Anaesthesia for Caesarean Section - Part 1

Immediate survival rate of puppies delivered by Cesarean-section is reported as 92% falling to 87% and 80% at two hours and 7 days, respectively (1,2). Although this is much improved from reports in the 1960’s when mortality rates were as high as 36% (3), it is still much greater than infant mortality following C-section in women (4). Mortality rates for bitches undergoing cesarean section dropped from approximately 13% (3) to 1% (1,2) over the past 40 years but is high compared to women in developed countries where overall maternal mortality has dropped to approximately 1 in 10,000 deliveries. Much of this improved success in women is attributed to better anesthetic management (5). We must strive for higher survival rates in our veterinary patients and their offspring.

Preparation for surgery
Over half of canine cesarean sections are emergency procedures (1). Puppy mortality is 12.7% in an emergency situation compared to 3.6% when elective. When labour is prolonged, dehydration, hypovolemia, sepsis, stress, exhaustion, and hypocalcaemia may be present leading to worse outcomes. Elective procedures should be considered in Bulldogs which constitute 17% of all cesarean sections (2).

In an elective situation there is time for a complete physical examination and blood work. In an emergency there may be no time to await results of all blood work, but a haematocrit, total protein, blood urea nitrogen, and blood glucose should always be measured before embarking on surgery. [...]