Caesarean Section

Question 1

When to consider a Caesarean section

Answer 1

• The fetus cannot be delivered by mutation and traction
• Dystocia is correctable but there is a large litter (polytocous species) so risk of secondary inertia or dam exhaustion
• There is uterine torsion or incomplete cervix dilation that cannot be remedied
• When fetotomy would be extensive, traumatic and time consuming
• Performed as an elective procedure
  ○ E.g. brachycephalic breeds

Question 2

Indications for caesarean in a cow

Answer 2

• When a live calf cannot be delivered by mutation and traction
  ○ Most tricky
• In cases of uterine torsion or incomplete cervix dilation
• In cases of hydrops or fetal monsters
• When fetotomy would be extensive, traumatic and time consuming
• When the farmer is not willing to risk the trauma of a natural birth on a valuable calf
• As an elective procedure (e.g. heifer pregnant to large bull)

Question 3

Important considerations in caesarean surgery

Answer 3

Important to make decision early
Know when to stop pulling
* Calves delivered by caesarean after traction has failed have a decreased chance of survival
* Better fertility for dam in traumatic delivery is avoided

Question 4

Rules of Thumb

Answer 4

Anterior Presentation
* Head and shoulder must be able to pass the pelvic canal or calf can’t be delivered
* Shoulders of calf are through pelvis when causes are at vulva
f you cannot get both carpuses to the vulva, the calf cannot be pulled without damage to the calf or cow

Posterior Presentation
* If hocks are one hand width outside vulva, hips should be through birth canal and you can deliver calf

Question 5

Indications for caesarean in mare

Answer 5

Only performer after referral to hospital
Anaesthesia may be performed to facilitate mutation
* May progress to caesarean if unsuccessful

When abnormal fetal disposition can’t be corrected
Uterine torsion
Severe deformities
Vaginal or vestibular obstruction

Question 6

Indications for caesarean in bitch and queen

Answer 6

Primary uterine inertia with poor response to oxytocin
Primary uterine inertia when there is a large litter
Obstructive dystocia which can’t be corrected
Any case with signs of fetal distress
* Bradycardia on ultrasound
Signs of placental separation with large litter
* Green discharge
Elective in brachycephalic breeds

Question 7

Indications for caesarean in ewe

Answer 7

• Feto-maternal disproportion
  ○ Often primiparous ewe or single lamb
• Failure of cervical dilation
  ○ “ringwomb”
• With irreducible or traumatised vaginal prolapse
• Most cases of abnormal fetal disposition can be corrected without Caesarean