A 24-yr-old African elephant (Loxodonta africana) was inseminated on 2 December 2000 and again on 4 December 2000. Pregnancy was confirmed on 21 January 2001 with an ultrasound evaluation, and elevated progesterone levels of over a 12- to 16-wk period supported the diagnosis. The pregnancy progressed without complication. Ultrasounds confirmed calf growth and movement throughout the pregnancy.
On 5 October 2002, 673 days post-insemination, the cow passed the mucous plug in the evening. The chorio-allantois ruptured shortly after that. There were a few modest contractions over a period of about 3 h, which then ceased. Fetal front feet could be palpated in the birth canal, just into the cranial pelvis. Fetal circulation was confirmed using color Doppler ultrasound of the fetal extremities. Oxytocin was administered on 6 October 2002. The first two doses resulted in a few good contractions. Fetal feet entered further into the pelvis, and fetal viability was confirmed again with color Doppler ultrasound. Oxytocin was administered three more times resulting in a few small contractions and some stretching. One dose of 110 IU oxytocin resulted in one large contraction, subsequent doses of oxytocin did not yield any appreciable additional efforts. That evening while walking the elephant, the amniotic sac broke releasing several liters of fluid. Blood was drawn and serum chemistries were within normal range. On 7 October 2002, the uterus did not respond to oxytocin. Color Doppler ultrasound of the fetal legs revealed no discernable fetal circulation. Antibiotics and supportive care were initiated. For the next week, the feet were easily palpated within the pelvis. For the several days the elephant was stiff and moderately depressed. Her appetite was good and she was drinking water. The elephant was given another dose of oxytocin on 15 October 2002, which resulted in a few moderate contractions, but no progress was made in delivering the calf. The next day the elephant seemed more depressed and uncomfortable. Her appetite and water intake were markedly reduced and within 2 days she exhibited what appeared to be abdominal pain. The elephant was treated aggressively with antibiotics and fluids for several weeks. Severe peritonitis was confirmed during a laparoscopic procedure and the elephant was euthanatized. The postmortem examination revealed a tear in the uterus and a normal-sized fetus in normal presentation in the birth canal. The fetus however was abnormal and had arthrogryposis affecting all four limbs to varying degrees. Both rear limbs of the fetus were particularly affected and the joints of those limbs were bent in an abnormal way, anchoring the fetus inside the dam. The arthrogryposis of the calf was likely the cause of the dystocia, and was likely the contributing factor to the tear in the uterus.