To remove placentas at caesar or not? Even in electives?

Re: To remove placentas at caesar or not? Even in electives?

Rob Davis — Thu, 08 Dec 2011 14:40:14 GMT

A little while ago one of our assistants performed a caesarian out of hours. A couple of the placentae were not ready to come away, so she decided to leave them in situ. This was explained to the owner at the time. Some months later, following our correspondence over the still outstanding bill for the caesarian, we received a letter stating that the bitch had been very ill after the surgery and all the pups had died. A "vet friend" of the owner had declared that it had been negligent to leave placentae behind and that this had been the cause of the pups' demise and the bitch's illness. He had not brought them into us at the time. We defended the assistant's decision. He did eventually pay his bill, presumabably as he couldn't find anybody to back up his claims of negligence. VDS advice at the time was that it was perfectly acceptable to leave placentae in the uterus.

Re: To remove placentas at caesar or not? Even in electives?

bob lehner — Thu, 08 Dec 2011 13:30:29 GMT

Agree - never remove them unless they literally fall out. I inject a small volume of oxytocin into the wall of the uterus after stitching up - seems to make it contract quickly and would like to think helps with separation and expulsion of residual placentas.

Re: To remove placentas at caesar or not? Even in electives?

Hannah Wynne Richards — Thu, 08 Dec 2011 10:08:29 GMT

Agree with above Don't try to tear away,give oxytocin and antibiotics

Wynne

Re: To remove placentas at caesar or not? Even in electives?

Braden Collins — Thu, 08 Dec 2011 04:42:21 GMT

I would agree with only removing the placentas if already loose. That's (almost) always been my approach and so far I've has no problems with retained placentas, etc. The couple of times I have tried removing one or two which were not quite ready to come away I have found increased bleeding was a problem.

Re: To remove placentas at caesar or not? Even in electives?

Joyce Whitehead — Wed, 07 Dec 2011 22:47:32 GMT

Personally I never remove them unless they detach very easily. I remember well a caeser as a student when the receptionist's Basset Hound bitch (it is always the staff dogs that go wrong) had all her placentas removed during the caeser and proceeded to bleed to death on the table, despite the poor vet frantically spaying her once he realised what was happening.

I don't do many elective caesers, but in the few I have done I have left placentas with no problems. I always warn the owners there will be quite a considerable amount of discharge in the first few days. I find that some will be passing the placentas by the time they are fully awake, as we always give oxytocin during the op to encourage involution. Rightly or wrongly I tend to send caesers home on antibiotics as a precaution anyway (not something I do for most routine ops).

Re: To remove placentas at caesar or not? Even in electives?

Michael Woodhouse — Wed, 07 Dec 2011 22:46:11 GMT

Mainly a cow vet here, but treat bitches the same as cows and if it's attached leave it be, if it's loose remove it.