5. 7. Fetal emphysema
8. Mummification / hydroallantois
9. Bicornual pregnancy in mares
10. Pregnancy toxaemia in ewes and does
11. Rupture of pre-pubic tendon
6. 1. Standing (suitable for left or right flank
approach)
2. Dorsal recumbency (suitable for ventral midline
or paramedian approach)
3. Lateral recumbency (suitable for ventro-lateral
and low flank approach)
7. 1. Flank approach: Paravertebral nerve block(T13,
L1,L2 and L3). Each site is infused with 20ml of
2%lignocaine.
2. Ventro lateral approach: line block- local
anaesthetic is injected all along the line of
incision. Each site is infused with 5ml subcut in
each direction and 10 ml into musculature.
3. Epidural anaesthesia:will provide adequate
anaesthesia of the flank
8. 1. Antibiotic administration
2. Clenbuterol HCl-potent tocolytic
3. Preperation of the surgical site:
• Dirt and dust should be brushed (surgical site and
perineum).
• Shave the surgical site
• Prepare skin using surgical scrub (7.5% pov. Iodine
/4% chlorhexidine gluconate solution)
• Apply surgical spirit
• Apply sterile drape
• Veterinarian should wear protective clothings.
9. The sites are
1. Left flank/ left paralumbar fossa approach
2. Right flank or vertical right flank
3. Ventro-lateral or left ventro-lateral oblique
4. Ventral or midline or paramedian
10. 1. Vertical left flank:
The incision begins 10 cm
ventral to the transverse
process of lumbar
vertebrae and extended
upto 30-40 cms just
behind the last rib.
11. 2. Low left flank approach:
The incision begins 15 cm
ventral to the transverse
process of lumbar
vertebrae and extended
down to just above the
milk vein
12. 3. Lateral oblique approach
Similar to vertical left flank
approach but involves
slightly oblique incission.
(from caudo-dorsal to
cranio-ventral)
13. • Uncommon
• Indicated if left flank approach is obstructed by
adhesions
• Access to the gravid uterus is good but the small
intestines interferes with the surgery.
14. • The incision is placed in
front of the stifle and
extends cranio-ventrally
in a slight oblique
direction up to 30-40 cms
just parallel to the base
of the udder.
15. Uncommon because
• it requires heavy sedation.
• Post operative wound
dehiscence is problematic.
• Sometimes leads to
herniation.
Access to the uterus is good
16. Adequacy of anesthesia should be checked
Skin is incised
Muscle layers are incised
a. External abdominal oblique a. Rectus abdominal muscle a. Linea alba
b. Internal abdominal oblique
c. Transverse abdominal muscle
Peritoneum is incised
17. Gravid horn is located and exteriorized
Fetus is in anterior presentation- anchor the hind limbs
Fetus is in posterior presentation- anchor the fore limbs
Uterine wall is incised over the calf’s leg using a scalpel all along the
greater curvature of the gravid horn
• Avoid incising the cotyledons
• Incision should be optimum to avoid uterine tear
• Avoid incising the extremities of the calf
• Suture repair is difficult if incision is extended close to cervix
The fetal membranes are ruptured manually
Critical step
18. Calf’s fetlocks are grasped and exteriorized
With the use of sterile calving ropes/chains fetus
is pulled
Live calf should be immediately attended and
surgeon should examine the uterus for the
presence of second calf
19.
20. 1. The uterotomy wound is sutured with chromic
catgut No. 2 using Cushing’s inverted suture
technique.
2. Oversewd with a 2nd layer using Lambert’s suturing
technique.
3. The peritoneum and muscular layers are sutured
with Vicryl No.2, using interrupted suturing
technique.
4. The subcutaneous layer is sutured with simple
continuous sutures using chromic catgut No. 1 and
the skin is sutured using Linex No.1 with horizontal
mattress.
