Risk Factors For Dystocia Research Articles

Risk factors for dystocia in primiparous and pluriparous beef cows at the Besuki Animal Health Center, Situbondo Regency, East Java, Indonesia

This study aims to determine the risk factors for dystocia in primiparous and pluriparous dams at the study site. Cases of dystocia, both maternal and fetal, were obtained as secondary data from records at the Situbondo Regency Animal Husbandry Service for year 2020 and 2021. Tracking on these secondary data was carried out to look for cows experienced dystocia and the owners’ names and addresses for interviews using a questionnaire worksheet. Interviews were conducted in February - May 2022 to obtain data on the maternal breed, age, feeding, fetal sex, and exercise frequency during pregnancy of the cows. Dystocia in the working area of the Besuki Animal Health Center in Sitobondo Regency in 2020 and 2021 occured in 50 cows which included primiparous (26%) and pluriparous (74%) cows. Breed, age, feed, and sex of the calves were not significantly different (p >0.05) between primiparous and pluriparous dams. However, the frequency of the exercises differed significantly (p <0.05) between primiparous and pluriparous dams. It could be concluded that the dystocia of cows in the study area was dominated by pluriparous parturition with exercises factor as the main cause.

Risk factors for dystocia in primiparous and pluriparous beef cows at the Besuki Animal Health Center, Situbondo Regency, East Java, Indonesia

This study aims to determine the risk factors for dystocia in primiparous and pluriparous dams at the study site. Cases of dystocia, both maternal and fetal, were obtained as secondary data from records at the Situbondo Regency Animal Husbandry Service for year 2020 and 2021. Tracking on these secondary data was carried out to look for cows experienced dystocia and the owners’ names and addresses for interviews using a questionnaire worksheet. Interviews were conducted in February - May 2022 to obtain data on the maternal breed, age, feeding, fetal sex, and exercise frequency during pregnancy of the cows. Dystocia in the working area of the Besuki Animal Health Center in Sitobondo Regency in 2020 and 2021 occured in 50 cows which included primiparous (26%) and pluriparous (74%) cows. Breed, age, feed, and sex of the calves were not significantly different (p >0.05) between primiparous and pluriparous dams. However, the frequency of the exercises differed significantly (p <0.05) between primiparous and pluriparous dams. It could be concluded that the dystocia of cows in the study area was dominated by pluriparous parturition with exercises factor as the main cause.

Reproductive Disorders of Cattle in the Tole District of Southwest Ethiopia and Their Prevalence and Associated Risk Factors

Reproduction is a basic requirement for efficient cattle production to continue or cease; whereas, reproductive disorders are the leading cause of economic loss in the cattle industry. To determine the prevalence and associated risk factors of major reproductive disorders in cattle in the Tole district, a cross-sectional study design was conducted from October, 2020, to October, 2021. To identify potential risk factors for cattle reproductive disorders, a multivariable random effect logistic regression analysis was used. A total of 400 randomly selected cows were examined, and 37.8% of them had at least one reproductive disorder. The three main reproductive disorders observed in the study area were abortion (17.8%), stillbirth (4.8%), and dystocia (3.3%). Risk factors for reproductive disorders in the study area included the calving season (OR = 3.7, 95% CL-1.37–7.18) and the accessibility of dogs to cattle (OR = 2.5, 95% CL-1.64–3.85). Accessibility of dogs to cattle in the study areas was also a risk factor for abortion (OR = 7.5, 95% CL-3.59–15.54). The present study also identified parity (OR = 5.2, 95% CL-1.05–26.04) as a risk factor for dystocia in cattle in the study areas. This demonstrated that losses in cattle production in the study areas are significantly attributed to reproductive problems. Hence, it is essential to increase public awareness of how reproductive disorders affect cattle production and to develop and implement appropriate control measures for these disorders. The causes of abortion and dystocia in various areas should be precisely identified and described through further research.

Gestational weight gain as a risk factor for dystocia during first delivery: a multicenter retrospective cohort study in Japan

BackgroundDystocia is a common obstetric complication among nulliparous women, which requires medical intervention and carries the risk of negative maternal and neonatal outcomes. Our aim was to examine the association between body mass index (BMI) and the occurrence of dystocia. We also identified cutoffs of gestational weight gain, based on pre-pregnancy BMI, associated with the risk of dystocia.MethodsThis was a multicenter, retrospective, cohort study conducted in two tertiary Maternal–Fetal medicine units in Fukushima, Japan. The study population included nullipara women who delivered at either of the two units between January 1, 2013, and December 31, 2020. Women (n = 2597) were categorized into six groups (G) based on their pre-pregnancy BMI: G1 (< 18.5 kg/m2), G2 (18.5 to < 20.0 kg/m2), G3 (20.0 to < 23.0 kg/m2), G4 (23.0 to < 25.0 kg/m2), G5 (25.0 to < 30.0 kg/m2), and G6 (≥ 30.0 kg/m2). Using G3 as a reference, multiple logistic regression analyses were performed to estimate the risk of dystocia for each BMI category. Receiver operating characteristic curve analyses were performed to determine the cutoff value of gestational weight gain for the risk of dystocia.ResultsThe highest BMI category (G6) was an independent risk factor for dystocia (adjusted odds ratio, 3.0; 95% confidence interval, 1.5–5.8). The receiver operating characteristic curve analysis revealed no association between gestational weight gain and the occurrence of dystocia in G5 and G6 (P = 0.446 and P = 0.291, respectively). For G1 to G4, AUC and predictive cutoffs of gestational weight gain for dystocia were as follows: G1, AUC 0.64 and cutoff 11.5 kg (P < 0.05); G2, AUC 0.63 and cutoff 12.3 kg (P < 0.05); G3, AUC 0.67 and cutoff 14.3 kg (P < 0.01); and G4, AUC 0.63 and cutoff 11.5 kg (P < 0.05).ConclusionA pre-pregnancy BMI > 30.0 kg/m2 was an independent risk factor for dystocia. For women with a pre-pregnancy BMI < 25.0 kg/m2, the risk of dystocia increases as a function of gestational weight gain. These findings could inform personalized preconception care for women to optimize maternal and neonatal health.

Identification of cow-level risk factors and associations of selected blood macro-minerals at parturition with dystocia and stillbirth in Holstein dairy cows

A deeper understanding of the risk factors for dystocia and stillbirth could help farmers make decisions about dairy cow management. The objectives of this study were to investigate cow-level risk factors associated with dystocia and stillbirth in a relatively large sample of dairy cows using multivariable linear regression models. The data consisted of 51,405 calving records of 14,546 Holstein cows from 3 dairy herds in Isfahan Province, Iran, collected between April 2011 and September 2017. To investigate the association between selected blood macro-minerals and the incidence of dystocia and stillbirth, blood samples were collected at the time of parturition from a random subset of these cows, which included 1311 animals. The incidence of dystocia and stillbirths averaged 14.7% and 4.3%, respectively. Results showed that calving year, calving season, dry period length, BCS, parity, calf sex, calf birth weight, twin status, and stillbirth were significantly associated with the incidence of dystocia. According to the Random Forest (RF) classifier, we found that dry period length, calf birth weight, and parity were the most important cow-level risk factors for the incidence of dystocia. Calving year, calving season, parity, twin status, dry period length, calf birth weight, calf sex, and dystocia were significantly associated with the incidence of stillbirths. The most important risk factors identified by the RF classifier for stillbirths were twin status, parity, dry period length, and calf birth weight. Also, interactions between the cow-level risk factors associated with dystocia and stillbirth were identified. The incidence of dystocia was associated with the interactions of twin status × calf birth weight and twin status × stillbirth. According to our analysis, the incidence of stillbirth is caused by interactions among several factors, such as twin status × length of dry period, twin status × calving season, and twin status × parity. The highest incidence of dystocia (21.3%) and stillbirths (5.4%) was observed in hypo-calcemic cows. In conclusion, twin status seems to be a determining factor for the incidence of stillbirths but not for dystocia. Finally, the results of this study may help the dairy industry make management decisions aimed at reducing dystocia and stillbirth rates.

Incidence of dystocia at piglet level in cloprostenol-induced farrowings and associated risk factors

Few studies have investigated risk factors for dystocia in swine, although this birthing abnormality can compromise welfare of both sows and piglets by increasing stillbirth rate and decreasing sow productivity. This study aimed to determine risk factors associated with dystocia at piglet level in cloprostenol-induced farrowings. A dystocia event was recorded when a birth interval exceeded 45 or when manual extraction was applied. Data were collected from 898 piglets born from 77 Landrace Yorkshire crossbred sows, which were induced for farrowing on day 114 of gestation. Generalized linear mixed models (GLMMs) were used to evaluate the association between dystocia and parity, gestation length, litter size, relative birth order (RBO (%) 100 birth order/litter size), birth weight, crown rump length, body mass index, ponderal index, piglet's sex, use of oxytocin, and stillbirth. Sows nested in farrowing batches were fitted as random factors in GLMMs. Incidence of dystocia at piglet and farrowing levels was 11.0 % and 75.3 %, respectively. The final multivariate model explained 20.1 % variation of dystocia. RBO had a quadratic effect on dystocia in which incidence of dystocia decreased from RBO 40 % to RBO 60 %–70 %, and then increased to the end of parturition. Piglets with birth weight 1700 and stillborn piglets had higher odds of dystocia in comparison with piglets with a birth weight of 900–1700 (OR 2.63; 95 % CI 1.66–4.18) and live-born piglets (OR 2.62; 95 % CI 1.12–6.15), respectively. This study indicates that dystocia is very common in cloprostenol-induced farrowings and suggests that the last one-third of parturitions is the most important stage to be supervised, and selection for homogenous litters and moderate high birth weight may reduce the rate of dystocia.

Risk factor analysis for beef calves requiring assisted vaginal delivery in Great Britain.

Dystocia has serious consequences for both mother and offspring. This study therefore aimed to identify risk factors for dystocia in vaginally delivered spring born beef calves in Great Britain (GB). Information on calving assistance, calf sex, birthweight, breed, twinning, dam parity and body condition score (BCS) was collected from 1131 calves across 84 GB farms. Variables were modelled against calving assistance as a binary response variable. Twins (Odds Ratio [OR] = 5.45), Charolais calves (OR = 3.24), calves from primiparous dams (OR = 5.75) and male calves (OR = 1.75) were at significantly increased risk of requiring calving assistance across all models. Calves born to cows classed as thin (BCS < 2.5/5) were identified in the univariate analysis and in one of the multivariate models (OR = 1.92) as having an increased likelihood of dystocia. Most beef herds have limited scope to manage cows on the basis of fetal gender and number. However, calf breed, dam body condition and management of primiparous dams can be manipulated to reduce the risk of dystocia and improve supervision. Poor body condition is a novel risk factor for dystocia in beef cows and worthy of further investigation.

CLINICAL SIGNIFICANCE AND RISK FACTORS OF DYSTOCIA

Reducing adverse events in labour is one of key tasks of obstetrics at present. Abnormalities in labour, and in particular, dystocia, require further in-depth investigation and coordinated interprofessional effort. The purpose of this study was to determine the risk factors for dystocia in a full-term monocyesis with foetal presentation. We carried out a clinical and statistical analysis of pregnancy and childbirth histories of 550 women at the Kharkiv Municipal Perinatal Centre for 2018-2019 depending on the presence of dystocia by applying descriptive statistics and the odds ratio (OR) methods. Results. The most important factors for dystorcia with OR &gt; 5.0 include diabetes mellitus (OR - 10.023; 95% CI 3.083-32.578), burdened gynecological history (OR - 7.385; 95% CI 2.671 - 20.423), foetus-pelvic imbalances (OR - 6.399; 95% CI 1.506 - 27.180) first birth (OR - 5.878; 95% CI 3.139 - 11.009) and the presence of infectious diseases of the genital tract (OR - 5.071; 95% CI 1.847 - 13.925). The value for preeclampsia was slightly lower (OR - 4.467; 95% CI 1.585 - 12.586). All other indicators had an OR &lt; 3.0, including gestational hypertension (OR - 2.882; 95% CI 1.388 - 6.071), obesity (OR - 2.360; 95% CI 1.118 - 4.98) large foetus (OR - 2.242; 95% CI 1.069 - 4,704) late reproductive age (OR - 2.075; 95% CI 1.144 - 3.765) and the presence of cardiovascular disease (OR - 2.040; 95% CI 1.009 - 4.124). A comprehensive assessment of risk factors is of great clinical importance for predicting dystocia and making decisions about the need for preventive and therapeutic measures.

Risk Factors for Dystocia and Perinatal Mortality in Extensively Kept Angus Suckler Cows in Germany

Dystocia and perinatal mortality are major animal health, welfare and economic issues in beef suckler cow production. The objective of this study was to identify risk factors for dystocia and perinatal mortality and to analyze the relationships of both traits to external pelvic parameters in extensively kept beef suckler cows. Calving ease and calf survival were recorded for 785 births on five Angus cattle farms in Germany. The prevalence of dystocia and perinatal mortality was 3.4% and 4.3%, respectively. A hierarchical model was used to predict dystocia and perinatal mortality. First-parity dams had a higher probability of dystocia (p &lt; 0.0001) than later-parity ones. Increasing birth weight was associated with an increasing risk for dystocia (p &lt; 0.05). The probability of perinatal mortality (p &lt; 0.0001) was higher in assisted births than in unassisted births. Calves from first-parity dams had a higher risk (p &lt; 0.01) of being stillborn than calves from dams in later parities. An increase in the length of the pelvis was associated with an increase in odds for perinatal mortality (p &lt; 0.001). In conclusion, the study indicates that dystocia and perinatal mortality are mainly problems in first-parity suckler cows. Concerning the predictive value of external pelvic parameters, further research is necessary.

Identifying risk factors for canine dystocia and stillbirths

Canine dystocia is a common problem that increases the risk of mortality to the dam and stillbirths for the pups. Understanding the risk factors for dystocia and stillbirth can help guide decision making to improve outcomes of whelping management. This study aimed to 1) evaluate risk factors for canine dystocia; and 2) assess risk factors for stillbirth in puppies, by examining all whelpings and puppies born in two breeding populations of guide dogs for a defined period of time. Dystocia risk factors were evaluated using a repeated measures model on 2,489 litters with an overall dystocia rate of 23.8%. Risk factors identified for dystocia were colony, litter size, and age of dam. Small litter size (<5 pups) had the highest dystocia rate of 36.5%, large litter size (>9 pups) had an intermediate dystocia rate of 26.9% and medium litter size had the lowest dystocia rate of 22.1%. Dystocia risk increased as the age of dam increased. Stillbirth risk factors were evaluated for 19,577 pups and the overall stillbirth rate was 5.9%. Risk factors identified for stillbirths were dystocia, litter size, cesarean section performed and breed. Pups from litters that had dystocia were 2.35 times more likely to be stillborn compared with normal litters born without dystocia. Stillbirth risk increased as litter size increased. Pups from litters of 11 or more pups were 1.45 times more likely to be stillborn. Specific information was available for a subset of pups and was used to evaluate the association with stillbirth. Low birth weight was associated with increased stillbirth risk but large pups were also at higher risk of stillbirth compared with average size pups. Stillborn pups had longer mean (102 vs 65 min) and median (47 and 32 min) inter-pup intervals compared with live pups. The positive predictive values for stillbirth were 13.5%, 28.4%, 31.8% and 36.5% when inter-pup interval threshold was set at 1, 2, 3 and 4 h respectively. There is a tradeoff between over diagnosing stillbirth and increased positive predictive value for stillbirth when inter-pup interval threshold is extended but the improvements were modest after 2 h. The last pup born in a litter regardless of litter size was significantly more likely to be stillborn. In conclusion, this paper details data driven parameters to use when making the decision to intervene during whelping that optimize survival for dams and puppies.

Risk Factors for Shoulder Dystocia: the Impact of Mother's Race and Ethnicity.

Shoulder dystocia is a rare but severe birth trauma where the neonate's shoulders fail to deliver after delivery of the head. Failure to deliver the shoulders quickly can lead to severe, long-term injury to the infant, including nerve injury, skeletal fractures, and potentially death. This observational study examined shoulder dystocia risk factors by race and ethnicity using a sample of 19,236 pregnant women who presented for labor and delivery from July 1, 2010 until June 30, 2013 at five locations. Multivariate analyses were used to identify risk factors associated with shoulder dystocia occurrence in racial/ethnic groups with high incidence rates. For White non-Hispanic mothers, the strongest risk factors were delivering past 40 weeks' gestation (odds ratio [OR]=2.4; 95% confidence interval [CI]=1.5, 3.9; p<.01) and use of epidural anesthesia during delivery (OR=4.4; 95% CI=3.0, 6.4; p<.01). Among Black non-Hispanic mothers, the risk factors with the greatest impact were use of epidural (OR=5.3; 95% CI=3.2, 8.7; p<.01) and having gestational diabetes and controlling the condition with insulin (OR=4.6; 95% CI=1.5, 13.8; p<.01). Additionally, among Hispanic mothers, having Spanish as primary language increased shoulder dystocia likelihood compared to those who did not cite it as their primary language (OR=2.3; 95% CI=1.1, 4.6; p<.05). This study provides evidence that risk factors for a labor and delivery condition can vary significantly across racial and ethnic subgroups. These differences emphasize the importance of evaluating risk by population subgroups and might provide a basis for labor and delivery clinicians to enhance personalized medicine to reduce adverse events.

Recurrent shoulder dystocia: is it predictable?

To examine the course and outcome of deliveries occurring in women who previously experienced shoulder dystocia. In addition, recurrent shoulder dystocia risk factors were assessed. A retrospective cohort analysis comparing all singleton deliveries with and without shoulder dystocia in their preceding delivery was conducted. Independent predictors of recurrent shoulder dystocia were investigated using a multiple logistic regression model. Of the 201,422 deliveries included in the analysis, 307 occurred in women with a previous shoulder dystocia (0.015%). Women with a history of shoulder dystocia were more likely to be older, experienced higher rates of gestational diabetes mellitus, polyhydramnios, prolonged second stage, operative delivery and macrosomia (>4000g) in the following delivery. Previous shoulder dystocia was found to be an independent risk factor for recurrent shoulder dystocia (OR=6.1, 95% CI 3.2-11.8, p value<0.001) in the multivariable regression analysis. Shoulder dystocia is an independent risk factor for recurrent shoulder dystocia. Deliveries in women with a history of shoulder dystocia are characterized by higher rates of operative delivery, prolonged second stage of labor and macrosomia.

1436 Maternal Weight Gain During Pregnancy and Neonatal Birth Weight: Moroccan Data

ObjectiveThe objective of this study was to investigate the influence of maternal weight gain on birth weight of a population of newborns.Patients and MethodsStudy including all patients who delivered in...

The Effect of Pelvic Size on Cesarean Delivery Rates: Using Adolescent Maternal Age as an Unbiased Proxy for Pelvic Size

ObjectivesDystocia, the presence of abnormal labor, is the most common indication for cesarean delivery. Risk factors for dystocia include abnormalities of expulsatile forces during labor, fetal factors, and maternal pelvic size abnormalities. The objective of our study was to evaluate the effect of pelvic size on the risk of cesarean delivery rates using adolescent maternal age as an unbiased determinant of pelvic size. MethodsWe conducted a population-based cohort study using the Center for Disease Control and Prevention’s Linked Birth-Infant Death and Fetal Death data on all births in the US between 1995 and 2004 for women aged 12 to 20. We excluded all births of gestational age under 24 weeks and those with reported congenital malformations or chromosomal abnormalities. Maternal age and mode of delivery information was obtained from the birth records. ResultsThere were 6,188,704 births in our cohort of which 1,863 were to women aged 12; 12,903 to women aged 13; 68,890 to women aged 14, and the remainder to women aged 15 and above. Cesarean delivery rates were highest amongst women aged 12 at 19.59 % and declined to 13.92% amongst 15 year-olds, and 14.84 % amongst 20 year olds. This effect was more pronounced when the analysis was restricted to macrosomic fetuses (P<0.005). ConclusionCesarean delivery rates increase the younger the maternal age is suggesting that pelvic factors can play an important role in dystocia.

Analysis of Risk Factors for Dystocia in a Turkish Holstein Herd

Analysis of Risk Factors for Dystocia in a Turkish Holstein Herd

Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study

BackgroundIn nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria.MethodsA multi-centre population based cohort study with prospectively collected data from 2810 nulliparous women in term spontaneous labour with a singleton infant in cephalic presentation. Data were collected by self-administered questionnaires and clinical data-records. Logistic regression analyses were used to estimate adjusted Odds Ratios (OR) and 95% confidence intervals (CI) are given.ResultsThe following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI): dilatation of cervix < 4 cm (1.63, 1.38–1.92), tense cervix (1.31, 1.04–1.65), thick lower segment (1.32, 1.09–1.61), fetal head above the inter-spinal diameter (2.29, 1.80–2.92) and poor fetal head-to-cervix contact (1.83, 1.31–2.56). The use of epidural analgesia (5.65, 4.33–7.38) was also associated with dystocia.ConclusionVaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern.

Prevalence and risk factors for dystocia in dairy cattle: A review

This review focuses on the case definition of dystocia, its current prevalence and recent temporal trends, the different types of dystocia and their associated risk factors in dairy cattle. The reported dystocia rates in dairy cattle internationally are generally <5%, apart from those in the United States, where they are higher. Given the skewed distribution of herd dystocia rates, average figures mask high prevalence herds. Phenotypic dystocia trends are generally increasing internationally and this trend has been partially attributed to the introduction of Holstein genes. The principal types of dystocia differ between primiparae and pluriparae, with feto-pelvic disproportion (FPD) predominating in the former and fetal malposition in the latter. In order of importance, the two major determinants of FPD are calf birthweight and maternal pelvic size. Abnormal fetal position is most influenced by the number of fetuses, parity and calf sire breed. Adequate weighting of dystocia in selection indices, achievement of heifer rearing targets prior to both service and calving, and appropriate periparturient management decisions are prerequisites for controlling dystocia in dairy cattle.

Maternal Morbidity Associated With Obstetrical Maneuvers in Shoulder Dystocia

Complications from shoulder dystocia during birth can result in morbidity for both the mother and infant, although past studies have largely focused only on risk factors for dystocia and perineal tears. This case-control study was done to learn whether the obstetrical maneuvers used to relieve shoulder dystocia and dystocia itself have adverse effects on the perineum or on the immediate postpartum outcome. A total of 140 cases of shoulder dystocia were compared with 280 control cases. All were singleton, vertex, full-term vaginal deliveries. Shoulder dystocia was more than twice as frequent in women having spontaneous vaginal delivery than in those having instrumental delivery. One type of direct fetal manipulation was needed to relieve shoulder dystocia in 29% of cases, and two types in 34%. Indirect fetal manipulation, usually the McRobert maneuver and/or suprapubic pressure, was used in 74 (53%) cases. Direct fetal manipulation, most often in the form of posterior arm delivery, was performed in 66 (47%) patients. Macrosomia was diagnosed in 42% of cases of shoulder dystocia and in 5% of control cases. Episiotomy was performed significantly less often in parturients with shoulder dystocia (55%) than in the control group (72%). Obstetrical maneuvers did not influence rates of postpartum urinary or vaginal infection. The risk of a third-degree perineal tear appeared unrelated to the number of obstetrical maneuvers carried out. The one anal sphincter rupture occurred in a case of shoulder dystocia where fetal manipulation was not necessary. Mean hemoglobin values were nearly identical in the two groups. Postpartum hospital time averaged 4½ days in both the case and control groups. The incidence of involuntary urine loss was 4.7% when fetal manipulation was carried out and 3.7% in control cases. These findings suggest that neither shoulder dystocia itself nor the fetal manipulations needed to relieve it increase maternal morbidity. Specifically, fetal manipulation did not increase the risk of urinary incontinence, fecal incontinence, or anal sphincter damage.

Dystocia: a study of its frequency and risk factors in seven cities of west Africa

Objectives: To determine the incidence of dystocia in seven west African cities, to attempt to discover what, if any, factors at the prenatal visit might identify women at risk of dystocia, and to assess the utility of such screening. Method: This prospective population study of 20 326 pregnant women in west Africa (MOMA) analyzed risk factors for dystocia on the basis of deliveries in health care facilities. Results: Incidence of dystocia was 18.3%. In the multivariate analysis, the risk factors were small stature, previous cesarean, and nulliparity. As screening tools these factors have inadequate positive predictive values, either singly or combined. Conclusion: It is almost impossible to predict the occurrence of dystocia before the onset of labor. Therefore, labor must be carefully monitored, and there must be health care facilities available that can manage complications, especially cesarean deliveries. If such facilities are not accessible, an effective referral system must be established.

Risk factors for dystocia in farmed red deer (Cervus elaphus).

To analyse data from a study of deer herd health and productivity to identify potential risk factors for the occurrence of dystocia. A 2-year longitudinal observational study of 14 red deer farms was carried out in New Zealand. About 2700 hinds were monitored each year for individual characteristics including body condition score (BCS), and reproductive performance. Grazing and calving management practices were recorded. During calving, farmers recorded calving difficulties (dystocia) that needed human assistance or caused the death of the hind. Risk factors potentially affecting the occurrence of dystocia were identified and analysed by multivariable statistical techniques. The percentage of hinds with dystocia was 0.52% (95% CI 0.32 to 0.78). Hinds with a post-winter BCS over 3.5 were 2.7 times as likely to experience dystocia as hinds scoring 3.5 or less. Given the same BCS class, bodyweight gain in late pregnancy was associated with an increased risk of dystocia. Grazing steep paddocks in the last trimester of pregnancy decreased the risk of dystocia in hinds with a BCS over 3.5. The risk of dystocia on red deer farms may be reduced if key individual animal, management and environmental factors are optimal.