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Therio > Dystocia and Obstetrics > Flashcards

Dystocia and Obstetrics Flashcards

1
Q

What are the main etiologies of dystocia?

A
  1. Uterine Dysfunction
  2. Small birth canal
  3. Fetus too big for birth canal
  4. Abnormal fetal presentation, position, or posture
  5. Abnormal fetal anatomy
  6. Polytocous pregnancy
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2
Q

What are the maternal factors that can lead to dystocia?

A

There are primary or secondary uterine inertia. Primary includes, myometrial defects, biochemical deficiencies (ACTH/cortisol), hysteria/environmental disturbance, deficient/excessive amnionic fluid, abdominal issues resulting n the inability to strain, and the ferguson’s reflex defect, obstruction of the birth canal due to a body pelvis or soft tissue issue.

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3
Q

Why is secondary uterine inertia important?

A

It has clinical relevance to littering bearing species like dogs, cats and swine

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4
Q

What is the ferguson’s reflex?

A

Birth causing the stretching of the cervix and vaginal wall in birth canal leading to the release of oxytocin

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5
Q

What important points should you cross off when taking a history on an animal that appears to be in dystocia?

A
  1. Primiparus vs. pluriparus
  2. Due date
  3. History of dystocia
  4. Length/vigor of ongoing delivery
  5. Vaginal discharge
  6. Fetal membrane/part been seen
  7. Assistance provided yet
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6
Q

When doing a PE on a dam in dystocia, what should you evaluate?

A
  1. Most important is stage of delivery
  2. Demeanor
  3. Ability to move
  4. T/ P/R/ MM
  5. Signs of fetal life
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7
Q

What is the normal HR of a puppy and a foal that is still alive?

A

Greater than 200 BPM for puppy

Around 80 BPM for a foal

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8
Q

After competing a PE on the dam, what is the next step?

A

Obstetrical exam while restraining and cleaning patient followed by a vaginal examination of the 3 Ps.

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9
Q

What are the 3 P’s ?

A
  1. Presentation
  2. Position
  3. Posture
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10
Q

How would you describe fetal presentation?

A

Longitudinal: cranial or caudal
Transerve: ventral or dorsal
Vertical…RARE

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11
Q

How would you describe fetal position?

A

Dorso-sacral
Dorso-pubic
Dorso-Ilial…Right or Left

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12
Q

How would you describe fetal posture?

A

If the joints are flexed vs. extended and if the head/ neck are flexed/extended

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13
Q

Describe what dog sitting is?

A

The fetus is presented cranially, positioned Dorso sacral, with the posture as all joints flexed on both forelimbs and hindlimb, except the hip joint is flexed.

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14
Q

Describe what True Breach is?

A

The fetus is presented caudally, positioned dorso-pubic, and the posture is front limb joints are flexed while hindlimb joins are extended except at the hip

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15
Q

What is the order of most conservative dystocia treatment to most aggressive?

A
  1. Give dam more time to give birth
  2. Drug therapy
  3. Manipulative treatment
  4. Surgical treatment
  5. Fetotomy
  6. Euthanasia
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16
Q

What is an ecbolic and what does it do? How much should be given?

A

Oxytocin, which stimulates contraction of the uterus. Should be used with caution in species with a cartilaginous cervix and avoided in pig gilts.

17
Q

Should you correct hypocalcemia and hypoglycemia before administering oxytocin?

A

Yes, always. And verify the fetal position with vaginal exam/radiography

18
Q

What would you administer to correct hypocalcemia/ hypoglycemia in the dam?

A

Give Ca++ borogluconate 10%, Ca++ gluconate or Ca++ lactate. Give glucose.

19
Q

What is the dose range of oxytocin that can be given to the dam?

A

0.25-5 IU (0.125-0.25ml) q 20-30 min, 2-3x

20
Q

What is manipulative treatment of dystocia?

A

Assisted vaginal delivery that involves mutation, rotation and or/ repulsion/repelling of fetus

21
Q

What are the most common obstetrical instruments that can be used for large animals?

A
  1. Lubricants
  2. Obstetric chain/hooks
  3. Fetotome
  4. Snares
  5. Wire Saw
  6. Calf jack
  7. De-torsion rod
  8. Hoe blade/guarded knife
  9. Eye hooks
22
Q

What are the most common obstetrical instrument that can be used for small animals?

A
  1. Spay hook

2. Sponge forceps (+- extra rubber grips)

23
Q

What types of lubricants can you use on a dam during dystocia?

A
  1. Soap/water
  2. Methyl cellulose
  3. Crisco
  4. J lube ( not good if uterus ruptures or you think you will do a C-section)
  5. Mineral oil or petrolatum
24
Q

Can you pump liquid lubricants?

A

Yes

25
Q

What is the proper placement of a chain on the fetuses legs/

A

Place loop above and half hitch below fetlock joint, connecting chain should be at the top of the leg

26
Q

What is 2 point traction versus 3 point traction?

A

When assisting with vaginal delivery, there can be traction two feet or traction of the two from feet plus the head/neck

27
Q

How can you aid that dam is she is straining too much during parturition?

A

Administer an epidural, sedate with alpha 2 agonists/phenothiazines/benzodiazepenes, or use a tocolytic

28
Q

What do epidurals do for the dam?

A

Stops abdominal staining and reduces pain

29
Q

What are some tocolytics you can administer to the dam?

A
  1. Epinephrine IM
  2. B2 agonist-clenbuterol ( not in FA oral in EG)
  3. . terbutaline/isoxuprine
30
Q

How long should you manually examine the dam internally after her water breaks?

A

20 minutes and if she hasn’t delivered any offspring or parts (head/ or two hind feet) then trace both legs and head to beyond to verify that they belong to the same fetus.

31
Q

What is important to remember when you are vaginally examining a dam?

A

Be as clean as possible and use copious amounts of non irritating lubricant

32
Q

How many joints bend in the same direction versus opposite direction when feeling the forelimbs versus hindlimb in the fetus?

A

The foreleg has 3 joints that bend in the same direction. The hindlimb has 2 joints that bend in the same direction, but the third bends in the opposite direction

33
Q

How do you want to pull a fetus out of the birth canal?

A

Know if you are pulling the forelimbs or hindlimb out first, then pull in an arc after giving the dam 20-3 min to see if labor will continue.

34
Q

After the dam has delivered, what should you do?

A

Check to see if there are twins, if there are vaginal or uterine tears including an intussescepted horn, asses need for medication, monitor passage of fetal membranes and make sure the offspring nurses and monitor for mastitis.

Therio (4 decks)

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