Birth trauma of a newborn: intracranial, cervical spine, their treatment. Consequences and treatment of birth injuries in newborns

Content:

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 different factors.

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. Causes 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 women;
• 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:

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

anomalies labor activity:

• protracted 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 of newborns are caused by a combination of several adverse factors that violate normal course childbirth. As a result of an undesirable set of circumstances, some internal organs or vital functions fetuses are violated, and in 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, birth injuries in a child are diagnosed only in cases where their signs are literally visible to the naked eye and represent open damage mechanical nature:

• 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 medical errors, neonatologists and pediatricians are not too active in diagnosing them. Therefore, most often the symptoms are detected after discharge from the hospital and are explained by pathologies. prenatal development or improper care for a newborn in the first days of his life.

Symptoms of soft tissue injuries:

• scratches, petechiae ( petechial hemorrhages), abrasions, ecchymosis (bruises);
• tumors;
• absence, its painlessness, often accompanied by jaundice and anemia.

Signs of trauma to the skeletal system:

• swelling and swelling;
• impossibility of execution active movements 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, cry weakness;
• deformities, shortening of the limbs.

Injury symptoms internal organs:

• bloating;
• , 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. Put correct diagnosis succeeds only after comprehensive survey and delivery of relevant tests. They will depend on the type of birth injury.

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.

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)

1. 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.
2. Spontaneous trauma occurs during normal labor.
3. 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 musculoskeletal system: fractures, fissures of the clavicle, femur, humerus, epiphyseolysis 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:

• Intracranial birth trauma is diagnosed more often than others, since soft bones skulls 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:

1. 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.
2. They themselves can lead to birth injuries.
3. The technique of the operation does not exclude mechanical damage to the fetus.

So in children, even after caesarean doctors diagnose skull injuries, displacement of several cervical vertebrae at once, retinal hemorrhages and other injuries. Those young mothers who consciously insist on having an operation in the absence of medical indications to her, they must understand that it is not always possible to protect the baby from injuries 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 cervical of the spine is so common in children born through this operation.

Care

Young mothers should be aware of the specifics of caring for children who have suffered birth trauma in order to minimize it. 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

1. Special care is not required.
2. Constant supervision at the local pediatrician.
3. Surgical control in the first 2 months of a baby's life.
4. Avoid re-injury to the bone.
5. 2 weeks after birth, an x-ray is taken and a conclusion is made about the fusion of the bones.

Spinal injury

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

With soft tissue injury

1. Care is not difficult.
2. Exception breastfeeding within 3-5 days. Drink expressed milk.
3. Abrasions are treated with a solution of brilliant green.
4. Complete peace.
5. Control of external symptoms birth trauma.

Damage to internal organs

1. Syndromic treatment.
2. Constant monitoring of the pediatrician.

Intracranial injury

1. Gentle mode.
2. In a serious condition - finding a child in a couveuse (a specially equipped incubator).
3. 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.
4. Leather processing, feeding, swaddling are done in the crib.
5. 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 with limited mobility or curvature of the spine, have a general strengthening effect on the body. Parents of affected babies should be aware baby massage with birth injuries and learn it to help the baby at home.

1. For the procedure, heated oils are used (preferably olive or fir).
2. To relax damaged or atrophied muscles, stroking, felting, shaking, light vibration are used.
3. To stimulate them - planing, deep stroking, kneading, rubbing with weights, hatching.
4. Tapping, squeezing techniques are strictly prohibited.
5. Massage is performed on the back, collar area, arms (starting from the shoulder), legs (starting from the hip), chest, abdomen.
6. The duration of the procedure is from 5 to 15 minutes.
7. The course includes 20-35 sessions.
8. 4 to 6 courses are required per year.
9. In addition to the classic, segmental or acupressure massage can be prescribed.

If the damage is severe and results in irreversible consequences, for the child is necessary 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 on the part of doctors, proper care on the part of 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 early diagnosis, professional treatment and with 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:

• - dropsy of the brain;
• horse racing intracranial pressure;
• mental retardation and physical development, cerebral palsy (these are the most frequent and dangerous consequences 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;
• 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 babies in the future have a 95% delay in mental, motor, speech development, violations of 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 mother's life during pregnancy;
• complete, balanced diet women;
• 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.

A newborn baby has a different from an adult skeletal system. It is characterized by flexibility in order to pass through rather narrow spaces without injury. birth canal. But there are precedents when, due to a combination of circumstances such as, for example, improper conduct of childbirth or emergency situations during them, birth injuries occur. A common birth injury is sprained cervical vertebrae. When such an injury occurs, the child needs emergency care and long-term follow-up after birth. So that you know more about the reasons for which a birth injury of the cervical spine occurs, the symptoms, treatment, and the consequences of the resulting sprain, let's talk about them in more detail.

In some cases, trauma to the cervical vertebrae leads to death, or provokes the development of a deep disability in the child. It is necessary to take into account the factors when it is most likely to occur - the causes of birth trauma:

Artificial stimulation of labor activity;
- C-section;
- severe prematurity of the child;
- usage obstetric forceps;
- too small or vice versa too big weight baby
- congenital pathologies of the development of the spine.

If a child weighs more than 4 kg at birth, then sprain or subluxation of the vertebrae occurs with highly likely in almost all cases.

After receiving a sprain of the cervical spine, there may be the following violations:

Spasticity of the infant's circulatory system;
- disturbances in the blood circulation of the brain caused by a deterioration in patency vertebral arteries;
- violations of the outflow of fluid from the skull or veins of the baby.

Such problems may well affect the functioning of the brain, threatening the health and even the life of the child. Often they are the cause of hydrocephalus - dropsy of the brain, and lead to jumps in intracranial pressure in children.

The stretching of the cervical vertebrae during birth is indicated a little later by such symptoms:

Retardation in the development of motor skills;
- decrease or even total absence some reflexes;
- the child may fall into a coma or have serious problems with self-feeding;
- flexion reflexes may be absent, spasms of the limbs are observed;
- there are digestive disorders - constipation, diarrhea, metiorism;
- the child suffers from headaches, he may lose consciousness;
- there are tachycardias;
- the baby develops more slowly than peers - later raises his head, sits down, gets up, etc.;
- after reaching the age of six, doctors can record enuresis;
- the development of the baby is significantly impaired, both verbal and mental;
- the spine may develop incorrectly, which is manifested by its deformities, flat feet, different leg lengths.

Effects

All these signs appear over time. The kid is growing, but his development is not going according to the age standard. In this case, the symptoms do not necessarily appear in a complex, they can be single. The child can sit down on time, but it will be difficult to walk, having impaired coordination of movements.

Such birth trauma is especially evident at the time of speech development. Children can start talking much later - only after one and a half to two years. At the same time, it is very difficult for them to link words and reproduce long sentences. The child is very excitable, he cannot concentrate on something specific, he has disturbances in the processes of memorization and thinking.

These children suffer from fine motor impairments. For them, a problematic task is to collect a pyramid or cubes, later they have difficulty dressing or drawing.
Stretching of the cervical vertebrae is manifested by violations and emotional sphere- increased nervousness, irritability and excitability.

With this birth injury, diseases such as bronchial asthma, eczema, food allergy, hydrocephalus, neurodermatitis, deformities of the spinal column and unilateral or bilateral paresis, there are also often violations of the cardiovascular system.

To prevent sprains, the following measures are very important:

Pregnancy planning in advance, eliminating diseases and optimizing lifestyle.

Normal nutrition and avoidance of infections while expecting a baby.

Getting competent medical care during pregnancy.

Timely medical care during childbirth and after them.

Competent actions of obstetricians.

The period of observation of the child after childbirth.

If injury does occur, A complex approach to restore the health of the baby. His treatment should include, first and foremost, normal nutrition brain. For this, the cervical spine is sometimes fixed. Often the child is fed through a tube or bottle, due to increased intracranial pressure.

The first time the condition of the child after childbirth can be very difficult. This period can take up to one month. The recovery period lasts up to six months of the baby's life. But if the child was provided with competent and timely medical care, then his body may well fully recover. This will completely neutralize the possible negative consequences of birth trauma. A huge role in this is played by the strict adherence of parents to medical instructions.

Stretching of the cervical vertebrae is quite common, but as you understand, with proper care and attention, as well as proper treatment, it can be completely neutralized. At the same time, timely medical care and observation of the child for a long period of time is important.

Childbirth is an unpredictable process, may have adverse effects for mother or child. Most often they pass without complications. Injuries to infants as a result of birth are observed in approximately 20% of cases. Timely diagnosis, treatment of disorders in the baby's body helps to avoid complications or reduce their consequences.

Causes

Birth injury characterized by damage to the internal organs, skeletal system, soft tissues of the child during birth. The reasons are divided into three groups.

Due to the condition of the mother

• Complications in the second half of pregnancy (preeclampsia);
• Pathologies in the development of the uterus (hypoplasia - small sizes, kinks);
• Narrowing of the pelvis;
• Heart disease, endocrine disorders, other systemic disorders;
• Exceeding the terms of pregnancy;
• The age of the mother (up to 18 - early, after 30 - late, for repeated births - over 35 years old);
• External factors - unfavorable working conditions, difficult environmental situation, bad habits.

Dependent on the state of the fetus

• Incorrect intrauterine location;
• oligohydramnios;
• Large fruit;
• Asphyxia during childbirth;
• prematurity;
• Anomalies in the development of the umbilical cord, entanglement of the fetus;
• Pathological disorders in development;
• intrauterine hypoxia;
• Incorrect position of the head when passing through the birth canal.

Conditions for childbirth

• Rapid or, conversely, protracted;
• Painful contractions, discoordinated uterine contractions;
• Changing the location of the fetus by an obstetrician (rotation);
• The strength of uterine contractions is weak or violent;
• Large fetal head in relation to the mother's pelvis;
• Use of obstetric forceps;
• Extraction of the fetus using a device - a vacuum extractor;
• C-section.

Birth injuries in newborns often occur when several factors occur. In most cases, they are observed in babies during a caesarean section.

Classification

By origin, there are two types of injuries that occur during childbirth:

1. Mechanical, obtained with external influence (common cause damage to soft tissue, skeletal system, joints);
2. Hypoxic - for a reason oxygen starvation caused by suffocation. Asphyxia is the main prerequisite for birth trauma of the central nervous system in a newborn.

Most of the mechanical damage manifests itself in the first days of a baby's life. They can be noticed immediately at the first examination of the child by a doctor. Signs of disorders caused by asphyxia can be early (detected before 3 days of life) and late (after 3 days).

Soft tissue injury

There are two types:

1. Injuries that are not life-threatening for the baby: abrasions (at autopsy amniotic sac), cuts (with caesarean section), bruises, redness. They are treated quickly, regularly treated with local antiseptics;
2. Serious injuries are muscle ruptures, the sternocleidomastoid is more often affected. Occur as a result of the use of obstetric forceps or breech presentation of the fetus.

Muscle tear appears painful swelling, can be diagnosed at the first examination in the maternity ward. Sometimes damage becomes noticeable after a few days, manifesting itself.

The child is prescribed therapy, consisting of the imposition of fixing rollers, exposure to dry heat, after healing, a course of massage is carried out. If after two or three weeks there is no improvement, an operation is prescribed, but not earlier than the baby is six months old.

Skeletal injury

The musculoskeletal system is damaged as a result of correct and wrong actions obstetrician. The following types of injuries are most common.

Clavicle fracture

Bone injury is often observed while maintaining the integrity of the periosteum. It is manifested by limited activity, crying, painful grimace when trying to passively move the handle from the side of the injury. Palpation reveals swelling, a sound similar to the creaking of snow, pain. Healing occurs when a tight bandage is applied to fix the shoulder girdle and arm for 2 weeks.

Humerus injury

The fracture is usually located in the middle or upper part of the bone, there may be a detachment of the tissue connecting the joint to the bone, a rupture of the articular ligaments. In some cases, there is a displacement of broken parts, blood entering the joint. The injury is formed during the extraction of the child in breech presentation.

External signs - the baby holds the hand close to the body, it is deformed and turned inward. Flexion is weakened, attempts at passive movements cause a painful reaction. For healing, a fixing bandage of plaster bandages is applied for a period of about 3 weeks.

Hip injury

Occurs when the fetus is removed by the pelvic end with an internal turn on the leg. A fracture is expressed in a strong displacement of parts of the bone due to muscle tension, swelling of the thigh, and limited movement. Often there is bluing in the area of ​​injury. The child is shown traction of the leg or connection of fragments with subsequent fixation. The tissues heal within a month.

cranial trauma

Can be of three types:

1. linear fracture;
2. depressed deformity;
3. separation of the back of the head from the sides.

The first two appear when using tongs. The third is formed by the outpouring of blood under the dura mater or mechanical compression. Symptoms are manifested by indentation - deformation of the bones of the skull of newborns is noticeable, with a strong deflection, convulsions are possible due to effects on the brain. There is no need for treatment, the union of the fracture occurs on its own.

neck injury

It arises due to its mobility, fragility as a result of rough bending, twisting, stretching. Birth trauma of the cervical spine in newborns (CBS) is formed when using obstetric forceps, rapid delivery, large fetal size.

The consequences for the child may be: developmental delay, speech problems, impaired motor skills, the risk of heart, lung, skin diseases. Natal trauma to the cervical spine can lead to nervous disorders, increased excitability, decreased activity, strong emotionality, aggression.

Spinal injuries are dangerous with possible damage to the central nervous system.

Head injury

This group includes.

birth tumor

Formed due to soft tissue edema strong pressure on the head (if during childbirth an occipital, facial presentation was observed), buttocks (with a pelvic position). Head injury occurs when prolonged labor, large fruit sizes, the use of a vacuum extractor. Signs - cyanosis, red spots. Treatment is not required, the tumor goes away on its own within a few days.

Subaponeurotic hemorrhage

It is formed in the area of ​​the tendon helmet of the head, can be observed under the skin of the neck. Manifested by swelling, swelling of the crown and neck. There is a risk of enlargement, infection, anemia due to blood loss, jaundice due to an increase in bilirubin levels. Most children pass without drug treatment within 2-3 weeks.

cephalohematoma

Appears with vascular damage, accumulation of blood under the cranial periosteum, in the region of the parietal, less often - occipital bone. At first, it is characterized by elasticity, noticeable on the third day of the baby's life, when the birth tumor becomes smaller. The location is limited to one bone, does not extend to the area of ​​​​others, and is painless. When probing, an accumulation of fluid is felt, the color of the skin at the site of the cephalohematoma does not change, redness is possible.

At the first time of a child's life, it can increase, become tense. A decrease is observed after 15-20 days, the formation completely resolves within two months. When stressed, x-rays are ordered to rule out possible damage cranial bones. Rarely, ossification of the formation is observed, the shape of the skull in the area of ​​injury changes slightly. Therapeutic measures prescribed for large cephalohematomas, with the threat of their increase (piercing, pressure bandages, antibiotics).

Damage to internal organs

The type is rare, occurs with a complex course of childbirth, trauma to the nervous system. More often there are injuries of the liver, spleen. Their signs are observed after 3 days, the condition of the baby deteriorates sharply, internal bleeding occurs. Inside abdominal cavity fluid accumulates, which is noticeable on ultrasound, the abdomen swells, reflexes are weak, vomiting is possible, there is no intestinal contractility, and a decrease in blood pressure.

Therapy depends on the manifestation of symptoms, with severe internal bleeding emergency surgery is performed. Birth injuries of the adrenal glands in newborns require the introduction hormonal drugs to normalize the level of glucocorticoids.

Injury to the nervous system

These include: intracranial birth trauma, spinal cord injuries, disorders peripheral departments nervous system. Dangerous serious complications, violations of the physical, mental development, epilepsy.

Intracranial injury

Intracranial birth trauma is formed when hemorrhage in the tissue and cavity of the brain. Symptoms depend on the area of ​​the lesion and may include:

• Sudden deterioration in the health of the newborn;
• Change in the nature of crying;
• Swelling of the fontanel on the crown;
• Eye twitching;
• violation of thermoregulation ( heat, chills - trembling);
• Reduction of reflex reactions - motor, sucking, swallowing;
• The appearance of suffocation;
• Convulsive conditions;
• Frequent regurgitation, vomiting.

Intracranial birth trauma is dangerous with an increase in hematoma, cerebral edema, and the risk of death of the baby increases. After the process is normalized, the child's condition becomes stable, with deterioration there is overexcitation, an uninterrupted cry. Traumatic brain injury can lead to lethargic sleep, coma.

Spinal cord injury

It is formed with a strong stretching or twisting of the spine. He himself is able to stretch without consequences for the baby, but the spinal cord, fixed in the lower and upper parts of the spinal canal, is not. Often the cause is an injury to the SHOP, or damage to the upper part thoracic. A rupture of the spinal tissue can be with the integrity of the spinal column, then the pathology is difficult to diagnose, including by x-rays. Characteristics of spinal cord injury of newborns during childbirth contains signs:

• muscle weakness;
• Reflective disorders;
• Suffocation;
• Weak crying;
• Anus gaping.

Severe injury may result in death due to respiratory failure. Often the spinal tissue heals, the baby's condition improves. Treatment consists in fixing the spinal column, in case of an acute course, diuretics and hemostatic agents are administered.

Injuries of the peripheral parts of the nervous system

Occur in individual nerves, their plexuses, roots. As a result of trauma to the facial nerve, there is a decrease muscle tone on the one hand: the eye opens, disappears nasolabial fold, the corner of the mouth is displaced or lowered. The state passes without medical intervention within 12-15 days. The nerve roots of the extremities may be affected, the signs are:

• Torticollis;
• Weakened muscles;
• Absence of some reflex reactions;
• Incorrect position of the head, limbs;
• Dyspnea;
• Cyanosis of the skin and mucous membranes.

With bilateral damage to the nerve of the diaphragm, the newborn cannot breathe, death occurs in half of the cases.

Diagnostics

In children in the first week of life, the following methods are used to detect trauma during childbirth:

• Visual inspection;
• Palpation;
• Ultrasound, including the head, if intracranial birth trauma is suspected;
• X-ray;
• MRI, CT;
• Reflex analysis;
• Puncture of cerebrospinal fluid;
• The study electrical activity brain using an electroencephalograph;
• Blood tests.

If it is necessary to confirm the diagnosis, they seek the advice of specialists in the field of neurosurgery, ophthalmology, and traumatology.

Features of care

Treatment of birth injuries of newborns is carried out in a hospital, if necessary, the mother and child are transferred to surgery department. Nurses take care of the baby, he remains in the hospital until he is fully recovered or the degree of recovery allows him to take care of the baby at home.

With complex birth injuries, the baby is fed and swaddled in the crib, prescribe vitamins, drugs for the treatment of cardiovascular diseases, the nervous system, physiotherapy, courses therapeutic massage, gymnastics. Regular follow-up with a pediatrician is required.

If the baby has an intracranial birth injury, he is transferred to a hospital, in the presence of serious complications, the child is observed in specialized clinics. With absence severe consequences the baby is discharged home after improvement clinical picture, he is regularly examined by a district neurologist.

With severe injuries affecting the nervous system, the child needs permanent care and attention. Parents often resort to the help of a nanny with a medical education, who performs the necessary therapeutic measures.

Prevention

Here are some tips to help reduce your risk of birth injury:

1. Pregnancy planning with a preliminary examination;
2. Treatment of existing diseases, especially chronic ones;
3. Limiting visits to crowded places during an epidemic of influenza, colds to reduce the risk of infection;
4. Taking medicines only after consultation with the doctor;
5. Balanced complete diet, a healthy lifestyle for several months before pregnancy and during gestation;
6. Registration in the gynecological office for early dates, regular visits and implementation of the recommendations of the supervising doctor;
7. Following the instructions of the obstetrician during childbirth, the correct attempts.

Most birth injuries are not life-threatening for the baby, they do not need to be treated: the body is able to recover on its own. AT severe cases constant supervision by doctors of narrow specialization and compliance with their recommendations is necessary.

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 steps 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 causes of a birth injury of the cervical spine, 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:

Childbirth is a natural process that can be very unpredictable. How the birth will go is largely influenced by anatomy and health. future mother and baby. But even if a woman does not have any health problems, she feels well and if medical examinations have positive character, in the maternity ward, an unforeseen event may occur that requires the help of doctors. Even the slightest deviation from the stable course of childbirth poses a threat to the unborn baby, since there is a risk that he will be born with a pathology. In most cases, natal trauma in the neck occurs in an infant.

In the article, we will understand what constitutes a birth injury of the cervical spine in newborns: the consequences, types and rules for the treatment of such an ailment.

Natal trauma is an injury that is received during childbirth. Babies are sometimes born with a neck injury. This is due to the physiology of the body of the newborn. The department of the cervical vertebrae, even in adults, is a weakly protected place. The ligaments and muscles of the baby are very weak, so there are big risk get a neck injury. There are various types of damage depending on how the SHOP is damaged.

Table number 1. Types of injuries during childbirth.

Causes of damage

The period of bearing a baby and his birth is an unpredictable time in which it is very difficult for doctors to correctly predict the behavior of the body of a mother and her baby. The causes of cervical injuries may be associated with failures on both sides. All reasons can be combined into two large groups: internal and external.

Causes of injury caused by the mother may be as follows.

1. Age. In a more mature, or vice versa, too young age, present high risk newborn injury.
2. Effect on the body hazardous substances. This may be due to living in a territory with an unfavorable ecological climate or near chemical plants, or if the woman worked at work with harmful conditions.
3. active toxicosis.
4. Overlapping a child.
5. Disease and infection of the genital organs.
6. Narrow pelvis.
7. Genital pathologies, which include: vaginitis, salpingitis and endometritis.
8. Venereal diseases.
9. Diseases of the cardiovascular system.
10. The uterus is small, or its neck and body bend forward, resulting in an acute angle.

Often there are also problems on the part of the fetus, which provoke injuries of the CS. Among them are the following.

1. premature birth.
2. Large fetus, which makes it difficult to pass through the pelvic opening.
3. Incorrect position of the child, i.e. feet down. The correct head should be at the bottom.
4. Hypoxia (some organs and tissues receive insufficient oxygen).
5. Asphyxia, which appears as a result of entanglement, which provokes a change in the cervical vertebrae.
6. Small amount of amniotic fluid.

And this is not the whole list of reasons that contribute to neck injuries in an infant. Prolonged, or vice versa, protracted labor, weakly - and hyperactive labor process most often provoke trauma.

In addition to these factors, there are mistakes made through the fault of doctors and obstetricians.

• the use of vacuum extraction. This refers to the extraction of the baby due to the vacuum extractor;

• use of forceps. Incorrect use of them leads to harm spinal column, arms and legs of a newborn;
• turning the child "on the leg";
• suffocation of the baby. When a child long time stays without oxygen, as a result of which carbon dioxide accumulates in the tissues.

Natal injuries of the vertebral sections and other pathologies often appear under the influence of several considered causes at once. Violation of childbirth entails disruptions in the vital activity of other organs female body, the force of injury can be minor and very severe. Most of them are detected during the development of the baby, but more severe ones can be detected immediately after the baby is born.

Video - Why do birth injuries occur?

How is it manifested?

Birth trauma SHOP in little patient can be seen immediately after birth. The first signs of injury include: the appearance of swelling and redness in the neck, too short or too long neck, excessive tension in muscle tissue and on the back of the head, while the neck itself arrives in an injured state.

In addition to noticeable symptoms, signs of damage include relaxation of the whole body, although in the order of things, a baby should have hypertonicity after a month of life. The respiratory process in the crumbs is complicated, groans, hoarseness and other extraneous sounds may appear. The nose area may become cyanotic.

The baby may show excessive anxiety, constant tearfulness, night screams, bad dream, unwillingness to breastfeed, regular regurgitation. In some cases, a heart rhythm failure is detected. The diagnosis of a natal neck injury can only be made by passing a complete detailed examination of the newborn. Ultrasound, radiography and dopplerography are performed. After the examination, it is possible to make an accurate diagnosis, determine the degree of injury, the level of severity and the nature of the lesion.

Consequences of birth injury

Even if the vertebrae of the neck are slightly injured, the damage will affect the child's later life. In the worst case, the spinal cord will rupture and the baby will die. But most of the consequences of the injury are manifested in the form of cerebral palsy, decreased susceptibility, loss of limb mobility.

The first signs of violations are invisible at first. But this does not mean that they do not exist at all, and the child recovered after the injury.

Terrible irreversible problems can arise in the shop due to birth trauma

Under the best circumstances, poor circulation of blood to the brain is manifested, due to which the mental abilities of the child slow down compared to their peers. Difficulties may arise later, when the child will go to school. At this time, as a rule, parents do not even realize that the cause lies in a neck injury.

Problems may appear as:

• migraines;
• high blood pressure;
• irregularities of the spine;
• muscle atrophy;
• vegetative dystonia.

Natal neck trauma also affects physical condition and emotional background of the child. Children with such difficulties show hyperactivity, their attention is poorly concentrated and their memory is poorly developed. Because of this, children in school have difficulties in the learning process.
After a year of a baby's life, the following defects in its development may appear: non-standard head sizes (it can be too big or too small), different length legs and arms, inhibited reaction. The sooner you seek help, the more likely return the child to a full life, or at least stabilize his condition.

Consequences of birth trauma

The outcome of birth trauma can be very different. There may be a hemorrhage in the brain, which will develop in the future, paresis, paralysis, slow growth of limbs, failure of muscle tone, convulsive phenomena, hydrocephalus, hypertension, seizures, pathology cranial nerves, cerebral paralysis, hydrocephalus, slow development of motor skills and speech apparatus, pneumonia, poor psycho-emotional development.

Diagnostics

It is possible to detect a neck injury in an infant after childbirth. It is worth considering some signs:

• redness and swelling of the neck;
• the neck looks either very short or very long;
• muscle spasms appear on the back of the head or neck;
• irregularities of the cervical spine.

Symptoms that are hard to notice right away:

• the body and limbs of the newborn are very relaxed;
• the baby breathes heavily and hoarsely, groans;
• the appearance of a blue tint in the nose;
• nervousness in the behavior of the newborn, disturbed sleep and constant crying;
• hard agrees to feeding, constant regurgitation;
• cardiac arrhythmia.

These signs are indicative of natal damage to the SC. For accurate diagnosis, it is worth using ultrasound and x-ray examination, dopplerography. As a result, information about blood flow in the head and neck area is obtained. After the examination, you can find out where they are and how much birth injuries are manifested.

Treatment of natal neck injury

Treatment of trauma is a rather complicated and time-consuming work. Treatment comes down to eliminating the causes of the pathology, but when it comes to birth trauma, it is impossible to eliminate the root of the problem. As a result, the treatment is reduced to the elimination of the results of the injury, the normalization of the cervical vertebrae. If a newborn child has a neck injury, the main thing to do is to fix the neck.

If a dislocation is detected, before proceeding with fixing the neck, the doctor needs to put the vertebrae of the neck in their original place. Fixation is carried out using a special method of swaddling. The neck is enclosed in a hard gauze roller. This fixation should be done 2 times a week. In special cases, the baby is not only swaddled around the neck, but also deprived of movement with the help of a special bed.

A month later active treatment you can move on to a new stage of treatment. Its main purpose is to tone muscles and stabilize the work of nerve endings. To do this, make a massage, a variety of baths, physiotherapy procedures. Similar therapeutic actions during the first year of a child's life, it is worth repeating 2-3 times. If a newborn has a cervical injury, he will remain in the hospital for approximately one more month. From the maternity ward, such babies are sent to children's department where the initial treatment begins. As the child's condition improves, you can not swaddle your neck and be discharged home. After that, the child is transferred to a regular examination in the hospital by an orthopedist and a neurologist. Massages, physiotherapy and baths are also done in a hospital or special rehabilitation clinic. It is enough to be under the supervision of doctors for a long time, the period of which depends on how quickly the child's condition is restored.

If a neck injury is accompanied by a dislocation of the vertebrae, from the moment of discharge, the doctor prescribes a Shants collar, which is worn around the neck. It can be prescribed for just a couple of hours a day, at the time of sleep or wearing throughout the day. It is worth choosing a collar taking into account the individual characteristics of the child, taking into account its weight and volume. A collar that is not appropriate for the baby can further complicate the injury.

Can a caesarean section prevent injury?

Delivery by caesarean section rarely results in cervical injury. At first glance, it may seem that unnatural childbirth is a cure for trauma, but this is not entirely true. Injuries during caesarean section can occur under the influence of the following reasons:

• cesareans are not performed on women in excellent health;
• not prescribed to women who can easily give birth on their own.

Caesarean section is prescribed in cases of detection of a threat to the life of the baby. Even at the time of the operation, the fetus is subjected to mechanical stress.
To remove the baby, an incision is made in the uterus measuring 25 cm in length, despite the fact that the shoulders of the child reach approximately 35 cm or more. As a result, obstetricians must remove the newborn with their own efforts. When the fetus moves through the birth canal of the mother, the body automatically works all its organs, including the lungs and heart. If the child is taken out with surgical intervention, such processes do not occur. Therefore, obstetricians trigger the functioning of organs through other ways that may affect nervous system baby.

According to statistics, a caesarean section is considered as dangerous as natural childbirth. In babies born in this way, in many cases, trauma of the skull, displacement of the vertebrae in the neck and blood flow to the eyeball. Therefore, it can be argued that it is almost impossible to bypass birth damage with the help of surgical intervention.

Care

Women should know all the subtleties of caring for a baby who has experienced birth trauma in order to avoid possible negative phenomena. There are many ways to treat. The choice of one or another method depends on the type of injury, its severity and influencing factors. If the damage is very serious, and the young mother does not have basic medical skills, in many cases, nannies-nurses are hired, who have a medical education and extensive experience in caring for sick children.

In case of injury to the limbs:

• special care is not required;
• registration with a pediatrician;
• observation by the surgeon during the first 2 months;
• prevent re-injury to the bone;
• 2 weeks after birth, take an x-ray to make sure the bone is properly fused;
• regularly examined in the dispensary;
• massage for preventive purposes.

Depending on the type of injury, care should be different.

For intracranial injury:

• complete rest and careful care;
• with a severe injury, it is worth placing the baby in an incubator;
• at seizures, choking, uneven breathing, exclude the movement of the baby;
• all procedures, including feeding, swaddling, skin treatment are carried out in the crib;
• damage to the head during childbirth, both external and internal, requires special way feeding, which occurs with a pipette or spoon, depending on the severity of the injury. In addition, tube feeding is prescribed.

Spinal cord injury poses a great danger to a child's life. Proper care will ensure the baby a long life:

• resort to methods to eliminate bedsores;
• regularly treat the urinary system;
• beware of infectious diseases;
• sometimes conduct a study to identify uropathy.

Soft tissue injury. We are talking about trauma to the muscles, skin and subcutaneous tissue. These include: scratches, hemorrhages, which in most cases are not dangerous and are easily tightened after local treatment. In many cases, damage affects the sternoclavicular muscle, the fibers of which are at risk of tearing.

For tissue damage:

• caring for a child does not require special skills and knowledge;
• need to give up breastfeeding for 5 days;
• provide complete peace of mind to the child;
• lubricate abrasions with a mixture of brilliant green;
• monitor external manifestations of damage;
• preventive measures to eliminate symptoms.

In case of birth injury of the cervical region, massage is very important. Its action is aimed at strengthening muscles, giving strength to bones, increasing blood flow and the process of metabolism of nutrients within the body.

To protect the fetus from cervical injuries, expectant mothers should follow a few basic preventive measures for the neonatal period. Such prevention should not be forgotten not only by women, but also by doctors.

• plan ahead for pregnancy
• be examined for chronic problems, and if they are found, undergo a full course of treatment and then you can start trying to get pregnant;
• give up bad habits, especially from drinking alcoholic beverages and smoking, a few months before pregnancy and at the time of bearing a child;
• control, treatment and prevention of intrauterine hypoxia;
• for the birth of a child, choose only proven and best hospitals;
• a month before the birth, consult with gynecologists, obstetricians, neuropathologists and neurologists who are directly or indirectly involved in the birth process.
• keep during pregnancy proper diet nutrition, take as many vitamins as possible, for example, Vitrum Prenatal Forte, etc.

• being pregnant, enroll in courses for expectant mothers;
• during pregnancy, avoid severe physical work, overwork, more rest, good sleep, more often to be in the fresh air;
• at the time of bearing a child, sign up for a regular appointment and examination in women's consultation to take the necessary tests;
• when pregnant, try not to be in society infected people, especially avoid patients with influenza, parainfluenza, rotavirus diseases, SARS, rubella, herpes, measles, chickenpox, plague, fever, tetanus, tuberculosis, toxoplasma;
• carry out actions that are aimed at identifying the Rh conflict (do not perform abortions, take into account the Rh blood of future parents, at the time oral sex use contraceptives)
• at the time of pregnancy, do not expose yourself to pathological factors, which include radio waves and ionizing radiation. These include: microwaves, MRI, X-ray, mobile phone, microwave ovens, computers, laptops, tablets;
• refuse to use drugs, pills, biologically active additives, other medicines and preparations;
• stop watching scary shows and movies.

If a birth injury nevertheless happened to a newborn, it is worth immediately starting a restorative and rehabilitation course of treatment.

conclusions

All deviations from the normal state of the baby must be detected even before childbirth. This will facilitate the birth process and minimize the risk of injury to the child.
However, if the child still received a cervical injury during childbirth, the newly-made mother should not be upset - if the right measures are taken in time, then all sorts of difficulties can be easily avoided.