47. Fetotomy: conditions, equipment, preparation, and steps of the most often used techniques in cows

Question 1

Indications for Fetotomy?

Answer 1

Indications for fetotomy:

• Dystocia cannot be solved by manipulation and forced extraction:

o Fetotomy

o Caesarean section

• The decision depends on the foetal life and economic value
• Caesarean section

o Foetus is alive and viable

• Fetotomy

o Foetus is dead

• After examination has revealed the presence of a dead foetus, and a safe delivery obviously cannot be made

by forced traction, the fetotomy should be initiated immediately

• Common fault before the decision:

o application of too great and too prolonged extractive force

o to avoid a CS or a fetotomy: - exerting excessive mechanical extractive force (calf-puller)

• The single most important factor:

o Precisely determining the proper time to cease attempting whole delivery of the foetus per vaginum

o in some cases: difficult to make the decision

• Many dystocia’s require only partial dismemberment of the foetus

o removal of a leg

o hip lock

o abnormal foetal posture

Question 2

Advantages of fetotomy?

Answer 2

Advantages of fetotomy

• Rapid reduction in the size of the foetus facilitates safe delivery per vaginam
• Exposure of the dam to major abdominal surgery is avoided
• The dam is spared inhumane treatment and possible trauma associated with application of excessive force
• Less aftercare is generally required
• Recovery time is shorter
• The general condition of the dam tends to remain more stable than after CS
• The monetary return is equal to that from CS

Question 3

Disadvantages of fetotomy?

Answer 3

Disadvantages of fetotomy

• May require more time to perform than a CS
• May be exhausting to the obstetrician
• The obstetrician is subjected to the risk of wound from the instrument or from a sharp fragment of foetal

bone

• Dangerous to dam

Question 4

Unsatisfactory results of fetotomy?

Answer 4

Unsatisfactory results of fetotomy:

• Operator’s lack of experience
• Poorly designed instruments
• Improper fetotomy technique
• The use of fetotomy only as a last option

Question 5

Perfection in fetotomy?

Answer 5

Perfection in fetotomy:

• Correctly designed instruments
• Proper lubrication
• Technical knowledge
• Adequate training and experience

Question 6

Fetotomy instruments?

Answer 6

Fetotomy Instruments:

• Thygesen fetatome

o Head (hardened steel with excellent plating)

o Two barrels

o Handhold

o Oval ring plate: anchoring the OB chain

• Fetotomy knife
• Saw wire
• Obstetrical chain
• Wire saw handles
• Chain handles
• Fetatome threader
• Krey-Schöttler double hook

o Stop: prevents overclosure of the instrument and laceration

• Snare introducer
• Eye hooks

o Required assistance

o Two assistants: desirable

o control tension on the saw wire

o actual sawing

o holding secure the fetatome during the fetotomy

Question 7

Instruction in use of the Fetatome?

Answer 7

Instruction in use of the fetatome

• After the wire has been placed:

o tension is applied to draw the wire snugly around the foetal part

o check for proper position

o wire check: not crossed or kinked

o tension on the wire must not be relaxed during the sawing Instruction in use of the fetatome

o during sawing: first moderately slow, short, continuous strokes with moderate pressure

o after firmly seated wires: long, continuous sawing strokes with heavy pressure

o If correctly performed: can be completed in a short time

Question 8

Lubrication?

Answer 8

Lubrication

• Proper lubrication is often the key to success
• Suitable lubricant

o Protection to the soft tissues

o Protection to the hands and arms of the obstetrician

Question 9

Types of total fetotomy?

Answer 9

Types of total fetotomy:

• Anterior (longitudinal) presentation:

1. Benesch
2. Götze
3. Baier-Schaetz

Question 10

Benesch-method?

Answer 10

Benesch-method:

1. Forelegs in the carpal joint
2. Head and neck
3. Thorax to the spinal column
4. Fetatome out of the vulva, fixed to the stump of the neck, horizontal cut
5. Evisceration
6. Thorax and abdominal slices
7. Pelvic bone between legs

Question 11

Gotze- method?

Answer 11

Götze-method:

1-3, 5-7: the same as in Benesch-method

4. Fetatome out of the vulva, lifting the upper laying leg out of the loop, rotation of the fetatome with 90°,

fixed to the stomp of the neck, vertical cut

Question 12

Baier schaetz method?

Question 13

Types of total fetotomy?

Answer 13

Types of total fetotomy:

• Posterior (longitudinal) presentation:

1. I
2. II
3. Baier-Schaetz

Question 14

1 method(posterior)?

Answer 14

I method (posterior):

1. Hindlegs in the tarsal joint
2. Cranial to the pelvic inlet to the spinal column
3. Fetatome out of the vulva, lifting the upper laying leg out of the loop, rotation of the fetatome with 90°, fixed to

the stump of the pelvic bone, vertical cut

4. Evisceration
5. New abdominal and thorax slices
6. Diagonal cut of the first part of the body (fetatome head fixed on one side, saw wire between the contralateral

foreleg and the neck)

Question 15

II. Method posterior?

Answer 15

II. method (posterior):

1, 4-6: the same as in the I. method

2. Cut spinal column through
3. Cut pelvic bone between the legs

Question 16

Baer scheatz method?