Dystocia and its causes
Abdul Quddus
Lecturer, FVAS, LUAWMS
Introduction
• Normal birth, defined as “eutocia”
• Difficult birth is defined as ‘’Dystocia’’
• dystocia comes from the Greek, dys-meaning difficulty and tocos-
meaning birth
• Inability of the dam to deliver its young through its own effort
• Major factor in calf mortality at or near birth
Consequences and cost of Dystocia
• The consequences of dystocia are numerous, and will depend upon
the severity. Firstly, there are the financially unquantifiable effects on
the welfare of dam and offspring. Secondly, there are the quantifiable
financial consequences. Dystocia results in:
• increased stillbirth rate and mortality of the offspring
• increased mortality rate for the dam
• reduced productivity of the dam
• reduced subsequent fertility and increased chance of sterility in the dam
• increased likelihood of puerperal disease in the dam
• increased likelihood of subsequent culling of the dam
Stages of labour
• there are three stages/phases of labour:
• Phase 1:the activation phase, during which there is rapid softening of
the cervix and the myometrium prepares for contractions by increased
expression of contraction associated proteins (CAPs) as a result of the
removal of inhibitory factors (such as progesterone, relaxin); and
increase of uterotrophic factors (such as prostaglandins, oestrogens);
increased stretchability of the uterine wall
• Phase 2: characterized by increasing myometrial contractility (by steep
increases of prostaglandin and oxytocin release), dilatation of the cervix
and expulsion of the fetus passage of fetus through the birth canal
(Lasts from 30 minutes-3 hours)
• Phase 3: the afterbirth stage, expulsion of the fetal membranes one or
more hours after the fetus, and the start of uterine and cervical
involution (Lasts 12-24 hours)
Causes of Dystocia
• Obstetricians have usually regarded dystocia as being either maternal
or fetal in origin
• Maternal Causes
• constriction of birth canal or deficiency of expulsive forces
• pelvic inadequacies, incomplete dilation of the cervix
• uterine torsion and improper cervix dilation are the most frequent
• Fetal Causes
• Fetal disproportion
• Fetal faulty disposition
Maternal Causes
Pelvic constriction
• An inadequate pelvis is a very frequent cause of dystocia in
bovine primipara (heifers). The pelvis is late maturing,
compared with some other aspects of skeletal development;
however, between 2 and 6 years of age it keeps pace with, or
even exceeds, overall body weight. For this reason dystocia is
far less frequent in cows than heifers.
• Pelvic constriction following fractures, where there has been
poor alignment of the pelvic bones, can be an important
cause of dystocia in any species
Maternal Causes
Incomplete dilatation of the cervix
• Several days before, and during, the first stage of parturition
the cervix undergoes considerable changes in its structure so
that it can dilate, becoming completely effaced and thus
allowing the fetus to pass from the uterus into the vagina and
hence to the exterior
• Incomplete cervical dilation is more likely to be due to
hormonal dysfunction, which normally causes the cervix 'to
ripen', or to a failure of the cervical tissue (most probably
collagen) to respond to the hormones that cause ripening
• In the multiparous cow hypocalcaemia, perhaps subclinical,
can impair uterine contractions and perhaps prevent cervical
dilatation. administer calcium borogluconate subcutaneously
and wait several hours
Maternal Causes
Neoplasms
• Neoplasms of the vulva and vagina may occur in all species
and thus serve as potential causes of dystocia because of
physical obstruction, although in fact they seldom do so. In
the cow, papillomata, sarcomata and submucous fibromata
of the vagina and vulva occur
• Neoplasms of the cervix are so rare in animals as to be of no
consequence in a consideration of the causes of dystocia.
Maternal Causes
Vaginal cystocele
• This is the name given to a condition occasionally encountered in the
parturient cow in which the urinary bladder lies in the vagina or vulva.
It is of two types:
• Prolapse of the bladder through the urethra. This is more likely to occur in
the mare consequent on the great dilatability of the urethra and the force
of straining efforts in this species. The everted organ will occupy the vulva
and will be visible between the labia
• Protrusion of the bladder through a rupture of the vaginal floor. In this
condition the bladder will lie in the vagina and it will further differ from the
previous one in that the serous coat of the organ will be outermost.
Maternal Causes
Torsion of the uterus
• Rotation of the uterus on its long axis, with twisting of the anterior
vagina, is a common cause of bovine dystocia
• Uterine torsion is a complication of late first-stage or early second-
stage labour. It is probably due to instability of the bovine uterus
• The parturient factor is probably the violent fetal movements that
occur in response to the increasing frequency and amplitude of
uterine contractions during the first stage of parturition, as it assumes
the normal disposition for normal birth
• Excessive fetal weight is also a predisposing factor
• anticlockwise direction is more common than in the other direction
and accounts for about 75% of cases
Maternal Causes
• Expulsive deficiency
• The expulsive force of labour is due to a combination of myometrial
contractions, and straining induced by the contraction of the
abdominal muscles.
• oxytocin and prostaglandins are involved directly and indirectly in
myometrial contractions. Any deficiencies in these hormones, or their
receptors through which they exert their action, will prevent or
reduce myometrial contractions.
• Calcium and related inorganic ions such as magnesium have a critical
role in smooth muscle contractions. Any deficiency will impair these
contractions, causing uterine inertia
Fetal dystocia
Fetomaternal disproportion
• Fetomaternal disproportion occurs if the fetus is larger than normal -
or the pelvic canal is too small or of incorrect shape.
• Its commonest cause of dystocia in cattle
• Fetal faulty disposition
• during parturition fetus must assume a disposition that enables it to
be expelled through the birth canal. Since these dispositions are
incompatible, changes must occur during the first stage of labour
Fetal Faulty disposition
Three terminologies are used in obstetrics for fetal disposition; presentation,
position, and posture refer to the orientation and arrangement of the calf
within the cow's reproductive tract during the birthing process.
Presentation signifies the relationship between the longitudinal axis of the
fetus and the maternal birth canal. It includes longitudinal presentation,
which can be anterior or posterior depending on which fetal extremity is
entering the pelvis; transverse presentation, ventral or dorsal·
Position: It focuses on the alignment of the calf's body parts, such as the
head, limbs, and trunk, with respect to the cow's birth canal. The position
can be described in various ways, including: Dorsosacral Position: The calf's
head and limbs are aligned with the cow's spine, which is the normal
position for delivery. Deviation Positions: If the calf's head or limbs are
deviated to the right or left, it indicates an abnormal position that may
require intervention.
Fetal Faulty disposition
• Posture specifically focuses on the degree of joint flexion or extension in the calf's
limbs and neck.
• Normal posture in a calf involves a flexed position. This means that the calf's limbs
are flexed towards its body, and the neck is flexed towards the chest. This flexed
posture allows for a more streamlined passage through the birth canal. Abnormal
postures involve deviations from the normal flexed position. Some examples of
abnormal postures include:
• Hyperextended Limbs: This occurs when the calf's limbs are extended too far
outwards or backwards, away from its body. Hyperextension of the limbs can make
the delivery more difficult.
• Extended Neck: If the calf's neck is extended or stretched out, it deviates from the
normal flexed position. An extended neck posture can also complicate the delivery
process
Anterior presentation Posterior presentation
Anterior presentation with the Posterior presentation with the
rear legs extended beneath the rear limbs extended beneath the
fetus ("dogsitting" posture), fetus (breech presentation)
Prevention of Dystocia
• As with all diseases and disorders, veterinarians should be endeavouring to
prevent and reduce the incidence of dystocia.
• For certain categories, such as faulty fetal disposition, our knowledge of the
mechanisms that occur during the first stage of parturition and are responsible
for ensuring that the fetus assumes the correct disposition for its normal
expulsion is very incomplete.
• However, there are some types of dystocia that can be reduced significantly;
these are invariably based on good husbandry
• There are two“ approaches to reducing the frequency and the severity of
dystocia: first, attempting to ensure that the size of the birth canal is adequate;
second, attempting to ensure that the size and conformation of the calf is such
that it can pass through the birth canal.
• pelvic area is moderately to highly heritable and can be increased in a herd by the
selection of breeding heifers and bulls
