Birth injuries can impair an infant's body and be caused by complications during delivery. They can lead to morbidity and mortality. Risk factors include prematurity, cephalopelvic disproportion, prolonged labor, malpresentation, instrumental delivery, and large infant size. Examination involves physical assessment of neurological function and checking for asymmetric structures. Types of birth injuries include skull injuries, cervical nerve injuries, phrenic nerve palsy, fractures of the skull and long bones, and intra-abdominal injuries. Management depends on the type of injury but may involve treatment of anemia, jaundice, physical therapy, ventilation support, and avoiding complications.

1. Cha-6-
Birth Trauma/Injuries
• Definition: impairment of infants body
structure/function
• Sustained during the birth process
• A voidable or unavoidable.
• Causes morbidity and mortality
• Risk Factors:
• Prematurity,CPD, Prolonged Labor,MalPo/Pre, Intrumental
Delivery and Macrosomal infant

2. Examination of Birth Injuries
• Physical examination,
• Neurological Examination
• Asymmetric structures and Function
• Ranges of Motion
• Integrity of scalps and Skin

3. Type of Birth Injuries
1. Skull Injuries
2. Cervical Nerves Injuries
3. Phrenic nerve injury (C3, 4 or 5 )
4. Fractures of Skull and Bone
5. Intra- abdominal injuries
6. Splenic Injuries

4. 1. Skull Injuries
1.1. Caput succedaneum
B/t subcutaneous and extra periosteal --fluid rarely B
Poorly defined margins
 usually associated with molding.
The lesion usually resolves spontaneously
Rarely causes significant blood loss or jaundice.
Management ?????

5. 1.2. Cephalohematoma
• It is a subperiosteal collection of blood
• It is always confined by suture lines
• Extensive causes hyperbilirubinemia and rarely
• The risk of infection is very rare.
• Skull fractures 5 – 20% of cases
• Management:
• Anemia and jaundice should be treated as needed

6. 1.3. Subgaleal hemorrhage
• It is hemorrhage under the aponeurosis of the scalp.
• Hemorrhage can spread across the entire calvarium.
• Signs are pallor, poor tone, and a fluctuant swelling on
the scalp, which cross the suture lines.
• There may hematoma, Ecchymosis, Pain and shock
• The blood is absorbed slowly & swelling resolves
gradually
• Management: ?????

7. 2.Cervical nerve root injuries
2.1 Brachial plexus injury
• The cause is excessive traction on the head, neck,
and arm during birth.
• Risk factors include macrosomia, shoulder dystocia,
breech presentation.
• Injury usually involves the nerve root
• Type
• A: Duchenne-Erb’s palsy
• B:Klumpke’s palsy:

8. A. Duchenne-Erb’s palsy: -
• Upper trunks (C5, C6 and occasionally C7) and is the most common type
• S/s: the arm is typically adducted and internally rotated at the shoulder.
• There is extension and pronation at the elbow and flexion at the wrist
• Moro is absent on the affected side.
• The grasp reflex is intact and sensation is variably affected.
B. Klumpke’s palsy: - injury C7/C8 to T1 and is the least common injury.
• The grasp reflex is absent and there is sensory impairment on the ulnar side
of the forearm and hand.
• Management:
• Physical therapy and passive range of motion

9. 3. Phrenic nerve injury
• Phrenic nerve injury leading to paralysis of the
diaphragm due to lateral hyperextension of the neck at
birth.
• R/f: breech and difficult forceps deliveries.
• At least 75%of patients also have brachial plexus injury.
• C/F
• Respiratory distress, cyanosis, tachypnea and dec. Mov; hemi
thorax
• Dx– confirmed by U/S opposite movt at inspiration
• Mgt: - the initial treatment is supportive.
• CPAP or mechanical ventilation
• avoid atelectasis & pneumonia.

10. 4. Bone and Skull Fractures
4.1 Skull fracture
4.2 Clavicular fracture:
4.3 Humeral fracture
4.4 Femoral fracture

11. • Thank You