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Clinical Reproduction > Parturition, Induction and Dystocia > Flashcards

Parturition, Induction and Dystocia Flashcards

1
Q

Why might we induce a dam to give birth?

A

1) Save the life of the fetus or dam

2) When gestation has gone passed the due date and there is the risk of dystocia from an oversized fetus

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2
Q

What are the requirements around Parturition Induction?

A

1) Viable fetus. e.g. mature lung surfactant
2) Delivery must not damage the offspring. e.g. high intra-uterine pressure
3) Dam must sustain the neonate. e.g. produce colostrum/ milk and bond with the offspring

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3
Q

What are the indications for Induction?

A

Clinical vs Management

Clinical: anticipate a large fetus, dam is ill or fetus is dead

Management: parturition in the presence of a skilled assistant (sows)

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4
Q

What are the available Inducing Agents that we have at our disposal?

A
  • Corticosteroids: mimics the cortisol response initiated by the fetus
  • Prostaglandins: luteolytic activity, used in species that maintain a luteal during pregnancy (not effective in sheep)
  • Anti-progesterone agents: block progesterone production
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5
Q

What are the Stimulation Agents that we have at our disposal?

A
  • Calcium salts: increase contractility
  • Oxytocin
  • Prostaglandin
  • Beta-blockers: dont actually stimulate, but will reduce stress effect. Not commonly used
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6
Q

When would you induce a mare to give birth/ Indications to induce a mare?

A
  • In an emergency
  • If the mare is waxing (producing beads of colostrum from her teats)
  • If there is a change in the mares colostrum
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7
Q

What is the average gestation of the mare? and the range?

A

Average: 340 days

Range: 320 - 365 days

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8
Q

What are the steps/ drugs used to induce a healthy mare?

A

Oxytocin given IV drip over the last few days of pregnancy

If her cervix opens (2 fingers wide) then give 120 IU/ 360-600kg and foaling will occur in 15-60 mins

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9
Q

What are the steps/ drugs used to induce a sick mare where you are trying to save the life of the foal?

A

Dexamethasone 100mg/day for 4 days starting at day 321

Caution: dystocia may occur due to incomplete rotation

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10
Q

What is the gestational length/ range of Cattle?

A

278 - 290 days

Note: generally if you induce before day 270 you will get a non-viable calf

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11
Q

What Inducing Agents can we use in a cow?

A

SAFER: Corticosteroids (long vs short acting), but may immunosuppress

  • Prostaglandins: causes explosive contractions which can be a problem if the cervix is not dilated
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12
Q

What are the pros and cons of using long acting vs short acting corticosteroids in the pregnant cow?

A

long acting: less predictable but more physiologically normal

short acting: more predictable but rapid

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13
Q

What are the 2 Combined Inducing Agent Protocols we might use to induce a cow?

A

1) Long acting steroid 10-14 days before term, followed by a short-acting steroid or PG 8 days later
2) Short acting steroid + PG = get a rapid response, she will calve down b/w 36 - 72 hours. Used in emergencies

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14
Q

What is the average gestational length of the sheep?

A

152 days

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15
Q

What is the only Inducing Agent available to us for sheep, and why?

A

Corticosteroids

Because the placenta is the source of progesterone

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16
Q

How far along is it recommended to wait to Induce a Sheep?

A

142 days minimum

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17
Q

What is the protocol for inducing a sheep?

A

Single IM injection 6 days before expected due date, she will give birth 2-3 days later

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18
Q

What is the gestational period of the Sow?

A

3 months, 3 weeks, 3 days

= 113 - 115 days

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19
Q

Why would we induce a sow?

A

To reduce piglet mortality

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20
Q

What is the Induction protocol for a healthy Sow?

A
  • Prostaglandin on days 112-113 between 8am - 10am = most will farrow the next day afternoon
  • +/- Oxytocin 24 hours after = will speed up time of farrowing
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21
Q

What is the Induction protocol for a sick Sow?

A

Corticosteroids: 75-100mg injected daily on days 101 - 104

She will farrow on day 109

Caution: piglet survival rate is low, but might save the sow if emergent

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22
Q

What is the Induction protocol in dogs?

A

Oxytocin: 2 - 5 IU

Note: a vaginal exam should be done to make sure she is ready to whelp

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23
Q

Why might we want to delay parturition, and how can we do it?

A

Used in dystocia cases when we want the dam to stop pushing/ contracting

Clenbuterol: cows, sows, ewes

24
Q

What are the 2 main types of Dystocia?

A

Maternal Dystocia vs Fetal Dystocia

Maternal: constriction/ narrowing of the birth canal + failure of expulsion

Fetal: fetal-maternal disproportion

25
Q

What is the most common form of maternal dystocia?

A

Incomplete Cervical Dilation

26
Q

What causes Incomplete Cervical Dilation in the cow?

A

1) Hormonal dysfunction
2) Inadequate physical dilation
3) Hypocalcemia
4) Scar tissue from previous injury or calving

27
Q

How can you treat Incomplete Cervical Dilation in the cow?

A
  • Try to manually dilate

- C-section if unsuccessful

28
Q

What is the laymens term for Incomplete Cervical Dilation in sheep?

A

Ringwomb

because a fibrous ring can be felt in the anterior cervix

Note: it is the most common cause of dystocia in sheep

29
Q

What is the cause of Incomplete Cervical Dilation in Sheep?

A
  • Hormonal disorder = high estrogen/ low prostaglandin
  • High incidence following pre-parturient prolapse of the vagina. This happens because of excess relaxation of the pelvic tissues and increased intra-abdominal pressure

Risk factors include: breed, high dietary estrogen, overconditioning and a sloping environment

30
Q

What are the stages of vaginal prolapse in sheep?

A

Stage 1: vagina prolapses when recumbent but disappears when standing

Stage 2: vagina prolapses and stays out when standing

Stage 3: vagina prolapses and cervix can be seen

31
Q

What is the treatment for a prolapsed vagina in the sheep?

A

Stage 1 - 2: clean, replace, retain

Stage 3: Epidural anesthetic +/- xylazine and place a suture e.g. purse-string suture

32
Q

What animals is Incomplete Relaxation of the Vagina/ Vulva commonly seen?

A
  • Heifers
  • Overconditioned animals
  • Seen in animals that have been interrupted during the parturition
  • Seen in older animals after previous birthing injuries
33
Q

What is the treatment for Incomplete Relaxation of the Vagina/ Vulva?

A
  • Try to manually stretch and open
  • Episiotomy but NOT into the rectum. INcise vulval lips at 10 or 3 o’clock, then suture with non-absorbable suture to re-establish normal vaginal morphology

Note: this WILL impact future parturitions, must warn owner

34
Q

What are the 2 types of Vaginal Cystocele?

A

1) Prolapse of bladder through the urethra (common in mare)

2) Protrusion of the bladder through a rupture in the vaginal floor

35
Q

What must you do with an animal that has a Vaginal Cystocele?

A

1) Stop dam from straining/ pushing (Clenbuterol in ewe, sow and cow)
2) Epidural +/- general sedation

3)
Type 1: differentiate from protruding fetal membranes, then invert via manipulation

Type 2: invert organ through the rupture and suture

36
Q

What animals is uterine torsion more commonly seen in?

A

Cattle (7 - 8%)

Alpacas

37
Q

What are the clinical signs associated with a uterine torsion?

A
  • prolonged 1st stage of labour
  • cow may show discomfort by rocking back and forth
  • torsion of birth canal may cause the lips of the vagina to be pulled in
38
Q

What is the treatment for uterine torsion?

A
  • Rotate

- Laparotomy +/- C-section

39
Q

Define Uterine Expulsive Deficiency

A

A deficiency in the contractility of the myometrium to successfully expel the fetus

40
Q

What causes Uterine Expulsive Deficiency?

A
  • Hypocalcemia
  • Exhaustion
  • Overexcitement: the dog can go into a nervous voluntary inhibition of labour, and sows can go into hysteria
  • Single pup/ kitten Syndrome = too low ACTH and cortisol to initiate parturition
41
Q

What is the treatment of Uterine Expulsive Deficiency?

A
  • Oxytocin
  • Assisted delivery
  • Calcium
  • Stressnil (in sows)
  • C-section
42
Q

Of the domestic species (pigs, dogs and cats, horses, cattle and sheep), list them from major dystocia cases to minor/ rare dystocia cases

A

Cattle > Sheep > Dogs and Cats > rare in horses and pigs

43
Q

What are the reasons for feto-maternal Disproportion?

A
  • Increased mass
  • Inappropriate conformation
  • Birth canal too narrow or incorrect shape
44
Q

The calf’s birth weight is dependent on what factors?

A
  • Breed: calf will average the size of dam and sire. double muscling?
  • Sex: males > females
  • Season and Climate: Calf born after cold winter = bigger (more blood flow to keep calf alive during cold)
  • Nutrition of Dam: only severe nutritional deficiency w/in last 90 days of gestation will influence birth weight
  • Length of Gestation: longer gestation have greater dystocia rates
  • IVF: constituents of the media used during IVF seem to create bigger calves (compared to AI or natural service). Also more likely to get fetal malformations
45
Q

What is the most common type of Bovine Dystocia?

A
  • Anterior Presentation

Heifers have a hard time birthing fetal head then the rest of calf is delivered normally

Cows have a hard time birthing bulky shoulders or chest

46
Q

How can we measure/ predict if a birthing will be difficult?

A
  • Sire known
  • Gestation Length known

If Inter-ischial distance to Digital Diameter is less than 2.25 then it will be a difficult delivery

  • Trial Traction Test: place hand in birth canal when calf head and feet are out, and see if there is any wiggle room
47
Q

What can you do if you know there will be a difficult calving?

A
  • Traction
  • Episiotomy
  • C-section
  • Fetotomy: removal of dead calf when C-section is not possible
48
Q

What can you do if you know there will be a difficult lambing?

A
  • If fetus is alive: traction on limbs and head with snares and lubricants
  • If fetus is dead: fetotomy by removing fetal leg
    note: common cause of dystocia in the ewe is bulky body features from ram
49
Q

What can you do if you know there will be a difficult foaling?

A
  • C-section is best

- CANNOT use traction on the head unless fetus is dead, delayed osseous union of fetal skull makes it risky

50
Q

When a fetus is being birthed, there are 3 dispositions you want to describe, what are they?

A

Presentation: anterior or posterior (head first or butt first)

Position: dorsal or ventral (right way up or up-side-down)

Posture: disposition of fetal head + limbs

51
Q

What tests can you do to check for signs of life in a fetus?

A
  • Pedal Reflex
  • Ocular Reflex
  • Suck Reflex
    caution: if the head has been stuck in the canal for a long time, you may get a false negative
    caution: if the fetus is ‘paddling’ it is a sign of hypoxia
52
Q

What is Fetal mummification and what is the treatment in cattle?

A
  • Fetus dies and the CL persists
  • The fluids get resorbed and the fetus dehydrates
  • Dam will fail to calf at expected time

Tx: PGF2alpha + lubrication +/- traction

53
Q

What is fetal Maceration and what is the treatment?

A
  • Fetus dies and CL regresses
  • No parturition occurs
  • soft tissue gets digested by bacteria, leaving behind bits of bone that can embed in the uterine wall
  • Leads to chronic endometritis and irritation

Tx: difficult/ impossible

54
Q

What is the definition for fetal mortality?

Hint: Best described in bovine

A

Calf death prior to, during or within 48 hours of calving, following a gestation period of at least 260 days, irrespective of the cause of death or the circumstances of the calving

55
Q

When do the majority of calf deaths occur?

A

Within 1 hour of calving (75%)

Pre-partum (10%)

Post partum (15%)

Clinical Reproduction (9 decks)

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