Into birth injury refers to a group of diseases that occur in infants during pregnancy or childbirth and is characterized by a variety of causes and signs.
Birth injuries can be subdivided into mechanical and hypoxic.
To mechanical forms of birth injury include:
To hypoxic birth injuries include brain and spinal cord, and internal organs resulting from asphyxia or hypoxia of the fetus and newborn.
– low weight of the fetus;
– excessive fetal weight;
– the pathology of childbirth — transient, prolonged;
– the forceps.
Causes of birth injuries
Mechanical injuries occur due to the mismatch of the size of the child and the birth canal. From child – large fruit, diabetic fetopathy, anomalies of position (front, parietal and breech, transverse lie), post-term pregnancy, malformations of the fetus (intrauterine hydrocephalus), and others. Mother’s side – the elderly, the anomalies of the pelvis (narrow or rheticus flat pelvis, exostosis (bone or bone and cartilage growth of non-neoplastic nature on the surface of bones), injuries with damage to the bones of the pelvis).
Hypoxic birth injuries occur as a result of asphyxia or hypoxia of the fetus and newborn. Under asphyxia or suffocation acute means the entry of oxygen, and hypoxia – long re-limiting the intake of oxygen with excess accumulation in the body of carbon dioxide and other oxidized products. The reason for the cessation of oxygen can be, for example, the cord wrapped around the neck, causing breathing difficulties, or in the oral cavity has accumulated mucus, or the language of the fuse, closing the trachea, etc.
Birth injuries in this or in that degree there is in every child. It occurs as a result of the generic process, the mechanical interaction of the mother and fetus. Birth injuries, or the postpartum state, in some cases, may increase the adaptive capacities of the child, and in the other (after the exhaustion of compensatory mechanisms and pathological processes) — to lower them.
Symptoms of birth injuries
Uterine tumor is a soft tissue swelling of the presenting to the birth canal part (usually the head) of the child due to venous congestion when passing through the birth canal of the mother, often with punctate hemorrhages on the skin. More common in children born of mothers with long-term eruption of the head, larger children. Swelling disappears within 1-2 days.
Cephalohematoma is a bleeding under the periosteum of the flat bones of the skull. The mechanism of injury is the displacement of the skin along with the periosteum and the rupture of blood vessels during the move, the baby’s head through the birth canal. Blood in cephalohematoma accumulates gradually and therefore the tumor, appearing during or shortly after birth, continues to grow for the first 2-3 days of a child’s life.
The most common hemorrhage into muscles is bleeding in the sternocleidomastoid muscle. This injury often occurs when breech presentation at birth or with the help of forceps or manual extraction of the fetus. Blood pours into the vagina muscles or the muscle itself. In the area of damaged muscle palpated small, moderately dense or testovatoy consistency tumor size from a walnut to plum, which often appears only at the end of the first or beginning of the 2nd week of a child’s life. To further develop torticollis – your baby’s head is tilted to the affected side and the chin in the opposite direction. Hemorrhage in other muscles are extremely rare.
Fractures most often occur in severe childbirth and obstetric interventions. One of the most frequent injuries of the skeleton is a broken collarbone. It is observed in 0,03-0,1% of the newborns, even if natural birth without obstetric benefits. Formed broken leg in a large fruit, with breech with tilting handles. Contribute to the fracture of turbulent or weak labors, a delayed version of a coat hanger, narrow pelvis in the mother. Often occurs a fracture of the right clavicle. This usually subperiosteal fracture in the middle third of the clavicle without bias. Fractures of the humerus and the femur are rare, they occur when bringing down the handle at the head or legs when breech presentation.
Nerve damage can have Central and peripheral origin. The most commonly affects the facial nerve and the nerves of the brachial plexus. Paralysis of nerves is observed during prolonged labor as a result of prolonged pressure on a nerve during the passage of the birth canal, and with the use of forceps and in fractures of the temporal bone.
A particularly detrimental impact of the lack of oxygen has on the brain cells, they just simply die. Therefore, the longer a child had asthma, the more severe will be the consequences. Nerve cells forming the fabric that comprises the substance of the brain begin to die after 5-7 minutes after the cessation of oxygen in the blood. The result of nerve cell death is the intellectual failure of varying severity – from mild mental retardation to severe degrees of retardation.
The main clinical significance of intracranial birth injuries, accompanied by damage of the Central nervous system: cerebral edema and intracranial hemorrhage. They result from both mechanical and hypoxic damage. Distinguish mild, moderate and severe intracranial birth injuries; the latter leads to death of the newborn in the first hours (days) after birth, or to the development of persistent organic changes in the Central and peripheral nervous system (mental retardation, paralysis, paresis, etc.). In the acute period of intracranial injury, is showing signs of Central nervous system of the newborn: generalized anxiety, screaming, frequent convulsive breathing, convulsions, observed limb tremor, insomnia, etc., combined with inhibition of reflexes of sucking and swallowing. The period of excitation is changed by the state of oppression with General lethargy, decreased muscle tone, weak cry, pale skin, the baby is sleepy, not waking up for feeding, often spits up. Characterized by frequent seizures secondary to asphyxia.
Do older children migrated birth injury most often seen in:
– scoliosis and posture.
Prevention of birth injuries
The main method of prevention of birth injuries is timely elimination of health problems in the future mother. Unfortunately, women think of pregnancy often before, and during, and preliminary treatment in such cases to speak of.
The prognosis of this disease depends not only on the severity of the injury, but also from the prescribed treatment and timely treatment. With timely diagnosis and proper treatment, the outcome will be favorable. Complete recovery occurs in 70-80% of children.
In some cases, the child may experience residual effects: tearfulness, restlessness, autonomic dysfunction, etc. In case of inadequate treatment or late diagnosis of a possible more serious outcome: cerebral palsy, mental retardation, etc.
Child’s birth injuries – what to do?
Birth injuries is detected in most cases in the hospital. Immediately assign the appropriate treatment. It is best to provide maximum comfort to the newborn (it is not applied to the chest, and fed expressed breast milk through a tube), if necessary, an ice pack to the head, oxygen therapy, vitamins, glucose, cardiac and vascular equipment, drugs that reduce the excitability of the Central nervous system, antihemorrhagic funds.
Children, birth injuries, require the supervision of a pediatrician, a neurologist and orthopedist.
A child with intracranial birth injuries is under medical supervision in a hospital. Assigned various treatments, minor procedures and special medications. It aims to resorption of the hemorrhage. In addition to the medication to the child shall be appointed physiotherapy, massage, gymnastics. Children have a good resilience, so the brain comes back to normal. If intracranial birth injuries was complicated by cerebral palsy or epilepsy, these kids see in specialized clinics. If there are no serious complications, the observation is performed at the local neurologist.