click below
click below
Normal Size Small Size show me how
Cesarean Section
Question | Answer |
---|---|
Indications | Dystocia- most common, emergency procedure Planned- certain breeds, history of dystocia |
Causes of Dystocia | mal-developed, mal-positioned, oversized fetus; small pelvic canal, history of pelvic trauma in mother; insufficient cervical dilation, uterine inertia (poor contractility) |
Stages of Labor | Stage 1- Nesting, Stage 2- Delivery, Stage 3- Placenta Expulsion |
Stage 1- Nesting | onset of contractions, 6-12 hours |
Stage 2- Delivery | starts with full dilation of cervix, fetus enters birth canal and membranes rupture, abdominal contractions begin, can take up to 4 hours for first fetus to be delivered, can take 2-3 hours for subsequent fetuses |
Stage 3- Placenta Expulsion | happens after each fetus delivered |
Signs of Dystocia | delivery takes > 4 hrs, strong contractions lasting longer than 30-60 mins w/o delivery of fetus |
Preparing for Surgery | spay pack with extra hemostats, extra people- rub, resiscitate, warm pups, dorsal recumbancy, clip and prep as for spay- incision will be to pubis, empty bladder |
Pup Anesthetic Time | minimize for pups- more likely to need drugs to resuscitate, some wait for opioids until after pups delivered |
Mom Anesthetic Time | minimize for mom- faster recovery = nurse pups quicker |
Types | C-section w/o OVH, C-section w/ OHE, En block resection |
Without OVH | planned c-sections for certain breeds, female intended to breed again |
With OVH | most common, prevent future dystocia, needed if uterus badly traumatized |
En Bloc Resection | entire uterus removed first, fetuses quickly removed by tech |
Incision | ventral midline- through linia alba |
Surgical Procedure | uterine horn gently exteriorized- careful not to tear uterine vessels, isolate uterus with lap sponges- avoid contamination of abdomen with uterine contents, uterine body carefully incised- lengthen with metzenbaum scissors |
Fetal Delivery | rupture amniotic sac manually, clamp and cut umbilical cord, fetus handed to non-sterile personnel |
Post Fetal Delivery | fully inspect repro tract, OVH, if no OVH- lavage outside of uterus, close uterine incision, return uterus to abdomen; lavage abdomen with warm saline |
Closure | close abdominal wall same as OVH, intradermal sutures best- less irritation to and from pups |
Neonatal Care | warm, dry towel, rub vigorously and dry, puppy swing or bulb syringe, assess for umbilical hernia and cleft palate, once stable ligate umbilical cord |
Drug Neonatal Care | Naloxone- if opioids, Doxapram- if need to stimulate respiration, Epinephrine and chest compression- if no heartbeat |
Post Op Considerations | mom fully awake before introducing pups, want pups nursing ASAP, observe carefully, want home ASAP, weigh pups daily, supplement if needed |
Mom Post Op Considerations | mucohemorrhagic discharge norm for few days (odor suggests infection), loose stool norm, should have good appetite, monitor mammary glands and milk production |
Complications | persistent hemorrhage, peritonitis, pyometra, incisional infection, mastitis |