Felis ISSN 2398-2950

Dystocia: maternal

Synonym(s): Uterine inertia (primary or secondary)

Contributor(s): Prof Gary England, Rob Lofstedt, Mushtaq Memon, Michelle Kutzler

Introduction

  • Inability of the uterus to contract and initiate parturition, or obstruction of the birth canal.
  • Rare in cat.
  • Seen in primiparous queens over 5 years and multiparous queens over 8 years.
  • Cause: uterine torsion, inguinal hernia of pregnant uterus, excess intrapelvic fat, narrow pelvic outlet, congenital defect within birth canal (eg septal defect or stricture), hypocalcemia, hypoglycemia, systemic illness. 
  • Signs: queen at full term but no contractions (primary uterine inertia), or contractions start but then cease (secondary uterine inertia).
  • Diagnosis: history, clinical signs, vaginal digital examination, biochemical analysis (measure serum calcium and glucose concentrations), ultrasonogaphy, radiography, vaginoscopy.
  • Treatment: administration of calcium and oxytocin as needed, Caesarean section.

Pathogenesis

Etiology

  • Failure of uterus to enter the first stage of parturition Parturition (primary uterine inertia).
  • Fatigue after prolonged contractions (secondary uterine inertia).

Predisposing factors

General

  • Previous pelvic injury.
  • Pelvic neoplasm.
  • Congenital defect within birth canal, eg septal defect or stricture.
  • Obesity Obesity.
  • Age.
  • Maternal debility/systemic illness.

Pathophysiology

  • Calcium is essential for normal muscle contraction, therefore if hypocalcemia  →  poor muscle contraction.

Timecourse

  • Usually 2-3 days from recognition of fact that the queen is 'overdue' to the decision to perform a Caesarean section.
  • 3-4 hours after the onset of parturition in cases of secondary uterine inertia brought on by obstructive dystocia Dystocia: fetal.

Diagnosis

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Treatment

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Holst B S, Axnér E, Öhlund M et al (2017) Dystocia in the cat evaluated using an insurance database. J Feline Med Surg 19 (1), 42-47 PubMed.
  • Smith F O (2012) Guide to emergency interception during parturition in the dog and cat.Vet Clin North Am Small Anim Pract 42 (3), 489-499 PubMed.
  • Pretzer S D (2008) Medical management of canine and feline dystocia. Theriogenology 70 (3), 332-336 PubMed.
  • Traas A M (2008) Surgical management of canine and feline dystocia. Theriogenology 70 (3), 337-342 PubMed.


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