A review of small ruminant Cesarean section: case selection, surgical techniques, care of the neonates, and postoperative care of the dam

Cesarean section is an important life-saving surgical procedure frequently performed by small ruminant practitioners. Knowledge of normal parturition and indications for obstetrical intervention are necessary for successful outcomes. If a doe or ewe is observed in active labor for more than an hour without signs of progression toward delivery of a fetus, obstetrical examination is indicated to guide appropriate interventions. It is often possible to relieve a dystocia without surgical intervention if the cervix is adequately dilated and the dam’s pelvis is of sufficient size to allow manipulation of the fetus. If vaginal delivery cannot be performed safely, a Cesarean section or fetotomy is indicated. The surgery is generally performed with sedation and local anesthesia, with a lumbosacral epidural preferred by the authors. The dam may be positioned in right lateral recumbency, standing, or dorsal recumbency, based on the surgeon’s preference and specifics of the case. The abdomen is entered routinely, the gravid uterus identified, and gently exteriorized through the abdominal incision. A hysterotomy incision is made over the greater curvature of the uterus to allow removal of the fetus(es). The uterus is closed with absorbable suture using an inverting pattern. The abdominal incision is closed routinely. Systemic antibiotics, ecbolic agents, and analgesic agents are recommended for the dam postoperatively. Survival of the dam is reported at 81–99% with post-surgical complications encountered in 33–77% of cases. Females may be retained for future breeding following surgery, with 84–100% of females reported to become pregnant in the subsequent breeding season.