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Endometrium: biopsy
Introduction
- Endometrial disease is common in the brood mare and the detailed histologic picture revealed by biopsy in association with other reproductive examination techniques can lead to a more accurate diagnosis and prognosis.
Uses
- Diagnosis of endometrial pathology.
- Part of a breeding soundness examination Reproduction: breeding assessment examination - mare.
- Microbiological assessment of the endometrium Endometrium: bacteriology.
Advantages
- Allows detailed histological appraisal of the endometrium.
Disadvantages
- Invasive.
- Poor technique/hygiene can cause bacterial endometritis Uterus: endometritis - bacterial.
- Should be used with caution in mares where pyometra Uterus: pyometra is a possible problem as uterine rupture may occur Uterus: rupture.
Technical problems
- The correct sampling technique is important.
- Obtaining a poor sample (too small or tissue crushed).
Alternative techniques
- Other reproductive examination techniques.
- External genitalia examination Vagina and cervix - manual examination.
- Manual examination of vagina and cervix Vagina and cervix - manual examination.
- Vaginoscopic examination Female: vaginoscopy.
- Endoscopy of the female reproductive tract Uterus: endoscopy.
- Endometrial sample (swab/cytobrush/low volume lavage) for microbiological Endometrium: bacteriology assessment and/or cytology Endometrium: cytology.
- Transrectal palpation of uterus, ovaries and cervix Urogenital: rectal palpation.
- Transrectal ultrasound of uterus, ovaries and cervix Ultrasonography: reproductive tract - female.
Time required
Preparation
- 15 min.
Procedure
- 10 min.
Decision taking
Criteria for choosing test
- Barren mares.
- Repeat breeder mares.
- Observed palpable or expected genital tract abnormalities.
- Breeding soundness evaluation (BSE) Reproduction: breeding assessment examination - mare.
- Behavioral anestrus during the breeding season Female: anestrus during ovulatory season.
- Pyometra Uterus: pyometra or mucometra.
- Recent embryonic or early fetal death Abortion: early embryonic/fetal death.
- Mares requiring genital or non-emergency surgery.
- Recipient mares in ET programs.
- Mares in research programs where foals are important.
- Mares with hemorrhagic discharge originating from the uterus.
- Mares with uterine masses identified on hysteroscopy or transrectal palpation/ultrasound.
Risk assessment
- Ensure the mare is safely and appropriately restrained (stocks/crush) Restraint methods and/or sedated as necessary Anesthesia: standing chemical restraint.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Schöniger S & Schoon H A (2020) The healthy and diseased equine endometrium: a review of morphological features and molecular analyses. Animals (Basel) 10 (4), 625 PubMed.
- Linton J K & Sertich P L (2016) The impact of low-volume uterine lavage on endometrial biopsy classification. Theriogenology 86 (4), 1004-1007 PubMed.
- Buczkowska J, Kozdrowski R, Nowak M & Sikora M (2016) Relationship between uterine biopsy score, endometrial infection and inflammation in the mare. Tierarztl Prax Ausg G Grosstiere Nutztiere 44 (3), 158-163 PubMed.
- Snider T A, Sepoy C & Holyoak G R (2011) Equine endometrial biopsy reviewed: observation, interpretation and application of histopathologic data. Theriogenology 75 (9), 1567-1581 PubMed.
- Ricketts S W & Alonso S (1991) Assessment of the breeding prognosis of mares using paired endometrial biopsy technique. Equine Vet J 23 (3), 185-188 PubMed.
- Van Camp S D (1988) Endometrial biopsy of the mare. A review and update. Vet Clin North Am Equine Pract 4 (2), 229-245 PubMed.
- Ricketts S W, Rossdale P D & Samuel C A (1978) Endometrial biopsy studies of mares with contagious equine metritis 1977. Equine Vet J 10 (3), 160-166 PubMed.
Other sources of information
- Schnobrich (2018) Disorders of the Reproductive Tract. In: Equine Internal Medicine. Eds: Reed S M, Bayly W M & Sellon D C. 4th edn. Elsevier, USA. pp 1235-1252.
- Kenney R M & Doig P A (1986) Equine Endometrial Biopsy. In: Current Therapy in Theriogenology: Diagnosis, Treatment and Prevention of Reproductive diseases in Small and Large Animals. Eds: Morrow D A. Saunders, USA.