Cesarean Section Dr. Adnan Ahmad

Riphah College of Veterinary Sciences Lahore

• Caesarean section is also commonly termed as C-Section in which uterus is exteriorized to take out the young one from the pregnant dam.

Caesarean section:

• The delivery of the fetus usually at parturition by laparohysterotomy is called caesarean section.

• Laparohysterotomy means the excision of uterus through an incesion in the abdominal wall.

Indications• Foetopelvic disproportion• Foetal maldisposition, which cannot be corrected by manipulation.• Irreducible uterine torsion.• Incomplete dialatation of cervix or other parts of birth canal.• Foetal monsters, which cannot be delivered by other means.• Uterine rupture or severe uterine haemorrhage.• Foetal emphysema.• Mummification and hydroallantois after failure of induction of parturition

by drugs.• Bicornual pregnancy in mares.• Pregnancy toxaemia in ewes and does.• Rupture of prepubic tendon.

MATERIALS REQUIRED:• Appropriate drugs for sedation and local anaesthesia• Resuscitation facilities including arrangements to dry and warm

the calf. Doxapram hydrochloride (50 mg) may be kept ready ina syringe with a suitable needle prior to surgery becausesometimes, it is needed urgently when calf is delivered.

• Sterilized calving ropes or chains which may be needed duringremoval of the foetus from the uterus.

• Antiseptic solution for skin preparation - 7.5% Povidone-iodineor 4% Chlorhexidin gluconate and surgical spirit.

• Sterilized drape.• Surgical kit: Scalpel, rat-toothed forceps, scissors, six haemostats,

needle-holders, round-body and cutting suture needles.• Suture material.• Antibiotics: Strepto-penicillin or ampicillin is useful.

Selection of operative site Large animals :The sites are

(i) Left flank.(ii) Right flank.(iii) Ventro-Iateral.(iv) Ventral or mid line.

Small animals :The sites are

(i) Flank region with an oblique angle parallel to thelast rib.(ii) Midline or linea alba.

Anaesthesia• Sedation should be avoided as it can cause recumbency detrimental to

fetal survival. If sedation is necessary, xylazine is commonly used (0.05-0.1 mg/ kg b.w. I/M).

• For flank incision, paravertebral anaesthesia should be given.• Inverted - L block:• An inverted - L block of the flank is an alternative to paravertebral

Anaesthesia.• Epidural anaesthesia:• Epidural anaesthesia is not essential but is useful to prevent straining

and tail movement during surgery.

Preparation for Bovine Surgery

• Local Block Drugs– Lidocaine (cheapest and safest)• lidocaine toxicity: muscular tremors, severe depression,

hypotension , occasionally convulsions• Toxic dosage: > 13cc of 2% lidocaine per 100 lb or > = 13 mg/kg

– mepivacaine, bupivacaine– Withdrawal time

Paravertebral Block (cont’d)

Pre-operative medication

• Pre-operative antibiotic is strongly recommended.

• Tocolytic agents such as clenbuterol-hydrochloride (10 ml) should be administered by intramuscular or intravenous route.

Pre-opp

• Secure the Head of Animal• Shave down the area where the incision will

be• Scrub the shaved area• Wash the area down with 70% Alcohol

Surgical technique

The surgical technique is performed in following steps:1. Opening of the flank2. Locating the uterus3. Opening of the uterus4. Removal of the foetus5. Management of the placenta6. Closing of the uterine incision7. Closing of the laparotomy incision

Post operative care

• 1. Routine antibiotic cover (with strepto-penicillin for 5-7 days).

• 2. Fluid therapy.• 3. Regular dressing of wound.

Complications of cesarean section• Peritonitis• Wound breakdown• Seroma formation - A pocket of sterile serous fluid accumulates

between muscle layers or under the skin. This can be confirmed when a sterile needle is inserted - serum flow-out.

• Retention of the foetal membranes• Metritis• Infertility• Mastitis (E. coli infection)• Sudden death.

References

• Applied Veterinary Gynecology and Obstetrics by Dr. Pradeep Kumar

• Roberts SJ. 1976. Veterinary Obstetrics and Genital Diseases.

Thanks