International Journal of Applied Animal Sciences, Volume 1(2):39-47 ISSN 1925-3869 (online)

©International Network for Scientific & Industrial Information

Review Article
Etiology, prepartal diagnosis and management of
maternal complications of gestation in the water
buffalo
Govind Narayan Purohit
Department of Veterinary Gynecology and Obstetrics, College of Veterinary and Animal Science,
Rajasthan University of Veterinary and Animal Sciences, Bikaner Rajasthan India. 334001
Corresponding author: gnpobs@gmail.com
_____________________________________________________________________________________________

ABSTRACT
The etiology, prepartal diagnosis and management of common maternal complications of gestation in buffalo are
mentioned. Although poorly understood the etiology of maternal complications usually appears to lie with the
disturbances in maternal homeostatic mechanisms or genital tract motility (vaginal prolapse, uterine torsion,
periparturient recumbency), disruption of maternal body structures (hernia, prepubic tendon rupture) or problems
with the fetus within the uterus (vaginal discharge, prolonged gestation). The incidence of vaginal prolapse appears
to be much frequent compared to other maternal complications described for buffalo. The diagnosis of most
maternal complications of pregnancy is easy due to the visible and palpable changes that follow. The management
strategy for maternal gestational complications is oriented towards safe completion of pregnancy or its termination
when this is not possible.

Key Words: Water buffalo, cervico-vaginal prolapse, uterine torsion, hernia, periparturient recumbency
Int. J. Appl. Anim. Sci. 1(2):39-47

INTRODUCTION or relaxation of the constrictor vestibuli muscle and

Periparturient reproductive disorders have
an adverse effect on the reproductive performance of
water buffaloes (Khan et al., 2009a). Complications
during pregnancy may result in economic losses
(Ibrahim, 1992; Rabbani et al., 2010). Bubaline
maternal conditions that can be potentially
problematic for pregnancy include cervico-vaginal
prolapse, uterine torsion, abdominal and
diaphragmatic hernia, rupture of the prepubic tendon
and periparturient recumbency (Purohit, 2012). The
etiology of many of the maternal complications
continues to be poorly described. The diagnosis of
common complications is easy; however, the
orientation of the therapy remains towards safe
completion of gestation or termination of pregnancy
when this is not possible. This review analyses the
common maternal gestational complications in water
buffalo.
CERVICO-VAGINAL PROLAPSE
Prolapse of the vagina means outward
protrusion of the vaginal floor, the lateral walls and a
portion of the roof of the vagina through the vulvar
lips. Rarely, the entire vagina and cervix (identifiable
by the cervical rings) are prolapsed out through the
vulva. The basic cause appears to be the weakening
atony of the vaginal musculature. By far antepartum
vaginal prolapse is described as the most common
maternal gestational complication in the water
buffalo (Sheth, 1970; Nanda and Sharma, 1982).
Cervico-vaginal prolapse is less common in water
buffalo compared to the vaginal prolapse (Khan et al.,
1984; Sah and Nakao, 2003). The incidence of pre-
partum cervico-vaginal prolapse has been described
to be higher (3-13%) in water buffalo (Sheth, 1970;
Nanda and Sharma, 1982; Kaikini and Deshmukh,
1984; Mishra et al., 1998). Vaginal prolapse has been
reported to be common compared to postpartum
prolapse in water buffaloes with the condition
reported for Murrah (Nanda and Sharma, 1982), Surti
(Sheth, 1970), Nili Ravi (Akhtar et al., 2008), Nepali
(Sah and Nakao, 2003) and Egyptian (Hussien et al.,
2009) water buffaloes. It seems that the incidence of
vaginal prolapse reported has been calculated from
actual cases attended and not from total calvings.
Mishra et al., 1998 recorded only three cases of
vaginal prolapse during a five year period at a
University farm at Jabalpur. However data analysis at
our University buffalo farm revealed zero incidence
of prepartal cervico-vaginal prolapse during a ten
year period (2001-2011) involving 529 calvings of
the Surti buffalo. A seasonal incidence of vaginal

39

prolapse has been described for water buffalo (Nanda
and Sharma, 1982; Samad et al., 1987; Bhatti et al.,
2006). The increased incidence with increasing
parities was not found in all studies (Pandit et al.,
1982; Bhatti et al., 2006). Stall fed buffaloes were
considered more prone to antepartum vaginal
prolapse (Mishra et al., 1998).
Etiology
Postulated etiologies for a higher incidence
of antepartum vaginal prolapse in water buffaloes at
some locations include low levels of plasma copper,
selenium and zinc (Dimanov and Dimitrov, 1988;
Kelkar et al., 1989; Bhatti et al., 2006; Akhtar et al.,
2012), low levels of serum calcium and phosphorous
(Nanda and Sharma, 1982; Pandit et al. 1982;
Sharawy et al., 1988; Mandali et al., 2002; Ahmad et
al., 2005; Bhatti et al., 2006; Akhtar et al., 2008) and
increased levels of plasma estradiol during late
gestation (Agarwal and Prasad, 2001; Mishra et al.,
1998; Siddiquee et al., 2006; Kumar et al., 2009).
The increasing levels of estrogen during the
last 2-3 months of pregnancy cause relaxation of the
pelvic ligaments and adjoining structures (Siddiquee
et al., 2006; Kumar et al., 2009). When the animal
sits down the intra-abdominal pressure (especially in
late pregnancy) is transmitted to the flaccid pelvic
structures tending to force the relaxed and loosely
attached vaginal floor and walls through the vulva.
Less common etiological factors described for
vaginal prolapse in the water buffalo include vaginitis
(Krishna and Dharani, 2010) and urinary tract
infection (Sharma et al., 1977). A hereditary
predisposition to prolapse is known in some breeds of
cows (Hussien et al., 2009) but not documented for
the buffalo. The condition is more common in
pleuriparous animals that had suffered dystocia
during previous parturitions, closely confined animals
(Mishra et al., 1998), animals fed high estrogenic
feeds (subterranean clover) and animals that had
ovarian cysts for prolonged periods. Antepartum
prolapse is common between 8-10 months of
pregnancy in water buffalo (Nanda and Sharma,
1982; Kumar, 1988; Mishra et al., 1998)
The pathogenesis and development of the
prolapse is progressive; it starts with the exposure of
some of the vaginal mucous membrane. The
prolapsed mass moves in and out as the water buffalo
gets up and lies down. The exposed mucous
membranes dry out and become irritable, leading to
straining and greater exposure of the mass. The
prolapsed tissues become edematous, leading to
further circulatory impairment and more swelling.
Ultimately the cervix and occasionally the intestines
and bladder may become involved (Veeraiah and
Srinivas, 2010). The prolapsed mass when remains
40
Int. J. Appl. Anim. Sci. 1(2):39-47
outside its normal location become progressively
inflamed and edematous. Prolapse may sometimes
recover spontaneously subsequent to parturition;
however it is likely to reoccur in subsequent
parturitions. High doses of estrogen injections given
to treat anestrus in buffalo can result into cervico-
vaginal prolapse (Purohit, 2009).
Diagnosis
The protrusion of an ugly looking soiled
mass is an obvious clue; a presumptive diagnosis is
frequently made by the owner. The prolapse is
common during the last 2 months of pregnancy in the
buffalo although it may be noticed as early as 4-5
months of pregnancy (Sah and Nakao, 2003). In mild
cases the prolapsed part may return to its normal
position when the animal stands up and often farmers
replace the prolapsed part when it is afresh (Pandit et
al., 1982). When the prolapse remains out for
prolonged periods it often swells up, is inflamed and
infected and when prolapse remains for very
prolonged periods, necrosis and gangrene occur
because of vascular insult and thrombosis may ensue.
In unattended cases suffering from cervico-vaginal
prolapse a purulent discharge may be evident (Pandit
et al., 1982), the cervical seal may liquefy with
subsequent death and maceration of the fetus, and
rarely death of the dam. The animal may exhibit
straining and tenesmus which may be intermittent or
constant depending upon the degree of prolapse, time
since prolapse and the inflammation that develops
subsequently (Purohit, 2012).
The prognosis in prolapse of cervix and
vagina depends upon the severity of the condition and
the length of time it has existed. Except in extreme or
severe cases, the prognosis is generally fair to good
for the life of the animal, and the fetus, if treatment is
prompt and aftercare is good (Sah and Nakao, 2003;
Hussien et al., 2009). In most extreme cases
complicated by the prolapse of rectum, death of fetus,
septic metritis, necrosis of prolapsed organ,
septicemia or constant violent straining, the prognosis
is guarded to poor (Bhatti et al., 2006).
Therapy
Once the organ is prolapsed out, it goes on
progressively increasing in size due to edema,
irritation and the tenesmus may increase. The method
of treatment selected for handling prolapse of the
vagina and cervix will vary with the severity of the
condition, the stage of pregnancy and the ability of
the owner to care for and observe the animal until
after parturition. The attending veterinarian must
advise the owner to keep the organ wrapped in a soft
wet cloth and free from dirt till the veterinarian
arrives. Replacement of the prolapse back to its

normal position should be the first aim of therapy.
The organ must be raised above to release pressure
over the bladder and this facilitates the animal to
urinate without difficulty (Kumbhar et al., 2009). The
organ must then, be washed with soap and water to
remove dirt and feces. Often, when the organ is
enlarged due to edema, the application of sugar, salt
and alcohol helps in reducing edema (Purohit, 2012).
The use of epidural anesthesia in reducing straining
before replacement must be restricted to some
specific cases only.
The organ must be sufficiently lubricated
with liquid paraffin or bland oil and replaced back by
slowly inverting inwards with constant pressure. This
can easily be done in a standing animal rather than
when the animal is sitting. Once the prolapsed part
has been replaced, the operator must keep his hand
inside for some time and then withdraw his hand
slowly. When animals are straining severely, often
the prolapse tends to reoccur and some sedatives may
initially be given. Epidural administration of 0.05
mg/Kg of xylazine reduces straining for 22 hours and
often prevents recurrence (Rai and Prabhakar, 2000).
The vulvar truss is thus of practical value in
pregnant dairy buffaloes and is a frequently used
method for prevention of recurrence of cervico
vaginal prolapse (Sheth, 1970; Kumar, 1988;
Kumbhar et al., 2009; Dharani et al., 2010). The truss
made of leather, wide cloth and ropes are good. Truss
must be padded with small towels. Too loose truss
may be of little value and too tight truss may cause
pressure necrosis.
The orientation of therapy is towards
maintaining the organ in its normal position and safe
completion of gestation. A wide variety of sutures
have been suggested for retaining the prolapsed organ
in cows including the buhner suture, the bootlace
suture, flessa sutures, and the interrupted horizontal
mattress suture (Purohit, 2012). Often, when the care
after placement of these sutures is not proper, or the
straining is violent, the sutures do not hold good,
often resulting into tearing of tissues and/or
contamination of the suture area. The umbilical tape
in useful for purse string sutures commonly used in
buffalo (Pandit et al., 1982; Singh et al., 2006;
Chaudhary et al., 2010). Two techniques for surgical
repair of vaginal and cervical prolapse in buffaloes
have been described. These include vaginopexy
(Minchev’s method) in which the vaginal walls are
tied to the croup muscles (Singh et al., 2006) and
cervicopexy (Winklers operation) in which the cervix
is fastened to the prepubic tendon but require
specialized needles and sufficient practice for proper
placement (Khan et al., 1984; Behesti et al., 2011).
These techniques are however difficult to perform
and thus they have not become popular (Behesti et
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Int. J. Appl. Anim. Sci. 1(2):39-47
al., 2011). A caslicks operation is also suggested
(Purohit, 2012) but this is often sub optimal as
constant straining is common in dairy cows and
buffalo. Constant straining is also a common problem
after replacement of the prolapsed organ. The use of
proper lubrication, anesthetic jellies, emollient
creams and mild sedatives before replacement often
reduce this straining. Other methods suggested to
reduce straining include epidural anesthesia, (4 ml of
2% procaine in 50% ethyl alcohol) (Pandit et al.,
1982) but their efficiency is often far from perfect
and hence cannot be suggested for routine practice.
To replace the older procedures of surgery
laparoscopic hysteropexy (Maher et al., 2001) has
been suggested for human patients with recurrent
uterine prolapse. Laparoscopic procedures for
Vaginopexy and Cervicopexy must be experimented
instead of the routine surgical procedures.
Termination of pregnancy in advanced pregnant
buffaloes with recurrent cervico-vaginal prolapse is
suggested (Murugeppa, 1998; Jeyakumar et al.,
2004). A combination of prostaglandin and
dexamethasone is a good choice for the purpose
(Purohit et al., 2012b)
In spite of many techniques described, the
therapy of prolapse is sometimes imperfect. Parentral
administration of calcium (150 mL SC),
phosphorous, antibiotics (Pandit et al., 1982; Kumar,
1988) and progesterone injections (500 mg IM)
(Nanda and Sharma, 1982) are often rewarding but
may sometimes evidence sub-optimal effects and the
author feels the more promptly the prolapse is
replaced and ample care provided, the more is the
likelihood of therapeutic efficiency and similar views
have been expressed by other workers (Sah and
Nakao, 2003). Care of animals with prolapse include
little of exercise, feeding of less bulky diets,
reduction in estrogenic feeds (if being fed) and
frequent watch of these animals. Feeding of seeds of
Argyreia speciosa have been reported to prevent
recurrent prolapse in buffalo (Dhillon et al., 2006) but
the trial was on a extremely small number of
buffaloes. Likewise the use of homeopathic medicine
Sepia 200 given orally have shown some promise in
the prevention of recurrent prolapse (Purohit, 2009)
but not proven experimentally.
TORSION OF THE UTERUS
Uterine torsion is the rotation of the
pregnant uterus on its longitudinal axis. The
condition is well known in parturient water buffalo
(Rabbani et al., 2010; Purohit and Gaur, 2011;
Purohit et al., 2011; Purohit et al., 2012a) and is
considered the single largest cause of dystocia in this
species (Srinivas et al., 2007; Purohit and Mehta,
2006; Purohit et al., 2011; Purohit et al., 2012a). Less

commonly does the problem occur during mid
gestation (Singh et al., 1979). In our own studies mid
gestation uterine torsion was recorded only in two
water buffaloes of the total 53 cases of uterine torsion
(Purohit and Mehta, 2006). Analysis of 529
parturitions in Surti buffaloes during a 10 year period
(2001-2011) at our University farm revealed no mid
gestation uterine torsion. Only 2% of the total uterine
torsions in one previous study occurred before
completion of gestation in water buffaloes (Mannari
and Tadkod, 1976). A recent study however,
evidenced an exceptionally high incidence of 58.4%
of uterine torsion in Egyptian water buffaloes during
the last trimester of pregnancy (Ali et al., 2011) with
high fetal mortality.
Etiology
The etiology of the condition is not well
understood although anatomical positioning of a
pregnant uterus, weak musculature of the broad
ligaments (Brar et al., 2008a,b) and inordinate fetal
movements have been assorted as the most frequent
cause (Ghuman, 2010).
Diagnosis
Mid gestation uterine torsion is manifested
by mild colic, sometimes with symptoms of mild to
severe straining. Animals become anorectic and
evidence mild degree of constipation. The diagnosis
is dependent on recto genital palpation of the location
of the broad ligaments and is comparatively easier
during the late gestation but difficult in uterine
torsions during early gestation. Transabdominal
ultrasonography has been recently mentioned to
evaluate the fetal viability and echogenecity of the
fetal fluids in uterine torsion affected water buffaloes
(Amin et al., 2011) but the sonographic features were
not described in this study. The prepartal diagnosis of
uterine torsion is thus difficult owing to weak clinical
symptoms and less proximity to parturition. Animal
owners must thus get their animals examined per
rectum if the animal evidences colic.
Therapy
Therapy of gestational uterine torsion is
similar to that described for uterine torsion at
parturition (Purohit et al., 2011). Mild degree uterine
torsions can be easily corrected by rolling of the
animal. Administration of progestagens should be
considered carefully as animal’s frequently complete
gestation without any difficulty subsequent to uterine
torsion correction. In cases where the uterine torsion
has persisted for long periods fetal death may ensue
and in these cases pregnancy termination should be
considered (Purohit et al., 2012b).
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Int. J. Appl. Anim. Sci. 1(2):39-47
ABDOMINAL HERNIA
Umbilical, inguinal, perineal and
diaphragmatic hernias when large enough increase
the probability of a pregnant uterus entering the
hernial sac. Umbilical hernias are hereditary, but
usually small (in size) in buffalo (Amle et al., 2004)
however animals with large sized hernias should not
be bred as they may pose difficulty when the gravid
uterus descends in them. Inguinal hernias are
hereditary or acquired and are known to be
uncommon in the water buffalo. Inguinal hernias are
usually unilateral and are characterized by a swelling
in the inguinal region which may become
progressively larger (if the uterine horn is present in
the hernial sac) as the pregnancy progresses. Perineal
hernias are uncommon in the water buffalo (Nair et
al., 1986; Patel et al., 1988) and they are seldom seen
concomitant to a pregnancy.
Unilateral ventral hernias are seen in water
buffaloes occasionally (Kumar et al., 1996) but rarely
during the advanced pregnancy. The hernia might be
present even before pregnancy and usually are a
result of trauma (due to horn butting or others). They
are mostly located on the right side of the abdomen.
The hernias may not pose any difficulty until a
portion of the uterus enters the hernial sac that is
easily palpable. Parturition may be difficult because
of the inability of the abdominal muscles to contract
equally and strongly and force the fetus out of the
birth canal. Surgical repair of the hernia when large
enough is indicated only in valuable animals (Sobti et
al., 1994).
Diaphragmatic hernias are the most common
type of hernia described for the buffalo (Naik and
Mehendale, 1969; Singh et al., 1977; Singh et al.,
1980; Misk et al., 1997; Misk and Semeika, 2001;
Mohindroo et al., 2007) including their surgical
correction by trans-thoracic (Gahlot et al., 1987) or
trans-abdominal approaches (Singh et al., 1977).
Diagnosis
Most hernias are easy to diagnose because of
the swelling/enlargements that are visible and
palpable. Diapgragmatic hernias may be confirmed
by ultrasonography (Misk et al., 2001; Mohindroo et
al., 2007).
Therapy
When observed during mid gestation most
hernias cannot be surgically corrected and should be
managed for successful completion of pregnancy by
abdominal support using canvas straps and movement
restriction. Unless very large, hernias seldom create a
problem during pregnancy. They mostly pose
problem at the time of parturition.

RUPTURE OF PREPUBIC TENDON OR
PREPUBLIC DESMORRHEXIS
This condition is seen most commonly
during pregnancy in the mare (Perkins and Frazer
1994; Mirza et al., 1997) and rarely in the water
buffalo (Sane et al., 1982). The condition is seen
most frequently in draft mares that are idle and well
fed, and infrequently in light mares (Purohit, 2012).
The condition is rather rare in buffalo because of the
presence of the sub pubic tendon, a structure that is
non-existent in horses. This structure in cows and
water buffalo provides an added support to the
prepubic tendon (Purohit, 2012). Severe edema of the
abdominal floor in the late pregnant water buffalo
should be viewed seriously.
The increased weight of the gravid uterus,
trauma, twins, hydrops of the fetal membranes and
fetal giants are predisposing factors. Because of a
transverse rupture of the prepubic tendon, the gravid
uterus drops downward into a sac formed by the skin
and cutaneous muscles.
Diagnosis
Symptoms of sudden enlargement of
abdominal region, intense pain and colic, fast
respirations may appear suddenly or slowly. When
the rupture is traumatic an animal may sometimes
collapse due to shock and possible hemorrhage.
Animals with ruptures are reluctant to lie down. The
animal has a typical sawhorse appearance, with an
elevation of the tail. The prognosis in rupture of the
prepubic tendon is always poor.
Therapy
Therapy is many times unsuccessful.
Movement of the animal should be restricted and
bulky diets should be avoided. Laxatives are
recommended. Suitable heavy, wide canvas webbing
should be tightened securely with straps around the
abdomen, to transfer the abdominal weight to the
spine. Induction of parturition must be considered,
and the animals monitored carefully to provide any
help at parturition (Purohit et al., 2012b). Slings may
be indicated in some cases. Caesarean section is
suggested for valuable animals’ especially to save the
progeny.
PERIPARTURIENT RECUMBENCY
There are numerous causes for recumbency
during pregnancy. Most of these conditions occur
during, or are aggravated by advanced pregnancy,
during which period there is very rapid growth of the
fetus coupled with progressive pelvic ligament
relaxation and increase in the size and development
of the udder (Yilmaz et al., 2006). Periparturient
recumbency is less frequent in the water buffalo.
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Int. J. Appl. Anim. Sci. 1(2):39-47
Many factors described for periparturient recumbency
in cattle include nutritional deficiencies, infectious
diseases, trauma, metabolic disorders and
hydroallantois (Purohit, 2012) and a few of these
factors might probably be existent in the water
buffalo.
PREPARTURIENT HYPOMAGNESAEMIA
(GRASS TETANY) AND HYPOCALCAEMIA
Both the conditions usually occur in dairy
cows on lush pastures such as wheat pastures or cows
grazing on pastures given heavy potassium fertilizers
(Purohit, 2012). The animals are anorectic and have a
low body temperature and become recumbent. Cows
with magnesium deficiency may evidence nervous
signs (Purohit, 2012). Diagnosis is often dependent
on the serum profiles and clinical signs. Therapy
involves administration of calcium or calcium and
magnesium preparations intravenously and removal
of the cows from lush pasture. Since dairy water
buffalo is rarely raised under similar conditions their
likely incidence is too low in this species, although
both hypocalcaemia (Patel et al., 2003; Khan et al.,
2009b) and hypomagnesaemia (Prathaban et al.,
1989) have been recorded in advanced pregnant water
buffalo (Solangi, 2004) with serum calcium levels
reaching as low as 5.6 mg/dL. Moreover many
studies on water buffaloes with antepartum prolapse
have shown deficiencies of calcium and phosphorous
(Nanda and Sharma, 1982; Pandit et al. 1982;
Sharawy et al., 1988; Mandali et al., 2002; Ahmad et
al., 2005; Bhatti et al., 2006; Akhtar et al., 2008) but
these water buffaloes did not evidence clinical
hypocalcaemia; thus it appears that preparturient
hypocalcaemia and hypomagnesemia is uncommon
in the water buffalo. Subclinical hypomagnesaemia in
water buffalo often do not manifest clinically.
PROLONGED GESTATION
Prolonged gestation may rarely occur in
water buffaloes. Many times improper record or
remembrance or non vigilance by the owner (animal
is sometimes thought to be pregnant on a particular
date but in fact the animal returned to estrus later and
was mated by a bull which was not noticed by the
owner). Moreover, some variation may occur in the
gestation length of various breeds. Likewise, calves
from certain sires are predisposed to longer gestation.
Male calves may have a slightly longer gestation.
Prolonged gestation is often suspected in mummified
fetuses. Various diseases like BVD and IBR that have
been recorded in water buffalo may cause pituitary
damage with resultant prolonged gestation (Galiero,
2007). Conditions like hydrocephalus may lead to
lack of pituitary support for onset of parturition.
Absence of fetal pituitary or pituitary malfunctioning

can; therefore, result in a prolonged gestation.
Feeding of some toxic plants like veratrum
californicum are known to result in a prolonged
gestation.
Diagnosis of a prolonged gestation is
dependent on efficient records in the absence of
which most currently available diagnostic procedures
are suboptimal. The termination of a prolonged
gestation usually involves the combined
administration of prostaglandin’s and corticosteroids
to water buffaloes, depending upon the stage of
gestation (Purohit et al., 2012b).
VAGINAL DISCHARGE DURING
PREGNANCY
A slight mucoid discharge is usual in
pregnant water buffaloes beyond 5-6 months of
pregnancy; however, a muco-purulent discharge must
be investigated promptly for pyometra, vaginitis or
pyelonephritis rather than pregnancy. Pregnant water
buffaloes developing vaginitis (Jeevanajyothi et al.,
2003) may even attract males. It is always wise to
make a speculum examination followed by recto
genital examination in the affected animals. Animals
with varicose veins may develop bleeding but not
reported for the buffalo.
A blood stained vaginal discharge is often an
indication of an impending abortion and should be
investigated promptly. It is pertinent to examine the
vagina and cervix by vaginal speculum. When the
cervix is open abortion is likely to follow shortly.
Clinicians often inject progestagens to such animals
which should be avoided as it often results in fetal
maceration in water buffaloes often complicating the
clinical outcome. The vaginal wall must also be
examined for any ruptures and if possible sutures or
cold packs and local antibiotic therapy must be
instituted in such cases.
CONCLUSIONS
The incidence of maternal gestational
complications is low at organized farms whereas in a
clinical setting antepartum vaginal prolapse is the
most common maternal gestational disorder in the
water buffalo. The incidence of prolapse,
periparturient recumbency and uterine torsion appears
to be increased due to deficiency of micronutrients
whereas prolonged gestation and vaginal discharges
originate from fetal pathology. Clinical management
of most gestational complications is oriented towards
safe completion of pregnancy or termination of
pregnancy when this is not possible. Supplementation
of pregnant water buffaloes with micronutrients
should be encouraged in areas with deficiencies and
laparoscopic approaches should be developed for
management of vaginal prolapse.
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