Indications and risks associated with fetotomy in dromedary camels The 32th meeting of the Saudi Biological Society Makkah Al- Mukarramah, Saudi Arabia April 18–20, 2017 Indications and risks associated with fetotomy in dromedary camels Ahmed Ali, Derar Derar, Fahd Alsobayil, Ali Alsamri

Introduction Dystocia causes extreme economic losses as it compromises the future productive and reproductive efficiency of the camel herds. Fetotomy involves removal of part(s) of a dead foetus to allow the delivery of the foetus in cases of dystocia. This procedure is mainly indicated to save the life of the dam and to avoid injuries related to prolonged handling. Most evidence for the indications, complications and post-operative fertility of fetotomy in camels are derived from the bovine or equine species. The aims of this study were to investigate: the cases of camel dystocia in which fetotomy was indicated. the commonly related complications. the associated risks for maternal mortality and future fertility.

Materials and Method Fifty female dromedary camels (6-12 y; 18 primipara, 32 multipara) presented due to severe dystocia. The female camels arrived at the clinic within 24 h (n = 3), 48 h (n = 13), 72 h (n = 9) and > 72 h (n = 25) of labor pain. The dams were examined per vagina for the adequacy of the soft and bony birth ways for normal passage of the fetus. All fetuses were dead and seven were emphysematous.

Materials and Method Fetotomy was carried out in these cases using a Thygesen fetotome. Fetotomy was carried out using one cut (n = 20), two cuts (n = 19), three cuts (n = 6) and four or more cuts (total fetotomy) (n = 5). Longitudinal cuts were used to remove the deviated head and neck at the base of neck and the flexed legs below the carpal (Figure 1). Oblique cuts were used for amputating the completely flexed legs at shoulder or hip joints (Figure 2). Total fetotomy was performed to relieve fetal emphysema (n = 4) or to overcome the narrowing of the cervix (n = 1), (Figure 3). The fetotomy procedure took < 15 min (n = 5), 15-30 min (n = 26), 31-45 min (n = 1), 46- 60 min (n = 3) and > 60 min (n = 5).

Figure 1. Partial fetotomy in anterior presentation in a fetus with deviated head and neck and double carpal flexion: Longitudinal cuts were used to remove the deviated head and neck at the base of neck and below the flexed carpal joints. Figure 2. Partial fetotomy in posterior presentation with double carpal flexion: Two oblique cuts were used to remove the completely flexed legs at the hip joints.

Figure 3. Total fetotomy of a dead fetus in posterior presentation with double hip flexion.

Materials and Method After fetotomy, all camels received intrauterine and systemic antibiotics and anti-inflammatory and oxytocin treatment. In total fetotomy, the uterus was washed with diluted povidone- iodine. The complications during and after fetotomy were recorded. Camels were naturally mated at least one month after fetotomy and the subsequent fertility rates were recorded.

Materials and Method Logistic regression analysis was performed to identify risk factors for the dependent variables of maternal mortality and fertility after fetotomy. The independent variables were: parity, duration of dystocia presence of fetal emphysema number of cuts duration of fetotomy occurrence of complications during or after fetotomy.

Results and Discussion Head and neck deviations alone or with carpal or shoulder flexions were the most common cases in which fetotomy was applied (27/50, 54%). Breech presentation was the second important indication (7/50, 14%). Complications were recorded in 18 cases; these included tearing of the soft tissue of the birth canal (n = 13), uterine prolapse (n = 3) and retained placenta (n = 2). Maternal mortality was recorded in 13/50 cases (26%). Deaths were observed in 5/7 cases of fetal emphysema, 3/12 cases with severe tearing of the soft birth way, 2/3 cases of uterine prolapse and in three cases with no definite cause. Maternal deaths occurred on the same day (n = 3), within 2-7 days (n = 6) and after 7 days (n = 4) of the fetotomy procedure and after partial (12/45, 26.7%) and total (1/5, 20%) fetotomy.

Results and Discussion A significant association was detected between maternal deaths and duration of dystocia (odds ratio = 4.67, P = 0.03), fetal emphysema (odds ratio = 3.93, P = 0.04) and complications during or after fetotomy (odds ratio = 8.9, P = 0.003). Ten females were proved pregnant in the same season as the fetotomy and 13 females in the second season (total pregnancy rate: 23/37, 62.2%).

Conclusion fetotomy may take its position as a practical alternative approach in managing cases of camel dystocia, providing there is no delay in intervention. Postural abnormalities were found to be the most common indication for fetotomy. Tearing of the soft birth way, uterine prolapse and retained placenta were complications observed after fetotomy. The duration of dystocia, presence of fetal emphysema and occurrence of complications during or after fetotomy were seen as risks associated with maternal mortality. Fertility after fetotomy appeared to be generally encouraging.