[Experience in treating children with the sequelae of birth-injury brachial plexitis at Evpatoriia health resort].
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Arm Injuries↗
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[Birth injuries of the locomotor apparatus].
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Arm Injuries↗
Intrauterine perineal tear: a rare birth injury.
A rare case of birth injury having intrauterine complete perineal tear is presented. Defunctioning sigmoid colostomy was undertaken because of bad perineal condition. The baby died of Pseudomonas septicemia on the 15th day before definitive surgical procedure could be undertaken.
Birth Injuries↗
Birth injuries of the brachial plexus.
Birth injuries of the brachial plexus are fairly common, but most affected newborns make quick recoveries without any specific intervention. A minority suffer more severe injuries that lead to varying degrees of life-long disability. Modem microsurgical techniques permit reconstruction of certain plexus injuries and, in carefully selected patients, can restore voluntary activity to target muscle groups. The degree to which reanimation of paralyzed muscles improves function and quality of life for these children is a more important matter that has not yet been addressed using modern standards of evidence. Brachial plexus reconstruction is only a first step in the multidisciplinary process needed to optimize long-term functional outcomes for severely affected infants.
Birth Injuries↗
Birth injuries of the brachial plexus.
Birth injuries of the brachial plexus are fairly common, but the majority of affected newborns make quick recoveries without any specific intervention. A minority suffer more severe injuries that lead to varying degrees of life-long disability. Happily, modern microsurgical techniques permit reconstruction of certain plexus injuries and, in carefully selected patients, can restore voluntary activity to target muscle groups. To what degree reanimation of paralyzed muscles improves function and quality of life for these children is a more important matter that has not yet been addressed at the level of modern standards of evidence. Brachial plexus reconstruction is only a first step in the multidisciplinary process needed to optimize long-term functional outcomes for severely affected infants.
Birth Injuries↗
Traumatic cervical syringomyelia related to birth injury.
A rare case of cervical syringomyelia related to breech delivery is reported. The initial diagnosis was bilateral brachial plexus palsy due to birth injury, which was revealed by magnetic resonance imaging (MRI) to be traumatic syringomyelia. The usefulness of MRI in the early diagnosis of cervical cord birth injury, especially in differentiating between brachial plexus palsy due to birth injury and spinal cord trauma due to birth injury in infancy, is emphasized.
Birth Injuries↗
Preliminary experiences with brachial plexus exploration in children: birth injury and vehicular trauma.
The application of microsurgical techniques to the peripheral nervous system has made possible the reconstruction of the brachial plexus after vehicular and penetrating injuries. We now report our preliminary experiences utilizing these same techniques in the microsurgical management of brachial plexus birth injury. In contrast to other authors and in distinction from our own experiences with vehicular trauma in children, we did not find lesions requiring reconstruction by grafting or neurotization in any of seven plexus explorations for birth injury. The history of the surgical management of brachial plexus birth injury is reviewed, and the rationale for exploration is developed in the context of the natural history of the condition. Differences between our experiences and the existing literature are analyzed, with particular regard for timing of operation and technique of intraoperative assessment of nerve injury. All children with birth injuries of the brachial plexus require careful, repeated neurological evaluation during the first few months of life. Although the great majority make a rapid and satisfactory spontaneous recovery, the minority who do not recover are destined to suffer significant, life-long disability. Microsurgical brachial plexus exploration may benefit this select group of patients.
Accidents, Traffic↗
Birth injuries to the epiphyseal cartilage.
A birth injury in the vicinity of a joint might lead to a fracture through the epiphyseal cartilage. The criteria for diagnosing such a fracture at radiography are considered and the continued remodelling of the bone demonstrated. The history of 2 cases with late diagnosis and serious long-term sequelae are described, in order to emphasize the necessity of early radiography.
Birth Injuries↗
Correlation of birth injury with maternal height and birthweight.
BACKGROUND: Infant or maternal injury during vaginal delivery is a constant threat to all involved, but difficult to predict. OBJECTIVE: To estimate the risk of birth injuries in an institution favouring trial of vaginal birth when there was doubt of the best mode of delivery. DESIGN: A retrospective cohort study. SETTING: University Hospital. POPULATION: Singleton 14,359 vaginal deliveries in cephalic presentation during 5(1/2) years. METHODS: The total caesarean section rate during this period was 9%. The likelihood of injury was evaluated by logistic regression analysis with injury as the dependent variable and maternal height and child birthweight as explanatory variables in birth injury risk estimation. MAIN OUTCOME MEASURES: Infant injury defined as one of the following: shoulder dystocia, clavicle fracture or brachial plexus injury; and maternal injury as anal sphincter rupture (ASR). RESULTS: There were a total of 318 infant injuries in 282 infants and 423 ASRs. A strong correlation was found between injury and both fetal macrosomia and short maternal stature, but macrosomia was a stronger indicator of injury. Birth injury risk estimation curves were constructed based on maternal height and birthweight. CONCLUSIONS: The present results confirm a strong correlation between fetal macrosomia and short maternal stature and the likelihood of injury during vaginal birth. Risk estimation curves were constructed that might be of great value for the obstetrician in choosing the mode of delivery in these cases.
Anal Canal↗
Birth-injury litigation.
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Birth Injuries↗
Cervical spine fracture-dislocation birth injury: prevention, recognition, and implications for the orthopaedic surgeon.
Spinal cord birth injury is rare, and orthopaedic surgeons infrequently encounter it. The injury is associated with hyperextension of the fetal head in utero and during delivery and with forceps-assisted breech vaginal deliveries. These cervical spinal cord injures may be complete or partial. They most commonly occur in the absence of bony injury, which can lead to diagnostic difficulties. Ultrasound and MRI studies are valuable diagnostic tools for identifying spinal cord injury in cases of hypotonic newborns with difficult deliveries. The authors report an unusual case of spinal cord birth injury with frank cervical fracture-dislocation following a difficult footling breech vaginal delivery. Early recognition of hyperextension of the fetal head in utero and planned cesarean section are important prevention methods. While this type of injury is rare, the pediatric orthopedic surgeon must understand its nature and severity to facilitate timely treatment.
Adult↗
The relationship of medical specialization (obstetricians and general practitioners) to complications in pregnancy and delivery, birth injury, and malformation.
In this paper, census data were used to assess the effectiveness in birth delivery of obstetricians and general practitioners.though the data reported require some qualification and additional research, preliminary results indicate that general practitioners report approximately three times more birth injuries and/or malformations (than do obstetricians) at birth. Both groups (obstetricians and general practitioners) report approximately the same number of complications in pregnancy and delivery. It was tentatively concluded that the similarity in diagnosed complications was probably due to diagnostic error. This error, in combination with sample differences and differing delivery techniques, resulted in the consequent differences in rates of birth injury and malformation.
Birth Injuries↗
[Pathological mechanism of injuries of the central nervous system following birth injury].
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Birth Injuries↗
[Incidence of birth injuries to newborn infants in relation to birth weight. An analysis of the Hessen perinatal study].
There has been a decrease in the incidence of obstetric traumas in single newborn in vertex presentation weighing more than 2.499 g between 1983 and 1992, in Hessian hospitals, the drop in incidence being from 0.70% to 0.33%. The rate of injuries depends on the birth weight. During the perinatal analysis period of 10 years the average rate of injuries is 0.47% in the birth weight range between 2.500-3.999 g, in the range between 4.000 and 4.499 g 1.61% and in the birth weight group above 4.499g 3.39%. These differences are statistically highly significant. During the ten years under report, 1.908 infant injuries at birth were recorded. 70% of these infants were in the 2.500-3.999 g range and only 6.7% in the weight group beyond 4.999 g. There are no comparable data in literature. The drop in the rate of injuries compared to 1983 is represented by a factor of 2.5 in the 2.500-3.999 g birth weight range, by 1.5 in the 4.000-4.499 g range and by 1.8 in the group over 4.999 g. We do not intend to artificially construct a connection, but during the report period there was an increase in the rate of Caesarean sections in cases of vertex presentation and single births, in all weight groups. If in any particular case the birth weight is estimated to be higher than 4.499 g according to sonographic examination, this does not imply that Caesarean section must be performed, since that would be associated with increased maternal morbidity.(ABSTRACT TRUNCATED AT 250 WORDS)
Birth Injuries↗
Cerebral birth injury as a cause of epilepsy.
The possible role of cerebral birth injury in the aetiology of epilepsy was evaluated by comparing the birth histories of 101 epileptic patients with focal seizures and 208 with non-focal seizures. The former were smaller at birth and their mothers were older and had higher blood pressures than the mothers of the latter. Although the two groups did not differ significantly with regard to the frequency of breech birth, assisted vaginal breech deliveries were significantly more numerous in the focal group. The injured half of the brain was as often pressed against the sacrum as against the symphysis during birth.
Adult↗
[Posterior fossa subdural hematoma in the newborn caused by birth injury].
Among various cases of intracranial hemorrhage in the newborn caused by birth injury, posterior fossa subdural hematoma is of serious nature in many cases and often results in death after critical clinical course due to compression of the respiratory center of the medulla oblongata. We have recently experienced two cases of subdural hematoma in the posterior fossa caused by birth injury, which we successfully treated non-surgically. Herein, we report these two cases and present a sequential CT scan of each. The first case is a full-term (39 weeks gestation) male infant. Delivery was carried out spontaneously with double footling presentation. At 20 hours of age, cyanosis and convulsion occurred. CT scan was performed and revealed high density areas in the posterior fossa, quadrigeminal cistern and longitudinal cerebral fissure. Bloody CSF was discharged per lumbar puncture and glycerol was infused intravenously, but the ventricle became enlarged. At this point at 9 days of age, the infant was admitted to our hospital. While he showed poor activity on admission, hematoma was absorbed gradually and disappeared at 3 months of age by conservative treatment. Now, at 6 years and 6 months of age, the patient has no neurological deficits. The second case is a full-term (40 weeks gestation) twin female infant. Due to breech presentation, delivery was conducted per breech extraction. At three days of age, vomiting, fontanel bulging and hypotonia were observed. CT scan revealed hematoma similar to that seen in the first case, and steroid and glycerol were infused intravenously. Conservative treatment was performed in this case also, and changes shown by CT scan were almost the same as those seen in the first case. The patient has no neurological deficits at 5 years and 7 months of age. Since the introduction of CT scan, early diagnosis of a subdural hematoma in the posterior fossa has been possible. But reports of successful surgical treatment are not so frequent.(ABSTRACT TRUNCATED AT 250 WORDS)
Birth Injuries↗