Obstetrical Maneuvers pt. 1

Question 1

4 classifications of obstet maneu

Answer 1

Mutation (or correction) - COMMON

Forced extraction (may be after mutation) - COMMON

Fetotomy

CS
- For small animals - recommended for small animals

Question 2

Definition: change of presentation, position or posture to bring the fetus to a normal presentation, position and posture
Ex. dorsotransverse fetus → maneuver → normal anterior longitudinal position

Answer 2

mutation/correction

Question 3

4 Specific manipulations

Answer 3

Repulsion or retropulsion
-Have space to work in
Rotation
Version
Extension and flexion

Question 4

Requirements prior to performing mutation:
Complete ____of the cervix;
movement of fetus in ___ and ____
rupture of fetal envelopes and adequate lubrication;

Answer 4

dilation
uterus and pelvis

Question 5

instruments of mutation/correction

Answer 5

1. Obstetrical chains
   Oblong ends “like choke chains” - thread one into the other
2. Obstetrical handles
3. Stomach pump
   -Pump in lubricants into the uterus/ birth canal
4. Stomach tube

5.Bucket of clean water
-For washing

6. Soap

7.Lubricant/s
-Vegetable oil - cheaper, easy to find
-Water-based obstetrical lubricants

8.Vaseline
-Coat lining of birth canal

Question 6

obstetric chains: longer ones go to the shoulder, shorter ones go around pastern of the animal t/f

Answer 6

t

Question 7

Returning fetus back to the uterus

Pushing fetus _____ in uterus to obtain adequate space for correction of fetal part in an abnormal presentation, position and posture

may be done only with instruments t/f

Do this when the uterus contracts, when the abdomen is not contracting. t/f

Answer 7

retropulsion

forward

f - can be done with hands

f - uterus RELAXES

Question 8

instruments for retropulsion krg

Answer 8

Kuhn’s crutch
-U-shape pushed against shoulder or any part u want to push back to gain leverage
Reindi’s repeller
Gunther’s repeller

Question 9

in handling dystocia in mare - put in ____ ataching the hindlimb into a ___

can you put lubricant? yes or no

This technique will help you in the mutation of fetal malpositions and even dystocia due to presentation problems not only in the mare but also in cattle and buffaloes. t/f

Answer 9

lateral recumbency

pulley

yes

t

Question 10

Positional problems
Turning the fetus on its’ long axis to correct the position

Aims for Dorsopubic/dorsoileal presentation - nakabaliktad back of fetus is closee to pubis or ileum → goal is to rotate back to _____ position

instrument used

Answer 10

rotation

dorsosacral

cammerer detorsion fork

Question 11

Problems with presentation
Effecting change in fetal presentation.
Difficult if you want ot convert from posterior to anterior longi presentation
If you have fetus in transverse position

Answer 11

version

Question 12

ventral presentation can be modified to a longitudinal presentation t/f

Usually limited to ___ (angle) and can be done by repelling one extremity of the fetus and exerting traction on the other.

Answer 12

f - transverse to longi

90

Question 13

Push hindlimb pull forelimb

Push - ___
Pulling – _____
First pass around shoulder
Attached a rope → assistant pull when ready to push → anterior longitudinal presentation

Answer 13

procedure for dorso trasnvers

repeller or hand
obstetric chains

Question 14

type of dorso transverse
moving the head of the fetus towards the pelvic inlet
More difficult if neck is also bent

posterior parts of the fetus are moved towards the pelvic inlet
Hindlimbs come out first

Answer 14

anterior or cephalic version

posterioir or pelvic version

Question 15

position - solution
posture - solution
presentation - soln

Answer 15

rotation
extension and flexion
version

Question 16

Extension and Flexion
Involves 3 things rlt

Answer 16

Repulsion of proximal extremity of limb

Lateral rotation of middle portion carpus, tarsus or neck, and

Traction on distal extremities

Question 17

in carpal flexion posture the chains are placed in the

Make sure the hoof will not injure the uterus → ___it to prevent sliding sa uterus

Answer 17

pastern

cup

Question 18

Carpal flexion posture
Repel
Push it and rotate backwards/Rotate middle portion outwards
Bring hoof in the ___
Pull out

Answer 18

middle

Question 19

Forelimbs: (conversion)
Elbow flexion→ grasp forearm to convert to ____flexion
Shoulder flexion → _____flexion → carpal flexion (or rekta carpal)

Answer 19

carpal
elbow

Question 20

Hindlimbs
Hip flexion –> __- flexion → rotate hocks to get hooves inwards
*Pull on the hocks to convert ___ flexion
Use arm to push outwards, hands grasp the hooves → bend it → take it out

Use of obstetrical chains and assistance for pulling
t/f

Answer 20

hock

t

Question 21

Withdrawal of fetus from birth canal of dam by application of force

Adequate lubrication is not essential t/f

Pull should be synchronous to straining of the cow t/f

Answer 21

forced extraction

f - ESSENTIAL

t

Question 22

Follow a upward arc t/f

Hips ___ or 5 degrees
Hindlimbs - parallel sa hindlimb ng animal t/f
Ensures the pelvis of fetus would pass into the widest diameter of the pelvis

Answer 22

f - downward
4
f - perpendicular

Question 23

Widest portion of fetus
Longest diameter -

One shoulder is through → easier na sa thorax t/f

Answer 23

shoulder and hip
oblique (making sure one of the limbs pass before the other one)

t

Question 24

in forced extraction avoid this

Answer 24

hip lock
ileac crest can lock in the bony pelvis of the dam if straight

Question 25

Obstetrical operation which has the obiect of reduction in the volume of the fetus either by mutilation or by division to be extracted in parts  Performed when delivery of the entire fetus is not possible Done on a dead fetus or when the life of the fetus is to be sacrificed

Answer 25

fetotomy

Question 26

cases where you cannot move dead fetus easily

Answer 26

Anasarca(bloated fetus), postural abnormalities, transverse presentation

Question 27

Cows: at least 4 hours → assist needed t/f

Answer 27

t

Question 28

Advantages of fetotomy resd

Answer 28

Rapid reduction in size of fetus facilitating safe delivery per vaginum. Shoulder flexion posture almost half a day Cows: at least 4 hours → assist needed fetotome - flexible contained in the tube to prevent damaging other parts of reproductive tract Exposure of dam to major surgery is avoided CSection not needed If dam is already exhausted = surgical risk  Short recovery time and less care is required afterwards.  Dam is more stable than with C-section General anesthesia - recumbent

Question 29

disadvantages of fetotomy mem

Answer 29

May require more time than C-section  Exhaustive and may cause injuries to obstetricians Making use of a wire soap?  May be dangerous to dam Can cause injuries

Question 30

Indications for performing fetotomy mredid

Answer 30

Malpresentation, malposition and malposture of fetus that cannot be corrected  Relative disproportion b/w size of fetus and maternal birth canal.  Emphysema  Deformities of maternal pelvis: exostosis, fracture, tumors Irreducible distortion of fetus- contraction of muscle, tendon and Wryneck.  Disease of fetus- hydrocephalus, ascites, edema and anasarca.