分娩12-24小时前狗会造巢，伴随子宫收缩频率增加，颤抖产热等。.ppt

1、犬貓產科,分娩前徵狀,體溫下降是重要的指標。在分娩第一期肛溫下降明顯，可能在12小時內開始分娩。小型狗下降到35，中型狗下降到36。分娩12-24小時前狗會造巢，伴隨子宮收縮頻率增加，顫抖產熱等。,Parturition within 12 hours,貓分娩前體溫下降的情形不如狗明顯。但貓分娩前會明顯焦慮不安且無食慾。,分娩,一般分娩間隔為5-120分鐘。80%分娩時是左右子宮角輪流娩出胎兒。胎兒數目多時，可能中間停留2小時，待排出胎盤後又再回復第二期。正常分娩應於第二期後6-12小時以內完成，超過24小時者對小狗及母體都不利。,難產,長頭狗可到10%的發生率。 體溫下降後又回復正常體溫，但

2、仍不見分娩者。狗排出綠色，貓排出紅褐色分泌物，但仍不見胎兒排出者。 尿水或羊水已排出2-3小時仍未見胎兒者。,難產,陣痛消失2小時以上或陣痛減弱。間隔超過2小時而未見下一隻小狗被分娩出時。 胎兒卡在產道時，或有明顯的難產原因如骨盤骨骨折時。產出死胎者。 有toxemia症狀時，身體狀況不佳，全身性水腫，出血，休克等。,母因性難產,子宮無力目前為狗貓難產的主要原因。原發性子宮無力起因於只懷1或2隻小狗，胎兒太多，胎水過多，胎兒過大等原因。 其他如遺傳、營養、脂肪浸潤肌肉層、年齡、神經內分泌不協調或是全身性疾病等。 繼發性子宮無力多是因為產道阻塞以致子宮肌肉層活力耗盡。,Pronounced to

3、ne,Flaccidity,母因性難產,先帶狗小跑。 確定產道無阻塞後，可給10% calcium gluconate, iv(1ml/min), 0.5-1.5 ml/Kg，隨時注意心跳，為保持小型狗的體力， 可給予10-20 ml 10 %glucose 。,母因性難產,給予鈣劑後若陣痛開始持續，則可考慮給予oxytocin(狗1-5 IU iv或2.5-10 IU, im，貓則給於0.5 IU，但不超過3 IU)。 若給oxytocin 2次無反應，則改用人力助產夾出胎兒(胎數少)或考慮使用帝王切開術。,胎因性難產,oversized fetuses posterior presenta

4、tion breech presentation lateral or downward deviation of the head backward flexion of front legs transverse or bi-cornual presentation 2 fetuses presenting simultaneously,oversized fetuses posterior presentation breech presentation lateral or downward deviation of the head backward flexion of front

5、 legs transverse or bi-cornual presentation 2 fetuses presenting simultaneously,Obstetricians check list,How many offspring already born?Approximate time of births and living state of any fetuses deliveredPassage of placenta?,Visual inspection of the vulvaVisual inspection of mammary glands,Note any

6、 fetal movementThe degree of the abdominal distensionThe presence of milk in the mammary glands,Obstetricians check list,Gynecological exam: digital vaginal examination,Check for presence of an amniotic vesicle or fetus,Check presentation of fetus,Assess tone and dimensions of the anterior vagina,De

7、termine the presence and nature of vaginal fluids,Assess dimensions of the bony pelvis,Obstetricians check list,Diagnosis of the cause of dystocia and treatment,Evaluate case history, health, and the results of vaginal and abdominal examinations,What is the cause of the dystocia?,The basic plan of t

8、reatment will be to deliver any presenting fetuses and encourage the uterus to present the remaining puppies at the pelvic,Is the litter at immediate risk?Is C-section necessary?,Obstetricians check list,Treatment options for dystocia case,Conservative treatmentAssisted delivery of a presenting fetu

9、sEcbolic administration followed by vaginal examMonitor the delivery of further offspring assisted manual delivery as requiredAssisting the efficiency of strainingForceps deliveryC-sectionConfirm delivery of the whole litter,難產救助,助產時需注意狗的骨盤腔開口較陰道高5-15 cm，而貓差不多是一致的高度，故牽引胎兒的方向時，小狗向後下方，而小貓向後方即可。,難產救助,陰

10、道觸診或x ray可知道胎位胎勢。 使用潤滑液是必須的，先將胎兒推回骨盤腔方向，可有較大空間調整胎勢，但要在母狗不努責時進行。,難產救助,骨盤腔之斜角線較寬，故牽引胎兒時可轉45，一邊頂住肛門周圍，再左右牽引。,難產救助,以雙指扣住頭頸部或臀部，另一隻手由母畜腹部撐住幫忙推。,難產救助,助產夾只適用於過大胎兒助產，而只有1或2隻過大胎兒時使用。助產夾只可夾頸部或臉頰部或骨盤骨，夾四肢上端但不可夾掌部。,Obstetricians check list,Maternal behavior unreliable indicator,Vaginal examination,Abdominal pal

11、pation,Abdominal Radiography/ultrasonography,Is parturition complete?,Clinical case,Female Golden Retriever1-year-old38.7 CMating on 4. Oct. and 5. OctAsk for a obstetric examination on 10. Dec.,All the puppies were delivered on 10. Dec.,Clinical case,Female mixed3-year-old37.4 CMated 64 days agoOne

12、 puppy was born last nightDepression, anorexia, green discharge was seen around vulva,Obstetricians check list,Assess fetal hearts is audible,Systemic manual palpation of the abdomen,Ultrasonographic examination of patients abdomen to confirm presence, viability, or evidence of fetal death,Radiograp

13、hic exam of abdomen: possible number or any further fetus, gross maldisposition,Gynecological exam: examination of the abdomen,Clinical case,Taiwan native2.5-year-old38.8 CMated 62 days agoDepression, anorexia, no discharge was seen around vulvaUltrasound: one dead fetus and another puppy with 104 heart beats/ min,Thanks for your attention!,