Fetal Distocia in a Jenny Due to Forelimb Flexion and Fetopelvic Disproportion

Fetal Distocia in a Jenny Due to Forelimb Flexion and Fetopelvic Disproportion | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Fetal Distocia in a Jenny Due to Forelimb Flexion and Fetopelvic Disproportion Pedro Vinícius Barbosa da Silva, Juliana de Moura Alonso, Moroni Dias de Souza Almeida, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8565302/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract In jennies, dystocia is rare and poorly documented, constituting an obstetric emergency that requires rapid diagnosis and appropriate intervention to preserve maternal health. This study aimed to report a case of fetal dystocia in a jenny, highlighting the obstetric diagnosis, therapeutic approach, and clinical outcome. A crossbred primiparous jenny was attended after approximately seven hours in stage II of parturition. Obstetric examination revealed anterior presentation, right lateral position, bilateral carpal joint flexion, head deviation, and fetal death. Following sacrococcygeal epidural anesthesia, corrective obstetric maneuvers were attempted but were unsuccessful due to fetopelvic disproportion. Partial fetotomy of the thoracic limbs was therefore performed, followed by cephalic repositioning using an obstetric hook, allowing vaginal removal of the fetus. No additional lesions of the birth canal were observed. The jenny showed satisfactory clinical recovery, remaining standing with spontaneous intake of food and water. Due to the lack of specific fetotomy instruments, technical adaptations were required during the procedure. Postural correction associated with partial fetotomy proved effective in resolving dystocia, preserving maternal integrity and emphasizing the importance of appropriate obstetric management in jennies. Donkeys Fetotomy Obstetrics Reproductive intervention Figures Figure 1 Background Equids have a gestational period ranging from 365 to 376 days, although wider variations from 340 to 395 days have been reported (Chauhan et al. 2013 ), with an average of 370 days in jennies (Mendoza and Toribio 2025 ). Parturition is characterized as a brief and intense process divided into three stages (Chauhan et al. 2013 ). During stage I, uterine and cervical preparation occurs, characterized by restlessness, sweating, and initial uterine contractions, culminating in rupture of the chorioallantois. Subsequently, stage II involves fetal expulsion, beginning with rupture of the allantois, and typically lasts 15 to 30 minutes in eutocic deliveries. Stage III comprises expulsion of the fetal membranes, which occurs within three hours after birth (Carluccio et al. 2015 ). Failure in any stage of parturition may result in dystocia, defined as a difficult delivery that can compromise neonatal viability and cause injury or death of the dam and/or fetus, frequently requiring veterinary intervention to complete delivery (Purohit 2011 ). In mares, although uncommon, dystocia represents a significant obstetric challenge. Prolongation of stage II is associated with increased neonatal complications, including stillbirth, and may originate from maternal causes or, more frequently, fetal abnormalities. Early identification and appropriate intervention before exceeding the maximum duration of stage II are therefore essential to ensure survival of both foal and mare (McCue and Ferris 2012 ). Fetal causes commonly involve abnormalities of fetal posture, such as incorrect positioning of the forelimbs, alone or combined with head deviation. Fetal malformations (e.g., hydrocephalus and arthrogryposis), fetopelvic disproportion, uterine torsion, twin pregnancy, and post-surgical uterine adhesions have also been described. Moreover, many mares present dystocia of combined origin rather than a single isolated factor (Ellerbrock et al. 2024 ). Decision-making between cesarean section and obstetric maneuvers in dystocia management should consider fetal viability, duration of labor, and degree of trauma. Although cesarean section is more invasive, it may represent the safest option in prolonged or difficult dystocia, particularly when there is risk of severe maternal injury. Assisted vaginal delivery is preferred in mild dystocia due to lower invasiveness and faster recovery (Freeman et al. 1999 ). Dystocia in jennies ( Equus asinus ) is rare, affecting an estimated 1–4% of cases, with causes similar to those in mares (Lu et al. 2006 ). As in mares, fetal causes predominate. Reports include posterior presentation (Kumar et al. 2024 ; Sachan et al. 2019 ), flexed limbs (Sachan et al. 2019 ), anterior presentation with one flexed limb (Chauhan et al. 2013 ), and a case of Schistosomus reflexus (Dubbin et al. 1990 ), all resolved by obstetric maneuvers with or without fetotomy. A case of maternal-origin dystocia associated with pelvic injury requiring three consecutive cesarean sections has also been described (Feyisa et al. 2025 ). Given the scarcity of reports and the clinical relevance of dystocia in jennies, this study aims to describe a case characterized by abnormal fetal posture with limb flexion, head deviation, and fetal death, requiring corrective obstetric maneuvers and partial fetotomy. Case Presentation A crossbred jenny approximately two years old, weighing an estimated 250 kg, was presented with dystocia. Anamnesis revealed no information regarding breeding date or expected parturition; the animal had been in labor for at least seven hours, showing abdominal contractions, restlessness, repeated standing and recumbency, and vaginal discharge. No prior manual or pharmacological intervention had been performed. On inspection, the jenny exhibited dyspnea, intermittent vocalization, and restlessness, alternating between standing and lateral or sternal recumbency (Fig. 1 a). Ventral abdominal distension and enlarged mammary glands were noted, consistent with late gestation. Partial exteriorization of fetal membranes through the vulva was observed (Fig. 1 b). Physical examination revealed heart rate of 60 beats per minute, respiratory rate of 28 breaths per minute, pale mucous membranes, capillary refill time of 2 seconds, reduced intestinal motility, and rectal temperature of 37.5°C. Obstetric examination was subsequently performed. Transrectal palpation indicated fetal engagement in the pelvic cavity. After antisepsis, transvaginal palpation using long obstetric gloves confirmed lack of fetal responsiveness. The fetus was in anterior presentation, right lateral position, with head deviation and bilateral carpal joint flexion. Assisted vaginal delivery was initially attempted. Sacrococcygeal epidural anesthesia was performed using 2 mL of 2% lidocaine without vasoconstrictor (Fig. 1 c). Head and neck retropulsion was initiated, followed by correction of the flexed forelimbs to orient them toward the birth canal. With both forelimbs extended, traction was applied using ropes (Fig. 1 d). However, alignment of the head and neck within the birth canal was not possible due to insufficient space (fetopelvic disproportion), and corrective attempts over approximately 30 minutes were unsuccessful. Partial fetotomy of the thoracic limbs at the carpal joints was therefore performed using a scalpel, as appropriate fetotomy instruments were unavailable. Ropes were tied to the distal radial epiphysis, increasing free space within the pelvic canal. Manual repositioning of the head remained difficult; thus, an obstetric hook was attached to the mandibular symphysis to facilitate repositioning and traction. This allowed alignment of the fetal head with the maternal body axis and subsequent extraction, followed by removal of the trunk (Fig. 1 e). Traction required three individuals, and significant difficulty was encountered during passage of the fetal pelvis, necessitating assistance from an additional person (Fig. 1 f). No additional trauma to the vaginal canal was observed following repositioning, traction, or fetotomy. Fetal evaluation revealed no signs of prematurity, evidenced by normal or relatively large size compared with the maternal pelvis, well-developed hair coat, fully keratinized hooves, and absence of prominent eyes or rounded head. Other indicators of fetal maturity could not be assessed. No fetal measurements were obtained. Postpartum treatment included gentamicin in dose of 6.6 mg/kg intramuscularly (IM), once a day (SID), for 5 days, ceftiofur (5 mg/kg IM, SID, 7 days), meloxicam (0.6 mg/kg IM, SID, 3 days), cloprostenol (250 µg IM, single dose), and oxytocin (40 IU, single dose). Hematological (Table 1 ) and biochemical (Table 2 ) analyses were performed. Table 1 Hematological and plasma fibrinogen values observed in the immediate postpartum period. Complete Blood Count (CBC) Erythrogram Parameters Result Reference Red blood cells (×10⁶/mm³) 8,47 4,4–7,1 PCV (%) 39 27–42 Hemoglobin (g/dL) 13,6 8,9–14,7 MCV (fL) 54,7 53–67 MCHC (g/dL) 29,3 31–37 RDW-cv (%) 13,9 16,1–22 Total Proteins Result 7,6 g/dL 5,8 − 7,6 g/dL Fibrinogen Result 800 mg/dL 100–600 mg/dL* Leukogram Parameters Result Reference Total leukocytes (×10³/mm³) 9.500 6.411–12.811 Segmented neutrophils (mm³) 4.465 2.400–6.300 Lymphocytes (mm³) 4.180 2.200–9.600 Monocytes (mm³) 855 0–750 Leukocyte morphology Activated monocytes (+) and reactive lymphocytes (+) * PCV: packed cell volume. MCV: mean corpuscular volume. MCHC: mean corpuscular hemoglobin concentration. RDW-cv: red cell distribution width - coefficient of variation. * reference values: Burden et al. ( 2015 ); Ribeiro et al. ( 2018 ). Table 2 Biochemical values observed in the immediate postpartum period. Serum Biochemistry Parameters Result Reference Urea (mg/dL) 35 9–31,2 Creatinine (mg/dL) 1,9 0,6 − 1,33 Albumin (g/dL) 3,25 2,15 − 3,16 AST(U/l) 408 238–536 GGT (U/l) 70,1 14–69 * AST: aspartate aminotransferase. GGT: gamma-glutamyl transferase. * reference values: Burden et al. ( 2015 ); Ribeiro et al. ( 2018 ). The jenny remained standing, showed no locomotor difficulty or severe pain, and exhibited spontaneous intake of food and water. Follow-up evaluation revealed no abnormalities in physiological parameters, no additional vaginal trauma, and no complications related to the obstetric intervention, indicating favorable clinical progression. Discussion and Conclusions Section Based on the clinical signs observed, the jenny was stalled in stage II of parturition (fetal expulsion stage), which is characterized by rupture of the chorioallantois and the appearance of the fetal limbs or head in the birth canal until complete fetal expulsion (Carluccio et al. 2015 ; Lanci et al. 2022 ). In eutocic deliveries in jennies, this stage lasts on average 19 minutes (Carluccio et al. 2015 ). In the present case, although rupture of the chorioallantois had occurred, no exposure of fetal limbs or head through the birth canal was observed, and the animal remained in this stage for a prolonged period, indicating the need for obstetric intervention. In equines, fetal presentation during dystocia can vary, with malposition of the forelimbs and abnormal flexion or extension of the head and neck being most commonly observed (Frazer et al. 1997 ). In jennies, posterior presentation (Sachan et al. 2019 ; Kumar et al. 2024 ) or anterior presentation with flexed limbs (Chauhan et al. 2013 ) has been reported. Thus, the findings of anterior presentation, right lateral position, head deviation, and carpal joint flexion observed in this case are consistent with descriptions previously reported in both mares and jennies. Although corrective obstetric maneuvers were performed as recommended, including fetal retropulsion into the uterus followed by correction of abnormal fetal posture (Lanci et al. 2020; Pynn 2015 ), these techniques were unsuccessful in completing delivery due to fetopelvic disproportion. The choice of vaginal delivery, despite the difficulties encountered, poses fewer risks to maternal life and to the fetus when viable, as it avoids general anesthesia and surgical intervention. However, vaginal delivery can be extremely challenging due to the limited pelvic space, as observed in this case, and carries a risk of trauma to the jenny or mare, potentially compromising future reproductive performance (Pynn 2015 ). Fetotomy is indicated when the fetus is nonviable (Carluccio et al. 2007 ) and when no progress in fetal traction is achieved after more than 15 minutes of obstetric manipulation (Pynn 2015 ). These criteria were met in the present case, as attempts to correct and extract the stillborn fetus exceeded this time frame. For proper fetotomy, the use of a complete obstetric kit is recommended, including obstetric chains and hooks, a fetotome with cleaning brush, fetotome wire saw, sterile wire cutters, wire handles, short wire introducer, Krey hook, fetotomy knife, sterile rubber gloves, obstetric lubricant, clean bucket, stomach tube, pump, and rope snare (Frazer 2001 ). In this case, the absence of these instruments represented a limiting factor, requiring technical adaptations using a scalpel blade, ropes, and an obstetric hook. Although the lack of appropriate equipment likely increased procedural difficulty, it did not compromise the final outcome. Ellerbrock et al. ( 2024 ) describe fetopelvic disproportion as one of several causes of dystocia in equines. Accordingly, in the present jenny, dystocia was likely of combined origin, involving both fetal malposture and fetopelvic disproportion, as evidenced by the difficulty in fetal traction even after correction of fetal posture and synchronization with uterine contractions. Hematological findings, including relative erythrocytosis and hyperfibrinogenemia, indicate hemoconcentration due to dehydration and an acute inflammatory response associated with stress and obstetric conditions. In equids subjected to physical exertion, increases in hematocrit and plasma proteins are commonly observed due to reduced plasma volume and subsequent hemoconcentration (Mueller 1994). Elevated plasma fibrinogen is recognized as part of the acute-phase response in jennies and is considered a sensitive marker of inflammation and systemic stress (Pérez-Ecija et al. 2020 ; Farias et al. 2025 ). Mild monocytosis and the presence of reactive lymphocytes indicate nonspecific inflammatory activation, commonly observed in equids following dystocia (Ellerbrock et al. 2024 ). Therefore, the hematological alterations observed are consistent with dehydration secondary to dystocia combined with an acute-phase inflammatory response. In jennies, serum urea and creatinine concentrations tend to remain within reference ranges during parturition (Bonelli et al. 2016 ). However, increased levels were observed in this case, suggesting possible prerenal azotemia secondary to renal hypoperfusion associated with dehydration. Similarly, increased serum albumin and GGT concentrations compared with reference values reported by Burden et al. ( 2015 ) and Ribeiro et al. ( 2018 ) may be attributed to hemoconcentration resulting from dehydration. Following the procedure, the jenny showed satisfactory clinical recovery, remaining standing, feeding spontaneously, and without additional complications. This outcome is consistent with other reports of dystocia in jennies, in which prompt and appropriate intervention favored maternal recovery without reproductive impairment (Chauhan et al. 2013 ; Feyisa et al. 2025 ; Kumar et al. 2024 ; Sachan et al. 2019 ). This case highlights the importance of prompt and adaptive obstetric intervention in the management of dystocia in jennies, even under structural limitations. Postural correction combined with partial fetotomy allowed resolution of delivery while preserving maternal integrity, demonstrating that technically sound approaches can be effective in challenging scenarios. The clinical and laboratory responses reinforce the need for postpartum therapeutic support and emphasize the resilience of the species in complex obstetric events. Declarations The authors declare that no funds, grants, or other financial support were received during the conduct of this study and the preparation of this manuscript, and that there are no financial or non-financial conflicts of interest related to this study. Pedro Vinícius Barbosa da Silva Nazareno, Moroni Dias de Souza Almeida and Gabriel Barbosa de Melo Neto were responsible for the clinical care and procedures. The planning and writing were performed by Pedro Vinícius Barbosa da Silva Nazareno and Gabriel Barbosa de Melo Neto. The text review was conducted by Juliana de Moura Alonso and Patricia Fernandes Nunes da Silva Malavazi. All authors read and approved the final manuscript. Ethical approval Not applicable. Author Contribution Pedro Vinícius Barbosa da Silva Nazareno, Moroni Dias de Souza Almeida and Gabriel Barbosa de Melo Neto were responsible for the clinical care and procedures. The planning and writing were performed by Pedro Vinícius Barbosa da Silva Nazareno and Gabriel Barbosa de Melo Neto. The text review was conducted by Juliana de Moura Alonso and Patricia Fernandes Nunes da Silva Malavazi. All authors read and approved the final manuscript. Data Availability Yes. Clinical, obstetric, and laboratory data were generated and analyzed during the conduct of this case report, including physical examination findings, obstetric assessment, therapeutic interventions, and hematological and biochemical results. All data generated or analyzed during this study are included in this published article. References Bonelli F, Rota A, Corazza M, Serio DG, Sgorbini M (2016) Hematological and biochemical findings in pregnant, postfoaling, and lactating jennies. 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Clin Tech Equine Pract 5(3):145–153. https://doi.org/10.1053/j.ctep.2006.03.008 McCue PM, Ferris RA (2012) Parturition, dystocia and foal survival: a retrospective study of 1047 births. Equine Vet J Suppl 44(41):22–25. https://doi.org/10.1111/j.2042-3306.2011.00476.x Mendoza FJ, Toribio RE (2025) An overview of donkey neonatology. Animals 15(13):1986. https://doi.org/10.3390/ani15131986 Mendoza FJ, Perez-Ecija RA, Monreal L, Estepa JC (2011) Coagulation profiles of healthy Andalusian donkeys are different than those of healthy horses. J Vet Intern Med 25(4):967–970. https://doi.org/10.1111/j.1939-1676.2011.0748.x Nimmo MR, Slone DE, Hughes FE, Lynch TM, Clark CK (2007) Fertility and complications after fetotomy in 20 brood mares (2001–2006). Vet Surg 36(8):771–774. https://doi.org/10.1111/j.1532-950X.2007.00335.x Pérez-Ecija A, Buzon-Cuevas A, Aguilera-Aguilera R, Gonzalez-De Cara C, Mendoza FJ (2020) Reference intervals of acute phase proteins in healthy donkeys. Animals 10(12):2408. 10.1111/jvim.16015 Pynn OD (2015) Managing dystocia in the field. In: Sprayberry KA, Robinson NE (eds) Robinson’s Current Therapy in Equine Medicine, 7th edn. Elsevier, St. Louis, pp 709–712 Purohit GN (2011) Intrapartum conditions and their management in the mare. J Livest Sci 2:20–37 Ribeiro RM, Duarte P, Viana VA, Araújo ML, Pedroza H, Ribeiro DSF (2018) Hemograma e bioquímica sérica de jumentos da região norte e noroeste do Ceará–Brasil. Rev Ci Vet Saúde Pública 5:38–46. https://doi.org/10.4025/revcivet.v5i1.37830 Sachan V, Kumar B, Saxena A, Chaudhary MK (2019) Dystocia due to bilateral hock flexion in a jenny ( Equus asinus ). Indian J Anim Reprod 40(1):61–62 Thiemann AK, Buil J, Rickards K, Sullivan RJ (2022) A review of laminitis in the donkey. Equine Vet Educ 34(10):553–560. https://doi.org/10.1111/eve.13533 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8565302","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":574433730,"identity":"b56bd60a-39e5-4b99-9316-a3fe3128f1d2","order_by":0,"name":"Pedro Vinícius Barbosa da 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using ropes after postural correction. \u003cstrong\u003ee\u003c/strong\u003e) Stillborn fetus partially extracted, with the trunk already exteriorized after correction of cephalic position and fetotomy of the forelimbs. \u003cstrong\u003ef\u003c/strong\u003e) Fetus completely removed via vaginal delivery following obstetric maneuvers and partial fetotomy.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8565302/v1/026ff860a642f2cb4f86089f.png"},{"id":102397702,"identity":"eec2478e-16bf-418f-bae3-5b368d292f00","added_by":"auto","created_at":"2026-02-11 10:19:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2065218,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8565302/v1/fc8b1022-ae99-49d1-8f07-201a7ac03ae8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eFetal Distocia in a Jenny Due to Forelimb Flexion and Fetopelvic Disproportion\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eEquids have a gestational period ranging from 365 to 376 days, although wider variations from 340 to 395 days have been reported (Chauhan et al. \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), with an average of 370 days in jennies (Mendoza and Toribio \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Parturition is characterized as a brief and intense process divided into three stages (Chauhan et al. \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). During stage I, uterine and cervical preparation occurs, characterized by restlessness, sweating, and initial uterine contractions, culminating in rupture of the chorioallantois. Subsequently, stage II involves fetal expulsion, beginning with rupture of the allantois, and typically lasts 15 to 30 minutes in eutocic deliveries. Stage III comprises expulsion of the fetal membranes, which occurs within three hours after birth (Carluccio et al. \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFailure in any stage of parturition may result in dystocia, defined as a difficult delivery that can compromise neonatal viability and cause injury or death of the dam and/or fetus, frequently requiring veterinary intervention to complete delivery (Purohit \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn mares, although uncommon, dystocia represents a significant obstetric challenge. Prolongation of stage II is associated with increased neonatal complications, including stillbirth, and may originate from maternal causes or, more frequently, fetal abnormalities. Early identification and appropriate intervention before exceeding the maximum duration of stage II are therefore essential to ensure survival of both foal and mare (McCue and Ferris \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFetal causes commonly involve abnormalities of fetal posture, such as incorrect positioning of the forelimbs, alone or combined with head deviation. Fetal malformations (e.g., hydrocephalus and arthrogryposis), fetopelvic disproportion, uterine torsion, twin pregnancy, and post-surgical uterine adhesions have also been described. Moreover, many mares present dystocia of combined origin rather than a single isolated factor (Ellerbrock et al. \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDecision-making between cesarean section and obstetric maneuvers in dystocia management should consider fetal viability, duration of labor, and degree of trauma. Although cesarean section is more invasive, it may represent the safest option in prolonged or difficult dystocia, particularly when there is risk of severe maternal injury. Assisted vaginal delivery is preferred in mild dystocia due to lower invasiveness and faster recovery (Freeman et al. \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e1999\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDystocia in jennies (\u003cem\u003eEquus asinus\u003c/em\u003e) is rare, affecting an estimated 1\u0026ndash;4% of cases, with causes similar to those in mares (Lu et al. \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). As in mares, fetal causes predominate. Reports include posterior presentation (Kumar et al. \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Sachan et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), flexed limbs (Sachan et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), anterior presentation with one flexed limb (Chauhan et al. \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), and a case of \u003cem\u003eSchistosomus reflexus\u003c/em\u003e (Dubbin et al. \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e1990\u003c/span\u003e), all resolved by obstetric maneuvers with or without fetotomy. A case of maternal-origin dystocia associated with pelvic injury requiring three consecutive cesarean sections has also been described (Feyisa et al. \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGiven the scarcity of reports and the clinical relevance of dystocia in jennies, this study aims to describe a case characterized by abnormal fetal posture with limb flexion, head deviation, and fetal death, requiring corrective obstetric maneuvers and partial fetotomy.\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eA crossbred jenny approximately two years old, weighing an estimated 250 kg, was presented with dystocia. Anamnesis revealed no information regarding breeding date or expected parturition; the animal had been in labor for at least seven hours, showing abdominal contractions, restlessness, repeated standing and recumbency, and vaginal discharge. No prior manual or pharmacological intervention had been performed.\u003c/p\u003e \u003cp\u003eOn inspection, the jenny exhibited dyspnea, intermittent vocalization, and restlessness, alternating between standing and lateral or sternal recumbency (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003ea). Ventral abdominal distension and enlarged mammary glands were noted, consistent with late gestation. Partial exteriorization of fetal membranes through the vulva was observed (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eb).\u003c/p\u003e \u003cp\u003ePhysical examination revealed heart rate of 60 beats per minute, respiratory rate of 28 breaths per minute, pale mucous membranes, capillary refill time of 2 seconds, reduced intestinal motility, and rectal temperature of 37.5°C. Obstetric examination was subsequently performed.\u003c/p\u003e \u003cp\u003eTransrectal palpation indicated fetal engagement in the pelvic cavity. After antisepsis, transvaginal palpation using long obstetric gloves confirmed lack of fetal responsiveness. The fetus was in anterior presentation, right lateral position, with head deviation and bilateral carpal joint flexion. Assisted vaginal delivery was initially attempted. Sacrococcygeal epidural anesthesia was performed using 2 mL of 2% lidocaine without vasoconstrictor (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003ec).\u003c/p\u003e \u003cp\u003eHead and neck retropulsion was initiated, followed by correction of the flexed forelimbs to orient them toward the birth canal. With both forelimbs extended, traction was applied using ropes (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003ed). However, alignment of the head and neck within the birth canal was not possible due to insufficient space (fetopelvic disproportion), and corrective attempts over approximately 30 minutes were unsuccessful.\u003c/p\u003e \u003cp\u003ePartial fetotomy of the thoracic limbs at the carpal joints was therefore performed using a scalpel, as appropriate fetotomy instruments were unavailable. Ropes were tied to the distal radial epiphysis, increasing free space within the pelvic canal.\u003c/p\u003e \u003cp\u003eManual repositioning of the head remained difficult; thus, an obstetric hook was attached to the mandibular symphysis to facilitate repositioning and traction. This allowed alignment of the fetal head with the maternal body axis and subsequent extraction, followed by removal of the trunk (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003ee).\u003c/p\u003e \u003cp\u003eTraction required three individuals, and significant difficulty was encountered during passage of the fetal pelvis, necessitating assistance from an additional person (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003ef). No additional trauma to the vaginal canal was observed following repositioning, traction, or fetotomy.\u003c/p\u003e \u003cp\u003eFetal evaluation revealed no signs of prematurity, evidenced by normal or relatively large size compared with the maternal pelvis, well-developed hair coat, fully keratinized hooves, and absence of prominent eyes or rounded head. Other indicators of fetal maturity could not be assessed. No fetal measurements were obtained.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003ePostpartum treatment included gentamicin in dose of 6.6 mg/kg intramuscularly (IM), once a day (SID), for 5 days, ceftiofur (5 mg/kg IM, SID, 7 days), meloxicam (0.6 mg/kg IM, SID, 3 days), cloprostenol (250 µg IM, single dose), and oxytocin (40 IU, single dose). Hematological (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) and biochemical (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) analyses were performed.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHematological and plasma fibrinogen values observed in the immediate postpartum period.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eComplete Blood Count (CBC)\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eErythrogram\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameters\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResult\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRed blood cells (×10⁶/mm³)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8,47\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4,4–7,1\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCV (%)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27–42\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemoglobin (g/dL)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13,6\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8,9–14,7\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCV (fL)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54,7\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53–67\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCHC (g/dL)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29,3\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31–37\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRDW-cv (%)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13,9\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16,1–22\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal Proteins\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResult\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7,6 g/dL\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5,8 − 7,6 g/dL\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFibrinogen\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResult\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e800 mg/dL\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100–600 mg/dL*\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLeukogram\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eParameters\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResult\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eReference\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal leukocytes (×10³/mm³)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.500\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.411–12.811\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSegmented neutrophils (mm³)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.465\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.400–6.300\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocytes (mm³)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.180\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.200–9.600\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonocytes (mm³)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e855\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0–750\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLeukocyte morphology\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"3\"\u003eActivated monocytes (+) and reactive lymphocytes (+)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e* PCV: packed cell volume. MCV: mean corpuscular volume. MCHC: mean corpuscular hemoglobin concentration. RDW-cv: red cell distribution width - coefficient of variation.\u003c/p\u003e \u003cp\u003e* reference values: Burden et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2015\u003c/span\u003e); Ribeiro et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBiochemical values observed in the immediate postpartum period.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eSerum Biochemistry\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameters\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResult\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrea (mg/dL)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9–31,2\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine (mg/dL)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,9\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,6 − 1,33\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin (g/dL)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3,25\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2,15 − 3,16\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAST(U/l)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e408\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e238–536\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGGT (U/l)\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70,1\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14–69\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e* AST: aspartate aminotransferase. GGT: gamma-glutamyl transferase.\u003c/p\u003e \u003cp\u003e* reference values: Burden et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2015\u003c/span\u003e); Ribeiro et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe jenny remained standing, showed no locomotor difficulty or severe pain, and exhibited spontaneous intake of food and water. Follow-up evaluation revealed no abnormalities in physiological parameters, no additional vaginal trauma, and no complications related to the obstetric intervention, indicating favorable clinical progression.\u003c/p\u003e "},{"header":"Discussion and Conclusions Section","content":"\u003cp\u003eBased on the clinical signs observed, the jenny was stalled in stage II of parturition (fetal expulsion stage), which is characterized by rupture of the chorioallantois and the appearance of the fetal limbs or head in the birth canal until complete fetal expulsion (Carluccio et al. \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Lanci et al. \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In eutocic deliveries in jennies, this stage lasts on average 19 minutes (Carluccio et al. \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). In the present case, although rupture of the chorioallantois had occurred, no exposure of fetal limbs or head through the birth canal was observed, and the animal remained in this stage for a prolonged period, indicating the need for obstetric intervention.\u003c/p\u003e\u003cp\u003eIn equines, fetal presentation during dystocia can vary, with malposition of the forelimbs and abnormal flexion or extension of the head and neck being most commonly observed (Frazer et al. \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e1997\u003c/span\u003e). In jennies, posterior presentation (Sachan et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Kumar et al. \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) or anterior presentation with flexed limbs (Chauhan et al. \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) has been reported. Thus, the findings of anterior presentation, right lateral position, head deviation, and carpal joint flexion observed in this case are consistent with descriptions previously reported in both mares and jennies.\u003c/p\u003e\u003cp\u003eAlthough corrective obstetric maneuvers were performed as recommended, including fetal retropulsion into the uterus followed by correction of abnormal fetal posture (Lanci et al. 2020; Pynn \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2015\u003c/span\u003e), these techniques were unsuccessful in completing delivery due to fetopelvic disproportion.\u003c/p\u003e\u003cp\u003eThe choice of vaginal delivery, despite the difficulties encountered, poses fewer risks to maternal life and to the fetus when viable, as it avoids general anesthesia and surgical intervention. However, vaginal delivery can be extremely challenging due to the limited pelvic space, as observed in this case, and carries a risk of trauma to the jenny or mare, potentially compromising future reproductive performance (Pynn \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFetotomy is indicated when the fetus is nonviable (Carluccio et al. \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) and when no progress in fetal traction is achieved after more than 15 minutes of obstetric manipulation (Pynn \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). These criteria were met in the present case, as attempts to correct and extract the stillborn fetus exceeded this time frame.\u003c/p\u003e\u003cp\u003eFor proper fetotomy, the use of a complete obstetric kit is recommended, including obstetric chains and hooks, a fetotome with cleaning brush, fetotome wire saw, sterile wire cutters, wire handles, short wire introducer, Krey hook, fetotomy knife, sterile rubber gloves, obstetric lubricant, clean bucket, stomach tube, pump, and rope snare (Frazer \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). In this case, the absence of these instruments represented a limiting factor, requiring technical adaptations using a scalpel blade, ropes, and an obstetric hook. Although the lack of appropriate equipment likely increased procedural difficulty, it did not compromise the final outcome.\u003c/p\u003e\u003cp\u003eEllerbrock et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) describe fetopelvic disproportion as one of several causes of dystocia in equines. Accordingly, in the present jenny, dystocia was likely of combined origin, involving both fetal malposture and fetopelvic disproportion, as evidenced by the difficulty in fetal traction even after correction of fetal posture and synchronization with uterine contractions.\u003c/p\u003e\u003cp\u003eHematological findings, including relative erythrocytosis and hyperfibrinogenemia, indicate hemoconcentration due to dehydration and an acute inflammatory response associated with stress and obstetric conditions. In equids subjected to physical exertion, increases in hematocrit and plasma proteins are commonly observed due to reduced plasma volume and subsequent hemoconcentration (Mueller 1994). Elevated plasma fibrinogen is recognized as part of the acute-phase response in jennies and is considered a sensitive marker of inflammation and systemic stress (Pérez-Ecija et al. \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Farias et al. \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMild monocytosis and the presence of reactive lymphocytes indicate nonspecific inflammatory activation, commonly observed in equids following dystocia (Ellerbrock et al. \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Therefore, the hematological alterations observed are consistent with dehydration secondary to dystocia combined with an acute-phase inflammatory response.\u003c/p\u003e\u003cp\u003eIn jennies, serum urea and creatinine concentrations tend to remain within reference ranges during parturition (Bonelli et al. \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). However, increased levels were observed in this case, suggesting possible prerenal azotemia secondary to renal hypoperfusion associated with dehydration. Similarly, increased serum albumin and GGT concentrations compared with reference values reported by Burden et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) and Ribeiro et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) may be attributed to hemoconcentration resulting from dehydration.\u003c/p\u003e\u003cp\u003eFollowing the procedure, the jenny showed satisfactory clinical recovery, remaining standing, feeding spontaneously, and without additional complications. This outcome is consistent with other reports of dystocia in jennies, in which prompt and appropriate intervention favored maternal recovery without reproductive impairment (Chauhan et al. \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Feyisa et al. \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Kumar et al. \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Sachan et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis case highlights the importance of prompt and adaptive obstetric intervention in the management of dystocia in jennies, even under structural limitations. Postural correction combined with partial fetotomy allowed resolution of delivery while preserving maternal integrity, demonstrating that technically sound approaches can be effective in challenging scenarios. The clinical and laboratory responses reinforce the need for postpartum therapeutic support and emphasize the resilience of the species in complex obstetric events.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003eThe authors declare that no funds, grants, or other financial support were received during the conduct of this study and the preparation of this manuscript, and that there are no financial or non-financial conflicts of interest related to this study.\u003c/p\u003e \u003cp\u003ePedro Vin\u0026iacute;cius Barbosa da Silva Nazareno, Moroni Dias de Souza Almeida and Gabriel Barbosa de Melo Neto were responsible for the clinical care and procedures. The planning and writing were performed by Pedro Vin\u0026iacute;cius Barbosa da Silva Nazareno and Gabriel Barbosa de Melo Neto. The text review was conducted by Juliana de Moura Alonso and Patricia Fernandes Nunes da Silva Malavazi. All authors read and approved the final manuscript.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003ePedro Vin\u0026iacute;cius Barbosa da Silva Nazareno, Moroni Dias de Souza Almeida and Gabriel Barbosa de Melo Neto were responsible for the clinical care and procedures. The planning and writing were performed by Pedro Vin\u0026iacute;cius Barbosa da Silva Nazareno and Gabriel Barbosa de Melo Neto. The text review was conducted by Juliana de Moura Alonso and Patricia Fernandes Nunes da Silva Malavazi. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eYes. Clinical, obstetric, and laboratory data were generated and analyzed during the conduct of this case report, including physical examination findings, obstetric assessment, therapeutic interventions, and hematological and biochemical results. All data generated or analyzed during this study are included in this published article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBonelli F, Rota A, Corazza M, Serio DG, Sgorbini M (2016) Hematological and biochemical findings in pregnant, postfoaling, and lactating jennies. 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Rev Ci Vet Sa\u0026uacute;de P\u0026uacute;blica 5:38\u0026ndash;46. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4025/revcivet.v5i1.37830\u003c/span\u003e\u003cspan address=\"10.4025/revcivet.v5i1.37830\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSachan V, Kumar B, Saxena A, Chaudhary MK (2019) Dystocia due to bilateral hock flexion in a jenny (\u003cem\u003eEquus asinus\u003c/em\u003e). Indian J Anim Reprod 40(1):61\u0026ndash;62\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThiemann AK, Buil J, Rickards K, Sullivan RJ (2022) A review of laminitis in the donkey. Equine Vet Educ 34(10):553\u0026ndash;560. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/eve.13533\u003c/span\u003e\u003cspan address=\"10.1111/eve.13533\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Donkeys, Fetotomy, Obstetrics, Reproductive intervention","lastPublishedDoi":"10.21203/rs.3.rs-8565302/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8565302/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIn jennies, dystocia is rare and poorly documented, constituting an obstetric emergency that requires rapid diagnosis and appropriate intervention to preserve maternal health. This study aimed to report a case of fetal dystocia in a jenny, highlighting the obstetric diagnosis, therapeutic approach, and clinical outcome. A crossbred primiparous jenny was attended after approximately seven hours in stage II of parturition. Obstetric examination revealed anterior presentation, right lateral position, bilateral carpal joint flexion, head deviation, and fetal death. Following sacrococcygeal epidural anesthesia, corrective obstetric maneuvers were attempted but were unsuccessful due to fetopelvic disproportion. Partial fetotomy of the thoracic limbs was therefore performed, followed by cephalic repositioning using an obstetric hook, allowing vaginal removal of the fetus. No additional lesions of the birth canal were observed. The jenny showed satisfactory clinical recovery, remaining standing with spontaneous intake of food and water. Due to the lack of specific fetotomy instruments, technical adaptations were required during the procedure. Postural correction associated with partial fetotomy proved effective in resolving dystocia, preserving maternal integrity and emphasizing the importance of appropriate obstetric management in jennies.\u003c/p\u003e","manuscriptTitle":"Fetal Distocia in a Jenny Due to Forelimb Flexion and Fetopelvic Disproportion","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-22 08:15:41","doi":"10.21203/rs.3.rs-8565302/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3eeb2c6f-4cfb-4a13-83e5-9b3d06302d2d","owner":[],"postedDate":"January 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-10T19:39:40+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-22 08:15:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8565302","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8565302","identity":"rs-8565302","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}