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Ultrasonography in Bovine

Reproduction

牛の繁殖における超音波検査Giovanni Gnemmi DVM, Ph.D, ECBHM

BOVINEVET

bovinevet@tiscali.it

www.bovinevet.com

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Uterus 子宮

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Pequeña curvadura小湾部

Grande curvadura大湾部

Grande curvadura

Cuerpo utero

3°proximal uterino子宮近位部

3°distal uterino子宮遠位部

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Uterus 子宮

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Uterus 子宮

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UTERUS 子宮: The Technique 技術

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S UTERUS 子宮: The Technique 技術

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UTERUS 子宮: The Technique 技術

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S UTERUS 子宮: The Technique 技術

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Uterus 子宮: Estrus 発情

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S Uterus 子宮: Metaestrus発情後期

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Uterus 子宮: Diestrus 発情静止期

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S Uterus 子宮: Proestrus 発情前期

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UTERUS PATHOLOGIES 子宮の病的状態

Septical Metritis 敗血症性子宮炎

Endometritis 子宮内膜炎

Pyometra 子宮蓄膿症

Mucometra 子宮粘液症

Abscess 膿瘍

Tubaric Diseases 卵管疾患

Neoplasie 腫瘍

UTERUS

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S UTERUS ULTRASOUND EXAM 子宮の超音波検査

Vaginal Vestibulus 腟前庭

Cervix 頸管

Body of uterus 子宮体

Horns of uterus 子宮角

Salpingis 卵管

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Vestibulus 前庭

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CERVIX 頸部

NORMAL CERVIX CERVICITIS頸管炎

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• Hand in vagina

手を腟に用いて

• Speculum 鏡

• Rectal palpation直腸触診

• Ultrasonography超音波診断

PUERPERAL METRITIS産褥性子宮炎Diagnosis 診断

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Normal Metritis

EARLY POST PARTUM分娩後初期

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Fever Normal Temperature

Disease Normal Disease Normal

ANTIBIOTIC

1. FANS 非ｽﾃﾛｲﾄﾞ系坑炎症剤2. Prostaglandinﾌﾟﾛｽﾀｸﾞﾗﾝｼﾞﾝ3. Nutrition 栄養4. Calcium ｶﾙｼｳﾑ 1. Nutrition 栄養

2. Calcium カルシウム

Monitoring

Early Postpartum 0-10: 分娩後初期TEMPERATUR MONITORING 体温モニタリング

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発熱

Morning rectal temperature: first 10 days post partum 直腸温のﾓﾆﾀﾘﾝｸﾞ：分娩後最初の10日間

48 % T° > 39.5°C without any clinical problem 48％は39.5度以上で臨床的問題はない

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ENDOMETRITIS: DIAGNOSIS 子宮内膜炎診断

• Speculum (60-80%) 鏡 Miller 1980; Dohmen

• Vaginal Manual Examination 腟触診 Sheldon 2002

• Rectal Examination (22%) 直腸検査 Miller 1980; Gilbert 1992

• Metricheck メトリチェック Riddle 2004

• Cytology 細胞診 Gilbert 2005-2006

ULTRASONOGRAPHY超音波検査

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Metritis 子宮炎:12 dias pp

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Metritis 子宮炎:12 dias pp

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S Metritis 子宮炎:12 dias pp

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Metritis 子宮炎:16 dias pp

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S Metritis 子宮炎:18 dias pp

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Metritis 子宮炎:18 dias pp

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S Endometritis 子宮内膜炎:産後20 days pp

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20 DAYS POST PARTUM分娩後２０日

• Primiparus Ø cervix > 5 cm初産牛の頸部直径

• Pluriparus Ø cervix > 7.5 cm経産牛の頸部直径験

PURULENT DESCHARGE化膿性の排泄（分泌）物

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S Endometritis 子宮内膜炎:産後23 days pp

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25-30 Days POST PARTUM

• Primiparus Ø cervix > 3.5 cm初産牛の頸部直径

• Pluriparus Ø cervix > 5 cm経産牛の頸部直径

• Presence CL 黄体の存在• Position of the CL 黄体の位置

MUCO PURULENT DESCHARGE

粘液性化膿性の排泄（分泌）物

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S Endometritis 子宮内膜炎: 産後26 days pp

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Endometritis 子宮内膜炎: 産後26 days pp

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S Endometritis 子宮内膜炎: 産後26 days pp

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Endometritis 子宮内膜炎: 産後28 days pp

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PRESYNCH

PG PG

AI

0 14 38

Giorno 0 : 28-33 ± 3 gg

GnRH

28

PG

35

GnRH

37

Endometrite: 25-33 giorni ppTherapy子宮内膜炎治療

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CL: IT IS REALLY ABSENT ?黄体は本当に不在か？

Sp CL- palpation

between 20-33 days: 45%

Ｓｐ黄体-直検20-33日の間：45％

LeBlancS.J. et Al. J.Dairy Sci. 85:2237-2249

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PGF 2 α

Endometritis：25-33 giorni ppTherapy 子宮内膜炎治療

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SUB CLINICAL ENDOMETRITIS : WHAT IS IT ?潜在性子宮内膜炎とは？

SUB CLINICAL ENDOMETRITIS (> 26 Days)

潜在性子宮内膜炎（26日以上）

• Uterine Infection 子宮感染• No vaginal desharge

Barlund et Al. 2008

Kasmanickam et Al. 2004

SUB CLINICAL ENDOMETRITIS( 21 – 33 Days)

潜在性子宮内膜炎（31-33日）

• PMN > 18%

SUB CLINICAL ENDOMETRITIS( 34 – 47 Days)

潜在性子宮内膜炎（34-47日）

• PMN > 10%

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S SUBCLINICAL ENDOMETITIS: ULTRASOUND CUT-OFF 潜在性子宮内膜炎：超音波のカットオフ

Kasimanickam 2004

Barlund et Al. 2008

↓

↑> 8 mm

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↑> 3 mm

Tickness Endometrium > 8 mm

子宮内膜の厚さTicknes uterine fluid > 3 mm

子宮分泌液の厚さ(Low Se, High Sp)

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SUBCLINICAL ENDOMETITIS?潜在性子宮内膜炎

Muco-purulent Endometritis 28 days post partum

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SUBCLINICAL ENDOMETITIS?潜在性子宮内膜炎

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SUBCLINICAL ENDOMETITIS?潜在性子宮内膜炎

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S SUBCLINICAL ENDOMETITIS潜在性子宮内膜炎

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> 8 mm

> 3 mm

SUBCLINICAL ENDOMETITIS潜在性子宮内膜炎

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S SUBCLINICAL ENDOMETITIS DIFFERENTIAL DIAGNOSIS潜在性子宮内膜炎鑑別の診断

• NORMAL1. PROESTRUS 発情前期2. ESTRUS 発情期3. METAESTRUS 発情後期

• ABNORMAL 1. OCD2. MUCOMETRA子宮粘液症

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ARTEFACT? ….YES THANK!アーチファクト？

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S ARTEFACT? ….YES THANK!ｱｰﾁﾌｧｸﾄ？

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ULTRASOUND DIAGNOSIS超音波診断

TICKNESS ENDOMETRIUM

子宮内膜の厚さUTERINE FLUID

子宮の分泌物

NO SUFICIENT!

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S Chronical Endometritis 慢性子宮内膜炎

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Chronical Endometritis 慢性子宮内膜炎 Piometra 子宮蓄膿症

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Piometra 子宮蓄膿症

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Mucometra 子宮粘液症

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S Fibrosis 線維症

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Salpingis 卵管炎

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S Intrauterin Abscess子宮内膿瘍

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S Intrauterin Abscess子宮内膿瘍

Abscess Uterine Large Leg.

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Haematoma 血腫

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S Intrauterine Cyst ??????????子宮内嚢腫？？？？？

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Intrauterine Cyst ??????????子宮内嚢腫？？？？？

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S Intrauterine Abscess ??????????子宮内膿瘍？？？？

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