Dystocia

Question 1

What is dystocia?

Answer 1

Abnormal foaling - must call vet

Question 2

How do you manage a mal-positioned foal?

Answer 2

Mutation & traction - assisted delivery, repositioning of the foal and pulling the foal

Question 3

How do manage a dead foal mal-positioned or deformed?

Answer 3

Fetotomy

Question 4

How to manage a live foal, mal-positioning that cannot easily be corrected, or grossly over-sized in relation to birth canal?

Answer 4

Caesarean section, Ideally within 1hr stage 2 labour, ventral mid-line incision.

Question 5

What is the correct position for the foal?

Answer 5

anterior, longitudinal, dorsosacral, extended.

Question 6

Name the 5 ways a foal can be mal-positioned.

Answer 6

1. flexion of one or both forelegs at delivery
2. a significant misalignment of the hoof of one leg and fetlock of the other
3. the forelegs positioned over foals head
4. ventral position of foal
5. breech positioned

Question 7

What is a uterine rupture, and what surface does it occur on?

Answer 7

Full or partial thickness laceration to the uterine wall. Usually occurs on ventral surface.

Question 8

what is the aetiology of uterine rupture?

Answer 8

violent foetal movement, uterine torsion, mutation in case of dystocia.

Question 9

What are the clinical signs of uterine rupture?

Answer 9

colic, severe haemorrhage leading to shock, minor or no haemorrhage with no signs, peritonitis.

Question 10

how is uterine rupture treated?

Answer 10

oxytocin, surgical repair if peritonitis.

Question 11

what is the prognosis of uterine rupture?

Answer 11

guarded, may breed again but with complications.

Question 12

what is uterine prolapse?

Answer 12

Uterus is pushed out of vagina and vulva.

Question 13

what is the aetiology of a uterine prolapse?

Answer 13

prolonged dystocia, forceful or fat extraction of foal, extraction before reproductive tract relaxed.

Question 14

what are the risks of uterine prolapse?

Answer 14

uterine tears and haemorrhage, infection and toxic shock, rupture of ovarian arteries.

Question 15

how is a uterine prolapse treated?

Answer 15

sedate, hold up uterus to reduce negative effects of gravity, examine and clean, gently replace.

Question 16

what is the prognosis of a uterine prolapse?

Answer 16

good

Question 17

what is a retained placenta, what is the prevalence?

Answer 17

Failure to deliver placenta 3hr post partum, most common dystocia (2-10% prevalence).

Question 18

what is the aetiology of a retained placenta?

Answer 18

dystocia, caesarean section, induction, Ca:P imbalance. Se deficiency, fatigue, uterine inertia, history.

Question 19

how are retained placentas treated?

Answer 19

tie up placenta that is visible, oxytocin and gentle manual removal

Question 20

what is a uterine torsion?

Answer 20

Uterus twists. Usually an issue during late gestation rather than parturition.

Question 21

what is the aetiology of a uterine torsion?

Answer 21

often unknown, sudden foetal movement, rolling.

Question 22

what is the diagnosis of a uterine torsion?

Answer 22

rectal palpation which reveals direction of twist.

Question 23

what is the treatment of uterine torsion?

Answer 23

1. During parturition, when cervix is relaxed, reach foetus and rock it to correct torsion
   
   2. Pre-partum or alternatively use Schaffer ‘plank in the flank’ method
   3. Surgical connection
      Once corrected: check foal visibility, assisted delivery with careful traction, monitor for uterine rupture.

Question 24

what is the prognosis of uterine torsion?

Answer 24

good. 50% foals survive, 70% mares

Question 25

what is delayed uterine involution?

Answer 25

Delayed involution considered after 30 days post partum.

Question 26

How does involution occur in the normal mare?

Answer 26

Size returns to: 35% of pregnant state after few hours, 2-3 times its size after 7 days (barren mares), returned to normal after 30-32 days.
Foal heat 4-10 days post partum.

Question 27

what is the aetiology of delayed uterine involution?

Answer 27

sequelae to retained placenta, abortion or dystocia.

Question 28

what is the treatment of delayed uterine involution?

Answer 28

Oxytocin infusion
Exercise
Antibiotics/lavage