The Revision Guide for Student Nurses (Part I)

Caesarean Section - Answers

ANSWERS

  1. What is dystocia?
    Difficult birth; non-productive straining by the dam for longer than an hour is cause for concern.
  2. What developmental defects may result in foetal dystocia?
    • Hydrocephalus.
    • Oedema.
  3. List key points crucial in the recognition of dystocia.
    • Know what is normal.
    • Establish the stage of pregnancy.
    • Establish relevant history and what has already been done by the owner.
    • Regularly monitor rectal temperature in order to detect the prepartum hypothermia.
    • Establish the time that straining commenced, the character of the straining efforts and whether any foetuses have been born.
    • Unproductive straining for longer than one hour is always cause for concern, and a veterinary surgeon should be contacted immediately.
  4. Give an example of a breed of dog that is commonly delivered by Caesarean and why?
    The bulldog, due to its large head size.
  5. Define presentation, position and posture (terms used to describe the orientation of the foetus).
    • Presentation - the direction of the long axis of the foetus in relation to the long axis of the dam.
    • Position - describes the dorsal axis of the foetus in relation to that of the dam and the degree of rotation (most species are born in the dorsal position).
    • Posture - describes the orientation of the head and legs of the foetus.
  6. What is meant by the "breech position"?
    The foetus is delivered in a posterior longitudinal presentation, usually in a dorsal position with the hind limbs flexed.
  7. Why is general anaesthesia for a Caesarean high risk?
    • The bitch or queen may have been fed.
    • The animal may be debilitated following straining.
    • Respiratory embarrassment due to the pressure of the gravid uterus on the diaphragm.
    • Beware with nitrous oxide due to the second gas effect.
    • Hypotension due to compression of the vena cava when the animal is in the supine position.
  8. List 3 possible reasons for vomiting during recovery from anaesthesia following Caesarean surgery.
    • The bitch or queen was not starved.
    • Increased gastric emptying time during labour.
    • Increased intra-gastric pressure during pregnancy.
  9. What complications may arise following Caesarean section?
    • Wound interference by the neonates suckling.
    • Problems with litter acceptance and subsequent reduction in colostrum intake.
    • Anaesthetic risk to the dam and/or neonates.
    • Risk of uterine rupture during surgery.
    • Post-operative risks such as infection and wound breakdown.
    • The dam may crush the litter if she is not able to co-ordinate herself properly following the anaesthetic.
  10. Why is Propofol an ideal induction agent for anaesthesia of a bitch or queen undergoing a Caesarean?
    Animals recovery rapidly once administration of the volatile agent is ceased.
  11. What are the 2 possible reasons for a Caesarean operation?
    • For the relief of dystocia.
    • Electively if concern regarding feto-maternal disproportion.
  12. How can the dam be encouraged to accept her litter following a Caesarean?
    Cover the neonates heads with her milk to encourage her to lick them. Take care not to allow the neonates to become too wet since this may cause hypothermia.