Causes and consequences of birth trauma of the cervical spine in newborns. Birth trauma, spinal injuries in children, cervical spine in newborns, consequences

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The birth process is quite unpredictable and can result in complications for both the mother and the baby. One such complication is birth trauma.

What's this?

Birth injuries of newborns are pathological conditions that occur during childbirth, in which tissues or organs are damaged in a newborn, as a result of which their functions are impaired.

With prenatal trauma in a newborn, the work of the main body systems is disrupted.

Types of injury

All injuries during childbirth are divided into:

Mechanical. These are bone fractures, head injuries, birth tumors, various hemorrhages, spinal cord and central nervous system injuries, cephalohematomas, injuries of the cervical spine, nerve damage, traumatic brain injury and other pathologies.
hypoxic. They are represented by damage to the internal organs and tissues of the brain, which leads to hypoxia and asphyxia during the birth process.

Cardiotocography is one of the methods for early diagnosis of intrauterine fetal hypoxia

Depending on the location of the lesion, injuries are distinguished:

Bones.
Soft tissues.
nervous system.
Internal organs.

Common Causes

To the appearance of mechanical birth injuries cite various obstacles in the advancement of the fetus through the female birth canal.

Cause of hypoxic injury is the complete or partial cessation of oxygen access to the child.

CNS damage or traumatic brain injury of the baby is one of the most common problems during childbirth.

Predisposing factors for which the risk of child injury during childbirth increases, include:

Large fruit weight.
Prematurity of the child.
Narrow pelvis of a pregnant woman.
Maternal pelvic injury.
Wrong presentation.
Mom's old age.
The rapidity of the birth process.
Prolongation of the birth process.
Stimulation of childbirth.
C-section.
Use of midwifery aids and devices.
Postmaturity.
Chronic fetal hypoxia.
Problems with the umbilical cord (entanglement, short length).

For a detailed explanation of how prenatal injuries occur in a baby, see the video:

Symptoms

The most common birth injuries are swelling of the soft tissues of the child's head, which is called a birth tumor. It looks like a small swelling on the head of a newborn. With such edema, babies can also experience hemorrhages in the skin in the form of small dots.
Cephalhematoma is manifested by hemorrhage in the baby's head. It occurs due to displacement of the skin and rupture of blood vessels, as a result of which blood collects under the periosteum of the cranial bones. The tumor appears immediately after childbirth and in the first two or three days its size increases.
Bleeding into the muscles often appears in the neck(in the sternocleidomastoid muscles) and looks like a moderately dense formation of a small size (for example, the size of a nut or the size of a plum).
Among bone fractures, the clavicle (often right) is most often damaged without displacement. With such an injury, when feeling the body of a newborn at the site of a broken collarbone, swelling, crunching and soreness are detected. Fractures of the femur or humerus are much less common. With them, movements in the limbs are impossible, their lethargy and soreness are noted.

Hematoma on the head of a newborn

Nerves can be damaged due to both hypoxia and mechanical trauma. The most common nerve problem is damage to the facial nerve. Often there are also injuries of the brachial plexus.
Traumatic brain injury may vary in severity. In severe cases, the baby may die in the first days or even hours after birth. Also, in severe trauma, organic changes in the tissues of the nervous system are possible, manifested by paralysis, paresis, and the development of mental retardation. Immediately after childbirth, the baby may develop convulsions, inhibition of the sucking reflex, breathing problems, severe crying, tremors of the arms and legs, insomnia, and other symptoms of CNS excitation. Further, the baby becomes lethargic, his cry and muscle tone weakens, the skin turns pale, the child sleeps a lot, sucks badly, burps a lot.
Injuries of internal organs are less common than other types of injuries and usually do not appear in the first time after childbirth. The baby may have damage to the adrenal glands, spleen, or liver. The condition of the baby worsens from the third to fifth day of life, when the hematoma in the damaged organ ruptures, which leads to internal bleeding and anemia.

Effects

The prognosis for birth injuries is affected by the severity of the injury, the timeliness of treatment, and the correctness of the selected therapy. If the child was correctly diagnosed in time and treated immediately, in 70-80% of cases he fully recovers.

The least dangerous damage to soft tissues and bones. The birth tumor usually disappears in one or two days without any consequences for the child's body. A small cephalohematoma resolves by 3-7 weeks of life without treatment. Due to a hemorrhage in the muscles of the neck, the child develops torticollis, in which the head of the crumbs leans towards the formation, and the chin is directed in the opposite direction. This condition is corrected by a special massage.

The magnitude of the hematoma affects the consequences of damage to internal organs. No less important is the extent to which the function of the affected organ has been preserved. For example, a large hemorrhage in the adrenal glands in many children leads to the development of chronic insufficiency of these glands.

The consequences of hypoxic injuries depend on the duration of the period when the child experienced a lack of oxygen. If such a period was long, a severe degree of delay in intellectual and physical development is possible, caused by the death of nerve cells in the brain. Children may develop cerebral palsy, hydrocephalus, seizures, nerve damage, encephalopathy and other pathologies. With an average degree of hypoxia in older children, increased fatigue, headaches, dizziness, and posture problems may occur.

For information on what hypoxia is and how to avoid it, see the following story:

Therapy

In most cases birth injuries are diagnosed in the maternity hospital, where the child is immediately prescribed the right treatment. In case of fractures, the damaged area is immobilized. In a serious condition of the baby, he is fed through a tube with colostrum, which the mother expresses.

With a severe degree of hypoxia, the treatment of the baby is carried out in the conditions of resuscitation of newborns.

In the treatment of injuries, depending on the type of damage, agents for blood vessels and the heart, drugs that affect the central nervous system, hemostatic agents, oxygen therapy, the introduction of vitamins and glucose are used.

Birth injuries can be caused by many factors, the most common being:

delivery time (rapidly fast or too long);
the time the fetus stays in the womb (premature and post-term babies);
application of the vacuum extraction method;
discrepancy between the anthropometric data of the pelvis of the mother and the head of the child;
use of caesarean section;
incorrect location of the fetus at the time of labor;
asynclitic insertion of the head;
use of forceps during childbirth.

There are many reasons and factors that affect the course of the process. According to the statistics of birth injuries, there are 3 main groups:

trauma associated with pathologies of the mother;
deviations during pregnancy and fetal development;
features of the natural course and delivery.

The pathologies of the mother include the age of the pregnant woman, the presence of female diseases, malfunctions of the cardiovascular system, a narrow pelvic passage, the gestational age at the onset of labor, etc.

Mostly, the bulk of birth injuries include deviations in the course of pregnancy and the formation of the fetus. Their appearance is caused by the breech presentation of the child, its size, short term, etc.

The abnormal course of the process of childbirth, their swiftness, the need for stimulation during small or intensive labor activity leads to the appearance of an injury.

This causes mechanical trauma to the newborn with obstetric devices and instruments, incompetent behavior of doctors and medical personnel.

Depression of the central nervous system of a newborn during and after childbirth can occur for three main groups of reasons: ischemic-hypoxic lesions, traumatic and infectious-toxic. Let's analyze each group in more detail.

Ischemic and hypoxic lesions of the central nervous system in newborns are due to a lack of oxygen in the blood of a child during childbirth. This may be due to prolonged and protracted labor, weakness of the birth forces, anomalies of the placenta and umbilical cord. With ischemia (the complete absence of oxygen), brain cells die, and the further picture of the disease depends on which part of the cortex this happens.
Traumatic lesions of the central nervous system - in the vast majority of cases occur during childbirth. The immediate cause can be an early birth (the baby’s head is born very quickly and gets injured), a large fetus, unskilled actions of an obstetrician, etc.
Infectious and toxic lesions may be associated with viral infection, alcohol, smoking during pregnancy, etc.

Brain lesions are most often of an ischemic-hypoxic nature, while the spinal cord is most often affected by physical trauma to the child's neck during childbirth.

To prevent this, it is very important to give birth in a good maternity hospital with a competent obstetrician, and in the first days after discharge, come to an appointment with an osteopath.

The optimal age for the first delivery is 20-25 years, since such women have much less chronic diseases and a history of abortions. The consequences of childbirth can be associated with trauma to the mother and baby if they occur at the age of over 30 years (for repeated pregnancies - over 35 years).

Perinatal pathology is more common in the presence of such risk factors:

incorrect position of the fetus in childbirth;
clinically, anatomically narrow maternal pelvis;
large fetus, or low body weight;
intrauterine oxygen starvation of the fetus;
premature, overdue fetus;
weakness of labor activity;
rapid childbirth;
fetal malformations, such as hydrocephalus;
a history of bone injury in a pregnant woman.

What are the symptoms

Immediately after birth, the clinical picture of perinatal pathology can be very different from that after a certain period of time. Below are the main signs of injury by type that a neonatologist detects as a result of the first examination of a child.

Soft tissue injuries

They are damage to the subcutaneous tissue, skin and muscles. These include a variety of abrasions, hemorrhages, and most of them are not dangerous and heal quickly after local treatment.

The consequences for the child may be more severe if the muscles are injured. Most often, birth injuries affect the sternocleidomastoid muscle, in which a rupture of fibers can occur.

Symptoms of pathology - the appearance of a hematoma in the affected area, as well as compaction, sharply painful when palpated. Sometimes these signs appear only after the child is discharged from the hospital, and in this case they are almost always accompanied by deviations in the normal position of the neck (torticollis, or tilt of the head in the direction where the muscle is torn).

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. She is in this case 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.

Postpartum injuries are diagnosed using modern methods, which are selected, depending on the type of injury, on the recommendation of a pediatrician, traumatologist, obstetrician.

Diagnostics includes:

Among the methods for detecting birth injuries, which are used both in the perinatal period (up to 7 days after birth), and in the first year of life and older:

examination of the newborn;
palpation of the head, neck, limbs;
Ultrasound and radiography;
MRI, CT;
functional tests;
consultations of narrow specialists.

Osteopathic treatments

For the appearance of a minimum of risks during childbirth, Mother Nature has taken all means to avoid injury and complications for the mother and child. She provided the baby with elastic bone tissues and natural shock absorbers so that, while transforming, he would fit into the narrow birth canal of the mother.

But in some cases, failures occur that require treatment.

In case of joint injuries or fractures with displacement, a limb traction device is used and temporarily fixed. The ability to restore bone tissue in children is significant, so it is very quickly renewed.

In some episodes, a tight bandage is enough, while in others, gypsum is necessary. The consequences of injuries are eliminated with the help of massage, electrical stimulation, exercise therapy.

When treating fractures in babies, a pediatric traumatologist is mandatory.

With cephalohematoma, treatment is reduced to monitoring a small patient. Usually, the injury resolves on its own and without complications, leaving no trace and without changing the appearance of the child.

But in practice, there are cases when subcutaneous hematomas continue to grow, this occurs in children predisposed to poor blood clotting. The disease lies in the genes and occurs due to a lack of vitamins K, C, R.

The infant is injected with hemostatic agents (vitamins, calcium chloride) and the treatment is supplemented with antibiotic therapy.

With torticollis, special massage techniques are used, electrophoresis with potassium iodide, the baby's head is laid and fixed on the sides with rollers.

When internal organs are damaged in a child, therapy is used that focuses on reducing blood loss. With internal bleeding, the method of laparoscopy or laparotomy is used.

Damage to the skin requires treatment with local antiseptics (iodine, alcohol) to prevent infection. As a rule, minor injuries heal by 5-10 days after birth.

Muscle ruptures and hematomas are treated by providing a corrective position for the child, eliminating the incorrect position of the limbs, head, neck, prescribing physiotherapy, massage, and introducing various absorbable drugs.

Sometimes in the first six months of life, a baby needs surgical correction of a birth muscle injury.

For fractures, standard treatment is carried out, including:

immobilization of limbs with the help of splints, Dezo bandages;
tight swaddling;
traction (traction);
physiotherapy;
massage.

Sequelae of a head injury

The consequences of a birth injury to the head can be very diverse. It all depends on how early the injury was detected and the course of treatment started.

Of course, late diagnosis can lead to a number of diseases:

development of cerebral palsy in a child,
mental retardation,
speech delay,
acquired epilepsy.

http://gidpain.ru/travma/rodovye-novorozhdennyh.html Birth injuries in children should be treated immediately, in order to avoid the manifestation of complications and pathologies. In infancy, everything is much easier to fix due to the anatomical features of the structure of bone tissues and the child's body. If measures are not taken in time, the child may become disabled and receive the following consequences of birth injuries:

headache, indigestion;
increased blood pressure, vegetative-vascular dystonia;
diseases of the musculoskeletal system;
mental retardation;
underdevelopment of fine motor skills, etc.

Prevention of birth trauma in newborns

Prevention of injuries during childbirth in infants involves determining the level of risk of their receipt during the period of observation of pregnancy, extremely careful handling of the newborn during childbirth.

During pregnancy and when planning it, it is important to follow the recommendations of doctors:

it is necessary to prepare for pregnancy;
undergo treatment for chronic diseases;
protect yourself from infection with viral and respiratory infections;
eat right and balanced;
be observed by a gynecologist;
lead a healthy lifestyle;
at the stage of childbirth, follow the instructions of the obstetrician and correctly conduct labor activities.

Injuries during childbirth are common. Many do not pose a threat to the life of the child, and the child's body copes with the problem on its own.

But in severe episodes, the help of a specialist in the field of neurosurgery, neurology and traumatology is necessary. And the mother must do everything possible to keep her baby healthy.

It is desirable for a woman to plan a pregnancy before the treatment or correction of chronic diseases, as well as to register for pregnancy on time.

More information

The process of childbirth is perhaps the most traumatic event in the life of a young child. Large compressive forces act on the fetal head in the birth canal, which, under certain conditions, cause injury.

Although the body of a newborn is well adapted to endure the stresses of childbirth, sometimes (and in our time, with the use of medical and surgical intervention in the process of childbirth, more often) protection fails and birth trauma occurs.

The reasons

Too much when a baby is born is completely unpredictable. The organisms of mother and child can behave differently, and medical omissions are not excluded.

The reasons can be both external and internal factors. According to statistics, birth injuries in newborns are due to the following indicators.

"Maternal" factors:

early or late age of a woman;
hyperanteflexia, uterine hypoplasia,
preeclampsia;
narrow pelvis;
cardiovascular, gynecological, endocrine diseases;
occupational hazards (if a woman, for example, worked in the chemical industry);
delayed pregnancy.

Fetal pathologies:

breech presentation;
oligohydramnios;
large sizes;
prematurity;
abnormal (with a turn) position of the fetus;
hypoxia;
asphyxia;
asynclitic (incorrect) or extensor insertion of the head.

Anomalies of labor activity:

protracted childbirth;
rapid delivery;
discoordinated or strong, as well as weak labor activity.

Mistakes in obstetrics:

Subluxation in the cervical region occurs as a result of both active and indirect impact on the head. Another provoking factor is the spontaneous contraction of the neck muscles.

In children, this usually happens when they turn their head, and it assumes an unnatural position. And given the hyperactive motor activity of children, this can happen quite often.

Subluxation of the cervical vertebrae in newborns is not only acquired, but also congenital. That is, this pathology is often the result of birth trauma.

During childbirth, the baby's head shifts relative to the main axis, as a result of which the force of muscle pressure in the birth canal changes and the articular ligaments are damaged.

Another common cause of the development of pathology is the improper performance of sports exercises. Subluxation can occur when falling on the head, during a headstand, when diving into an unexplored and shallow reservoir, with incorrectly performed somersaults and other sports exercises.

Most often, the causes of such a pathology are traumatic effects, sometimes it can be the result of tumor growth, severe muscle spasms, and even incorrect position during sleep.

Separately, it is worth dwelling on cases of neck dislocation in a child, sometimes even in a newborn. In an infant, neck dislocation often occurs due to trauma during childbirth.

The child almost always receives such an injury with an unnatural presentation or as a result of entanglement of the neck with the umbilical cord. These factors can cause powerful bending deformities in the cervical region and subsequent dislocation of the neck in one vertebra or several at once.

Sometimes the reason for the displacement is insufficient control of the position of the child's head - its sharp tipping.

For patients who have reached adulthood, the main causes of neck dislocation are somewhat different - in the vast majority of cases, these are the consequences of traumatic disorders.

Dislocation of the neck, with a complete loss of intervertebral connections, is not common, the main part of such injuries is represented by subluxations, which are especially dangerous, due to mild symptoms.

READ ALSO: Is it possible to die from cervical osteochondrosis

The first symptoms of neuralgia may appear only after a few months, and this makes treatment difficult. Often, by this time, partial loss of hearing, vision and disturbances in motor activity are observed.

Here is a list of the reasons that most often leads to a dislocation of the neck - to the displacement of its complete or partial vertebrae:

Birth injuries can be caused by many factors, the most common being:

delivery time (rapidly fast or too long);
the time the fetus stays in the womb (premature and post-term babies);
application of the vacuum extraction method;
discrepancy between the anthropometric data of the pelvis of the mother and the head of the child;
use of caesarean section;
incorrect location of the fetus at the time of labor;
asynclitic insertion of the head;
use of forceps during childbirth.

In many ways, birth injuries are due to the fact that a pregnant woman belongs to a risk group for one or another indicator. Thus, the age of the expectant mother has a significant influence on the outcome of childbirth.

Perinatal pathology is more common in the presence of such risk factors:

incorrect position of the fetus in childbirth;
clinically, anatomically narrow pelvis mothers;
large fetus, or low body weight;
intrauterine oxygen starvation of the fetus;
premature, overdue fetus;
weakness of labor activity;
rapid childbirth;
fetal malformations, such as hydrocephalus;
a history of bone injury in a pregnant woman.

Kinds

Depending on the cause and nature of the damage, there are different kinds birth injuries, the main classifications of which are two.

Classification No. 1 (for reasons)

Among all subluxations of the cervical vertebrae, there are three types of this pathology, which are most often diagnosed in children:

signs

In hospitals, injuries during childbirth in a child are diagnosed only in cases where their signs are literally visible to the naked eye and represent open mechanical damage:

fractures;
breaks;
tears;
dislocations;
hemorrhages (hematomas);
compression.

Since birth injuries in children require, in some cases, a judicial and prosecutorial investigation due to the identification of medical errors, neonatologists and pediatricians do not diagnose them too actively.

Therefore, most often the symptoms are detected after discharge from the hospital and are explained by pathologies of intrauterine development or improper care of the newborn in the first days of his life.

Symptoms of soft tissue injuries:

scratches, petechiae (pinpoint hemorrhages), abrasions, ecchymosis (bruises);
tumors;
absence fontanel pulsation, its painlessness, is often accompanied by jaundice and anemia.

Signs of trauma to the skeletal system:

swelling and swelling;
inability to perform active movements with the injured limb;
pain syndrome, because of which the child often cries a lot;
the main signs of intracranial birth trauma are muscle weakness, temperature changes, asthma attacks, uncoordinated movements of the limbs, their trembling, convulsions, spontaneous eye movement, bulging of the fontanel, drowsiness, crying weakness;
deformities, shortening of the limbs.

Symptoms of internal injuries:

bloating;
muscular hypotension, atony;
depressed physiological reflexes;
constant profuse regurgitation;
arterial hypotension;
vomit.

Signs of CNS disorders:

lethargy, areflexia;
muscle hypotension;
weak cry;
diaphragmatic breathing;
autonomic disorders: sweating, vasomotor reactions;
shortness of breath, cyanosis, bulging of the chest;
congestive pneumonia;
asymmetry of the face, mouth;
displacement of the eyeball;
difficulty in sucking.

Most of the symptoms of birth trauma in a baby do not appear immediately, but only 4-5 days after his birth. It often happens that the mother attributes lethargy and drowsiness to the normal state of the crumbs, and in the meantime, there is damage to any internal organ.

It is possible to make the correct diagnosis only after a comprehensive examination and the delivery of appropriate tests. They will depend on the type of birth injury.

READ ALSO: Exercises for lumbar osteochondrosis of the spine

With the world on a string. The charming wry smile of Hollywood actor Sylvester Stallone is nothing more than a consequence of a serious birth injury. As well as a severe speech impediment, from which the artist had to get rid of for a long time.

Symptoms of birth trauma in newborns

Soft tissue injuries

They are damage to the subcutaneous tissue, skin and muscles. These include a variety of abrasions, hemorrhages, and most of them are not dangerous and heal quickly after local treatment.

The consequences for the child may be more severe if the muscles are injured. Most often, birth injuries affect the sternocleidomastoid muscle, in which a rupture of fibers can occur.

Symptoms of pathology - the appearance of a hematoma in the affected area, as well as compaction, sharply painful when palpated. Sometimes these signs appear only after the child is discharged from the hospital, and in this case they are almost always accompanied by deviations in the normal position of the neck (torticollis, or tilt of the head in the direction where the muscle is torn).

Diagnosis of birth trauma

It is difficult to diagnose "subluxation of the cervical vertebrae" because its symptoms are often similar to those of other pathologies. Usually, for an accurate diagnosis of subluxation, it is enough to take X-rays of the neck in the direct posterior and lateral projections.

However, given the severity of the condition of a particular patient, the doctor can also take an x-ray in an oblique projection. If there is a suspicion of displacement of the atlas, then an x-ray is performed through the oral cavity.

As additional means of diagnosing subluxation of the cervical vertebra, magnetic resonance and computed tomography are used. To rule out neurological diseases, a consultation with a neurologist may be required.

Reencephalography is used to diagnose chronic subluxation.

Among the methods for detecting birth injuries, which are used both in the perinatal period (up to 7 days after birth), and in the first year of life and older:

examination of the newborn;
palpation of the head, neck, limbs;
Ultrasound and radiography;
MRI, CT;
functional tests;
consultations of narrow specialists.

Treatment of birth trauma in newborns

The treatment of this pathology of the musculoskeletal system consists of such measures as the reduction of the displaced vertebra and further restorative procedures. Correctly put the vertebrae in place can only be a qualified chiropractor or traumatologist - orthopedist.

The doctor will adjust and treat the child's subluxation only if there are no severe complications, such as cracks, torn ligaments, etc. Surgical hospitalization of the victim will facilitate the work of a specialist and further treatment.

Treatment of this pathology in children involves the use of conservative methods. After the reduction of the displaced vertebra, the child must be provided with proper attention from adults.

Learning disabilities, clinical attention deficit disorder mimicking ADHD.

Developmental delay in any form.

Headaches, complaints of heaviness in the head.

Deficiency in motor skills, up to paralysis and paresis of the limbs.

Social maladjustment.

In adults:

Chronic pain syndrome, pain in the back and limbs.

Headaches, migraine, noise and ringing in the ears.

Dizziness, lack of coordination, etc.

Osteopathic treatment of the consequences of birth injuries of the neck

Often the parents of such children first hear about a neck injury from a pediatric massage therapist. However, a neurologist with careful palpation examination can also detect changes in the bone structure of the vertebrae and muscle tone. The most successful osteopathic diagnosis of neck injuries in infants.

Treatment of a neck injury in the first days of a child's life can prevent all negative consequences in the future. An osteopath without the help of X-ray or MRI reveals abnormalities in the bone structure of the cervical vertebrae, their articulation with each other and the bones of the skull. In infants, these connections are very mild, so it is important that the doctor masters precisely children's diagnostic techniques.

Elimination of neck dysfunctions is carried out immediately at the first session. The doctor also checks the entire body of the baby and, if necessary, corrects birth injuries. A second session is usually scheduled after 2-4 weeks.

Today we offer an article on the topic: "Birth trauma of the cervical spine in newborns." We have tried to describe everything clearly and in detail. If you have questions, ask at the end of the article.

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.

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Birth injury SHOP and its types

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 in an adult, the CS (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 its displacement. 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 fractures of the 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 set the cervical vertebrae into 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.

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Trauma to the cervical spine is a very significant injury that can cause severe and irreparable consequences. Its significance is determined both by the general condition of the victim and the consequences leading to disability (in cases of spinal cord injury). Approximately 40% of these bruises are fatal.

Signs of damage to the cervical spine

The cervical vertebra is the most mobile part of the body. This contributes to the performance of a variety of motor functions. The vertebral arteries run through the openings of the transverse processes of the vertebrae of the neck. They supply blood to the brain. If as a result of an injury there is insufficient blood supply, then the following symptoms appear:

head pain;
feeling of dizziness of the head;
dark spots before the eyes;
wobbly gait;
sometimes speech is disrupted.

When the neck is bruised with damage to the fibers of the nerves, there are signs that develop due to compression of the spinal cord:

the appearance of pain in the neck, which gives to the back of the head, upper limbs, shoulders, shoulder blades;
loss of sensation and ability to move;
dysfunction of the pelvic organs.

When the spinal cord is injured, a partial or complete loss of its conductivity occurs. If the violation is partial, then symptoms appear:

there are separate reflexes and the ability to motor function below the site of injury;
local sensitivity is maintained.

The patient is able to perform some movements. He feels if the skin-muscle folds are captured. During a complete violation of conduction appears:

complete loss of sensation and motor functions in areas of the body below the injury point;
lack of urination and defecation or they are unconscious.

Signs of neurological disorders in neck injury depend on the location of the lesion. If an injury to the lower part of the cervical spine is received, the signs are as follows:

impaired motor function and paralysis of the arms and legs;
constricted pupils, discoloration of the iris, sunken eyeballs.

When the upper vertebrae are damaged, the following symptoms develop:

limb dysfunction;
disturbed breathing;
the presence of dizziness;
loss of the ability to swallow;
difficulties with speech;
decrease in heart rate;
disappearance of sensation of pain and temperature (if the brain is affected on one side).

birth trauma

Birth trauma of the cervical spine occurs due to mechanical stress occurring during childbirth. Causes of injury in a newborn:

incorrect location of the fetus;
a rather narrow pelvis in the mother;
a large mass in a child;
prolonged pregnancy;
the presence of tumors in the genital area;
obstetric intervention.

Natal trauma to the cervical spine occurs due to various kinds of forced bending, stretching or turning. After all, in a baby, this department is very thin, flexible and sensitive. Natal injuries are divided into:

rotational (if the obstetrician tries to help the baby pass through the birth canal by manipulating hands or forceps, which can provoke subluxation or displacement of the atlas, deformity of the articulation of the vertebrae, compression of the spinal canal).
distraction (when the child is large, the obstetrician makes great efforts during childbirth, which provokes the possibility of separation of the vertebral bodies from the discs themselves, ruptures of the ligaments, and injury to the spinal cord).
flexion-compression (when the birth is rapid, the baby's head encounters resistance while moving through the birth canal, so fractures of the vertebral bodies occur).

Such damage leads to the following phenomena in the newborn:

the appearance of spasms;
disorder of the blood flow of the brain;
failure of the outflow of venous blood;
disorder in the work of the central nervous system (there is a violation of motor development).

Birth trauma of the cervical spine in newborns further leads to the fact that:

The baby later than usual begins to hold his head, roll over, walk.
The child will have a later speech development.
The child suffers from the development of memory and attention.
The child may lag behind in growth, suffer from ailments of the musculoskeletal system.

Deviations in the newborn associated with injuries of the cervical spine are well cured.

With their immediate treatment, the prognosis is favorable. If the injury is not treated, it can adversely affect the development and health of the baby in the future.

Possible consequences

The consequences of mutilations of the cervical region are pains spreading throughout the spinal column. With this type of injury, swelling occurs, even if the spinal cord is not affected. It puts pressure on the nerves and spinal cord. Consequences of injury to the cervical spine:

interruptions in the work of the heart (up to its stop);
disturbances in the work of the respiratory system;
loss of sensation (possible paralysis of the body);
malfunctions of internal organs;
limitation of motor function due to the tension of certain muscle groups (in rare cases).

Features of therapy

Treatment of this type of injury is a laborious and lengthy process. Only after examination by a specialist and diagnostic studies, a diagnosis is made, treatment is prescribed. Depending on the severity of the injury and symptoms, prescriptions are made: drug therapy, physio- or manual treatment, wearing a neck bandage, blockade, surgery.

Childbirth does not always go well for both the mother and the baby. For various reasons, during the delivery process, birth injuries of newborns can occur - damage to the spine (usually the cervical spine), head, bones, and internal organs. Diagnosis and treatment of such a pathology as birth trauma of newborns should be timely and adequate. Otherwise, the consequences can become the most serious - from problems with intelligence and physical disability to the death of a child.

In obstetric practice, the trauma of a newborn during childbirth is understood as a violation of the integrity of the organs, tissues, skeleton of the child, which is caused by the influence of mechanical forces. Perinatal pathology is a widespread and very urgent problem: injuries of varying severity are diagnosed in 11% of newborn babies. In 50% of cases, they are combined with trauma to the mother during childbirth, including ruptures of the genital organs, the formation of fistulas.

Classification of birth injuries

Conventionally, all traumatic lesions of the child during childbirth are divided into:

mechanical (due to external influence);
hypoxic (due to mechanical influence, the child experiences hypoxia, asphyxia, which cause CNS injury).

In newborns, birth trauma can affect different areas of the body. Depending on its localization, there is such a classification:

Injury to bones, joints. This includes all fissures, fractures of the femur, clavicle, shoulder, head bones, etc.
Soft tissue injury. These are damage to the skin, muscles, the appearance of birth tumors, cephalohematoma.
Trauma to internal organs. The group includes hemorrhages in any organs of the peritoneum.
Injury to the nervous system, or any damage to the nerve trunks, brain, spinal cord.

The latter group is divided into the following types of injuries of newborns in childbirth:

intracranial birth trauma;
trauma of the peripheral nervous system;
spinal cord injury.

Intracranial birth trauma includes subdural, intraventricular, subarachnoid, epidural hemorrhages.

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In addition, it is customary to differentiate the types of birth trauma according to the degree of responsibility of the obstetric service:

Spontaneous. Occurs during complicated or normal childbirth due to circumstances beyond the control of the doctor.
Obstetric. It appears due to the actions of the midwife, including the correct ones.

Causes of birth trauma

In many ways, birth injuries are due to the fact that a pregnant woman belongs to a risk group for one or another indicator. Thus, the age of the expectant mother has a significant influence on the outcome of childbirth. The optimal age for the first delivery is 20-25 years, since such women have much less chronic diseases and a history of abortions. The consequences of childbirth can be associated with trauma to the mother and baby if they occur at the age of over 30 years (for repeated pregnancies - over 35 years).

Perinatal pathology is more common in the presence of such risk factors:

incorrect position of the fetus in childbirth;
clinically, anatomically narrow maternal pelvis;
large fetus, or low body weight;
intrauterine oxygen starvation of the fetus;
premature, overdue fetus;
weakness of labor activity;
rapid childbirth;
fetal malformations, such as hydrocephalus;
a history of bone injury in a pregnant woman.

Mother's diseases also negatively affect the nature of childbirth - pathologies of the heart, blood vessels, diabetes mellitus, gynecological disorders, as well as complications of the course of pregnancy (preeclampsia, polyhydramnios, placental abruption). Birth injuries of newborns often occur due to the unreasonable use of obstetric instruments and aids (emergency caesarean section, forceps, etc.). Usually, serious damage to the fetus (for example, severe intracranial birth trauma) occurs when several adverse factors are combined that can cause disruptions in the biomechanics of the act of delivery.

The immediate cause of mechanical birth trauma is the complex rotation of the fetus, removing it with the help of a vacuum, forceps. Hypoxic injuries occur if there is suffocation (acute termination of oxygen supply) or prolonged oxygen starvation of the baby with the accumulation of carbon dioxide in its tissues. Their causes are associated with tightening of the umbilical cord knot, accumulation of mucus in the mouth, retraction of the tongue, which is recorded against the background of violations of the birth process as a result of anomalies in labor activity or the actions of a midwife.

Birth injuries during caesarean section are diagnosed three times more often than during vaginal delivery. This is mainly due to the “cup effect”: when the baby is artificially removed from the uterus, negative intrauterine pressure is formed behind his body. As a result, the created vacuum interferes with the normal exit of the child, and the surgeon has to make significant efforts to pull out the newborn. As a result, injuries to the cervical spine often occur, especially in premature babies with weakened bones and ligaments.

Symptoms of birth trauma in newborns

Soft tissue injuries

They are damage to the subcutaneous tissue, skin and muscles. These include a variety of abrasions, hemorrhages, and most of them are not dangerous and heal quickly after local treatment. The consequences for the child may be more severe if the muscles are injured. Most often, birth injuries affect the sternocleidomastoid muscle, in which a rupture of fibers can occur. Symptoms of pathology - the appearance of a hematoma in the affected area, as well as compaction, sharply painful when palpated. Sometimes these signs appear only after the child is discharged from the hospital, and in this case they are almost always accompanied by deviations in the normal position of the neck (torticollis, or tilt of the head in the direction where the muscle is torn).

Another type of soft tissue injury is cephalhematoma. It is an outpouring of blood under the periosteum of the head bone (usually parietal). It is necessary to distinguish this pathology from a birth tumor - swelling of the skin and the fiber located under it, which occurs due to strong compression of the area. Both types of pathologies are similar on their own, so the child does not need therapy.

Skeletal injury

The most common lesions of the cervical spine, which are associated with mechanical overload during childbirth. The vertebrae of the cervical spine are the most fragile, therefore quite vulnerable. The most common neck injuries:

excessive stretching;
impacted subluxations;
twisting of the head, neck.

True dislocations are extremely rare, and babies with such a pathology die almost immediately. Among the injuries of the joints and bones, fractures are also observed (more often - a fracture of the clavicle without displacement, rarely - a fracture of the humerus, femur). Fracture signs:

swelling;
bruise;
soreness in the affected area;
limitation of limb mobility;
crying of the child with passive movement of the arm, leg;
lack of necessary reflexes;
shortening of the bone
bone deformity.

Usually, all the consequences of such injuries are reversible, so the child will not need dispensary observation as he grows up.

Injuries of internal organs

Such injuries are not common. In most cases, damage affects the liver, adrenal glands, spleen. Hemorrhages in these organs do not manifest themselves for the first 2 days, but later there is a sudden deterioration in the baby's condition:

hematoma rupture;
increase in the area of hemorrhage;
anemia;
malfunctions of the damaged organ;
bloating;
according to ultrasound - the presence of fluid in the peritoneum;
severe muscle hypotonia;
inhibition of reflexes;
failure of the intestines;
lowering blood pressure;
vomit.

The consequences and prognosis depend on the severity of the injury. If the newborn does not die immediately, then the prognosis will be determined by how much the injured organ has retained its functionality. For example, after damage to the adrenal glands, the child most often develops chronic insufficiency of these organs.

Nervous system trauma

The most severe of birth injuries is considered damage to the central nervous system. Especially dangerous for life are head injuries accompanied by intracranial hemorrhages, which are caused by mechanical impact and hypoxia. The clinical picture largely depends on where the hemorrhage is localized and to what extent cerebral circulation is impaired. Main symptoms:

stupor;
dilation of the eyes;
neck stiffness;
inhibition of reflexes;
inability to suck, swallow;
asthma attacks;
convulsions;
bulging fontanelles;
tremor;
oculomotor disorders;
vomit;
regurgitation;
increase in body temperature.

With the growth of the hematoma and its compression of different parts of the brain, all of the above symptoms become even more pronounced, and the newborn may fall into a coma. Usually, with a serious hemorrhage, the baby dies in the first days of life.

Another severe type of nervous system injury is spinal cord injury. All segments of the spine in a newborn are well extensible, but the brain located in their canal is fixed from below and above, therefore it is less mobile. Most often, spinal cord lesions are found in the region of the lower cervical spine, or in the upper thoracic region. Sometimes the spinal cord can rupture with visible integrity of the vertebrae, which is very problematic to detect even during an X-ray examination. Symptoms of this type of perinatal pathology:

weak cry;
violation of reflexes;
muscle hypotension;
low physical activity;
lethargy;
distension of the bladder;
respiratory disorders;
limb movement disorder.

A child with a severe spinal cord injury may die from respiratory failure, but often the pathology slowly regresses, and the baby's condition improves. In most cases, various neurological disorders persist during the first years or throughout life.

With injuries of the peripheral nervous system, the nerve roots or nerve plexuses are damaged (more often - the facial, brachial, phrenic, median nerve). Symptoms are reduced to an abnormal position of the head, neck, limbs, limitation of spontaneous movements, muscle hypotension, the absence of some reflexes, shortness of breath, cyanosis, and swelling of the chest. If treatment is started immediately after birth, in most cases recovery occurs. With bilateral paresis of the phrenic nerve, on the contrary, a lethal outcome is recorded in half of the cases.

In pediatric practice, there are many situations when the consequences of birth trauma are detected after the child is discharged or a few months after birth. Symptoms of injury may include:

weak muscle tone, or hypertonicity;
low activity;
lack of movement in one of the limbs;
twitching of arms, legs;
inability to straighten the limbs;
frequent crying for no reason;
weak sucking reflex;
throwing food out of the mouth;
constant regurgitation;
pale skin;
protrusion of the tongue;
leakage of feces, urine;
sleep with head thrown back;
non-compliance with time-limited skills (does not sit, does not walk, etc.).

After a year of life, birth injuries can manifest themselves with the following clinical picture: abnormal head sizes, frequent tantrums, crying, hyperactivity, lethargy, disorders of the musculoskeletal system, mental abnormalities, different lengths of limbs, convulsions, paresis. It should be remembered that only an early appeal for help will help the child become a full-fledged member of society or significantly improve his condition.

Consequences and complications of injuries in newborns

As a result of trauma, the child often dies in the first days after birth. If the baby survived, his future health is highly dependent on the severity of the injury and the adequacy of treatment. Consequences at an older age can manifest themselves in the form of a lag in physical and mental development, allergies, spinal diseases, enuresis, diseases of the upper respiratory tract, increased intracranial pressure. Manifestations of the so-called psycho-organic syndrome are often diagnosed - intellectual insufficiency, convulsions, neurosis, seizures, mental retardation, etc. Often these pathologies develop against the background of hydrocephalus of the brain.

Diagnosis of birth trauma

Among the methods for detecting birth injuries, which are used both in the perinatal period (up to 7 days after birth), and in the first year of life and older:

examination of the newborn;
palpation of the head, neck, limbs;
Ultrasound and radiography;
MRI, CT;
functional tests;
consultations of narrow specialists.

Treatment of birth trauma in newborns

Damage to the skin requires treatment with local antiseptics (iodine, alcohol) to prevent infection. As a rule, minor injuries heal by 5-10 days after birth. Muscle ruptures and hematomas are treated by providing a corrective position for the child, eliminating the incorrect position of the limbs, head, neck, prescribing physiotherapy, massage, and introducing various absorbable drugs. Sometimes in the first six months of life, a baby needs surgical correction of a birth muscle injury.

For fractures, standard treatment is carried out, including:

immobilization of limbs with the help of splints, Dezo bandages;
tight swaddling;
traction (traction);
physiotherapy;
massage.

Injury during childbirth of internal organs requires the treatment of each syndrome separately, as well as hemostatic therapy. In case of damage to the adrenal glands, hormonal treatment is performed; in case of rupture of foci of hemorrhages in any organ, urgent surgical intervention is necessary. In the future, the baby may need lifelong hormone therapy, but often children feel satisfactory.

Treatment options for brain damage include:

subdural puncture for pumping out blood that has poured out of the cerebral arteries;
the use of absorbable, diuretic drugs;
brain surgery (bypass surgery);
antibiotic treatment (with the development of inflammation of the meninges).

In spinal cord injuries, treatment is reduced to immobilization of the affected area, analgesic, dehydration therapy, the introduction of hemostatic drugs, vitamins. After the removal of acute symptoms, physiotherapy, massage, gymnastics, wearing various orthotics, treatment with biostimulants, accelerators of tissue regeneration, etc. are prescribed. Similar methods of therapy are recommended for the baby if the nerve trunks of the peripheral nervous system are damaged.

Prevention of birth trauma in newborns

Unfortunately, it is impossible to completely prevent birth trauma. But to reduce its likelihood, obstetricians should timely identify pregnant women at risk for perinatal pathology, correctly apply various methods and manipulations in childbirth. It is desirable for a woman to plan a pregnancy before the treatment or correction of chronic diseases, as well as to register for pregnancy on time.

Useful information

constant general fatigue;
drowsiness;
malaise;
periodic causeless pain in the internal organs;
depression

Content:

The reasons
signs
Caesarean section - salvation?
Effects
Prevention

When born, children can get birth injuries - serious damage to organs and tissues. They also include a holistic response of the body to these disorders. No one is safe from them, but if there is such a threat, doctors do everything possible to prevent any, even the slightest injury to the baby. However, the delivery process until the very end is unpredictable and can go completely differently than planned. That is why, even with modern medical equipment and highly qualified doctors, the percentage of birth injuries is quite high. This is explained by a variety of factors.

The reasons

Too much when a baby is born is completely unpredictable. The organisms of mother and child can behave differently, and medical omissions are not excluded. The reasons can be both external and internal factors. According to statistics, birth injuries in newborns are due to the following indicators.

"Maternal" factors:

early or late age of a woman;
hyperanteflexia, uterine hypoplasia,
preeclampsia;
narrow pelvis;
cardiovascular, gynecological, endocrine diseases;
occupational hazards (if a woman, for example, worked in the chemical industry);
delayed pregnancy.

Fetal pathologies:

breech presentation;
oligohydramnios;
large sizes;
prematurity;
abnormal (with a turn) position of the fetus;
hypoxia;
asphyxia;
asynclitic (incorrect) or extensor insertion of the head.

Anomalies of labor activity:

protracted childbirth;
rapid childbirth;
discoordinated or strong, as well as weak labor activity.

Mistakes in obstetrics:

turning the fetus on the leg;
the use of forceps (this is the main cause of birth trauma to the central nervous system in children, since not only the baby’s limb is often damaged, but also the spine with the spinal cord);
vacuum extraction of the fetus;
C-section.

Very often, birth injuries in newborns are caused by a combination of several adverse factors that disrupt the normal course of childbirth. As a result of an undesirable combination of circumstances, some of the internal organs or vital functions of the fetus are violated, and to varying degrees. Some of them are so serious that they are diagnosed immediately. However, in some cases they can manifest themselves only over time.

According to statistics. In Russia, according to statistics, 18% of births end in injuries to the baby. But, given the problems of diagnosis in maternity hospitals, statisticians assure that the official figure is significantly underestimated.

signs

In hospitals, injuries during childbirth in a child are diagnosed only in cases where their signs are literally visible to the naked eye and represent open mechanical damage:

fractures;
breaks;
tears;
dislocations;
hemorrhages (hematomas);
compression.

Since birth injuries in children require, in some cases, a judicial and prosecutorial investigation due to the identification of medical errors, neonatologists and pediatricians do not diagnose them too actively. Therefore, most often the symptoms are detected after discharge from the hospital and are explained by pathologies of intrauterine development or improper care of the newborn in the first days of his life.

Symptoms of soft tissue injuries:

scratches, petechiae (pinpoint hemorrhages), abrasions, ecchymosis (bruises);
tumors;
lack of pulsation of the fontanel, its painlessness, often accompanied by jaundice and anemia.

Signs of trauma to the skeletal system:

swelling and swelling;
inability to perform active movements with the injured limb;
pain syndrome, because of which the child often cries a lot;
the main signs of intracranial birth trauma are muscle weakness, temperature changes, asthma attacks, uncoordinated movements of the limbs, their trembling, convulsions, spontaneous eye movement, bulging of the fontanel, drowsiness, crying weakness;
deformities, shortening of the limbs.

Symptoms of internal injuries:

bloating;
muscular hypotension, atony;
depressed physiological reflexes;
constant profuse regurgitation;
arterial hypotension;
vomit.

Signs of CNS disorders:

lethargy, areflexia;
muscle hypotension;
weak cry;
diaphragmatic breathing;
autonomic disorders: sweating, vasomotor reactions;
shortness of breath, cyanosis, bulging of the chest;
congestive pneumonia;
asymmetry of the face, mouth;
displacement of the eyeball;
difficulty in sucking.

Most of the symptoms of birth trauma in a baby do not appear immediately, but only 4-5 days after his birth. It often happens that the mother attributes lethargy and drowsiness to the normal state of the crumbs, and in the meantime, there is damage to any internal organ. It is possible to make the correct diagnosis only after a comprehensive examination and the delivery of appropriate tests. They will depend on the type of birth injury.

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Kinds

Depending on the causes and nature of the injuries, there are various types of birth injuries, the main classifications of which are two.

Classification No. 1 (for reasons)

If intrauterine pathologies and fetal anomalies were the provoking factors, neonatal birth trauma in a child is diagnosed. In some cases, it can be prevented if detected in advance by ultrasound.
Spontaneous trauma occurs during normal labor.
Obstetric trauma is caused by certain physical actions, doctor's manipulations.

Classification No. 2 (by damage)

1. Damage to soft tissues: skin, muscles, subcutaneous tissue, tumor, cephalohematoma.

2. Injury to the osteoarticular system: fractures, cracks in the clavicle, femur, humerus, epiphysiolysis of the shoulder, subluxation of the joints, damage to the bones of the skull.

3. Violations in the work of internal organs: hemorrhages in the liver, adrenal glands, spleen.

4. Birth injuries of the central nervous system:

more often than others, intracranial birth trauma is diagnosed, since the soft bones of the skull do not withstand compression and pressure by the birth canal;
spinal cord
peripheral nervous system (Duchene-Erb palsy, Dejerine-Klumpke, paresis of the diaphragm, facial nerve).

Each of the injuries is dangerous for the life of the baby and does not pass without consequences. Particularly often diagnosed is a birth injury to the head, which paves the way for the entire body and is thus squeezed or broken. The result is a violation of the functioning of the central nervous system, which is practically untreatable. Much less often, such cases occur during caesarean section, but it does not guarantee 100% safe removal of the baby into the world from the mother's womb.

Data. In 90% of women who have children with cerebral palsy, delivery was artificially induced or accelerated.

Caesarean section - salvation?

According to statistics, birth injuries during caesarean section are rare, but not excluded. It seems that with a planned, well-thought-out operation, any surprises can be avoided, but nature also makes its own adjustments here. Doctors explain this by various factors:

Strong compression of the child during the passage of the birth canal starts the work of his cardiovascular and respiratory systems. With cesarean delivery, this mechanism is absent, the restructuring of the body to function outside the uterus occurs in other, unnatural ways, which further affects the development of the child's central nervous system.
The very indications for a caesarean section can lead to birth injuries.
The technique of the operation does not exclude mechanical damage to the fetus.

So in children, even after cesarean, doctors diagnose skull injuries, displacement of several cervical vertebrae at once, retinal hemorrhages and other injuries. Those young mothers who consciously insist on an operation in the absence of medical indications for it should understand that it is not always possible to protect the baby from injury in this way.

Keep in mind! With a caesarean section, the doctor makes a transverse incision on the uterus 25 cm long. And the average circumference of the shoulders in most babies is at least 35 cm. Accordingly, obstetricians have to make an effort to remove them. Therefore, birth trauma of the cervical spine is so common in children born through this operation.

Care

Young mothers should keep in mind the specifics of caring for children who have suffered birth trauma in order to minimize its negative consequences. Treatment is very diverse, as it depends on the type of damage, their severity, aggravating factors. If the injury is of a very serious nature, and the woman does not have a medical education, nannies are often invited who are able to professionally care for such children.

If the skeletal system (limbs) is damaged

Special care is not required.
Constant supervision at the local pediatrician.
Surgical control in the first 2 months of a baby's life.
Avoid re-injury to the bone.
2 weeks after birth, an x-ray is taken and a conclusion is made about the fusion of the bones.

Spinal injury

Regular exercise therapy.
Constant dispensary supervision.
Therapeutic and preventive massage.
Spinal cord injury is very dangerous, but with proper care, babies live a long time: measures must be taken to prevent bedsores, ongoing treatment of the urinary system and various infections, and periodically take the child to examinations to detect uropathy.

With soft tissue injury

Care is not difficult.
Exclusion of breastfeeding for 3-5 days. Drink expressed milk.
Abrasions are treated with a solution of brilliant green.
Complete peace.
Controlling external symptoms of birth trauma.

Damage to internal organs

Syndromic treatment.
Constant monitoring of the pediatrician.

Intracranial injury

Gentle mode.
In a serious condition - finding a child in a couveuse (a specially equipped incubator).
In the presence of convulsions, respiratory disorders, asphyxia, any movements of the child are excluded. It will be necessary to provide him with maximum immobility.
Leather processing, feeding, swaddling are done in the crib.
Any trauma to the head during childbirth (both internal and external) involves feeding with a spoon or pipette, possibly tube feeding.

Massage

Of great importance are exercise therapy and therapeutic massage in case of damage to the spine and limbs, cerebral palsy. They strengthen weakened muscles, improve blood circulation and metabolic processes in the affected area, restore coordination of movements, fight limited mobility or curvature of the spine, and have a general strengthening effect on the body. Parents of affected babies should know the features of baby massage for birth injuries and learn it in order to help the baby at home.

For the procedure, heated oils are used (preferably olive or fir).
To relax damaged or atrophied muscles, stroking, felting, shaking, light vibration are used.
To stimulate them - planing, deep stroking, kneading, rubbing with weights, hatching.
Tapping, squeezing techniques are strictly prohibited.
Massage is performed on the back, collar area, arms (starting from the shoulder), legs (starting from the hip), chest, abdomen.
The duration of the procedure is from 5 to 15 minutes.
The course includes 20-35 sessions.
4 to 6 courses are required per year.
In addition to the classic, segmental or acupressure massage can be prescribed.

If the damage is serious and has caused irreversible consequences, the child needs professional care, in particular, a birth injury of the brain requires neurosurgical care in a hospital. The period in the first 1-5 months of a baby's life is especially difficult. If he was given timely, competent help from doctors, proper care from his parents, the body will recover as much as possible and return to normal as much as possible. However, much depends on the severity of the deviation. For example, a birth injury of the neck in a newborn without damage to the central nervous system can be completely neutralized. But if the nerve endings are damaged, the consequences cannot be avoided even with proper care.

On a note. The use of any stimulants during childbirth (prostaglandins, kelp, antiprogestogens, balloons, oxytocin), as well as bladder puncture, often leads to damage to the baby's central nervous system. Moreover, in 90% of cases, it is not detected at the time of childbirth, but is diagnosed by a neurologist later.

Effects

Complications and consequences of birth injuries are of varying degrees. With timely diagnosis, professional treatment and proper care, they can be avoided. But some processes turn out to be irreversible and significantly affect the functioning of the brain, while threatening not only the health, but also the life of the baby. The most common and severe consequences are called:

hydrocephalus - dropsy of the brain;
jumps in intracranial pressure;
retardation in mental and physical development, cerebral palsy (these are the most frequent and dangerous consequences of a birth traumatic brain injury when the child's central nervous system is damaged);
reduction or complete absence of some reflexes;
to whom;
fatal outcome;
spasms of the limbs;
tachycardia;
muscle atrophy;
enuresis;
hyperactivity, rapid excitability, increased nervousness;
speech disorders;
paralysis;
diseases: bronchial asthma, food allergies, eczema, neurodermatitis, deformity of the spinal column (this is most often caused by a birth injury of the spine), paresis, disorders in the functioning of the cardiovascular system.

Parents of children who have received birth injuries should be extremely attentive to such babies and be as patient as possible. If CNS lesions are superficial and not accompanied by total changes in the functioning of the brain and spinal cord, recovery is possible with complex treatment and caring care. Despite this, many of these kids in the long term - 95% delay in mental, motor, speech development, impaired muscle tone. The consequences of birth trauma are often very, very distant.

Note. Early clamping of the umbilical cord is one of the causes of encephalopathy and mental retardation in children.

Prevention

To avoid such negative and very life-threatening consequences for the baby, birth injuries are prevented even in the neonatal period by both parents and doctors:

planning conception and pregnancy in advance;
timely treatment of diseases in both parents;
healthy lifestyle of the mother during pregnancy;
complete, balanced nutrition of a woman;
immediate elimination of infections caught during pregnancy;
obtaining professional medical care;
regular consultations with a gynecologist.

Doctors should take into account during childbirth any pathologies and abnormalities in the development of the fetus, identified during pregnancy. This greatly reduces the risk of injury to the baby. Professionalism and competent, well-coordinated actions of obstetricians in case of any deviation that has arisen are a guarantee of a safe, successful delivery.