What is veterinary obstetrics ?

• Veterinary obstetrics is a branch of veterinary science that

deals with medical and surgical care together with
manipulations of the female animals in gestation, labor,
purperium and care of the neonates.
• Obstetrics is combined with gynaecology under the discipline
known as obstetrics and gynecology (OB/GYN) which is a
surgical field.
 Obstetrical procedures

• Mutation : repulsion, rotation, version and extension

• Fetotomy or embryotomy
• Caesarean section
• Obstetrical anaesthesia and analgesia

• Episiotomy
• Hysterectomy of prolapsed uterus
 Procedures preliminary to the handling of
obstetrical operation

• The history of case

• The general examination – It includes physical condition of
patient whether it is thin and emaciated, too fat or in good
condition, if patient is recumbent the veterinarian should
examine that is it exhausted or able to rise?, Temprature ,pulse
rate, any discharge for example much fresh blood is present
,injury to birth canal has probably occurred due to intervention
of the owner or someone else.
• If possible animal should be standing at the time of the
examination; if animal fails to get up ,its rear parts should be
raised above the front by lowering the front parts or rear parts
may be placed on bags of straw for proper rectal examination.
• Animal’s external genitalia and surrounding structures should be
washed thoroughly with warm water and soap.
• In case of dystocia it is very important to check birth passage
and caudal uterus portion for evidence of any trauma.
Obstetrical equipment
Cont.
• Surgical kit with sterile drape
• Absorbable suture material for closure of peritoneum, muscles
and subcutis and monofilament or braided nylon for skin.
• Antibiotics such as penicillin, streptomycin, ampicillin and
water soluble antibiotics to instill into peritoneal cavity before
wound closure.
 Sterilization

• Instruments used during caesarean or fetotomy should be

properly sterilized before their use
• Sharp instruments like scissors, needles ,scalpel blades are
sterilized by autoclaving at 121°C ,15 psi pressure for 30
minutes
• Drainage catheter and endotracheal tubes are sterilised by
chemical sterilization
 Obstetrical anaesthesia

• Generally local anaesthesia is used in obstetrical surgery mostly

2% lignocaine hcl , combination of lignocaine and xylazine , in
horse detomidine is also used as an anaesthesia.
• In bitch general anaesthesia is preferred along with adequate
oxygenation and intravenous fluid( RL@10-20 ml/kg/hr)
• In bitch ultra short acting barbiturates and propofol is most
useful for induction and for maintenance volatile agents like
isoflurane is preferred.
 Epidural anaesthesia
• Epidural anaesthesia is ideal for obstetrical purpose.
• Single injection of local anaesthetic solution into epidural
space producing anaesthesia of anus, perineum, vulva and
vagina and also abolishing pelvic sensation and straining.
• A dose rate of 1.0 ml/100 kg of 2% lidocaine or lignocaine
hydrochloride injected 5 ml will produce obstetric anaesthesia
lasting about 30–150 minutes
 Mutation
• Mutation are those operations by which fetus is returned to a
normal presentation, position & posture by repulsion, rotation,
version and extension of the fetal extremities to relieve
dystocia
• Repulsion - pushing of the fetus back out the pelvis to
facilitate other corrective steps.
• Rotation -  the turning of the fetus on its long axis.
• Version - the rotation of the fetus on its transverse axis.
• Extension - the correction of flexural deformities of the
extremities.
 Fetotomy

• Operations to remove dead fetus by reducing its size

• It is of two types 1) Subcutaneous & 2) Percutaneous
• Fetotomy in anterior presentation involves amputation of head,

cephalotomy amputation of neck, amputation of forelimb, etc

• Fetotomy in posterior presentation involves bisection of
pelvis, amputation of rear limbs at tarsus, evisceration and
breakdown of ribs in posterior presentation
Fetotomy instruments
 Surgical principles applied to fetotomy

• All instruments should be sterilised before fetotomy

• Perianal area should be properly washed with warm water and
epidural anaesthesia should be given prior to inserting
fetotome.
• After removal of fetus birth canal should be examined for any
laceration and if possible suture should applied at the site of
laceration
 Episiotomy

• When constriction of vulva due to hypoplasia or improper

growth causes dystocia episiotomy is performed
• First wash site of operation and remove dirt and dung then apply
antiseptic over site of incision
• An incision is made about one third down the lateral wall of
vulva through the skin mucosal junction to allow the vulva to
stretch in a controlled fashion during the passage of fetus.
• After removal of fetus incision should sutured with vertical
mattress sutures of catgut and/or nylon
 Vagino – cervical prolapse

• Prolapse of floor, lateral walls and roof of vagina through the

vulva with the cervix
• Incidence most commonly seen in cow and ewe
• Causes

1. Due to oestrogenic hormone secretion at late pregnancy

2. High intra abdominal pressure
3. Hereditary or genetic factors
Surgical correction
 Caesarean section

• Generally there two approaches for caesarean section are

performed 1) flank laparotomy 2) ventrolateral laparotomy
• For standing surgery, the animal should be restrained using a
halter, preferably in a calving pen, tied such that the animal’s
right flank is against a wall and the head is in the corner, in
order to limit movement during surgery.
• For ventrolateral approach cow is sedated with xylazine and
placed in lateral recumbency.
• For flank incisions, paravertebral anaesthesia of the nerves
associated with the transverse processes of T13, L1, L2 and L3
is indicated. Each site is infused using 20 ml of 2–3%
lignocaine with adrenaline; 12–14 ml to block the ventral
nerve branches, 6–8 ml for the dorsal branches.
• For ventrolateral incision linear local anaesthesia (2%
lignocain) at the site of incision is given.
• Before surgery myometrial relaxation is done by
administration of muscle relaxent like clenbuterol.
 Preparation of surgical site
• A wide surgical field should be prepared.

• Initially, dirt and dust should be brushed from the surgical site
before the operative site is clipped or shaved
• The skin should be prepared using a surgical scrub (7.5%
povidoneiodine or 4% chlorhexidene gluconate)solution
followed by surgical spirit.
• Sterile drapes should be applied;

• Surgeons and assistants should wear sterile surgical gowns with

long-sleeved plastic gloves (with the finger tips cut off) and
surgical gloves.
Surgical technique
Skin incision

Muscle layers

Peritoneum

Locating uterus

Opening uterus

Removal of fetus

Closure of surgical incision

 Surgical principles of caesarean section

• Animal should be properly restrained

• Surgical instruments should be sterilized before surgery
• Gentle handling should be done to prevent rupture of uterus
during surgery
• After removal of fetus uterine suture should always taken from
cervical end to other end
• Before closure of surgical wound water soluble antibiotic
should infused into peritoneum to prevent peritonitis.
Cont.

• Surgeon should wear sterilised surgical gloves and long sleeve

along with sterilised gown
• Muscle relaxant agents should given prior to operation to relax
uterus for ease of surgery
• Post operatively daily dressing with antiseptic agents and
course of antibiotics and anti inflammatory drugs should be
done
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