Etiology, Clinical Presentation, and Management of Birth Injuries

Introduction

Birth injuries refer to physical trauma sustained by a newborn during labor and delivery. While advances in obstetric care have reduced their occurrence, they remain an important concern in pediatrics.

Causes and Risk Factors

• Prolonged labor: Increased stress on the fetus due to prolonged contractions.
• Instrumental delivery: Use of forceps or vacuum extraction may lead to trauma.
• Macrosomia: Large birth weight increasing the likelihood of complications.
• Breech or abnormal presentations: Non-cephalic presentations pose a higher risk.
• Maternal conditions: Diabetes or obesity influencing fetal growth and delivery.

Common Birth Injuries

• Clavicular fractures: Most common birth injury due to pressure on the shoulders.
• Facial nerve palsy: Compression or trauma during delivery.
• Brachial plexus injury: Injury to nerves due to excessive stretching.
• Cephalohematoma: Blood collection beneath the periosteum due to trauma.
• Subgaleal hemorrhage: Potentially life-threatening bleeding in the scalp region.

Clinical Presentation

Newborns may exhibit weakness, restricted limb movement, facial asymmetry, or soft tissue swelling. Immediate evaluation is necessary.

Management Strategies

Management depends on severity:

• Observation: Minor injuries resolve with time.
• Physical therapy: Facilitates nerve and muscular recovery.
• Orthopedic intervention: Necessary for fractures and joint issues.
• Surgical repair: Indicated for severe nerve damage.

Prevention

Preventative measures include improved prenatal care, optimized delivery techniques, and identifying high-risk pregnancies early.

Conclusion

Birth injuries can have lasting effects on newborns, making timely diagnosis and intervention crucial. Advances in medical care have significantly reduced associated risks.