Fetal-Birth-Injuries

Fetal-Birth-Injuries - Fetal Birth Injuries Dr. Ashraf...

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Unformatted text preview: Fetal Birth Injuries Dr. Ashraf Fouda Domiatte General Hospital Definition The term birth injury is used to denote: avoidable and unavoidable mechanical, hypoxic and ischemic injury affecting the infant during labor and delivery. Birth injuries may result from : 1.I nappropriate or deficient medical skill or attention. 2.T hey may occur, despite skilled and competent obstetric care. Definition Incidence Has been estimated at 2-7/1,000 live births . Predisposing factors : 1. M acrosomia, 2. P rematurity, 3. C ephalopelvic disproportion, 4. D ystocia, 5. P rolonged labor, and 6. B reech presentation. 5-8/100,000 infants die of birth trauma, and 25/100,000 die of anoxic injuries; Such injuries represent 2-3% of infant deaths. Incidence Cranial Injuries Erythema, abrasions, ecchymoses, Of facial or scalp soft tissues may be seen after forceps or vacuum-assisted deliveries. Their location depends on the area of application of the forceps. Subconjunctival ,retinal hemorrhages and petechiae of the skin of the head and neck A ll are common. A ll are probably secondary to a sudden increase in intrathoracic pressure during passage of the chest through the birth canal. P arents should be assured that they are temporary and the result of normal hazards of delivery. Molding M olding of the head and overriding of the parietal bones are frequently associated with caput succedaneum and become more evident after the caput has receded but disappear during the first weeks of life. R arely, a hemorrhagic caput may result in shock and require blood transfusion. Caput succedaneum Diffuse , sometimes ecchymotic, edematous swelling of the soft tissues of the scalp involving the portion presenting during vertex delivery. It may extend across the midline and across suture lines. The edema disappears within the first few days of life. Analogous swelling, discoloration, and distortion of the face are seen in face presentations. No specific treatment is needed, but if there are extensive ecchymoses, phototherapy for hyperbilirubinemia may be indicated. Caput succedaneum Caput succedaneum Cephalhaematoma Cephalhaematoma I t is a subperiosteal haematoma most commonly lies over one parietal bone. I t may result from difficult vacuum or forceps extraction . Management:- It usually resolves spontaneously. - Vitamin K 1 mg IM is given. Cephalhaematoma Cephalohematoma Is a subperiosteal hemorrhage , so it is always limited to the surface of one cranial bone. There is no discoloration of the overlying scalp, and swelling is usually not visible until several hours after birth, because subperiosteal bleeding is a slow process....
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Fetal-Birth-Injuries - Fetal Birth Injuries Dr. Ashraf...

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