The document discusses birth injury caused by forceps delivery and Group B Strep (GBS) infection. It provides details on:
1) The risks of forceps delivery to both mother and infant, including facial injuries, bruising, and skull fractures for infants and tears, pain, and bladder injuries for mothers.
2) GBS infection, which affects 25-40% of women, putting infants at risk of meningitis, pneumonia, and sepsis if exposed during birth. Treatment involves antibiotics.
3) Symptoms of GBS in infants include fever, breathing issues, and stiffness in the first week of life.
An impairment of the infants body function or structure due to adverse influences that occur at birth. Injuries to the infant may result from mechanical forces (i.e., compression, traction) during the birth process. 0.7% (Seven of every 1,000) births result in birth injuries, though most women give birth in modern hospitals surrounded by medical professionals. Birth injuries account for fewer than 2% of neonatal deaths. Infant mortality resulting from birth trauma fell from 64.2 to 7.5 deaths per 100,000 live births from 1970-1985. Birth injuries can be classified to Soft tissue injuries, Head and neck injuries, Facial injuries, Cranial nerve injuries, Spinal cord injuries, Peripheral Nerve injury, Fractures & Torticollis, Intra-abdominal injury. Proper management neccissates, early recognition of trauma, Careful physical and neurological evaluation, Establish whether additional injuries exist, Injury may result from resuscitation, Assess Symmetry of structure & function, Specific examination such as cranial nerve, joint range of motion, scalp/skull integrity.
Newborn Birth Injuries: The Untold Story
Introduction:
As a result of the birth process some injuries occur that may be minor, whereas other may be more serious. Despite skilled midwifery and obstetric care in developed, birth trauma still occurs.
Definition:
An impairment of the infants body function or structure due to adverse influences that occur at birth.
Risk factors:
Primi parity,
Small maternal stature
Prolonged or usually rapid labor
Malpresentation of the fetus
Use of mid forceps or vaccum extraction
Fetal macrosomia or large fetal head
Classification:
Based on areas involved:
1. trauma to skin and superficial tissues
2. muscle trauma
3. nerve trauma
4. fractures
PREVENTION OF BIRTH INJURIES
- To prevent or to detect early intrauterine fetal asphyxia.
- To avoid premature delivery.
- To avoid traumatic vaginal delivery.
- To extend the use of caesarean section in abnormal & complicated presentation more liberally.
- Improve the level of doctor and nurses
THANK YOU.
An impairment of the infants body function or structure due to adverse influences that occur at birth. Injuries to the infant may result from mechanical forces (i.e., compression, traction) during the birth process. 0.7% (Seven of every 1,000) births result in birth injuries, though most women give birth in modern hospitals surrounded by medical professionals. Birth injuries account for fewer than 2% of neonatal deaths. Infant mortality resulting from birth trauma fell from 64.2 to 7.5 deaths per 100,000 live births from 1970-1985. Birth injuries can be classified to Soft tissue injuries, Head and neck injuries, Facial injuries, Cranial nerve injuries, Spinal cord injuries, Peripheral Nerve injury, Fractures & Torticollis, Intra-abdominal injury. Proper management neccissates, early recognition of trauma, Careful physical and neurological evaluation, Establish whether additional injuries exist, Injury may result from resuscitation, Assess Symmetry of structure & function, Specific examination such as cranial nerve, joint range of motion, scalp/skull integrity.
Newborn Birth Injuries: The Untold Story
Introduction:
As a result of the birth process some injuries occur that may be minor, whereas other may be more serious. Despite skilled midwifery and obstetric care in developed, birth trauma still occurs.
Definition:
An impairment of the infants body function or structure due to adverse influences that occur at birth.
Risk factors:
Primi parity,
Small maternal stature
Prolonged or usually rapid labor
Malpresentation of the fetus
Use of mid forceps or vaccum extraction
Fetal macrosomia or large fetal head
Classification:
Based on areas involved:
1. trauma to skin and superficial tissues
2. muscle trauma
3. nerve trauma
4. fractures
PREVENTION OF BIRTH INJURIES
- To prevent or to detect early intrauterine fetal asphyxia.
- To avoid premature delivery.
- To avoid traumatic vaginal delivery.
- To extend the use of caesarean section in abnormal & complicated presentation more liberally.
- Improve the level of doctor and nurses
THANK YOU.
Newborn Care was written for healthcare workers providing special care for newborn infants in level 2 hospitals. It covers: resuscitation at birth, assessing infant size and gestational age, routine care and feeding of both normal and high-risk infants, the prevention, diagnosis and management of hypothermia, hypoglycaemia, jaundice, respiratory distress, infection, trauma, bleeding and congenital abnormalities, communication with parents
Speaker Name: Anjali
Topic: "Demystifying Nystagmus"
Hello Everyone, Namaste!! We would like to notify you all that Mero Eye Foundation is going to conduct an "EYE TALKS-Webinar", and we will be having our session live broadcast on YouTube (Session No. 118)
DATE: at, 07:300 PM NPT, 07:15 PM IST, 22nd May 2021.
YouTube links: https://youtu.be/b4G12rRvXFc
Hydrocephalus
introduction
Hydrocephalus, also known years ago as “water on the brain”, is a condition where the circulation system of the body’s cerebrospinal fluid (CSF) is not functioning properly. The CSF accumulates in the brain and causes intracranial pressure. A shunt is usually placed to equalize the flow of CSF, which requires surgery. The diagnosis and surgery can be very frightening for the parents as well as the child
definition
Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity
INCIDENCE
It is found in 1-3 of every 1000 born children in world wide
Classification
Non communicating. In the non communicating type of congenital hydrocephalus, an obstruction occurs in the free circulation of CSF.
Communicating. In the communicating type of hydrocephalus, no obstruction of the free flow of the CSF exists between the ventricles and the spinal theca; rather, the condition is caused by defective absorption of CSF, thus causing increased pressure on the brain or spinal cord.
CAUSES
Obstruction. The most common problem is a partial obstruction of the normal flow of CSF, either from one ventricle to another or from the ventricles to other spaces around the brain.
Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb CSF; this is often related to inflammation of brain tissues from disease or injury.
Overproduction. Rarely, the mechanisms for producing CSF create more than normal and more quickly than it can be absorbed.
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
Poor feeding. The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
Large head. An excessively large head at birth is suggestive of hydrocephalus.
Bulging of the anterior fontanelles. The anterior fontanelle becomes tense and bulging, the skull enlarges in all diameters, and the scalp becomes shiny and its veins dilate.
Setting sun sign. If pressure continues to increase without intervention, the eyes appear to be pushed downward slightly with the sclera visible above the iris- the so-called setting sun sign.
High-pitched cry. The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability. Irritability is also caused by an increase in the intracranial pressure.
Projectile vomiting. An increase in the intracranial pressure can cause projectile vomiting
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
conclusions
Newborn Care was written for healthcare workers providing special care for newborn infants in level 2 hospitals. It covers: resuscitation at birth, assessing infant size and gestational age, routine care and feeding of both normal and high-risk infants, the prevention, diagnosis and management of hypothermia, hypoglycaemia, jaundice, respiratory distress, infection, trauma, bleeding and congenital abnormalities, communication with parents
Speaker Name: Anjali
Topic: "Demystifying Nystagmus"
Hello Everyone, Namaste!! We would like to notify you all that Mero Eye Foundation is going to conduct an "EYE TALKS-Webinar", and we will be having our session live broadcast on YouTube (Session No. 118)
DATE: at, 07:300 PM NPT, 07:15 PM IST, 22nd May 2021.
YouTube links: https://youtu.be/b4G12rRvXFc
Hydrocephalus
introduction
Hydrocephalus, also known years ago as “water on the brain”, is a condition where the circulation system of the body’s cerebrospinal fluid (CSF) is not functioning properly. The CSF accumulates in the brain and causes intracranial pressure. A shunt is usually placed to equalize the flow of CSF, which requires surgery. The diagnosis and surgery can be very frightening for the parents as well as the child
definition
Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity
INCIDENCE
It is found in 1-3 of every 1000 born children in world wide
Classification
Non communicating. In the non communicating type of congenital hydrocephalus, an obstruction occurs in the free circulation of CSF.
Communicating. In the communicating type of hydrocephalus, no obstruction of the free flow of the CSF exists between the ventricles and the spinal theca; rather, the condition is caused by defective absorption of CSF, thus causing increased pressure on the brain or spinal cord.
CAUSES
Obstruction. The most common problem is a partial obstruction of the normal flow of CSF, either from one ventricle to another or from the ventricles to other spaces around the brain.
Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb CSF; this is often related to inflammation of brain tissues from disease or injury.
Overproduction. Rarely, the mechanisms for producing CSF create more than normal and more quickly than it can be absorbed.
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
Poor feeding. The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
Large head. An excessively large head at birth is suggestive of hydrocephalus.
Bulging of the anterior fontanelles. The anterior fontanelle becomes tense and bulging, the skull enlarges in all diameters, and the scalp becomes shiny and its veins dilate.
Setting sun sign. If pressure continues to increase without intervention, the eyes appear to be pushed downward slightly with the sclera visible above the iris- the so-called setting sun sign.
High-pitched cry. The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability. Irritability is also caused by an increase in the intracranial pressure.
Projectile vomiting. An increase in the intracranial pressure can cause projectile vomiting
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
conclusions
About fetal distress in pregnancy
Child cause fetal distress due to hypoxia there are maternal factors like cardiovascular hypothyroidisim acute bleeding . Fetal factors like cardiovascular dysfunction, deformity,, umbilical cord and placenta factors
MYELOMENINGOCELE copy.pptx a slide describing the conditionAjisafeZainab
Myelomeningocele is a disorder of the nervous system particularly the spine and spinal cord, before we go further in this presentation there are some terms to know to aid understanding.
➢Neural tube; The neural tube forms the early brain and spine, As development progresses, the top of the neural tube becomes the brain, and the rest of the tube becomes the spinal cord. An NTD happens when this tube doesn't close completely somewhere along its length. Neural tube closure is completed 28 days (four weeks) from conception.
➢Alpha fetoprotein; AFP is a protein that the liver makes when its cells are growing and dividing to make new cells. AFP is normally high in unborn babies. After birth, AFP levels drop very low. Healthy children and adults who aren't pregnant have very little AFP in their blood. Maternal AFP serum level is used to screen for Down syndrome, neural tube defects, and other chromosomal abnormalities.
➢Spinal bifida; Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD).
Nursing management of myelomeningocele
Types of spinal Bifida
Pathophysiology of myelomeningocele
Spina bifida is a birth disorder that involves the incomplete development of the spine. In the first month of pregnancy, a special set of cells forms the “neural tube;” the top of the tube becomes the brain, and the remainder becomes the spinal cord and structures around it. In spina bifida, the neural tube doesn’t close completely and some of the bones of the spine do not close in the back. This can result in an opening anywhere along the spine and may cause damage to the spinal cord and nerves.There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and myelomeningocele. The symptoms of spina bifida vary from person to person, depending on the type and level of involvement. Most cases are mild and do not require special treatment. The more serious cases involve nerve damage.
Occulta is the mildest and most common form in which one or more bones of the spinal column (vertebrae) are malformed. The name “occulta,” which means “hidden,” indicates that a layer of skin covers the opening in the bones of the spine. It usually shows no symptoms and is often found by accident on an x-ray or similar test.
Closed neural tube defects are a diverse group of disorders in which the spine may have malformations of fat, bone, or the membranes (the meninges) that cover the spinal cord. Many of these neural tube defects require surgery in childhood. People with this type of spina bifida may have weakness of the legs and trouble with bowel and bladder control. These issues may change or progress as children grow. It is important to have close communication with doctors to minimize these changes as much as possible.
Meningocele occurs when the meninges protrude through the spine and cause a sac of spinal fluid on the back. This fluid is typically only around the brain and spine, but a problem with the bony covering over the spine allows it to poke out. The malformation contains no nerves and may or may not be covered by a layer of skin. Individuals with meningocele may have minor symptoms.Myelomeningocele is the most severe form of spina bifida. A portion of the spinal cord or nerves are exposed in a sac through an opening in the spine that may or may not be covered by the meninges. The opening can be closed surgically while the baby is in utero or shortly after the baby is born. Most people with myelomeningocele experience changes in brain structure, leg weakness, and bladder and bowel dysfunction.
Myelomeningocele is often called a "snowflake condition" because no two people with the condition are the same. Typically, if the opening in the spine is lower down the back, the person will experience less symptoms. People with myelomeningocele require close follow-up with physicians throughout their childhood and lifespan to maximize their function and prevent complications like kidney failure.Complications of spina bifida may include:
Abnormal sensation or paralysis, which mostly occurs with closed neural tube defects and myelomenin
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
1. Birth injury cause
Forceps Delivery Injury
Birth-assisting tools have been commonplace during difficult deliveries for many
decades. Although they are certainly beneficial when used appropriately, the
percentage of birth injuries associated with these tools, in particular forceps, has
been a cause for concern. Even though the statistics show that birth injuries due to
forceps use is a real problem, physicians continue to use them, despite the chances
of inflicting trauma on infants.
Forceps and their Use
A pair of forceps is a birth-assisting tool that closely resemble large salad tongs.
The open end of forceps are typically placed around infant’s head to help guide the
baby out during the mother’s contractions. Most physicians acknowledge that
sometimes there is a risk of forceps delivery injury, but if there are other problems
during labor and delivery, they may turn to forceps for assistance.
Doctors Use Forceps
The most common reason forceps are used happens when the mother is unable to
push the baby out alone during delivery. This can happen for a variety of reasons
including maternal exhaustion, a prolonged second stage of delivery, illness or
infection, hemorrhage, or when drugs keep the mother from being able to push the
baby out successfully. Fetal factors that indicate the use of forceps include a breech
delivery or a troublesome reading in the fetal heart tracing. Often these factors
(both fetal and maternal) are time-emergent and doctors justify the use of forceps
as an emergency dictates. In almost all cases, forceps are not used unless there is a
means to perform an emergency cesarean section surgery (C-section) should the
use of forceps prove unsuccessful.
Risks of Using Forceps
When forceps are used, both mother and baby are at risk for injuries.
2. Maternal risks include:
Tears and lacerations in the lower genital tract area
Fecal and/or urinary continence
Perineum pain
Anemia
Bladder injuries
Urethra injuries
Infant risks include:
Facial palsy and facial injuries
Bruising and swelling on the head
Skull fractures
Seizures
Brain damage
Symptoms of a Forceps Injury
In most instances, the symptoms of a forceps injury are straightforward, such as
lacerations or bruising. Other symptoms of forceps injury can include a misshapen
head, nerve damage, skull fractures, and hemorrhages (brain bleeds). Be certain to
get your baby’s head and brain checked for a number of related birth injuries that
may poseserious health issues, including: seizure disorders, strokes, hypoxic
ischemic encephalopathy (HIE), and cerebral palsy.
Group B Strep Infection
GBS, also known as group B streptococci, is a bacterial infection that
affects anywhere from 25-40% of women. Contrary to popular myths,
GBS infections are not related to the group A strep, a bacteria that causes strep
throat. More severe, group b strep is a virus that a woman develop in the vaginal or
in the rectal area without knowing it. It is not considered a sexually transmitted
disease, and doctors still don’tknow how a woman gets it as she often shows zero
symptoms of having the virus.
GBS
The Centers for Disease Controland Prevention (CDC) suggests that all women
have a GBS test between 35 and 37 weeks of pregnancy. The testing process is
3. relatively simple: the doctortakes a swab and sends it off for cultured testing,
which generally that takes anywhere from 24-48 hours. Although there are no
symptoms to go by, there are several risk factors involved in developing GBS.
Women are more prone to GBS if they:
Previously had GBS during pregnancy
Have (or had) a urinary tract infection during pregnancy
Experience labor before 37 weeks of pregnancy
Have a baby more than 18 hours after their water breaks
Develop a high fever during labor
Treatment for GBS for Mothers
If you are found with GBS when you’re tested at the recommended time in your
pregnancy, your doctorshould prescribe pregnancy-friendly antibiotics. It’s
possible that during delivery, your child can get GBS when passing through the
birth canal and coming into contact with the virus. By taking antibiotics, the virus
can be attacked before your baby passes through the birth canal.
Dangers of GBS to Infants
Infants exposed to GBS can experience a number of health problems. As
mentioned earlier, not all babies will become sick if exposed to the virus, but every
infant who is, runs the risk of:
Meningitis
Pneumonia
Sepsis
Stillborn death
Dangers of GBS to Mothers
Mothers too, may experience a number of health problems, including:
Bladder infections
Uterine infections
Fever
Symptoms of a Group B Strep Infection
4. It’s important to keep an eye out for a group B strep infection in infant so that you
can get treatment for them as quickly as possible. These symptoms usually develop
anywhere within the first 24 hours of life to the first week of life, and may include:
fever, breathing problems, grunting sounds, bluish skin, seizures, limpness,
stiffness, heart rate and blood pressure abnormalities, poorfeeding, and fussiness.
Doctors can easily diagnose GBS in infants, sometimes with a chest X-ray and
sometimes lab studies that require samples of various different fluids such as
blood, urine, and cerebrospinal fluid. Infants with GBS may be prescribed with
antibiotics to fight the infection.
Epidural
An epidural, also known as epidural anesthesia, is a regional anesthesia
administered intravenously to block pain in the lower part of the body. A long
needle is typically inserted into your back, around the spinal cord area,
usually after the cervix has dilated to at least 4 centimeters. A thin catheter is
threaded through the needle, which ensures that the medication hits the epidural
area and the catheter stays in place. Once the catheter is in place, medication will
fluidly disperse either intermittently or continuously.
Types of Medications Used in Epidurals
Medications used is epidurals are known as local anesthetics, meaning medicines
used to reduce pain sensation in the targeted areas without you being fully unaware
or unfeeling of other local senses. The most common types of medications used in
epidurals include:
Bupivacaine
Lidocaine, or
Chloroprocaine
In the majority of instances, these medications are used in combinations with
narcotics or opoids to ensure maximum pain relief and to help reduce the dosage
amount of the local anesthetics.
Risks Associated with Epidurals
Maternal risks associated with epidurals include:
Seizures and dizziness
5. Infections
Spinal membrane injuries
Arachnoiditis
Breathing problems
Nerve damage
Long-term backpain
Increased risk of vacuum extraction or forceps use during delivery
Lower blood pressure
Infant risks include:
Difficulties with breastfeeding
Lack of oxygen, leading to more serious health problems, such as cognitive
disorders and cerebral palsy
Brain injuries
Infant stroke
Coma
Low Apgar scores
Poormuscle tone
Medical Mistakes and Epidural Injuries:
Administering too much medication
Administering medication the mother is allergic to
Injecting the needle into the wrong area
Failure to monitor maternal and fetal distress
Administering the epidural before proper cervix dilation
Administering an epidural to a mother who uses blood thinners or has a low
platelet counts
Hydrocephalus
Hydrocephalus is a medical condition in which there is an unusual buildup of
cerebrospinal fluid (CSF) in brain cavities known as ventricles. According to the
National Institute of Nervous Disorders and Stroke (NINDS), the exact number of
hydrocephalus is hard to determine because it strikes both children and adults.
Hydrocephalus can be a congenital condition. However, it can also be acquired in
cases of head trauma before, during, or birth.
6. defination
The condition’s name comes from the Greek words “hydro” (water) and
“cephalus” (head). Its literal translation is “water on the brain,” but the liquid that
accumulates in the ventricles is not water but CSF. CSF is necessary for the brain
to function. CSF protects the brain by serving as a cushion for the cerebral cortex.
It also protects the brain from infections and minor impacts to the skull.
Additionally, CSF helps regulate the involuntary function of the circulatory system
in the brain. CSF fits inside the subarachnoid spaceand within the ventricular
system in and around the brain and the spinal cord. A healthy brain usually
produces 500 mL of CSF daily. The central nervous system constantly reabsorbs
CSF, so the average amount of the liquid within the brain and spinal cord at any
given time is approximately 100-160 mL. Hydrocephalus’ various forms occur
when there is a problem with the flow or reabsorption of CSF. According to
NINDS, there are two main types of hydrocephalus: congenital, which is present at
birth, and acquired. External factors, including other diseases or head trauma,
usually cause acquired hydrocephalus. Both of the main forms of hydrocephalus
come in two categories: communicating and non-communicating.
Communicating hydrocephalus
In communicating hydrocephalus, the ventricles of the brain are still open and
CSF can still flow inside them. However, the CSF can’t flow out of the ventricles
because the exits are somehow blocked.
Non-communicating hydrocephalus
In non-communicating hydrocephalus, the flow of CSF along the narrow passages
that connectthe ventricles is completely blocked. A common cause of non-
communicative hydrocephalus is the narrowing of the passage called the aqueduct
of Sylvius. This small pathway connects the third and fourth ventricles.
Causes of Hydrocephalus
In most cases, it is hard to identify what causes hydrocephalus. Genetic
abnormalities or developmental disorders linked to conditions such as spina bifida
sometimes cause the congenital forms of hydrocephalus. Other possiblecauses are
meningitis, tumors, intraventricular bleeding, or subarachnoid hemorrhages.
Traumatic head injuries before or during delivery can also cause blockages in the
7. cranial ventricles and prevent the normal flow of CSF in a baby’s central nervous
system.
Symptoms of Hydrocephalus
The severity of hydrocephalus symptoms depends on many variables, including a
person’s age, how advanced the condition is, and personal differences in tolerance
for the disease. Some babies, for instance, don’t experience any negative effects
from hydrocephalus becausethe size of their skulls increases. In these cases, CSF
continues to flow normally among the ventricles becausethe elasticity of the still
growing skull prevents narrowing of the cranial passages. In cases where the
aqueduct of Sylvius and other passages are blocked, the symptoms are more
severe. The most obvious signs of hydrocephalus in babies are an abnormally large
head or an unusually fast increase of the head’s circumference. Hydrocephalus
may also cause headaches, irritability, vomiting, seizures, and sleepiness. In severe
cases, hydrocephalus may also cause comas.
Treatment Options
Shunt surgery is the most common form of hydrocephalus treatment. Doctors
generally insert catheters called shunts into the cerebral ventricles. The shunts
allow CSF to flow normally in the central nervous system and prevent further
accumulation of the liquid in the ventricles. The excess fluid flows into other
spaces in the bodyand then reabsorbed. This form of treatment usually works well,
but it can cause complications if problems occurwith the shunts. The two main
problems associated with surgically-implanted shunts are:
Shunt failures
Shunt infections
According to the Hydrocephalus Association, 50% of all shunts fail within two
years. They usually fail due to the natural changes in the skull as a child gets older.
Shunts are made to last a long time and are resilient, but the components can wear
out over time. In some cases, they can get loose or break in several pieces. Shunts
can also be clogged or get disconnected. Shunt failure results in renewed pooling
of CSF and the return of symptoms such as headaches, nausea, and vomiting.
Fever
Irritability
Vision problems
8. Shunt systems need both constant monitoring and regular medical follow-ups. This
helps to keep the negative effects of shunt failure under control and allows
physicians to schedule shunt replacement operations to prevent further
complications.. Bacteria already present in a child’s bodyoften cause shunt
infections. Symptoms may include redness or tenderness along the shunt tract, sore
neck or shoulder muscles, and a low-grade fever. Another surgical treatment for
hydrocephalus is a procedurecalled third ventriculostomy. Using a tiny fiber optic
camera called a neuroendoscope, doctorsinspect the ventricular surface. When the
neuroendoscopeis in place, they use a tiny tool to drill a small opening on the third
ventricle’s floor. This hole removes the blockage in the ventricle and allows the
CSF to flow normally again.
Prognosis
Shunts and third ventriculostomies relieve the pressureinside the skull and prevent
more neurological damage. Nevertheless, some children may still experience
adverse effects such as persistent headache even though the intracranial pressure is
gone. hydrocephalus often causes neurological damage, it can have a negative
effect on a child’s intellectual and physical development. If left untreated,
progressive hydrocephalus can be fatal.However, parents and loved ones should
know that a hydrocephalus diagnosis is not necessarily a death sentence for a baby.
Effective treatments for hydrocephalus exist. Proper monitoring by parents and
caregivers can minimize its effects. As a result, many children with hydrocephalus
grow up to lead normal lives with relatively few difficulties.
Cystic Fibrosis
Sometimes a life-threatening disease, cystic fibrosis is an inherited disorder
marked by abnormal glands that producethicker and more abnormal mucus and
sweat. In some cases, the build-up of mucus often resides in the lungs, the
digestive tracts, and other areas of the body. It’s the cystic fibrosis in the lungs that
interferes with respiration and sometimes causes life-threatening problems. When
an infant has cystic fibrosis, the mucus builds up in the lungs, the pancreas, and the
liver, which not only complicate the function of those organs but likewise make the
infant prone to infections in those areas.
Cystic Fibrosis Life-Threatening
Not only are the infections in organs such as the liver, lungs, and pancreas
dangerous, but most children end up having life-threatening complications from
9. the presence of the mucus in the lungs. As the lungs are one of the last organs to
develop in the fetus before birth, and because the fetus doesn’tget practice using
the lungs before birth, infants already have a hard time learning to use their lungs.
Yet, when you introduce the challenge of extra mucus in the lungs, the infants have
trouble breathing –sometimes the challenge is too much for them. Additionally, the
mucus of cystic fibrosis resides in the digestive tract, interfering with the way that
newborns process important nutrients.Often, infants with cystic fibrosis are
underweight, have trouble breathing, and have a heightened risk of dying for the
condition’s complications.
Cause of Cystic Fibrosis
Cystic fibrosis is a genetic disease and can only because via a parent passing down
gene changes to the infant. There is no way to stop cystic fibrosis, aside from
diagnosing a parent with the disorder and informing them that it can be passed
down. However, there are several instances in which cystic fibrosis may be
considered a birth injury, including:
Physicians fail to screen the infant for cystic fibrosis, and therefore fail to
provide medical treatment
A woman receives eggs, sperm, or an embryo that was not screened for
cystic fibrosis (wrongful pregnancy)
Misread or improperly performed genetic testing prior to pregnancy
Symptoms of Cystic Fibrosis
If for whatever reason your physician has not diagnosed the baby with cystic
fibrosis during pregnancy, there are a number of symptoms that the baby
may exhibit, including:
Breathlessness
Foul-smelling and greasy stool
Intestinal blockage
Inflamed nasal passages
Persistent cough that produces thick spit or mucus
Poorweight gain and growth
Repeated lung infections
Severe constipation
Wheezing
Salty skin
10. Stomach pain and/or bloating
Keep in mind that not all infants will exhibit every symptom and not all infants
will exhibit the same symptoms.
Cystic Fibrosis
While there is no cure for cystic fibrosis, there are treatments that can lessen the
symptoms and can help the child to live a little more comfortably as long as that is.
Treatment may includes:
Preventing and controlling lung infections
Loosening and removing thick mucus from affected areas
Preventing and treating blockages in the digestive tract
Providing sufficient nutrition in any way possible, and,
Preventing dehydration so that the digestive tract works properly
Infant Dystonia Disorder
Dystonia disorder is a disorder that appears to affect the muscles. Dystonia
disorder appears to affect the muscles because it causes writhing, slow,
involuntary movements or postures taken by the muscles. In fact, the disorder is
caused due to miscommunication between the brain and the nerves, making it a
neurological disorder instead of a muscular disorder.
Infant Dystonia Disorder Caused in Newborns
Infantdystonia is a disorder caused by genetics or via a birth injury that leads
to by hypoxia (a lack of oxygen to the brain causing low levels of oxygen and thus
inflicting brain damage), or neonatal brain hemorrhage.
Dystonia caused by birth injuries is referred to as acquired dystonia. Other causes
of acquired dystonia for infants could be infections, an adversereaction to certain
drugs, and lead or carbon monoxide poisoning (though rare).
Symptoms of Infant Dystonia
In addition to uncontrolled muscle movement, other symptoms of dystonia
include dragging a leg, cramping in the foot, involuntary pulling in the neck, and
uncontrollable blinking.Symptoms generally affectonly one side of the body, and
11. usually stabilize within five years. However, accidents and injuries can worsen the
symptoms.
Infant Dystonia Diagnosed
Since infant dystonia is a neurological disorder, oneof the mostcommon ways of
diagnosing the disorder is through neurological testing. Sometimes it’s identified
with a head CT scan or an MRI, and sometimes it’s diagnosed with an
Electroencephalogram (EEG).
Dystonia Treated
Treatment options many include non-drug therapies, oralmedications, injected
medications, surgery, and complementary therapies. Often, therapy matches the
severity of the dystonia and the abilities of the patient. Obviously if the patient is
an infant, physicaltherapy might be moredifficult than, say, injected medication.
HIE
HIE is a brain dysfunction caused by a reduction in the supply of oxygen to the
brain and other organs (hypoxia), compounded by low blood flow to vital organs
(ischemia). Encephalopathy refers to any condition that results from reduced blood
and oxygen supply to the brain.Since this is considered a brain injury, the time of
the oxygen deprivation generally relates to the perinatal period, just before and just
after delivery.HIE caused by asphyxia is the leading cause of infant fatalities in the
United States, as well as the primary sourceof severe impairments.
Symptoms of HIE
There are a number of symptoms associated with HIE, including:
Meconium-stained amniotic fluid
Low heart rate
Poormuscle tone
Weak breathing or no breathing at all
Bluish or pale skin color
Excessive acid in the blood
Tests to confirm HIE after symptoms have been assessed include: CT scan, MRI
scan, echocardiography, and ultrasound. Optional tests may include
electrocardiogram (EKG), electroencephalogram (EEG), and evoked potential
12. tests. Generally, patients are evaluated on whether they have mild, moderate, or
severe symptoms of HIE and the condition is controlled from there.
Effects of HIE
The conditions of HIE vary, depending on whether the infant has mild, moderate,
or severe symptoms. There are several different kinds of treatment, some that
merely address emergency symptoms and keep your child alive, but there are
others that try to reverse or diminish the brain damage.Most of the time, babies
with mild symptoms can have a life uninhibited by HIE, whereas babies with
severe symptoms may have a shortened lifespan with a number of painful
problems.Effects of HIE may include developmental delays, epilepsy, cognitive
issues, motor skill development delays, and neurodevelopment delays. The true
severity of HIE generally cannot be determined until the baby reaches three to four
years of age.
Causes
There are a number of different causes of HIE, any of which can occur before,
during, or after the baby is born.Various problems or medical complications may
cause HIE during pregnancy in the antepartum period. These include:
Maternal diabetes with vascular disease
Problems with blood circulation to the placenta
Preeclampsia
Cardiac disease
Congenital infections of the fetus
Drug and alcohol abuse
Severe fetal anemia
Lung malformations
HIE can also affect infants during labor and delivery, or what is called the
intrapartum period. Common intrapartum complications may include:
Excessive bleeding from the placenta
Very low maternal blood pressure
Umbilical cord accidents
Prolonged late stages of labor
Abnormal fetal position
Rupture of the placenta or the uterus
13. In addition, Infants can suffer from the effects of HIE in the postpartumperiod.
Premature babies are particularly at risk of suffering brain injury or even death if
HIE occurs after delivery. The most common causes of postpartum HIE include:
Severe cardiac or pulmonary disease
Infections, including sepsis and meningitis
Severe prematurity
Low neonatal blood pressure
Brain or skull trauma
Congenital brain malformations
In some cases, there are no identifiable causes for infant HIE.
treatment
Doctors have various options to treat HIE, all of which are determined by the
causes of the condition and the amount of damage to the baby’s brain. This makes
it impossible for physicians to develop a definitive treatment for neonatal cases of
HIE. The basic goal of HIE treatment is to supportthe baby’s affected organs.
Treatment options include:
Mechanical ventilation to help a baby who can’t breathe without assistance
Cooling the baby’s brain or bodyto reverse brain hypoxia caused by high
temperatures
Hyperbaric oxygen treatment in cases where HIE is caused by carbon
monoxide intoxication
General anesthesia and medications to controlseizures
Treatments to assist the baby’s heart function and control blood pressur
Difference Between a Birth Defect and a Birth Injure
There is a big difference between a birth defect and a birth injury. A birth defect is
health problemthat a child was genetically predisposed with. A birth injury is a
health condition that happens as a result of medical malpractice to a child that
was going to be born normally with no health problems.Birth defects can at times
be considered a birth injury if medical negligence caused the defects. For
example, severalmedications havebeen linked to an increased risk of birth
defects. If a physician and/or manufacturer fails to informthe mother of the risks
14. of birth defects when taking the medication while pregnant, they may be liable
for damages.
PPHN Be Prevented
Doctors now believe that a child has an increased risk in PPH if the mother
increases the selective serotonin reuptake inhibitors (SSRIs)during the last
trimester of pregnancy. Sometimes an indication of SSRIs could be maternal
depression.
Symptoms of PPHN
The symptoms of PPHN may differ according to each infant. While one baby may
exhibit all of the typical symptoms, another may only exhibit a few. The most
common symptoms associated with PPHN include:
Blue-tint to the skin
The infant may appear ill shortly after birth
Rapid heartbeat and rapid breathing
Oxygen levels that stay low after the infant receives 100% oxygen
treatment
The most important thing is that the medical staff members get your child
breathing again. Even if an infant is breathing in 100% pure oxygen, PPHN still
results in poorblood oxygen levels.
Methods of treatment may include include:
Continuous monitoring of oxygenation and blood pressure
Maintaining a normal blood pressure
Correction of glucose and electrolyte abnormalities
Nutritional support
Minimal handling of the newborn, and
Minimal use of invasive procedures.
Once these methods have been executed, the baby may require other therapeutic
methods such as:, assisted ventilation, nitric oxide, high frequency oscillatory
ventilation, inotropic support, surfactant administration, high-frequency
ventilation, ECMO, endotracheal intubation, correction of acidosis and alkalosis,
15. hearing evaluation, and a postdischarge neurologic evaluation by a neurologist or
developmental pediatrician.
RISK
PPHN keeps your babyfrom breathing normally. This is extremely dangerous to
your baby’s health becausethe longer an infant is deprived of oxygen, the more
hypoxic the baby’s blood becomes. This kind of oxygen deprivation can cause the
baby’s brain to react adversely, causing long-term cognitive problems such as
a learning disability, autism, and/or ADHD. Infant death can also occurin severe
cases of PPHN, although with immediate medical intervention, the chances of
mortality are lowered significantly.
Vacuum Extraction
When a difficult labor takes too long, a doctor may chooseto usea vacuum
extractor to assistwith delivery. During a contraction, the doctor will apply a soft
cup or a hard cup to the top and back of the baby’s head and will help to use
suction to assist will pulling the baby out.
What Kind ofInjuryCana VacuumExtractorCause
The FDA has warned that using a vacuumextractor can unnecessarily risk the
baby’s health. The baby should be younger than 34 weeks gestation, the child
should not be proportionately too large for the mother’s pelvis, baby’s head
shouldn’tbe too far up in the birth canal, the baby should not require
repositioning to be properly delivered, and the mother should be fully dilated.
Birth injuries vary depending on how the vacuumextractor was used (or misused)
but generally the injuries include skullfractures, retinal hemorrhages, brachial
plexus injuries brain hemorrhages, and cerebralpalsy. Some of these conditions
untreated lead to paralysis, intellectual disability, and other life-long conditions,
and someconditions (such as a hemorrhage) left untreated could even lead to
death.
Symptoms of Vacuum Extraction-Related Birth Injuries
Because the types of injuries vary, symptoms varydepending on the injury itself.
For example, if the injuries are primarily related to the brachial plexus nerves (the
nerves between the neck and shoulder), the child’s symptoms may be more
related to arm weakness, paralysis, or a claw-likehand. Thosesymptoms would
not be the same symptoms as related to, say, skullfractures. However, becausea
vacuumextraction does relate to the brain and most of the injuries are head or
16. brain related, the two most common symptoms are lethargy and seizures, which
may happen within hours of birth.
Vacuum ExtractionInjuries Preventable
Vacuumextraction injuries are preventable. Sometimes a mother can request
that a doctor uses forceps instead of a vacuumextractor, and other times during
delivery, the mother can ask the doctor whatstage the baby is at before she
approves the useof a vacuumextractor.If the parents are finding out after the
fact that the baby has a birth injury dueto a vacuumextraction, there are ways
that the injury can be treated, though long term recovery is slow, and some
children may not be able to make a full recovery at all, depending on how severe
the injuries are.
Placental Abruption
Placental abruption occurs when the placenta becomes separated from the inner
wall of the uterus, typically after 20 weeks gestation. Placental abruption can
happen from a variety of reasons, including previous pregnancies that had
placental problems, maternal age and infections, smoking during pregnancy,
diabetes, high blood pressure, and more. In some cases, the cause is unknown, but
women with the risk factors of placental abruption should be monitored carefully.
If left undiagnosed and untreated, it can lead to a host of long-term and life-
threatening medical conditions including cerebral palsy (CP), cognitive disorders,
premature birth, and a heightened risk of the infant dying.
Placenta Previa
Although it’s a rare condition affecting less than 10% of all pregnancies, placenta
previa is a dangerous condition that can lead to asphyxia, low birth weight, heart
abnormalities, SP, seizures, stillbirth, and more. Placenta previa occurs when the
placenta moves towards the bottomof the womb, covering the cervix either
marginally, partially, or fully. Bed rest and medications are advised for the women
who experience partial or marginal placenta previa, but it will greatly depend upon
on how severe the symptoms. For instance, excessive vaginal bleeding is one the
most common symptoms, and if doctors cannotget the bleeding under control,
they may schedule a C-section immediately.
Other treatment options include:
17. Vitamin K injections to help promote blood clotting, which in turn can
reduce severe bleeding
Steroid injections to strengthen the infant’s lungs
Blood transfusions
Medications to help stop labor, if applicable
If the placenta is fully covering the cervix, a scheduled C-section almost always
follows. Physicians try to wait until at least the 36th week of pregnancy before
delivery, yet if the infant or mother’s life is in danger, they may start delivery
earlier.
Placental Insufficiency
Placental insufficiency, also known as utero-placental insufficiency, is marked by
problems with blood flow to the placenta during pregnancy. Consequently, the
placenta is unable to delivery the needed nutrients and oxygen to the infant. There
are several causes and risk factors that can contribute to developing placental
insufficiency, including high blood pressure, gestational diabetes, improper
maternal weight gain, smoking, maternal blood disorders, maternal infections, and
more. Placenta previa is more severe if it develops early in pregnancy. If left
untreated, placental insufficiency may lead to infant neurological impairment, CP,
seizures, small size and weight, and cognitive disabilities. Treatment typically
consists of bed rest, getting high blood pressureunder control, patient education,
and in some cases, working with a high-risk maternal fetal specialist.
Other forms of treatment may include:
Low doseaspirin
Fetal monitoring
No use of narcotics and/or anesthesia during labor