Obstetric manoeuvres

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It describes the actions by veterinarian to correct the abnormal PPP of fetus to help the fetus to get out.

Text of Obstetric manoeuvres

  • 1. OBSTETRIC MANOEUVRESByDr.Sulake Fadhil Abbas

2. OBSTETRIC MANOEUVRES1)Retropulsion (repulsion)2) Version3) Rotation4) Extension and adjustment of the extremities 3. Retropulsion (Repulsion)Retropulsion means pushing the fetus cranially from thevagina (and the bony pelvic canal) towards the uterus.Repulsion may be accomplished by the operator's arm orby the use of a crutch or repeller. In anterior presentation,the crutch or hand of the operator is usually placed on thefetus between the shoulder and chest or across the chestbeneath the neck. In the posterior presentation, the hand orcrutch is placed in the perineal region over the ischial arch. 4. Repulsion is difficult or impossible in the recumbentanimal resting on its sternum as the abdominal viscera arepushing the fetus back toward the pelvis. If the animal isrecumbent, it should be placed on its side with its fourlegs extended.Repulsion is difficult or impossible in the recumbentanimal resting on its sternum as the abdominal viscera arepushing the fetus back toward the pelvis. If the animal isrecumbent, it should be placed on its side with its fourlegs extended. 5. VersionVersion means alteration of transverse or vertical tolongitudinal presentation. This is done most oftenin the mare in transverse presentation of the fetus.The version is usually limited to 90 degrees and byrepulsion on one end of the fetus and traction onthe other, the transverse presentation is changed toa longitudinal presentation. If possible, the fetusshould be turned into a posterior presentation; thisprevents the head and neck from complicating thedelivery. 6. RotationRotation entails alteration of the position of a fetus bymoving it around its longitudinal axis: for example, fromthe ventral to dorsal position. It is more often required inhorses than in cattle and is much more easily effected onthe responsive live fetus, which may be readily rotated bydigital pressure on the eyeballs, protected by the lids; thiscauses a convulsive reaction, and slight rotational forcethen completes the manoeuvres 7. In dorso-ilial position, repulsion is usually notnecessary but may be helpful. Lubrication of thebirth canal caudal and downward traction on theextremities, and rotation of the fetus with theoperator's arm in the birth canal readily corrects thisabnormal position.If the fetus is in a dorso-pubic position it should berepelled out of the pelvis, leaving the limbs in thepelvic cavity, chains are fastened to the fetlock andcross traction is applied by two assistants. 8. Depending upon which way the fetus is to be rotated, oneleg is pulled at first upward, then horizontally to the left orright and then downwards, while the other leg is beingpulled underneath the first leg downward and obliquelytoward the right or left. 9. Anterior presentation , Dorso pubic positionRotation usingtorsion ForkPosterior presentation, dorso pubic and rotation by Fork 10. Carpal flexionTreatmentThe fetus is repelled and the flexed carpus pushedupwards and forwards from the obstetrician so thatthe missing foot can be found more readily. The footis cupped in the hand and brought carefully up intothe pelvis 11. Shoulder flexionThe obstetrician's hand is advanced down the limb towards the carpaljoint. The limb is grasped and brought up into the carpal flexion position,and then the foot is brought into the pelvis.The obstetrician's hand is advanced down the limb towards the carpaljoint. The limb is grasped and brought up into the carpal flexion position,and then the foot is brought into the pelvis. 12. TTHHAANNKKSS