Caesarian section for management of 540[degrees] uterine torsion in a cow.
One of the most frequent causes of maternal dystocia in cows nearing parturition is uterine torsion. The fetus and its membranes are rotated along with uterus, leading to compression of uterine artery, hemorrhage or seepage of blood in allantoic cavity and resultant fetal death in utero. The birth canal is occluded because of rotation of uterus and delivery of fetus cannot occur (Prabhakar et al., 1994). Uterine torsion is a diagnostic dilemma for Veterinarians and a difficult obstetric procedure.
History and Clinical findings
A crossbred Jersey cow with complete term showing signs of parturition and unable to parturate since last 24 hours. The animal was frequently getting up and lying down and had colic pain. The animal was uneasy, dull and restless.
Upon gynaeco-clinical examination it was initially diagnosed as a case of right-sided uterine torsion. The degree of torsion could not be assessed correctly at this stage.
Uterine torsion is an obstetrical emergency and hence was attended on priority. It is essential to bring back a twisted uterus to its normal position (detorsion). To improve the general condition of patient fluid replacements, antibiotics and corticosteroids at standard dosages were given. A modification of rolling technique called Schaffer's method, as described by Arthur (1966) and is recommended widely for detorsion of uterus in bovines. In this method, a slightly flexible wooden plank of 9-12 feet long and 8-12 inches wide is placed on recumbent cow's flank with lower end of plank on ground. An assistant stands on plank while animal is slowly turned over by pulling the ropes. By following above technique, an attempt was made to correct torsion. The animal was rolled 3 times, but with no success.
In present case, as it was presented after 24 hours and also degree of torsion was supposedly quite high, detorsion attempts failed. Detorsion failure is common in cases presented beyond 24-36 hours of delay and in animals where dead emphysematous fetus (Prabhakar et al., 1994) is present or uterine adhesions or uterine rupture is present. Similar views have been expressed by other workers (Dhaliwal ef al., 1993; Prasad et al., 1998).
Cesarean section is suggested in uterine torsion that fail to be corrected by rolling or in long standing cases where fetus is dead and uterine adhesions/rupture are likely (Purohit, 2006).
The animal was operated with left oblique ventrolateral approach with animal in right lateral recumbency as it results into minimum post operative complications (Purohit and Mehta, 2006). The operation was done with mild sedation and local infiltration.
The uterus was exteriorated with due caution and incised at position where fetal extremity was felt. After removal of a dead fetus, 3 complete rotations (540 degree) were made to detort uterus (Fig. 1-2).
For healing of uterine damage and involution, 20-40 I.U Oxytocin was injected within uterine wall at 3-4 or more locations. The abdominal wound was closed routinely. The animal was given Inj. Streptopenicillin 2.5 gm IM along with anti-inflammatory and appetite stimulants for five consecutive days and surgical sutures were removed on 12th day post operation. The animal was stable and taking normal feed and water and had an uneventful recovery (Fig. 3).
The prognosis of uterine torsion is good during early correction. In cases treated beyond 24-36 hours, chances of fetal survival are negligible. The dam survivability is high with rolling but comparatively lower with cesarean section because of poor patient condition and postoperative complications. Similar findings have been previously recorded (Prabhakar et al., 1997; Singh and Dhaliwal, 1998).
In conclusion, uterine torsion must be attended on priority with sufficient care of the patient and rolling of animal in right direction. When 3-4 rolling fail to correct torsion cesarean section must be done immediately.
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Dhaliwal, G.S., Prabhakar, S. and Sharma, R.D. (1993). Torsion of pregnant uterine horn in a cow--A case report. Indian J Anim ReprodM: 129.
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Prasad, S., Singh, O.V. and Dabas, Y.P.S. et al. (1998). Clinical management of delayed uterine torsions of more than 360[degrees] in buffaloes--Case reports. Indian Vet J 75: 890-91.
Purohit, G.N. (2006). Maternal causes of dystocia in cows and buffaloes. In, Suresh SH, Tandle MK eds. Veterinary Obstetrics A Practical Guide, Jaypee Brothers Medical Publishers New Delhi p. 16-25.
Purohit, G.N. and Mehta, J.S. (2006). Dystocia in cattle and buffaloes: A retrospective analysis of 156 cases. Vet. Pract. 7: 31-34.
Prabhakar, S., Singh, P. and Nanda, A.S. et al. (1994). Clinico obstetrical observations on uterine torsion in bovines. Indian Vet. J. 71: 822-24.
Prabhakar, S., Dhaliwal, G.S. and Sharma, R.D. et al. (1997). Success of treatment and dam survival in bovines with pre-cervical uterine torsion. Indian J Anim. Reproof 18: 121-23.
Singh, J. and Dhaliwal, G.S. (1998). A retrospective study on survivability and fertility following cesarean section in bovines. Indian J Anim Reprod 19:21-23.
Khaja Mohteshamuddin (1), R.G. Bijurkar and M.K. Tandle
Department of Veterinary Gynaecology and Obstetrics Veterinary College Karnataka Veterinary, Animal and Fisheries Sciences University (KVAFSU) Bidar--585401 (Karnataka)
(1.) Assistant Professor and Corresponding author. E-mail: email@example.com
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|Title Annotation:||Short Communication|
|Author:||Mohteshamuddin, Khaja; Bijurkar, R.G.; Tandle, M.K.|
|Date:||Jul 1, 2014|
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