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Raksha Technical review 2013; 3(1):29-31

Cesarean section in sow Pramod Kumar, G. N. Purohit and J.S. Mehta Department of Veterinary Gynaecology and Obstetrics College of Veterinary and Animal Science, Rajasthan University of Veterinary and Animal Sciences, Bikaner Rajasthan India Abstract Cesarean section in sow if indicative should be done promptly before the sow become toxic and has friable uterine tissue and vessels. Because the birth canal is too small for inspection for unborned pigs via palpation, radiography or ultrasound may be indicated to reveal undelivered piglets. For cesarean section indications, anesthesia, operative technique and post operative care is described. Key words- cesarean, sow, post operative care The sow is considered a difficult obstetrical patient because although surgery is many times needed, it is difficult to identify the cause of dystocia even after the operation (Pearson, 1999). Cesarean section in sow is a rare operation to relieve from dystocia (Ghosh, 2007). A decision for or against cesarean section must be based on the condition of sow, the value of sow, onset of labor, type of dystocia, and the and the potential number of live fetuses remaining (Leman et al. 1986). Higher percentage of recoveries will occur when the operation is performed within a 24 hours after the onset of labor (Frank, 1964). IndicationsThe major indications enlisted (Titze, 1977; Renard et al. 1981; Ghosh, 2007) were vaginal prolapse, fetopelvic disproportion, fetal emphysema, secondary

Raksha Technical review 2013; 3(1):29-31

uterine inertia and cervical non-dilation. The preparturient prolapse results in considerable edematous swelling and tissue rupture on handling. Uterine inertia is another important indication for cesarean section. The other less frequent indications are maternal immaturity, pelvic deformity, uterine torsion and fetal deformities like conjoined piglets. Sometimes it is difficult to evaluate the presence of further piglets during delivery either manually or ultrasonographically. A radiograph must be obtained to assure the presence of piglets before the operation is performed. Elective hysterotomy has been increasingly performed on sows to obtain disease free piglets which are then reared artificially (Amass et al. 1996).

Anesthesia Because of difficulties in restraint either general anesthesia or deep sedation and local analgesia is used to perform the operation. When inhalation anesthesia like halothane or isoflurane are available, sedation with intravenous thiopentone sodium (150-200mg/kg IV) or methohexitone sodium (Pearson, 1999) followed by halothane-nitrous oxide oxygen mixture is used. Pre-medication with atropine (0.04-0.07 mg/kg SC or IV), glycopyrrolate (0.01-0.02 mg/kg SC) or diazepam (0.55-1.1 mg/kg IM) can be done. Some breeds like Landrace are known to be sensitive to halothane (Pearson, 1999) and hence care should be exercised while dealing with these breeds. Some of the other suggested parentral anesthetics for the sow include a combination of intramuscular azaperone (2 mg/kg) and intravenous metomidate (2 mg/kg) with local infiltration anesthesia or alternatively, ketamine hydrochloride (15-20 mg/kg) alone or with azaperone or diazepam (0.55-1.1 mg/kg) (Pearson, 1999). Propofol (5 mg/kg IV) or telazol (4.4 mg/kg IM) and xylazine (2.2 mg/kg IM) are other anaesthetic combinations. However, all these combinations are known to result in a high incidence of postoperative hind limb paralysis (Renard et al., 1981) and hence should be used carefully.

Raksha Technical review 2013; 3(1):29-31

Operative techniqueThe operation is performed through a vertical sub-lumbar or ventral flank incision on either side with the sow resting in lateral recumbency (Turner and Mcllwraith, 1989). The gravid horn should be exteriorized for incision outside the peritoneal cavity in order to minimize peritoneal contamination. The incision is made as close to the uterine body as possible. The piglets at the ovarian poles of the cornua are squeezed down the horn and grasped through the incision. The sows uterus must be carefully sutured as too much force may tear the uterus. The operative site is closed routinely by separately suturing the peritoneum, muscles and skin. Post operative care The post operative care depends on the general condition of the sow. In general administration of antibiotics and analgesics should be done for 3-5 days and oxytocin should be given post-operatively to hasten the uterine involution. RefrencesAmass SF, Struve R, Clark LK and Wu CC (1996). Cesarean section: A surgical method to drive piglets free of strptococcus suis. Swine Health and Production. 4: 196-199. Ghosh SK (2007). Cesarean section in a crossbred pig. Indian J Anim Reprod 28: 96-97. Leman AD, Straw B, Glock RD, Mengeling WL, Penny RHC and Scholl E (1986). Disease of Swine, 6th Edn. Lowa University Press, ames, lowa, Usa.pp.866-873. Pearson H (1999). The cesarean operation. In:Arthur GH, Noakes DE, Pearson H, Parkinson J eds Veterinary Reproduction and Obstetrics 7th ed Philadelphia WB Saunders co. p311-31. Renard A, St Pierre H, Lamothe P and Coyture Y (1981). Hysterectomy in the sow: indication and post operative complications. Med Vet Quebec 10: 6-11. Titze K (1977). Obstetrics in pigs with special consideration of cesarean section. Dtsch Tierarztl Wochenschr. 84(4):135-8.

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Turner AS and McIlwraith CW (1989). Techniques in Large Animal Surgery. 2nd ed. p. 254, Lippincott Williams & Wilkins, Philadelphia.

Fig 1 The sow is placed in right lateral recumbency and the ventral flank area is prepared for surgery.

Fig 2 The skin incision is given and the subcutaneous facia is separated.

Fig 3 The gravid uterine horns of the sow are taken out of the abdomen and packed with sterile drapes.

Raksha Technical review 2013; 3(1):29-31

Fig 4 The uterine horn of a sow being excised closer to the body during cesarean section.

Fig 5. A piglet being removed after excising the uterine horn of a sow during cesarean section.

Fig 6. The muscle layer of a sow being sutured during cesarean section.