SA Pregnancy + Parturition Flashcards
What is the gestation length in a dog? from LH surge, ovulation + mating date?
*65 days +/- 24hrs from LH surge
*63 days +/- 24hrs from ovulation
*From mating date = 57-73days
How can you perform a pregnancy diagnosis in a dog?
*ultrasound - 25days onwards
*relaxin assay - 30days onwards
*Palpation - 30days onwards
*Radiography - 45days onwards
How would you perform an ultrasound? What can you see?
*Front legs in air in small breed so uterus drops caudally
*Look for heart beats, ribcage, lungs (look like liver -no air)
*Pyometra = hypoechoic
What are benefits of ultrasound?
*Rapid
*Earliest reliable detection method
*No sedation
*Can assess foetal size + heart rates
What are limitations of ultrasound?
*Can see false negatives (too early)
*Need to learn to use
Why can radiography only be done from day 45 onwards?
*Foetal ossification occurs from day 42 onwards
What is stage one of normal parturition? What are the clinical signs?
*6-36hours
*drop in progesterone + rise in prolactin
*Temp drop in bitch
*Restless, anorexia, milk production, infrequent uterine contractions, nesting behaviour, vulvar licking
What is stage two of parturition? CLinical signs?
Labour
*2-12 hours
*Rupture of allantochorion of 1st puppy
*Strong straining = puppy produced within 30mins
What is stage 3 of parturition?
*expulsion of placenta
When would we worry with parturition?
*Signs of foetal distress = 1.meconium
2.green vaginal discharge without puppy = indicator of placental detachment
*Maternal problems = Vaginal haemorrhage, severe pain, exhaustion or systemic disease
*Delays = foetal visible in birth canal with no progression of delivery (>30mins)
or >4hrs between pups
What are the maternal factors for dystocia?
*Uterine inertia - primary / secondary
*physical obstruction of birth canal - narrow pelvis
What are foetal factors of dystocia?
*Oversized foetus
*Malpresentation
*Malformation
What is primary uterine inertia?
*Failure to START stage 2 (labour)
associated with litter size
- 50% <3pups
-very large litter = myometrial stretch + inability to contract
What is secondary uterine inertia?
*Failure to progress through second stage labour + complete - usually after prolonged contractions
-Hormonal, fuel, maternal exhaustion
What can be done to investigate dystocia?
*Physical exam
*Ultrasound
*Radiography
*Blood tests
What can be done with physical exam to investigate dystocia?
*Pups - is there pup in birth canal / presentation / stuck?
*Ferguson’s reflex - vaginal palpation = strong uterine contraction if not = uterine inertia
*Discharge - concerning discharge = haemorhage / green without pup
*Obstructions
What blood tests can be carried out for dystocia investigation?
*PCV + total solids
*Blood glucose
*Lactate
*Creatinine
What can be checked on ultrasound?
*Evindence of rupture
*Foetal viability
What is medical management of malpresentation?
*Gentle manipulation of lubricant + sterile gloves
What is medical management of secondary uterine inertia?
*Correct calcium + glucose abnormalities
*Oxytocin if no obstruction
What are the risks anaesthetic for the pups?
*Drug may cross placenta + impact pups
*Risk of hypothermia
What are the anaesthetic risk to the bitch?
*Pregnancy increases oxygen demands
*Higher cardiac output
*Risk of venous obstruction from gravid uterus on vena cava
*Delayed gastric emptying
*Hypothermia
Should you pre-med a pregnant bitch?
*Avoid if possible - only give if no choice
How should you pre-oxygenate?
*Tight fitting mask = maximise oxygenation
Why should you catheter before surgery?
*Correct fluid losses before surgery - maintain blood pressure
What can be done as pre-op prep?
*Try clip before anaesthesia + initial skin scrub
What can be used to induce anaesthesia?
Propofol or Alfaxalone
*Fast onset
*Titred to effect
Where will local anaesthesia be needed?
*Skin /subcutis + linea alba
When would you give systemic analgesia?
*After pups have been delivered so no placental transmission
*NSAIDS - meloxicam
*Opioids - methadone
*Paracetamol
What is the surgical approach to a c-section?
*Midline approach = abdominal entry (large enough to exteriorise uterus)
*Exteriorise + pack abdomen with damp swabs
*Uterine incision = milk puppies down each horn
*Check for pups before closure
*Uterine closure = 2 layer closure - monofilament absorbable
*Flush + close - remove swabs + flush abdomen, dry + close abdomen in 3 layers
What should be done as neonatal care?
*Warming equipment - box with warmed towels + heat pad
*Resus equipment - IV catheters (umbilicus), Clamps (umbilicus) + Resuscitation drugs = atropine, adrenaline
What can be done during recovery of bitch?
*Clean teats
*Keep warm
