BIRTH TRAUMA

TRAUMA DURING BIRTH OCCURS TO: Skin and superficial tissues Muscles Nerves Bones

TRAUMA TO SKIN CAUSES IATROGENIC Forceps blade Vaccum extractor cups Scalp electrode Scalpels Poorly applied forceps blade or vacuum extractor cups Fetal blood sampling Incision of uterus at cesarean section

TRAUMA TO SKIN MANAGEMENT Keep the site clean and dry

INJURIES TO THE HEAD CEPHALHAEMATOMA It is the collection of blood in between the pericranium and flat bone of the skull It is unilateral Over the parital bone

CEPHALHAEMATOMA CAUSES Rupture of small veins Fracture of skull bone

CEPHALHAEMATOMA CHARECTERISTICS Never present at birth Gradually develops after 12-24 hours Swelling is limited by the suture lines Circumscibed,soft,fluctuant and incompressible Their may underlying fracture of the skull

SCALP INJURIES MINOR INJURIES FRACTURE SKULL

INTRACRANIAL HAEMORRHAGE TRAUMATIC ANOXIC PRIMARY HAEMORRHAGE

TRAUMATIC EXTRADURAL HAEMORRHAGE Fracture skull bone SUBDURAL Rupture of small vein

TRAUMATIC CAUSES Excessive moulding Rapid compression during the delivery Forcible forceps traction Wrong application of blade

TRAUMATIC CLINICAL FEATURES Baby delivered stillborn Respiratory depression High pitch cry Neck retraction Incoordinate ocular movement Convulsion Vomiting Bulging of anterior fontanelle

ANOXIC INTRAVENTRICULAR Common in premature infants Due to intense congestion SUBARACHNOID Due to tear of tributary veins INTRACEREBRAL Small petichial haemorrhage due to anoxia

ANOXIC PREVENTION To prevent or detect earlier To avoid traumatic vaginal delivery To extend the use of cesarean section Administration of vit K intramuscularly

ANOXIC DIAGNOSIS USG Doppler ultrasonography CT Scan MRI

ANOXIC TREATMENT Quite surrounding Incubator Cleanliness of air passage Avoid hypoxemia Restrict handling NG Feed Fluid balance Vit K Antibiotic Anticonvulsant