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Dystocia in Domestic Animals and its Management

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DOI: 10.18782/2394-3726.1089

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Available & Biomedi.
online Rese. (2020) 7(3), 1-11
at www.ijpbr.net ISSN: 2394 – 3726

DOI: http://dx.doi.org/10.18782/2394-3726.1089 ISSN: 2394 - 3726

Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11
Review Article

Dystocia in Domestic Animals and its Management

Goitom Weldeyohanes1 and Haben Fesseha2*
1
Researcher, Tigray Agricultural Research Institute, Humera Agricultural Center, Ethiopia
2
School of Veterinary Medicine, Wolaita Sodo University, P.O Box 138, Wolaita Sodo, Ethiopia
*Corresponding Author E-mail: [email protected]
Received: 15.04.2020 | Revised: 23.05.2020 | Accepted: 4.06.2020

ABSTRACT
Dystocia is difficult for parturition that requires assistance for helping delivery. The causes can
be maternal factors (uterine inertia, inadequate size of the birth canal) and/or fetal factors
(oversized fetus, abnormal orientation as the fetus enters the birth canal). Improper cervical
dilation appears to be a more frequent maternal cause of dystocia in cattle. The usual clinical
signs are the onset of labor without delivery of fetus or fetal membranes and later regression of
parturition signs. An incorrect diagnosis of dystocia may result in an unnecessary cesarean
section. It most commonly occurs in heifers than mature cattle. The factors which influence the
likelihood of dystocia include infection, heredity, nutrition, calf sex, exercise, cow age, and
gestation length. Although dystocia cannot be eliminated from a herd; the incidence can be
greatly reduced by management decisions made before the breeding season and during
gestation. No clear boundaries exist between dystocia and eutocia (normal birth), but guidelines
based on progress and duration of the delivery may aid the veterinarian and the producer in
deciding when to interfere with the birth process. In the last century, a lot of improvement
occurred in the techniques used to deliver and resuscitate calves. Although it is not possible to
eliminate dystocia, improvements in the management of heifers during their development and
observation of cows and heifers during the calving season are critical for reducing calf losses.
Keyword: Cesarean section, Dystocia, Farm animals, Risk factor, Treatment

INTRODUCTION to conceive and nourish the embryo and

Reproduction is an important consideration in deliver the viable young ones at the end of a
the economics of cattle production. In the normal gestation period (Ball & Peters, 2008).
absence of regular breeding and calving at the Reproductive disorders negatively affect their
appropriate time, the dairy enterprise will not productive and reproductive performances in
be profitable. A healthy calf each year is the dairy cows (Fesseha & Ayele, 2020).
usual goal of reproduction. This is possible Dystocia is one of the reproductive
only by increasing the reproductive efficiency problems that occur when the first or second
of the animals. Successful reproduction stage of labor is prolonged and assistance is
encompasses the ability to mate, the capacity required for delivery.

Cite this article: Weldeyohanes, G., & Fesseha, H. (2020). Dystocia in Domestic Animals and its
Management, Int. J. Phar. & Biomedi. Rese. 7(3), 1-11. doi: http://dx.doi.org/10.18782/2394-3726.1089

Copyright © May-June, 2020; IJPBR 1

Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
Dystocia comes from the Greek dys (difficult) dystocia appears higher in the larger breeds
and tokos (birth). Dystocia also called calving such as Holstein, Brown Swiss, and Hereford
difficulty, is defined as prolonged and difficult (Mee, 2008).
parturition with assistance frequently being The usual clinical signs are the onset
required. The incidence of dystocia in cattle of labor without delivery of the fetus and/or
has been widely studied because of its effects fetal membranes and later regression of
on productivity (Youngquist & Threlfall, parturition signs. The animal may show signs
2006) and the overall incidence varies with the of mild discomfort. The animal may adopt a
species and with breeds within the species. rocking horse stance and show mild colic pain
Dystocia in small ruminants is considered of (Fesseha and Ayele, 2020; Fossum et al.,
low incidence worldwide (<5%) (Brounts et 2007). Partial anorexia, dullness, and
al., 2004; Purohit & Mehta, 2006). depression may be evident. One or both lips of
Dystocia has a direct negative impact the vulva are pulled in because of the torsion
on calves (e.g., prolonged hypoxia, significant of the birth canal. When the cervix is fully
acidosis, vigor, increased stillborn calves, etc.) dilated it is not palpable as a separate structure
and dams (e.g., trauma, paresis, metritis, and is continuous with the vagina. The
endometritis, etc.). Dystocia or difficult incompletely dilated cervix is palpable through
parturition represents a true emergency faced per rectum examination (Purohit et al., 2011).
by the veterinarian, and effective management The causes of dystocia are categorized
is essential for the survival of both calf and into maternal and fetal origin to formulate a
dam and the dam's subsequent fertility. clinical management plan for an individual
Dystocia is most commonly caused by animal (Kebede et al., 2017; Youngquist and
abnormalities of fetal presentation (the portion Threlfall, 2007). Maternal Causes: Dystocia,
of the fetus that enters the vaginal canal first), which arises in the mother due to maternal
position (the relationship of the fetal spine to factors, is caused either by constriction of the
the dam's pelvis), or posture (the relationship birth canal or by a deficiency of expulsive
of the fetal extremities to its body), but can forces. The constrictive forms of which the
also result from fetal oversize or maternal most important are pelvic inadequacies,
factors such as pelvic abnormalities or uterine incomplete dilation of the cervix or ring
inertia. The incidence of dystocia has been womb, and uterine torsion (Linde-Forsberg
reported to be anywhere from 4% to 10% of and Eneroth, 2000). The most common fetal-
all births. Dystocia should be approached related causes of dystocia are head deviation,
systematically, to deliver a live calf as quickly forelimb flexion, breech presentation, dog
as possible with minimal complications sitting position, and fetal malformations
(Abera, 2017; Moges, 2016). (Bhattacharyya et al., 2012; Bhattacharyya et
Amongst all domestic animals, cattle, al., 2015).
and buffalo are considered the species in Fetomaternal disproportion is not only
which the incidence of dystocia appears to be a factor by itself but a relationship between
highest (Noakes et al., 2018; Purohit et al., maternal and fetal factors and can be defined
2011). The incidence is around 5 percent as an obstruction of calf expulsion originated
overall but reaches almost 100 % in some by the calf size/birth weight or pelvic
breeds of dogs and 20% in some breeds of cats dimensions of the dam, that may have several
(Linde-Forsberg and Eneroth, 2000). The factors in its origin (Mee, 2008). The
bovine species are most often affected with dimensions of the bony pelvis are too small to
dystocia (Noakes et al., 2001). It is apparently allow passage of the fetus. This is most
higher in dairy than beef cattle. Besides, commonly caused by maternal immaturity and
consideration must always be given to the often occurs as a result of young being served
effect of breed, age, and parity in the at too young an age. A small pelvis is a
interpretation of results. The incidence of component in dystocia due to fetopelvic
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Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
disproportion and is exacerbated in cases factor in calf mortality at or near birth
where the fetus is larger than normal (Jackson, (Mekonnen & Moges, 2016). So, this is to
2004). highlight the cause, risk factors, signs,
The consequences of dystocia are management, and prevention.
numerous, ranging from increased stillbirths 2. Causes of Dystocia
and perinatal mortality to severe trauma to the Generally, dystocia can be caused as a result
offspring or its mother. Moreover, dystocia of maternal and fetal causes (Abera, 2017).
affects both the welfare of the dam and Only in the last three decades, however, has
offspring. Also, it results in an increased the research been effectively directed toward
chance of sterility in the dam, increased the causes and management of dystocia. This
likelihood of puerperal disease in the dam, and may be associated with the more widespread
subsequent culling of the dam and also implementation of herd health programs and
increased mortality rate of the dam. the use of computers to facilitate data
Furthermore, dystocia reduced productivity of management. The incidence of dystocia varies
the dam and reduced subsequent fertility but generally is more common among first-calf
(Abera, 2017; Frame, 2006; Noakes et al., heifers, because they have not yet reached
2018). Accordingly, Dystocia is so important their mature size, and then decreases with age
in the farm economy since it frequently occurs (Bhattacharyya et al., 2015; Frame, 2006).
in a different farm of cattle and the major

Fig. 1: Normal presentation of the fetus during parturition

Dystocia of maternal origin also be involved in secondary uterine inertia

Dystocia of maternal origin may be caused by (Fossum et al., 2007; Megahed, 2018; Moges,
uterine inertia, small pelvic size, failure of 2016).
cervical dilation, and uterine torsion. Failure of Dystocia of fetal origin
cervical dilation and uterine torsion is the most Broadly, the fetal origin of dystocia can be
common cause of dystocia of maternal origin. divided in general to the abnormal 3P’s (P1-
Failure of cervical dilation is associated with presentation, P2-position, and P3=-posture)
long-term progesterone supplementation and excessive fetal size relative to the maternal
during pregnancy (Mekonnen & Moges, pelvis (Feto-pelvic-disproportion) (Kebede et
2016). Dystocia caused by the small size of the al., 2017; Noakes et al., 2018). Dystocia
dam is rarely seen if females are bred for the caused by an oversized calf in a normal
first time when they reach at least 65% of anterior longitudinal presentation is common
adult weight and height. Narrowing of the in beef cattle. The calf's muzzle and forefeet
birth canal may be caused by space-occupying are presented at the cow's vulva. Presentation
lesions or masses. Uterine inertia, arising from is the relation between the long axis of the
weak or absent uterine contractions, is foetus and the maternal birth canal; position
occasionally seen in older animals or animals indicates the surface of the maternal birth
with prolonged pregnancy. Hypocalcemia may canal to which the foetal vertebral column is
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Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
applied and posture refers to the disposition of insufficient size (Relative oversize) or the
the movable appendages of the foetus and fetus may be unusually large and cannot be
involves flexion or extension of the foetal neck delivered through a pelvic canal of normal size
or limbs. The normal delivery is made (Kebede et al., 2017).
longitudinal, in the anterior presentation, Fetomaternal disproportion is mostly
dorsal sacral position; with bilateral foreleg caused as a result of the large fetus and fetal
extension (Anderson, 2012; Pearson et al., abnormalities, or abnormal presentation,
2014a). position, or posture. Carpal flexion and lateral
Spontaneous delivery with other fetal or ventral deviation of the head and neck are
presentation, position, or posture is unlikely the most common fetal malposition and caused
unless the fetus is quite small or the dam’s by the long neck and limbs of the fetus in these
pelvis is unusually large (Abera, 2017). species (Pearson et al., 2014b). Unilateral or
Deviation of the head and flexion of the bilateral hack or hip flexions (breech) occur in
various joints in anterior presentation, flexion posterior presentation. Schistosoma reflexus,
of both hind limbs (Breech) in posterior ankylosis, and anomalies (hydrocephalus, fetal
presentation, or twins may cause dystocia anasarca, and emphysematous fetus) are also
(Hillman & Gilbert, 2008). The most common cause of dystocia in cattle. Even though
cause of dystocia in cattle is feto-pelvic presences of twins are rare in cattle but should
disproportion. The situation is most common always be considered in cases of dystocia
in heifers where the fetus is of normal size for (Frame, 2006; Hillman and Gilbert, 2008;
its breed but the maternal pelvis is of Purohit et al., 2012).

Fig. 2: Abnormal presentation of the fetus during parturition

In addition, Dystocia can also be classified as the absence of obstructive causes (Pearson et
functional or obstructive. Functional dystocia al., 2014a).
usually is termed inertia and can be classified Secondary uterine inertia
as primary or secondary (Jackson, 2004). It occurs following a prolonged second stage
Primary uterine inertia of labor and may be associated with
It is the most common cause of dystocia in obstructive dystocia. Obstructive dystocia may
dogs and cats, with a reported incidence of up result from relative or absolute fetal oversize.
to 91% of cases (Jackson, 2004; Mee, 2008). Absolute fetal oversize refers to a fetus that is
In primary uterine inertia, the myometrium too large to pass along a maternal birth canal
produces weak, infrequent contractions that is of normal dimensions. Relative fetal
resulting in a failure to deliver the fetuses. oversize refers to a fetus of normal size that
Primary uterine inertia can be further classified cannot pass along the maternal birth canal
as complete or partial. In complete primary because the latter is abnormally small or
inertia, second stage labor does not start; restricted in some way. Relative fetal oversize
whereas in partial primary inertia, second- is equivalent to maternal obstructive dystocia
stage labor starts but labor ends prematurely in (Jackson, 2004; Pearson et al., 2014a).
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Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
3. Risk factors associated with the It is often associated with an oversized foetus.
prevalence of Dystocia in farm animals Uterine torsion, from 180 to 720°, prevents
Risk factors for dystocia include abnormal size entry of the foetus/fluids into the twisted
and position of the fetus, abnormal maternal vaginal lumen such that the animal shows no
pelvis shape as affected by prior trauma, sign to indicate the end of first stage labour.
metabolic bone disease, dysfunctional uterine Failure of the cervix to dilate fully is a
action, cervical or vaginal stricture, and common consequence (Pearson et al., 2014a).
macrosomal anomalies such as gestational Rotation of the uterus on its long axis with
diabetes, hydrocephalus, and fetal hydrops. twisting of the anterior vagina is a common
Multiparity may also predispose animals to cause of bovine dystocia, less common in
dystocia, especially in species where single small ruminants and small animals. Uterine
births are the norm (Al-Amin, 2018; Fossum et torsion is a complication of late first-stage or
al., 2007; Frame, 2006). early second stage labour. It is probably due to
The challenge of early detection of dystocia in instability of the uterus which results from the
animals relates to housing conditions and the greater curvature of the organ being dorsal and
environment as well as their ability to delay from the uterus being disposed anteriorly to its
labor and hide signs of distress until late in the subilial suspension by the broad ligaments
disease process. Dystocia is more easily (Abera, 2017; Beagley et al., 2010).
observed for indoor animals than those housed Uterine Inertia
in large outdoor enclosures and free-range Uterine inertia is a condition where the uterine
naturalistic environments. In these expulsive forces fail to deliver a fetus. This
environments, it may not be until the situation condition is common in dairy cows and older
has progressed to a critical stage that signs of beef cows with clinical hypocalcemia (milk
dystocia become apparent, even to the most fever). Parturition does not progress beyond
experienced observer. It is due to these factors the end of first stage labour. Vaginal
that animals presenting with dystocia are often examination reveals the cervix to be fully
in critical condition and requires immediate dilated with the foetal membranes intact. Often
treatment (Mortimer, 2009; Pearson et al., the calf is already dead. There may be other
2014b; Purohit et al., 2012). signs of hypocalcemia including recumbency
Incomplete Cervical Dilatation and inability to rise, and free gas bloat
Failure of the cervix completely to dilate is a (Pearson et al., 2014b).
relatively common cause of dystocia in the Uterine inertia is classified conventionally into
dairy bovine. It may occur in the heifer, primary and secondary uterine inertia. The
multiparous cows, and other species. Improper most common cause of primary uterine inertia
cervical dilation appears to be a more frequent in dairy cows is considered to be
maternal cause of dystocia in cattle (Benesch hypocalcemia, with the animal showing signs
and Wright, 2001). Formation of scar tissue of milk fever as calving is about to begin.
due to injuries sustained at previous calving in When the uterine musculature becomes
aged animals, improper relaxation during exhausted after the failure of the delivery of a
parturition, congenital stenosis of the vagina, maldisposed or oversized fetus or due to
vaginal obstruction by fibrous bands, obstruction in the birth canal, then the
perivaginal abscess or cysts can occlude the condition is known as secondary uterine
genital passage and hinder with the delivery of inertia. The contractions in the uterus then stop
the fetus (Purohit et al., 2011). or become weak and transient. The animal
Uterine Torsion shows no progress in parturition after the
Torsion of the uterus usually occurs in a second stage of labor (Purohit et al., 2011).
pregnant uterine horn and is defined as the It is produced by a lack of tone or failure of
twisting of the uterus on its longitudinal axis. the uterine muscles to contract. Primary
Uterine torsion is relatively common in cattle. uterine inertia is a failure of uterine muscle to
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Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
contract normally at parturition which may fetuses present simultaneously and become
occur due to failure of the muscle to respond impacted in the maternal pelvis, one fetus only
to hormonal stimuli and disease of muscle or is presented but cannot be born because of
lack of failure to release hormones such as defective posture. position or presentation;
estrogen and possibly oxytocin, that initiate posture is often most at fault, the lack of
uterine contraction in normal muscles extension of limbs or head being due to
(Ghuman, 2010). insufficient uterine space; uterine inertia,
Hernia of the Gravid Uterus defective uterine contractions are caused,
Occasionally hernia of the gravid uterus occurs either by the excessive fetal load or by
through a rupture of the abdominal floor. The premature birth. When inertia is present, the
accident is one of the advanced pregnancy, birth of the first or second fetus does not
occurring from the seventh months onwards in proceed although the presentation is normal
large animals. It is probable that in the (Noakes et al., 2018; Pearson et al., 2014a).
majority of cases a severe blow on the Malposition of fetus
abdominal wall is the exciting cause although Further causes of obstructive dystocia are
many observers have stated that it may occur faulty fetal disposition such as transverse
without traumatic influence; the abdominal presentation, lateral or ventral deviation of the
musculature becoming in some way so head, or breech posture (especially if the first
weakened that it is unable to support the fetus in a primiparous dam is concerned).
gravid uterus. The site of the original rupture Dead fetuses may occasionally cause
is the ventral aspect of the abdomen, at the obstructive dystocia, especially if the first
right side in the case of cows. Ventral fetus to be delivered is dead or if massive
displacement of the uterus is an uncommon emphysema formation has already taken place.
cause of dystocia in cows. It is seen in animals Furthermore, obstructive dystocia may also be
with a ventral hernia or rupture of the prepubic caused by pathological alterations of the soft
tendon where the pregnant uterus passes or bony tissue of the birth canal (pelvic
downward into the point of the hernia fractures, tumors, vaginal prolapse, congenital
(Benesch and Wright, 2001; Ghuman, 2010; malformations of the uterus, the vagina or the
Pearson et al., 2014b). vestibulum) (Kebede et al., 2017; Pearson et
Fetal Oversize al., 2014a).
A large number of studies conducted on dairy 4. Clinical presentation and Diagnosis of
and beef cows point out that the calf birth Dystocia
weight, especially in 2-year old first calving Clinical signs of Dystocia
heifers, significantly affects the difficultly in Dystocia requiring major obstetric intervention
calving (Purohit et al., 2011). and early diagnosis of dystocia is very
Fetal Maldisposition important because it may evolve rapidly to a
Although abnormal presentations are thought critical situation endangering the life of both
to be repeatable (Cows that have an the fetus and the dam (Divers and Peek, 2019;
abnormally presented fetus once are more Kebede et al., 2017). The diagnosis and
likely to do so again), there is little that can be treatment of dystocia require a good
done to reduce the relatively small percentage understanding of normal parturition,
of calves that experience dystocia due to sensitivity to the welfare of both dam and
abnormal presentation. Various diseases of the offspring, and good practical competences.
fetus can result in the altered shape of the fetus However, identifying the exact point at which
and dystocia in cattle (Anderson, 2012; normal birth ceases and dystocia occurs is not
Kebede et al., 2017). easy. Any apparent or suspected departure
Twinning from normal birth should be investigated (Al-
Twin gestation in cattle often culminates in Amin, 2018; Moges, 2016; Pearson et al.,
dystocia. Twin dystocia is of three types: both 2014a).
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Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
Specific signs of dystocia are: prolonged, non- Diagnosis of Dystocia
progressive, first stage labor; the cow standing The diagnosis of dystocia is based on history
in an abnormal posture during first stage labor- and physical examination (Mortimer, 2009).
in case of uterine torsion the cow may stand Before starting the clinical examination,
with a dipped back in the sawhorse posture focusing on the following: physical condition
and failure of the calf to be delivered within 2 and body condition score of the cow; is the
cow standing or recumbent; brief physical
hours of the amnion appearing at the vulva.
examination; if there are any membrane or
Obvious malpresentation, malposture, or
fetal part visible in the vulva; if so, identify the
maldisposition-like the appearance of the fetal
membrane and its condition or the fetal
head but no forelimbs, the tail but no hind presentation and position; is there any vaginal
limbs, the head, and a single forelimb, the discharge that may indicate, for example, fetal
appearance of detached chorioallantois, fetal death (Megahed, 2018; Noakes et al., 2018).
meconium or blood-stained amniotic fluid Upon arrival at the farm, this information is
appears at the vulva (Kumar, 2015). completed by inquiring for additional details
Dystocia should be considered in any about the clinical history to obtain as much
of the following situations: 1) animals with a pertinent history as possible and this should
history of previous dystocia or reproductive include: the expecting calving date (Gestation
tract obstruction, 2) parturition that does not length); information about the sire; if the cow
is first calving or not and, if pluriparous, if the
occur within 24 hr after a drop in rectal
previous calving evolved easily; for how long
temperature to <100°F (37.7°C), 3) strong
is the cow in labor; if there was any progress
abdominal contractions lasting for 1–2 hr
in calving; if some assistance has been given
without passage of a puppy or kitten, 4) active so far and which measures were undertaken.
labor lasting for 1–2 hr without delivery of Some other questions about the recent health
subsequent puppies or kittens, 5) a resting of the cow should also be asked (Moges, 2016;
period during active labor >4–6 hr, 6) a bitch Mortimer, 2009).
or queen in obvious pain (eg, crying, licking, In cases of fetomaternal disproportion
or biting the vulva), or 7) abnormal vulvar vaginal examination is often difficult.
discharge (eg, frank blood, dark green However, when called for acting on a dystotic
discharge before any neonates are born labor, one must remember that all kinds of
dystocia are possible and that during the
(Hillman and Gilbert, 2008; Pearson et al.,
clinical approach, some steps must be
2014a).
followed (Abera, 2017; Noakes et al., 2018).
Additionally, the usual clinical signs Moreover, dystocia should be suspected if the
are the onset of labor without delivery of the first stage of labor exceeds 6 hours with
fetus and/or fetal membranes and later increasing signs of discomfort or if the second
regression of parturition signs. The cow may stage of labor does not progress normally
show signs of mild discomfort. The animal within 10 minutes of the rupture of the
may adopt a rocking horse stance and show amniotic sac. Dams may show signs of
mild colic pain (Abera, 2017; Benesch and distress, with frequent alternation between the
Wright, 2001). Partial anorexia, dullness, and standing and sitting positions, side to side
rolling, and excessive vocalization and
depression may be evident. One or both lips of
straining. Abnormal (bloody or purulent)
the vulva are pulled in because of the torsion
discharge in a term female warrants immediate
of the birth canal. When the cervix is fully obstetric evaluation. One rule that we always
dilated it is not palpable as a separate structure observe is to attend immediately to any
and is continuous with the vagina. The parturient female that the owner says is not
incompletely dilated cervix is palpable through acting normally (Kumar, 2015; Linde-
per rectum examination (Purohit & Mehta, Forsberg and Eneroth, 2000; Noakes et al.,
2006; Purohit et al., 2012). 2018).

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Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
To determine the appropriate therapy, the environment, concurrent disease, and presence
cause of dystocia (obstructive vs of a live calf (Fossum et al., 2007; Frame,
nonobstructive) must be determined and the 2006; Noakes et al., 2018).
condition of the animal assessed. A thorough Assisted Vaginal Delivery
history regarding breeding dates, previous Before manipulation is attempted, it is often
parturitions, pelvic trauma, etc, is desirable. necessary to repel the fetus back into the
The animal should be examined for signs of uterus. Sedation, intravenous administration of
systemic illness that, if present, may clenbuterol, and installation of warm fluids
necessitate an immediate cesarean section. The and lubricants into the uterus facilitate this
normal vaginal discharge at parturition is a process. The uses 1 L of a nonsterile
dark green color; abnormal color or character lubrication product containing sodium
warrants immediate attention. A sterile digital carboxymethylcellulose in 10 L of warm water
vaginal examination should be performed to is recommended. A more extreme version of
evaluate the patency of the birth canal and the this technique has been described in which the
position and presentation of the fetus(es). uterus is filled with water from a hose to “flat”
Radiography or ultrasonography can determine the fetus and aid in its manipulation. As a
the presence and number of fetuses, as well as general rule, if no progress has been made
their size, position, and viability (Frame, 2006; with 15 minutes of obstetric manipulation, an
Jackson, 2004; Youngquist and Threlfall, alternate approach should be considered, such
2007). as fetotomy, controlled vaginal delivery
5. Treatment of Dystocia (CVD), or cesarean section (Abera, 2017;
Dystocia in cattle can be relieved by different Frame, 2006; Jackson, 2004).
obstetric methods, including the caesarean When manipulations are successful
operation and fetotomy. Nowadays, the and the fetus is in the normal dorsosacral
caesarean operation is one of the most position for delivery, traction should be
common surgical procedures performed by applied carefully, in conjunction with the
veterinarians in cattle practice and is dam’s contractions. The fetal ropes should be
considered a routine obstetric technique. It has looped above the fetlocks, with a half hitch
high maternal and fetal survival rates and often placed below the joint. Head ropes should only
is less exhausting, speedier, and safer than be used for positioning, not for traction. The
fetotomy. There are three main goals: (1) incidence of retained fetal membranes and also
survival of the cow; (2) survival of the calf; uterine prolapse is higher following dystocia.
and (3) maintenance of fertility. A prompt To prevent this, the membranes should be
decision to perform a caesarean operation is carefully tied up and the dam gave a low dose
important for optimum success. Ideally, it is of oxytocin (e.g., 20 units, IM). To minimize
carried out when a live calf cannot be the risk for uterine, prolapse, the uterus should
delivered after 15-20 minutes of manipulation be palpated per vagina to ensure there is no
(Abera, 2017; Benesch and Wright, 2001). invagination of either of the uterine horns,
The cow is a good surgical risk, which can progress to uterine prolapse if not
provided that the environment is suitable for corrected (Frame, 2006; Pynn, 2015).
aseptic abdominal surgery. The need for Moreover, Medical management may
urgent intervention is indicated if there is be considered when the condition of the dam
evidence of fetal hypoxia, as shown by and fetuses is stable, when there is proper fetal
hyperactive movements of the fetus and position and presentation, and when there is no
expulsion of the meconium, identifiable in the obstruction. Oxytocin (3-20 U in bitches, 2-5
amniotic fluid. A successful prognosis depends U in queens) given IM up to 3 times at 30-min
on several factors, such as the skill and speed intervals, with or without 10% calcium
of the surgeon, duration of dystocia, the gluconate (3-5 mL, IV slowly) may promote
physical condition of the dam, surgical uterine contractions. If no response follows, a

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Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
cesarean section should be performed (Fossum If calving difficulty is a problem in your herd,
et al., 2007; Kumar, 2015; Mekonnen and feed heifers well enough to weigh at least 85%
Moges, 2016). of their expected mature weight at first
Cesarean Section calving. Maintenance of calcium homeostasis
Surgery is indicated for obstructive dystocia, throughout the transition is imperative for
dystocia accompanied by shock or systemic uterine health (Anderson, 2012; Martinez et
illness, primary uterine inertia, prolonged al., 2012). The use of anionic salts can reduce
active labor, or if medical management has the incidence of clinical hypocalcemia (Milk
failed. Caesarian section, also called fever) to <2% in multiparous cows and also
laparohysterotomy, means the extraction of the reduce the incidence of subclinical
fetus or foeti from the mother animal, through hypocalcemia in early postpartum (Martinez et
a surgical opening in the abdominal wall and al., 2012; Pearson et al., 2014a; Pynn, 2015).
the uterus. It is commonly indicated in cases of Cows and heifers should be fed to give birth in
dystocia when a calf cannot be delivered by suitable body condition neither being thin nor
normal parturition cascade (Fesseha and fat because fat cows tend to experience more
Ayele, 2020; Noakes et al., 2018; Pynn, 2015). calving problems. Restricting food in the late
There are different available surgical stages of pregnancy does not prevent a large
approaches for bovine caesarean section: the calf and leads to weak labour and increased
standing left paralumbar celiotomy, standing dystocia rates and adequate exercise is good
right paralumbar celiotomy, recumbent left especially at late pregnancy. Not all dystocia
paralumbar celiotomy, recumbent right can be prevented, such as mal-presentations
paralumbar celiotomy, recumbent ventral
and early intervention is paramount in
midline celiotomy, recumbent ventral
ensuring a live birth. Farmworkers need to be
paramedian celiotomy, ventrolateral
trained to deal with dystocia and recognize
celiotomy, and the standing left oblique
when further help is needed. A delay in
celiotomy. Each has its own advantages and
assisting may mean the loss of the calf or
disadvantages. The selection of an approach
injury and even the death of the cow (Abera,
should be based on the type of dystocia, the
2017; Anderson, 2012).
cow’s condition, the environmental conditions,
the availability of assistance, and the surgeon’s
CONCLUSION
preference (Fesseha et al., 2019; Kumar, 2015;
Dystocia (difficult birth) occurs when the first
Newman, 2008; Newman and Anderson,
or second stage of labor is prolonged and
2005).
assistance is required for delivery. Dystocia
6. Prevention of Dystocia
Veterinarians endeavoring to prevent and cases are stressful events for both mother and
reduce the incidence of dystocia. This can be offspring with potentially lifelong
prevented with proper reproductive consequences and have a large economic
management and good husbandry practices. impact on farmers due to calf death, injury or
This, in turn, helps to decrease the incidence of death to the cow, veterinary cost, as well as the
dystocia (Noakes et al., 2018). Early decrease pregnancy rate of the cow after losing
intervention minimizes the effects of dystocia a calf and has a detrimental effect on the
on calves. Heifers should be monitored welfare of the cow and the calf. It has been
regularly and provided with assistance caused by maternal and fetal factors. The
promptly if stage II labor is prolonged. incidence of dystocia varies but generally is
Producers must be well trained to intervene more common among first-calf heifers,
appropriately in dystocia and recognize when because they have not yet reached their mature
to call the veterinarian. A balanced nutritional size, and then decreases with age. The
program helps control losses associated with diagnosis of dystocia is based on the history of
mineral deficiency (Anderson, 2012; Frame, the case, general clinical examination of the
2006). cow, and specific examinations like vaginal
Copyright © May-June, 2020; IJPBR 9
Weldeyohanes and Fesseha Int. J. Phar. & Biomedi. Rese. (2020) 7(3), 1-11 ISSN: 2394 – 3726
and rectal examinations. The diagnosis and cows: prevalence, clinical picture and
treatment of dystocia constitute a large and management by a modififi ed
important part of the science of obstetrics and Bühner’s technique using infusion
require a good understanding of normal (drip) set tubing as suture material.
parturition. Obstetrical operations such as Veterinarski Arhiv 82, 11-24.
mutation, forced traction, fetotomy, and Bhattacharyya, H. K., Bhat, F. A., & Buchoo,
cesarean section are used to relieve dystocia. B. A. (2015). Prevalence of dystocia
Uterotonic (ecbolic) drugs like oxytocin and in sheep and goats: a study of 70 cases
prostaglandins are used to cause a marked (2004-2011). Journal of Advanced
uterine contraction as to expel uterine Veterinary Research 5, 14-20.
contents. Although it is not possible to Brounts, S. H., Hawkins, J. F., Baird, A., &
eliminate dystocia, improvements in the Glickman, L. T. (2004). Outcome and
management of heifers during their subsequent fertility of sheep and goats
development and observation of cows and undergoing cesarean section because
heifers during the calving season are critical of dystocia: 110 cases (1981–2001).
for reducing calf losses. Accordingly, early Journal of the American Veterinary
intervention medical as well as surgical Medical Association 224, 275-281.
assistance and maintenance of a balanced Divers, T. J., & Peek, S. F. (2019). The
nutritional program also minimizes the effect clinical examination. Medical Science
of dystocia. 155, 3-15.
Fesseha, H., & Ayele, A. (2020). Recurrent
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