1. Dystocia : Causes, Treatment and Prevention
ผศ. ชัยวัฒน์ จรัสแสง

2. References
Arthur’s Veterinary Reproduction and Obstetrics : Noakes, D.E., Parkinson, T.J. and England, G.C.W. 8 th edition (2001)
Handbook of Veterinary Obstetrics : Jankson, P.G.G. 2 th
(2004)
The technique of Fetotomy in Large Animals : Bierschwat, C.J. and deBois, C.H.W.

3. Dystocia : consequences and cost of dystocia
Increased stillbirth rate mortality
Increased neonatal morbidity
Increased mortality rate for the dam
Reduced productivity of the dam
Reduced subsequent fertility and increased chance of sterility
Increased likelihood of puerperal disease in the dam
Increased likelihood of culling

4. The stages of birth First stage Second stage Third stage
Relaxation and dilation of cervix
Fetus adopts birth posture
Uterine contraction
Chorioallantois enters vagina
Second stage
Uterine contraction continues
Fetal enters birth canal
Abdominal contraction
Amnion enters vagina
Fetus expelled
Third stage
Placenta expelled

8. Causes of dystocia Maternal causes Fetal causes
Failure of explosive forces
Uterine
Abdominal
Obstruction of birth canal
Bony pelvis
Soft tissue
Fetal causes

9. Uterine failure of explosive forces
Primary uterine inertia
Myometrial defects
Biochemical deficiencies
Hysteria/environmental disturbance
Oligoamnion
Premature birth
Secondary uterine inertia
Uterine damage or rupture
Uterine torsion
Abdominal

10. Obstruction of the birth canal
Bony pelvis
Fracture, breed, diet, immaturity, neoplasm, diseases
Soft tissue
Vulva : congenital, fibrosis, immaturity
Vagina : congenial, fibrosis, prolapsed, neoplasia, abscess, hymen
Cervix : congenital, fibrosis, failure to dilate
Uterus : torsion, deviation, herniation

11. Fetal causes Hormone deficiencies Fetopelvic disproportion
ACTH/ cortisal
Fetopelvic disproportion
Fetal oversize
Fetal monster
Fetal maldisposition
Malpresentation
Malposition
Malposture
Fetal death

12. Fetal terminology Presentation Position Posture
The relationship between the long axis of the fetal and the long axis of the birth canal. (anterior, posterior, transverse, vertical)
Position
Surface of the maternal birth canal to which the fetal vertebral column. (dorsal, ventral, lateral)
Posture
The position of the head and limbs of the fetus.

15. Dystocia in the cow Incidence 3-10 % Environmental factors
Diet, supervision, disease, Induction of birth
Intrinsic factor
Age, parity, body weight, pelvic size
Breed
Calf weight, sex and size
Gestation length
Sire effect
Calf presentation

16. Causes of dystocia in the cow
Fetopelvic disproportion 45 %
Fetal malpresentation %
Failure of cervix and
vagina to dilate %
Uterine inertia %
Uterine torsion %
Maternal abnormalities %
Fetal abnormalities %

17. Failure of the explosive forces
Uterine inertia
Premature birth
Failure of abdominal expulsive forces
Uterine rupture
Uterine torsion

18. Obstruction of the birth canal
The bony pelvis
The soft tissues
Torsion of the uterus
Downward deviation of the uterus

19. Fetopelvic disproportion
Fetal monster
Conjoined twins
Dicephalus
Siamnese twins
Shistosomus reflexus
Bulldog calf
Perosomus elumbis
Hydropcephalus
Fetal anasarca
Fetal ascites

22. Fetal maldisposition Malpresentaion Malposition Posterior presentation
Transverse presentation
Vertical presentation
Malposition
Ventral position, lateral position

25. Fetal maldisposition Malposture Lateral deviation of the head
Downward deviation of the head
Retention of a forelimb
Carpal flexion
Shoulder flexion
Retention of hindlimb
Hock flexion
Hip flexion

26. Approach to a case of dystocia in the cow
Assistance required
Restraint of the patient
Sedation
Uterine relaxation
Epidural anesthsia
Equipment
Case history
General clinical examination

31. Vink Jack

32. HK calf puller

33. Vaginal examination Examination of the fetus Evidence of fetal life
Evidence of fetal death

34. Manipulative delivery
Is vaginal delivery likely to be possible and successful?
Comparison of the size of the fetus and birth canal

35. Treatments
Mutation and force extraction
Caesarian section
Fetotomy

36. Mutation and force extraction
Retropulsion
Rotation  longitudinal axis
Version  transverse axis
Extension and Adjustment of the extremities
Traction

40. Hock flexion

41. Mutation and force extraction
Repulsion of the proximal portion of the extremity
Lateral rotation of the huddle portion of the extremity
Traction on the distal portion of the extremity

42. Forced Extraction Retraction from out-site Mutation already Caution
Disposition
Oversize
Small birth canal
Uterine inertia
Cervix no dilate
Paralysis obturator nerve
Severe vulva tear