h them the determination of gestation:!1
age, will then become a great deal more refined in dogs.
Very little daw is available on the crown-rump-
length of feline fetuses (OW.tsn;\NSEN and
1982). They have a mean Icngth of about 3.5 em on Day
35, 6.5 em on Day 40, 8.0 em on Day 45, 10 em on Day
50 and 11.5 em on Day 55.
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... S.19, p"" pattum ut.'t .. , """da)' ahcrpartunliQd. One
"to be r<O>l\"iud in<ide ,I>< u""'"
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5.3.1.4 Day51 lu 65 ufpregnancy
lnrclativc\cntlS\hcamounloffctalfluiddccrca.'>eS
duringtht:la.o;ttrimestcrafpregna",:ywth"tthcfetuscs
no looger float inside the uterus (Fig. 5.27). but instead

(lM!lll l}ClaI.1982).Fctalflu;dcaoonl)be .. cncranial.
lyandcamJailylathcfctuSl."S.Sinccthcprcgnan<.)"isOOl
characterizedb)'lhemntraslbetweentheanechoicfelai
fluidandtbeeciloicfclalref\cction..in.o;ideil,ilmaybe.
CQ01Cdilflcuit to Jistingui'lh fetal from matemal ti'iM'cs.
ncad COI<:O!ptu'!CS, in partic"lar. may be overlooked
duringh""tycl<3lnination..
Duringthc las! trimcslcrofprcgnatl()'mo<t fet uses
<,moo( be <lepic,cd in 1010 an the muni!or. N ...... the

of panial measuren .. nt. (e.g. from cmwnlO heart base
+ from heart ooscto mmp)
5.3.1.5 0bstetric diagnustics
In the oh/ae!rical conten. ullra"'nography is avalua-
hie diagnostic tool for the offctal viability in

andFH;s[YI9R6,ScHM1DTelaI.191!6)wilh thedepic-
ti<lnnflhepuL"'tinghcananimrortanlcritcrioninthi,
I'r.gnanlUlnW 245
TCgaru.lnuJdilion.thcnumber"nJpo6itionoflhcfc
11l. .... shnuldbea........sedduringlhcobsletricexarnirnl
l>on. Sonogrophic <;Canning ,,ill u<U.all yoonlnbule ';g-

tionisimlicatcdornot.
Inlheca",ofa dead fetus a frequem irnp""""'-'n "
thai the fetll< ha.. adopted an unphysinklgicpoMll'" in-
siJcthc utcrus. Its Iorlgitl.l<liool axis appcars Jistinctly
bem.lnromparisontolivefetusesthewtlincofd .... "J


oo.crvoowithio ooe Jay of fetal dcUlh(O"VID5ONCt 1

5.3.I.ti Postpanum uterus
Afkrparturitionth .... poo1panummcruso(lhcbiICh
runbesonographicallydepicted.ltislCCnasabroaJ.
echoic hand "hich mo.'pastlhe
lcndscranially iototh<: aWomcn (Fig. 5.29), h,,,,,o<>-
gJaphic Slru<.1urc consists ofHl1 .... m"ling Hrca> of hypo-
cchoicandcchoiclis.-;ues, The echoic areas reprcscnt
Ihc brnad uterineromponem,oflhe.il'" oflhe pre
,iousplaccntHtion(PnLAJ;l990)
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246 U/lrrlSOllogralHIY ill dogs and cars
"' ig. S.JO: Embl)'Onic death in a bitt h around Day 22 of preg-
nancy. The pear shape of the concept us 10 the right of the
urinary bladder is e\fident.
n,. S.JI: Embl)'Onic death in a bit eh around Day 26 of preg-
nancy. No embryonic Strocturescould Dc: found inside the em-
bryonic vesicle (all'O\o\'S). !-"'our other conceptuses did contain
embr)'onic echoes; four In'c pups were born.
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5.3.2 Uterine pathology
5.3.2.1 Embryonic death
()ccm:ionally an embryonic mortality can be sonogra-
phically observed in a biteh (TAVERNE et al. 1985). The
result ing rcsorptions may involve individual ooncep-
tuses or the entire liller. Ultrasound examination dur-
ing the ampullary stage of early gestation reveals that
the conceptuses usually have a spherical to ovoid
shape. In some cases of embryonic rcsorptions it was
noticed that some embryonic vesicles developed dif-
fe rent shapes. Some of them .... 'ere obviously more flat ,
appeared fl accid and they became irregular in shape.
occasionally developing pointed ends (Fig. 5.30). Such
Uterille pathofogy 247
vesicles were also smaller than the neighboring, live
ones or WdS to be expected based on the mat ing date.
Apart from the above, oonccptuses al Day 25 10 35
have been seen to oontain no or only small internal em-
bryonic echoes (Fig. 5.31). When such abnormally
shaped or sized concepllL'iCS as well as conceptuses
without internal embryonic echoes were follCM'Cd dur-
ing the further oourse of the pregnancy they were secn
to become progressivcly smaller until they eventually
disappeared. In those C".lSCS where an embryonic death
had been diagnosed in most C".l.SCS it only affected single
oonceptuscs; the remainder of the litter continued 10
develop unC\'Cntfully.
Avtorsko z a s ~ ellO gradivo
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by Dr.Stator & Saraajka
248 UllfflSOlIOl,'Trlphy j ll dogs ami cats
Fig, 5.32: Pyometra in :1 bitch. Thc utcrinc lumen is dillll cd 10
sc\'cral centimctcrs. Duc to the very lon uous naturc or the
utcrine horns the ult rasound beam hit SC\'Cml wall sections
(arTOl'o'S). 1bc uterus appears panitioned.
Fig, 5.33: Photograph of an excised pyomctra of II bitch. The
utcrus shows pscudo.lmpullll r dilations.
AvlO SkO zasc 10 radivo
,
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by Dr.Stator & Saraajka
I
5.3.2.2 Pyometra, endometritis,
cystic glandular hyperplasia
An imponan! indication for ultrasonography in
bitches and cats is the detection of pathological condi-
tions of the uterus. These include pyometra. endometri-
tis and C)'SIie glandular hyperplasia and their transitional
fonns.
The recognition of markedly nuidfilled pyometras
in bitches and cats is easy (SoiMIDT et al. 1986. PvCZAK
1990). In .... 'Cll developed pyometras the accumulated
Ouid leads to severe dL .. tention of the uterus (Fig. 5.32).
Frequently. the uterus does not produce an image of a
long, nuid filled tube, but rather shows thin sections of
uterine wall appearing inside the nuid at irregular inter
vals and creating a compartmentalized image of the
uterus. This image origi nates from the severe IWisting in
tbe uterine horns. sections of whkh. sometimes com-
pletely kinked. come to lie close together. The echo-
Uten'ne pathology 249
genicity of the pyometra exudate varies between almost
anechoic and moderately echok (KOMAREK 1986,
PFo':l :ENDARGER and FEENEY J 986). It primarily de-
pends on the degree of cellularity of the exudate. From
a differential diagnostic point of view the pyometra
must be differentiated from the hcmometra. The ultra-
sonogram is not of much help when making the dif-
ferentiation. The clinical examination has to provide
the conclusive decision in these cases et al.
1986).
Pyometras with ampullary di lations of the uterine
horns can also be found. These pseudoampul1ae can be
si ngle or multiple and uni- or bilateral (Fig. 5.33). Pya-
metras with these ampullary dilations can be confused
with early pregnancies (PvCZAK 1990). When attempt-
ing to differentiate between the two the presencc of
embryonic or fetal eehoes inside the nuid will support a
positive pregnancy diagnosis.
Avbr koza
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by Dr.Stator & Saraajka
250 Ultrasollography ill dogs alltl ems
tig. 5.J4: Trol lJSV(:r.;c sc,",ion through the pclvk area or a bitch
suffering from endometrit is. A cross sc.:ction through 11 ut erine
hom (arrows) is secn next to the urinary bladder. The hom
has a thickened walland contains a small amount of cxudatc.
tlg. 5.35: Ultrasonogram of a bileh gUI loops (ar-
rows) filled with "'Ulery contents. The nuid filled intestine
must be differentiated rrom :1 uterus :lffeC!cd by inn:lmmatory
changes.
fIg. 5.36: Cystic glandular hypcrptas.ia of the endometrium. A
longitudinal section through one uterine hom (UJ'TO\\.'S) shows
modcroltc. hypocehoic changes in wall.
Av s 0 10 ra vo
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by Dr.Stator & Saraajka

!e<:\cd ins,"" lhe Ouidora Jl)\.'ffietru. l\<.<;uc
from the: u!erinc"'3II. wch!l'l polyps and !Um'XH3JI be
llIeca"""ofsuchimugt$.
In"","",ofpyOmelralhe utcriocw;tll can he: vcry
. lfRnendomc.'tritiswi!h

woogrammay.oowar.t>\.'relythickellO.'d, cchoicuter-
inewaUwilh tile11Xlf'Oi.'hypocchoiccxudatc,n.;,li.:i"
lumen (Fig. 5.34). eas.". 01 without any
ck.'aTfluidll(O.J/TIulation!;RredifflCll1t\udiaSJl("'l.'OO


(rom pyorn<:tr""(F,,, 5,35). ' I'bt Cllnine abdomcn ron
taininggu! Ioo[>!fiTi<:,lwl!h ,'cryli<juidiog.:staClmocc;t
Nronallypruduccanultl1l""'lOllrnmsimillU"tn.andea.y
IOwnr"", "'ilh. a IJIllClr . Inc:aseooldnubt it is im
ponam 10 i&:ntii'y.p",rcrdbiy in CI"OtIS1iC.'C'\ion. rwo fluid
fllkd \h(: level of\h(: HpcXoIthc urinarybiad-
de . lk:<c then he mon; ronfidenlly identified R,

l1lI:abilitytooc-pidC)O>ticglandularhypcrplilSiann

"",lri<l1 rysto and. if present. lhe amount of any ItOCIIITIU-
IatcdOuid(Ycv.o; l990). ' I'btde!liooolllusmod,-
!ionisvnlysucce.o.IJ"uJinCleliof.eYCredegcneratiooof
lhecnd<'m,,,rium and ... here largcrcy<tO:: !olruclUfC'l an:
p<C .... n! (Fig. 5.36). 1'bt ch.ange<duc 10

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by Dr.Stator & Saraajka
252 Referellces
References to chapter 5
BoNDSTAM, S . . I. AlJTAID and M. KJ.Jtn.i.INEN (l9fl3): Rc.aJtilM
ullruound prqnano:y d.iagno&is in !be birl. I . unall Anim. Ptta. 24,
W-S-LSI .
8om>Es"rAM, S .. M. J{}.au).n'n<, I. AutAID and M. Foa$$ (1984):
Ewuatinf Ille CUIX)' cl canine prq!WIC)' and linn- size
lISi", real-lilM llluuound. Ana -00. 25, 327- 332.
8oIJurt, D. (1982): Applkation de all dbgnostk: de
i' blinn cllez .. chimne de SIIII. Acad. vtl . Fr . . H,
229-232.
CAAmI, R. E. and T. Rowta (1984): Preliminary IU>dy cl!be IIluuo-
nogrJJIhie and mJ dee1op'k!llln Illedog. Am.
J. Yd. Res. 45, lll9-t26S.
CtwmAtUEN, l . OS M. SCtiM/Of (1982): AIdmbesIertlmeUe al fostre
hoi hllnd OS Pt. Nord. Vet. Med. 34, 3S4--161.
DAVIDSON, A. p' , T. G. NYL-\l'iD and T. TSUlWl (1986): PregI\anty
dQposit: with ultruound in Ille domestic cat . \let . R.cIiol. Tl.
109- 1\4.
Ev.vu, H. E. and W. 0. SAo: (l97l): PreIIatal tlewlopment di;lme.
Slie and Ilbol'1l1o,y mammals: GTOWIh nlfVCS, Qternal feanua and
xlted rde1enoes. Zentbl . \let. Med. Reihe C 2, 11-45.
F'LOcJooEII. M .. P: KltAMEItS. U. Hnn. K. HIJTII;W.'5! F' und S.
ARNOUI (l9fI8): Fl'1l1Ier&$$llna de, TrklltiJUil bei der Hundin. I . vel.
Mel!. A 35, 4S4.
GOmu, A.R. und I. (1983): :z..... Ttichti,-
kc:illerkenouna mil dem VETOSCAN Ullruchallgeril -
ICII LInd Gmuen des Ens'ttes bei del' Hilndin. OUch. JXriml . Wschr.
..........
HOUT. P: A. and R. D. PHEMIfiElt (1971); The tlewlophlenl
or !be q : Preimpllntllion events. Siol . Rejlioo. 5,
INAM, T. N. MAl'5U1, R. SIlIMIZIJ and T. IMORl (1984): Uie or echo-
graphy in bitches ror del: :Iion or (MIWion and prq!WIC)'. 'let. Ree.
ILS, Tl6-m.
IotISSTON. S. D. . F. 0. SWrrn. N. C. BAlin!. G. R. JOHSSTON and D.
A. FEENEY (1983): PreIIatal indkaton cl puppy viabilily II tcnn.
Compo on Conlinuina fd,.K'IOOn S, Xl13- I026.
KaMAlEX, J. V. (1986) : Dia&note cineI' Pfi'Cllttnl
belm Hund. Kkinlier Ptu. 31. 297- 298.
LAUIUN, c., S. SCilM,pr und J. W. DuDFNl\AllSFN (19fl2) ; &sic: Erfah
rungen mit dem ADR Rc.aJTlme-Scanner till' 1'rtdItigkeitJd.iagnoIe bel
Schar. Sdrwein. HLInd und KIlle. BeI'I . Milnch. lictlnl . WsdIr. 95,
."...,.
UOIAND, I . J., B. CAaut:J;, I. BEJ:nAtm et P. F. VtAaD (1982) : lma-
p tqraphique:s de I'ItIIIOnIie .bdotnlnalc des wni_ do .. uli
ques. Bull. AQd. vtt . Fr. 55, 223- 228.
MAlLII.OC, J. M. (1982): OJ'lnostic" de JCSllltion chet ]a dIaue par
khosraphie. Bull . Acad. vtt. Fr. 55, 233-236.
MAIUlIIC. J. M . S. CHAFFAUX. 1. J. lmlAND, B. CAWIll et F. HEITZ
(19110): de ]a pIIIPMln chez II cIwIC: utilisation de 1'110-
graphic. Reel. r.w. &. Alfon I.S6, 899-907.
NOMlIlA, K. (r984) : Prqnanc:y d.iagnoIiJ by rcal-ti1M ulln . Dlllnd
SCIIU'Itr in bitda. J. Jap. vee. med. As5. 11, 140-144.
1'oFFE1."IAMllll, E. M. and 0. A. F'aHsY (t986): Use or gny-.we
ilIllle l1ia&notis or itproduc:tive di .... se ilIllle bili:h:
18 cue. (1981 - 1984). I . Am. I'et . mee!. As5. 189, 90-95.
PYczAx, T. (1990): Einsaam6&lichRRn del' Sono&nPhic ill der gynl-
und geburtshilOiehen Di.-gr ..... i k bci HLInd LInd Kaue. Vet.
1JItd. Di$$. , Manchen.
SCtiMIDr, S., D. SCHaAD und B. GIfSE (1986): UluasehalJdiagnostit
in der Gynitolosit' belm K1cintier. Tkriml . Ptu. W, 123- 141.
SHIl.l.I! , V. M . and J. GoNrAaU (198l): The Uie <:A ultfNOiqraphy
for preJiWIt)' di'l"'*i' ill Ille bitch. 1. Am. Yd. 1JItd. Au. 187,
1021-102!!i.
TAVIiKI'>"l!, M. A. M .. A. C. 0ut!l0!5 and R. "'N Oow (l9fI!!i) : Prq .
nancy diagnolil in !be dog: I bel"" E ., abc:Iominal
and linear .my TeIl time lqnphy. The \\ttrinary QuarlCrty 1,
249-U.t
To.u., R. I. .. M. A. WALKtiJI: and G. A. HmY (1986): A COiTtpIIUon
<:A rul-lilM uJllIIO\Jnd. palpation and i n prqnancy deICe
lion and liner size detcnnination in the bitch. \let . p .... joI . 27, 102- m
AvtorSKO zasl!l e'lO gradivo
I
I
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by Dr.Stator & Saraajka
Subject illdex 253
Subject index
Numbers indicate teX! pages, italic Iwm/)en indicate figures with a cenain subject. Letters before the numbers indi-
cate the speci es: E .. Equine, 8 .. Bovine, OC .. ()vine and Caprine, P .. Porcine, CF .. Cani ne and Feli ne.
A
Abortion E 71.
Aea::s.<;ibility E Cii.l.!& B l1l
AllanlOChorion E ll.. B 119U. 73. 1.99, DC 3.28,
Allantoic
- fluid E49f. 15.. R 133.210I t 167,2.16!
-sac E49f. l&1 B2.lJ. 121. 280.
Allanlois E 1.61l U:L B Ul. 2 79(. 133. W. 2 161
O ' 5.10.
Amniun E Il. II l1lL. l2.L U1. 2.l!9t 133, W. Z 1M DC 201.
flO U 8 P l19.
Amniotic
-fluid E15... B I3J. L10It J.a l . JtlJ.
-sac OC l11.. P 4.16,
A mode ullra..JUnd see ulifll.'\()uoo, " mode
Ampullae O ' 233, 239,
Ane:struo; E 41 ,
Aona, abdominal fC11lS. aorta. abdominal
AnifllC'l IS, liS,
Anel)', carotid sec fetus. anery. carofid
- umbil ical ce anery. umbilical
8
Biparietal diameter DC m J,ll. Cf' 2:l.1
Blastocyst .: ;U.
Brain fetus. bfllin
C
Caruncle: B 139, 2. 108[. DC 3.17. 205.
Catheter . ballooned !L L1ifJ.
Cervical ring! B
CeMlt F. u.;U. 8 Bi.llJ. J U. P 2.1.2.1.lJ. Ct' 5, 3.
Cestrian Cdion 0 ' 245,
OXlrion E 53. B J J 9f. OC l21.
Qipping E 181. Cf 221.
ailons felU$. d ilom
Colon E U. L.Z. P zu.
Conceptus E 43f. 1. 5?[. 62.12. 8 119f, 2. 73j.
- mobmty E 45, 55. 79,
- g.ro">'>lh E 4Sf, UJ. B 123r.
Coma: scanner n. H!1. m
eo"""
- albicans B 21.
- hemorrlulgieum E 29{, /.17(, P 2li.
- luteum E ill. I.IIC B II 9Sf, 215C Ul2. z..H.. OC 191. 3.5j.

- - ao:c'S/iOI)' E 31 f.
- - growth B 21. 103f, 2. 4J{.
- - of pregnancy E zz.:ll. 1.19{, B 2:12..!! l.1Z. 10l f. 241(;
P 4, 7,
- - pt:1"5t.\lrng OC Zll2.
- - regre.o;sing E 1,1] B 2.J2.
- - - Il 100f,
- - - I
Cotyk:don OC l.l1!..
Couplinggel I !.IK9,
9.S f.1.l7t 109, 1.S7C OC !.2LM.
Crov.1l rump length, embryonic or fella] E 41)(, B 125f. In.
218Z OC 201f, P " I, 4.16. CF 239, 1.1.1. 243,
Cumulus oophorus 1!2..
q..
- CMlrian see follieular, <MIrian cyst
- endometrial sec: endomelrial cySts
C)'st3dcnoma Jo: .J2. W f,
C)"SIie oolllus luteum see oolllus luteum ... ;th c n; !)'
C)'Slie glandular hyperplasill CF 249f, 116.
o
Diaphragm !iCC fetus, diaphrugm
I 63f, 2.159, I..8.l..
Didtrus 8 2J...1.ill. 11 3f.
- follicle see follick. d iestrus
Doppler ultrasound see ultrasound, Doppler
Double o, 'ulatioo see ()\'Ulation, double: ovulat ion
E
Ear see felllS. c:ar
ECG DC 3,10.
Echo- see ul\rao;ouoo
Echograph)' !iCC SOI'IOgmphy
Ectoderm E l.fll..
Ejaculate Jo: ill...J.L
Embryo E P M. 491, 1./16, B Y1 z...u. 121, 2.11J. ill Z.B:L
Wf, OC 199f. J..l.8. HO(, P 219f, ".m 0' 237f, 5.15[.
- ascent E 41)(. 1,61f,
-g.ro">'>,h t; 41)f, B I21.125f, P 22 1.
- transfe r B2.103,
Embryonic death E 45f. L11. 62.. 1.95l 1l. B 137, 21().1{.
OC 201 , 207, .iZ2. CF m 5.30(;
Endoderm P/, 61,
Endometrial
- folds E ;ll.Llfl.62. I/o1 I/O! n f, B1ll2.lll 1...ll. 295l
OC 199, ill
- cysts m. L'll. ll.:a LIBf
Endometrit is E il 7Sf. B 139f, 2 Hlf, Ct ' ' 49f 1.l:L.
Endometrium 1' /.6, o!1.. /.47C 62..1l. 1. l 05C B II Sf, ill l!L
Epiph)'si!; lIH,
Estrus E 19,33,41, B 93f,113f,
- secretion B 11Sf, 267t: 1.. !..L
E;o:lremily. froll t, hind !iCC felus,
Ere !iCe fel us, eye
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by Dr.Stator & Saraajka
254 Subject il/dex
f
Fab: sec felllS. falxccmm
Femur !iCC fetllS, femur
Fertility B IOH,
Fetal
- dclllh see cmhl)1)ni(: death
- macenuion B lJl. 21!lZ
- mummirlClltion 8 111 1.. 1iM. OC m
- E S7f.
Fetometl)' I-: 65f, L21f. B 1m. 2 1N[. OC 2m. c t" 243,
FeM a. 1. 69(. 61f. U?lC B 143f. 21 n t OC 2mf .J.l }(,
p 221. CF 241f. 5.21[.
- abdomen /.ffi 8 122,1. W I. 173. 2/ll.
- age determination I-: 65f. 1.91t 8 I 75{, 1. 11l7(. OC m
- MJr1Il. alvloolinai B
- IIrtel)'. camtid 8 I..ll.
- ariel)'. umbilical t: ld12. 8 1M. l.61. 2.16{.
- brain B 149,
- - cav: t: hl. UU. 1.9/l 8 1.11& 147(, 2./21{, I.1l. l ,m ,
OC mJ...ll P 4.21,
- ctrt:brlll ventricle B 2122 149. 2.fUf
- d a.... B 16S, 1. 156(. 1.163.
- dims B 169,
- corpus 8 2. I25f
- diaphragm U2 /oIJ. 2. /oIJ, O ll:!.
- car B 151, 2.IJ1.
- fllJf1t 8 ll2.1.!!J. 1M 11541. I..H.l... OC .!.l.i 2(13,
P " 1,:1. 1&
- hind B J.22. z..u 1M. 2 /58(. W. OC J.ll.;m.
P 221.
- eye 8 I..:li. 1. 11 71 J..1i. 2 J741.
OC l!I.l.
- - lashc!l
-- lid 8
- - lens t: 61l..B:l.
- fab: ccrcbri 8 2. 122, 1:!2. 1. IUf
- femur B IM. IRI, 2. JSS,
- gcnitalt ubC'rck EU B 1691. 1. 165.
- pouolh B Tabk 1. I. 1. 1.81f,
- head t: 1.69[; 6.5. [.g], B J.22. 1.9Jt I..:li. Ul lll2 OC J.ll.
p 221.ll1l. l.lL O Z!l. Ul.
- heart E 61 . LB6. B l UJf L59.. OC )'1", P 221. ". /1r, O .t..,U.
--chambl:r I-: 6.L L86. B U2, 2 /.u,
-- rate t: 6LUl.62. B I..11.!n. 1. I Z6.
- - ,'alve!; ..
- humerus 8 l SI.
- h)'J7OthBlanlllS
- ilium U
- il l
- intCSl inc
- 181. 2.lS1.
- kidney
- Ial)=
- liYcr I-: &LM. B 1212145. OC :!.1:L J..2l1 J..J!l O 2-13,
- luII& B 159. OC l..22"
-l1l8JIdibk B In. 2. 11/, 2. 119f,
_ ma;<ilta 8 Z 1ZI 149f. 1.119f,
- meUlCarpus D 1!!,1 z' l54f IRI. 1.l&
- rneUltal'Ml.' 8 1M.1.JJ8j; W. 2/&i
- mouth B 149. 1.117f,
- n:w.1 bone K ! 51, 1, 1,11,
- neck E 6l.. L1lJ. U 2.140{.
- B 149f. 1. 11/if:
_ omasus B Z 1/4
- oWf>e:ltion 8 122.291. HL mf. 2 /J"f. Q ' z:u.
- OMium intl'llOlminale 8 ..!. U7.
- palate H I49. 1. 127f,
- pekis
- penis B 1m.
- phalanI 8 iti.l.l, I.U l . tH.I.
- pituitaI)' B 1.11Jf,
- plexus choriodc:i B 149.
- position o( H ill
- p ft'put"C 8 Ih9.
- radius H 16). 2 1$", uu..
- rib 1-: 61. [.8 /.91. 67.1.91 Uli1. 179. 218I. OC m J . Z7.
P 221. 4. 19f. CF & 1.ll.
- OImen 8 1.147,
- scapula II 2. 1 j.I. I..8.l.
- sphcnoidc bone 8 2112.
- spinal cord ): f...& B mf. },/ 16
- stomach 1-: !!.l1...M. ill !!1 B 159. 1. 145C Il1 OC J:l&
P 22 I , :I.1D. Ct 243, HJ.
- tai l 1-;61 . H m.l.l3&
- tOlnk E J..&!. l.!l.J... !!1 L!H B m.. 179. 21m P :uI.
ct' 243,
- umbilical cord E 5 I. 1.67, I. roo 63. n. B 1;:9. Z. 94, 167, 1. 160(,
179.
- urinal)' blaMer 8 Z!.1.!.2:f.
- !iCJl)Ium E 6.1
- Slemum 8 1.139, uz.
- 9I1cus 5plcnialis B 1.125t
- tCBIll B 1691, 1.166f,
- Ieeth U I49, 2. I27f,
- lc::SIis .: & B llL1.li'Ot
- IOOr.u: t: 61 U!A 6Sf. 1.9(}. 8 In. 2. U 21 111 } IU OC
UJ.
P4. 11Jf,
- tibia H IM.1. 15l!. 11!.l.
- longue 8 !5 J. 1.1 xr.
- trachta 8 U1..2 UO,
- ulna 8 16J. 2.Ij", IRI.
- vein, call(b,l CII\-al E 1.&1 8 1.. UJ,
- .'rin. umbilical E 6.1 L1J!l. U 1('7, 1,161.
- ''encbrae E 6:l. L1lJ. 8 mf. 2.JJ"C 179. }, I 8l. P 221. crldJ,
- venehral
- - art'h B IS3f,
- - body B 153f. 1.IJ6.
- - column .: 6.l. B In r. OC 20). J.Z9t
- \'Uk'3 R It!2.
FlXlltion OC Il!2. P 211. CFlli
Foal heal E 7If, I/O{
Follidc E 15f. l.PJ. 8 891', 1. JJC OC 191f. OC I..2L lZ !!!f:.
P2.1.S.M
- anD\wtoric t: 33f. J.JJC
- diel;tros 8 93. 1.18l
- dominllnl E 1..2. L1.Z. B 2J.2.l.L
- during pregnancy E II B 2J.
- c::SIfUS E!.,2f" 1..2. l .l1{, B 1.1 J{. 93f. 1.1:I. OC 191 r, P zu.
- gm"",h t: 19. 1.12. B93. 21/,
- hclnOffhagc t: ll. LU ll.. l.JJ.
- hemorrhagic E 33(. Lll.
- luteinizing Ell /.JJt
_ melc:st1US H 93, 2 17.
- pr'CO"ulattn)' E 1.2.
- proestrus K lU.l....U.
<110 1wo
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,
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by Dr.Stator & Saraajka
- punclure E 23, I, lSI.
- shape E 12, 1. 14[. BB2,
- size E 19, ill B 91f, 2. 12f,
FolliculHr
- antrum E lL 21. B !!9{,
- cyst t)"St B I01f,1,49f, P 211, :L
- nllid E
- luteal C)'St
- thecalqst B 107f, 249f,
- wall t: 15, 11.21. 8 891.2,13,219,
- 8 93.212[.
Frontal S1ion 149,
FSII OC J,9,
G
Genital lubcTrlc: !'oC:C genital tubercle
Granulosa cdl tumor E 37, 1,17[' B ill , 1,S9/.
retardation B UI.
Gut see intc:stillC
H
BOO ll!S..
!iean !il:e al'iO hean
- adr.'ity, embl),onK:: E 49, fi9, 79. B 121. 125, 137. OC 199.
e r 237,
Heat sec eslrus
Hind extremity see fetus. extremity. hind
Horizontal S1ion 67. 143, 2116,
Humerus fetus, humerus
HydraUamois E l l. L2& OC209. J. ll.
Hydmmnion E 1 1. L'2& OC m
Hydromctr.! OC 207f. J. ll[.
Hymen. E !L Ull.
I
Ilium sec felus, ilium
ImpcdllllOC L l.
Impbmation E <1.5 .51, 79.
Inguinal gland OC 189,
IntC$line sec also Fetus. intestine CF 235, 251, 5,35.
- wall 1. 7.
[odil1C solution B l:!.L LJ 14,
Ischium fetus. isctIium
J
K
Kidney !'oC:C fetus. kidney
L
lAIynx see fetus.laryru:
uucocytes E L I Q9,
Unearscanncr g Slf,2.lf, 187, 227.
l.ivt:r sce fetus.lM:r
Lochia E 7 I f. 1.1()()f, B 139. 1.1Q9(;
Lochiometra E ll,l. IOl. Bl.lIl,
Longitudinal !iCCtion 143,
Lung sec fetus,lung
Lutcal tiSMlC 95r, losr,
Lutcinwtion E ll. 33.1.11['
Luteol)Sis E B
"
MltCCration sec fetal. maceration
Mandible sec fetU$, mandiblo:
Mwcilla !iCC fetus. mwcilla
Malian so:ction 143. L l1(!,
Ml:5Odcrm E I..&.L
Metacarpus !iCC fetus. metacarpus
Metatarsus !iCC fetus, metatarsus
Metestrus 8 9H.2/7, ilL
Muoomctr.l t: 11. L LlL OC m
Multiple pregnant)' OC 199. 200.
MummifICation sec fetal nlUmmiflCalion
Myo metrium E41,1.47[' B I17.
N
Neck see fetus, neck
Nose sec fetus.. I'IO!Io!
Subject imler 255
Nuclear magnclK:: resonance imaging 123.2.83. 1, 97, .1. 19.
o
Obsteulcal cxamination 245.
OMiflCation sec fet us.. ossi fICation
OYarian
- hematoma E 1"J6,
- !Umor 37f, 1.37[. B Ill, 1.59f, ct' 231, .tl.
- C)'St E 39. 1,4J[. B 107f. 2.49[. OC 191 . .!.& P 217. 4.8[
Ct' 231, 5.5[
OYarieaomy E 37.
0Ya1)' E IS, B 89f, 211[. OC 19lf, 3,5[ P 215f. H C
Ct' 231. 5.5C
Ovulation E 19f. !J2121. 8 91 f, OC 193. P 215.
- doublo: (MIlation E !2. I. /.J. 31. 53. 55.
p
Palate sec felus, palate
Paramedian 51ion 143,
Panurition E 61.
Petom sc:c: also fetus, pelvis B 2.6f,
Penetration depth 87.111. 173.
Penis !iCC fetus. penis
PGF sec: proSlagiandin
Placenta CF 241.5.11[.
I'lacentation E CF 245. ,U2.
Pl:tCCnlomc B I ll. 292, 197/. 133. OC 199. 1./.2, 205. l 29f.
Plcl!us ehoriodei see fetus, plexus choriodei
I'MSG see ECG
Position see also fetus, position 159
l'osIerior pn.:!il:ntation 159. 173, 2./73,
I'ostpanum period 8 139.1.108[.
Preputt see fet us. prepuce
Proestrus B 93, 11 7.
I' roge:o;lemne E 33, B l05f.
Prostaglandin OC 193, J. 9f, Z!!2. 134.
Pregnancy
- age determination E 65f. 1.911. B 115f. 2.187[. DC 203,
- diagnosis. sonographic
- - aa:urrdC)' E 43f, B OC 187,207, r 223, 4.22.
- - lime or E 45r. 8 I OC 201f. 2OSf, P 22.3. ct' 235,
- disorder Ell 1,98[. B 137. 2.J04f, DC 200. CF 245. ill
Presentation. anterior 159. 173. 1. 173.
Punclure
- de\o;c", E a LB!l.
- of felus sec letol. punclun:
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256 Subject inda
- of follides sec follicle. puncture
E n. I. J09f, 8 141, 1. /J5, OC 201f, .til. CF 249f,
5.31t
Q
R
Radius sec felllS, radius
Rcflenioo ill 131,
- 1'C\'CmeTluion 8S, l Z
- specular rclkction 45, 12.
- wrfac:e Ii. 125,
Ra;tal examinalion Ell , Z2. 8 83,
Rectum E lL B 83, ct' 229,
Reo;oIution 871,29f,
Re5OrJMion sec embryonic dealh
Rc-.'Cmcralion sec relkctioo, l1:\'Crbcration
Rumen sec felllS, romen
S
Sagittal settion 1J. 2.2.I43, 2tt6,
Sec!or scanncr 1.3, 83f, 1. 3f, 1lJ. l61f, 143, 181, 221,
So: dc:tennilUllion . : 6J. B
Scanningwidth B 131.
Scapula !ieC fetus, scapula
StmIum sec: felus, !crUmm
Shadowing sec ultrasound shadolo.'S
5ooognIphy, ledmiquc: of
- . U. 65. OC 181f. U 201. P 213. 4. 1. 223.
O 221f. H f,
- lransrectal t; II, U 65. L!l!1 B 83f.2/f, OC 181f. ,1.2 201.
P 2m. 4,1. 223.
- lr .. nsv-.. ginaJ E,t!. LI..!!. 571.1.80/.
Sound lICe
Specular reflection sec relkClion. specular rdkdion
Spinal cord St.'e felm. spinal cord
Spoir;e ,,'hccJpanem E4 1,/ ,48f,
Slemum 5CC fetus. iIIcmum
Stomach lICe felus, iIIomadi
Superovulation B 91 f. 2. J9f, 101. 239. OC 193. 3.9f,
T
Tail sec fettK, lail
TesticuJardc::scem .: 63, 8 111,
Testis 5CC fetus. lesti5
Thorall see fetus. lhorall
TIbia sec feltK, libia
Tongue see fetus. longue
TndIea sec fetus. tradlea
Tnmsverscposilion 2.173.
Transvcrsc SCCIion S3. H/. I U. }. 61f, V Ol 143. 2.116.
Trophoblast OC 191.
Twin pregnancy E 31. 45. 51 f. L7Jf, 12. B Ui. 2103. OC 3.21t
201.
- Ifealmcnt E 55,
U
Ulna see ulna
Ultrasound
- absor-p(ion U. 65, 131, 141. ISS. 163.
- A mode 181.201. 213.
- Doppler 181, 2Q1, 2n.
- enhancement ISf. I.8/.
- examination :ICC iIOl'lOgIlIphy
- frequency 17. 25, 43. S 1, 87f. 2. 9f, 125. 287[. 131. 181, 201. 223,
_ gel seeeoupling!,'C1
- impact 1.Sf. ill
- ref1cclion 1. 7, 163,
- shadows ISf. I,Bf, 1,39. 6\. ISSf. ll1.
- "'-ave 87.
Umbilical cord sec umbilical cord
Urinary blaMer also felll, Urinary bladder Ell . 1,2. 1.1.
n , 1.110 B SS. 2 5f, 2.13. OC lIN. J..J..!!l. CF m 5,3t
Urine E 1 1. /.1, 1,3, n .
Uromctra En.I,IIl.
UtelU5 t: 41 f. B l13f. OC 3.1f, 195f. P 219f. 4,1lf, Ct' 5. 3f, 2Jlf,
- infusion t: 15. 1,108.
- nonpregnant 41f. 1,47/. B 22j. IIJf, 2,{)1f, OC 3,3[ 195,
J. lIt P 219. 4,1l{; Ct' 5, 3. 233.
- - during3na11U5 4\.
- - during dic::sllU5 E 41. 1,47. B 113f, 261. 2.66.
__ during $1\15 E 41, 1.48f, 11, B 113f. 2.62. 1.65 .?67f,
OC 195. 1..1.Z.
- - during postpanum period t: 1\f, / ,JOOf, 8 139, 2.JOSf,
CF 245. 1..Z&
- pregnant E 4Jf. 1.5l:f, B 2.38. 119f. 2. 73f. OC 191f,J,JJl P 219.
4. 14f, CF 233. 5,Bf,
Uteril'lC
- body E lJ. L.1 45. B 85.
- oompanIDC'nl5 B Il l, J..95f, OC 199. J.l6f,
- cu,,-alure
- - large B 2.2. 1 U 2, 61. 2.6jf, 2 75. OC .!:L. 195.
- - small B 1!1. 2.61. 26j. 2. 75. OC 195.
- hom E !1. 1,4f, 1.47[. 45. B 85. I \3f, 2.61f, 2.69f, OC 191.
- lumen E43. 15, B 1 IS. 121 , 131. 2.9S/. OC 19S,
- wall E4S, J.j& 12. B lISf. 2.61f, 131 . }. 9's/. OC 195.
V
Vagina E n . BSS,
Vein. umbilical 5ee fetus, \'Cin. umbilical
Venebral column see (elus, \'Cnebnll column
Ven ical scction B 145,
VeMibulum B SS.
w
x
y
Yolk sac E 49f. 1.6Jf, L74, CF 237. 1 15. 241, ill
z
Zonary placenta .scc placenta
Avto 'Sko tC'lO cradi
www.vet4arab.co.cc
by Dr.Stator & Saraajka
Veterinary Reproductive Ultrasonography covers all
of the most important domestic large and small
animals and is a comprehensive and uniquely
Illustrated account of veterinary gynecologic
examination and reproduction. Commendng with
the common indications for ultrasonography.
gynecologic and obstetric examination. the book
mo"e5 on to interpret ultrasonogfaphic findings. The
pregnant and non-pregnant uterus. pathologic
changes of the uterus and other abnormal
ultrasonographic findings are desaibed and
explained.
This comprehensive guide to horse. cattle. sheep,
goat. swine, dog and cat gynecologic examination
and reproduction explains technique as well as
intetpietation.lts extensive i1Iusbation provides quick
acce1S and answers.
IIrterinary Reproductive Ultrasonography. with i1s
nearly 400 top-quality illustrations and descriptive
legends. is the definitive guide to reproductive
problems facing the busy practitioner in day-to-day
proctice.
--

I
ISBN 3-89993- 005-3
9
A
www.vet4arab.co.cc
by Dr.Stator & Saraajka

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