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Equine veterinary journal2024; 56(4); 650-659; doi: 10.1111/evj.14094

Twin management in the mare: A review.

Abstract: Twin gestation in the mare is undesirable and can have disastrous consequences. As in many cases, the key to success in twin management lies in a thorough follow-up and accurate recording of clinical findings in the pre-breeding examination. A pregnancy diagnosis in the mobility phase is imperative for a good outcome in the event of twin reduction. If a twin gestation is not diagnosed during this early pregnancy stage, several other procedures exist for managing post-fixation twins (>16 days) with varying degrees of success. Most twin pregnancies are the result of multiple ovulations (dizygotic twins). However, monozygotic twins are also sporadically diagnosed, due to the increasing number of transferred in vitro produced equine embryos. In these cases, the most optimal treatment strategy still needs to be determined. This review provides an overview of the various twin reduction techniques described with the expected prognosis as well as of some less reported techniques with their results. In addition, physiological events and the reduction techniques are demonstrated to the user in virtual 3-dimensional illustrations.
Publication Date: 2024-04-09 PubMed ID: 38594910DOI: 10.1111/evj.14094Google Scholar: Lookup
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  • Journal Article
  • Review

Summary

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This research paper reviews the methods and techniques used to manage twin pregnancies in horses, detailing strategies for early diagnosis, twin reduction and treatment. It also discusses differing outcomes depending on the type of twin pregnancy and how advancements in embryo transfer have impacted the occurrence of identical twins in horses.

Understanding Twin Pregnancies in Horses

  • The paper first explains that twin pregnancies are problematic in horses and can lead to undesirable outcomes. The survival and wellbeing of both the mare and her foals can be compromised due to the physical stress and complications that dual pregnancies can cause.
  • The research details that most twin pregnancies result from dual ovulation, leading to fraternal twins. However, anecdotal evidence suggests a rise in identical twins due to the increased practice of in-vitro embryo transfer. Different management approaches are required for both circumstances.

Pregnancy Diagnosis and Early Management

  • Early diagnosis of a twin pregnancy improves the chance for successful management. The researchers stress the necessary follow-up and recording of signs during the pre-breeding examination.
  • Diagnosis during the mobility phase is highlighted as crucial. The mobility phase is the period when the conceptuses are still moving freely in the uterus; twins can be separated more easily and the less viable one can be reduced without damaging the healthier one.

Management of Late Detection

  • The paper elaborates on various procedures that exist if twin gestation is not diagnosed during the early stage. The post-fixation stage is when the embryos have attached to the uterus walls and are no longer moving freely, making their separation more difficult.

Twin Reduction Techniques and Prognosis

  • The researchers review various techniques for twin reduction, including some that are under-reported. The expected outcomes and prognoses of these methods are provided, giving horse breeders and veterinarians a broad and comprehensive resource on this topic.
  • The study also uses 3-dimensional virtual illustrations to effectively demonstrate the physiological processes and reduction techniques. This visual aid makes it easier for readers to understand the complex procedures involved.

Cite This Article

APA
Peere S, van Den Branden E, Papas M, Gerits I, Smits K, Govaere J. (2024). Twin management in the mare: A review. Equine Vet J, 56(4), 650-659. https://doi.org/10.1111/evj.14094

Publication

ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 56
Issue: 4
Pages: 650-659

Researcher Affiliations

Peere, Sofie
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Merelbeke, Belgium.
van Den Branden, Emma
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Merelbeke, Belgium.
Papas, Marion
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Merelbeke, Belgium.
Gerits, Ilse
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Merelbeke, Belgium.
Smits, Katrien
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Merelbeke, Belgium.
Govaere, Jan
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Merelbeke, Belgium.

MeSH Terms

  • Animals
  • Female
  • Pregnancy
  • Horse Diseases / therapy
  • Horse Diseases / diagnosis
  • Horses
  • Pregnancy Reduction, Multifetal / veterinary
  • Pregnancy, Twin
  • Pregnancy, Animal

References

This article includes 83 references
  1. Hodder ADJ, Liu IKM, Ball BA. Current methods for the diagnosis and management of twin pregnancy in the mare.. Equine Vet Educ 2008;20:493–502.
  2. Jeffcott LB, Whitwell KE. Twinning as a cause of foetal and neonatal loss in the Thoroughbred mare.. J Comp Pathol 1973;83:91–106.
  3. Merkt H, Jöchle W. Abortions and twin pregnancies in Thoroughbreds: rate of occurrence, treatments and prevention.. J Equine Vet 1993;13:690–694.
  4. Whitwell KE. Investigations into fetal and neonatal losses in the horse.. Vet Clin North Am: Large Anim Pract 1980;2:313–332.
  5. Wolfsdorf K. Management of twins in the mare.. Equine Vet Educ 2011;24:60–61.
  6. Frazer G. Twins.. Current therapy in equine medicine 2003;p. 245–248.
  7. Leon A, Pillon C, Tebourski I, Bruyas JF, Lupo C. Overview of the causes of abortion in horses, their follow‐up and management.. Reprod Domest Anim 2023;58:93–101.
  8. Roach JM, Foote AK, Smith KC, Verheyen KL, de Mestre AM. Incidence and causes of pregnancy loss after Day 70 of gestation in Thoroughbreds.. Equine Vet J 2021;53:996–1003.
  9. Chevalier F, Palmer E. Ultrasonic echography in the mare.. J Reprod Fertil Suppl 1982;32:423–430.
  10. Wolfsdorf KE, Macpherson ML. Management of twins.. Equine Vet Educ 2010;22:326–331.
  11. Ball B. Management of twin pregnancy in the mare–after endometrial cup formation.. Recent Advances of Equine Reproduction: International Veterinary Information Service 2000.
  12. McKinnon AO. Management of twins.. Equine reproduction 2011;p. 2099–2117.
  13. Ginther OJ. Mobility of twin embryonic vesicles in mares.. Theriogenology 1984;22:83–95.
  14. McKinnon AO. Twin reduction techniques.. Current therapy in equine reproduction 2007;p. 357–373.
  15. Ginther OJ. The twinning problem: from breeding to day 16.. Proc Am Assoc Equine Pract 1983;29:11–26.
  16. Schnobrich MR, Riddle WT, Stromberg AJ, Leblanc MM. Factors affecting live foal rates of Thoroughbred mares that undergo manual twin elimination.. Equine Vet J 2013;45:676–680.
  17. Ginther OJ. Relationships among number of days between multiple ovulations, number of embryos, and type of embryo fixation in mares.. J Equine Vet 1987;7:82–88.
  18. Newcombe JR. The relationship between the number, diameter, and survival of early embryonic vesicles.. Pferdeheilkunde 2004;20:214–220.
  19. Roberts CJ. Termination of twin gestation by blastocyst crush in the broodmare.. J Reprod Fertil Suppl 1982;32:447–449.
  20. Pascoe D, Pascoe R, Hughes JP, Stabenfeldt G, Kindahl H. Management of twin conceptuses by manual embryonic reduction: comparison of two techniques and three hormone treatments.. Am J Vet Res 1987;48:1594–1599.
  21. Nath LC, Anderson GA, McKinnon AO. Reproductive efficiency of Thoroughbred and Standardbred horses in north‐east Victoria.. Aust Vet J 2010;88:169–175.
  22. Davies Morel MCG, Newcombe JR, Lauber M. Manual reduction of multiple embryos in the mare: the effect on subsequent pregnancy outcome.. Vet J 2012;192:322–325.
  23. Carnevale E, Ginther O. Defective oocytes as a cause of subfertility in old mares.. Biol Reprod 1995;52:209–214.
  24. Rambags B, Colenbrander B, Stout TAE. Early pregnancy loss in aged mares: probable causes and possible cures.. Pferdeheilkunde 2003;19:653–656.
  25. Woodward EM, Christoffersen M, Campos J, Squires EL, Troedsson MHT. Susceptibility to persistent breeding‐induced endometritis in the mare: relationship to endometrial biopsy score and age, and variations between seasons.. Theriogenology 2012;78:495–501.
  26. de Mestre AM, Rose BV, Chang YM, Wathes DC, Verheyen KLP. Multivariable analysis to determine risk factors associated with early pregnancy loss in Thoroughbred broodmares.. Theriogenology 2019;124:18–23.
  27. Sheerin P, Howard CE, LeBlanc MM, Stromberg AJ. Effects of operator, treatment and mare age on the live foal rate of mares after manual twin reduction.. Anim Reprod Sci 2010;121:312–313.
  28. Ginther OJ. The nature of embryo reduction in mares with twin conceptuses: deprivation hypothesis.. Am J Vet Res 1989;50:45–53.
  29. Ginther OJ. Post‐fixation embryo reduction in unilateral and bilateral twins in mares.. Theriogenology 1984;22:213–223.
  30. Ginther OJ. Using a twinning tree for designing equine twin‐prevention programs.. J Equine Vet 1988;8:101–107.
  31. Wolfsdorf KE, Rodgerson D, Holder R. How to manually reduce twins between 60 and 120 days gestation using cranio‐cervical dislocation.. Proc Am Assoc Equine Pract 2005;51:284–287.
  32. Ginther OJ. Twin embryos in mares II: post fixation embryo reduction.. Equine Vet J 1989;21:171–174.
  33. McKinnon AO, Rantanen NW. Twins.. Equine diagnostic ultrasonography 1998;p. 141–156.
  34. Bowman T. Ultrasonic diagnosis and management of early twins in the mare.. Proc Am Assoc Equine Pract 1987;32:35–43.
  35. Mari G, Iacono E, Merlo B, Castagnetti C. Reduction of twin pregnancy in the mare by transvaginal ultrasound‐guided aspiration.. Reprod Domest Anim 2004;39:434–437.
  36. Allen WR, Moor RM. The origin of the equine endometrial cups. I. Production of PMSG by fetal trophoblast cells.. Reproduction 1972;29:313–316.
  37. Ginther OJ. Maternal aspects of pregnancy.. Reproductive biology of the mare: basic and applied aspects 1992;p. 291–344.
  38. Pascoe DR, Stover SM. Effect of surgical manipulation, placental fluid, and flunixin meglumine on fetal viability and prostaglandin F2 alpha release in the gravid uterus of mares.. Am J Vet Res 1989;50:1505–1511.
  39. Crabtree JR. Management of twins in horses.. In Pract 2018;40:66–74.
  40. Jonker F, Parleviet J, Pycock J, Vos P. Twin reduction in sixteen mares by transvaginal ultrasound‐guided puncture of the embryonic vesicle.. The 34th British Equine veterinary Association Congress 1995;45–49.
  41. Rau J, Tiedemann D, Sielhorst J, Tönissen A, Burger D, Martinsson G. Effects of mares' age and day of gestation on efficacy of transvaginal ultrasound‐guided twin reduction.. Tierärztliche Praxis Ausgabe G: Großtiere /Nutztiere 2018;46:172–177.
  42. Journée SL, de Ruijter‐Villani M, Hendriks WK, Stout TAE. Efficacy of transvaginal ultrasound‐guided twin reduction in the mare by embryonic or fetal stabbing compared with yolk sac or allantoic fluid aspiration.. Theriogenology 2013;80:346–349.
  43. Klewitz J. Evaluation of pregnancy and foaling rates after reduction of twin pregnancy via transvaginal ultrasound‐guided aspiration in mares.. J Am Vet Med Assoc 2013;242:527–532.
  44. Sielhorst J, Baade S, Neudeck K, Tönissen A, Rohn K, Hollinshead F. Success rates and factors influencing pregnancy outcome after 464 transvaginal ultrasound‐guided twin reductions in the mare.. Equine Vet J 2024;56(4):726–734.
    doi: 10.1111/evj.14071google scholar: lookup
  45. Bracher V, Parlevliet J, Pieterse M, Vos P, Wiemer P, Taverne M. Transvaginal ultrasound‐guided twin reduction in the mare.. Vet Rec 1993;133:478–479.
  46. Macpherson ML, Reimer JM. Twin reduction in the mare: current options.. Anim Reprod Sci 2000;60–61:233–244.
  47. Govaere JLJ, Hoogewijs MK, De Schauwer C, Dewulf J, De Kruif A. Transvaginal ultrasound‐guided aspiration of unilateral twin gestation in the mare.. Equine Vet J 2008;40:521–522.
  48. Morris L, Greenwood R, Allen W. Transvaginal ultrasound‐guided reduction of twin conceptuses in the mare.. Pferdeheilkunde 1999;15:614–617.
  49. Wolfsdorf KE. Management of postfixation twins in mares.. Vet Clin North Am Equine Pract 2006;22:713–725.
  50. Beavers K, Burden C, Mckinnon AO. Management of twin pregnancies by umbilical and fetal oscillation in the mare.. Clin Theriogenol 2017;9:468.
  51. Chopin J. A new technique for twin reduction in the mare.. Animal reproduction chapter meeting at the ANZCVS science week 2017;p. 15–17.
  52. Arnold LC, Stout TAE, Claes ANJ. Ultrasound‐guided fetal thorax compression to reduce post‐fixation twins in the mare.. Equine Vet J 2024;56(4):735–741.
    doi: 10.1111/evj.14060google scholar: lookup
  53. Peere S, Van den Branden E, Smits K, Polfliet E, Govaere J. Thoracic compression to reduce twin pregnancy at 55-65 days in the mare: a case series.. ECAR 2024 Conference 2024.
  54. McCue PM. Twin reduction: thoracic compression.. Equine reproductive procedures 2021;p. 307–308.
  55. Wolfsdorf K. Twin reduction: cranio‐cervical dislocation.. Equine reproductive procedures 2021;p. 303–306.
  56. Wolfsdorf KE, Rodgerson D, Holder R, Schoergendorf A. Success rate of post‐fixation twin reduction using cranio‐cervical dislocation.. Proc Am Assoc Equine Practnrs 2009;55:257–261.
  57. Govaere J, Hoogewijs M, De Schauwer C, Van Loon G, de Kruif A. Incomplete placentation after twin reduction in a mare.. Vet Rec 2008;163:747–748.
  58. Allen WR, Wilsher S. A review of implantation and early placentation in the Mare.. Placenta 2009;30:1005–1015.
  59. Wilsher S, Allen WR. Factors influencing placental development and function in the mare.. Equine Vet J 2012;44:113–119.
  60. Allen WR, Wilsher S, Turnbull C, Stewart F, Ousey J, Rossdale PD. Influence of maternal size on placental, fetal and postnatal growth in the horse. I. Development in utero.. Reproduction 2002;123:445–453.
  61. Wilsher S. Love thy neighbour – unless they are sharing your uterus.. Equine Vet Educ 2022;34:22–25.
  62. Rantanen N. Ultrasound guided fetal cardiac puncture for twin reduction in mares.. Proceedings of the Annual Meeting of the Society of Theriogenology 1990;169–170.
  63. Rantanen NW, Kincaid B. Ultrasound guided fetal cardiac puncture: a method of twin reduction in the mare.. Proc Am Assoc Equine Pract 1988;34:173–179.
  64. Ball BA, Schlafer DH, Card CE, Yeager AE. Partial re‐establishment of villous placentation after reduction of an equine co‐twin by foetal cardiac puncture.. Equine Vet J 1993;25:336–338.
  65. Pascoe RR. Methods for the treatment of twin pregnancy in the mare.. Equine Vet J 1983;15:40–42.
  66. Douglas RH, Ginther OJ. Effect of prostaglandin F2a on length of diestrus in mares.. Prostaglandins 1972;2:265–268.
  67. Allen WE. Ovarian changes during early pregnancy in pony mares in relation to PMSG production.. J Reprod Fertil Suppl 1975;23:425–428.
  68. Cuervo‐Arango J, Aguilar JJ, Vettorazzi ML, Martínez‐Boví R. eCG concentrations, luteal structures, return to cyclicity, and postabortion fertility in embryo transfer recipient mares.. Theriogenology 2015;84:1003–1013.
  69. Aguilar J, Luzuriaga I, Pardo Chavero V, Leaniz J, Casale P, Carboneti L. Interruption of gestation and reuse of recipient mares in a commercial embryo transfer program.. J Equine Vet 2012;32:412–413.
  70. Daels PF, Mohammed H, Montavon SME, Stabenfeldt GH, Hughes P, Odensvik K. Endogenous prostaglandin secretion during cloprostenol‐induced abortion in mares.. Anim Reprod Sci 1995;40:305–321.
  71. Buso WTK, McKinnon AO. Induction of abortion during midgestation in mares.. Can Vet J 1982;23:358.
  72. Volkman D, De Cramer K. Prostaglandin E (2) as an adjunct to the induction of abortion in mares.. J Reprod Fertil Suppl 1991;44:722–723.
  73. Card C. Induction of abortion and parturition.. Proceedings of The Italian Association of Equine Veterinarians Congress 2010;15–19.
  74. Meadows SJ, Binns MM, Newcombe JR, Thompson CJ, Rossdale PD. Identical triplets in a Thoroughbred mare.. Equine Vet J 1995;27:394–397.
  75. Newcombe JR. The probable identification of monozygous twin embryos in mares.. J Equine Vet 2000;20:269–274.
  76. Govaere J, Hoogewijs M, De Schauwer C, Van Zeveren A, Smits K, Cornillie P. An abortion of monozygotic twins in a warmblood mare.. Reprod Domest Anim 2009;44:852–854.
  77. McCue PM, Thayer J, Squires EL, Brinsko SP, Vanderwall DK. Twin pregnancies following transfer of single embryos in three mares: a case report.. J Equine Vet 1998;18:832–834.
  78. Mancill SS, Blodgett G, Arnott RJ, Alvarenga M, Love CC, Hinrichs K. Description and genetic analysis of three sets of monozygotic twins resulting from transfers of single embryos to recipient mares.. J Am Vet Med Assoc 2011;238:1040–1043.
  79. Sper RB, Whitacre MD, Bailey CS, Schramme AJ, Orellana DG, Ast CK. Successful reduction of a monozygotic equine twin pregnancy via transabdominal ultrasound‐guided cardiac puncture.. Equine Vet Educ 2012;24:55–59.
  80. Roberts MA, London K, Fernando Campos‐Chillón L, Altermatt JL. Presumed monozygotic twins develop following transfer of an in vitro‐produced equine embryo.. J Equine Vet 2015;26:89–94.
  81. Dijkstra A, Cuervo‐Arango J, Stout TAE, Claes A. Monozygotic multiple pregnancies after transfer of single in vitro produced equine embryos.. Equine Vet J 2020;52:258–261.
  82. Aston KI, Peterson CM, Carrell DT. Monozygotic twinning associated with assisted reproductive technologies: a review.. Reproduction 2008;136:377–386.
  83. Peere S, Papas M, Gerits I, Van den Branden E, Smits K, Govaere J. Management of monozygotic twins in the mare.. J Equine Vet 2022;113:103988.