Dystocia

Define dystocia

Difficult birth

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What are the two main factors that cause dystocia?

Foetal and maternal

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Oversized foetuses (relative to the size of the birth canal) may be the result of:

Breed conformation, actual foetal oversize (when the litter size is small and large foetuses develop in the uterus), and foetal abnormalities (includes foetal monsters, resulting in relative overisze and dystocia)

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Is dystocia considered to be almost normal for breeds with exaggerated physical characteristics e.g. large head size

Yes it is

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What are the two main causes of maternal dystocia?

Poor straining efforts by the dam or uterine inertia (may be result of nervousness or pain but more often result of poor myometrial contractions), and obstruction of the birth canal

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Primary Uterine Inertia

The total or partial absence of contractions to expel a normal foetus through an obstructed birth canal

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Give 2 thought reasons for primary uterine inertia

Breed predisposition and large litter overstretching the uterus

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What are another 2 thought reasons for primary uterine inertia

Small litter not stimulating the uterus enough (small foetuses cannot apply enough pressure on the uterine wall) and systemic: obesity, lack of exercise/poor condition of uterine musculature (old age), hypocalcaemia, septicaemia

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Is primary uterine inertia more common in dogs or cats?

Dogs. Rare in cats

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What medical treatment should be given for primary uterine inertia?

Oxytocin or calcium borogluconate (oxytocin should only be given where it is certain there is no obstruction to the birth canal). In certain cases caesarean surgery may be necessary.

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Secondary Uterine Inertia

Cessation of uterine contractions after they have started. Commonly result of uterine exhaustion following obstructive dystocia (may occur spontaneously during second stage parturition)

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If the cause of dystocia is relieved what can be given?

Administration of oxytocin and calcium.

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Obstruction of the birth canal may be the result of abnormalities of the birth canal these are what:

Deformity of the pelvic bone (may be congential malformations, developmental abnormalities or as a result of trauma, commonly following RTA), soft tissue abnormalities within the pelvis (press against the pelvic tract)

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Obstruction of the birth canal may be the result of abnormalities of the birth canal these are what:

Abnormality of the reproductive tract itself (e.g. torsion of the uterus, uterine constrictions)

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What information is required when dystocia is a concern?

Gestation period, collect relevant history, determination of time of mating (pregnancy length varies 56-72 days from mating), rectal temperature taken, behavioural changes, time when straining first occured and the character of the straining

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What information is required when dystocia is a concern?

Times that puppies/kittens were born - any born? Time inbetween/last one was born?, ***** age/first litter/breed, tending to pups/all placentas delivered/how many pups expected, water broken/contractions?

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Medical advice should be sought if:

Foetus has been expelled over 2 hours, foetus is not delivered 20-30 minutes of strong and regular contractions, *****'s body temperature below 37.7 and any specific problem found on physical exam

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Two causes of dystocia in the mare

Foetal dystocia (abnormal positioning of long foetal limbs and necks), maternal dystocia (uterine inertia, pelvic abnormalities and ruptured pre-pubic tendons

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If dystocia occurs in equids what must be required?

Cesarean section

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What are the physiological changes that may affect the patient's response to anaesthesia?

Hypoventilation and subsequent hypoxia, increased oxygen requirement, level of gas administration required is less

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General aims during anaesthesia for caesarean section are what?

Adequate oxygentation, maintain blood volume and prevent hypotension and minimise depression of the foetus and dam during and after surgery

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What are post - operative cesarean complications?

Haemorrhage, infection, pain, d+ (hormonal influences), wound breakdown (sucking -s/c sutures), not bonding/rejection, no milk, buster collar, attack/eat babies, hypothermia and delayed recovery

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What neonatal requirements may be needed after a cesarean section?

Keep warm, resuscitate pups/kittens, check hearts and respiration, removal of the amniotic sac, clamp, ligate and disinfect the umbilic cord (if dam unable to tend to herself), rub the neoate with a clean towel to dry it and stimulate respiration

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What neonatal requirements may be needed after a cesarean section?

Clear any fluid from the mouth and nose using suction and provide oxygen supplementation if the neonate is slow to start breathing

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What are the signs of dystocia in the mare?

Expulsion of allantoic fluid but no sign of amnion or foal shortly after, visibility of the allantochorion but no allantoic fluid, continued forceful abdominal contraction but no sign of foal, visibility of the amnion but no contraction effort

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What are the signs of dystocia in the mare?

Mare is continually getting up and rolling side to side, the foal is stuck at the hips with its head, legs and chest out

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Dystocia

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