Pre-operative and operative difficulties during bovine caesarean section in Belgium and associated risk factors.

The aim of this study was to describe the difficulties encountered during caesarean section (CS) in practice on mainly Belgian Blue (BB) cows and to identify the associated risk factors. Data were collected using a questionnaire completed by veterinarians of the Ambulatory Clinic of the Faculty of Veterinary Medicine, Ghent University (Belgium), immediately after performing a CS. Results revealed that the BB breed had fewer severe pre-operative problems than animals of other breeds, most probably due to the fact that CSs in this breed are performed in a very early stage of parturition. Mild as well as severe difficulties were more likely to happen during surgery in cows that had undergone a CS before. Cows at their second or third surgery had a significantly higher proportion of larger calves and more skin scar tissue was present, both increasing the risk of abdominal wall muscular and uterine haemorrhage. These factors can all lead to problems with exteriorization and suturing of the uterus; hence special attention is needed when performing a CS on a cow which has experienced the procedure before. The more experienced veterinarians were less likely to report difficulties during the operation than less experienced surgeons.