Postpartum uterine diseases in dairy cows: etiology, clinical pathology, diagnostic methods, comparative treatments, and herd management: A Comprehensive Review

Postpartum uterine diseases—specifically acute metritis, clinical endometritis, and pyometra—are major causes of reduced reproductive efficiency, prolonged intervals to conception, an increased number of services per conception, and significant economic losses in dairy cattle. Bacterial contamination of the uterine lumen occurs in over 90% of dairy cows immediately after calving. However, the persistence of specific uterine pathogens—notably Escherichia coli, Trueperella pyogenes, Fusobacterium necrophorum, and Bacteroides species—compromises endometrial tissue and disrupts ovarian activity. This review evaluates the microbial etiology, clinical diagnostic procedures, comparative treatment regimens, and management strategies for postpartum uterine health in dairy cows. Comparative assessments have shown that combination treatment protocols—incorporating luteolytic doses of Prostaglandin F2α (PGF2α) alongside estradiol benzoate or systemic/intrauterine broad-spectrum antimicrobials (such as oxytetracycline)—achieve significantly higher clinical cure rates (84.3%–87.5%) and shorter calving-to-conception intervals compared to monotherapy or uterine lavage with antiseptics. Optimizing transition cow nutrition, calving hygiene, and periparturient immune status remains crucial for disease prevention.