Different “historical” tales in Western and non-Western cultures about caesarian section
Even in Greek mythology Apollo removed Asclepius (god of medicine) from his mother’s womb by SC
The origine of the word “caesarian” is doubtful
“Caesarean”: surgical birth “caesones”
Julius Caesar(Plinius) and other” viri illustri”
At that time procedure only performed as alast resort when the mother was dying or death
Roman law “Lex Regia” :” Negat lex regia quae preagnans motua sit, humari” forbidden to bury a dead pregnant woman before the fetus has been removed
Section”=> Jacques Guillimeau (1598)
Similar terminology is used in other languages
“Kaiserschnitt” in German
“Emperor’s section” in English
“Keizersnede” in Dutch
Caedere = ‘to cut’ Caesones => children born by post-mortem
operations
Indications changed during the years
attempts to save (the soul) of the fetus when the mother was dying
occasionally trying to save the mother
19th century => mother’s health in danger
20th century => fetus became a patient
1480 southern Germany => first explicit instructions
midwife
anesthesia/analgesie: wine
incision around the pubic bone
let the uterus open
wound closure with 3-4 ligatures with silk
plaster: eggs, hemp, Armenian clay
1500: Switzerland
Jacob Nufer (pig gelder) => permission (from the religious authorithies)to operate his wife
Wife survived => gave birth to five other children
Child alive
Technique described by missionary Felkin (Uganda, 1879) anesthesia => banana-wine
antiseptic => banana-wine
midline incision
uterus was squeezed until contracted
red hot iron was used for hemorrhaging
cervix was dilated from inside to allow lochia to escape
peritoneum, muscles and skin => closed together with sharp spikes
root past on the wound + bandage
Material anesthesia
▪ Alcohol or botanical preparations
▪ Diethyl ether (1846) or chloroform
1860 => antiseptic (carbolic acid)
1928 => Penicilline Technique
First the uterus was left open ▪ afraid of infection of sutures
▪ had to remove the sutures (not possible)
▪ contraction/ relaxation of the uterus will make sutures ineffective
First operations performed on motheranimals in agonie to save the live of the foetus
First attempts to save also the motheranimal’s live
in 1813(Morange) by a cow
In 1815(Gohier) by a ewe
Following years by different animal species (dog 1878, sow 1920)
More knowledge about asepsis antisepsis, anesthesia
Great break-trough during and after WWII
Better anesthetic products and techniques
Discovery of sulfonamides and antibiotics: penicilline
+/- 1940 in US on “veterinary schools” many Sc with success
First Caesarean Section in Belgium (Faculty of Veterinary Medicine) 1949 prof. Vandeplassche M. and co-operators
Cows brought to the veterinary faculty:
dead calf: foetotomie, living calf :sectio caesarea
Standing position,afterwards mostly in lying position(pressing during operation,tired animals, longtime in labor, big foetus, involuated uterus)
Results better and better
Since 1950 SC performed in the field +/- 1960 => Operation procedure changed in
practice from lying to standing position Zoötechnique changes
Double purpose breed(Middle - High Belgium) more and more selection to double muscled animals(Belgian Blue)(Southern part Belgium)
Results after SC very good, safest way to be born for a (dm)calf, relatily cheap(low vet-cost)
1984 Introduction milkquotum
Small dairyfarms changed to meatproduction local breed crossbreed with BB(milkquotum sold)
Larger dairy farms more selection to milkproduction(friesian holstein )
In northern part of Belgium also a lot of BB
2008: 700.000 Belgian Blue cows 700.000 Dairy cows(F-H) cows Crossbreed FH and BB: better price calf
Technical procedure
=> good technique and good habits can prevent a lot of complications
Necessary for the preservation of the Belgian Blue breed
High % SC in BB => critized in Europe (specialy Scandinavian countries) animal welfare
Special Belgian situation:
small distance between farm and vet- practice
ideal climate(soft winter )
many trained veterinarians
(to)low price(+/-100 euro) of CS :vets- competition(plethora)
2008 difficult economic situation in meat
production
Advantage:
docile character of the animal
low percentage retained placenta
mostly carrying in the right horn
a lot of farms well equiped => CS-box
+/- planned operations
Poor contamination uteruscontent
Advantage
CS early in parturition (planned CS)
▪ low prevalence of perinatal death after CS
▪ relaxed uteruswall
▪ Only small risk for pressing during CS
High quality chirurgical suture-materials
Experienced vets
Disadvantage: BB have elective CS in 95-99%
permanent monitoring necessary(day/night) ▪ temperature method can be a good help
sometimes too late => calf already dead => no profits
multiple CS: adhesions, scar tissue
heavy calves
inbreeding => neonatal defects
Advantage non, always emergency solution still it is better to perform a good CS than a complicated
extraction
Disadvantage long time in parturition => animals are tired contamination of the uteruscontent more muscle bleeding already involution of the uterus higher risk for pressing during CS higher risk for lying down during CS
In Belgium a lot of CS are performed due to the creation of a artificial cattlebreed: the double muscled“Belgian Blue”
This is only possible in Belgium (intensive beefcattlefarming),
Animal welfare problem :“local”, never “worldwide” problem
BB often used in crossbreed programs Risk for higher % of SC
Sectio caesarea is a good and practical chirurgical technique to solve obstetrical problems
Knowledge, training and experience(= sum of
all mistakes) is necessary to avoid complications and to become a good outcome and better animal welfare
[email protected] DVM Ambulatory clinic Department of Reproduction, Obstetrics and
Herd Health Faculty of Veterinary Medicine Ghent University Salisburylaan 133, B-9820 Merelbeke,
Belgium