Fetotomy and C-Section Flashcards Preview

Theriogenology > Fetotomy and C-Section > Flashcards

Flashcards in Fetotomy and C-Section Deck (39):
1

What is an episiotomy?

An incision into the vulva because it's not totally dilated.

2

When performing an episiotomy, where do you make your incisions?

At 10 and 2 to avoid creating a rectovaginal fistula.

3

How do you close up an episiotomy?

If it's just a small cut (1-2"), you can just let it heal naturally, otherwise need to suture closed.

4

What is a fetotomy?

Using gigly wire in the uterus to cut off parts of the calf.

5

How do you decide between a C-section and a fetotomy?

Ask the farmer who is more important, the cow or the calf.

6

What are 3 benefits of a fetotomy?

Reduced trauma and expense
Shorter recovery and less aftercare
Less impact on future of dam (reproductive or production)

7

Which indication for a fetotomy is really a management issue?

Fetomaternal disproportion.

8

What is the main indication for a fetotomy?

A dead fetus

9

What are 5 reasons for a fetotomy?

Uncorrectable fetal malposition
Delivery by traction not working
Fetomaternal disproportino
Some fetal monsters
Incomplete cervical dilation

10

Why do you need to weigh your pros and cons of doing a fetotomy in a cow with incomplete cervical dilation?

Because you need to be able to get your tools in, and get the pieces out.

11

What are the 2 main requirements for performing a fetotomy?

Enough space between the uterine wall and the fetus.
Need to be able to remove the parts with easy traction.

NOTE: If these are not possible, then consider a C-section.

12

What position is preferred for a fetotomy?

Standing

13

What is the most common fetotomy?

A partial fetotomy.

14

What is a partial fetotomy?

Amputation of the head, neck or limbs.

15

How many cuts are involved in a full fetotomy?

6-7

16

What are the cuts in a full fetotomy?

Decapitation or cervical amputation
Forelimbs
Detruncation
Division of pelvis

17

When decapitating, how far back do you want to go?

As far down the neck as you can.

18

When amputating the forelimbs, where are you trying to cut?

Under the shoulder blades to dis-articulate them and avoid jagged bones.

19

When dividing the pelvis, how do you want to make your cut?

Diagonally to make pulling of one side a little easier.

20

When you show up to a dystocia case, what decision do you need to make if you can't pull the calf?

Can you do a fetotomy quickly or do you need to go to a C-section.

21

What is a true breach birth?

Bilateral hip flexion in a posterior presentation.

22

What are the 3 main indications for a C-section?

Vaginal delivery is unsafe for the dam or fetus
Inadequate room to place a fetotome
Oversize large fetus

23

90% of C-sections are due to one of these 5 reasons:

Fetal oversize
Incomplete cervical dilation
Irreducible uterine torsion
Fetal deformity
Errors of fetal presentation, position or posture

24

What is the ideal environment for a C-section?

In your hospital, where it's clean with good lighting.

25

What are 3 advantages of a ventral midline C-section?

Best exposure
Least abdominal contamination
Best cosmetics

26

What are 3 disadvantages of a ventral midline C-section?

Restraint is difficult and needs assistance
Evisceration if suture dehiss
Respiratory compromise from dorsal recumbency

27

Why would you not do a ventral midline C-section on a dairy cow?

Because of the milk vein.

28

What is the most common C-section position?

Standing flank

29

What are 3 advantages to a standing flank C-section?

Easy restraint
Closure is simplified
Surgeon is comfortable

30

What are 3 disadvantages of a standing flank C-section?

less exposure
Peritoneal contamination
Standing animals can do DOWN (too much sedation)

31

Which flank is most commonly used for a standing flank C-section?

The left flank so the rumen can be used to hold everything else back.

32

What are 2 advantages of a recumbent flank C-section?

Moderate exposure
Closure may be more secure

33

What are 3 disadvantages of a recumbent flank C-section?

Hard to exteriorize
Restraint
Contamination

34

When closing a C-section, what type of suture pattern do you use on the uterus?

An inverting pattern

35

What are the 3 goals to closing the uterus after a C-section?

Serosa to serosa apposition
Tight seal (no leaking)
Minimal suture/knot exposure

36

What do you need to be careful not to include when closing the uterus post-C-section?

The placenta

37

What suture pattern is a good one to use to close the uterus post-C-section?

Utrecht pattern

38

When closing a C-section, why do you need to work quickly with the uterus?

Because oxytocin is working immediately, so you're racing the uterus shrinking.

39

What post-op care would you provide a cow after a C-section?

Stall rest
NSAIDs + analgesia