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Polish Journal of Veterinary Sciences Dec 2023The Black-and-White (BW) breed, which until recently had dominated in Europe, was replaced by the Holstein-Friesian (HF) breed. As a result, the incidence of dystocia...
The Black-and-White (BW) breed, which until recently had dominated in Europe, was replaced by the Holstein-Friesian (HF) breed. As a result, the incidence of dystocia has increased. Dystocia occurs most frequently in heifers, and it is associated with high calf weight and/or too narrow pelvic openings in heifers. The aim of this study was to evaluate retrospectively the effects of pelvic dimensions and rump angle on calving ease in two cattle breeds. The research was carried out in four barns where BW and HF cattle were used. The course of parturition was evaluated in 317 heifers (BW, n=169; HF, n=148) based on direct observations. Calves were weighed, external and internal pelvic measurements were performed (using the Rice pelvimeter), and rump angle was determined in heifers. Based on the course of parturition, heifers of both breeds were divided into easy calving (EC) and difficult calving (DC) groups. The frequency of DC was 24.3% in HF heifers and 13.1% in BW heifers. In comparison with DC heifers, EC heifers had a larger pelvic area, in particular the internal dimensions of the bony pelvis, and a higher rump angle. In comparison with BW heifers, HF heifers had a smaller rump angle, a narrower pelvis and a lower ratio of pelvic area to calf weight. High dystocia rates in HF heifers could result from a relatively large fetus size and a less preferable pelvic size and rump angle. High variation in the internal pelvic dimensions in HF heifers indicates that the incidence of dystocia can be reduced through selection for a larger pelvic size and the optimal rump angle.
Topics: Cattle; Pregnancy; Animals; Female; Birth Weight; Retrospective Studies; Pelvis; Dystocia; Parturition; Cattle Diseases
PubMed: 38088415
DOI: 10.24425/pjvs.2023.148288 -
Journal of Midwifery & Women's Health 2015Contemporary labor and birth population norms should be the basis for evaluating labor progression and determining slow progress that may benefit from intervention. The... (Review)
Review
Contemporary labor and birth population norms should be the basis for evaluating labor progression and determining slow progress that may benefit from intervention. The aim of this article is to present guidelines for a common, evidence-based approach for determination of active labor onset and diagnosis of labor dystocia based on a synthesis of existing professional guidelines and relevant contemporary publications. A 3-point approach for diagnosing active labor onset and classifying labor dystocia-related labor aberrations into well-defined, mutually exclusive categories that can be used clinically and validated by researchers is proposed. The approach comprises identification of 1) an objective point that strictly defines active labor onset (point of active labor determination); 2) an objective point that identifies when labor progress becomes atypical, beyond which interventions aimed at correcting labor dystocia may be justified (point of protraction diagnosis); and 3) an objective point that identifies when interventions aimed at correcting labor dystocia, if used, can first be determined to be unsuccessful, beyond which assisted vaginal or cesarean birth may be justified (earliest point of arrest diagnosis). Widespread adoption of a common approach for diagnosing labor dystocia will facilitate consistent evaluation of labor progress, improve communications between clinicians and laboring women, indicate when intervention aimed at speeding labor progress or facilitating birth may be appropriate, and allow for more efficient translation of safe and effective management strategies into clinical practice. Correct application of the diagnosis of labor dystocia may lead to a decrease in the rate of cesarean birth, decreased health care costs, and improved health of childbearing women and neonates.
Topics: Cesarean Section; Delivery, Obstetric; Dystocia; Female; Humans; Labor Onset; Labor, Obstetric; Oxytocin; Pregnancy; Trial of Labor
PubMed: 26461189
DOI: 10.1111/jmwh.12360 -
Reproduction in Domestic Animals =... Sep 2023Ultrasonography can be used for canine pregnancy diagnosis, determination of gestational age, assessing foetal maturation and readiness for birth, monitoring high-risk... (Review)
Review
Ultrasonography can be used for canine pregnancy diagnosis, determination of gestational age, assessing foetal maturation and readiness for birth, monitoring high-risk pregnancies, assessing foetal distress, evaluating bitches in dystocia and foetal gender determination. As the quality and resolution of ultrasound machines have improved, the clinician's abilities to utilize ultrasound as an integral part of reproductive evaluation of all aspects of pregnancy have exponentially increased. This paper reviews the use of ultrasonography throughout pregnancy and the advances made in the interpretation of captured images.
Topics: Female; Pregnancy; Animals; Dogs; Dystocia; Fetal Development; Gestational Age; Reproduction; Ultrasonography; Dog Diseases
PubMed: 37724659
DOI: 10.1111/rda.14446 -
Medicina (Kaunas, Lithuania) Mar 2021: Fetal overgrowth is related to many perinatal complications, including stillbirth, cesarean section, maternal and neonatal injuries, and shoulder dystocia. It is... (Review)
Review
: Fetal overgrowth is related to many perinatal complications, including stillbirth, cesarean section, maternal and neonatal injuries, and shoulder dystocia. It is related to maternal diabetes, obesity, and gestational weight gain but also happens in low-risk pregnancies. There is ongoing discussion regarding definitions, methods of detection, and classification. The method used for detection is crucial as it draws a line between those at risk and low-risk popula-tions. : For this narrative review, relevant evidence was identified through PubMed search with one of the general terms (macrosomia, large-for-gestational-age) combined with the outcome of interest. : This review summarizes evidence on the relation of fetal overgrowth with stillbirth, cesarean sections, shoulder dystocia, anal sphincter injury, and hem-orrhage. Customized growth charts help to detect mothers and fetuses at risk of those complica-tions. Relations between fetal overgrowth and diabetes, maternal weight, and gestational weight gain were investigated. : a substantial proportion of complications are an effect of the fetus growing above its potential and should be recognized as a new dangerous condition of Fetal Growth Acceleration.
Topics: Acceleration; Cesarean Section; Diabetes, Gestational; Dystocia; Female; Fetal Macrosomia; Humans; Infant; Infant, Newborn; Pregnancy
PubMed: 33801377
DOI: 10.3390/medicina57030228 -
The Journal of Dairy Research Aug 2023We investigated the relationship between dam's pelvic and calf's dimensions with dystocia due to fetopelvic disproportion in the Holstein breed and estimated risk...
We investigated the relationship between dam's pelvic and calf's dimensions with dystocia due to fetopelvic disproportion in the Holstein breed and estimated risk factors and dystocia probability. For this purpose, external pelvic measurements were performed in 402 heifers 15 ± 11 (1-38) days ante-partum and specific conformation measurements were obtained from their calves 1.7 ± 1.2 post-partum. Dystocia was defined as the inability of the heifer to complete parturition spontaneously within 120 min after the appearance of the amnion with normal presentation, position and posture or as having definite obstetrical obstacles within 60 min. Overall and fetopelvic disproportion dystocia incidence was 10.4% and 5.2%, respectively. Heifer measurements mainly influenced overall dystocia, whereas calf conformation was related solely with fetopelvic dystocia. Specifically, heifers with a small pelvis (hip width <49.95 cm, pelvic inlet area <333.2 cm, pelvic volume <7799.2 cm) had 2.8 to 3.5 times greater incidence of overall dystocia (19.0-20.8%) compared to heifers with a larger pelvis (incidence of 7.0-7.6%). Regarding calf factors, sex (male calves), body weight, chest circumference and fetlock joint circumference significantly increased the odds of experiencing dystocia due to fetopelvic disproportion compared with female, lighter or smaller calves. In a backward elimination model with independent variables treated as continuous, an area under the ROC curve of 0.66 regarding the prediction of overall dystocia based on heifer pelvic length, and of 0.64 for the prediction of fetopelvic dystocia based on fetlock joint circumference was found. The combination of the two variables in one model improved the ROC area to 0.71 regarding dystocia due to fetopelvic disproportion, reaching acceptable level of discrimination. Our findings indicate that dystocia due to fetopelvic disproportion in heifers is mainly influenced by the fetal side. Additionally, the estimation of pelvic dimensions of the dam before parturition and specific conformation characteristics of the calf during parturition, especially fetlock joint circumference, could aid obstetricians and herdsmen regarding dystocia probability and parturition surveillance.
Topics: Pregnancy; Animals; Cattle; Female; Male; Birth Weight; Dystocia; Pelvis; Body Weight; Parturition; Cattle Diseases
PubMed: 37587723
DOI: 10.1017/S0022029923000468 -
Obstetrics and Gynecology Clinics of... Dec 2017The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 49 on Dystocia and Augmentation of Labor defines a prolonged second stage as more... (Review)
Review
The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 49 on Dystocia and Augmentation of Labor defines a prolonged second stage as more than 2 hours without or 3 hours with epidural analgesia in nulliparous women, and 1 hour without, or 2 hours with epidural in multiparous women. This definition diagnoses 10% to 14% of nulliparous and 3% to 3.5% of multiparous women as having a prolonged second stage. Although current labor norms remained largely based on data established by Friedman in the 1950s, modern obstetric population and practice have evolved with time.
Topics: Cesarean Section; Dystocia; Female; Humans; Labor Stage, Second; Parity; Patient Care Management; Pregnancy; Risk Factors; Time Factors
PubMed: 29078938
DOI: 10.1016/j.ogc.2017.08.009 -
Journal de Gynecologie, Obstetrique Et... Dec 2015The objective of this review is to propose recommendations on the management of shoulder dystocia. (Review)
Review
OBJECTIVE
The objective of this review is to propose recommendations on the management of shoulder dystocia.
MATERIALS AND METHODS
The PubMed database, the Cochrane Library and the recommendations from the foreign obstetrical societies or colleges have been consulted.
RESULTS
In case of shoulder dystocia, if the obstetrician is not present at delivery, he should be systematically informed as quickly as possible (professional consensus). A third person should also be called for help in order to realize McRoberts maneuver (professional consensus). The patient has to be properly installed in gynecological position (professional consensus). It is recommended not to pull excessively on the fetal head (grade C), do not perform uterine expression (grade C) and do not realize inverse rotation of the fetal head (professional consensus). McRoberts maneuver, with or without a suprapubic pressure, is simple to perform, effective and associated with low morbidity, thus, it is recommended in the first line (grade C). Regarding the maneuvers of the second line, the available data do not suggest the superiority of one maneuver in relation to another (grade C). We proposed an algorithm; however, management should be adapted to the experience of the operator. If the posterior shoulder is engaged, Wood's maneuver should be performed preferentially; if the posterior shoulder is not engaged, delivery of the posterior arm should be performed preferentially (professional consensus). Routine episiotomy is not recommended in shoulder dystocia (professional consensus). Other second intention maneuvers are described. It seems necessary to know at least two maneuvers to perform in case of shoulder dystocia unresolved by the maneuver McRoberts (professional consensus).
CONCLUSION
All physicians and midwives should know and perform obstetric maneuvers if needed quickly but without precipitation.
Topics: Birth Injuries; Delivery, Obstetric; Dystocia; Extraction, Obstetrical; Female; Humans; Infant, Newborn; Practice Guidelines as Topic; Practice Patterns, Physicians'; Pregnancy; Shoulder
PubMed: 26530178
DOI: 10.1016/j.jgyn.2015.09.048 -
Tierarztliche Praxis. Ausgabe G,... Oct 2023Dystocia represents a life-threatening condition for mare and foal. Morbidity and mortality rates due to a difficult birth, as well as the influence on fertility of the... (Review)
Review
Dystocia represents a life-threatening condition for mare and foal. Morbidity and mortality rates due to a difficult birth, as well as the influence on fertility of the mare were analyzed, based on a review of publications. This was aggravated by the fact that no standardized diagnostic code was used and that most publications do not clearly describe how extensively the examinations were performed beforehand. Retentio secundinarum is the most common complication caused by dystocia. Other complications are injuries to the soft birth canal and the colon. These occur more frequently after surgical obstetrics than following assisted vaginal deliveries. Performing a fetotomy increases the risk of injury to the birth canal. After a caesarean section, the risk for retained placenta increases significantly. In order to evaluate the possibility of medical progress over time, mortality rates of mare and foal were investigated and divided in surgical and conservative obstetrics within the period of 1970-1990 and 1991-2021. The average maternal mortality rate following caesarean section amounted to 18% in the time period between 1970 and 1990 and 14% between the years from 1991-2021. After fetotomy, the two determined mortality rates amounted to 29% and 10% for the time between 1970 and 1990. In the period 1991-2021, the rate varies between 4% and 44% with an average mortality rate of 14%. Following controlled vaginal delivery, the average mortality rate is 9%. Literary sources were however only available for the current time period and range between 6% and 29%. The morbidity and mortality rate of foals is very high. Following caesarean section on average 53% of foals are dead on delivery, with a range of 13-79% in case reports from the years 1991-2021. The number of dead foals in the context of conservative obstetrics is of a similar scale. Postnatal foal diseases are largely due to intrapartum hypoxia during dystocia and obstetric injury. In consequence of a difficult delivery, mares experience reduced fertility. In numerous cases this however may be compensated by pausing from further breeding in the same year. The number of cases evaluated in this context however remains too small to advocate any recommendations for breeding following incidents of dystocia.
Topics: Animals; Horses; Female; Pregnancy; Cesarean Section; Dystocia; Delivery, Obstetric; Parturition; Morbidity
PubMed: 37956674
DOI: 10.1055/a-2180-2182 -
Journal of Feline Medicine and Surgery Mar 2022Cats are common pets worldwide. Successful breeding of cats starts with the selection of suitable breeding animals, and care should be taken to avoid inbreeding. Keeping... (Review)
Review
PRACTICAL RELEVANCE
Cats are common pets worldwide. Successful breeding of cats starts with the selection of suitable breeding animals, and care should be taken to avoid inbreeding. Keeping cats in smaller groups reduces stress and facilitates management.
CLINICAL CHALLENGES
Breeding cats is challenging in many ways. Group housing is a common scenario, and care should be taken not to have groups that are too large, because of the risk of stress and infectious diseases. Feline pregnancy and parturition both vary in length, which is one reason why it may be challenging to diagnose dystocia. In queens with pyometra, a vaginal discharge may not be evident due to their meticulous cleaning habits.
AUDIENCE
This review is aimed at clinicians in small animal practice, especially those in contact with cat breeders.
PATIENT GROUP
Reproductive emergencies occur in both intentionally and unintentionally bred cats, and more often in young or middle-aged queens. Pyometra tends to be a disease of older queens.
EVIDENCE BASE
Evidence is poor for many conditions in the breeding queen, and information is extrapolated from the dog or based on case reports and case series.
Topics: Animals; Breeding; Cat Diseases; Cats; Communicable Diseases; Dystocia; Female; Pregnancy; Pregnancy Complications; Pyometra; Reproduction
PubMed: 35209770
DOI: 10.1177/1098612X221079708 -
The Medico-legal Journal Mar 2022Shoulder dystocia, or shoulder entrapment at birth, is an obstetrician's nightmare, which not infrequently leads to court litigation with complaints of serious foetal...
Shoulder dystocia, or shoulder entrapment at birth, is an obstetrician's nightmare, which not infrequently leads to court litigation with complaints of serious foetal and/or maternal damage. Increasingly, retrospective management scrutiny is extending well beyond second stage birth mechanics and involving all case file entries, history taking, ultrasound scan measurements and haematology profile results, etc. The article highlights some medico-legal issues including the influence of the ruling on patient disclosure and subsequent management.
Topics: Dystocia; Female; Humans; Infant, Newborn; Pregnancy; Retrospective Studies; Shoulder; Shoulder Dystocia
PubMed: 35156438
DOI: 10.1177/00258172211066364