Birth trauma (physical)

Brain delivery trauma
Position of the child is important for normal birthing procedure. Head-first birth is preferred.
SpecialtyObstetrics, pediatrics

Birth trauma refers to damage of the tissues and organs of a newly delivered child, often as a result of physical pressure or trauma during childbirth. The term also encompasses the long term consequences, often of cognitive nature, of damage to the brain or cranium.[1] Medical study of birth trauma dates to the 16th century, and the morphological consequences of mishandled delivery are described in Renaissance-era medical literature. Birth injury occupies a unique area of concern and study in the medical canon. In ICD-10 "birth trauma" occupied 49 individual codes (P10-Р15).

However, there are often clear distinctions to be made between brain damage caused by birth trauma and that induced by intrauterine asphyxia. It is also crucial to distinguish between "birth trauma" and "birth injury". Birth injuries encompass any systemic damages incurred during delivery (hypoxic, toxic, biochemical, infection factors, etc.), but "birth trauma" focuses largely on mechanical damage. Caput succedaneum, bruises, bleeding along the displacements of cranial bones, and subcapsular hematomas of the liver are among reported birth injuries. Birth trauma, on the other hand, encompasses the enduring side effects of physical birth injuries, including the ensuing compensatory and adaptive mechanisms and the development of pathological processes (pathogenesis) after the damage.[2]

Signs and symptoms

Complications from birth trauma can include damage to the head, spinal cord, soft tissues, and organs.[2]

Trauma to the head of the infant can manifest as Caput Succedaneum, skull fractures, extracranial and intracranial hemorrhages, and cranial nerve injuries. Caput Succeedaneum is seen as edema in the scalp due to squeezing of the veins from increase pressure while passing through the birth canal.[2]

Birth trauma is uncommon in the Western world in relation to rates in the third world. In the West injury occurs in 1.1% of C-sections.[3][4]

Causes

  • Cephalo-pelvic disproportion,
  • the quick and rapid delivery,
  • delayed and prolonged delivery,
  • the abnormal birth position,
  • Asynclitic birth (asinclitismus),
  • abnormal fetal attitude (extensor inserting head),
  • obstetric turn,
  • acceleration and stimulation of the birth,
  • breech presentation,
  • forceps and vacuum extraction.[5]

While any number of injuries may occur during the birthing process, a number of specific conditions are well described. Brachial plexus palsy occurs in 0.4 to 5.1 infants per 1000 live birth.[6] Head trauma and brain damage during delivery can lead to a number of conditions include: caput succedaneum, cephalohematoma, subgaleal hemorrhage, subdural hemorrhage, subarachnoid hemorrhage, epidural hemorrhage, and intraventricular hemorrhage.

The most common fracture during delivery is that of the clavicle (0.5%).[7]

Epidemiology

Disability-adjusted life year for birth asphyxia and birth trauma per 100,000 inhabitants in 2002[8]
  no data
  less than 150
  150-300
  300-450
  450-600
  600-750
  750-900
  900-1050
  1050-1200
  1200-1350
  1350-1500
  1500-1750
  more than 1750

References

  1. ↑ V.V.Vlasyuk Birth trauma and perinatal disorders of cerebral circulation. St. Petersburg, "Nestor History, 2009 - 252 p. ISBN 978-5-98187-373-7.
  2. 1 2 3 V, Dumpa; R, Kamity (2020). "Birth Trauma". PubMed. PMID 30969653. Retrieved 2020-07-27.
  3. ↑ Alexander JM, Leveno KJ, Hauth J, et al. (October 2006). "Fetal injury associated with cesarean delivery". Obstet Gynecol. 108 (4): 885–90. doi:10.1097/01.AOG.0000237116.72011.f3. PMID 17012450.
  4. ↑ "רשלנות רפואית בהריון". Saturday, May 2, 2020
  5. ↑ Demissie K, Rhoads GG, Smulian JC, et al. (July 2004). "Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis". BMJ. 329 (7456): 24–9. doi:10.1136/bmj.329.7456.24. PMC 443446. PMID 15231617.
  6. ↑ Andersen J, Watt J, Olson J, Van Aerde J (February 2006). "Perinatal brachial plexus palsy". Paediatr Child Health. 11 (2): 93–100. PMC 2435328. PMID 19030261.
  7. ↑ Beall MH, Ross MG (December 2001). "Clavicle fracture in labor: risk factors and associated morbidities". J Perinatol. 21 (8): 513–5. doi:10.1038/sj.jp.7210594. PMID 11774010.
  8. ↑ "Mortality and Burden of Disease Estimates for WHO Member States in 2002" (xls). World Health Organization. 2002.
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