Obstetrical Maneuvers pt. 1 Flashcards
4 classifications of obstet maneu
Mutation (or correction) - COMMON
Forced extraction (may be after mutation) - COMMON
Fetotomy
CS
- For small animals - recommended for small animals
Definition: change of presentation, position or posture to bring the fetus to a normal presentation, position and posture
Ex. dorsotransverse fetus → maneuver → normal anterior longitudinal position
mutation/correction
4 Specific manipulations
Repulsion or retropulsion
-Have space to work in
Rotation
Version
Extension and flexion
Requirements prior to performing mutation:
Complete ____of the cervix;
movement of fetus in ___ and ____
rupture of fetal envelopes and adequate lubrication;
dilation
uterus and pelvis
instruments of mutation/correction
- Obstetrical chains
Oblong ends “like choke chains” - thread one into the other - Obstetrical handles
- Stomach pump
-Pump in lubricants into the uterus/ birth canal - Stomach tube
5.Bucket of clean water
-For washing
- Soap
7.Lubricant/s
-Vegetable oil - cheaper, easy to find
-Water-based obstetrical lubricants
8.Vaseline
-Coat lining of birth canal
obstetric chains: longer ones go to the shoulder, shorter ones go around pastern of the animal t/f
t
Returning fetus back to the uterus
Pushing fetus _____ in uterus to obtain adequate space for correction of fetal part in an abnormal presentation, position and posture
may be done only with instruments t/f
Do this when the uterus contracts, when the abdomen is not contracting. t/f
retropulsion
forward
f - can be done with hands
f - uterus RELAXES
instruments for retropulsion krg
Kuhn’s crutch
-U-shape pushed against shoulder or any part u want to push back to gain leverage
Reindi’s repeller
Gunther’s repeller
in handling dystocia in mare - put in ____ ataching the hindlimb into a ___
can you put lubricant? yes or no
This technique will help you in the mutation of fetal malpositions and even dystocia due to presentation problems not only in the mare but also in cattle and buffaloes. t/f
lateral recumbency
pulley
yes
t
Positional problems
Turning the fetus on its’ long axis to correct the position
Aims for Dorsopubic/dorsoileal presentation - nakabaliktad back of fetus is closee to pubis or ileum → goal is to rotate back to _____ position
instrument used
rotation
dorsosacral
cammerer detorsion fork
Problems with presentation
Effecting change in fetal presentation.
Difficult if you want ot convert from posterior to anterior longi presentation
If you have fetus in transverse position
version
ventral presentation can be modified to a longitudinal presentation t/f
Usually limited to ___ (angle) and can be done by repelling one extremity of the fetus and exerting traction on the other.
f - transverse to longi
90
Push hindlimb pull forelimb
Push - ___
Pulling – _____
First pass around shoulder
Attached a rope → assistant pull when ready to push → anterior longitudinal presentation
procedure for dorso trasnvers
repeller or hand
obstetric chains
type of dorso transverse
moving the head of the fetus towards the pelvic inlet
More difficult if neck is also bent
posterior parts of the fetus are moved towards the pelvic inlet
Hindlimbs come out first
anterior or cephalic version
posterioir or pelvic version
position - solution
posture - solution
presentation - soln
rotation
extension and flexion
version
Extension and Flexion
Involves 3 things rlt
Repulsion of proximal extremity of limb
Lateral rotation of middle portion carpus, tarsus or neck, and
Traction on distal extremities
in carpal flexion posture the chains are placed in the
Make sure the hoof will not injure the uterus → ___it to prevent sliding sa uterus
pastern
cup
Carpal flexion posture
Repel
Push it and rotate backwards/Rotate middle portion outwards
Bring hoof in the ___
Pull out
middle
Forelimbs: (conversion)
Elbow flexion→ grasp forearm to convert to ____flexion
Shoulder flexion → _____flexion → carpal flexion (or rekta carpal)
carpal
elbow
Hindlimbs
Hip flexion –> __- flexion → rotate hocks to get hooves inwards
*Pull on the hocks to convert ___ flexion
Use arm to push outwards, hands grasp the hooves → bend it → take it out
Use of obstetrical chains and assistance for pulling
t/f
hock
t
Withdrawal of fetus from birth canal of dam by application of force
Adequate lubrication is not essential t/f
Pull should be synchronous to straining of the cow t/f
forced extraction
f - ESSENTIAL
t
Follow a upward arc t/f
Hips ___ or 5 degrees
Hindlimbs - parallel sa hindlimb ng animal t/f
Ensures the pelvis of fetus would pass into the widest diameter of the pelvis
f - downward
4
f - perpendicular
Widest portion of fetus
Longest diameter -
One shoulder is through → easier na sa thorax t/f
shoulder and hip
oblique (making sure one of the limbs pass before the other one)
t
in forced extraction avoid this
hip lock
ileac crest can lock in the bony pelvis of the dam if straight
Obstetrical operation which has the obiect of reduction in the volume of the fetus either by mutilation or by division to be extracted in parts
Performed when delivery of the entire fetus is not possible
Done on a dead fetus or when the life of the fetus is to be sacrificed
fetotomy
cases where you cannot move dead fetus easily
Anasarca(bloated fetus), postural abnormalities, transverse presentation
Cows: at least 4 hours → assist needed t/f
t
Advantages of fetotomy resd
Rapid reduction in size of fetus facilitating safe delivery per vaginum.
Shoulder flexion posture almost half a day
Cows: at least 4 hours → assist needed
fetotome - flexible contained in the tube to prevent damaging other parts of reproductive tract
Exposure of dam to major surgery is avoided
CSection not needed
If dam is already exhausted = surgical risk
Short recovery time and less care is required afterwards.
Dam is more stable than with C-section
General anesthesia - recumbent
disadvantages of fetotomy mem
May require more time than C-section
Exhaustive and may cause injuries to obstetricians
Making use of a wire soap?
May be dangerous to dam
Can cause injuries
Indications for performing fetotomy mredid
Malpresentation, malposition and malposture of fetus that cannot be corrected
Relative disproportion b/w size of fetus and maternal birth canal.
Emphysema
Deformities of maternal pelvis: exostosis, fracture, tumors
Irreducible distortion of fetus- contraction of muscle, tendon and Wryneck.
Disease of fetus- hydrocephalus, ascites, edema and anasarca.
