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Cesarean section in Iraqi Awassi ewes: A case study
Theriogenology
CESAREAN
40:435-439,1993
SECTION IN IRAQI A.F. Majeed ,M.B.
AWASSI EWES: Taha and 0.1.
A CASE Azawi
STUDY
Department of Surgery and Obstetrics College of Veterinary Medicine University of Mosul Mosul, IRAQ Received
for
December May 20,
publication: Accepted:
4, 1991 1993
ABSTRACT We describe criteria for choosing Cesarean section to treat dystocia, and identify factors that appeared to influence the success of Cesarean section in Iraqi Awassi ewes under clinical condition. The study was conducted on 276 ewes presented for dystocia during the lambing seasons from 1985 to 1990. out of 130 (07%) ewes assigned to undergo Cesarean section, 65 (50%) had ringwomb, while oversized -Fetus, emphysematous fetus, fetal monsters and hydroallantois accounted for 37 (28%5), 16 (13%>, 10 (7%) and 2 (1%) of the ewes, respectiuely. Primiparous and 2year old ewes (54%) as well as ewes carrying singletons (53%) were assigned to surgery more frequently than multiparous ewes Ewes that delivered male lambs over 2 Y of age carrying twins. underwent surgery more frequently than those with female lambs (63 us 37%). The maternal survival rate was 95% while after 86% of the surgeries the ewes had an uncomplicated recovery and conceived in the following estrus, Based on this case study, Cesarean section appears to be a safe and successful procedure of dystocia in Iraqi Awassi ewes. for management Ker
words:
Dystocia,
Cesarean
section,
Awassi
ewes,
Ovine
INTRODUCTION Dystocia is often a major cause of lamb loss in the flock. in great economic hardship to the producer. (1) and may result There are several procedures used for the treatment of dystocia Depending on the circumstances, Cesarean section was t2,3). reported to be an effective method for treatment of most types of dystocia and was safe for the dam as well as the fetus, especially when performed as early as possible after onset of labor (4-6). The most common indications for Cesarean section in the ewe are failure of the cervix to dilate and relative or absolute oversize of the fetus (2-4). In rare cases fetal emphysema and monsters may require a Cesarean section to deliver the fetus (2). The success of a Cesarean section is related to several factors including absence of infectious causes of abortion, cervical prolapse and trauma resulting from attempted delivery of lambs by the shepherd (6).
Copyright@1993 Butterworth-Heinemann
436
Theriogenology
This study teas designed to find out a safe method for treatment of dystocia in Iraqi Awassi ewes under clinical conditions and to identify factors influencing the success rate of the Cesarean section. MATERIALS
AND
METHODS
Animals. The cases in this report were presented at Mosul University, College of Veterinary Medicine, Obstetric Clinic during lambing seasons from July, 1985 till April, 1990, Ewes (n = 276) of various ages and parities were brought by the owners from seueral different flocks to the clinic, within 12 h after the onset of labor. Breed , age , number of lamb born , age at last breeding , time at the last insemination and date of onset of clinical signs of parturition were recorded for all ewes . Recorded clinical signs included body temperature , pulse rate , respiration rate and careful vaginal examination . Treatment
groups.
Assignment to treatment groups depended on clinical assessment by the attending ueterinarian, and thus uas not random. One of the following treatments was chosen: 1) correction of fetal maldisposition and traction (n = 1081, 2) pharmacological treatment of ringwomb when fetal membranes were not yet ruptured when delivery per uaginam was (n = 381 or 3) Cesarean section, judged to be impossible (n = 130). Pharmacological treatment consisted of one or a combination of the following: 1) e&radio1 benzoate (2 mg i.m.i, 2) Calcium borogluconate 20% (30 ml s.c.1 with estradiol benzoate (2 mg i.m.1, or 3) dinoprost tromethamine (10 mg i.m.1, Surgery was chosen in all cases of ringwomb, oversized fetus and fetal monsters. The surgical procedure was performed on recumbent animals through a paramedian incision under local anesthesia induced with Lidocaine Hcl 3%. A positive response to surgery was recorded when the ewe showed no abnormal infected suture line or elevation of body vaginal discharge, temperature, and had conceived in the following season. RESULTS
AND
DISCUSSION
Cesarean sections were required in 07% (1301276 1 of the ewe The primary cause of dystocia which presented with dystocia. required delivery of lambs by Cesarean are shown in Table 1. Ringwomb or failure of the cervix to dilate occurred in 50% which agrees with that reported by (651130) ewes, a proportion Vaginal prolapse Arthur et a1.(3) ,Taha et al.(S) and Copland (7). was associated with ringwomb in 18% (121651 of the ewes* a Estradiol b Lutalyse,
benzoate, Interuet International , B.V.Boxmer,Holland. Upjohn Company, Kalamazoo, MI, USA.
437
Theriogenology
and was related to poor physical condition and excessive straining during delivery of twin fetuses. Similar findings were previously reported to be associated with hormonal and calcium/magnesium imbalances (8 - 10). Table
1.
Causes
Primary causes of dystocia Cesarean section.
of dystocia
required
n
lambs
by
sg.4 13.3 7.69 1.53
130
Total
of
Percentage
65 37 16 10 2
Ringwomb Oversized fetus Emphysematous fetus Fetal monsters Hydroallantois
delivery
100
The incidence of relative or absolute feto-pelvic incompatibility observed in our study (28%; 371130) agreed with that reported by others (5 - 7) and was found to be related to fetal size, sex, sire and nutritional status of the ewe, causes that had been also enumerated by other investigators (3,6). Pathological emphysematous
condition
fetus
and
of the
fetuses
hydroallantois
were
such as fetal observed in
monsters,
12.3% (16/130 1, 7.6% (lo/1301 and 1.5 % (2/130) of dystocia cases treated with Cesarean section respectively . Similar observation were made by Arthur et a1.(3) and Taha et a1.(5).
Responses to the 3 treatment regimens for dystocia were judged as positive when followed by conception in the subsequent estrus (Table 2I.Maternal survival rate following surgery was 95% (124/130). Of those that survived 90% (112/124> showed a positive response as compared to 80% (861108) that conceived after- assisted delivery per vaginam, and 53% (20/38) after pharmacological therapy. The 12 ewes that did not conceive on the subsequent estrus (10%) all suffered from chronic metritis after surgery, Uterine infections are a common post-surgical complication in ewes as reported by Taha et a1.(5) and Scott (6). Table
2.
The
results
Treatments Manual delivery Medical and Hormonal Cesarean section Total
of different
i'dumber
Positive
methods response
of treatments. Efficiency%
108
86
79.60
38 130 276
1::
52.60 95.0
218
438
Theriogenology
Cesarean section. was performed in the primiparous and two years old ewes for almost 55% (70/130) of all operations. The difference in the number of primiparous and the number of multiparous dams requiring Cesarean was similar to that reported by Taha et al.(S>,Scott (6) and Grommers et al.(ll) , however the primiparous ewes required more assistance than older ewes (3,6) . Cesarean section was performed more frequently in single births (53%) 69/130 than in twin births (47%) 61/130 , and in ewes having male lambs (63%) 121/191 than those having female lambs (37%) Similar observations have been made by Taha et al.(S), 70/191. The higher Scott (6),Grommers et al.{111 and Scales et a1.(12). incidence of Cesarean section observed in ewes having male lambs might be due to their higher birth weight (6,11,12).
43% and
The survival rate for lambs (82/191) which is lower than Scott (6).
delivered by Cesarean section was the rate reported by Taha et al.(S)
We were able to document some of the factors related to Cesarean section in Iraqi Awassi ewes and to demonstrate that surgery a ppears to be a successful procedure for treatment of dystocia.
REFERENCES I.
McSporran, K.O. Dystocia in sheep. Current Therapy in Theriogenology. Philadelphia, 1980, pp 916-918.
In: Morrow,D.A.,(ed) W.B. Saunders Co.,
Veterinary Obstetrics and Genital 2. Roberts, S.J. by author, Ithaca, NY. Distributed ed., Published Bras., Inc., Ann. Arbor, MI , 1971, pp 227-235.
Diseases. 2nd by Edwards
,G.H., Noakes ,D.E. and Pearson ,H. Veterinary 3. Arthur Reproduction and Obstetrics 6th ed., Bailliere Tindall, 323-324. London , 1989, pp 4. Cox, J.E. Liverpool, 5. Taha. ewes. 6. Scott, cases.
Surgery of the Reproductive Liverpool University Press
M.B., Majeed, Mesopotamia J
A.F.
. 2:
and
Ali,
121-128
Tract ,
1982,
in Large Animals. PP 163.
J.B.
Dystocia (1987).
P.R. Ovine Caesarian Operation Br,Vet.J. 145: 558-564 (1989).
:A Study
M.D. Caesarian Section in Sheep 7. Copland, Current Therapy in Theriogenology. W.B. Philadelphia, 1980, pp 965-966.
in
Awassi
of 137
field
.In: Morrow, D.A. Saunders Co.,
ted)
Observations on serum calcium levels in 8. Stubbings, D.P. ewes in North Lincolin-Shire in relation to prolapse of vagina and incomplete cervical dilatation. Vet.Rec. 89: 296-300 (1971).
439
Theriogenology
9.
The etiology of ringwomb or partial dilatation Ward, W.R. of the cervix. Vet.Annual, 15th issue, ed Grunseel and Hill, Bristol, 1971, pp 75-78.
10. Sobiraj, A., Busse, G, Gips, H. and Bostedt, H. Investigation in to the blood plasma profiles of electrolytes, 17 B-oestradiol and progestrone in sheep suffering from vaginal Br.Vet.J. 142: 2X8-223 inversion and prolapse antepartum. (1986). 11. Grommers, F.J., ELuing, L. and Van Eldik, difficulties in sheep .Anim. Reprod. Sci. (1985). 12. Scales, G.H., Burton, R.N. birth weight and nutrition Res. 2: 75-82 (1986).
P. 2:
Parturition 965-374
and Moss, R.A. Lamb mortality , in late pregnancy. N.Z,J.Agric.
CESAREAN
40:435-439,1993
SECTION IN IRAQI A.F. Majeed ,M.B.
AWASSI EWES: Taha and 0.1.
A CASE Azawi
STUDY
Department of Surgery and Obstetrics College of Veterinary Medicine University of Mosul Mosul, IRAQ Received
for
December May 20,
publication: Accepted:
4, 1991 1993
ABSTRACT We describe criteria for choosing Cesarean section to treat dystocia, and identify factors that appeared to influence the success of Cesarean section in Iraqi Awassi ewes under clinical condition. The study was conducted on 276 ewes presented for dystocia during the lambing seasons from 1985 to 1990. out of 130 (07%) ewes assigned to undergo Cesarean section, 65 (50%) had ringwomb, while oversized -Fetus, emphysematous fetus, fetal monsters and hydroallantois accounted for 37 (28%5), 16 (13%>, 10 (7%) and 2 (1%) of the ewes, respectiuely. Primiparous and 2year old ewes (54%) as well as ewes carrying singletons (53%) were assigned to surgery more frequently than multiparous ewes Ewes that delivered male lambs over 2 Y of age carrying twins. underwent surgery more frequently than those with female lambs (63 us 37%). The maternal survival rate was 95% while after 86% of the surgeries the ewes had an uncomplicated recovery and conceived in the following estrus, Based on this case study, Cesarean section appears to be a safe and successful procedure of dystocia in Iraqi Awassi ewes. for management Ker
words:
Dystocia,
Cesarean
section,
Awassi
ewes,
Ovine
INTRODUCTION Dystocia is often a major cause of lamb loss in the flock. in great economic hardship to the producer. (1) and may result There are several procedures used for the treatment of dystocia Depending on the circumstances, Cesarean section was t2,3). reported to be an effective method for treatment of most types of dystocia and was safe for the dam as well as the fetus, especially when performed as early as possible after onset of labor (4-6). The most common indications for Cesarean section in the ewe are failure of the cervix to dilate and relative or absolute oversize of the fetus (2-4). In rare cases fetal emphysema and monsters may require a Cesarean section to deliver the fetus (2). The success of a Cesarean section is related to several factors including absence of infectious causes of abortion, cervical prolapse and trauma resulting from attempted delivery of lambs by the shepherd (6).
Copyright@1993 Butterworth-Heinemann
436
Theriogenology
This study teas designed to find out a safe method for treatment of dystocia in Iraqi Awassi ewes under clinical conditions and to identify factors influencing the success rate of the Cesarean section. MATERIALS
AND
METHODS
Animals. The cases in this report were presented at Mosul University, College of Veterinary Medicine, Obstetric Clinic during lambing seasons from July, 1985 till April, 1990, Ewes (n = 276) of various ages and parities were brought by the owners from seueral different flocks to the clinic, within 12 h after the onset of labor. Breed , age , number of lamb born , age at last breeding , time at the last insemination and date of onset of clinical signs of parturition were recorded for all ewes . Recorded clinical signs included body temperature , pulse rate , respiration rate and careful vaginal examination . Treatment
groups.
Assignment to treatment groups depended on clinical assessment by the attending ueterinarian, and thus uas not random. One of the following treatments was chosen: 1) correction of fetal maldisposition and traction (n = 1081, 2) pharmacological treatment of ringwomb when fetal membranes were not yet ruptured when delivery per uaginam was (n = 381 or 3) Cesarean section, judged to be impossible (n = 130). Pharmacological treatment consisted of one or a combination of the following: 1) e&radio1 benzoate (2 mg i.m.i, 2) Calcium borogluconate 20% (30 ml s.c.1 with estradiol benzoate (2 mg i.m.1, or 3) dinoprost tromethamine (10 mg i.m.1, Surgery was chosen in all cases of ringwomb, oversized fetus and fetal monsters. The surgical procedure was performed on recumbent animals through a paramedian incision under local anesthesia induced with Lidocaine Hcl 3%. A positive response to surgery was recorded when the ewe showed no abnormal infected suture line or elevation of body vaginal discharge, temperature, and had conceived in the following season. RESULTS
AND
DISCUSSION
Cesarean sections were required in 07% (1301276 1 of the ewe The primary cause of dystocia which presented with dystocia. required delivery of lambs by Cesarean are shown in Table 1. Ringwomb or failure of the cervix to dilate occurred in 50% which agrees with that reported by (651130) ewes, a proportion Vaginal prolapse Arthur et a1.(3) ,Taha et al.(S) and Copland (7). was associated with ringwomb in 18% (121651 of the ewes* a Estradiol b Lutalyse,
benzoate, Interuet International , B.V.Boxmer,Holland. Upjohn Company, Kalamazoo, MI, USA.
437
Theriogenology
and was related to poor physical condition and excessive straining during delivery of twin fetuses. Similar findings were previously reported to be associated with hormonal and calcium/magnesium imbalances (8 - 10). Table
1.
Causes
Primary causes of dystocia Cesarean section.
of dystocia
required
n
lambs
by
sg.4 13.3 7.69 1.53
130
Total
of
Percentage
65 37 16 10 2
Ringwomb Oversized fetus Emphysematous fetus Fetal monsters Hydroallantois
delivery
100
The incidence of relative or absolute feto-pelvic incompatibility observed in our study (28%; 371130) agreed with that reported by others (5 - 7) and was found to be related to fetal size, sex, sire and nutritional status of the ewe, causes that had been also enumerated by other investigators (3,6). Pathological emphysematous
condition
fetus
and
of the
fetuses
hydroallantois
were
such as fetal observed in
monsters,
12.3% (16/130 1, 7.6% (lo/1301 and 1.5 % (2/130) of dystocia cases treated with Cesarean section respectively . Similar observation were made by Arthur et a1.(3) and Taha et a1.(5).
Responses to the 3 treatment regimens for dystocia were judged as positive when followed by conception in the subsequent estrus (Table 2I.Maternal survival rate following surgery was 95% (124/130). Of those that survived 90% (112/124> showed a positive response as compared to 80% (861108) that conceived after- assisted delivery per vaginam, and 53% (20/38) after pharmacological therapy. The 12 ewes that did not conceive on the subsequent estrus (10%) all suffered from chronic metritis after surgery, Uterine infections are a common post-surgical complication in ewes as reported by Taha et a1.(5) and Scott (6). Table
2.
The
results
Treatments Manual delivery Medical and Hormonal Cesarean section Total
of different
i'dumber
Positive
methods response
of treatments. Efficiency%
108
86
79.60
38 130 276
1::
52.60 95.0
218
438
Theriogenology
Cesarean section. was performed in the primiparous and two years old ewes for almost 55% (70/130) of all operations. The difference in the number of primiparous and the number of multiparous dams requiring Cesarean was similar to that reported by Taha et al.(S>,Scott (6) and Grommers et al.(ll) , however the primiparous ewes required more assistance than older ewes (3,6) . Cesarean section was performed more frequently in single births (53%) 69/130 than in twin births (47%) 61/130 , and in ewes having male lambs (63%) 121/191 than those having female lambs (37%) Similar observations have been made by Taha et al.(S), 70/191. The higher Scott (6),Grommers et al.{111 and Scales et a1.(12). incidence of Cesarean section observed in ewes having male lambs might be due to their higher birth weight (6,11,12).
43% and
The survival rate for lambs (82/191) which is lower than Scott (6).
delivered by Cesarean section was the rate reported by Taha et al.(S)
We were able to document some of the factors related to Cesarean section in Iraqi Awassi ewes and to demonstrate that surgery a ppears to be a successful procedure for treatment of dystocia.
REFERENCES I.
McSporran, K.O. Dystocia in sheep. Current Therapy in Theriogenology. Philadelphia, 1980, pp 916-918.
In: Morrow,D.A.,(ed) W.B. Saunders Co.,
Veterinary Obstetrics and Genital 2. Roberts, S.J. by author, Ithaca, NY. Distributed ed., Published Bras., Inc., Ann. Arbor, MI , 1971, pp 227-235.
Diseases. 2nd by Edwards
,G.H., Noakes ,D.E. and Pearson ,H. Veterinary 3. Arthur Reproduction and Obstetrics 6th ed., Bailliere Tindall, 323-324. London , 1989, pp 4. Cox, J.E. Liverpool, 5. Taha. ewes. 6. Scott, cases.
Surgery of the Reproductive Liverpool University Press
M.B., Majeed, Mesopotamia J
A.F.
. 2:
and
Ali,
121-128
Tract ,
1982,
in Large Animals. PP 163.
J.B.
Dystocia (1987).
P.R. Ovine Caesarian Operation Br,Vet.J. 145: 558-564 (1989).
:A Study
M.D. Caesarian Section in Sheep 7. Copland, Current Therapy in Theriogenology. W.B. Philadelphia, 1980, pp 965-966.
in
Awassi
of 137
field
.In: Morrow, D.A. Saunders Co.,
ted)
Observations on serum calcium levels in 8. Stubbings, D.P. ewes in North Lincolin-Shire in relation to prolapse of vagina and incomplete cervical dilatation. Vet.Rec. 89: 296-300 (1971).
439
Theriogenology
9.
The etiology of ringwomb or partial dilatation Ward, W.R. of the cervix. Vet.Annual, 15th issue, ed Grunseel and Hill, Bristol, 1971, pp 75-78.
10. Sobiraj, A., Busse, G, Gips, H. and Bostedt, H. Investigation in to the blood plasma profiles of electrolytes, 17 B-oestradiol and progestrone in sheep suffering from vaginal Br.Vet.J. 142: 2X8-223 inversion and prolapse antepartum. (1986). 11. Grommers, F.J., ELuing, L. and Van Eldik, difficulties in sheep .Anim. Reprod. Sci. (1985). 12. Scales, G.H., Burton, R.N. birth weight and nutrition Res. 2: 75-82 (1986).
P. 2:
Parturition 965-374
and Moss, R.A. Lamb mortality , in late pregnancy. N.Z,J.Agric.