Equis ISSN 2398-2977

Uterus: caesarean section

Contributor(s): Terry Blanchard, David Dugdale, Graham Munroe

Introduction

  • Parturition occurs rapidly in the mare and prompt assistance is needed for dystocia   Reproduction: dystocia  .
  • Delay can be fatal for the foal and mare, and reproductively detrimental for the mare.
  • If the dystocia cannot be corrected by assisted or controlled delivery in 15-30 min, then cesarean section is indicated to deliver a live foal and/or minimize damage to the mare's reproductive tract.

Uses

  • Dystocia  Reproduction: dystocia with a live foalin which assisted/controlled delivery (including under general anesthesia) cannot deliver the foal in 15-30 min:
    • Severe malpositioning, eg transverse presentation ('dog sitters').
    • Inadequate birth canal dimensions.
    • Fetal monsters, eg schistogenes.
  • Dystocia  Reproduction: dystocia with a dead foalwhere controlled delivery is unsuccessful and the risks of fetotomy to subsequent reproductive performance are greater than the risks of a general anesthetic and a Caesarean section - fetotomy incisions can severely damage the mare's reproductive tract especially the cervix:
    • Fetal emphysema.
    • Loss of placental fluids and partial uterine involution.
    • Uterine or severe vaginal injuries.
  • Elective procedurein mares with severe illness close to term.
  • Uterine torsion  Uterus: torsion  where surgical correction is unsuccessful or impossible.

Advantages

  • Less trauma to reproductive tract.
  • Better subsequent fertility.
  • Better fetal survival rates than fetotomy or prolonged attempts at vaginal delivery.

Disadvantages

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Survival rate for mare: 81% (61-100%) depending upon cause of dystocia.
  • Survival rate for foal: 30% depending upon early initiation of surgery and appropriate anesthesia.
  • Subsequent conception rates for mares: 50%, with 25% of these aborting (hence overall 35% foaling rate).
  • Decreased fertility can be caused by uterine adhesions, inability of uterine wall to adapt to fetal growth, focal endometrial destruction, trauma and damage to other area of the reproductive tract.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Embertson R M (1999) Dystocia and ceserean sections - the importance of duration and good judgement. Equine Vet Educ 31 (3), 179-180 PubMed.
  • Freeman D L, Hungerford L L, Scheffer D, Lock T F, Sertich P L, Baker G J, Vala W E & Johnson J K (1999) Cesarean section and other methods for assisted delivery - comparison of effects on mare mortality and complications. Equine Vet Educ 31 (3), 203-207 PubMed.
  • Juzwiak J S, Slone D E Jr, Santschi E M & Moll H D (1990) Cesarean section in 19 mares. Results and post-operative fertility. Vet Surg 19 (1), 50-52 PubMed.
  • Slone D E Jr (1988) Ovariectomy, ovariohysterectomy and cesarean section in mares. Vet Clin North Am Equine Pract (3), 451-459 PubMed.


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