Female Uro Flashcards
what are the maternal indications for C-section in cows?
- immaturity
- uterine tear
- uterine hydrops
- pelvic deformities
- uterine torsion
- lack of cervical dilation
what are the fetal indications for C-section in cows?
- fetal oversize
- malposition
- elective (high value calf)
- pathology (conjoined twins, schistosomus reflexes, hydrocephalus, emphysematous)
- mummification
- prolonged gestation
what are the 3 approaches for standing C-section in cattle?
- L paralumbar fossa (flank) = most common
- R paralumbar fossa
- L oblique (Marsenic approach)
what are the 4 approaches for recumbent C-section in cattle?
- ventral midline
- R paramedian
- R paramamary (ventrolateral)
- L paralumbar
where is the uterus located in a standing L paralumbar fossa C-section?
medial to rumen
what prevents SI eviscerations in standing L paralumbar fossa C-sections?
rumen
when should you do a recumbent ventral midline approach to a c-section?
down/reluctant to stand cow
when should you do a recumbent R paramedian approach to a c-section?
down/reluctant to stand cow
when should you do a recumbent R paramammary approach to a c-section?
emphysematous fetus
tell me the broad steps to performing a C-section in a routine dystocia
L paralumbar fossa (standing)
1. exteriorize uterus
2. remove the calf
3. close the uterus
4. close the abdominal wall
how do you exteriorize the uterus in a C-section in a cow?
- ID uterus
- ID hind legs/foot/hock (fetus)
- place 1 hand on fetlock and second under hock
- pull leg up to and over incision, locking leg in incision via fetlock and hock
compare/contrast reducing uterine torsions prior to and after calf removal
prior:
- increases risk of uterine rupture
- easier to externalize uterus
- easier to suture uterus
after:
- decrease risk of uterine rupture
- hard to externalize uterus/increases contamination
- hard to suture uterus
tell me in broad strokes how to remove a calf during a c-section
- full thickness uterine incision (avoid spillage of uterine contents internally)
- sterile calving chains + assistant
- put on calving chains, utilizing assistant (make sure to tell them not to touch you - they’re not sterile!)
- assistant pulls calf
- check for 2nd calf!
tell me how to close the uterus after a c-section
- 2 layer inverting (Utrecht), catgut size 2 or 3
- don’t sew placenta into incision, don’t go full thickness
- lavage w sterile saline (no gauze)
tell me how to close the abdominal wall after a c-setion
(same as other surgeries)
- transversus/peritoneum = close together, SC/absorbable’
- internal abd obl = single layer, SC/absorb
- external abd. obl = single layer, SC/absorb
- skin: non-abrosb, 3-polyamide, ford interlocking, finish with 1-2 simple inter. (remove if drainage needed)
list 4 intra-op complications with c-sections with routine dystocias
- uterine exteriorizztion
- recumbent/down cattle
- rumen/SI evisceration
- uterine integrity/tears
list 5 post-op complications with c-sections with routine dystocias
- peritonitis
- wound infection/dehiscence
- SQ emphysema
- retained placenta
- death
true or false: the mortality rate for cows with emphysematous fetuses is low
false! its high (66%)
and those that survive, most are not fertile after (cull)
tell me the type of fluids you want to use with c-sections for emphysematous fetus
hypertonic
is euthanasia of the cow a good option when the cow has an emphysematous fetus?
yes
what is the single most important factor for cow survival and future fertility when doing a c-section with an emphysematous fetus?
exteriorize the uterus as much as possible
what are the 3 categories of c-section?
Emergency (non-emphysematous)
Elective
Emphysematous
when done as a last resort, c-sections have a _____ px.
poor
decision to perform c-section should be made in _______.
<20 mins
