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Birth injuries
- 2. INJURIES TO HEAD The common injuries to head includes: • Cephalhematoma • Caput succedaneum • Intracranial hemorrhage • Fracture of skull bones • Scalp injures
- 3. Caput succedaneum • It is edematous swelling on the babies scalp due to infiltration of serous fluid by the pressure of cervix, bony pelvis or vulval ring.
- 5. • The swelling develops due to reduced venous blood supply and lymphatic drainage from scalp. • The area become congested and edematous and present as caput at birth.
- 6. • It may cross the suture line. • Grow less • It pits on pressure. • Nonfluctuant & diffuse in nature • No management required. It disappear within 36hours.
- 7. CEPHALHEMATOMA • It is collection of blood in between periosteum and flat bone of skull.
- 8. • It occurs due to rupture of small veins from skull resulting from friction between the fetal skull and pelvis. • It may be associated with fracture of skull bone. • It doesn’t present at birth, it develops a few hours after birth. • It is incompressible.
- 9. • Fluctuant swelling. • Usually unilateral. • It tends to grow and may persists for weeks. • The scalp may show discolouration. • Most cephalhematoma disappear spontaneously after few days or week. • No active treatment required. • Vitamin K 1 to 2 mg IM given
- 11. INJURIES TO NERVE • Facial palsy • Brachial palsy a. Erb’s palsy b. Klumpke’s palsy
- 12. FACIAL PALSY • It is also known as Bell’s palsy. • The facial nerve may injured by direct pressure of the forceps or by hemorrhage or edema around the nerve. • It may in normal delivery with much pressure.
- 13. FEATURES OF FACIAL PALSY • Facial asymmetry • Inability to close eye & absence of rooting reflex on affected side. • It recovers within weeks, because of more regenerative power and short length of nerve.
- 14. BRACHIAL PALSY • The damage occurs in brachial nerve roots or in trunk of brachial plexus due to stretching or haemorrhage or tearing of fibers. • It can cause due to hyper extension of neck during delivery. • There are two Types.
- 16. ERB’S PALSY • This involves c5, c6 cervical root. And this is most common. The features are: a. The paralysis causes with elbow extended b. Pronation of forearm c. Flexion of wrist d. Arm recoil is lost e. Moro reflex absent
- 18. Klumpke’s Palsy • It occurs due to damage to 7th or 8th cervical nerve or 1st thoracic nerve. The features are: a. Paralysis of muscles of forearm with wrist drop and flaccid digits. b. The arm is flexed at the elbow, the wrist extended with flaccid hands and flexed fingers.
- 19. INJURIES TO BONE • Long bone fractures • Spinal fracture • Dislocation of joints
- 20. PREVENTION OF BIRTH INJURIES • Neck should not be stretched during vaginal delivery to prevent brachial palsy. • Episiotomy should be carefully to prevent scalp injury. • Continuous fetal monitoring • Special care to be taken during preterm delivery. • Precautions followed during forceps delivery. • Delivery should be done by skilled personnel • Prolong labor should be managed carefully.