Birth Injuries in Neonates.

Abstract

1. Gangaram Akangire, MD* 2. Brian Carter, MD*,† 1. *Division of Neonatology, Children’s Mercy Hospital-Kansas City, MO 2. †Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO 1. Clinicians should understand the outcome of birth-related extracranial and intracranial injuries and the most appropriate time of intervention. 2. Clinicians should understand the outcome of long bone fractures that occur during the birth process. 3. Clinicians should understand when to consult with neurosurgery when faced with a depressed skull fracture after a birth and be familiar with clinical outcomes. 4. Clinicians should understand the outcome of facial nerve injury and brachial plexus injury resulting from birth trauma. 5. Clinicians need to understand the medicolegal implications of birth injuries and the importance of careful documentation. After completing this article, readers should be able to: 1. Discuss delivery conditions that increase the risk of birth injuries. 2. List favorable and unfavorable outcomes following birth injuries. 3. Describe common birth injuries and delineate current evaluation and management from the general pediatric practitioner’s perspective. 4. Focus on emergency situations that involve traumatic bleeding; nerve injury; and fractures of the skull, clavicles, and long bones that require urgent assessment and intervention. Birth injury is defined as the structural destruction or functional deterioration of the neonate’s body due to a traumatic event at birth. Some of these injuries are avoidable when appropriate care is available and others are part of the delivery process that can occur even when clinicians practice extreme caution. Amniocentesis and intrauterine transfusions can cause injuries before birth, and these and any injuries that occur following neonatal resuscitation procedures are not considered birth injuries. However, injuries occurring from fetal scalp electrodes and intrapartum heart rate monitoring are considered birth injuries. Over the past 20 years, the number of deaths due to birth injuries has declined such that they no longer are …