Factors affecting outcomes of bovine cesarean sections, with a focus on maternal survival to 14 d after surgery.

Abstract

Objective: The objective was to determine associations between various factors before, during, and following cesarean sections in cattle done in the United Kingdom from November 2013 to October 2015.

Animals and procedure: This was a non-randomized, observational study that collected > 300 variables related to the surgery and possible relationships with the outcomes, with a focus on postoperative dam survival. More than 4600 cases were collected by ~400 veterinarians in 51 clinics, members of the XLVets UK group. Information was collected via 3 questionnaires: the 1st shortly after surgery, the 2nd during a 14-day follow-up, and the 3rd during a 12-month check (done 18 mo postoperatively).

Results and conclusion: Ultimately, 2900 cases were analyzed with a multilevel fixed-effects logistic regression, with veterinarians nested within practices as random effects used to estimate associations between explanatory variables and outcome. The hypothesis that the incidence of dam death by 14 d postoperatively is not significantly different between dairy versus beef cattle was rejected. Strong predictors that improved dam survival 14 d postoperatively were shorter duration of surgery (from skin incision to calf removal), paravertebral anesthesia, exteriorizing the uterus for hysterotomy, a beef dam, the dam standing during surgery, and oversewing (double layer) the uterine incision. In contrast, strong predictors that deteriorated dam survival were a worsening uterine index score, a higher score of veterinarian dissatisfaction with the surgery, a higher lactation number, and twin pregnancy. Several variables did not significantly affect dam survival, including antisepsis type or protocol, suture material or pattern used for closure of any incision, type of antibiotic used or where applied, use of a protective drape, rinsing or cleansing the uterine incision, removing abdominal blood clots, calf sex, or cause of dystocia.