Cesarean Section and Right Femur Fracture: A Rare but Possible Complication for Breech Presentation

Capobianco, Giampiero; Virdis, G; Lisai, P.; Cherchi, Claudio; Biasetti, Ornella; Dessole, Francesco; Meloni, Giovanni Battista

doi:10.1155/2013/613709

Cited by 9 publications

(11 citation statements)

References 13 publications

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“…7 Capobianco et al stated that caesarean delivery reduces the risk of traumatic injury to the newborn compared to vaginal delivery, especially with breech presentation, but it does not eliminate this possible accidental complication. 8 Among these lesions, lacerations to both superficial and deep tissue are reported. The percentage of fetal incised wounds is overall quite small (their incidence is about 1.5-6%), but it is an underestimated phenomenon, as sometimes these lesions are not documented by surgeons in the operative summary.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are also more serious lesions such as fractures or lesions affecting the nerves or eyes that have significant consequences for the affected infants. 8,[11][12][13][14] In general, skin lesions can be treated immediately with good aesthetic results. However, parents consider fetal lacerations during caesarean section a serious complication because of the obvious iatrogenic origin.…”

Section: Discussionmentioning

confidence: 99%

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Fetal laceration during caesarean section and its medico-legal sequelae

Esposito¹,

Escolino²,

Paternoster

et al. 2014

Med Sci Law

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Fetal laceration is a recognized complication of caesarean delivery. The aim of this study was to investigate the incidence, type, location, risk factors and long-term consequences of accidental fetal incised wounds during caesarean delivery. During a five-year period, we observed 25 cases of fetal lacerations caused by the scalpel during hysterotomy. In 20 of these cases, we observed these lesions as consultants for the Neonatologic Care Unit; the other five cases came under our care after an insurance claim for damages against the gynaecologist. All the infants had a lesion located to the head. In only 5 of the 25 cases the lesion was reported in the operative summary, and only 16 of the 25 mothers had signed an informed consent before surgery. With regard to the 20 cases diagnosed at the Neonatologic Care Unit, the lesion was closed using single stitches in nine cases, and with biological glue in 11 cases. Concerning the five cases that underwent legal proceedings against the gynaecologist, a clinical examination was performed by an expert in Public Health and Social Security in collaboration with a paediatric surgeon to evaluate the degree of biological damage. In all five cases, the result of the legal challenge was monetary compensation for the physical and moral damage caused by the gynaecologists to the patients and their parents. Accidental fetal lesions may occur during caesarean delivery; the incidence is significantly higher during emergency caesarean delivery compared to elective procedures. Patients should sign an informed consent in which they should be informed about the risk of the occurrence of fetal lacerations during caesarean delivery in order to avoid legal complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fetal laceration during caesarean section and its medico-legal sequelae

Esposito¹,

Escolino²,

Paternoster

et al. 2014

Med Sci Law

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show abstract

“…При этом нет единой точки зрения на вопрос, какой из методов родовспоможения -естественный или оперативный -наиболее опасен в отношении получения ребенком родовой травмы. Одни исследователи придерживаются мнения, что наиболее травмоопасными являются роды через естественные родовые пути [18][19][20][21]. Часть исследователей убеждена в том, что опасность переломов несет кесарево сечение, особенно выполняемое по экстренным показаниям [22][23][24][25].…”

Section: результаты и обсуждениеunclassified

“…Значительно реже, чем переломы плечевых костей, у новорожденных диагноcтируют бедренные фрактуры [21]. Частота встречаемости данного вида повреждений во время родов со-ставляет в среднем 0,13 случая на 1000 новорожденных [45].…”

Section: результаты и обсуждениеunclassified

Fractures of long tubular bones in newborns: mechanisms of injuries, methods of diagnosis, and treatment

Скрябин

Геннадьевич²,

Akselrov

et al. 2018

Pediatr Traum Orthop Reconstr Surg

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Background. Medical information on the provision of emergency trauma care to newborns with fractures of tubular bones is scarce. Aim. This scientific review aimed to inform children's orthopedic traumatologists regarding the main mechanisms of injury, methods of diagnosis, and treatment of fractures of long tubular bones in newborns. Material and methods. The article presents a systematic analysis of 60 scientific works of domestic and foreign authors on topical aspects of fractures of long tubular bones in newborns from 1986 to 2018. For writing the literature review, we used modern electronic databases of medical information: PubMed, MEDLINE, Ulrich’s Periodicals Directory, DOAJ, Cyberleninka, and еLibrary. Results and discussion. Similarly from the analysis of scientific publications, the main mechanism of fractures of limb segments in newborns is intranatal trauma, in which the child can receive both during birth through the birth canal and during cesarean section. The predisposing factors for obtaining bone fractures are intrauterine osteopenia, congenital diseases of the digestive system, and prematurity. Fractures are diagnosed on the basis of clinical examination and results of ultrasound and X-ray studies of the injured limb. In the treatment of limb bone fractures, both conservative and surgical methods are used. In recent years, a tendency has been clearly observed in scientific publications, highlighting the ever-widening introduction into clinical practice of operational methods for stabilizing fractures of long tubular bones in newborns, including using the techniques of transosseous osteosynthesis. Conclusion. The presented article fills the existing gap of summarizing scientific publications on the treatment of fractures of limbs in newborns.

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“…We also conducted a review of literature which reveals that certain complications in the mother predispose neonates to femur fractures by cesarean. Capobianco et al [ 5 ] argue that even if the cesarean helps reduce the risk of occurrence of traumatic injury compared to vaginal delivery particularly if there is an association of breech presentation, it does not completely exclude the occurrence of an unexpected complication such as fracture of the femur.…”

Section: Introductionmentioning

confidence: 99%

Fracture of the Femur of A Newborn after Cesarean Section for Breech Presentation and Fibroid Uterus : A Case Report and Literature Review

Farikou

Bernadette

Daniel

et al. 2014

Journal of Orthopaedic Case Reports

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Introduction:The practice of cesarean section is known to decrease the occurrence of long bone fractures. We present here an unusual diaphyseal fracture of the femur of a newborn after cesarean section, the only case observed in our 14 years of practice.Case Report:The patient was a 3.4-kg female child born at 38 weeks of gestation. The mother was a primipara and aged 39 years. Ultrasound examination at 20th week revealed intrauterine fibroids with a breech presentation. Therefore, elective cesarean section was indicated. There was no apparent bone disorder that could predispose to sustain femur fracture. The fracture was treated successfully with a bilateral spica cast. The cesarean section was indicated in an aged primipara, bearer of uterine fibroids, and breech presentation. She had a good general health status, but her bone density was unknown since this examination is not routinely performed in our clinical settings in Africa.Conclusion:Elderly age, primipara status, presence of uterine fibroids, and breech presentation are usual indications for cesarean section. However, there are not many reports on femur fracture after cesarean section. Our present case suggests that despite the latest advances in delivery techniques, cesarean section for breech presentation predisposes the neonate to femoral fractures.

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Cesarean Section and Right Femur Fracture: A Rare but Possible Complication for Breech Presentation

Cited by 9 publications

References 13 publications

Fetal laceration during caesarean section and its medico-legal sequelae

Fetal laceration during caesarean section and its medico-legal sequelae

Fractures of long tubular bones in newborns: mechanisms of injuries, methods of diagnosis, and treatment

Fracture of the Femur of A Newborn after Cesarean Section for Breech Presentation and Fibroid Uterus : A Case Report and Literature Review

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