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

Question 1

After examination has revealed the presence of a dead fetus, and a safe delivery obviously cannot be made by forced traction, the fetotomy should be initiated immediately

Answer 1

➔ Clear diagnosis of a dead fetus o rigormortis

o signs of emphysema (hairloss, stinking)

Question 2

Common fault before the decision

Answer 2

• application of too great and too prolonged extractive force
• in order to avoid a CS or a fetotomy: - exerting excessive mechanical extractive force (calf-
puller)

Question 3

Indications

Answer 3

• The single most important factor
o determining precisely the proper time to cease attempting whole delivery of the fetus
per vaginum
o in some cases: difficult to make the decision
• Many dystocias require only partial dismemberment of the fetus
o removalofaleg
o hiplock
o abnormalfetalposture

Question 4

Advantages

Answer 4

• Rapid reduction in the size of the fetus 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 5

Disadvantages

Answer 5

• 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 fetal bone
• Dangerous to dam

Question 6

Unsatisfactory results

Answer 6

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

Question 7

Perfection

Answer 7

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

Question 8

Fetotomy instruments

Answer 8

• Fetotomy knife
• Saw wire
• Obstetrical chain
• Wire saw handles (Simon, Schebitz, Liess)
• Chain handles
• Fetatome threader
• Krey-Schöttler
• double hook
• Snare introducer
• Eye hook

Question 9

Thygesen fetatome

Answer 9

• Head (hardened steel with excellent plating)
• Two barrels
• Hand-hold
• Oval ring plate: achoring the OB chain
• Different cutting planes by fetotomy
    o Fortrunning cutting plane 
    o Siderunning cutting plane
    o Backrunning cutting plane

Question 10

Required assistance

Answer 10

• Two assistants: desirable
o control tension on the saw wire
o actualsawing
o holding secure the fetatome during the fetotomy

Question 11

Instruction in use of the fetatome

Answer 11

• After the wire has been placed:
o tension is applied to draw the wire snugly around the fetal part
o checkforproperposition
o wire check: not crossed or kinked
o tension on the wire must not be relaxed during the sawing
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 12

Lubrication

Answer 12

• Proper lubrication is often the key to success
• Suitable lubricant
• protection to the soft tissues
• protection to the hands and arms of the obstetrician

Question 13

Fetotomy in the cow

Answer 13

• Standing position
• Epidural anesthesia: 4-8 ml lidocaine hydrochloride
o controlstraining
o alleviate pain
o allow the animal to remain standing
→Single injection of local anaesthetic into the epidural space
→coccygeal and posterior sacral nerves are affected
• in case of recumbency : try to induce to stand
• fractious animal: combined tranquillisation and epidural anaesthesia
• recumbent cow unable to stand up: deep epidural anaesthesia (20-60 ml)
o elevation of hind quarters

Question 14

Types of total fetotomy

Answer 14

Anterior (longitudinal) presentation:

1. Benesch-method
2. Götze-method
3. Baier-Schaetz-method

Posterior (longitudinal) presentation:

1. I.-method
2. II.-method
3. Baier-Schaetz-method

Question 15

Types of total fetotomy

Benesch-method

Answer 15

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
5. Thorax and abdominal slices
6. Pelvic bone between legs

Question 16

Types of total fetotomy

Götze-method

Answer 16

1. Forelegs in the carpal joint
2. Head and neck
3. Thorax to the spinal column
4. Fetatom out of the vulva, lifting the upper laying leg out of the loop, rotation of the fetatom with 90°, fixed to the stomp of the neck, vertical cut
5. Evisceration
6. Thorax and abdominal slices
7. Pelvic bone between legs

Question 17

Types of total fetotomy

I. method (posterior)

Answer 17

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 etatome 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 (fetatom head fixed on one side, saw wire
   between the contralateral foreleg and the neck)

Question 18

Types of total fetotomy

II. method (posterior)

Answer 18

1. Hindlegs in the tarsal joint
2. Cut spinal column through
3. Cut pelvic bone between the legs
4. Evisceration
5. New abdominal and thorax slices
6. Diagonal cut of the first part of the body (fetatom head fixed on one side, saw wire
   between the contralateral foreleg and the neck)

Question 19

Types of total fetotomy

Baier-Schaetz-method (posterior):

Answer 19

1. One hindleg with one part of the pelvic bone
2. Other hindleg with the rest of the pelvis + one part of the abdomen
3. Thorax + the remaining abdomen
4. Cut of the first part of the body (one foreleg turned back + the rest of the thorax
5. Cut of the first part of the body (one foreleg turned back + the rest of the thorax