CESAREAN SECTION

Obstetrical Maneuvers

They are five type of operation and procedure can be done. The purpose of this operation to return the fetus to normal P P P and came out safety to him and dam. The operation can be done in all or most cases of dystocia and use one or more procedure can be used to deliver the fetus and the procedure of operation should be carefully and gently should be made

1-Repulsion and Retroplusion

It’s the first procedure and used in all cases of dystocia. It mean pushing the fetus inside of uterus or out of the birth canal to uterus abdominal cavity where the space is available for the correction the abdominally in PPP because pelvic cavity is narrow to correction.

This procedure can be done by the obstrical hand or crutch and the place of this instrument or hand between the shoulder and chest of the fetus in anterior presentation, but in posterior presentation the placed on the perineal region over the ischeal arch, This procedure must be to prevent straining by use epidural analgesia.In some cases the repulsion is became difficult because the animal is recumbent. .

2-Rotation

Turning of the fetus on its longitudinal axis to bring it in dorsal position in case of ventral or lateral position. This procedure is easily in life fetus by application of digital pressure or eye ball. This causes a convulsion reflex response or use obstetrician hand or torsion fork to correct the position. In anterior presentation to obstetrician hand or torsion fork place between shoulder of fetus but posterior presentation place between the thighs, and can use lubricant in old case in the birth canal because made the operation easier and prevent the injury and trauma in birth canal.

3-Version

Rotation of the fetus on its transverse axis in to anterior or posterior presentation in case of vertical or transverse presentation. This procedure need firstly repulsion the fetus in the uterus and then correction to normal presentation. If is possible done should be turned the fetus to posterior longitudinal presentation to prevent the complication result in devission of the head and neck

4-Extension

This procedure to correction of abnormal posture usually to flexion of one or more of the extremities causing dystocia. This procedure need the repulsion in the uterus because is difficult within the pelvic cavity and need three mechanical principles which are necessary to make the correction easy:
A-Repulsion of the proximal portion of the extremity. B-Lateral rotation of the middle portion of the extremity. C-Traction of the distal portion of the extremity.


5-Traction
With drawl the fetus outside of birth canal by used traction force or manual force after the correction of PPP. In anterior presentation can be chain or rope and place in pastern (above of the fetlock joint) also it can applied around the lower jaw but same time strong traction cause injury or fraction in this bone,
But in dead fetus can be used in lower jaw or make loop around the neck behind the head and the muzzle must be direct with head to avoid the head deviation during traction or used blunt or pointed hock placed in orbit and pull the fetus from it.

Caesarean section

The caesarean operation is a routine obstetric procedure in cattle practice which has high maternal and fetal survival rates and is less exhausting, speedier and safer than fetotomy. A prompt decision to perform caesarean operation is important for optimum success. The need for urgent intervention is indicated if there is evidence of fetal hypoxia as shown by hyperactive movements of the fetus and expulsion of the meconium, identifiable in the amniotic fluid.


Is a routine obstetric procedure including delivery of dead or alive fetus by laparohysterotomy. It is the safest and less exhausting method to relief dystocia with a high maternal and fetal survival rates. Usually applying when embryotomy or obstetrical maneuvers are difficult or imposable to be perform.

A successful prognosis depends onseveral factors:● skill and speed of the surgeon● duration of dystocia● availability of skilled assistance● surgical environment● concurrent disease● presence of a live calf.

,,… Feto pelvic disproportion

Breech presentation

Dog sitting posture

Uterine torsion

Ring womb

Hydrocephalus

Ascites (Kid)

Anasarca

Fetal anomalies( Double head)

Uterine rupture

Vaginal prolapse

Conjoined twins

Oversize lamb (Prolong gestation)

Mummified Fetus

Hydrallantois

Ventral hernia

Maternal recumbency (Pregnancy toxaemia

Sites of operation



1-Upper (Left or right flank) sub lumber approach


Left flank Advantage 1-Standing 2-No omentum, intestine prolapses 3-Reduce shock 4-Good healing 5-Uterine torsion Disadvantage 1-More assistants 2-Recumbency 3-Fetal Delivery

Right flank Advantage 1-Oversize fatal 2-Standing 3-Small incision 4-One assistant Disadvantage 1-Omentum & intestinal 2-Restraint & infection

Ventrolateral approach

Ventrolateral oblique approach Advantage 1-lateral recumbency 2-Contamination of abdominal cavity is low 3-easy access to uterus Disadvantage 1-Long incision 2-Hernia 3-Avoid milk vein 4-Prolpses the small intestine

Para median Approach

Midline (Lina alba) approach

Anesthesia

- The animal should be restraint according to the site of operation, sedation with xylazin should be applied in case of nervous animals. - Paravertebral N.B of the last thoracic and first three lumber spinal nerves. - Epidural analgesia but loss of the hind limbs control may be result leading to recumbency.

- Local analgesia either by the means of liner infiltration or field block using lidocain 2 %. - General anesthesia using chloral hydrate-magnesium sulfate or pentobarbital, but ruminal tympany and regurgitation of the ruminal fluids during the operation may occur.



Operation technique

Post operative care

Course of antibiotic therapy for 5-7 days. Calcium borogluconate. Oxytocin 40-100 IU. Some animals show signs of shock manifested by respiratory grunting, drooping of the ear, recumbency, coldness of the buccal mucous membranes, in this case fluid therapy is indicated e.g glucose or saline solution with corticosteroid administration.


- If the newborn is alive, colostrum must be given soon (30-60 min) after the operation. - In case of mare, administration of tetanus antitoxin should be applying. - Tincture iodine should be applying on the site of operation for (5-7) days. - The skin suture can be removing after (10-14) days.

Clearing air pass way

Respiration can be stimulate by rubbing the newborn with a towel

Complications

Peritonitis. Metritis. Abscess. Toxemia. Infertility. Retention of placenta. Hernia. Bleeding. Fistula and adhesions.