Impact of decision to delivery time of fetal mortality in canine caesarean section in a referral population

Abstract

In human medicine, there is a recommended decision to delivery interval (DDI), which allows for the optimization of protocols and systematic review of hospital success. In veterinary medicine, no such guideline has been established or investigated. The purpose of this study was to investigate the relationship between the interval from the decision to perform a caesarean section and the delivery of the neonates and fetal mortality at the time of surgery. One hundred and fifty canine caesarean sections were evaluated retrospectively. Caesarean cases were dichotomized to those that had at least one perinatal death and cases where all puppies survived. Factors that increased the likelihood of at least one perinatal death at caesarean section were: cases that presented as an emergency caesarean section, the dam presenting with a fetus in the vaginal canal, the dam not having a history of previous caesareans sections, and being multiparous. Even though there was no association of DDI with likelihood of having perinatal death, timing related factors that increased the likelihood of having at least one perinatal death at caesarean section were: cases where total anaesthesia time was longer than 2 h; time from induction to start of surgery was longer than 45 min and surgical time longer than 75 min. In conclusion, time is a factor in the success of canine caesarean sections and further research is needed to better define the optimal decision to delivery time in canine caesarean sections in order to optimize fetal survival and hospital protocol success rates.

Risk factors for neonatal mortality prior to hospital discharge in brachycephalic and nonbrachycephalic dogs undergoing cesarean section

“…8,9 Previously identified risk factors for neonatal death include emergency c-section for treatment of dystocia, obstructive dystocia, older age of the bitch, primiparous history, and increasing duration of anesthesia and surgery. 8,10,11 Despite the relatively low rate of neonatal death reported in previous studies across all breeds, neonatal outcomes in brachycephalic dogs appear to be worse when compared to nonbrachycephalic breeds. Results of one study showed that that brachycephalic bitches had half the odds of survival of all puppies in the litter at 2 hours post-c-section compared to litters from nonbrachycephalic bitches.…”

Incidence and concomitant factors of cesarean sections in the bitch: A questionnaire study

“…C-section has long been considered an emergency surgery (8, 17); however, the increasing reports on the benefits of elective C-sections have led to the conclusion that in certain cases an elective C-section, regardless of anesthesiological and surgical risks, has more benefits for both the mother and the litter than disadvantages (1,9,14). It has been reported that especially breeders of breeds highly at risk opt more frequently for an elective C-section (4,18). Therefore, different protocols have been described regarding the timing and preparation for elective C-sections as the correct timing is crucial to the survival of the neonates (10-12, 16, 19).…”

“…Despite the high number of studies on risk factors for dystocia in the canine, the role of prior C-sections as a risk factor is rarely reported (9,23). In a work by Proctor et al (18), 25 of 149 bitches had a history of prior C-section and nearly half of these bitches underwent an elective C-section at the end of the following pregnancy. Another very important factor driving the decisions of many breeders toward an elective C-section is the fear of stillbirth.…”

Retrospective study on the use of lumbosacral epidural analgesia during caesarean section surgery in 182 dogs: Impact on blood pressure, analgesic use and delays

“…A recent study identified the time between induction of anaesthesia and the start of surgery as a risk factor for neonatal death in dogs undergoing caesarean section. 14 The time between induction of anaesthesia and transferring the dog to the operating room was compared between our groups. We expected that differences could be attributed, at least in part, to time invested in performing the epidural injection.…”