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Theriogenology > Principles of Obstetrics > Flashcards

Principles of Obstetrics Flashcards

1
Q

what are some maternal causes of dystocia (5)

A

1) abnormal pelvis size or fracture
2) abnormal cervix (ringwomb)
3) uterine prolapse
4) uterine inertia
5) uterine torsion

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2
Q

what commonly causes failure of cervical dilation in:
1) sheep
2) cows

A

1) ringwomb
2) uterine torsion, or dead calf

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3
Q

how does ringwomb present in sheep and is there a genetic link

A

fetal membranes hanging from vulva; yes

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4
Q

what is uterine inertia and what are primary and secondary causes

A

inability of the uterus to produce contractions

primary: hypocalcemia, overstretching (hydrops, multiple fetuses)

secondary: exhaustion of the myometrium after prolonged and unsuccessful delivery attempt

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5
Q

what are some fetal causes of dystocia

A

1) fetal-maternal disproportion
2) fetal malalignment
3) multiple fetuses
4) fetal monsters

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6
Q

what is the most common cause of dystocia in cattle and what breed is this most associated with

A

fetal-maternal disproprtion; double-muscled breeds like Belgian blue

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7
Q

when does fetal-maternal disproportion commonly occur in dogs

A

when only a single pup that can grow too big for pelvis

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8
Q

what is the most common cause of dystocia in horses (and alpacas)

A

fetal malalignment

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9
Q

a calf is born with spinal curvature, unfused thoracic and abdominal walls and ankylosis

what is the diagnosis?

A

schistosomus reflexus

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10
Q

a calf is born with vertebral agenesis and arthrogryposis, flexure and ankylosis of the hindlimbs, no vertebrae caudal to the thorax, and a flat pelvis

the front half is relatively normal

what is the diagnosis?

A

perosomus elumbus

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11
Q

what is an autosomal recessive trait that is common in angus breeds

A

neuropathic hydrocephalus

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12
Q

what equine breeds are commonly associated with hydrocephalus and why

A

Belgian and Friesian horses; autosomal recessive mutation in B3GALNT2

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13
Q

what are 2 common causes of dystocia in dogs

A

1) fetal anasarca (associated with bulldogs)
2) fetal ascites (associated with organ abnormalities)

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14
Q

what is the most common cause of dystocia in cows

A

fetopelvic disproportion

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15
Q

what is the most common cause of dystocia in mares

A

fetal malalignment (most commonly head or limb deviation)

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16
Q

what is the most common cause of dystocia in the bitch

A

uterine inertia

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17
Q

what is the most common cause of dystocia in the queen

A

uterine inertia

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18
Q

what is the most common cause of dystocia in the ewe

A

fetal malalignment (often complicated with multiple fetuses)

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19
Q

what is the most common cause of dystocia in the ewe

A

fetal malalignment

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20
Q

what is the most common cause of dystocia in the sow

A

uterine inertia, followed by fetal malalignment

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21
Q

what three terms are used to describe the fetal alignment

A
  • presentation
  • position
  • posture
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22
Q

presentation describes

A

the relative association of the long axis of the fetus with the maternal birth canal

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23
Q

what is normal presentation

A

anterior longitudinal (posterior longitudinal also normal in cows)

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24
Q

how can you tell whether the fetus is presenting in anterior or posterior longitudinal

A

anterior: the fetlock and carpus joints bend in the same direction

posterior: the fetlock and hock joints bend in opposite directions

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25
Q

what is an additional test besides palpation of joints that you can use to determine the presentation

A

anterior: palmar aspects of hooves point down; feel for head

posterior: plantar aspects of hooves point up; feel for tail

unless the fetus is upside down, always use palpation first

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26
Q

T/F posterior presentation is normal in cows but usually requires assistance

A

T

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27
Q

what is position

A

describes the surface of the maternal birth canal to which the dorsal aspect of the fetus is aligned

28
Q

what is normal position

A

dorsal-sacral

29
Q

what is posture

A

describes the disposition of the fetal head, neck and limbs

30
Q

what is normal posture

A

extended neck and limbs

31
Q

what is normal presentation, posture and positioning (use horses as an example)

A

anterior longitudinal, dorsal sacral, extended head and limbs

32
Q

describe breech

A

posterior longitudinal with bilateral hip flexion

33
Q

describe two types of abnormal presentation

A

transverse (dorsal or ventral) and vertical (dog sitting)

34
Q

a mare is foaling and delivery appears normal (two toes and a nose) and then suddenly stops

what do you expect is happening

A

the baby is malpositioned and is in vertical presentation (dog sitting)

35
Q

what is abnormal position

A

dorso-pubic; right or left dorsal-ilial

36
Q

what are some examples of abnormal posture

A

lateral deviation of the head and neck; uni or bilateral carpal flexion, ventroflexion of the head (vertex); uni or bilateral shoulder flexion

37
Q

what abnormal posture commonly causes rectovaginal fistulas

A

foot nape

38
Q

T/F breech and posterior longitudinal, dorso-sacral with bilateral hock flexion are the same thing

A

F
breech: posterior longitudinal, dorso-sacral with bilateral hip flexion

not the same as bilateral hock flexion

39
Q

you are presented a mare with dystocia and all you can see is the foals head

what is the likely posture of the foal

A

we know the foal is anterior longitudinally presented and dorso-sacral position

posture could be either bilateral shoulder flexion or bilateral carpal flexion

40
Q

what do you want to assess on your initial exam of a dystocia

A

1) history (gather on way to farm)
2) general physical exam
3) cervix dilation
4) torsion?
5) fetal viability
6) fetal number
7) uterine tears
8) pelvic size/abnormalities
9) presentation, position and posture

41
Q

what is the rule of 3

A

must see two limbs and a head present to pull

42
Q

when dealing with dystocia we want to be as ________ as possible and be as ________ as possible

A

be as aseptic as possible and be as lubey as possible

43
Q

where do you give an epidural in large animals with dystocia

A

sacro-coccygeal or C1-C2

44
Q

why do we give epidural

A

reduces straining to help with extraction of the fetus (may result in more work for us though as we will need more assistance)

45
Q

what lube do you NOT want to use in a dystocia and why

A

polymer lube; it is linked to acute deaths, and if it goes peritoneal causes hemolysis, peritonitis, renal failure and death

46
Q

how do we most commonly assess fetal viability

A

fetal reflexes, also heartbeat, ECG or ultrasound can be used

47
Q

how do fetal reflexes dissapear

A

from peripheral to central

48
Q

how do we test fetal reflexes

A

1) interdigital claw
2) swallowing
3) eyeball (disappears last)

49
Q

what fetal reflex is not consistent

A

anal

50
Q

what is diagnostic traction

A

when you bring the head and two limbs into the birth canal with chains and see if you can make progress

51
Q

what are good signs when you perform diagnostic traction

A
  • hooves out with straining and in when straining stops
  • fetlocks/hocks can be extended a hand’s width past the vulva
52
Q

what are bad signs when you perform diagnostic traction

A

1) prolonged labour and head still not in pelvis
2) head goes back in when you start pulling the legs
3) forelimbs crossed
4) volar surfaces of hooves directed medially

53
Q

what are the 3 principles of fetal repositioning

A

1) control
2) repulsion
3) rotation

54
Q

how do we use rotation to reposition the fetus

A

1) bring distal limb in medially
2) rotate joint laterally

55
Q

how do you place calving chains

A

with a double half-hitch; one hitch above the fetlock, one below on the pastern

56
Q

T/F the fetal hooves have protective structures so it is not necessary to use any additional caution on the hooves

A

F; need to cup to prevent damage as we are correcting

57
Q

how do you prevent hiplock

A

rotate the fetus 45 degrees through the widest angle of the pelvis

58
Q

what are the 4 options for resolution of dystocia

A

1) assisted vaginal delivery (standing)
2) controlled vaginal delivery (anesthetized)
3) fetotomy
4) c-section

59
Q

how do we perform assisted vaginal delivery

A

1) correct position
2) deliver in a downward arc
3) walk fetus through birth canal one forelimb in front of the other

60
Q

T/F assisted vaginal delivery can be performed with or without epidural and sedation

A

T

61
Q

how much force is needed to deliver a calf

A

70kg

62
Q

T/F controlled vaginal delivery can be performed with or without sedation or epidural

A

F: it is performed under general anesthesia

63
Q

what is a benefit of controlled vaginal delivery compared to assisted vaginal delivery

A

you can have members of the team preparing for c-section or fetotomy while you are working on the CVD

64
Q

when you are called to the field for a dystocia and do an initial evaluation you determine the foal is alive; what is your next series of steps and timeline

A

1) determine if the foal can be delivered vaginally (do diagnostic traction)
2) if diagnostic traction confirms foal cannot be pulled -> c-section
3) if diagnostic traction confirms foal can be pulled -> spend 10 minutes on assisted vaginal delivery
4) if assisted vaginal delivery does not work -> spend 15 minutes on controlled vaginal delivery
5) if controlled vaginal delivery does not work -> c-section

65
Q

you are called in for a dystocia and on initial assessment determine the foal is dead. what is your next series of steps and timeline

A

1) may decide to move on directly to fetotomy if you perform diagnostic traction and the foal cannot be delivered vaginally
2) if diagnostic traction confirms vaginal delviery is possible -> spend 10 minutes on assisted vaginal delivery
3) if AVD fails -> spend 15 minutes on controlled vaginal delivery
4) if CVD fails -> consider C-section or fetotomy

Theriogenology (18 decks)

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