Birth injury

DEFINITION
• An impairment of the infants body function or structure
due to adverse influences that occur at birth.
Risk factors
• Primiparity
• Small maternal stature
• Maternal pelvic anomalies
• Prolonged or unusually rapid labor.
• Oligohydramnios .
• Malpresentation of the fetus.
• Use of mid forceps or vaccum extraction .
CLASSIFICATION OF BIRTH INJURIES
• Soft tissue –
– Abrasions –
– Erythema petechia –
– Ecchymosis –
– Lacerations -Subcutaneous fat necrosis • Peripheral nerve –
– Brachial plexus palsy –
• Skull –
– Unilateral vocal cord paralysis –
– Caput succedaneum –
– Radial nerve palsy –
– Cephalohematoma –
– Subgaleal hemorrhage – • Lumbosacral plexus injury
– Linear fractures – • Musculoskeletal injuries –
– Intracranial hemorrhages – Clavicular fractures –
• Face – – Fractures of long bones –
– Subconjunctival hemorrhage – – Sternocleido-mastoid injury
– Retinal hemorrhage • Intra-abdominal injuries –
– Liver hematoma –
– Splenic hematoma –
• Cranial nerve & spinal cord injuries – Adrenal hemorrhage –
--Facial palsy – Renal hemorrhage
 CAPUT SUCCEDANEUM
• Bruising and oedema of presenting part
extending beyond the margin of the skull bone
• Prolonged delivery,
• ventouse delivery
• Pressure from uterus and vaginal wall during
vaginal delivery
• Detected on ultrasound/vaginal examination
• Resolves in few days
• Usually no complication
  CEPHALHAEMATOMA
• Bleeding below periosteum, confined within margins of the skull suture .
• More common while using metal cup
• Resolved in 4 to 6 weeks
•  Complications include-
– a. Anemia, jaundice (1-16%)
– b. Calcified (hard around the edge, soft at the center): will resolved
– focus of infection; meningitis, osteomyelitis
• Occasionally associated by linear skull fracture (5-20%)
• Management-
– Subside itself.
– If infection is suspected, aspiration of the mass If sepsis, antibiotics
hyperbilirubinemia – photo therapy Subgaleal hematoma Transfusions may be
required if blood