Birth injuries in newborns

Many newborns suffer only minor injuries during birth.

Very rarely, nerve damage or broken bones occur.

Most injuries heal without further treatment.

A difficult delivery with the risk of injury to the baby can occur with extremely large fetuses. Doctors recommend a cesarean section Cesarean section In a cesarean section, the baby is delivered surgically after the woman’s abdominal wall and uterus are opened with an incision. In the United States, up to 30 percent of all. Learn more (caesarean section) if they expect the baby to weigh more than 11 pounds (more than 10 pounds if the mother has diabetes). An unfavorable birth position of the child in the uterus also increases the risk of injury ( Position and posture of the child Position and posture of the child Birth injuries are damages that occur due to physical pressure during birth, mostly when passing through the birth canal. Many newborns suffer only minor injuries. Learn more ).

Birth injuries most often occur due to the natural application of force during labor and delivery. In the past, when cesarean section was still associated with high risks, doctors used forceps for difficult births Vaginal-surgical deliveries A vaginal-surgical delivery is a delivery in which a vacuum extractor or forceps are used. A vacuum extractor consists of a small, rubber-like. Learn more (a surgical instrument with rounded corners that fits around the fetal head) to help pull out the fetus. However, pulling the fetus out of the birth canal with forceps carried a high risk of birth injury. Today, forceps are used only in the last moments of delivery, and thus rarely cause injury. Overall, the rate of birth injuries has dropped sharply from previous decades, thanks to better prenatal screening with ultrasound Overview of Common Neonatal Complaints Neonatal disorders can occur before birth, while the fetus is maturing in the womb during labor and delivery After birth About 10 percent of newborns require. Learn more , the limited use of forceps and because doctors often resort to a cesarean section when they can foresee that there is a higher risk of birth injury.

Position and posture of the baby

Towards the end of pregnancy, the baby turns into the birthing position. Usually the child’s face is facing backwards (towards the woman’s back), with the face and body pointing in the same direction, the head is bent and the child is in the head position.

A positional anomaly is a position in which the face faces forward and the face, forehead, rump, or shoulder are forward.

Did you know .

Compared to the last decades, severe birth injuries have become quite rare nowadays.

Head and brain injuries during birth

A head injury is the most common injury during childbirth.

A Head deformation is not an injury. Deformity refers to a normal change in the shape of the baby’s head caused by pressure on the head during delivery. In most births, the head passes through the birth canal first. Because the fetal skull bones are not yet rigidly fixed, the head elongates as it is pushed through the birth canal. This allows the fetus to pass through the birth canal more easily. The deformity does not affect the brain or cause any problems that need to be treated. The head shape gradually becomes round again over several days.

The resulting swelling and bruising of the scalp Are harmless and completely regress within a few days.

One Bleeding outside the bones of the skull can lead to blood pooling either above or below the thick fibrous periosteum (periosteum) on one of the bones of the skull.

A Cephalhematoma is an accumulation of blood At the periosteum. Cephalhematomas feel soft and can continue to grow after birth. Cephalhematomas disappear by themselves after weeks or months and almost never need to be treated. However, they should be checked by a pediatrician if they become red or have fluid coming out of them. Sometimes some of the blood calcifies and leaves a hard lump in the scalp. The lump is not dangerous, is usually hidden by hair, and does not require treatment.

An subgaleal hematoma is a hemorrhage directly under the skull but via The periosteum that covers the bones of the skull. Blood in this area can spread and is not confined to one area, like cephalhematoma. There may be massive blood loss and shock Circulatory shock Circulatory shock is a life-threatening condition in which organs receive little blood, reducing oxygen supply, leading to damage and sometimes death. Learn more Lead a blood transfusion Overview of blood transfusion A blood transfusion involves transferring blood or blood components from a healthy person (a donor) to a sick person (a recipient). Blood transfusions serve to. Learn more makes necessary. A subgaleal hematoma can be caused by the use of forceps or a suction cup, or it can be the result of a problem with blood clotting Overview of Blood Clotting Disorders Blood clotting disorders (coagulation disorders) are disorders of the body’s ability to control the formation of platelets. These disruptions can lead to the following: Too little. Learn more be.

It can lead to fracture (Fracture) of a skull bone occurs before or after delivery. As long as the skull bone is not depressed (depression fracture), the bone usually heals quickly without treatment.

Did you know .

Most birth injuries are caused by natural forces during labor and delivery.

Bleeding in and around the brain

Bleeding in and around the brain (intracranial bleeding) is caused by injury to a blood vessel inside the skull. These injuries are the result of

Serious conditions in the newborn that cut off blood and oxygen supply to the brain

A problem with blood clotting

Sometimes, an intracranial hematoma occurs after a normal delivery in an overall healthy newborn. The cause of bleeding in such cases is unknown.

Most babies with hemorrhage have no symptoms; some may be lethargic (sluggish), eat poorly, and/or have seizures.

Bleeding can occur in several places in and around the brain:

Under a Subarachnoid hemorrhage is a hemorrhage under the inner of the two membranes surrounding the brain. This is the most common type of intracranial hemorrhage in newborns, usually in infants who have been carried to full term. Newborns with a subarachnoid hemorrhage may occasionally have apnea (cessation of breathing), seizures during the first 2 to 3 days of life Seizures in children Seizures are periodic disturbances in the electrical activity of the brain that cause some degree of temporary brain dysfunction. When older infants or. Experience more or suffer lethargy, but usually end up doing well again.

A Subdural hematoma Is a hemorrhage between the inner and middle layers of tissue that surround the brain. It occurs much less frequently today, thanks to improved delivery techniques. A subdural hematoma can put increased pressure on the surface of the brain. Newborns with a subdural hematoma may have disorders such as z. B. Develop seizures.

A Epidural hematoma Is bleeding that forms between the outer covering (dura mater) of the tissue that covers the brain (meninges) and the skull. An epidural hematoma can be caused by a skull fracture. When the hematoma increases pressure in the brain, the soft spots between the bones of the skull (fontanelles) can bulge out. Newborns with an epidural hematoma may suffer from apnea or seizures.

In the case of intraventricular hemorrhage There is a pooling of blood in areas of the brain that are normally filled with fluid (ventricles).

A intraparenchymal hemorrhage Occurs in the brain tissue itself. Intraventricular hemorrhage and intraparenchymal hemorrhage usually occur in very immature newborns Preterm birth A preterm baby is one who is born before 37. Week of pregnancy was delivered. Depending on when they were delivered, newborns may have underdeveloped organs that are outside of the. Learn more on and are due to an underdeveloped brain rather than a birth injury. Most of these hemorrhages do not cause any symptoms. However, severe bleeding may cause apnea or a bluish-gray discoloration of the skin, or the newborn’s entire body may stop functioning normally. Newborns with severe bleeding have a poor prognosis. However, they usually survive minor bleeding without further damage.

Newborns with a hemorrhage need to be in a neonatal intensive care unit Neonatal intensive care unit (NICU) Neonatal disorders can occur before birth, while the fetus is maturing in the womb during labor and delivery After birth About 10 percent of newborns require. Learn more (NICU) are brought to be monitored, receive supportive care (such as warmth), infusions through the vein (intravenous), and other treatments they need to maintain body functions.

bleeding around the brain

A hemorrhage can occur in several places in and around the brain.

Nerve injury

Nerve injury may occur before or during delivery. These injuries usually cause weakening of the muscles controlled by the injured nerve. Nerve injuries can occur in the

Facial nerve: wry facial expression

Brachial plexus: arm and/or hand weakness

Spinal cord (rare): paralysis

A Injury to the facial nerve Is present when the affected newborn cries and his or her face looks crooked (asymmetrical). This injury is caused by pressure on the nerve, due to:

The way the fetus had been lying in the womb before birth

the fact that the nerve had been pressed against the mother’s pelvis during delivery

a delivery with the help of forceps

Treatment of the facial nerve injury is not required, and the muscle weakness resolves within 2 to 3 months. However, facial nerve weakness can sometimes be caused by a congenital disorder rather than an injury and will not simply go away on its own.

The Brachial plexus Is a group of large nerves that lie between the neck and shoulder and lead to each arm. During a difficult delivery, one or both of the baby’s arms may be stretched and the brachial plexus nerves may be injured ( brachial plexus damage brachial plexus damage The brachial plexus (networks of interwoven nerve fibers of the various spinal nerves) may be damaged by injury, tumors, blood pockets (hematomas), or autoimmune reactions. Learn More ) and result in partial or complete weakness or paralysis of the baby’s arm or hand. Weakness of the shoulder or elbow is called Erb’s palsy, and weakness of the hand and wrists is called Klumpke’s palsy. About half of brachial plexus injuries occur in difficult deliveries, including babies who are too big, and about half occur in babies who have normal deliveries. Injuries to the brachial plexus are less common in babies born by cesarean section. However, in order for the nerves to regenerate, extreme shoulder movements should be avoided. Many milder injuries resolve after a few days. If the abnormality is more severe or if it lasts more than 1 to 2 weeks, physical or occupational therapy is recommended for straightening and gentle movement of the arm. If there is no improvement after one to two months, doctors usually recommend that the baby be evaluated by a pediatric neurologist and/or orthopedic surgeon at a pediatric specialty clinic to determine if surgery would be beneficial.

Sometimes Phrenic nerve, That passes through the diaphragm (muscle wall that separates the organs of the chest from the organs of the abdomen and aids in breathing) is injured, resulting in diaphragmatic paralysis on that side. In this case, the newborn may suffer from breathing difficulties and sometimes need assistance with breathing. A phrenic nerve injury usually heals completely on its own within a few weeks.

Injuries to the Spinal cord due to overstretching during birth are extremely rare. These injuries may result in paralysis below the site of injury. Often, spinal cord damage is permanent. Some spinal cord injuries that occur at the very top of the neck can be fatal because they prevent the newborn from breathing properly.

Other nerves, such as the radial nerve in the arm, the sciatic nerve in the small of the back, or the obturator nerve in the leg can also be injured during delivery.

Bone injuries

Bones can break (fracture) before and during delivery, even during a normal delivery.

Fracture of the clavicle (collarbone) is relatively common, occurring in 1 to 2 percent of newborns. Sometimes these fractures are not discovered until several days after birth, when a clump of tissue has formed around the fracture. A clavicle fracture does not seem to bother newborns and it does not need to be treated. It is completely healed on its own after a few weeks.

Sometimes fractures of the upper arm bone (humerus) or the thigh bone (femur) can occur. Doctors usually place a loose splint on the bone to restrict movement. These fractures may cause pain for the first few days when the baby moves. But they usually heal well, unless the end of the bone (where the growth plates are) was affected.

Multiple fractures can also occur in newborns with certain genetic diseases in which the bones are very fragile.

Injuries to skin and soft tissue

Slight injuries may be seen on the newborn’s skin after birth, especially in areas that were exposed to intense pressure during labor or first exited through the birth canal. Instruments needed for delivery, such as forceps Vaginal-surgical deliveries A vaginal-surgical delivery is a delivery that uses a vacuum cup (vacuum extractor) or birth forceps. A vacuum extractor consists of a small, rubbery. Learn more can injure the skin. Newborns born face-first may have swelling and bruising around the eyes and face, and breech birth in the genital area (see Positional anomalies Positional anomalies describes whether the baby’s face faces backward in the womb (toward the mother’s back, d. h. Face down if the mother is lying on her back) or forward . Learn More ). These bruises do not need to be treated.

The use of instruments during delivery and stress to the newborn (z. B. due to asphyxia) can injure the fatty tissue under the skin (called subcutaneous fat necrosis in newborns). This skin lesion may be visible as reddened, firm bumps on the trunk, arms, hips, and buttocks. This type of injury usually heals on its own within weeks or months.

Perinatal asphyxia

Perinatal asphyxia is a decrease in blood flow to the baby’s tissues or a decrease in oxygen levels in the baby’s blood, during and after delivery. Common causes include:

Obstruction of blood flow through the umbilical cord

Developmental abnormalities of the fetus (z. B. if there is a genetic anomaly)

Severe infection of the fetus

taking certain medications before birth

Severe bleeding in the mother

Severe maternal illness

Sometimes the exact cause of perinatal asphyxia is not found.

Regardless of the cause, newborns appear pale and lifeless at birth. You breathe weakly or not at all and have a very slow heart rate. Need to be resuscitated (resuscitated) after delivery. Resuscitation can be done by using a resuscitation bag and face mask to force air into the lungs, or by inserting a breathing tube into the baby’s neck (endotracheal intubation). If asphyxia occurs due to sudden blood loss, the newborn may be in shock Circulatory shock Circulatory shock is a life-threatening condition in which the organs are starved of blood, reducing oxygen supply, resulting in damage and sometimes death. Learn more stand. Through a venous line, they receive immediate fluids and sometimes a blood transfusion Overview of blood transfusion A blood transfusion involves transferring blood or blood components from a healthy person (a donor) to a sick person (a recipient). The purpose of blood transfusions is to. Learn more .

Newborns with asphyxia may show signs of injury to one or more organ systems, including:

Heart: unhealthy skin color, low blood pressure

Lungs: Difficulty breathing and low oxygen levels

Brain: lethargy, seizures and even coma

Kidneys: Decreased urine output

Liver: difficulty making the proteins needed for blood clotting

Intestine: problems with milk digestion

Blood-forming system: low platelet count and bleeding

Newborns can receive medications to support their heart function and artificial respiration Artificial respiration is done through a ventilator that supports airflow in and out of the lungs. Some patients with respiratory insufficiency need such a ventilator. Learn more about respiratory support needs. Some newborns who have been resuscitated can benefit from lowering their body temperature below the normal temperature of 37 °C for 72 hours. Transfusions of blood cells and blood plasma may be necessary to solve the problems with the hematopoietic system. Most organs damaged by perinatal asphyxia recover within a week, but brain damage can linger.

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