Birth injuries and injuries

May 25, 2018 04:15 | Baby Diseases
In the pathology of a newborn, birth trauma occupies a significant place. On average, about 2% of newborns receive traumatic lesions during labor. Birth trauma occurs either spontaneously during the passage of the fetus through the birth canal , or in complicated births requiring appropriate measures( fetal rotation, forceps application, vacuum extraction, surgical intervention, etc.).Prenatal prophylaxis, timely hospitalization of women with pathological pregnancy, widening of indications for cesarean section and provision of conditions for its fulfillment significantly reduced the number of started cases and thus almost eliminated the need for traumatizing fetus extraction methods. At the present time, fractures of the skull, limb fractures, etc. are less often observed, etc. This heavy birth trauma is the result of external mechanical action and is proportional to its strength. Birth trauma is also observed in normal childbirth. Each fetus undergoes a known violent action during childbirth, either from the contracting uterus or from the side of the birth canal. The cause of birth trauma can be a discrepancy between the size of the fetus and the size of the pelvis, the wrong position of the fetus and the consequences of vaginal operations. The severity of the injury depends on the strength of the impact. The resistance of the child's organism is more important here than the violence inflicted during childbirth. In essence, birth traumatism is a combination of very different effects on the fetus during labor: pressure on the fetal body, compression of the skull, fluctuations in pressure in the circulatory system, disorder of uteroplacental circulation, hypo- and anoxia, abrupt transition from high pressure in the uterus to morelow pressure of the external environment, etc. The duration of labor and the rigidity of the birth canals are also important, etc. It is not necessary to associate birth trauma only with mechanical violence. Often in the genesis of trauma, fetal hypo- or anoxia plays a central role. There are generic lesions of the skin and subcutaneous tissue, muscles, skeleton, peripheral nerves, CNS.

Birth injury, especially intracranial injury, can cause fetal death during or after childbirth, and if a newborn can be saved, the consequences can be a variety of psychomotor disorders.

In the course of childbirth, under the influence of various mechanical effects, almost any organ can be damaged. In addition to traumatic bleeding, bone fractures and nerve damage are of great importance.

Fractures of bones , except for a relatively frequent fracture of the clavicle, occur rarely during normal delivery. Fracture of the clavicle is usually found only after a few days: a palpable callus is the size of a hazelnut, in case of a fresh fracture, there is also a squeak, a crunch of the clavicle. Usually, this fracture does not require treatment, and only if there is limited movement due to pain, resort to fixing the arm with a bandage. Easily palpable dents of the bones of the skull;Surgical treatment is indicated only when symptoms of brain damage appear. Fractures of the parietal bone can cause cefalogematoma, but often occur asymptomatically. If the newborn does not move any limb, there is no Moro reflex on this side, and the passive movement of this limb is painful, then it is possible to suspect fracture of this limb or separation of the epiphysis of the bone( epiphysis).With appropriate orthopedic treatment, recovery comes surprisingly quickly.

Quite often occurs or a hematoma of the fibers of the sternoclavicular-nipple muscle is quite common. Approximately in the middle of the muscle, a bulge is measured as large as a nut. This can lead to the development of torticollis. The head is tilted to the side of damage, and the chin is turned in the opposite direction. The child is put on the sore side and a hard pillow is placed between the head and shoulder;Several times a day they control and correct the position of the head. If the situation does not improve after 2-3 months, orthopedic treatment is indicated.

Traumatic spine injuries, accompanied by hemorrhages, can cause symptoms of transverse lesion. Despite the severe clinical picture at the beginning, the outcome can be quite satisfactory.

Presentation of the handle or childbirth with the use of an extractor may become the cause of two types of damage to the brachial plexus.

Erb-Duchenne Paralysis (shoulder type).In this case, V and VI are affected by the cervical roots. At the same time, the hand is in a peculiar position, it is withdrawn, it hangs motionless down, the forearm is turned to the inside, the palm is turned back, however the finger movements can be preserved. Moro's reflex is absent on the affected side. In some cases, with the defeat of the IV cervical spine, the situation can be complicated by the symptoms of diaphragmatic paralysis: cyanosis, chest type of breathing, high standing of the diaphragm.

Paralysis Klumpke ( forearm type).The defeat of VII and VIII cervical roots causes paralysis of the flexor and extensor muscles of the forearm and fingers. The sympathetic fibers appearing in the first thoracic spine are also often damaged;In this case, on the affected side of the eyes is deeply set, the eye gap and the pupil are narrowed. To balance the pulling action of normal antagonist muscles, first fixation with appropriate tires, then massage, passive movements, faradization, and possibly nerve stitching are used. The latter is justified if, within 10-14 days, there is no improvement, and the electromyographic data indicate a degeneration of the muscles.

The forecast in this case is very uncertain, since it is not known to what extent restoration of functions can be achieved. It all depends on whether there was only a bruise, swelling or breakage of nerves.

Women's magazine www. BlackPantera.en: Eric Kerpel