Birth Injury


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Birth Injury

 

an injury to organs and tissues sustained by an infant during birth. Birth injuries are usually caused by irregular labor contractions, the elasticity of the fetal tissues, and the lowering of the fetus’s hypoergy and reduced adjustment. Predisposing factors include toxicoses of pregnancy, cardiovascular disease of the mother, infections suffered during pregnancy, metabolic disturbances, and premature and post-term birth. Fetal asphyxia commonly results in birth injury.

The most common birth injuries are intracranial hemorrhages, fractures of the clavicles and the humerus, pareses of the facial nerve, and paralyses of the brachial plexus. Of major clinical significance are intracranial birth injuries accompanied by damage to the central nervous system; such injuries include brain edema and intracranial hemorrhages (most often the consequence of severe fetal asphyxia). There are mild, medium, and severe degrees of intracranial birth injury. The last leads to death of the newborn in the first hours or days after birth or to the development of stable organic changes in the central and peripheral nervous systems (mental retardation, paralyses, pareses). In the acute period of intracranial trauma there are symptoms of excitation of the central nervous system. These symptoms include general restlessness, crying, accelerated convulsive breathing, convulsions, and insomnia. Suppression of the sucking and swallowing reflexes is also observed. The period of excitation is replaced by a state of depression marked by general sluggishness, decreased muscle tone, weak crying, and pallor. Frequent attacks of secondary asphyxia are characteristic.

Rest is prescribed for a newborn that has sustained birth injuries. The infant is fed expressed mother’s milk through a probe. An ice bag is applied to the child’s head, and oxygen therapy is used. Vitamins, glucose, cardiac and vascular agents, preparations that decrease the excitability of the central nervous system, and antihemorrhagics may be prescribed. Children who have suffered birth injury need observation by a pediatrician, a neuropathologist, and an orthopedist.

Birth injuries can be prevented through the timely detection and treatment of complications and diseases of pregnant women and through proper delivery procedures, which take into consideration the condition of the fetus.

REFERENCE

Mnogotomnoe rukovodstvo po akusherstvu i ginekologii, vol. 3, part 3. Moscow, 1964.

A. P. KIRIUSHCHENKOV

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