Caesarian section in Cow and Bitch
- Caesarean section is the delivery of the fetus, usually at parturition, by laparohysterotomy. This operation is performed when mutation, forced extraction and fetotomy are deemed inadequate or too difficult to be relieve the present dystocia or when it is desired that the fetus to be delivered alive.
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| C-Section |
INDICATIONS
- Fetal oversize
- Incomplete cervical dilatation
- Irreducible uterine torsion
- Fetal deformities
- Faulty fetal disposition
- Fetal emphysema
- Miscellaneous indications
Selection of operative site
- Right Upper Flank
- Left Upper Flank
- Right Or Left Lower Flank Oblique Abdominal Incision
- Ventral Abdominal Approach
RIGHT UPPER FLANK
ADVANTAGE
- Easier and in standing position.
- Incision can be smaller.
- Chances of herniation is less.
DISADVANTAGES
- More difficult to restrain and control.
- It is difficult to bring the uterus to the incision.
- Abdominal contamination with uterine content.
LEFT UPPER FLANK
- No interference of intestine.
- Full rumen may cause difficulty.
RIGHT OR LEFT LOWER FLANK OBLIQUE ABDOMINAL INCISION
ADVANTAGES
- Easy access to the gravid horn.
- Muscles in this region stretch easily.
- It is easier to prevent contamination at the abdominal cavity by uterine fluid.
- Less possibility of herniation.
DISADVANTAGES
- On right side it is difficult to control the prolapse of small intestine.
VENTRAL ABDOMINAL APPROACH
- Slight lateral to the fore udder and extends forward as far as necessary, usually 12 to 14 inches.
ADVANTAGE
- It is prevents uterine contents being released in to abdominal cavity.
DISADVANTAGES
- Chances of herniation.
- Abdominal wall composed of fibrous tissue, tunic and will not strech.
ANAESTHESIA
- Local Infiltration or Inverted “L” Block
- Paravertebral Nerve Block
- Epidural Anaesthesia
- Sedation with Xylazine
OPERATIVE TECHNIQUE
- Dissection Preparation of Surgical Site and Local Infiltration
- incision: 10-12 Inch
- of External Oblique, Internal Oblique and Transvese Abdominus
- Cutting of Peritoneum
- Omentum: Pushed cranially or incised
- Greater Curvature of Uterus is incised avoiding Placentomes
- Removal of Foetus and Foetal Membrane
SUTURING
- UTERUS: LAMBERT/CRUSHING SUTURE CHROMIC CATGUT# 2 OR 3
- PERITONEUM: CONTINOUS CHROMIC CATGUT# 2
- ABDOMINAL MUSCLE: CONTINOUS LOCK OR HORIZONTAL INTERRUPTED METRESS
- SKIN: SIMPLE INTERRUPTED OR CROSS METRESS OR HORIZONTAL METRESS WITH NYLON OR COTTON THREAD
- SKIN SUTURES REMOVED IN 7-10 DAYS
POST OPERATIVE CARE
- I/V fluids
- Parenteral anti-histamines
- Anti histamines
- Analgesics
- After operation: 30 to 50 I.U. of oxytocin 300 to 450 ml CBG I/V
Post operative complications
- Maternal death due to shock secondary to exhaustion, toxemia, hemorrhage and excessive manipulation of abdominal pressure
- Retained fetal membrane & metritis are common.
Three post operative complications:
[1] Peritonitis
[2] Adhesions of the uterus with surrounding viscera & around dehiscense & infertility ,
[3] Hernia
Caesarean section in canines
Indication:
- Narrow pelvis
- Uncorrectable fetal malpresentations.
- Fetal monstrosities
- Uterine inertia
Anaesthesia:
- Decided on the viability of the fetus.
- If the fetus are live ~local infiltration of 2% Lignocain HCL + Tranquilization
- After removing pups ~ general Anesthesia.
- If the pups dead~ gives general anesthesia directly for C.S.
Site for operation
- The preferred line of incision is linea-alba by putting the animal in dorsal –recumbency.
- Flank approach is also being prectised.
Procedure
- Skin incised followed by linea-alba
- Incision of peritoneum
- Exteriozation of uterus & packing peritoneal cavity
- Incision on uterus
- Removal of foetus & placenta
Suture
- Uterus: inverted continuous suture with catgut
- Peritoneum and muscle ~ suture in single or two tiers interrupted suture with catgut.
- Skin suture: interrupted with nylon.
Procedure of Caesarean section in Bitch
- Skin is the first layer to be incised followed by linea alba .
- After incising the peritoneum it is important to differentiate between the urinary bladder and the uterus
- The uterus is exteriorized through the line of incision and the peritoneal cavity properly packed to avoid any spillage of the infected discharges into it .
- Along with the fetuses the placenta is also removed, however, if placenta is firmly attached it can be left in the uterus.
- Undue traction on adhered placenta will lead to excessive bleeding
- Inverted continuous sutures are applied on the uterus with catgut.
- Thoroughly clean the uterus with saline before it is replaced into the abdominal cavity.
- Peritoneum and muscles are sutured in the single or two tiers.
- Contrary to bovines, interrupted sutures are preferred on muscles to avoid wound dehiscence if at all any of the stitch breaks due to aggressive behavior of the bitches.
- Skin sutures in interrupted manner are applied using nylon.
Tags:
Reproduction