Retention of fetal membranes, or retained placenta, usually is defined as failure to expel fetal membranes within 24 hr after parturition. Normally, expulsion occurs within 3–8 hr after calf delivery. The incidence in healthy dairy cows is 5%–15%, whereas the incidence in beef cows is lower. The incidence is increased by abortion (particularly with brucellosis or mycotic abortion), dystocia, twin birth, stillbirth, hypocalcemia, high environmental temperature, advancing age of the cow, premature birth or induction of parturition, placentitis, and nutritional disturbances. Cows with retained fetal membranes are at increased risk of metritis, displaced abomasum, and mastitis.
Retention of fetal membranes is mediated by impaired migration of neutrophils to the placental interface in the periparturient period. The impaired neutrophil function extends into the postpartum period and probably mediates the recognized complications of retained fetal membranes. Cows with retained fetal membranes have increased cortisol and decreased estradiol concentrations in late pregnancy. They may also have an altered prostaglandin (PG) E2:PGF2 ratio. Uterine contractility is increased in affected cows. (Placental detachment, rather than uterine motility, is responsible for retention of fetal membranes.)
Diagnosis is usually straightforward as degenerating, discolored, ultimately fetid membranes are seen hanging from the vulva >24 hr after parturition. Occasionally, the retained membranes may remain within the uterus and not be readily apparent, in which case their presence may be signalled by a foul-smelling discharge. In most cases, there are no signs of systemic illness. When systemic signs are seen, they are related to toxemia. Uncomplicated retention of fetal membranes is unsightly and inconvenient for animal handlers and milkers but generally not directly harmful to the cow. However, cows with retained fetal membranes are at increased risk of developing metritis, ketosis, mastitis, and even abortion in a subsequent pregnancy. Cows that have once had retained fetal membranes are at increased risk of recurrence at a subsequent parturition.
Manual removal of the retained membranes is not recommended and is potentially harmful. Trimming of excess tissue that is objectionable to animal handlers and contributes to gross contamination of the genital tract is permissible. Untreated cows expel the membranes in 2–11 days. Routine use of intrauterine antimicrobials has not been found to be beneficial and may be detrimental. Although advocated at various times, oxytocin, estradiol, PGF2α, and oral calcium preparations have not been shown to hasten expulsion of retained membranes or to prevent complications. When systemic signs of illness are present, systemic treatment with antimicrobials is indicated. In herds in which incidence of retained fetal membranes is unacceptably high, predisposing causes should be sought and eliminated. Supplementation with vitamin E and selenium for herds in which these nutrients are deficient has been found to be beneficial.
Last full review/revision December 2014 by Robert O. Gilbert, BVSc, MMedVet, DACT, MRCVS