Birth Injuries
Objectives
By the end of this lesson, the leaner will be able to:-
Learn about inquiries that happen at birth, presentation, management
and possible prevention
Introduction
• Birth injuries happen during the birth process.
• Proper management of labour in the first stage
and second stage may prevent or and reduce the
incident of birth injuries to the newborn.
Types of Birth Injuries
Common birth injuries include:-
1. Caput succedaneum
2. Cephalo-haematoma
3. Palsies
4. Fractures
5. Dislocations
6. Cuts
1. Caput Succedaneum
A diffuse edematous swelling under the scalp and above the periosteum.
Caused by excessive molding
Characteristics
• It is present at birth
• It does not usually enlarge
• It pits on pressure
• Crosses a suture line
• It resolves spontaneously and is self limiting
• It resolves by 36 hours of life
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Caput Succedaneum
2. Cephalo-Haematoma
This is collection of blood under the periosteum, the periosteum is torn
from the skull bones as a result of friction between skull bones and
pelvic bones during a vaginal delivery.
• Caused by:- Prolonged second stage of labour Common in precipitate
labor or Cephalopelvic disproportion, during assisted vacuum
delivery.
Management:- Observe the infant, the swelling will dissolve.
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2. Cephalo-Haematoma
Characteristics
• Is not present at birth, swelling appears after 12 hours.
• Grows larger over subsequent days.
• Can persist for weeks.
• The swelling is firm and does not pit on pressure.
• The swelling is fixed and does not cross a suture line.
2. Cephalo-Haematoma
Caput succedaneum or Cephalo-hematoma
??
3. Palsies
This are Brachial plexus Injuries
Involving Nerve roots from the 5th to 8th cervical and the 1st
thoracic vertebrae
Trauma occur during breech delivery or shoulder dystocia.
Including:-
a) Erb’s palsy
b) Klumpke’s palsy
c) Total brachial plexus palsy
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Palsies
a) Erb’s Palsy(Waiters Tip Position)
Damage involving the C5 and C6.
Characterized by:-
• Paralysis of shoulder and arm
• The arm is inwardly rotated, the elbow extended, the wrist
pronated and flexed and the hand partially closed
• Arm is limp, some movement of the fingers and arm is
possible.
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Erb’s Palsy(Waiters Tip Position)
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Palsies
b) Klumpke’s Palsy
Occurs due to damage of C7, C8, and T1.
Characterized by:-
• Unaffected shoulder and upper arm
• Paralysis of lower arm, wrist and hand
• Wrist drop
• Loss of grasp reflex
Palsies (Klumpke’s Palsy)
Palsies
c) Total brachial plexus palsy
• Complete paralysis of shoulder, arm and hand
• Lack of sensation
• Circulatory problems
4. Fractures and Dislocations
• Common fractures involve the skull, clavicle, humerus and femur.
• Clavicular fractures occur in breech deliveries, shoulder dystocia,
and macrocosmic babies.
• Humerus and femur fractures occur in breech deliveries
• Skull fractures are common in instrumental deliveries
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Shoulder Fracture
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Skull Fractures
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Skin Lesions Lacerations
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Summary
• Describe the characteristics of above birth injuries
• Compare and contrast Cephalo-hematoma and Caput succedaneum
• State the nursing intervention for an infant with the above birth
injurers