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Embryological Development of the Genital Tract (General responses to…
Embryological Development of the Genital Tract
Disorders of sexual development (DSD)
Classified based on sex chromosome, presence of SRY gene, gonads present, tubular genitalia and external phenotype
Types
Aneuploidy
abnormal number of chromosomes
True Hermaphrodite
possess gonadal tissue of both sexes
ovotestis
one gonal of each type
Pseudohermaphrodite
Male pseudohermaphrodite
Female pseudohermaphrodite
sex chromosomes and gonads are of one sex but the ducts and external genitalia are of the opposite sex
Freemartinism/ Chimerism
female calf born co-twin with a male calf
placental anastomosis
testes develop earlier in embryonic life
TDF, MIS and testosterone enter female twin's circulation
impaired female gonadal development
Morphological features
Relatively normal genitalia
Enlarged clitoris, long tufts of hair round vulva, skin fold from groin to umbilicus
Hypoplastic and blind ended vagina
Hypoplastic vulva and vestibuleUnderdeveloped uterus
Vestigial vesicular glands present at base of paramesonephric ducts
Small/ underdeveloped mammary glands
Stunted ovaries with seminiferous tubules
Mosaics
Pathology of the Female Reproductive Tract
Ovaries
Congenital Abnormalities
Ovarian agenesis or duplication
Ovarian remnant syndrome
Cysts
Ovarian hypoplasia
Acquired Pathology
Cysts
Follicular cysts
pigs and cattle
failure of ovulation
failure of LH peak
secrete oestrogen
affect cyclic activity and behaviour
anoestrus. nymphomania
cystic endometrial hyperplasia
mammary hyperplasia
Luteinised cysts
in pigs and cattle
failure to ovulate
delayed/ inadequate LH release
cyst partially luteinised
no oestrogen production
multiple
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DDx
cystic corpora lutea
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Cystic corpora lutea
NORMAL
Epithelial inclusions cysts
infertility in mares
Cytic rete ovarii
bitches and queens
Physiological
Graafian/ ovarian
Inflammation
oophoritis
repair by granulation tissue formation
fibrous adhesions to bursa
Ovarian Neoplasia
Germ cell origin
teratoma
dysgerminoma
Gonadal stroma
granulosa and thecal cells
Granulosa-theca cell tumour
mare and cow
Unilateral
Benign
Encapsulated, nodular white grey surface
cystic +/- haemorrhage
Secrete oestrogen/ progesterone/ testosterone
persistent oestrus
male behaviour
cystic endometrial hyperplasia
pyometra
Tumours of the surface epithelium
Adenocarcinoma
pale, nodular, cauliflower-like masses
cystic endometrial hyperplasia
Uterine tubes
Obstruction
hydrosalpinx
Inflammation
pyosalpinx
Uterus
Congenital abnormalities
Segmental aplasia of uterine horns and/ or uterine body
Failure of the caudal parts of the paramesonephric ducts to fuse
Failure of fusion of the paramesonephric ducts with the urogenital sinus
Acquired pathology
Abnormal position/ location
Torsion
pregnancy/ pyometra
congestion, oedema, foetal death, uterine rupture
Prolapse
post partum, secondary to hypocalcaemia, prolonged dystocia
congestion, oedema, necrosis, shock
Rupture
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Endometrial changes
Atrophy
loss of ovarian function
age related, secondary to hypopituitarism, anoestrus, ovariectomy
Hyperplasia
hormone influence
granulosa cell tumours
Non-cystic hyperplasia occurs in sheep following ingestion of oestrogenic plants
Endometrial polyps
bitch and queen
focal enlargement of uterine horn
pedunculated mass of stroma and dilated glands
may prolapse through the cervix
Inflammation
Examples
Endometritis
Sequelae
Ascending infection
Descending infection
Septicaemia
Embolic spread
endocarditis
Chronic endometritis
Pyometra
Placentitis
Endometrosis
Pyometra
Myometritis
Perimetritis
Metritis
Routes
via cervix
mating/parturition
Post-partum
dystocia, retained placenta, failure of involution
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Infection at mating
non-specific endometritis
rapidly cleared by neutrophils
Taylorella equigenitalis
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haematogenous
Macroscopic observations
slight opacity of oestral mucus
malodourous
dark brown to grey uterine contents
ulcerated, congested, haemorrhagic mucosa
Cystic endometrial hyperplasia and pyrometra in the dog
Clinical signs: middle aged/old, entire bitch that has never been bred, inappetance, lethargy, vomiting, PUPD, +/- uterine discharge, pyrexia, neurophilia and a painful/distended abdomen
Caused by oestrogen priming followed by elevated progesterone
Subsequent bacterial infection by E.colil, Staph A, Strep spp.
Macroscopically : Distended uterine horns containing pus within congested aerosol surfaces
Microscopically: Marked endometrial hyperplasia with cystic glands, inflammatory cells (often neutrophils), congested blood vessels
Extra-genital lesions: Toxaemia/ septicaemia, membranoproliferative glomerulonephritis, myeloid hyperplasia in the bone marrow, extramedullary haematopoiesis in the liver, spleen
Miscellaneous pathology of the uterus
Subinvolution of placental sites
persistent bloody discharge +/- necrotic placental tissue
Hydrometric/Mucometra
Uterine neoplasia
Usually primary tumours with rare metastasis
Examples
Uterine carcinoma
Leimyoma
Non-infectious Conditions of the Pregnant Uterus
Rupture
Vetnral herneation
Adventitial placentation
Hydroamnios and hydroallantois
Prolonged gestation
Prolonged gestation
Twinning
Post parturitient haemorrhage
Umbilical cord torsion
Vagina and vulva
Congenital defects
Swelling
Trauma
Inflammation
Fistulas
Neoplasia
Squamous cell carcinoma
Transmissable venereal tumour
Melanotic tumours
Vaginal leiomyoma
General responses to Disease During Pregnancy
Early embryonic death
Mummification
Maceration and emphysema
Abortion
Stillbirth
Live birth
Congenital malformation of the foetus
Retained foetal membranes causing metritis and endometritis
Terminology
Mesonephric ducts
Wolffian
develop into epidydymis and vas deferens
secrete Mullertian inhibitory substance
regression of paramesonephric ducts
Paramesonephric ducts
Mullerian
under oestrogen influence
develop into oviduct, uterus, cranial vagina
Chromosomal sex
XX
XY
Gonadal sex
presence/absence of SRY gene