Causes and consequences of birth trauma of the cervical spine in newborns. Birth trauma of the cervical spine in newborns

How a birth injury of the cervical spine occurs in newborns, the consequences of this injury - such questions are within the competence of a neurologist. Childbirth is a natural process, but it is often unpredictable. Of great importance is the anatomical structure of the woman in labor and the baby, the level of qualification of the birth attendant.

What is pathology?

In a newborn baby, the bone structure is different from an adult - it is flexible. This avoids injury during the passage of the birth opening. But if the birth proceeds with complications, then there is a chance that the baby will be injured. Of all the possible most common is the natal injury of the cervical spine. Knowing the cause, how the injury was received, it is possible to determine the type of damage to the SHOP.

1. 1 Rotary - occurs due to a threat to the health of the mother or child, doctors have to speed up the process of childbirth. To do this, they resort to forceps or pull the baby with their hands. These actions lead to subluxation, displacement of the first atlas vertebra, compression of the spinal canal.
2. 2 Distraction - occurs due to the fact that the fetus is large or the baby walks with legs. At the same time, the obstetrician tries to help the woman in labor, making efforts that lead to the separation of the vertebrae, the breakage of the ligaments.
3. 3 Flexion-compression - occurs during rapid labor, when the baby's head gets stuck in the birth canal. From compression, a fracture of the vertebrae can occur.

Birth trauma of the cervical spine in newborns has severe consequences. The worst thing is death. Severe include: paralysis, paresis and cerebral palsy.

In a newborn with this type of injury, damage to large vessels, nerve roots, rupture of nerve fibers, brain, hemorrhage, cerebral edema can occur.

Not always natal injuries are noticeable. When damaged, the cerebral blood supply is disrupted, leading to a developmental delay. It happens that the first signs appear at preschool age, and sometimes at school.

Symptoms and consequences for the baby

In order to recognize a birth injury in time, you need to know its symptoms. Symptoms of birth trauma:

1. 1 Swelling, redness on the neck.
2. 2 The neck looks a little longer or shorter.
3. 3 The occipital and cervical muscles are tense.
4. 4 The baby's neck is permanently crooked.

These symptoms can be seen when examining a baby, but there are also those that are visible in the behavior of the child and the activities of his body:

1. 1 Spasms.
2. 2 The outflow of venous blood is intermittent.
3. 3 Absence of hypertonicity characteristic of the newborn.
4. 4 Breathing is accompanied by wheezing and groans.
5. 5 Cyanosis in the region of the nasolabial triangle.
6. 6 The baby is restless, sleeps badly, cries for no reason.
7. 7 Tachycardia is present.
8. 8 Poor appetite, frequent regurgitation.

Natal trauma does not go unnoticed for the baby. It harms both the physical and mental health of the child. Most of these signs appear with growth. And not always the symptoms are in the complex, they can be one at a time.

1. 1 The child grows, matures, but his development does not keep up with him. He may start sitting on time, and walk later and with difficulty, because he will have impaired coordination of movements.
2. 2 Often birth injuries affect speech. The kid begins to speak later than his peers, speech is given to him with difficulty. It is difficult for him to speak long sentences, to link words. These children have problems with memory, thinking.
3. 3 For kids with SHOP damage, it is difficult to collect cubes, pyramids. This is due to a violation of fine motor skills. It is difficult for them to draw, to dress. They can't fasten buttons on their own.
4. 4 The consequence of a natal injury can be bronchial asthma, allergies, neurodermatitis, eczema, hydrocephalus, cardiovascular problems.
5. 5 Depending on how severely the spinal cord was injured during the injury, the baby may also experience neurological consequences, which are expressed by paresis, paralysis, osteochondrosis, and scoliosis. Muscle tone decreases, weakness of the muscles of the shoulder girdle is observed. There is vegetovascular dystonia. At an older age, headaches, urinary incontinence, and digestive problems may begin.
6. 6 Schoolchildren with birth trauma may have problems with learning, behavior. They can be both passive and overactive, excitable, emotional and even aggressive. All this, in turn, leads to a decrease in self-esteem, which further worsens the nervous system. In severe injuries, irreversible phenomena occur, resulting in disability.

The consequences of injury to the cervical spine are difficult to treat, especially if the injury is neglected. This lengthy process requires the patience of both parents and the patient. Thus, increased attention during labor and subsequently to the condition of the baby can play a big role in his life. Timely help is the key to a healthy life.

Newborn babies have a different skeletal system than adults. It is characterized by excellent and developed flexibility only so that the child can pass through the narrow birth canal without getting a birth injury. But it is also possible to identify a number of cases when a newborn child receives a birth injury due to improper conduct of childbirth or any wrong actions that have taken place, just the same, there is a possibility of receiving a birth injury when the child passes through the birth canal. Often you can find a birth injury sprains in the cervical vertebrae. If the child nevertheless received it, then he needs to urgently provide emergency assistance, and it is necessary to keep him under the supervision of doctors after birth. In this article, you will learn more about the reasons why a birth injury of the cervical spine occurs, as well as its symptoms, treatment, and the consequences of the resulting sprain, we will talk about them in more detail.
There are, unfortunately, cases when a child, having received an injury to the cervical vertebrae, can be fatal. We will consider all the factors related to the receipt and occurrence of birth trauma.

Factors in the occurrence of birth trauma:

There are also the following disorders that occur after receiving a sprain of the cervical region:

Hydrocephalus of the brain in a child

The following symptoms indicate a sprain of the cervical vertebrae during birth:

To prevent sprains, the necessary measures taken are important:

Although childbirth is a natural process, it is impossible to call it completely predictable. The course of childbirth is strongly influenced by the anatomical features of the mother and baby, the state of health of both. However, even in women with ideal health and an obstetric history in the delivery room, a situation may arise that requires medical intervention and assistance. Any deviation from the normal course of childbirth poses some danger to the baby, because he risks injury. Natal trauma of the cervical spine in newborns is quite common.

The wording "natal trauma" means that the damage was received during childbirth. Trauma to the cervical spine in newborns is one of the most common birth injuries. This is due to the physiological characteristics of the infant body. Even the human SHOP (cervical spine) is very vulnerable. In a baby, the muscles and ligaments are very weak, so it is very easy to injure the neck during exercise. Depending on how the injury of the cervical spine was received, several types of injuries can be distinguished.

Rotational injury

In some cases, in order for a child to be born, he needs to be helped in moving through the birth canal. This happens in situations where it is necessary to speed up the process of childbirth due to a threat to the health of the mother and baby, or with the development of secondary weakness of labor activity (the contractions weaken and the woman cannot give birth herself). To help the baby be born, obstetric forceps are applied to the head. In some situations, the obstetrician acts with his hands. To pass the head, it is slightly turned clockwise and counterclockwise, that is, they perform rotational movements. Such a load can lead to subluxation of 1 cervical vertebra or it. This is fraught with narrowing of the spinal canal and compression of the spinal cord.

Distraction injury

Such injuries of the cervical spine occur due to its excessive stretching. In childbirth, this is possible in two situations. The first case is a large fetus, which obstetricians “pull up” by the head, because the shoulders do not pass through the birth canal. Another case is a large fetus and breech presentation. In this situation, obstetricians "pull" the child by the pelvic end, since the head does not pass through the birth canal. Such stretching is dangerous by rupture of the ligaments and separation of the vertebral bodies from the intervertebral discs. The spinal cord may be damaged.

Flexion-compression injury

If in the previous case the cervical region was subjected to strong stretching, then in this case it is subjected to excessive compression. This happens during rapid labor, when the head "gets stuck" in the birth canal, and the body is rapidly moving forward. Rapid labor can occur naturally or as a result of induction of labor. Compression injuries are also possible when obstetricians try to maintain the integrity of the perineum and it creates an obstacle to the exit of the fetus. From strong squeezing, the child may have vertebral bodies.

What is dangerous birth injury of the cervical spine

Regardless of the severity of natal trauma in newborns, such damage is bound to have consequences. The most terrible variant of the consequences of a birth injury is a fatal outcome. Sufficiently severe consequences of damage to the cervical spine at birth can be cerebral palsy, paresis or paralysis of the limbs.

Sometimes there are no obvious consequences of the injury. This does not mean that the child is absolutely healthy. With damage to the cervical region, circulatory disorders of the brain often occur, as a result of which the baby may lag behind in development. Some consequences generally appear only closer to preschool and school age. At that time, few associate them with the trauma received at birth.

These consequences include:

• headache;
• high pressure;
• weak muscle tone;
• motor disorders;
• clubfoot;
• problems with the spine (scoliosis, osteochondrosis).

The birth trauma of a newborn does not go unnoticed not only for physical health, but also for the mental sphere. Its consequences can be hyperactivity, low concentration, poor memory. It is quite difficult for a child with such an anamnesis to study at school.

Manifestations of natal CS injury

It is possible to determine the presence of a natal injury of the cervical spine in the first hours after the birth of the baby. A number of symptoms are noticeable during a routine examination:

• the child has swelling and redness of the neck;
• visually the neck looks too long or short;
• the muscles of the neck and neck are very tense;
• the baby's neck is fixed in a curved position.

In addition to signs that can be detected during examination, trauma manifests itself in changes in the behavior and functioning of the body:

• the body and limbs of the baby are relaxed (despite the fact that for newborns muscle hypertonicity is characteristic);
• the child's breathing is accompanied by wheezing and moaning sounds;
• cyanosis is noticeable in the region of the nasolabial triangle;
• the baby behaves restlessly, sleeps badly, screams;
• the newborn sucks badly at the breast, often burps;
• irregular heartbeat may occur.

These signs are quite specific, so their presence is highly likely to indicate a birth injury. However, in order to accurately determine whether there were injuries to the cervical spine, studies are needed: radiography, ultrasound (to determine the condition of the vertebrae) and dopplerography (to assess blood flow in the vessels of the head and neck). Only after these studies can accurately determine the nature and severity of damage to the cervical spine.

Treatment of natal cervical injury

Usually, treatment consists in eliminating the cause of the disease, but in the case of a birth injury, it is impossible to eliminate the cause. In this regard, the treatment is aimed at eliminating the consequences of the injury, restoring the normal functioning of the cervical region.

If a newborn or a newborn has a natal CS injury, the first and most important event is neck fixation. In case of dislocation, before fixing the neck, the orthopedist must be in place. Fixation is carried out using a special method of swaddling, when the neck is enclosed in a hard cotton-gauze roller. You need to swaddle in this way for at least 2-3 weeks. In some cases, the child is not only fixed with a neck, but also immobilized the child with the help of a bed from a field worker.

3-4 weeks after the start of treatment, the next stage begins. Its goal is to restore muscle tone and normalize the functions of the nervous system. At this stage, massage, various baths, physiotherapy (electrophoresis) are carried out. Such courses of rehabilitation therapy in the first year of life should be carried out 2-3 times.

If a child is injured in the cervical region during childbirth, he will be discharged home in about a month. From the maternity hospital, such babies are discharged to the children's department, where primary treatment is carried out. After the child can not fix the neck, the baby goes home and in the clinic comes under the supervision of a neurologist and an orthopedist. Massages, baths and physiotherapy are also carried out in a polyclinic or a special rehabilitation center. You can be registered with a neurologist and an orthopedist for a long time, depending on how successfully the recovery is going.

In the event that an injury to the cervical spine is accompanied by a dislocation of the vertebrae, after discharge, the doctor may prescribe wearing a Shants collar. It can be prescribed for several hours a day, for sleep only, or for around-the-clock wear. It is necessary to select such a collar strictly individually, focusing on the weight and volume of the baby's body. An incorrectly fitted collar can only exacerbate the problem of the cervical region.

Birth injuries are problems that have arisen in the perinatal period or during the birth process. In newborns, the spine is very sensitive to any kind of mechanical influences.

This is due to the fact that ossification is barely beginning to appear, and at the time of childbirth, the spine consists of cartilage tissue.

What are the symptoms

Often, a birth injury of the spine in newborns occurs in cases where labor was stimulated, obstetric forceps were used, or an operation was performed.

It is worth noting that the weight of the child also plays an important role in this matter. So, babies with a small weight, for example, less than three kilograms, as well as newborns with a large weight, more than 4 kg, may be at risk.

As for the symptoms of a birth injury of the cervical spine, it is very diverse, and sometimes even imperceptible and sometimes delayed in time. In general, due to the fact that the arteries were clamped, the following symptoms can be distinguished:

• impaired brain functions;
• increased intracranial pressure;
• the occurrence of problems with the nervous system;
• delayed speech and motor development;
• hyperexcitability and hyperactivity;
• disorders associated with the musculoskeletal system;
• enuresis;
• allergic reactions of a different nature;
• other autonomic abnormalities (these include migraines, fainting, meteosensitivity, general fatigue, and even diarrhea).

Note that in each individual case, the symptoms may be different. It is necessary to carefully monitor the child to tell the doctor more detailed information.

Varieties

There are 3 mechanisms that can lead to spinal injuries during childbirth:

• Compression - it occurs in cases where there is a large difference in uterine pressure and forces that prevent the fetus from moving further along the birth canal.
• Distraction - this mechanism is associated with the artificial extraction of the fetus by the pelvis or head.
• Rotational - it is associated with improper management of childbirth.

These mechanisms may occur singly or may be combined.

We propose to consider the main types of spinal injuries caused during childbirth:

1. "Short neck syndrome" - it is especially noticeable when the baby is in a supine position. Looking at the child, it seems that he does not have a neck. This feeling disappears when the baby is picked up. Short neck syndrome is associated with displacement of the first and second vertebrae. What does this threaten in the future? A person may develop conditions such as headaches, scoliosis, and decreased vision;
2. “Syndrome of transverse folds on the neck” - outwardly it looks approximately the same as in the first case, however, this syndrome is distinguished by the presence of a large number of folds on the neck, which constantly break;
3. "Cervical insufficiency syndrome" - this condition is characterized by a decrease in strength in the baby's arms. This is expressed in the fact that, for example, the baby does not have enough strength to rise, grabbing the fingers of mom or dad. It happens that only one arm is weakened in the crumbs. This condition is called Robinson's syndrome. What are the consequences of this injury? In adulthood, a person may develop scoliosis, flat feet, and even curvature of the legs;
4. If your baby is extremely flexible and can twist their legs incredibly, do not be touched by this. This may indicate a fairly serious injury in the sacral region;
5. Frequently repeated fainting, as well as a regularly stuffy nose, also speak of an injury to the cervical spine.

Keep in mind that the above list of possible spinal injuries during childbirth is far from complete. Each case must be considered separately, with its symptoms and possible consequences.

About Diagnosis and Therapy

Diagnosis of trauma to the spinal column caused during childbirth includes the following steps:

• identification of mechanical damage, for example, squeezing or hemorrhage;
• ultrasound diagnostics (ultrasound) is often used for a more accurate diagnosis;
• depending on the age of the crumbs, as well as its condition, radiography methods can be used.

As for the treatment of injuries of the spinal column received during labor, all the actions of specialists will be aimed at ensuring normal blood supply and blood circulation in the brain.

In some cases, it may even be necessary to fix the cervical region until the lost or impaired functions are fully restored, or until the intracranial pressure returns to normal.

For the treatment of birth injuries, experts often recommend manual therapy. In this case, it has established itself at a high level, since in many cases manual exposure gives positive results.

The doctor also prescribes medication. Medication can also be done on its own or in combination with manual therapy for better results. In especially severe cases, surgery may be prescribed to get rid of the pathology.

We would like to note that the diagnosis, as well as the treatment of spinal injuries received during the birth process, must be carried out strictly under the supervision of a specialist. Do not self-medicate, even when it comes to massage.

Birth injuries of the vertebrae should be corrected only by the appropriate doctors, because we are talking about the prosperous future of your child!

Denial of responsibility

The information in the articles is for general information purposes only and should not be used for self-diagnosis of health problems or for medicinal purposes. This article is not a substitute for medical advice from a doctor (neurologist, internist). Please consult your doctor first to know the exact cause of your health problem.

I will be very grateful if you click on one of the buttons
and share this material with your friends :)

Childbirth is most often a very unpredictable process.

Not always everything goes smoothly for both the woman in labor and the baby. For various reasons, newborns may experience birth injuries: damage to the spinal column (usually the cervical region), head, bone structures or internal organs. If you do not provide timely assistance to the baby, the consequences can be very sad.

general description

In newborns, unlike adults, the bone structure is quite flexible, which is very useful when passing through the birth canal, as it helps to avoid injury. But if complications arise during childbirth, then there is a high probability that everything will not work out very well for the baby and he will receive some kind of damage.

Among all birth injuries, natal (related to childbirth) injury, affecting the cervical segment of the ridge, dominates. Whatever the severity of the damage, it does not pass without a trace for the baby. That's why concerned parents want to know what is the danger of a birth injury of the cervical spine.

Effects

Apart from a possible fatal outcome, various forms of cerebral palsy are considered the most severe consequences of birth injuries of the neck area. In addition, against the background of cerebral hypoxia, which occurs due to the pathology of the cervical segment, a child may be diagnosed with mental retardation.

And some consequences can make themselves felt after a long time. These include the following:

• frequent attacks of headaches;
• vegetative-vascular dystonia of hypertonic or hypotonic type;
• decreased muscle tone;
• violation of fine motor skills;
• deformity of the foot, in which it deviates inward from the longitudinal axis of the lower leg;
• spinal diseases.

In addition, the mental health of the baby is severely disturbed. He is hyperactive, has a low concentration of attention, forgetful. All this makes it very difficult for him to study at school.

Possible reasons

In addition to finding out the likely consequences, parents are also interested in what causes pathology. Birth injuries are more likely to occur in the presence of such concomitant factors:

• incorrect presentation (transverse, oblique) of the fetus;
• functionally or anatomically narrow pelvis of the woman in labor;
• large or small fruit;
• oxygen deficiency in the fetus in the womb;
• premature or delayed birth;
• insufficient in strength, duration and frequency of contractile activity of the uterus, due to its hypotonic dysfunction;
• quick, rapid childbirth;
• congenital malformations of the fetus;
• trauma of the skeletal system in a woman in labor in history.

Quite often, generic herbs have a mechanical reason when obstetricians use various instruments in the delivery room for no particular reason. But most often it is not correct to blame only medical personnel, since birth injuries occur when several factors are combined simultaneously that can make pathological changes in the biomechanics of the birth act.

And if we talk about artificial delivery (caesarean section), then in such cases, injuries during childbirth are diagnosed 3 times more often than if this process occurs naturally.

This is due to the fact that when obstetricians take the baby out of the uterus, a vacuum is created behind his body, which prevents the baby from exiting normally. In view of this, the doctor is forced to remove the newborn with effort. And if a child is born prematurely and his bones and ligaments are still quite weak, then injuries to the cervical segment are more guaranteed.

Types of natal injuries and their symptoms

In newborns, the ligamentous-muscular apparatus is still very weak, therefore, with a certain kind of load, trauma to the neck very easily occurs. Types of damage are divided according to the method of injury. Obstetricians clearly understand how to recognize this or that injury and they have developed a special algorithm of actions in such situations.

The presence of a birth injury of the neck is determined even in the first 2-3 hours after the appearance of the baby. During a routine physical examination, the following symptoms will be noticeable:

In addition to visual signs, the following symptoms may also occur:

• arms, legs, as well as the body of the baby are in a relaxed state, although they should be in hypertonicity;
• the child is breathing heavily with a groan and wheezing;
• cyanosis (cyanosis) of the nasolabial triangle;
• the quality of sleep is disturbed in a newborn, he is naughty more than expected;
• the child sucks weakly at the breast, burps more often than usual;
• cardiac arrhythmia occurs.

Neonatologists are well acquainted with such symptoms, so they can almost unmistakably assume the presence of a birth injury in an infant.

rotary

The baby does not always progress successfully on its own, therefore, in some cases (there is a threat to the life of the mother / child), obstetricians try to help him with the help of hands or special forceps.

Rotational (rotational) movements of the baby's head are performed, which can lead to displacement of the articulated surfaces of the first and second cervical vertebrae while maintaining a point of contact or damage to the connection of the cervical vertebrae with each other and with the skull.

In addition, a displacement of Ⅰ of the cervical vertebra and the occurrence, accompanied by compression of the spinal cord and nerve roots emerging from it, are possible. But most often, such rotational injuries occur only in the case of the negligence of medical personnel.

distraction

When the baby is large enough at the time of birth and his shoulder girdle does not pass into the birth canal or an incorrect presentation of the fetus is diagnosed, then in some cases obstetrician-gynecologists will have to make special efforts during natural delivery. This may be associated with distraction injuries: damage to individual cartilage of the spine, complete disruption of the integrity of the ligaments in the cervical region, and damage to the spinal cord or nerves of the spinal canal.

Flexing squeezing

Flexion-compression injuries are most often diagnosed in babies who were born quickly. In the case of primiparas - faster than 4 hours, and in the case of repeated births - faster than 2 hours. The situation is especially aggravated if the baby is large. Passing quickly through the birth canal, he encounters resistance with his head, which can lead to a compression violation of the integrity of the vertebral bodies.

Video

What are the causes of birth trauma in newborns?

Diagnostics

The main and most effective diagnostic methods used both in the perinatal period (the first week after birth) and at an older age:

• physical examination of the infant;
• palpation of the head, neck, upper and lower extremities;
• ultrasound and radiography;
• magnetic resonance and computed tomography;
• assessment of innate reflexes;
• electroencephalography.

In addition, you may additionally need to consult specialized doctors (osteopath, neurologist, psychotherapist).

Treatment

Algorithm of actions aimed at restoring the normal functioning of the cervical region:

1. If the injury is associated with a dislocation, then an orthopedist or vertebrologist, who is in place, should work with the baby before fixation. Then the neck of the newborn is fixed with a hard roll of cotton and gauze. It is necessary to resort to such manipulation for 2-3 weeks. And in some severe cases, a plaster bed is used, which is a plaster impression of the back half of the head, neck and torso and is used to completely immobilize the spinal column.
2. After 3-4 weeks, they move on to the next therapeutic stage, during which special attention is paid to restoring muscle tone and normalizing the functions of the nervous system. At this stage, small patients are recommended massage and various physiotherapy procedures. During the first year of life, parents should responsibly approach the rehabilitation of the baby and attend such courses at least 2-3 times.
3. If the neck injury includes displacement of the vertebra relative to what lies below, then the baby may be recommended to wear. In different cases, wearing such a neck splint can be recommended from 2-3 hours a day to permanent. It is necessary to select the Shants collar very carefully so that it fully fits the parameters of a particular child. An incorrectly chosen orthosis can only harm the neck, which is already not in the best condition.

If during childbirth the child was injured in the cervical region, then he will be discharged only after 3-4 weeks. Moreover, they are discharged from the maternity hospital on time, but transferred to the children's department for primary treatment.

And when the neck no longer needs to be fixed, the baby is allowed to go home, but is registered with a neurologist and an orthopedist in a children's clinic. Such a child will continue to need massage and physiotherapy, which will be provided to him at the local clinic or at a special center for the recovery of children.

Complications

Natal trauma of the cervical spine in a newborn has the following consequences:

1. Despite the fact that the child may begin to sit on time, he often has problems with walking, since the development of the musculoskeletal system and ataxia may be impaired against the background of a birth injury.
2. Neck injuries in the future can affect the speech capabilities of the baby. He does not speak longer than other children, and when he begins to make attempts, his speech is incoherent and incomprehensible. It is difficult for such children to formulate thoughts, remember information, and think logically.
3. After experiencing trauma to the cervical spine, children have a problem with the ability to perform small and precise movements with their hands and fingers. It is difficult for them to collect even fairly large objects (cubes, pyramids), not to mention some smaller details. They fail to hold a pencil or pen correctly, fasten buttons, tie shoelaces.
4. The neurological consequences directly depend on how badly the spinal cord was damaged during the injury. The kid may face curvature and degenerative-destructive pathology of the spine in the future. In addition, he may know firsthand what paresis associated with muscle paralysis is. There is an VVD, which in adolescence will torment with a headache, loss of spatial orientation, fainting.
5. Schoolchildren who have a history of a birth injury of the neck most often study poorly and have unsatisfactory behavior. On the one hand, they can be passive, but hyperactivity, aggressiveness, and excessive emotionality are more often noted. As they grow older, these children may have too low self-esteem and they become asocial.

The consequences of injuries of the cervical spine are treated quite difficult if the condition is already running. As a rule, the recovery period is long and requires a lot of patience from both the parents and the patient.