Cesarean section
Synonym(s): Surgical management of dystocia in cattle.
Introduction
- This article describes the technique used to perform a cesarean section and discusses the decision making processes involved in determining when a cesarean section is appropriate.
- Please be aware that this information is designed to be a useful guide for the veterinary surgeon, but is not prescriptive. The decision making process will very much depend on the individual case and its unique circumstances.
Uses
Maternal dystocia- Expulsive defect:
- Myometrial defect:
- Primary uterine inertia (inability of the uterus to contract sufficiently).
- Secondary uterine inertia (decreased effectiveness of uterine contractions as parturition progresses).
- Defective or inadeqate straining.
- Myometrial defect:
- Inadequate birth canal:
- Failure of cervix, soft tissues or ligaments to relax.
- Uterine torsion; definitely if complete torsion (>2700).
- Obstruction of birth canal, eg pelvic fracture.
- Inadequate pelvic diameter*
- Fetal oversize:
- Normal but large*.
- Defective or monster calf.
- Faulty disposition or alignment:
- Abnormal presentation.
- Abnormal position.
- Abnormal posture.
- Fetal death.
- Signs of fetal distress.
- History of previous dystocia or cesarean.
- Predictable dystocia due to breed predisposition, eg Belgian blue cattle Belgian blue cattle or misalliance, eg heifer too small when mated.
Advantages of performing the procedure
- Increased chance of a live calf if intervention is performed early.
- Reduced chance of secondary complications to cow, eg peripheral neuropathies.
Disadvantages
- Cost.
- Risk of surgical and post-surgical complications in the dam, including death.
- May reduce subsequent fertility of dam.
- Anesthetic depression of calf (if sedative used).
Alternative techniques
Alternative treatments for inertia
- Manipulation of reducible malpresentations.
- Manual traction of fetus.
- Correction of uterine torsion.
- Fetotomy Fetotomy/embryotomy if calf is dead.
Time required
Preparation
Assessing the situation- Obtain a history for the dam:
- Expected due date?
- Primigravida vs multigravida?
- Problems during pregnancy?
- When were signs of first stage labor seen?
- What has the farmer observed since?
- What has the farmer done so far?
- Has the cow received any treatments?
- What are the farmer's expectations/needs?
- Assess dam general status.
- Assess presentation, position and posture of calf.
- Assess viability of calf.
- Assess the environment for performing the procedure.
- Safe?
- Adequate lighting?
- Cleanliness?
- Good footing?
- Area to safely restrain cow?
- Administer Epidural Epidural (if not already performed for assessment of the fetus).
Procedure
- 30-90 minutes (for an uncomplicated cesarean, in the hands of an experienced surgeon).
- Procedure should be performed as quickly and safely as possible.
Decision taking
Criteria for choosing test
- Assessment of the cause of dystocia Dystocia.
- History suggestive of fetomaternal disproportion.
- Presence of uterine inertia.
- Decision often a subjective assessment of the dam and calf status and experience of the veterinary surgeon.
- Value of calf vs value of cow may play a deciding role.
Diagnosis of Dystocia
- Hugely variable gestation lengths between breeds and sires.
- Records not always reliable, particularly in beef systems.
- Intervention in cows: stage two labor lasting for greater then 1 hour.
- Intervention in heifers: No significant progress made after 30 minutes of appearance of fetal membranes.
- There are a lot of conflicting statements in the literature, as to the normal length of stage 2 labor. Published lengths range from:
- 1-2 hours (heifers).
- 0.5 – 1.5 hours (cows)
- Some sources state that normal stage 2 labor in cows should be less than an hour.
- There is also some literature which considers that earlier intervention produces a better outcome for cow and calf.
- There are a lot of conflicting statements in the literature, as to the normal length of stage 2 labor. Published lengths range from:
- General reasons for intervention:
- Weak or infrequent abdominal straining.
- Absence of abdominal straining.
- Obvious fetomaternal disproportion or obstruction.
- Signs of systemic illness.
- Evidence of fetal death.
- Meconium visible as vulval discharge.
Risk assessment
- Risk of fetal death.
- Risk of cow death.
- Safety of environment for performing procedure.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Lyons N A et al (2013) Aspects of bovine caesarean section associated with calf mortality, dam survival and subsequent fertility. Vet J PubMed.
- Newman K D (2008) Bovine caesarean section in the field. Vet Clin North Am Food Anim Pract 24, 273-293 PubMed.
- Schultz L G et al (2008) Surgical approaches for caesarean section in cattle. Canad Vet Jour 49, 565-568 PubMed.
- Kolkman I et al (2007) Protocol of the caesarean section as performed in daily bovine practice in Belgium. Reprod Domest Anim 42, 583-589 PubMed.
- Newman K D & Anderson D E (2005) Cesarean section in cows. Vet Clin North Am Food Anim Pract 21, 73-100.
- Dawson J C & Murray R (1992) Caesarean sections in cattle attended by a practice in Cheshire. Vet Rec 131, 525-527 PubMed.
- Barkema H W et al (1992) Fertility, production and culling following caesarean section in dairy cattle. Theriogenology 38, 589-599 PubMed.
- Cattell J H & Dobson H (1990) A survey of caesarean operations on cattle in general veterinary practice. Vet Rec 127, 395-399 PubMed.
Other sources of information
- Raphael Guatteo, Caroline Lesort & Gwenola Touzot-Jourde (2023) Impact of Meloxicam Administration in Cows Prior to Caesarean Section on the Efficacy of Passive Immunity Transfer in Calves. Animals MDPI. 13, 37 Online
- Hendrickson D A & Baird A N (2013) Cesarean Section in the Cow. In: Turner and McIlwraith’s Techniques in Large Animal Surgery. Wiley Blackwell. pp 258-265.
- Fubini S L & Ducharme N G (2004) Cesarean Section. In: Farm Animal Surgery. Ed: Fathman E M. Saunders. pp 382-387.
- Noakes D E, Parkinson T J & England G C W (2001) The caesarean operation. In: Arthur&rsqu