• Can be used to deliver part(s) of a dead fetus per vaginum in cases of dystocia.

Uses

• Used in conjunction with traction and manual manipulation to deliver calves in cases of abnormal presentation, position and posture.
• Presence of fetal abnormalities (joint ankylosis ie Schmallenberg virus Schmallenberg virus), hydrocephalus or fetal monsters.
• In cases of fetomaternal disproportion.
• In cases of complete uterine inertia (where cesarean section Cesarean section is not an option).

Advantages

• Avoids major abdominal surgery.
• Potentially better long term effects on fertility and production.
• Likely lower cost than cesarean section.

Disadvantages

• Only to be used when the fetus can be confirmed dead.
  • Lack of fetal reflexes (withdrawal, blink, anal sphincter).
  • Lack of heart beat on palpation of fetal thorax.
  • Lack of pulse in umbilicus.
• If unsuitable equipment is used then can be traumatic to reproductive tract.

Technical problems

• Can be physically demanding.
• Can be difficult even for experienced surgeons.
• Fetal monsters or joint ankylosis can increase difficulty.
• It can be hard to identify a fetus as dead.

Alternative techniques

• Manipulation of dystocia Dystocia to allow normal delivery.
• Cesarean section Cesarean section.
• Partial fetotomy vs total fetotomy.
• Emergency slaughter Slaughter: emergency slaughter for human consumption.
• Euthanasia Euthanasia: techniques.

Time required

Preparation

• Sedation, if necessary (10 - 30 minutes) Sedation: overview.
  • May have an effect on myometrial contractions.
• Epidural is essential (10 minutes to effect) Epidural.
• Tocolytics such as Clenbuterol Clenbuterol hydrochloride can be used for uterine relaxation.
• NSAIDs Anti-inflammatory drugs: an overview.
• Antibiotics (unless fresh dead).

Procedure

• Depends on presentation, experience, equipment.
• The key factor in duration of the procedure is the experience of the veterinarian.
  • In the Netherlands a total fetotomy is described as taking only 20 minutes by experienced veterinarians.
  • In the authors experience, depending on presentation of the fetus and a multitude of other factors, fetotomy procedures can take anywhere from 20 minutes to one hour.

Decision taking

Criteria for choosing test

• Non-correctable dystocia.
• Dead fetus.
• High value dam.
• Degree of difficulty (number of cuts needed to resolve dystocia).
• Economic constraints.
• Lower risk than cesarean (ie emphysematous calf).

Indications and common procedures

• Forelimb removal:
  • When one or more limbs are in abnormal posture and cannot be manipulated.
  • In fetal oversize where leg is or is not presented.
• Removal of neck/head:
  • Indicated for deviation of head/neck or fetal oversize. Reduces size of thorax as shoulders can move medially when traction applied.
• Hip lock:
  • Exposed cranial part of fetus incised caudal to thoracic cavity, abdominal organs removed. Fetal pelvis then split down the middle.

Risk assessment

• Safety for personnel.
• Potential for damage to reproductive tract and long term fertility.