This document discusses various types of birth injuries that can occur during delivery, including causes, symptoms, and treatments. Common birth injuries are head injuries, nerve injuries, and skin/subcutaneous or muscle injuries. Head injuries include caput succedaneum, cephalhematoma, skull fractures, and intracranial hemorrhage. Nerve injuries involve facial palsy, brachial plexus injuries like Erb's palsy and Klumpke's palsy. Causes of birth injuries include precipitous labor, prolonged/obstructed labor, fetal macrosomia, abnormal presentations, instrumental deliveries, and fetal anomalies. Prevention involves comprehensive prenatal care, screening high risk babies, fetal

1. BIRTH INJURIES
GOWHAR RASHID BHAT
BSC NURSING 4TH YEAR
GOVT NURSING COLLEGE GMC SRINAGAR

2. Definition :-
 Birth injuries are the trauma that arise during the time of delivery .
 It can be:-
 Prenatal (before delivery)
 Intranatal (during delivery)
 Post natal (after delivery)
 Common birth injuries are:-
 Head injuries (96%) cephalic presentation is common.
 Nerve injuries.
 Other injuries.
 Skin and subcutaneous.
 Muscle injuries.

3. CAUSES:-
1. Precipitous labor:- Also known as Rapid labor.
 A labor is called precipitous labor when the combined duration of the first and
second stage is then 3 hours.
 Can cause intracranial stress and hemorrhage because of rapid expulsion without
time molding of the head.
Molding:-
 Change in shape of fetal head while passing through the resistant birth passage
during Labor.
 There is no change in size and volume.
2. Prolonged or obstructed labor:-
 The labor is said to be prolonged when the combined duration of Ist and second
stage is more than arbitrary time limit of 18 hours.
Obstructed labor:-
 Also Known as Dystocia.

5.  It is the arrest of vaginal delivery of the foetus due to mechanical obstruction.
Eg. Large sized baby.
Small women etc.
1. Fetal Macrosomia:-
 According to WHO, In India, infact with birth weight >4kg at term is said to be
macrosomic fetus.
 Caused due to Maternal hyperglycemia, etc.
2. Cephalic disproportionately:-
 It is the disparity or disproportion in the relation between the head or pelvis.
 It can be due to:-
A large sized baby,
Contracted pelvis,
Or both .

6. 1. Abnormal presentation:- (Breech):-
 Most common malpresentation.
 Baby is lying longitudinaly.
 Buttocks, foot or feet are presenting parts instead of its head.
 C- section is usually recommended.
COMPLICATIONS:-
 Injuries to baby’s legs or arms such as dislocation or broken bones.
 Umbilical cord problems. The Umbilical cord can be flattened or
twisted during delivery. Which can cause nerve or brain damage due to lack of oxygen.
2. Shoulder Dystocia:-
 It is a birth injury that happens when one or both shoulders of a baby gets
stuck inside the mother’s pelvis during labour and birth.
3. Fetal anomalies:-
 Like Macrosomia ( generalized fetal enlargement).

8. Other causes
1. Very low birth weight infant’s:-
 When a baby is born weighing less than 5 pounds. (<2.5kg).
 Bady is not so strong.
2. Instrumental delivery (Forceps or ventouse):-
 Also known as Assisted delivery.
 Forceps or ventouse suction cups are used.
 Can cause brain and skin damage.
3. Inadequate maternal pelvis:-
 Also Known as CEPHALOPELVIC DISPROPORTIONATELY.
 Occurs when fetal head is too big for the pelvis.
 Can cause compression to the head leading to fractures, hametoma ,etc.
4. Oligohydramnios
5. Intimate partner violence:-
 Abuse or aggregation that occurs in a romantic relationship.

9. HEAD INJURIES:-
1. Caput succedaneum:-
 It is a process where there is edema or swelling on the scalp of newborn.
 Swelling happens in between skin and top of periosteum without blood.
 Mostly caused due to the overlapping of suture lines of newborn.
 Least severe.
 Can disappear in some days by itself.
Symptoms:-
 Puffiness under the skin of scalp.
 Skin is swollen nad soft.
 Discoloration of skin.
Management:-
 No management .
 Disappears within 36 hours.

10. 1. Cephalhematoma:-
 It is the collection of blood in between the pericranium and the flat bone of the skull.
 It is usually unilateral and over the parietal bone.
Causes:-
 It is due to rupture of a small emissary vein from the skull and may be associated with
fracture of the skull bone.
 May be caused by Forceps delivery.
Symptoms:-
 Soft and bulge on the babies skull.
 Anemia.
 Jaundice.
 Infection.
Treatment:-
 Disappears after 1-2 days.
 Infection> incision > Drainage > antibiotics.

11. 1. Scalp injuries:-
 Minor injuries:-
these are minor such as abrasion in forceps delivery.
incision wound during CS.
Management:-
Dressed with an antiseptic solution like 2% mercurochrome.
 Fracture skull:-
Break in the continuity of bones of skull.
May be of linear or depressed type.
Causes:-
Forceps delivery.
Spontaneous delivery.
Diagnosis:-
x-ray or CT scan.
Treatment Is Symptomatic.

12. 1. Intracranial Hemorrhage:-
 It can be:-
 External to the brain:-
Epidural:- blood collection between inner skull and dura Matter.
Subdural:- in between Dura and arachnoid matter .
Subarachnoid spaces:- in between arachnoid matter and pia matter.
 In the brain:-
Cerebrum.
Cerebellum.
 Incidence:-
 Subdural hemorrhage > 70%
 Subarachnoid > 20%
 Intracerebral > 20%
 Causes:-
 Excessive moulding.
 Rapid compression.
 Forcible Forceps traction.

13.  Management:-
 Investigations :-
 USG
 Doppler USG
 CT scan
 MRI
 CSF
 Treatment:-
 In case of hydrocephalus:-
 Phenobarbitone:- 20 mg/kg IV as loading dose and 3-4 mg/kg/day in divided doses.
 Phenetoyin :- 20mg/kg IV as loading dose and 3-4mg /kg/day maintenance dose.

14. NERVE INJURIES:-
 Facial palsy:- Also known as Bell’s Palsy.
 Sudden weakness in the muscles on one half
of the face due to the damage in cranial nerve VI
i.e, facial nerve.
 Symptoms:-
 Facial assymetry.
 Facial paralysis.
 Inability to close eye’s.
 Loss of taste from 2/3rd
 Affect the blinking reflex.
 SUCKING REFLEX IS NOT AFFECTED, as it is controlled
by 5,7,9,10 and 12 th cranial nerve.
 Management:-
 Prednisolone (steroid)
 Physiotherapy to strengthen the muscles.

15. iam = internal acoustic meatus

17. BRACHIAL PLEXUS:-
 Brachial means arms.
 Plexus means collection of nerves.
 It’s a network of spinal nerves constituted by anterior primary rami of C5, C6, C7, C8,
and T1.
 DISORDERS:-
1. Brachial palsy:-
Weakness or paralysis of the arm as a result of significant injury to the brachial plexus.
Caused due to shoulder dystocia.
2. Erb’s palsy:-
Nerve root of C5 and C6 injury.
Symptoms:-
Shoulder drop with arm hang downwards.
Medial rotation of hand. (Know as WAITERS TIP POSITION).
Moro reflex absent due to loss of sensation.

18. 1. Klumpke’s palsy :-
Nerve root of C7,C8 and T1 injury.
Symptoms:-
Wrist drop.
 OTHER INJURIES:-
 Skin and subcutaneous tissues:-
 Bruises and lacerations on the face
and usually caused by Forceps blades
 Scalpel cut or laceration injury may occur during CS.

19. Prevention of injuries in newborn:-
1. Provide comprehensive antenatal and intranasal care
2. Screen out high risk babies who are likely to get injury during delivery.
3. Continuously do fetal monitoring to find out cerebral anoxia.
4. Give episiotomy carefully.
5. Don’t unduly stretch the neck.