Maternal and Neonatal Outcome Following Elective Cesarean Section based on Progesterone Levels in High Risk Pregnant Dogs

Abstract

Background: Elective cesarean section (CS) is an appropriate therapeutic modality in high risk pregnant dogs and it is scheduled following a drop in serum progesterone to less than 2ng/ml. However, a series of progesterone assays are required to confirm this drop in serum progesterone levels and this voluntary waiting period often results in foetal loss. The present study aimed to assess the innocuity of elective CS in dogs before the prepartum decline of serum progesterone, without administration of any priming agents. Methods: Elective CS was performed on an estimated day 63 of ovulation in seven high risk pregnant dogs with a serum progesterone level between 2-5 ng/ml (Group I) and maternal and neonatal outcomes were assessed in comparison with nine dogs that underwent elective CS at serum progesterone less than 2 ng/ml (Group II). Histopathological examination of lung tissue from dead neonates was performed to ascertain the presence of type II pneumocytes for assessing lung maturity. Result: Even though progesterone levels were above 2 ng/ml in dogs of Group I at the time of elective CS (3.11±0.29 ng/mL), the live birth rate was 96.97 per cent with acceptable neonatal survival. The histopathology of lung tissue from dead neonates from Group I revealed the presence of type II pneumocytes. The study suggested that elective CS in dogs could be done on day 63 after ovulation without compromising foetal lung maturity and a drop in serum progesterone level to less than 2 ng/ml was not mandatory for puppy survivability.