Possible complications after birth trauma of the cervical spine in newborns. Birth trauma, spinal injuries in children, cervical spine in newborns, consequences

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

What is pathology?

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

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

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

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

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

Symptoms and consequences for the baby

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

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

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

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

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

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

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

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.

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.

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. In this case, it has established itself at a high level, since in many cases manual exposure gives positive results.

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

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.

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.

More information

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.

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 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)

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.

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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.

Childbirth is an unpredictable process that can have adverse consequences for the 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 trauma is 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:

Mechanical, obtained by external influence (a common cause of damage to soft tissue, skeletal system, joints);
Hypoxic - due to 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 injuries

There are two types:

Injuries that are not life-threatening for the baby: abrasions (during the opening of the fetal bladder), cuts (during caesarean section), bruises, redness. They are treated quickly, regularly treated with local antiseptics;
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 rupture is manifested by 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 osteoarticular system is damaged as a result of the correct and incorrect actions of the 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:

linear fracture;
depressed deformity;
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 injury of the cervical spine can lead to nervous disorders, increased excitability, decreased activity, strong emotionality, and aggression.

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

Head injury

This group includes.

birth tumor

It is formed due to soft tissue edema with strong pressure on the head (if occipital, facial presentation was observed during childbirth), buttocks (with pelvic location). A head injury appears during prolonged labor, large fetus sizes, and 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. In most children, it resolves without medical 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 - the 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. With stress, X-rays are prescribed to rule out possible damage to the cranial bones. Rarely, ossification of the formation is observed, the shape of the skull in the area of injury changes slightly. Therapeutic measures are 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. Fluid accumulates inside the abdominal cavity, 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 of hormonal drugs to normalize the level of glucocorticoids.

Injury to the nervous system

These include: intracranial birth trauma, spinal cord injury, disorders of the peripheral parts of the nervous system. Dangerous serious complications, disorders of 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 (high temperature, 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 a trauma to the SHOP, or damage to the upper part of the thoracic region. A rupture of the spinal tissue can be with the integrity of the spinal column, then the pathology is difficult to diagnose, including from 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 in muscle tone on one side: the eye opens, the nasolabial fold disappears, the corner of the mouth shifts or drops. The condition resolves 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;
Studying the electrical activity of the 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 the surgical 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, therapeutic massage courses, 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. In the absence of severe consequences, the baby is discharged home after the clinical picture improves, he is regularly examined by the district neurologist.

With severe injuries affecting the nervous system, the child needs constant 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:

Pregnancy planning with a preliminary examination;
Treatment of existing diseases, especially chronic ones;
Limiting visits to crowded places during an epidemic of influenza, colds to reduce the risk of infection;
Taking medicines only after consultation with the doctor;
A balanced, complete diet, a healthy lifestyle for several months before pregnancy and during gestation;
Registration in the gynecological office in the early stages, regular visits and implementation of the recommendations of the supervising doctor;
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. In severe cases, constant monitoring by highly specialized doctors and compliance with their recommendations is necessary.