Birth trauma (physical)
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Birth trauma (BT) refers to damage of the tissues and organs of a newly delivered child, often as a result of physical pressure or trauma during childbirth. The term also encompasses the long term consequences, often of a cognitive nature, of damage to the brain or cranium. Medical study of birth trauma dates to the 16th century, and the morphological consequences of mishandled delivery are described in Renaissance-era medical literature. Birth injury occupies a unique area of concern and study in the medical canon. In ICD-10 "birth trauma" occupied 49 individual codes (P10-Р15).
However, there are often clear distinctions to be made between brain damage caused by birth trauma and that induced by intrauterine asphyxia. It is also crucial to distinguish between "birth trauma" and "birth injury". Birth injuries encompass any systemic damages incurred during delivery (hypoxic, toxic, biochemical, infection factors, etc.), but "birth trauma" focuses largely on mechanical damage. Caput succedaneum, subcutaneous hemorrhages, small subperiostal hemorrhages, hemorrhages along the displacements of cranial bones, intradural bleedings, subcapsular haematomas of liver, are among the more commonly reported birth injuries. Birth trauma, on the other hand, encompasses the enduring side effects of physical birth injuries, including the ensuing compensatory and adaptive mechanisms and the development of pathological processes (pathogenesis) after the damage.
Signs and symptoms
Sequelae can occur in both the mother and the infant after a traumatic birth.
Birth trauma is uncommon in the Western world in relation to rates in the third world. In the West injury occurs in 1.1% of C-sections.
- Cephalo-pelvic disproportion,
- the quick and rapid delivery,
- delayed and prolonged delivery,
- the abnormal birth position,
- asinclitic birth (asinclitismus),
- abnormal fetal attitude (extensor inserting head),
- obstetric turn,
- acceleration and stimulation of the birth,
- breech presentation,
- forceps and vacuum extraction.
Risk factors include vacuum extraction and the use of forceps.
While any number of injuries may occur during the birthing process. A number of specific conditions are well described. Brachial plexus palsy occurs in 0.4 to 5.1 infants per 1000 live birth. Head trauma and brain damage during delivery can lead to a number of conditions include: caput succedaneum, cephalohematoma, subgaleal hemorrhage, subdural hemorrhage, subarachnoid hemorrhage, epidural hemorrhage, and intraventricular hemorrhage.
- V.V.Vlasyuk Birth trauma and perinatal disorders of cerebral circulation. St. Petersburg, "Nestor History, 2009 - 252 p. ISBN 978-5-98187-373-7.
- Alexander JM, Leveno KJ, Hauth J, et al. (October 2006). "Fetal injury associated with cesarean delivery". Obstet Gynecol 108 (4): 885–90. doi:10.1097/01.AOG.0000237116.72011.f3. PMID 17012450.
- Demissie K, Rhoads GG, Smulian JC, et al. (July 2004). "Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis". BMJ 329 (7456): 24–9. doi:10.1136/bmj.329.7456.24. PMC 443446. PMID 15231617.
- Andersen J, Watt J, Olson J, Van Aerde J (February 2006). "Perinatal brachial plexus palsy". Paediatr Child Health 11 (2): 93–100. PMC 2435328. PMID 19030261.
- Beall MH, Ross MG (December 2001). "Clavicle fracture in labor: risk factors and associated morbidities". J Perinatol 21 (8): 513–5. doi:10.1038/sj.jp.7210594. PMID 11774010.
- Beck CT (2009). "Birth trauma and its sequelae". J Trauma Dissociation 10 (2): 189–203. doi:10.1080/15299730802624528. PMID 19333848.
- "Mortality and Burden of Disease Estimates for WHO Member States in 2002" (xls). World Health Organization. 2002.