2. Fertility is one of the key determinants of the lifetime performance of a cow. For beef cows and for pastoral dairy cows, it is necessary for a calf to be produced every 365 days

3. One of the most significant causes of infertility in cattle is the complex of diseases that includes retained fetal membranes (RFM), puerperal metritis, endometritis, pyometra and other nonspecific infections of the uterus. These diseases share common etiological factors, predispose to one another and, to a large extent, share common treatments.

4. Several systems have been described in attempt to classify and define uterine infection. Uterine infections are generally classified according to clinical signs and degree of severity, which is in adhere to definitions used by theriogenologists.

5. Dohoo et al., (1984) classified uterine infection into three categories; primary metritis occurs within the first 21 days of calving, secondary metritis between 21 and 60 days, and tertiary metritis after 60 days postpartum.

6. Olson et al. (1986) have classified uterine infection slightly differently, puerperal metritis (acute septic metritis) occurs between the time of calving and recovery of the sensitivity of the pituitary gland to GnRH at days postpartum. Metritis and endometritis usually occur between resolution of pituitary sensitivity to GnRH and the first postpartum ovulation. Postovulatory infections arise during the time between the first ovulation and complete uterine involution. Diseases of the postovulatory period include chronic metritis, endometritis, and pyometra.

7. Roberts (1986) classified endometritis into mild endometritis which is characterized by little infiltration of lymphocytes and plasma cells with few fibrosis and cystic glandular degeneration, and the second type as severe endometritis and characterized by scar tissue formation in the endometrium with thickness of uterine tissue due to high infiltration of leukocytes associated with severe changes in uterine glands including atrophy, cystic degeneration and necrosis.

8. The uterus
Consist of
1 –endometrium : it is lined by simple columnar or pseudo stratified columnar epithelium and lamina propria-sub mucosa consist of two layer
A- superficial loose C.T. consist of (B.V.,fibroblast, macrophage, mast cell in cow found melanophores).
B-deep layer (loose C.T.) and is much less cellular than the superficial layer.

9. 2-myometrium:
It is composed of inner thick circular layers of smooth muscle fiber and an outer thin longitudinal layer of smooth muscle fiber both are separated by stratum vasculais the muscle cells increase in size and number during pregnancy.

10. 3-perimetrium:
It composed of a layer of mesothelium cells under line by a layer of loose C.T., smooth muscle cells, B.V. , lymph V, and nerve fibers are present in this layer.

11. Acute Puerperal Metritis

12. Acute Puerperal Metritis:
Also called postpartum metritis, toxic puerperal metritis or acute septic metritis
It occur in all species.
occurs within the first 10 days after parturition.
Acute onset.
Contamination of reproductive tract at parturition and often it follows complicated parturition.

13. Predisposing factors for acute metritis:
1. Uterine damages:
stillbirth, dystocia, twins, cesarean section,
retained placenta, delayed uterine involution.
2. Metabolic conditions:
milk fever, ketosis, left displaced abomasum.

14. Clinical signs: Depressed, febrile, and inappetent.
Uterine discharge is reddish-brown, fetid and watery (cows) but may not be observed in other species.
elevated body temperature.
Milk production is diminished
The palpation of the uterus per rectum reveals an enlarged and flaccid uterus.
Acute puerperal metritis responds well to systemic antimicrobial therapy - usually penicillin

17. Treatment:
An ideal treatment of metritis should eliminate bacteria from the uterine cavity and the subendometrial layers without inhibiting uterine defense mechanisms.
It should provide optimal reproductive performance in the current lactation, and not cause economic losses by milk withdrawl.

18. The best method for the therapy of acute metritis was using a systemic antibiotic treatment.
The effective treatment was achieved by administration of penicillin, oxytetracycline, systemically.

19. Pyometra

20. Pyometra: It is on of chronic metritis.
It is characterized by accumulation of pus or mucopurulent in the uterus.
The corpus luteum is retained and absence of oestrus.

21. The condition usually occur following:
Pyometra:
The condition usually occur following:
Abnormal parturition.
Uterine infection.
Abnormal uterine involution in some condition such as: abortion, premature birth, dystocia, retained placenta and septic metritis.

22. Pyometra:
Pyometra may be exists for days or more after parturition with a failure of estrus.
Some time pyometra occur after service and this condition usually associated with early embryonic death.

23. Pyometra: Symptoms: Failure of estrus.
When the cervix is opened, the pus is observed when the cow lies down, at urination or at defecation.
On rectal examination the uterine wall is usually thicken, flaccid and atonic.

24. Pyometra: Treatment: Firstly the corpus luteum must be removing.
If the new estrus cycle is begin, the cervix will dilate, the uterus will contract and the pus will be evacuated.
PGF2α.
Estradiol + Oxytocin.

26. Pyometra: Pyometra Pregnancy Bilateral distension of the uterus.
Unilateral distension of the uterus
The consistency of the pus is heavy.
Placental fluids are watery.
Pinching of the uterine wall dose not reveal the slipping of fetal membranes.
slipping of fetal membranes.

27. Pyometra: Pyometra Pregnancy No uterine artery thrilling.
Thicken uterine wall
Uterine wall is thin.

28. Mucometra & Hydrometra

29. Mucometra & Hydrometra:
Both conditions are occur due to accumulation of mucin in the uterus which may vary from a watery fluid to a simisolid.
These cases were seen as a secondary result of cystic ovaries.

32. Uterine therapy 1- local antibiotic 2- systemic antibiotic
3-uterine washing
4- hormonal therapy

36. Grasp the cervix and push it forward to straighten vaginal folds.

37. Grasp the external opening to the cervix with the thumb on top and the forefingers underneath to close the fornix and guide the gun tip into the cervix.

38. Using the flexibility of your wrist, twist and bend the cervix until you feel the second ring slide over the gun tip.

39. Use your index finger to check gun placement (1/4 inch past the end of the cervix)

40. Push the plunger slowly so that drops of solution fall directly into the uterine body.

41. Show the solution in the uterine body and horn

42. Thank you