This document summarizes key concepts related to dystocia (prolonged second stage of labor) in animals. It defines presentation as the relationship between the fetus and birth canal, including longitudinal, transverse, and vertical presentations. It also defines position and posture. The document outlines procedures to examine an animal experiencing dystocia, including history, general exam, and specific exam of the fetus and birth canal. Obstetric operations discussed include mutation, forced traction, foetotomy (fetal dissection), and caesarean section. Details are provided on techniques for each operation.

1. Recent Advances in
Handling of Dystocia
Submitted by:
Rahul Katiyar
PhD Scholar
Div. Of AR
Id No. P-1856

2. Dystocia
• Definition: 2nd
stage of labour is prolonged
PRESENTATION
 Relationship between longitudinal axis of dam with
the longitudinal axis of fetus and part of fetus facing
towards birth canal.
 Longitudinal- (Normal)
 Transverse -(Abnormal)
 Vertical- (Abnormal)

3. • Longitudinal:
Anterior Posterior

4. • Transverse:
 Dorso transverse Ventro transverse

5. • Vertical
Ventro vertical
dorso vertical
Position
Definition: Relationship between vertebral column of
fetus in longitudinal presentation of head of fetus in
transverse presentation with four quadrants of maternal
pelvis.

6.  Position in Longitudinal Presentation:
Dorso-sacral (Normal)
Dorso- iliac right (abnormal)
Dorso- iliac left (abnormal)
Dorso-pubic (abnormal)

7.  Position in transverse Presentation:
1. Cephalo iliac right (abnormal)
2. Cephalo iliac left (abnormal)
 Position in vertical Presentation:
1. Cephalo sacral (abnormal)
2. Cephalo pubic (abnormal)

8. • Posture
• Definition: Relationship between movable
appendages of fetus with its own body.
• Normal posture:

9. 1.Fore limb flexion
 Shoulder flexion – unilateral & bilateral
 Knee flexion- unilateral & bilateral
 Fetlock flexion- unilateral & bilateral
 Right shoulder flexion left shoulder flexion

10. • Bilateral shoulder flexion left carpal flexion
• Bilateral carpal flexion

11. Hind limb flexion
 Hip flexion – unilateral & bilateral
 Hock flexion – unilateral & bilateral
 Metatarsal flexion- unilateral & bilateral
Bilateral Hock Flexion

12. Flexion of head and neck
 Upward deviation
 Downward deviation
 Left lateral deviation
 Right lateral deviation

14. Normal P.P.P.

15. Procedures preliminary to the
handling of dystocia
Procedures preliminary to the
handling of dystocia
Dystocia: an emergency case → so for success
1. Early handling
2. Careful examination of animal- a must for correct diagnosis
& sound line of treatment.

16. Points to be considered before
handling
Points to be considered before
handling
1. History of the case-
Collect history & other information during general exam. &
preparation.
a. Duration of gestation period to know full term or
premature.
b. Parity status of animal.
c. Previous breeding history e.g dystocia or other
abnormalities during previous parturition.
d. Any illness or unusual symptoms during last 2 m of G.P or
last few hrs. Length of time animal is restlessness/
Anorectic/ straining. Nature of straining- slight
intermittent or frequent & forceful

17. Contd…
g. Appearance and rupture of water bag and type of fluid.
h. In multiparous- if any fetus expelled – live or dead
i. Any assistance provided by owner/ vety. & what is its
nature?
j. Animal is standing or recumbent.
k. Whether there has been vomiting in the case of the bitch &
cat?
Note- The onset of vomiting, together with great increase of
thirst, s/b regarded as grave signs in these species.

18. 2. General examination-2. General examination-
a. Physical condition of animal- Thin/ emaciated or too fat or
good.
b. Posture of dam-
i. standing- good condition
ii. If recumbent- whether able to get up
or not?
If not: Whether exhausted or
 Obturator paralysis (common in hip lock condition
especially in heifer).
 Parturient paresis or other condition (paraplegia of
pregnancy, in older animals).

19. Contd…
c. Record
Pulse, temp. and respiration etc. which are increased
because of efforts of parturition.
d. Note: Color of mucous membrane- especially in
exhausted and prostrate animal to know internal
hemorrhage orshock due to rupture of uterus or its
vessels.
Examine vulva to know-
i. Nature of vulvar discharge,
if present –
Whether watery, mucoid, bloody or fetid- indicates fetal
condition.

20. Contd…
ii. If much fresh blood- injury to birth canal.
iii. Character of fetal membrane (indicative of fetal
condition and length of time dystocia)
iv. If protruding fetus, note the condition (dry or moist) &
disposition.
v. Edema – indicates length of time dystocia has existed
vi. Trauma to vulva- indicates previous attempt to relieve
dystocia.
Epidural anesthesia- to suspend defecation & animal will
remain in standing position.
5. Specific Examination- includes exam. of genital tract &
fetus (p/rectal & p/vaginal).

21. Contd…
Examination of genital tract
Exam. of birth canal to see whether it is
a.Dilated b. Twisted c. Stenosed
d. Inflamed/ Swollen
e. Prescence of gummy mucus indicates that parturition
yet not started or in early stage
iii. Exam. of cervix to see degree of dilation or relaxation,
whether any evidence of torsion
iv. Note-size of pelvic inlet in relation to size of fetus.
v. Any other abnormalities of birth canal s/b noted.

22. B. Examination of the fetus-B. Examination of the fetus-
1. Diagnosis of live / dead fetus to know prognosis & line of
action.
a. Indications of Live fetus -
i. Grasping or pulling the foot,
movement of the limb.
Pinching the eye ball – shaking of head.
iii. Placing the finger inside mouth- suckling or movements
of the tongue & jaw.
iv. Putting fingers in anus- in breech presentation-
contraction of the anal sphincter.
Note- If these signs are not present fetus is considered as
dead.

23. Contd…
b. Dead fetus- determine degree of
decomposition
1.By s/c edema or emphysema
2. Whether hair is sloughing
3. Whether putrid fetid odor is present
How to know time of death-
If emphysema & hair sloughing- death before 24- 48 hrs or
more.
ii. If no emphysema in a fetus time may be determined by
degree of cloudiness, turbidity or graying of cornea.
Death after 6-12 hrs- cornea – grey & opaque without
edema.

24. Contd…
2. Examination of presentation, position, posture and
developmental abnormalities (terratological defect)
i. Tail lying in birth canal or hanging from vulva- Breech
presentation.
ii. Tail & limbs in birth canal- Posterior presentation
iii. Head & limbs in birth canal- Anterior
presentation.
iv. Feet are lying in the birth canal – determine whether fore/
hind limb.
Hind limb- Only one joint (fetlock) between Hoof & hock.
Fore limb- Two joints (fetlock & knee) between Hoof &
elbow.

25. Contd…
v. After knowing presentation – determine position by sole.
Feet are protruding through vulva
i. Sole facing-
a. downward- anterior longitudinal presentation, dorso sacral
position or post. Longitudinal presentation, dorso pubic
position (rare type).
b. Upward – Posterior longitudinal presentation, dorso sacral
or anterior longitudinal presentation ,dorso- pubic position
(rare)
vi. Fore limbs extended quite apart
↓
Downward deviation of head & neck.

26. Contd…Contd…
viii. If more than 2 limbs are approaching in
the birth canal, condition m/b –
a. twins
b. double monster
c. Schistosomus refluxus
d. ventro-transeverse pregnancy in
mare
e. The protrusion of the allantochorion into the vagina
& from the vulva (red bag) indicates placental separation.

27. Contd…Contd…
ix. Defective fetus (monster)
Characteristics of monsters-
a. Severe atrophy of muscles of limbs-
limbs are thin, very firm & rigid
b. Ankylosis & distorsion

28. Prognosis-Prognosis-
Varies between Causes, species affected.
1. More prolong dystocia Poorer
2. Greater trauma & infection Graver
3. In mare, graver than other species b/c
i. Fetus dies within 30-40 min. after start
of the labor.
Mare pelvis is longer
iii. Fetal extremities are longer, making correction of dystocia
more difficult

29. Contd…Contd…
3. In cow & Sheep –
Fetus dies after 3-12 hrs of labor & emphysema sets in 24-
36 hrs of labor.
4. In bitch- Death of fetus within 6-8 hrs & emphysema 24-36
hrs of labor but some of other fetuses may still be alive.
Death of all fetus after 48 hrs of labor.

30. Obstetrical operation for releiving dystocia-
1. Mutation.
2. Forced traction.
3. Foetotomy.
4. Caesarean section (Laparohysterotomy)
1. MUTATION : those operations by which a fetus is
returned to normal presentation, position and posture
by repulsion, rotation, version and adjustment or
extension of flexed extremity.
Repulsion or retropulsion- consist of pushing of fetus out
of maternal pelvic inlet or birthcanal into the abdominal
cavity.

31. Rotation: It is turning of fetus on its long axis to bring the
fetus in dorsosacral position.
Version: It is rotation of fetus on its transverse axis into an
anterior or posterior presentation.
Adjustment of extremities: the flexed limbs are extended
out to relieve dystocia.
2. FORCED TRACTION:
Utrecht technique of traction:
(a). Anterior presentation :
 Cross traction: cross traction of fore limbs in anterior
presentation helps to reduce the shoulder dimension
of the fetus and helps in smooth passage of thorax.
 Alternate 2 point traction: extension of limbs
separately thereby the shoulder joint of one limb passes
ahead of the other

32. Traction Force
Right
*Alternative
traction
wrong

33.  Alternate 3 point traction: traction on forelimbs
untill the head is through the pelvic inlet and
then simultaneous traction on head and limbs.
 Rotation of fetus from dorsosacral to dorso ilial
position to prevent hiplock.

34. • CARPAL FLEXION POSTURE (KNEE
FLEXION)
• SHOULDER FLEXION POSTURE

35. • LATERAL DEVIATION OF HEAD AND
NECK
By using eye hooks
and rope
By using mandibular
robe

36. • DOWNWORD DEVIATION OF HEAD
AND NECK

37. • BREECH PRESENTATION
Correction by transfer it into hook and make extension

38. FOETOTOMY
Means dissection of fetus
Advantages:
 Rapid reduction in size of fetus facilitate delivery per
vaginum
 Expo
FOETOTOMY
Means dissection of fetus
Advantages:
 Rapid reduction in size of fetus facilitate delivery per
vaginum
 Exposure of dam to major abdominal surgery is
avoided.sure of dam to major abdominal surgery is
avoided.

39.  Dam is spared inhuman treatment & possible trauma
associated with application of excessive force to
extractive device.
 Less after care is generally required.
 Recovery time is shorter.
 The general condition of dam tends to remain more
stable than after caesarian section.
 The monetary return is equal to that from caesarian.
Disadvantages
 It may require more time to perform than a C.S.
 May be exhausting to the obstetrician
 The obstetrician is subject to the risk of wound from the
instrument or from a sharp fragment of fetus bone
 Dangerous to dam.

40. Classification of fetotomy:
(i) Total foetotomy: cutting fetus into two halves
(ii) Partial foetotomy: cutting of fetus appendages as:
 Subcutaneous foetotomy
 Percutaneous foetotomy
General indication for complete foetotomy:
 A relatively oversized fetus
 An absolute oversized fetus
 A pathologically enlarged fetus
 Partrially dialated cervix

41. Instruction in use of instrument:
 Wire should be checked for proper position and
examined, make sure it is not crossed or kinked.
 Tension on wire must not be relaxed during the
sawing.
 Use new good quality of wire.
 Sawing should begin with moderately , slow, short,
continuous strokes and application of moderate
pressure. As the wire becomes firmly seated long
continuous sawing strokes are applied with heavy
pressure.

46. CAESAREAN OPERATION
Delivery of fetus usually at parturition by
laparohysterotomy.
Hysterectomy: to perform laparotomy and remove
uterus itself.
Indications:
 Physical immaturity of dam.
 Incomplete dilatation of cervix- Ring womb in sheep
 Deformities of pelvis
 Schistosomus reflexus, ankylosis, double monsters,
emphysema, large size of fetus.
 Irreducible uterine torsion.
 Rupture of prepubic tendon of mare

47. Site for operation:
(i) Large animals: Ventral, Ventrolateral or Sublumbar incision.
(ii) Small animals: Flank region with an oblique angle parallel to last
rib, Midline or linea alba.
Anaesthesia :
(i). Large animals:
 Small dose of epidural anaesthesia to control straining.
 Paravertebral nerve block of the last thoracic and first three
lumbar spinal nerves.
 Local infiltration or field block by 2 % procaine HCL.
 Heavy sedation by chloral hydrate or xylazine may be indicated.
(ii). Small animals:
 EWE- paravertebral nerve block or local infiltration.
 SOW- sedative like chlorpromazine, promazine or
triflupromazine hydrochloride.
 BITCH & CAT- premedication with sequil & then
local anaesthesia

48. Thank you