Retained fetal membranes (RFM) in cattle have adverse effects on fertility and production. Understanding the pathophysiology and causes of RFM is important for managing this disease. The hormonal processes that lead to normal placental separation are multifactorial and begin before parturition. A variety of risk factors, including early or induced parturition, dystocia, hormonal imbalances, and immunosuppression, can interrupt these normal processes and result in retention of the placenta. Current research does not support the efficacy of many commonly practiced treatments for RFM. Systemic administration of antibiotics can be beneficial for treating metritis after RFM, but antibiotic administration has not been shown to significantly improve future reproduction in cows with RFM. Collagenase injected into the umbilical arteries of retained placentas specifically targets the lack of placentome proteolysis and might enhance placental release. However, such therapy is costly and its benefits in terms of improving subsequent reproductive function have not been evaluated. 6,7 RFM have been associated with increased risk for endometritis, metritis, ketosis, and mastitis. [9][10][11][12] These diseases can in turn lead to decreased fertility 13 and potential losses in milk production. 14 In a meta-analysis of studies analyzing the effects of disease on reproduction, RFM were associated with 2 to 3 more days to 1st service and 4 to 10% lower conception rates at 1st service, resulting in an average of 6 to 12 additional days to conception in cows with RFM versus cows without RFM.3 However, only 5 of the 13 included studies found decreased milk production associated with RFM.15 It should be noted that a variety of factors, including case definitions, other associated diseases, and culling risk, complicate the interpretation of impact of RFM on both reproduction and milk production.Knowledge of the placental anatomy and physiology is helpful to understand causes of RFM and formulate treatment plans accordingly. The following review focuses on the normal placental detachment, causes and risk factors for RFM, and therapeutic options.
Physiology of Placental DetachmentCattle have cotyledonary placentas, wherein the fetal cotyledons are attached and envelop the maternal caruncles, forming the placentome. This connection is facilitated by villi from the cotyledons, and microvilli interactions at the cotyledon-caruncle interface. Collagen links the interface together at several sites, and the breakdown of this collagen is likely a key factor in placental separation.
16The normal sequence of events initiating parturition involves fetal cortisol induction of placental enzymes that direct steroid synthesis away from progesterone and toward estrogen. 17 Increased estrogen results both in the upregulation of oxytocin receptors on the myometrium and secretion of prostaglandin F2 alpha (PGF2a).18 Prostaglandin initiates myometrial contractions and results in lysis of the corpus luteum (CL).
19Lysis of the CL leads to secretion of relax...