Prolonged parturition and impaired placenta expulsion increase the risk of postpartum metritis and delay uterine involution in sows

It was hypothesized that prolonged parturition and impaired placenta expulsion increase the risk of postpartum metritis and delay uterine involution. At parturition, for 99 Yorkshire x Large White sows (parity 2-5), we determined the number of liveborn (NLP; 14.8 +/- 3.4) and stillborn piglets (NSP; 1.1 +/- 1.1), farrowing duration (FAR, time between first and last piglet; 333 +/- 249 min), placenta expulsion duration (PLA, time between first and last placental part; 292 +/- 241 min) and number of expelled placental parts (PART; 3.0 +/- 1.0). FAR was categorized as 'normal' (<300 min; n = 44/99) or 'prolonged' (>300 min; n = 55/99). The relative PLA (rPLA; (PLA * 100)/FAR; 76 +/- 101%) and the relative PART (rPART; (PART * 100)/(NLP + NSP); 22 +/- 8%) were calculated and placenta expulsion was categorized as 'normal' (rPLA and rPART > 10%; n = 93/99) or 'impaired' (relPLA and relPART < 10%; n = 6/99). We also recorded whether manual palpation occurred (Yes/No) and/or oxytocin was used (Yes/No). After parturition, an ultrasound examination of the uterus was performed once for each sow between the 2nd and 7th day postpartum and the uterine size (mean sectional area of three to five uterine cross-sections) and intrauterine fluid accumulation (Yes/No) were recorded. Uterine size was categorized as 'normal' (n = 55/99) or 'enlarged' (n = 44/99) and used as an indicator of delayed uterine involution. Intrauterine fluid was used as an indicator of metritis. Prolonged FAR (35/54, 2.0 +/- 0.5,13.1, 7.6; n/N, beta +/- SE, Wald chi(2), Odds; P = 0.001), manual palpation (12/17, 1.5 +/- 0.7, 4.4, 4.3; P = 0.036), oxytocin administration (18/31, -1.5 +/- 0.7, 4.7, 0.2, P = 0.040) and NSP >= 2 (15/21, 1.4 +/- 0.7, 3.8, 3.9; P = 0.052) were associated with increased uterine size (n = 44/99) and NSP >= 2 (7/21, 2.6 +/- 0.9, 8.7, 13.7; P = 0.003), manual palpation (10/17,1.8 +/- 0.8, 5.0, 6.0; P = 0.025), prolonged FAR (13/15,1.7 +/- 0.8, 4.3, 5.7; P = 0.039) and impaired PLA (4/6, 3.3 1.7, 4.0, 26.9; P = 0.044) with intrauterine fluid accumulation (n = 15/99). The results confirm the hypothesis, indicating that prolonged parturition and impaired placenta expulsion increased the risk for postpartum metritis. Stillborn piglets and manual palpation were also identified as risk factors. Postpartum metritis delays uterine involution whereas the use of exogenous oxytocin supports it. (C) 2017 Elsevier Inc. All rights reserved.