The Visual Guide to
Canine Reproduction
Obstetrics: Cesarean Section

Uterine Incision.
Incision along the greater curvature of the uterus over the puppy fetus.
Verstegen J (2009)

Incision of the Fetal Membranes.
Incision of the fetal membranes during C-section taking care not to cut the puppy fetus.
Verstegen J (2009)

Clamping the Umbilical Cord.
The umbilical cord is clamped with a pair of forceps prior to ligation from the puppy.
Verstegen J (2009)

Clamping the Umbilical Cord.
The puppy's umbilical cord is clamped with a pair of forceps prior to ligation. A second set of forceps will be placed and the umbilical cord will be transsected between the two forceps. The forceps attached to the fetus will be passed off to the assistant who will ligate the cord and remove the forceps. The forceps attached to the fetal membranes will be placed out of the way until all fetuses are removed at which time the fetal membranes can be removed along with the forceps.
Verstegen J (2009)

Ready to Clamp the Umbilical Cord.
The puppy's umbilical cord is clamped with a pair of forceps prior to ligation. A second set of forceps will be placed, and the umbilical cord will be transsected between the two forceps. The forceps attached to the fetus will be passed off to the assistant, who will ligate the cord and remove the forceps. The forceps attached to the fetal membranes will be placed out of the way until all fetuses are removed at which time fetal membranes can be removed along with the forceps.
Verstegen J (2009)

Removal of the Placenta.
The fetal portion of the zonary placenta is removed from the puppy. Normal dark blood from the edges of the zonary placenta is called the marginal hematoma.
Verstegen J (2009)

Uterine Closure after C-Section.
Closure of the uterine incision with two layers: 1) apposition of the cut edges and 2) infolding pattern to seal the mesometrium.
Verstegen J (2009)

Selecting First Pup.
The uterus is laid out and the first pup is selected. The one selected is usually in the middle of the horn to allow additional pups to be removed through the same uterine incision.
LeBlanc MM (2013)

Delivery of the First Pup.
Head of the first puppy is delivered. An assistant is ready to receive the pup to initiate respiration.
LeBlanc MM (2013)

Stimulation of the First Pup.
The chest is massaged to stimulate respiration.
LeBlanc MM (2013)

Support Team.
Several assistants aid in getting the newly delivered pups to start breathing by stripping the nostrils, extending the neck, and gently massaging the chest wall.
LeBlanc MM (2013)