Assessment of the bovine uterus with endometritis using Doppler ultrasound

Postpartum uterine diseases such as metritis and endometritis are highly prevalent in dairy cows. These diseases negatively affect the reproductive performance and consequently economic activity. Cows in the puerperal period presenting endometritis may have alterations in the hemodynamics of the uterine tissue and the uterine arteries, which differ them from healthy cows. Therefore, this study aimed to use the Doppler ultrasonography to describe the hemodynamic changes in the uterus of cows showing endometritis diagnosed between 25 - 35 days postpartum. Eighty-nine Holstein Friesian females with 25 to 35 days postpartum were studied. Cows were assigned to two experimental groups, infected or not infected, according to the results of the endometrial cytology. Clinical examination, vaginoscopy, Doppler ultrasound and sample collection (saline solution was injected and recovered by endoscopie method aiming cytological and microbiological evaluation of the uterus) were also performed. Cows with endometritis had the cervix (P = 0.040) and the left horn (P = 0.020) increased compared to healthy cows. 78.6% of the endometritic cows showed abnormal uterine discharge, while 57.6% of healthy cows had this same condition (P = 0.0005). The spectral Doppler evaluation of the uterine arteries revealed no differences between groups. Bacillus spp., Trueperella pyogenes, Escherichia coli and Staphylococcus intermedius were the most isolated bacteria among samples. Higher score or increase of uterus vascularization of the endometrial Doppler was correlated with Trueperella pyogenes (P = 0.0003) and intrauterine heterogeneous content (P = 0.0047). Finally, mesometrial Doppler was correlated with endometrial Doppler (P < 0.001), uterine bacteria (P = 0.001) and intrauterine heterogeneous content (P = 0.049). Regarding the evolution of uterine alterations, Doppler ultrasonography provides fast results and is a lesser invasive technique such as uterus biopsie and endometrial citology and gives answers about fertility and uterus health.