Neonatal Birth Traumas: Risk factors and types

Abstract

Background: Birth trauma is defined as injury to neonates resulting from mechanical forces (such as compression or traction) during the process of birth. Birth injury is used to denote avoidable and unavoidable mechanical and hypoxic-ischemic injury incurred by neonates during labor and delivery. Maternal, labor and infant factors can predispose to birth traumas. Many types of birth traumas can be found including intra and extra cranial, spinal, peripheral nerves, fractures and visceral. Patients and methods: A cross sectional study was done on 200 babies (100 babies for the study group and 100 babies for the control group), admitted to special care baby unit of Baghdad Teaching Hospital, during the period between 1st of October 2007 to the 30th of March 2008. Results: There was an increased percentage of birth trauma in preterm babies, large birth weight, mothers who were primigravida, had history of contracted pelvis, diabetes mellitus, prolong second stage of labor, abnormal fetal presentation, and shoulder dystocia. Trauma of cranium was the most common type of birth trauma, of which caput succedaneum (68%) was the most common one. Conclusions: Birth trauma is still a significant problem in this maternity ward causing some morbidity. The significant risk factors were macrosomia, prematurity and multiple pregnancies, primigravida, chronic maternal illness like diabetes mellitus, history of pelvic anomalies or contracted pelvis, prolonged labor especially the second stage, abnormal fetal presentation and shoulder dystocia. So we recommend assessment of the fetal weight, mother pelvis capacity and presentation before delivery, so that macrosomic fetus might be delivered by cesarean section, and prevent premature delivery, and better use of investigations like ultrasound,x-ray,CT scan for early diagnosis and further management of birth trauma.