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Theriogenology > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

What is the first step to successful delivery assistance? What should producers/owners do?

A

recognizing a normal delivery

triage pregnant animals

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2
Q

What triggers the beginning of parturition?

A

uterine crowding causes increased fetal ACTH, which initiates a cascade of hormonal changes

  • fetus decides the date, dam decides the time
  • larger litter = more crowding = shorter gestation
  • singleton/mummy = no crowding = will not initiate parturition
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3
Q

What are the 3 stages of parturition?

A
  1. preparatory - uterine contraction, rotted fetal position (equine), chorioallantois/chorioamnios rupture
  2. fetus enters the vagina and is expulsed
  3. expulsion of fetal membrane
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4
Q

What is Ferguson’s reflex?

A

neuroendocrine reflex caused by the straining forces of the fetus against the cervix and cranial vaginal, inducing the release of additional oxytocin

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5
Q

What tends to increase the risk of a foal failing to survive during parturition?

A

every 10-minute increase in duration of labor at stage 2 beyond 30 mins

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6
Q

Parturition, differences in species:

A
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7
Q

In what 2 situations should intervention during parturition in mares be done?

A
  1. premature placental separation (red bag)
  2. foal not born within 20 mins after a mare releases allantoic fluid
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8
Q

In what 3 situations should intervention during parturition in cows be done?

A
  1. non-progressing parturition stage 1 (uterine torsion)
  2. > 2 hr after the first appearance of the amnion at the vulva
  3. no progress observed within a 30 min interval
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9
Q

In what 3 situations should intervention during parturition in bitches/queens be done? In bitches especially?

A
  1. no delivery of pup/kitten within 4 hours after the beginning of stage 2
  2. exhibit strong contraction for >30 mins without producing pup/kitten
  3. prolonged intercal (>2 hr) between delivery of pup/kitten

green vaginal discharge without delivering the first pup - obstructive dystocia, C-section recommended

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10
Q

In what 2 situations should intervention during parturition in small ruminants be done?

A
  1. fetal membranes at vulva for >3 hr without delivery - digital examination shows an incompletely dilated cervix (ringworm) –> C-section, dilation not helpful
  2. 30 min rule - examine 30 mins after the breaking of the chorioallantoic membrane and after delivery to look for an additional fetus
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11
Q

In what situation should intervention during parturition in camelids be done?

A

cria not born within 20 mins after the beginning of stage 2

  • like mare, has a short stage 2
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12
Q

In what situations should intervention during parturition in sows be done?

A

piglet interval >2 hrs

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13
Q

What is the difference between superfecundation and superfetation?

A

successive fertilization of two or more ova by different sires –> more common in feral situations and in swine

successive fertilization of 2 or more ova of different ovulations, resulting in presence of embryos of unlike ages

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14
Q

What is the difference between ecbolic and tocolytic agents?

A

increase uterine contractions (PGF2a, oxytocin)

inhibit uterine contractions
- N-Butylscopolammonium (Buscopan) - anticholinergic
- Clenbuterol - anticholinergic
- epidural anesthesia

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15
Q

How is fetal disposition described?

A
  • Presentation
  • Position
  • Posture
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16
Q

What is fetal presentation? What are the 3 terms used to describe it?

A

orientation of the fetal spinal axis to that of the dam and the portion of the fetus that enters the vaginal canal first

  1. LONGITUDINAL - anterior vs posterior, fetal spine parallel to dam’s
  2. TRANSVERSE - ventral vs dorsal, fetal spine not in like with dam’s
  3. VERTICAL - ventral vs dorsal, fetal spine is perpendicular to dam’s (dogsitting)
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17
Q

How is fetal position described?

A

LONGITUDINAL - based on the surface of the maternal birth canal to which the fetal vertebral column is applied OR the relationship of the fetal dorsum to the quadrant of the dam –> dorsal (dorso-sacral), ventral (dorso-pubic), left/right lateral (left/right dorso-ilial)

TRANSVERSE - relationship of the fetal head to the quadrants of the dam –> right/left cephalo-ilial

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18
Q

What is fetal posture?

A

disposition of the movable appendages of the fetus, involving flexion or extension of the neck or limb joints

  • lateral flexion of the neck
  • hock flexion
19
Q

Fetal presentation, position, and posture:

A
20
Q

What are 4 possible methods of obstetric manipulation to aid parturition?

A
  1. REPULSION - fetus repelled from the pelvic canal to increase space in the uterus to correct malposition
  2. MUTATION - manipulation of extremities with correction of postural abnormalities
  3. ROTATION - turning fetus on its longitudinal axis (hip-lock during calving)
  4. VERSION - manual changing of the polarity of the fetus with reference to the mother to correct transverse presentation –> head and forelimbs are repelled into the uterus while the hindquarters are pulled into the pelvic canal
21
Q

What are 7 causes of dystocia?

A
  1. fetal materal disproportion
  2. faulty fetal disposition
  3. hereditary - schistosomus reflexus, hydrocephalus, anasarca
  4. nutritional - obesity (pelvic canal obstructed by fat
  5. infectious - dead fetus
  6. traumatic - hernia, rupture of prepubic tendon, tear of abdominal muscles
  7. uterine inertia
22
Q

Causes of dystocia:

A
23
Q

How are small animal dystocias most commonly resolved? What other method are commonly used in large animals?

A

medical

  • mutation and rotation
  • forced extraction
  • fetotomy
  • C-section
24
Q

What restraints are recommended for assisted vaginal delivery and controlled vaginal delivery?

A

minimal - light sedation, epidural anesthesia, NEVER deal with it in a chute

general anesthesia

25
Q

Before the decision of how to resolve dystocia, what should be done?

A
  • check for fetal viability and distress - U/S for fetal heartbeat, radiographs for intra-fetal gas accumulation or abnormal skeletal arrangements, reflexes (suckle, anal tone, sublingual pulse)
  • check for uterine torsion
26
Q

Before deciding on medical treatment of dystocia, what 2 things should be done?

A
  1. radiographs - determine fetal number as well as malposition or fetal-maternal mismatch
  2. U/S - fetal viability and presence of distress

(if obstruction is present, do NOT give ecbolics)

27
Q

What are the 2 major medical treatments of dystocia?

A
  1. oxytocin - NEVER given with obstruction, microdoses recommended, move onto C-section if nothing is delivered with 3 doses repeated in 15-30 mins (SQ, IV, IM)
  2. calcium solutions - concurrent cardiac monitoring for arrhythmias, SQ given 5 mL per location every 4-6 hours
28
Q

What lubricants are commonly used for resolving dystocia? What is avoided?

A

methylcellulose-based

polyethylene polymer-based (J-Lube) –> fatal peritonitis in mares

(administered through sterile nasogastric tube and pump)

29
Q

What part of anatomy predisposed cows to dystocia? How is this approached?

A

oval shaped pelvic canal

  • alternate by pulling one limb at a time to decrease diameter of shoulders
  • hip lock - rotate calf 45 degreed to decrease diameter across the pelvis
30
Q

How is recumbency used to resolve dystocia?

A

changed the angle of the pelvis to increase the functional diameter of the pelvic canal

  • NOT done in chute, can’t get the cow out
31
Q

How can it be determined if a fetus is in anterior or posterior presentation if a limb can be observed?

A

FORELIMB - first two movable joints (fetlock and carpus) flex in the same position

HINDLIMB - first two movable joints (fetlock and hock) flex in the opposite direction

32
Q

What are possible causes of no palpable limbs or both forelimb and hindlimb seen in cases of dystocia?

A

NONE - true breech (posterior longitudinal presentation with a bilateral hip flexion), schistosomus reflexus, dorso-transverse presentation (dog sitting)

BOTH - multiple fetuses, schistosomus reflexus, ventro-transverse presentation

33
Q

Repositioning unilateral carpal flexion:

A

retropulse fetus to gain space then pull on flexed carpus

34
Q

Repositioning unilateral shoulder flexion:

A
35
Q

How is a forced extraction done correctly? What tools can be used?

A

apply traction during abdominal contractions of the dam and constantly monitor progress

  • hands
  • clamps/forceps
  • OB chains, straps - applied above and below fetlock
  • head snare - behind ears, wedge in oral cavity
  • mechanical extractor - calf jack
36
Q

How are OB chains put on correctly?

A

place a loop above the fetlock and a half hitch around the pastern

  • tie over the front to avoid pressure on tendons
  • shorter chain = more power
37
Q

What are 3 pros and 3 cons to performing fetotomy for dystocia?

A

PROS - avoids expense and risks of C-section, may prevent further trauma to dam through excessive traction, reduces the size of the fetus

CONS - lacerations to genital tract, time-consuming, infections to obstetrician or dam if fetus is septic, necrotic, or emphysematous

(dislocate joint for delivery, avoid breaking bones!)

38
Q

What is a complete fetotomy?

A

dismembering an oversized fetus with 5-6 cuts

  • not always necessary for delivery
39
Q

What kind of fetotomy is recommended in mares? If the foal is dogsitting or breeched? Why?

A

partial –> use one cut to remove the head or one foreleg

more complicated cuts, consider a C-section

MM of mare’s vaginal and cervix are easily abraded and can form adhesions

40
Q

What post-dystocia care is necessary?

A
  • check for additional fetuses
  • examine genitourinary tract for laceration, hemorrhage, and infection - recto-vaginal fistula, perineal laceration, necrotizing vaginitis, metritis
  • examine fetal membranes, appropriate retained placental therapy
41
Q

What are 4 risk factors for perineal laceration?

A
  1. first delivery
  2. unopened Caslick’s suture
  3. dystocia - foot-nape position
  4. delivery of large fetus
42
Q

What are the 3 degrees of perineal lacerations?

A

1st DEGREE = skin and MM of dorsal commissure

2nd DEGREE = musculature of constrictor vulvae and perineal body

3rd DEGREE = complete disruption of vaginal vault and/or roof of the vestibule, rectal floor, and anal sphincter, and perineal septum/body

43
Q

What are 3 membrane removal techniques used in mares?

A
  1. uterine lavage
  2. Burns’ technique - chorioallantois is distended with dilute povidone-iodine or saline solution for 15 to 30 minutes to facilitate release of microcotyledons from the endometrium
  3. umbilical vessel infusion

Theriogenology (22 decks)

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