Pathology of parturition in large animals

Question 1

Pathological delivery (dystocia) is in latin

Answer 1

difficult delivery = partus gravis seu difficilis

for expulsion of the fetus help is needed (obstetrical aid)

Question 2

Stillbirth in latin

Answer 2

partus mortuus

dead, but in normal presentation fetus will be expelled without any aid

Question 3

Retention of fetal membranes (RFM) in latin

Answer 3

retensio secundinarum

fetal membranes are not expelled during normal time after delivery of fetus.

Question 4

Main causes of dystocia in cattle. (6)

Answer 4

In cow according to frequency:

1. Fetus and birth canal (pelvis) disproportion (especially in first time calvers).
2. Fetal malpresentation, malpositions and malpostures e.g. posterior presentation.
3. Uterine torsion
4. Uterine inertia (low contraction activity)
5. Twins (when in same horn, one is always posterior positioned)
6. Fetal monsters, fetal membranes pathology

Question 5

Fetal presentation in the context of parturition:

Answer 5

The relationship between the long axis of the fetus and the long axis of the maternal birth canal.

Thus presentation can be longitudinal (anterior or posterior), transverse, or (very rarely) vertical.

Question 6

Fetal position in the context of parturition:

Answer 6

That surface of the maternal birth canal to which the fetal vertebral column is applied.

Thus position can be dorsal, ventral or lateral (right or left).

Question 7

Fetal posture in the context of parturition:

Answer 7

The disposition of the head and limbs of the fetus.

Question 8

Broad causes of dystocia, extrinsic (4) and intrinsic (4).

Answer 8

extrinsic or environmental:
diet (excess condition and poor condition both)
supervision (ppl disturbing natural birthing too much)
diseases e.g. hypocalcemia
induction of birth

intrinsic:
age
parity
body weight
pelvic size of dam

Question 9

Answer 9

obstetrical snares

(rope version of obstetrical chains)

Question 10

Answer 10

obstetrical forks

Question 11

Answer 11

snare guides in order to place snares on parts of the calf within the uterus

Question 12

Answer 12

Eye hooks and their connection with obstetrics string by one snare (A) and separately (B).

Question 13

Answer 13

Obstetrics ring knife

Question 14

Answer 14

Krey-Schöttler’s double –jointed hooks for use only in dead calves

Question 15

Answer 15

Mechanical calf puller

Question 16

Correct placement of obstetrical chains.

Answer 16

Always Place a chain loop around the leg just above the fetlock (ankle), plus a half-hitch just above the hoof.

Question 17

Main rules for obstetrical aid, first 7 rules.

Answer 17

1. Asepsis and the use of antiseptics.
2. Avoid the manual rupture of the fetal membranes before the cervix is totally open.
3. Start the obstetrical aid only after you know the exact cause. Aid should be given according to a specific plan and if that plan
   does not work within 20 minutes, we should change the plan.
4. It is much easier to give obstetrical aid in a standing animal versus in a recumbent animal. In recumbent animals, the aid is easier when limbs are malpostured or head is in upper position.
5. Life saving (mother and fetus). Inspect general status of the animal.
6. Lubrication
7. If there is more than 2 limbs in birth canal, check whether they are front or hind limbs and whether they belong to the same fetus.

Question 18

Main rules for obstetrical aid, second set of rules (rules 8-14).

Answer 18

8. Obstetrical snares are placed separately onto each leg, if necessary, the head will be fixed with a third snare. With twins, the obstetrical snares should be labeled.
9. For traction of the fetus, maximum 4 person power is used. Traction should be even and should be done only during the cow’s contractions.
10. If the birth canal is narrow & bony, do not use excessive force. Do cesarean section or fetotomy instead.
11. All corrections of malpositions or postures should be done in utero, not in the vaginal canal (no space for that). The fetus should be pushed back into uterus between contractions.
12. Always do a final check when obstetrical aid is completed. Check for injuries and bleeding.
13. Fetotomy only in case of dead fetuses and emphysemic fetuses.
14. Communication with owner is very important.

Question 19

For successful delivery in heifers, the external distance between coxal tubers should measure at

Answer 19

minimum 40 cm at insemination.

Height of the heifer’s back should be minimum 120 cm at insemination.

Question 20

cow gestation in days

Answer 20

283 days

Question 21

Relatively large fetus (fetus magnus relativus)

versus

Absolutely large fetus (fetus magnus absolutus)

Answer 21

Relatively large fetus: fetus size is normal, but birth canal is narrow.

Absolutely large fetus: fetus size is too big, birth canal size is normal and birth canal is normally open (most frequent cause for difficult delivery in cow).

Question 22

Application of calving ropes to what part of the calf?

Answer 22

A = to the head, B = to the leg

Question 23

Malpostures in anterior presentation. Describe deviation of the head:

Answer 23

Happens frequently (ca 49%) and is frequently right side deviation

Side deviation of the head common (lateroflexio capitis dextra, sinistra)
Always according to cow flank not the fetus flank

Caused by: incomplete opening of the cervix (premature rupture of fetal membranes, weak fetus (cannot extend head into the birth canal)

May happen during assisted calving, during traction of the fetus when the head is not inserted into birth canal.

E.g. Calf neck ankylosis, hydrocephalus, dead fetus

Question 24

Clinical signs of malposturen of the calf’s head in anterior presentation.

Answer 24

Hoof tips are visible from the vulva, hoof plantar surface is downward, leg on the side of the head deviation is less visible.

Possible to palpate the head and nose, but if the uterus is strongly contracted around the fetus we can feel only ear tips.

If head deviation is corrected in the wrong way (downward), it can result in neck torsion and fetal death.

Question 25

Downward deviation of the head prognosis.

Answer 25

much worse than in case of side deviation, more difficult to fix

Question 26

Unilateral metacarpophalangeal (pastern) flexion.

Answer 26

The flexed carpus is found at the pelvic inlet or impacted in the vagina.

Question 27

Answer 27

Foot-nape malposture

Question 28

Answer 28

Retention of a hindlimb or both:
This occurs in some cases of posterior presentation and may involve hock flexion or hip flexion of one or both hind limbs.

Question 29

Answer 29

Hip flexion (breech presentation)

Most frequently both sides.

Question 30

Answer 30

lateral malposition

Question 31

Answer 31

ventral malposition with posterior presentation

Question 32

Answer 32

ventral malposition with anterior presentation

Question 33

How long should you try to correct malpresentation before resorting to cesarean or fetotomy?

Answer 33

20 min