Episiotomy in Animals: Indication, Restraining, Instruments & Procedure in Veterinary Obstetrics

Episiotomy is a surgical incision made in the vulvar region, specifically through the perineum, to enlarge the birth canal and facilitate delivery during difficult parturition.

In veterinary obstetrics, it is commonly performed in primiparous animals or in cases where the vulva and perineum are too tight to allow safe passage of the fetus, helping to prevent severe tissue tearing or trauma.

Indications

Episiotomy is a preventive measure employed to avoid uncontrollable tearing of the vulva and perineum during parturition. It should not be performed until the vulva and surrounding tissues have undergone sufficient relaxation.

If necessary, an episiotomy can be combined with fetotomy to facilitate delivery.

This procedure is primarily indicated in primiparous animals when dystocia is caused by incomplete dilatation of the vulva.

In older animals, it may also be performed when fibrosis and constriction of the vulva have resulted from previous lacerations.

Restraint

Low epidural anaesthesia/analgesia is administered to provide restraint and minimize discomfort during the procedure.

Instruments

Two obstetrical chains and a rope or chains with handles, a pair of blunt and sharp-pointed scissors, 2–3 haemostats, a needle driver, No. 2 chromic catgut, No. 2 silk or synthetic non-absorbable suture material, and suture needles.

Procedure

When the fetus is presented anteriorly, its head is secured with a snare and brought posteriorly so that it engages the dorsal part of the vulva, stretching it as taut as possible.

In the case of a posteriorly presented fetus, the hind limbs are secured and advanced until the vulva is sufficiently stretched. Using scissors, one or both lips of the vulva are incised about 3–6 cm away from the dorsal commissure.

Each incision is made in a dorsolateral direction over the tightly engaged fetal part, on which constant traction is maintained.

The incisions are continued until the fetus can be delivered through the vulva with minimal resistance. Intrauterine liquid replacer should be applied liberally during the procedure.

After delivery of the fetus, both incisions are carefully apposed and sutured if deemed necessary—the vaginal mucosa with a continuous catgut suture and the perineal skin with simple interrupted non-absorbable sutures.

Healing may be accompanied by fibrosis and permanent constriction of the vulva, which has to be taken into account if further breeding of the animal is considered.