AS CESAREAN SECTION became a practical solution to bovine dystocia, emphasis on fetotomy (embryotomy) markedly declined until, in many schools of veterinary medicine, the student now receives only limited instruction and training in application of the technique.
Throughout my professional career I have been convinced that fetotomy has a proper place in veterinary obstetrics. Admittedly, to many times fetotomy has been used as a last resort solution to dystocia. Too often, extensive efforts have been wasted on excessive traction and manipulation, the reason (excuse would be more accurate) being lack of technical knowledge and the unsuitable design of instruments.
I was privileged to spend a sabbatical leave ( 1968-69) with Professor Dr. C. H. W. deBois (the colleague with whom this manual was co-authored) at the Clinic for Veterinary Obstetrics and Gynecology, The State University of Utrecht, Utrecht, The Netherlands. There I observed, learned and practiced the techniques and procedures described in this manual. This experience entirely changed my concept of fetotomy.
Formerly, my primary concern was focused on the fetus, with the welfare of the dam secondary. At Utrecht the reverse is true, the purpose of fetotomy being to achieve sufficient reduction of fetal size to permit safe extraction, thereby avoiding the risk of stress and injury caused by excessive traction and manipulation.
My convictions were further strengthened at Utrecht by observations of postfetotomy recovery. The vast majority of dystocias relieved by fetotomy had a definitely shorter recovery time as compared with those relieved by cesarean section. At Utrecht, far more cesarean sections than fetotomies are performed annually (approximately 500 cesarean sections as compared to approximately 200 fetotomies).
The argument that a complete (total) fetotomy is too timeconsuming is not valid. I have seen Professor Dr. deBois perform a complete fetotomy in twenty minutes.
This manual is written with the thought of sharing the procedures and techniques of fetotomy with students and fellow colleagues. There is no intent of portraying those techniques as being my own; they are those taught at Utrecht. ................... Dr. C. J. Bierschwal
A VERY PRIMITIVE FORM of fetotomy was even used in early history. The Greek scholar, Aristoteles (4th century before Christ), and the Roman author, Columella (1st century after Christ), report this technique in their writings. However, centuries had passed before a practical method of fetotomy was developed.
Early ii the 18th century came the development of the subcutaneous fetotomy. At the end ofthe 18th century arid in the beginning of the 19th century several boks appeared in the Ne.therlands describing this technique. During the 19th century, the technique of subcutaneous fetotomy was being constantly perfected. At present we still teach the principles of subcutaneous fetotomy. Since 1930, the subcutaneous fetotomy has been gradually replaced by percutaneous fetotomy.
Franck experimented in 1876 with a wire saw but, due to the lack of the right materials and other parts of equipment, this methOd was not suitable for practical use. Later workers, among others van Staa and Ehler (1903), improved the quality of the wire saw, although the technique became more practical after the construction of suitable parts in 1906 by Neuharth and in 1921 by Thygesen. The fetatome of Thygesen became the more popular, forming the basic design for the instrument devised by my predecessor, van der Kaay, which is stiil being used.
With the introduction of the use of epidural anesthesia for the cow by Benesch in 1926, a basis was formed for a quick and efficient percutaneous fetotomy. This technique has been perfected through the years and the principles of the procedure which we use are found in this manual.
Each year we deliver approximately 1300 cows, of which 200 are by fetotomy and 500 by cesarean section. The decision as to fetot;omy or cesarean section is made on the basis of fetal life and economic value. As an example, if the cause of dystocia is a large fetus and there is no fetal life, a fetotomy is performed. If the fetus is alive, the value of the fetus is the deciding factor. as to which procedure will be performed.
The charges for fetotomy in the Netherlands are less than half that asked for a cesarean section. In the Netherlands, a veterinary obstetrician is expected. to be skilled in both of these delivery techniques. Prof. Dr. C. H. W. deBois