Ancillary treatment to support pregnancy in cases of medical disease

Systemic disease occurring in the pregnant mare presents many unique challenges and complications to routine case management, including the limitations on surgical interventions and pharmaceutical choices, as well as the inherent need to support fetoplacental health to prevent pregnancy loss. The Case Report by Sinovich and colleagues in this issue exemplifies some of these challenges (Sinovich et al., 2022). Cases of maternal medical disease affecting almost all body systems can have profound effects on fetoplacental health, fetal viability and pregnancy maintenance due to the presence of severe stress, endotoxaemia or endogenous prostaglandin production (Giles et al., 1993; Perkins, 1999; Bucca, 2006). Therefore, treatment and expedited resolution of the primary disease process when possible is paramount. Due to the varied nature of diseases affecting the vast number of possible body systems, an investigation into individualised pregnancy support measures is impractical, and treatments used in cases of reproductive disease such as ascending placentitis are frequently applied as ancillary measures to support fetoplacental health and to promote pregnancy maintenance.