**3. Tools and protocols during parturition**

During parturition, it is important to recognize birth complications and treat accordingly. Further, evaluation of colostrum quality is necessary in order to know whether the sow has good quality colostrum or if piglets need additional colostrum from another sow. Also, the vitality and colostrum uptake of the piglets need to be assessed. Piglets with low vitality and low colostrum uptake are at risk of starving and hypothermia. Both increase piglet mortality, especially due to crushing by the sow. **Tables 2** and **3** provide protocols for diagnosis and treatment of birth complications. **Tables 4** and **5** provide guidelines for the assessment of colostrum quality and piglet vitality.

#### **3.1 Diagnosis of birth complications**

Appropriate and prompt treatment of a sow with birth complications is important to avoid still- or weak-born piglets and to increase piglets' health and survival. This can be achieved through continuous farrowing supervision [56]. Farrowing supervision is also necessary for reducing the risk of puerperal disease [38]. Already before parturition, it is important to spot those sows that may be at risk of dystocia. These sows are usually gilts or old sows (≥6 parity), thin (≤14 mm) or fat (≥23 mm) sows, constipated sows (<2), and sows with history of birth complications and birth of still

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**Table 4.**

**Table 3.**

**Table 2.**

*Tools and Protocols for Managing Hyperprolific Sows at Parturition: Optimizing Piglet Survival…*

and weak piglets [11, 57]. These sows need an obstetrical examination if more than 30 min have passed since the last piglet was expelled (**Table 2**) [12]. This applies also to sows that are restless and have strong abdominal contractions during parturition

*Risk factors for birth complications. Farrowing supervision should occur every 30 min when sow is at risk.* 

*Guideline for evaluating colostrum quality (colostrum collected from several anterior teats within 0–3 h from* 

*DOI: http://dx.doi.org/10.5772/intechopen.91337*

*Otherwise, farrowing supervision once an hour.*

*Guidelines for diagnosis and treatment of birth complications [12, 61–69].*

*the start of farrowing) using Brix refractometer [70].*

*Tools and Protocols for Managing Hyperprolific Sows at Parturition: Optimizing Piglet Survival… DOI: http://dx.doi.org/10.5772/intechopen.91337*

and weak piglets [11, 57]. These sows need an obstetrical examination if more than 30 min have passed since the last piglet was expelled (**Table 2**) [12]. This applies also to sows that are restless and have strong abdominal contractions during parturition


#### **Table 2.**

*Animal Reproduction in Veterinary Medicine*

**Figure 1.**

**3. Tools and protocols during parturition**

*ducts, and milk ducts. Images taken by Stefan Björkman.*

**3.1 Diagnosis of birth complications**

functional teats, also the morphology is important. Piglets tend to suck first from teats that are close to the abdominal midline and have longer inter-teat distances [53]. Thus, a functional teat with short inter-teat distance and/or long distance between teat base and abdominal midline may be unusable for the piglet [54].

*Severe prepartum edema of the mammary gland. Visual inspection (A) reveals dimpled skin with persistent marks of the floor, swollen teats, and indistinguishable gland complexes. Ultrasonographic image (B) shows shadowing, thickened dermal tissue, hyperechoic lobuloalveolar tissue, and enlarged blood vessels, lymphatic* 

Furthermore, severe edema of the mammary gland before parturition will have a negative impact on teat accessibility, reduce colostrum quality, and increase the risk of PDS [48, 49]. The degree of mammary gland edema can be graded visually or via ultrasound [48, 49, 55]. At visual inspection, sows with severe udder edema have dimpled skin with persistent marks of the floor (**Figure 1A**). Further, teats are swollen and mammary glands are indistinct (**Figure 1A**) [48, 49]. Ultrasound of the mammary glands shows thickened dermal and subdermal tissues, hyperechoic lobuloalveolar tissue with enlarged blood vessels, and severe shadowing (**Figure 1B**) [48, 49, 55]. Also at the end of lactation, the assessment of the mammary gland, as described above, is crucial and should be used for the decision of removing the sow from the herd.

During parturition, it is important to recognize birth complications and treat accordingly. Further, evaluation of colostrum quality is necessary in order to know whether the sow has good quality colostrum or if piglets need additional colostrum from another sow. Also, the vitality and colostrum uptake of the piglets need to be assessed. Piglets with low vitality and low colostrum uptake are at risk of starving and hypothermia. Both increase piglet mortality, especially due to crushing by the sow. **Tables 2** and **3** provide protocols for diagnosis and treatment of birth complications. **Tables 4** and **5** provide guidelines for the assessment of colostrum quality and piglet vitality.

Appropriate and prompt treatment of a sow with birth complications is important to avoid still- or weak-born piglets and to increase piglets' health and survival. This can be achieved through continuous farrowing supervision [56]. Farrowing supervision is also necessary for reducing the risk of puerperal disease [38]. Already before parturition, it is important to spot those sows that may be at risk of dystocia. These sows are usually gilts or old sows (≥6 parity), thin (≤14 mm) or fat (≥23 mm) sows, constipated sows (<2), and sows with history of birth complications and birth of still

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*Risk factors for birth complications. Farrowing supervision should occur every 30 min when sow is at risk. Otherwise, farrowing supervision once an hour.*


#### **Table 3.**

*Guidelines for diagnosis and treatment of birth complications [12, 61–69].*


#### **Table 4.**

*Guideline for evaluating colostrum quality (colostrum collected from several anterior teats within 0–3 h from the start of farrowing) using Brix refractometer [70].*


#### **Table 5.**

*Behavioral and physiological indicators of low colostrum intake and neonatal mortality.*

or to sows with prolonged parturition (>300 min) [12]. Obstetric intervention is usually not indicated before 1–15 h has passed since the last piglet was born in sows without risk for dystocia, which are at the beginning of parturition (<300 min since the expulsion of the first piglet) and show no signs of strong abdominal straining or restlessness [11, 12, 57]. Restlessness can occur if stress and pain are present [58]. For instance, increased stress induces higher frequency of postural changes and longer duration of standing position of sows during the expulsion stage of parturition [58].

Whenever the abovementioned criteria are fulfilled, an obstetrical examination needs to be performed. An obstetric examination includes palpation and ultrasonography of the birth canal [12, 59]. Palpation of the birth canal should always occur through the rectum and not through the vagina. Vaginal palpation can lead to an increased risk of subsequent dystocia, stillborn piglets, and PDS [3, 7, 12, 57]. Rectal palpation is necessary to determine the exact cause of dystocia before any intervention is undertaken. When no piglet is felt within the birth canal, then the cause of dystocia is uterine inertia [8, 9, 12]. Other causes are, e.g., obstruction of the birth canal due to ventral deviation of the uterine horns or fetal malposition [8, 9, 12]. After these obstructive causes are ruled out, treatment for uterine inertia can be applied [12].

Ultrasonography can be used to determine whether farrowing is over or if the sow has retained piglets [59] or placentae [60] (**Figure 2**).

#### **Figure 2.**

*Transabdominal ultrasonographic image of a non-expelled piglet (A; arrows indicate vertical and horizontal dimension) and placentae (B; arrows indicate placentae). Scale bars on right margins in 1 cm steps. Images taken by Alexander Grahofer (A) and Stefan Björkman (B).*

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*Tools and Protocols for Managing Hyperprolific Sows at Parturition: Optimizing Piglet Survival…*

Oxytocin, an uterotonic agent, is used during farrowing to treat dystocia by provoking uterine contractions [61]. If primary uterine inertia occurs, before administration of any exogenous oxytocin, we recommend trying means of releasing endogenous oxytocin, e.g., manual induction of the Ferguson reflex and massaging the udder of the sow [8]. Furthermore, movement and physical exercise of the sow have positive effects on the farrowing duration, especially if the sow is still at the beginning of the second phase [12]. If that does not help, we recommend waiting for at least 30 min. Often progesterone has not fully declined and oxytocin receptors are not fully expressed [62], which makes oxytocin administration contraindicated. In this case, possible stressors and sources of pain should be investigated, and provision of nest-building material or application of pain medication may be indicated. If the sow is constipated, removing feces from the rectum by hand is

Immediate application of exogenous oxytocin is indicated if secondary uterine inertia is diagnosed towards the end of the second phase of parturition [12]. Several studies were conducted to prove the effect of oxytocin on the birth process and piglet survivability and to evaluate the proper dosage of oxytocin in dystotic sows [63–65]. An intramuscular administration of 10 IU of oxytocin did not cause any side effects. However, higher dosages led to an increase in stillborn piglets, changes in the umbilical cord, and higher meconium scoring [63–65]. Furthermore, the improper use of oxytocin can lead to unwanted side effects. These side effects are increased uterine inertia and manual assistance [66, 67] as well as ruptured or damaged umbilical cord [68] and decreased placental blood flow [69]. Hence, we recommend administering oxytocin only restrictively, e.g., 5–10 IU one to two times

It is possible to easily collect colostrum during parturition due to the almost continuous (every 5–40 min) milk ejections [29]. A brix refractometer can be used for quality assessment. Brix refractometer can be an inexpensive, rapid, and satisfactorily accurate method for estimating IgG concentration on farm [70, 71]. We recommend collecting a colostrum from several anterior teats within 0–3 h from the start of farrowing when the IgG level peaks [70]. If this is done early during parturition, sows with low-quality colostrum can be spotted and more support to her litter, e.g., assisted nursing and split suckling, can be provided. Nevertheless, it is possible to determine colostrum quality at any stage of parturition. This may be indicated if piglets are born late (farrowing duration > 12 h). Differentiation between good and poor IgG content of colostrum is possible interpreting the results with the categories proposed in **Table 3**. Colostrum with an IgG level of 50 mg IgG/ml is considered of good quality [14]. When Brix values are <20%, they reflect very low levels of IgG, while values from 25% upwards are considered to correspond to good or very good concentration of IgG in colostrum. Results between 20 and 24% are defined as borderline [70]. With borderline results, we suggest taking another sample within 1–2 h to determine whether the development of the estimated IgG

*DOI: http://dx.doi.org/10.5772/intechopen.91337*

**3.2 Treatment of birth complications**

beneficial.

during parturition [12].

**3.3 Colostrum collection and quality assessment**

content is stable, increasing, or decreasing from the initial value.

piglets using a feeding bottle with a suitable nipple or using a syringe.

Colostrum can also be stored and used later for piglets with low colostrum intake or for litters of sows with low colostrum quality. Colostrum can be stored in a fridge for 1–2 days or in the freezer for 3–6 months. Only sows with high colostrum quantity and quality should be selected. The collected colostrum can be administered to

*Tools and Protocols for Managing Hyperprolific Sows at Parturition: Optimizing Piglet Survival… DOI: http://dx.doi.org/10.5772/intechopen.91337*
