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Friday, May 23, 2014

Hemorrhage after endometrial biopsy

Keywords: biopsy, endometrial, hemorrhage, equine

The approximate site for biopsy is shown relative to the cervix (is framed within the green rectangle in the inset image).  Large, deep and penetrating biopsies can occur, causing mild to severe hemorrhage but this is rare and to the author’s knowledge has never been reported to be fatal.  Nevertheless, owners should be warned of this possibility, noting that blood may appear on the vulvar lips within one or two days of the biopsy being taken.

This image shows the dorsal surface of the endometrium and two sites (green arrows) where biopsies were taken 24 hours earlier. A large blood clot can be seen adjacent to the biopsy site that is lowest in this image. The upper biopsy site appeared to be less traumatic.  In this case, the mare did indeed show a small amount of blood on her vulvar lips the morning after the biopsy was taken.

Image size: 1500 x 1125px

Usually, there is far less hemorrhage than this after uterine biopsy. The image below, also taken 24 hours after biopsy shows a more typical appearance (note the small lymphatic cysts; a very common finding in older mares):

Image size: 1019 x 697px

Biopsy sites heal very quickly in mares and within 48 hours, the site of a biopsy is barely visible. Therefore biopsies can be taken from mares during the first few couple of days of estrus and can be inseminated at the time of ovulation, three or four days later.