12th Lecture

DYSTOCIA
&
ITS CAUSES
 Definition

Dystocia: when 1st or especially 2nd stage of

parturition is markedly prolonged, become
difficult/impossible for the dam to deliver a calf
without artificial aid, the condition is termed as
dystocia.

Eutocia: is a safe, easy, natural & physiological

parturition.
 Incidence
 Cattle 3 to 10%, apparently higher in dairy than
beef breeds.
 Much more in heifers/primipara than pluripara.
 Higher in pregnancies that terminate early due to
uterine diseases, fetal death & twinning or after
prolong gestation due to excessive size of fetus.
 Signs of Dystocia in Cows and Evidence of Fetal Life
• No clear demarcation exist between dystocia and
eutocia, but progress and duration of parturition
may help veterinarian in deciding when to intevene
the birth process.
• Birth process may be slower in some breeds i.e.
(Charolaise) or might be due to relative large size
of fetus.
• Calf may survive up to 8-10 hrs but 2nd stage or
delivery time is much shorter than this.
 Continued
• Specific signs may include
1. Prolong, non progressive 1st stage of labor.
2. Cows standing in abnormal posture in 1st stage
i.e. in Ut. Torsion may stands with a dipped back
or swayback posture.
3. Strains vigorously for 30 minutes without the
appearance of calf.
4. Failure of calf to be delivered within 2 hours of
the amnion appearance at vulva.
 Continued
5. Obviously in mal PPP, you will see fetal head
but no limbs or one limb or the tail but no hind
limbs or one limb.
6. The appearance of Chorioallontois, fetal
meconium or blood stained amniotic fluid at
vulva.
7. Viability of fetus is determined via checking
various fetal reflexes. Limb withdrawal, suckle
reflex, eye reflexes and anal tone can be assessed
to determine fetal viability.
 GUIDELINES FOR OBSERVATION AND INTERVENTION

• Recommended guidelines are:

1. Minimum observation of every three hours.
2. Once a cow/heifer is in stage 2 of calving, should be
observed more closely until calf is delivered.
3. Intervention if:
a) In stage 1 over 6-8 hours.
b) In stage 2 over 2 hours or if trying for over 30 min-
60 min and making no progress.
c) Heifer/cow has quit trying for over a 15-20 min.
period.
d) Heifer or cow has not passed membranes within 12
hours of calving.
 Causes

• May be
1. Basic
2. Immediate.
– Basic causes are studied for obtaining knowledge to
prevent occurrence of dystocia.
– Basic causes may include
1) Hereditary
2) Nutritional & management
3) Infectious
4) Traumatic
5) Miscellaneous/combined causes
 Basic causes
1. Hereditary
• Causes related to the dam :
1. Hypoplasia of vagina, cervix, and vulva.
2.Double uterus, uterus unicorns, double cervix.
3. White heifer disease.
• Causes related to the fetus including:
1. Ankylosis.
2. Prolong gestation.
3. Bull dog.
4. Muscular hypertrophy.
5. Schistosoma refluxes.
 2.Nutritional & Managemental
• Improper nutrition leads to retarded body and
pelvic growth.
• Excessive feeding results in excessive fat deposition
in the pelvic region as well as muscular weakness
& may cause dystocia.
• Feeding or grazing the pregnant females on plants
(teratogenic) that may cause fetal deformity.
• Breeding of heifers at too young age or breeding of
an aged females favor dystocia.
• Cross breeding between large size sire breed with
small size female of other breed.
 3. Infectious causes

• Parasitic diseases affect general health of animals,

thus at birth the dam is thin and weak.

• Any severe infection of uterus, the uterine wall

may lose its tone or ability to contract causing
incomplete dilation of cervix & uterine inertia.

• Infections causing death or premature birth of

fetus, renders its extremities to postural defects.
 4. Traumatic causes
• Abscess, ventral hernia causes inability of the
abdominal muscles to force the fetus through out
the birth canal.
• Rupture of the prepupic tendon in the late
gestation.
• Torsion of the uterus due to sudden slipping,
falling, or rolling in advanced pregnancy will cause
twisting of the birth canal.
• Fractures of the pelvic bone with secondary
deformity cause stenosis of the birth passage
leading to difficulties at birth.
 5. Miscellaneous/combined causes
• Hormonal imbalance of estrogens, progesterone,
relaxin, and failure of normal releasing of
Oxytocin may cause delay of the 2nd stage of
parturition because of uterine inertia.
• Calf weight, sex & size.
• Gestation length: In some breeds, it may reach to
290 instead of 283 days. In late pregnancy fetal
weight increases at 0.5kg/day & long bones also
increases
 Immediate causes
• The immediate causes of dystocia are of two
types depending on its origin.
1. Fetal
2. Maternal
 Fetal causes of dystocia
• They are numerous & might be due to abnormality
in
– Presentation
– Position
– Posture
– Excessive size of the fetus
 Continued

1. Presentation: its abnormality may be due to

- Certain posterior longitudinal presentation in uniparous
animal
-All transverse, ventral
2. Position: include dorso-illial & dorso-pubic.
3. Posture: flexion of limbs beneath the body in
uniparous  all ventral, lateral or dorsal flexion of
head & neck
4. Size of fetus: increase in size include anasarca,
ascites, large tumor/fetal giantism in prolong
gestation, fetal abnormalities i.e. monster, general
ankylosis etc
 Fetus 3. Fetal Death
1. Oversize
a. Absolute
Small litter
Breed Position
Prolong gestation -Dorso-pubic
b. Developmental -dorso-ilial
defect 2. Faulty Disposition
-Duplication
-Ascities
-anasarca
-hydrocephalus

Posture Posterior Presentation

Hock flexion
Presentation Hip flexion (Breech)
-Posterior Anterior Presentation Fetlock/pastern flexion
-Transverse Limbs flexion
-Vertical Carpal flexion
Elbow
Shoulder
Head Flexion
Lateral
Upward
Downward
 Maternal Causes
• Parturition is very complicated process & if
any part/parts of this process fails to continue
or if it goes uncoordinated, so this may lead to
dystocia
• Mainly the causes for dystocia might be
1. Maternal
2. Fetal
Depending on the origin of the problem
• As you kniw in many species the fetus initaite the
process of birth & dramtic changes take place in the
hormonal level of dam
• The maternal part for birth of a fetus is the provision
of
1. Expulsive forces
2. Bony/soft tissues of BC through which fetus passes.
 The fetal component of birth involve
1. Initiation of birth process
2. Assumption of correct posture & being small enough to
pass through BC.
 Maternal causes of dystocia
1. Failure of the expulsive forces:
a) Uterus
i. Primary uterine inertia: might be due to
a. Myometrial defects i.e. the uterus is unable to contract because of
 Over stretching: due to hydrops, twining, triplets or large
fetuses
 Degeneration (toxic/senility)
 Uterine infection/systemic illness
 Small litter size(under stretching)
This primary uterine inertia might be due to
(i) P4 & E2 ratio that is important for uterine contractility i.e. E2
increases the synthesis of contractile protein myosin & increase
receptor for oxytocin/PGF2α etc
(ii) Oxytocin + PGF2α are directly involved in contraction & any
difiencey in it or its receptors through which they exert that this
action, will lead to prevention/reduction of myometrial contraction
(iii) Ca/Mg: a common cause of dystocia is hypocalcaemia with
the cow showing a sign of milk fever near to calving
These mineral play a vital role in smooth muscle
contraction of uterus & any diffiency can lead to
failure of uterus to contract.
 Relaxin : relaxation of cervix & also help in
relaxation of pubic sympysis
ii. Secondary uterine Inertia
 Actually its not the cause but the result of dystocia
due to some other cause, usually of obstructive
nature. This might be due to uterine rupture or
torsion.
 Rupture may be due to traumatic injury because of an
accident with vehicle, falling etc.
 May occur in weak-point in the uterine wall/may be
due to vigorous uterine manipulation
 Uterine torsion – already discussed
b) Abdominal forces:
the animal is unable to strain because of
o pain, debility, diaphragmatic, tracheal/laryngeal
damage
o Straining is induced by contraction of abdominal
muscles with closed glottis because abdominal
muscles don't come into play until myometrium has
forces the fetus/fetal membranes into pelvic canal &
stimulate pelvic sensory nerves which in turn
stimulate abdominal muscles to contract.
 Obstruction in birth canal
• Bony pelvis
– This might be due to its fracture resulting in closure of BC
– In some breed the gestation length is longer & the calf
size (0.5 kg/day in last days of pregnancy) in proportion
to maternal pelvis is greater (beef breed)
– Poor diet: poor diet ↑ incidence & ↓ calf viability
– Heavy feeding  calf size ↑, intra-pelvic fat deposits. ↑
dystocia incidence & risk of vaginal laceration
– Immunity of dam
– Neoplasm: neoplasm of vulva/vagina can be found in all
species & serves as potential cause of dystocia because
of physical obstruction
• Soft tissues
– Vulva: relaxation of vuvla is a part of normal preparation
of birth but sometime there is stenosis/constriction of
vulva/vistibules which might be due to hyperplasia or this
stenosis might be due to formation of scar tissue &
fibrosis due to injury in previous calving, that may prevent
normal relaxation. Might be due to immaturity .
– Vagina: its relaxation is also a normal preparation for birth
but due to scar tissue formation in previous calving
– Lumen of vagina may be obstructed by hymen, peri-
vaginal abscess, tumor or cyst formation.
• Vaginal cystocele: the condition in which Uterine body lied in
vagina or vulva
• Prolapse of uterine body through urethra
• Protrusion of bladder through vaginal floor
• Cervix:
– Its failure is the common cause of dytocia as well
– Its failure to dilate might be due to so many things
like
– Cervical induration  primary uterine & cervical
inertia, secondary uterine inertia with cervical
involution
– Might be due to fibrosis which usually take place in
old cow because of cervical laceration, uterine &
cervical infection.
• Uterus
– Torsion, hernia, adhesion usually take place
through rupture of abdominal floor
– Severe blow at the abdominal wall is the major
cause
– Sometime abdominal musculature become so
weakend that it is unable to support gravid uterus.