Birth injury

 Birth injury

Birth injury occurs during birth process. Usually occurs, if presentation is breech or forceful extraction is done. 

Types of birth injuries are;

1. Soft tissue injury

2. Caput succedaneum

3. Cephalohematoma

4. Nerve injuries

1. Soft Tissue Injury

Soft tissue injury are;

1. Erythema and abrasion

Due to application of forceps during fetal delivery.

2. Petechiae

Pin point hemorrhage, seen in chest, face and head of baby.

3. Ecchymosis

Occurs after traumatic delivery.

4. Subconjunctival hemorrhage

Repture of capillaries in sclera from preesure on fetal head during delivery.

2. Head injury

Head injuries are;

1. Caput succedaneum

Edematous swelling (swollen with excessive accumulation of fluid) of soft tissues of scalp area that occur during vertex delivery (head first come during delivery).

2. Subgaleal hemorrhage

Collection of blood between skin of scalp and skull.

Collection of blood beneath aponeurosis (white fibrous tissue) that cover the inner surface.

3. Cephalohematoma

When blood vessels repture during labour to produce bleeding into area between bone and it's periosteum.

4. Subdural, subarachnoid and intracranial hemorrhage 

Subdural hemorrhage;

Collection of blood in subdural space.

Subarachnoid hemorrhage; 

Collection of blood in subarachnoid space.

Intracranial hemorrhage;

Involve ventricles (intraventricular hemorrhage) of premature infants delivered without any trauma.

3. Nerve Injury

1. Facial palsy

Pressure in facial nerve during delivery; result in injury to facial nerve.

Results in loss of movement affected side of face and forehead.

When infant cries; movement occur only on unaffected side and affected side eye does not close.

2. Brachial palsy

Injury to brachial plexus causes paralysis of upper arm with or without paralysis of forearm or hand.

1. Erb-Duchnne palsy

Upper plexus palsy

Causes due to stretching or pulling away shoulder from head.

2. Klumpke's palsy

Lower plexus palsy

Severe streching of upper extremities.

3. Phrenic nerve palsy

Paralysis of diaphragm.

Seen in ultrasound as elevated diaphragm.

Lung on affected side doesn't expand and breathing difficulty occurs.