Cattle C-section: Advantages and disadvantages

The cesarean section is among the oldest surgical procedures performed in veterinary medicine [1]. The indications for a cesarean operation and the rationale behind making an appropriate decision have been extensively reviewed [2]. Analysis of published cases indicates that the following six major indications collectively account for 90% of all cesarean operations: fetomaternal or fetopelvic disproportion, incomplete dilation or induration of the cervix, uterine torsion, fetal anomalies, abnormal fetal disposition, fetal emphysema [3]. However, among cattle veterinarians, there is a diversity of opinions regarding cesarean sections: some advocate for the procedure, citing its benefits and favorable outcomes, while others contend that it has a negative economic impact and poor long-term prognosis [2]. The main C-section techniques and their advantages are the following [2]: • Left paralumbar: prevents intestinal prolapse but may cause rumen prolapse and difficulty extracting the calf; • Right paralumbar: harder to keep intestines inside; used for large calves in the right uterine horn; • Ventral midline/paramedian: preferred when the cow cannot stand; better for fetal emphysema but challenging suturing and udder interference; • Ventrolateral (lying): hidden incision, easier uterus access, but high infection and herniation risk; • Left-sided oblique (standing): commonly used, allows better uterine access and calf extraction but requires physical strength. The primary determinant of a successful cesarean section in bovines is the timing of the intervention. Early surgical intervention significantly increases the probability of survival for both the cow and the calf. Current veterinary guidelines recommend performing a cesarean section within a maximum of six hours to optimize outcomes [1]. If legs and/or the head cannot be manually repositioned into the birth canal, an immediate decision to perform a C-section should be made [2]. Caution should be taken when predicting the outcome in cases of emphysematous fetuses: fetotomy is not always an option, and in such cases, the survival rate after surgery is also quite low. Intensive post-operative care and high doses of medication are essential for the cow’s recovery [4].