Birth injuries

Question 1

List 3 risk factors for birth injury.

Answer 1

• Malposition
• Macrosomia
• Maneouvres during birth
• Instrumental delivery - forceps or ventouse

C-section has rediced the rates of birth injury significantly

Question 2

What is caput succedaneum? What is the prognosis?

Answer 2

Bruising and oedema of the presenting part extending beyond the margins of the skull bones; resolves in a few days

Question 3

What is a cephalohaematoma? What is the prognosis?

Answer 3

Haematoma from bleeding below the periosteum, confined within the margins of the skull sutures. It usually involves the parietal bone. The centre of the haematoma feels soft.

It resolves over several weeks.

Question 5

What is a chignon and what is its cause?

Answer 5

Oedema and bruising from Ventouse delivery

Question 6

What is subaponeurotic haemorrhage? What are the complications?

Answer 6

AKA Subgaleal haemorrhage

Very uncommon – diffuse, boggy swelling of scalp on examination, blood loss

May be severe and can lead to hypovolaemic shock and coagulopathy

Question 7

Label this.

Answer 7

Question 8

What is this?

Answer 8

Erb’s palsy - affected arm lies straight, is limp, and with the hand pronated and the fingers flexed (waiter’s tip position).

Question 9

What is this?

Answer 9

Chignon

Question 10

What is this?

Answer 10

Large cephalohaematoma

Question 11

What fractures are common at birth?

Answer 11

Clavicle - in shoulder dystocia a snap may be heard or a lump noticed a few weeks after birth; no treatment and good prognosis

Humerus/femur - femur midshaft during breech delivery or humerus during shoulder dystocia; there is deformity and reduced movement but heals rapidly with immobilisation