Obstetrician’s view of the physiology of equine parturition and dystocia.

The research article is a comprehensive review of the author’s 40 years of clinical experience in handling more than a thousand cases of difficult births (dystocia) in horses (mares) of various breeds. It focuses on problems like stillbirth, injuries to the mare during childbirth, and prolonged pregnancy, suggesting strategies for prevention and treatment, including insight on when to resort to a caesarean section.

Clinical Experience & Dystocia Incidents

• The author uses his vast clinical experience over 40 years, handling more than 1000 cases of dystocia in mares, to provide insights into this significant issue.
• Dystocia, or difficulty in giving birth, has been addressed across various breeds of mares to give a comprehensive view.

Perinatal Mortality & Genital Tract Lesions

• The article discusses the high rate of stillbirths and perinatal death of foals, a major concern in equine obstetrics.
• The author also brings attention to severe lesions that develop in the mare’s genital tract during foaling and in the early postpartum period.
• Suggestions are provided to prevent and treat these complications, highlighting the importance of early detection and intervention.

Embryotomy & Caesarean Sections

• The author emphasizes the advantages of partial embryotomy, a procedure to remove a dead or nonviable foetus in parts, to avoid unnecessary caesarean sections.
• While recognizing the role of caesarean sections in managing difficult births, the author also raises concerns about their overuse or misuse.

Prolonged Gestation, Uterine Torsion & Transverse Presentation

• Special focus is given to cases of prolonged gestation, where the foal’s development extends beyond the normal gestation period causing complications during birth.
• The research discusses dystocia caused by prior torsion or twisting of the uterus before birth, a condition known as preparturient uterine torsion.
• The author also reviews instances of transverse presentation, where the foal is positioned horizontally instead of vertically in the uterus. This condition can arise from a bicornual (two-horned) pregnancy, and is identified as the most critical indication for a caesarean section.

Improved Caesarean Section Outcomes

• The research proposes recommendations to enhance the results of caesarean sections for both the mare and the foal.
• These suggestions potentially point towards better surgical techniques, preoperative and postoperative care, or innovations in veterinary anesthesia and medication.