Incomplete Cervical Dilation
Incomplete cervical dilation occurs very occasionally in heifers
but the true incidence is difficult to determine because in most
situations the onset of first stage labour has not been noted. It
is probable that some dystocia cases are classified as incomplete
cervical dilation but merely represent over-zealous interference
during early first stage labour. Typically, the opening is only
5-10 cm in diameter which may just allow passage of one hand.
Fig 1: Some dystocia cases are classified as
incomplete cervical dilation but may represent over-zealous
Manual pressure applied for 10 to
15 minutes may gradually dilate the cervix in some cases but such
cases may well represent those heifers disturbed during early first
stage labour. In some cases the vulva may also fail to dilate
properly because there has been no pressure from the water bag and
veterinary attention is necessary. Natural dilation is achieved by
pressure from an intact water bag being pressed through the cervix
into the vagina by contractions of the uterus. For this reason it
is unwise to manually rupture the waterbag until full dilation is
Too early/frequent human
interference may delay normal progression of first stage labour
especially in heifers. Farmers should be encouraged to leave cattle
undisturbed for four hours after the appearance of a mucus string
or allantochorion at the vulva, especially in heifers. However,
frequent bouts of powerful abdominal contractions occurring more
frequently than every five minutes or so must be investigated.
Dystocia caused by an oversized
calf in normal anterior longitudinal presentation is common in beef
cattle. The calf's muzzle and forefeet are presented at the cow's
Reasonable traction should deliver
the calf when two people pulling can extend both front legs such
that the fetlock joints protrude one hand's breadth beyond the
vulva within 10 minutes' traction. Such movement of the calf's
forelegs represents extension of both elbow joints into the cow's
pelvis. Veterinary attention is necessary if greater traction is
applied without obvious progress and the elbows are not extended
Fig 2: The fetlock joints protrude more than
one hand's breadth beyond the vulva - this calf will be delivered
Review bull selection especially
in heifers, with reference to EBV's
Do not calve cows in BCS >3
(scale 1 to 5).
Restrict breeding period to nine
weeks to prevent an extended tail to the calving period with
consequences of reduced cow supervision and increased BCS
especially in spring-calving herds at pasture.
Tears in the vaginal wall during
delivery of the calf may be sufficient to allow the protrusion of
submucosal fat or extend to cause rupture of the uterine artery
with life-threatening consequences.
Haemorrhage from a major artery in
the vagina must be identified immediately after the calf has been
delivered and veterinary attention sought urgently.
Fig 3: Protrusion of submucosal fat from a
vaginal tear acquired during delivery of an oversized calf.
Fortunately, the tear did not extend to a major blood
Hip lock often arises when
excessive and inappropriate traction has been applied to an
oversized calf in anterior longitudinal presentation. The cow
quickly becomes exhausted with the calf protruding to the back of
the rib cage but firmly lodged as the hips enter the cow's
Fig 4: Excessive and inappropriate traction has
been applied to this oversized calf in anterior presentation
resulting in hip lock.
Further traction whilst attempting
to rotate the calf or roll the cow is rarely successful and risks
obturator/sciatic nerve damage of the cow. Immediate veterinary
attention is essential.
The calf's forequarters are removed
and the remaining vertebral column and pelvis are divided using
embryotomy wire. The split hindquarters can be pushed apart and
Fig 5: The calf's forequarters are removed using
embryotomy wire then the remaining vertebral column and pelvis are
Veterinary expertise is essential
where there are doubts whether the oversized calf can be safely
Leg back (Anterior longitudinal presentation with
unilateral shoulder flexion)
Leg back is a common malposture in cattle obstetrics. The calf's
head and one fore foot are presented at the vulva.
Fig 6: Leg back is a common
Correction of this malposture is
best achieved after extradural injection by a veterinary surgeon to
prevent forceful straining. After five minutes the calf's head and
protruding foreleg are well lubricated and slowly repelled until
the calf's poll is level with the pelvic inlet. By first grasping
the calf's forearm then the mid metacarpal region, the elbow and
carpal joints of the retained leg are fully flexed which brings the
foot towards the pelvic inlet. With the fetlock joint fully flexed,
and the foot cupped in your hand to protect the uterus, the foot is
drawn forward into the pelvic canal extending the fetlock joint.
Traction on the distal limb extends the elbow joint and the foot
appears at the vulva where a calving rope is applied above the
fetlock joint. Click for video simulation
The cow should now be haltered and
tethered low down to a post in the calving box. Steady traction of
two people pulling on the calving ropes applied to both legs will
generally result in the heifer/cow assuming lateral recumbency
which aids delivery of the calf.
The calf's umbilicus should be
immediately fully immersed in strong veterinary iodine and repeated
2 and 4 hours later. Two litres of colostrum are administered by
orogastric tube to ensure adequate antibody transfer because the
calf will be unable to suck as a result of its swollen tongue.
Head back (Anterior longitudinal presentation with
lateral deviation of the head)
Lateral deviation of the head is a
common calving problem; the calf is often dead. Both fore feet are
presented in the maternal pelvis (and possibly at the vulva).
The head back is often mistaken for
a calf in posterior presentation (coming backwards) because you can
feel two legs but no head. Note than the hooves face down not up
and you are able to feel the carpal joints (knees) not the hocks or
Correction of the malposture is not
easy especially when the calf is dead and veterinary attendance is
often necessary. After extradural anaesthesia, the calf's forelegs
and neck are carefully repelled as far as possible. A finger can be
placed into the calf's mouth or an eye socket in an attempt to pull
the head around into the pelvic inlet. Click for video
simulation Alternatively, a leg rope placed around the
calf's lower jaw. Once corrected, a head rope is placed behind the
calf's poll and through its mouth to assist alignment into the
pelvic inlet. Click for
video simulation The calf is then delivered by
traction as described above.
Recognition that second stage
labour has not progressed and timely intervention.
Calf coming backwards
(Posterior longitudinal presentation)
Posterior presentation is a common
cause of dystocia in cattle. Typically, the calf pelvic limbs
protrude from the cow's vulva about one hand's breadth short of the
Two strong people pulling on
calving ropes should be able to extend both hocks more than one
hand's breadth beyond the cow's vulva (calf's hindquarters now
fully within the pelvic inlet) within 10 minutes. Further traction
will deliver the calf safely. Other guidelines include whether your
hand can be extended over the calf's tail head and underneath both
stifle joints when the calf is drawn into the pelvic inlet.
Fig 7: Only moderate traction should be
necessary to extend both hocks of the calf more than one hand's
breadth beyond the cow's vulva.
Potential complications - calf
Multiple rib fractures. Rupture of
Prolonged delivery resulting in
compression of umbilical vessels causing lack of oxygen.
Breech presentation (Posterior longitudinal
presentation with bilateral hip flexion).
The calf's pelvis is firmly lodged
at the entrance to the maternal pelvis with both hindlegs extended
alongside the body.
Cattle show typical signs of first
stage labour when they appear restless and isolate themselves
wherever possible but abdominal straining is not seen because the
foetus does not engage within the maternal pelvis.
Fig 7: Cattle with a breech presentation show
initial signs of first stage labour but then appear restless with
the tail raised.
The waterbag may rupture but
remnants of the foetal membrane may not appear at the vulva. The
calf's tail is readily palpable on vaginal examination. In some
cases the calving problem is not noted until the calf/calves die
and the cow develops severe toxaemia.
Fig 8: Calf in breech
presentation - the calf tail protrudes from the cow's
An extradural injection is given by
a veterinary surgeon to block the cow's forceful abdominal
contractions. The calf's tail head is slowly repelled beyond the
level of the cow's pelvic inlet as far as your reach allows.
Commencing distally, one calf's foot is cupped in your hand and the
fetlock joint fully flexed. As the hind foot is drawn toward the
maternal pelvis, the hock and stifle joints are fully flexed.
Correction now involves extending each hip joint in turn while the
distal limb joints (stifle, hock and fetlock joints) remain fully
flexed. Further gentle repulsion of the calf may be necessary at
this stage. In this manner a breech presentation is converted to a
posterior presentation. Click
for video simulation
Premature rupture of the umbilical
vessels if the umbilicus has become hooked around one hind leg
while correcting the hip flexion.
Uterine rupture during repulsion of
the calf or correction of the hip flexion causing fatal
Fig 9: Uterine rupture
during repulsion of the calf or correction of the hip flexion has
caused peritonitis in this cow.
Simultaneous presentation of two calves
There are many possible
combinations of heads and legs when two calves are presented
simultaneously. It is necessary to identify which leg corresponds
to which head by tracing the leg to the shoulder region, and then
to the neck and head. Once both legs and head have been correctly
identified and roped, the other calf is gently repelled as traction
is applied to the first. Only slight/moderate traction should be
necessary to deliver a twin calf in this situation; if little
progress is being made it is essential to check that you have
selected the correct anatomy. It is important to differentiate
simultaneous presentation of two calves from foetal
Regular supervision of calving
cows. Examine those cattle suspected of first stage labour
exceeding six hours.
In most cases, any malpresentation
of the calf will be more easily corrected with the cow in the
standing position as this allows the calf to be repelled. Once the
presentation is correct, delivery is best achieved with the cow in
full lateral recumbency as, in that position, the pelvis is at its
Immediate Post-partum checks.
Immediately after the calf has been
delivered and the airways cleared, the cow must be examined
Uterine rupture occurs during
assisted delivery most commonly with the calf presented in breech
presentation but also with lateral deviation of the calf's
If the condition is not recognised
immediately the cow may appear to be normal for several hours after
delivery. She then becomes increasingly dull and depressed with a
painful expression, no appetite and little milk production. As
peritonitis develops over several days, the abdomen becomes
increasingly distended which contrasts with the cow's much reduced
Fig 10: As peritonitis develops over several
days, the abdomen becomes increasingly distended which contrasts
with the cow's much reduced appetite.
Treatment of diffuse peritonitis
involving small intestine is invariably hopeless and cow must be
euthanased for welfare reasons when this diagnosis is
2) Vaginal tears/laceration
Haemorrhage from a major uterine
artery may result from excessive traction in over-conditioned
heifers and is apparent once the pressure has been removed with
delivery of the calf. Haemorrhage from a major artery in the vagina
must be identified immediately the calf has been delivered and
veterinary attention urgently requested.
Monitor dry cow and heifer body
condition scores regularly especially during the summer months. An
episiotomy should be carefully considered in overfat heifers. Avoid
excessive traction by electing to perform a caesarean
Uterine torsion is relatively
common in cattle. It is often associated with an oversized foetus.
Uterine torsion, from 180 to 720°, prevents
entry of the foetus/fluids into the twisted vaginal lumen such that
the animal shows no sign to indicate the end of first stage labour.
Failure of the cervix to dilate fully is a common
The cow may isolate herself from
others in the group and show signs of first stage labour including
slackening of the sacro-iliac ligaments but the foetal membranes
(allanto-chorion) do not appear at the vulva. The vulva and tail
head are slack which contrasts with the constricted (tight) vaginal
lumen which is typically dry lacking mucus. As your hand passes
into the vagina there is a distinct twist (corkscrew effect) with
can be either clockwise or anti-clockwise. With a torsion less than
360° it may be possible to reach the cervix
which is dilated with foetal extremities distally. In those cases
where the torsion is more than 360°, or
when the calf cannot be reached a caesarean operation is the best
way of ensuring the delivery of a live calf and an undamaged
If left unattended for several
days, the cow becomes sick due to death of the calf and development
of a septic metritis.
A uterine torsion can be identified
by the tight vagina with an obvious "corkscrew" feel. Veterinary
attention is necessary to correct the twisted uterus.
Uterine inertia is not uncommon in
dairy cows and older beef cows with clinical hypocalcaemia (milk
fever). Parturition does not progress beyond the end of first stage
labour. Vaginal examination reveals the cervix to be fully dilated
with the foetal membranes intact. Often the calf is already dead.
There may be other signs of hypocalcaemia including recumbency and
inability to rise, and free gas bloat.
Fig 11: Uterine inertia is not uncommon in
dairy cows and older beef cows with clinical hypocalcaemia (milk
Fig 12: Parturition does not progress beyond the end
of first stage labour.
400 mls of 40% calcium
borogluconate injected intravenously. If the calf is alive, it is
usual to leave the cow for up to two hours to allow parturition to
Hypocalcaemia is discussed further
in the bulletin on metabolic diseases.