Clinical Approach to Obstetrical Cases

A clinical approach to obstetrical cases in veterinary practice involves a systematic evaluation and management of reproductive emergencies and complications during parturition.

It begins with a thorough history-taking, including information about the animal’s age, parity, gestation length, previous reproductive performance, and any signs of labor or abnormal discharge.

This is followed by a detailed physical and obstetrical examination, which may include rectal and vaginal palpation to assess fetal position, presentation, posture, and viability, as well as maternal pelvic conformation and birth canal condition.

Dystocia cases are handled promptly as emergency calls. The examination of the parturient animals as well as all subsequent obsvtetrical procedure should be planned and performed in such a way that trauma to the dam is minimal and to deliver a life of foetus.

History of the Case

In most cases a calf can be delivered without anamnesis. However the examination can be better guided if the anamnesis is known. Information to be collected from the owner includes.

• Previous breeding history
• General management during pregnancy
• Is the animal prime or multi parous
• No and types of previous dystocia
• Has full term arrived or delivery premature
• When did straining begin
• Nature of straining
• Has straining ceased
• Appearance of water bag and if so when was it first seen
• Rupture of water bag and escape of fluid
• Have any part of the fetus appeared at the vulva
• Has examination been made and has assistance been attempted, if so nature of assistance
• Is the animal able to rise up
• In case of multiparous species have any young been born, naturally or otherwise.
• Is the animal still taking food
• In case of bitch and cat has there been any vomiting

Restraint of Animal

The animal should be properly restrained during examination so that they do not injure the operator at the time of examination.

• Cows: Should be fastened and secured with rope or halter
• Sheep: Fore limbs should be tied together and the rear parts elevated by an assistance
• Mares: A twitch should usually be applied to the lip and one four leg held up.
• Sows: secured by a strong rope with a loop around the upper jaw behind the canine teeth or the sows secured and placed in farrowing crates.
• Dogs: Should be muzzled
• Cats: Should be held firmly by an assistant

General Physical Examination

The animal’s physical and general condition should be noted. If in recumbent state; Pulse, temperature, respiration, mucous membrane, hydration and rumen motility should be evaluated. Examination of the udder to detect mastitis should be done. Significance of any abnormality should be considered.

Obstetric Examination (External)

Attention is paid to the changes observed in the vulva and surrounding area and vulvar discharges. Attention is paid to parts of the fetus protruding to assess the nature of dystocia are the exposed foetal parts moist or dry. If foetal membranes are protruding the nature of condition is evaluated. Are they moist and glistening.

If membranes are dry and dark in colour the case is a protracted one. Attention should be paid to nature of discharge. Blood if profuse generally indicate recent injury to the birth canal. A dark foetid discharge indicate a delayed case.

Obstetric Examination (Internal)

Vaginal examination should be done only under hygienic condition. External genitalia and surrounding part are thoroughly washed. In mare the tail should be bandaged, in bitches sheep and goat the hairs around perineum clipped.

The operator should wash his hands and lubricate it before proceeding to make a vaginal examination.

Epidural anesthesia may be induced to prevent straining and defecation. The birth canal should be examined to see if it is dilated, twisted inflamed, swollen or necrotic.

The degree of dilation or relaxation of the cervix should be noted. The size of pelvic inlet, vagina and vulva in relation to size of foetus should be assessed.

The foetus should be examined for any abnormal presentation, position and posture. The foetus should be examined if it dead or alive as these alters the prognosis or the manner in which the case is to be handled.

If the foetus is dead, the degree of decomposition should be accurately determined by the amount of subcutaneous edema or emphysema-whether if there is sloughing of hairs. If the fetus is alive, the part of the presenting fetus is to be identified.

Intrauterine Liquid Replacement

Intrauterine liquid replacement is a most important procedure in preventing or minimizing trauma to the birth canal from friction arising during assisted delivery.

Assisted delivery must never be attempted when intra uterine liquids have been lost and the walls of the birth canal and the skin of the fetus dry.

Manipulations inside the birth canal can be more easily and safely performed when the fetus is floating in lubricant liquid.

Preparations

• The simplest Intrauterine liquid replacer is soap water.
• Mucus obtained by boiling 250 g linseed in 10 litres of warm water and then filtered while hot (linseed tea).
• 1000 gms of methylcellulose in 45 litres of warm water.
• J-tube-poly ethylene polymer-25% solution is prepared for lubrication.

Procedures

• Intrauterine liquid is introduced into the genital tract as far as anterior as possible over the dorsal aspects of the fetus.
• Liquid should be replenished at frequent intervals, 0.5 to 1 at a time to permit manipulation and traction.

The liquid should be removed after delivery of fetus.