Birth trauma (a.k.a. birth injury) relates to those conditions caused by both physical/mechanical and hypoxic injuries.
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Epidemiology
Birth trauma occurs in ~5 per 1000 births 2.
Risk factors
- asphyxia
- breech presentation
- shoulder dystocia
- instrument delivery
- macrosomia
- obstructed labor
Pathology
Etiology
There are a wide range of conditions related to birth trauma, ranging from superficial and minor injuries through to fatal injuries.
Musculoskeletal
- superficial bruising, grazes and lacerations
- caput succedaneum
- cephalohematoma
- long bone fractures, especially clavicular and femoral
- fibromatosis colli
- skull fracture
- vertebral fractures, in particular of C7 and T1 2
CNS/PNS
- brachial plexus injury
- congenital facial nerve palsy
-
intracranial hemorrhage (ICH)
- subdural hemorrhage (most common ICH)
- extradural hemorrhage (rare)
- neonatal hypoxic-ischemic encephalopathy
- spinal cord injury
Differential diagnosis
Birth trauma may not be readily apparent initially, and may have a delayed presentation. Non-accidental injuries can be considered in the neonate in the correct context.
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