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资源设置对难产治疗母犬的幼仔存活但不影响母犬存活:243 例(2015-2020 年)。

Resource setting impacts neonatal but not maternal survival in bitches treated for dystocia: 243 cases (2015-2020).

机构信息

1Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.

2College of Veterinary Medicine, Cornell University, Ithaca, NY.

出版信息

J Am Vet Med Assoc. 2024 Mar 7;262(6):818-824. doi: 10.2460/javma.23.09.0516. Print 2024 Jun 1.

Abstract

OBJECTIVE

To compare maternal and fetal outcomes of dystocia managed surgically and nonsurgically at referral hospitals (RHs) versus community medicine clinics (CMCs), determine the rate of C-section, and evaluate the incidence of hypoglycemia and hypocalcemia in bitches presented with dystocia.

ANIMALS

Bitches presented with dystocia at 2 RHs and 2 CMCs.

METHODS

Information on signalment, presence of hypoglycemia and/or hypocalcemia, diagnostic imaging performed, nonsurgical and surgical interventions performed, maternal and fetal outcomes, and total cost of care was obtained from the electronic medical records of bitches presenting for dystocia between October 2015 and October 2020. Descriptive statistics were performed and outcome compared between RHs and CMCs using a Fisher exact test, with a P < .05 considered significant.

RESULTS

230 bitches were evaluated with 243 separate episodes of dystocia, with 183 (75%) episodes treated at an RH and 60 (25%) at a CMC. There was a low incidence of hypoglycemia (5% [9/178]) and ionized hypocalcemia (1% [2/164]). Seventy-three percent (177/243) of bitches underwent surgical intervention, 25% (61/243) received nonsurgical management, and 2% (5/243) transferred to their primary veterinarian. There was no difference in survival for bitches operated at an RH compared with a CMC. However, bitches operated at an RH were more likely (P = .04) to be discharged with at least 1 live neonate.

CLINICAL RELEVANCE

In bitches diagnosed with dystocia, hypoglycemia and hypocalcemia were rare. The majority of bitches underwent a C-section. The setting where the C-section was performed did not impact maternal survival.

摘要

目的

比较转诊医院(RH)和社区医疗诊所(CMC)中手术和非手术处理的难产的母婴结局,确定剖宫产率,并评估患有难产的母犬低血糖和低钙血症的发生率。

动物

在 2 家 RH 和 2 家 CMC 就诊的患有难产的母犬。

方法

从 2015 年 10 月至 2020 年 10 月就诊于难产的母犬的电子病历中获得了母犬的一般信息、低血糖和/或低钙血症的存在、进行的诊断影像学检查、非手术和手术干预、母婴结局以及总治疗费用等信息。使用 Fisher 确切检验对 RH 和 CMC 之间的结果进行了描述性统计和比较,P<0.05 被认为有统计学意义。

结果

共评估了 230 只母犬,243 个单独的难产病例,183 个(75%)病例在 RH 治疗,60 个(25%)病例在 CMC 治疗。低血糖(5% [178/3567])和离子化低钙血症(1% [2/164])的发生率较低。73%(177/243)的母犬接受了手术干预,25%(61/243)接受了非手术治疗,2%(5/243)转至其主治兽医。在 RH 接受手术的母犬与 CMC 相比,生存率没有差异。然而,在 RH 接受手术的母犬更有可能(P=0.04)出院时至少有 1 只活产仔犬。

临床意义

患有难产的母犬中,低血糖和低钙血症罕见。大多数母犬接受了剖宫产。进行剖宫产的地点并未影响母犬的存活率。

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