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Ultrasonographic diagnosis of adhesions, quantification of uterine wall and managerial perspectives of uterine torsion in buffaloes.

The present study aimed to diagnose uterine adhesion using ultrasonography to decide the treatment approach for better survival of buffaloes suffering from uterine torsion. The peculiar visceral slide against the other abdominal organs induced by breathing was considered an absence of uterine adhesion, while the total absence of visceral slide was considered the presence of uterine adhesions on ultrasonographic examination. The 59 Mehsana buffaloes suffering from uterine torsion were divided into two groups based on the presence (Group I; n=27) or absence (group II; n=32) of adhesions. The mean pixel values (MPV) and thickness of uterine wall were also quantified in both the groups. In group I, sever type adhesions (n=16/27) were directly subjected to cesarean section (CS), while fibrinous adhesions (n=11/27) were subject to rolling by Sharma's modified Schaffer's method, and if rolling failed were further, subjected to CS and adhesions were confirm during CS. In Group II, 28 buffaloes were subjected to rolling by Sharma's modified Schaffer's method and 4 buffaloes were directly subjected to CS because of longer duration of illness (≥3 days), higher degree (≥180°), and previous field handling. The incidence of adhesions was 45.76 per cent (27/59) in buffaloes with uterine torsion. The degenerative changes such as oedematous (hyperedema - hypoechoic with anechoic trabeculae) or thin (homogenous hypoechoic), sloughing of serosa, and wall separation were observed in the uterine wall. The significantly thinner uterine wall (P=0.017) and higher MPV (P=0.001) were evident in group I than group II. The weak negative non-significant correlation between uterine wall thickness and MPV was observed in group I (r = -0.250, P = 0.147) and group II (r = -0.235, P = 0.089). The dam survival rate was 48.15 per cent (13/27) in group I and 81.25 % (26/32) in group II. There was a significant (P=0.04) association between the treatment approach and dam survival. Ultrasonography has synergistic diagnostic value for uterine adhesions by evaluating uterine surfaces beyond the reach of obstetricians during a manual clinical examination. Thereby avoiding futile efforts to relieve uterine torsion by rolling might help to improve dam survival by planning a better obstetrical maneuver to salvage buffaloes suffering from uterine torsion.