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Clinical Reproduction > Caesarian Section/ Hysterotomy > Flashcards

Caesarian Section/ Hysterotomy Flashcards

1
Q

What is the most common position, side, and incision when doing a C-section in a cow?

A
  • Standing (L-R)
  • caudal 1/3 of Paralumbar Fossa/ Flank
  • Vertical or 45 degree incision
  • approx 40cm long

note: a lateral recumbency approach would be more suitable if the calf or uterus is infected, and this way you are able to bring the uterus out and deal with it externally
note: lateral recumbency will require more help as you have to work against gravity

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2
Q

What are the Maternal indications of deciding to do a C-section in a cow?

A
  • Relatively oversized fetus: heifers, bulls, “breed”, embryo transplants
  • Inadequate cervical dilatation
  • Abnormal pelvic conformation
  • Prepubic tendon rupture
  • Uterine rupture
  • Congenital or traumatically induced vaginal constriction
  • Irreducible uterine torsion
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3
Q

What are the Fetal indications of deciding to do a C-section in a cow?

A
  • Fetal mal-positioning that cannot be corrected per vaginum
  • Oversized fetus: genetic mismatching, prolonged gestation, double-muscling
  • Fetal monsters/ emphysematous fetuses that cant be delivered per vaginum/ fetotomy
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4
Q

What is one of the most important preparations of the cow before starting a C-section?

A
  • Restraint
  • Tail tie!
  • Leg clamps
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5
Q

A cow presents for a C-section, upon examination you agree that C-section is the best option, however she is also showing signs of hypocalcemia. What should you do?

A
  • Address the hypocalcemia first by doing Calcium infusion +/- fluids
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6
Q

What Anesthetic protocol is used for C-section in the cow?

A

Paralumbar fossa: Line block or inverted L-patten of the flank/ paralumbar fossa

OR:
Paravertebral: 4 blocks

+ Spasmolyticum: Clenbuterol (Planipart) to stop myometrium from contracting

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7
Q

What can be done if a cow is straining before or during a C-section?

A
  • Epidural with lidocaine (less than 5mLs to ensure no loss of motor function)
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8
Q

Are Antibiotics and NSAID’s indicated in a C-section?

A

Yes!

24 hours prophylactic antibiotics + NSAIDs at all times

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9
Q

If things begin to go wrong and the farmer wants to send the cow to slaughter right after the C-section, can he do this?

A

Technically no, with the use of blocks and especially Clenbuterol, the cow should not be sent for slaughter until the withdrawal period has ended
If the cow has had antibiotics or NSAIDs, then absolutely not until the withdrawal period has ended!

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10
Q

What layers of tissue will be encountered as you begin the C-section surgery?

A
  • Skin
  • Subcutis
  • External Oblique muscle
  • Internal Oblique muscle
  • Transversus muscle
  • Peritoneum
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11
Q

Once inside the abdomen of a C-section procedure, what must be done?

A
  • Explore abdomen
  • Determine the position of the calf
  • Try to grab the back leg + hock. If the head is towards you, or the back is towards you, then you need to rotate the calf by gently rocking
  • Lock the hind limb on the ventral end of the surgical wound
  • Incise uterus over calf feet: don’t cut the calf
  • Apply chains to the legs and have assistant hold (JUST HOLD the chains)
  • Make incision large enough to allow delivery of the calf
  • Finally assistant should pull the calf up and out, and the surgeon holds uterus
  • Break the fall of the calf with your foot/ leg so it slides down: less traumatic than just falling to the ground
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12
Q

Once the calf is removed, what do you check for?

What suture pattern, suture type and size is used to close a C-section in a cow ?

A
  • Check Uterus: remove placenta if it comes out easily and check for any uterine tears. Lavage with saline and check for bleeding caruncles
  • Close uterus with:
    2 layer closure: simple continuous or inverting (Lembert/ Cushing)
    OR
    1 layer closure: Modified cushing (Utrecht method)
  • Buried knots
  • Suture material: Vicryl #2 or bigger, round needle
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13
Q

Once the uterus is surgically closed, what drug can be given intra-operatively and why?

A
  • 20 IU Oxytocin (IV if possible)

To help reduce the size of the uterus

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14
Q

How do you close a C-section incision, in a cow?

A
  • Close each layer individually
  • Interrupted pattern in the skin is better, in the case that certain parts of the incision become contaminated or loose- it will allow for easier access back into the incision should you need to go back in
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15
Q

What is the neonatal care required after a C-section?

A
  • Dont drop the calf
  • Confirm breathing
  • Place in a dry, clean site
  • Dry off the calf and have a heat lamp
  • Resuscitation if necessary
  • Check and dip the navel
  • ADEQUATE Colostrum!
  • Maternal bonding
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16
Q

What is the post-operative care required for a C-section in a cow?

A
  • 20 IU Oxytocin (IV if possible): if not already given intra-operatively
  • Antibiotics: theoretically prophylactic Ab’s should be enough, but 5 day script can be helpful to ensure no infection present
  • Analgesia: NSAID’s
17
Q

What are some complications associated with C-section in cattle?

A
  • Peritonitis
  • Metritis/ endometritis
  • Wound swelling, leading to seroma and abscesses
  • Abdominal adhesions: prevent with buried knots and using Vicryl (absorbable)
  • Reduced fertility: 15% decrease
18
Q

What are the reasons for doing a C-section in a sheep or goat?

A
  • Same as bovine

- + terminating pregnancy in ewes suffering from pregnancy toxemia or ketosis

19
Q

What position is used in C-section of sheep and goats?

A
  • Dorsal Recumbancy (on their back)
20
Q

What Anesthetic is used in a C-section on a sheep or goat?

A
  • Lidocaine (dilute 0.5 - 1%, <4mg/kg)

caution: it is important to dilute lidocaine in small ruminants as it has a higher chance of toxicity

21
Q

What is the surgical approach to a C-section in sheep and goats?

A

Preferred: Ventral midline
or
- Paramedian
- Left flank

22
Q

Once at the uterus of a sheep or goat, what is the surgical procedure?

A
  • Incision of the uterus on the greater curvature (from upper 1/3 to bifurcation
  • Check and retrieve all lambs (usually 2)
  • Remove placenta only if detached
23
Q

How is the uterus closed in a sheep or goat?

A
  • Close uterus with:
    2 layer closure: simple continuous or inverting (Lembert/ Cushing)
    OR
    1 layer closure: Modified cushing (Utrecht method)
  • Buried knots
  • Suture material: Vicryl #1 or bigger, round needle
24
Q

What is the post-operative care of the sheep/goat C-section

A
  • Antibiotics
  • NSAIDs
  • Oxytocin
25
Q

What 2 species is uterine torsion most common, and when during gestation does it usually occur?

A

Cow: end of gestation or during onset of labour resulting in dystocia

Horse: during gestation (usually last 2 months), resulting in colic

26
Q

If a uterine torsion is diagnosed in a cow, what can be done?

A
  • Vaginal approach (if in partu): rocking the fetus back into normal position
  • C-section: Standing Left flank approach
    note: remember in cows, the uterus usually torsed at the time of labour
27
Q

If a uterine torsion is diagnosed in a horse, what can be done?

A
  • Rolling Technique: anesthetize horse, place plank and rotate horse)
  • Send to surgery at referral! Standing flank on side towards uterus is twisted OR a ventral midline
    note: remember in horses, the uterus usually torsed 2 months before labour, hence C-section is not viable

Clinical Reproduction (9 decks)

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