Kedilerde normal doğum ve planlı sezaryen sonrası uterus involüsyon sürecinin ultrasonografi ile izlenmesi

ECE GÖGKIYAS

Kedilerde normal doğum ve planlı sezaryen sonrası uterus involüsyon sürecinin ultrasonografi ile izlenmesi

Thesis Type: Postgraduate

Institution Of The Thesis: Ondokuz Mayis University, Lisansüstü Eğitim Enstitüsü, Doğum Ve Jinekoloji (Veteriner) Dalı, Turkey

Approval Date: 2026

Thesis Language: Turkish

Student: ECE GÖGKIYAS

Supervisor: Serhan Serhat Ay

Open Archive Collection: AVESIS Open Access Collection

Abstract:

Uterine involution is a physiological process during which the uterus returns to its pre-pregnancy state, characterized by endometrial regeneration, elimination of bacterial contamination, and a reduction in smooth muscle mass. In cats, this process is characterized by an odorless, red-black lochial discharge that may persist for up to three weeks. During a normal postpartum period, the general condition of the queen remains stable; however, in cases of bacterial contamination, clinical signs may develop beginning with fever, depression, and anorexia, potentially progressing to septic shock and even death. Therefore, monitoring the involution process by ultrasonography enables early detection of potential complications and timely intervention. Data in the literature regarding the normal postpartum period in cats are limited. Knowledge of the normal ultrasonographic appearance of uterine involution would be beneficial for the management of the postpartum period. The aim of this study was to describe uterine involution following normal parturition and elective cesarean section in cats using real-time ultrasonography. Fifteen healthy cats of different breeds were evaluated in two groups: the normal delivery group (NDG; n = 8) and the elective cesarean section group (PSG; n = 7). The NDG consisted of queens brought to the animal hospital by owners who anticipated difficulties in managing the birth process but whose deliveries were completed without assistance under clinical supervision. The PSG included queens with a high risk of dystocia due to breed predisposition, pelvic narrowing, or similar factors, for whom elective cesarean section was requested by the owners. No medications that could affect uterine involution were administered. All cesarean procedures were performed by the same surgical team, and all kittens were delivered through a single incision made in the uterine body. Ultrasonographic measurements were obtained transabdominally with the animals in dorsal recumbency. Measurements began immediately after the last kitten was delivered in the NDG and immediately after extubation in the PSG (0 hour). Within the first 48 hours, measurements were performed at 6-hour intervals; thereafter, once daily until day 7, and then weekly until day 28. In both uterine horns, transverse sections were obtained between the hyperechoic serosal layers, including four different placentation sites and the transverse section of the cervix. The mean of the four placentation sites was used for calculations. When mean uterine body diameters were evaluated, no statistically significant difference was observed between the NDG (20.61 ± 3.3 mm) and PSG (17.97 ± 1.56 mm) at 0 hour (p > 0.05). However, at 42 and 48 hours and on days 3 and 4, the mean values in the NDG were significantly lower than those in the PSG (p = 0.023; p = 0.003; p = 0.037; and p = 0.001, respectively). In contrast, comparison of cervical measurements revealed that values in the NDG were significantly higher than those in the PSG throughout the entire measurement period (p ranging from 0.000 to 0.0026). Overall, uterine diameter decreased gradually and in parallel in both groups from day 0 to day 28, with an accelerated reduction observed between days 2 and 4 in the NDG. The difference in cervical diameter was attributed to the performance of cesarean section before complete cervical dilation in the PSG. In conclusion, postpartum uterine involution in cats can be safely monitored by ultrasonography up to day 28, and elective cesarean section does not appear to have any clinically significant delaying or adverse effect on uterine involution compared with normal parturition.