Birth Trauma

Question 1

What is subgaleal hemorrhage?

Answer 1

Bleeding into the potential space of the gala aponeurotica or subaponeurotic area

Associated with vacuum-assisted delivery and can lead to severe hypovolemia and DIC risk.

Question 2

What are the types of skull fractures?

Answer 2

Linear and depressed

Linear fractures are often asymptomatic and heal spontaneously, while depressed fractures may require surgical intervention.

Question 3

What is the prognosis for a depressed skull fracture?

Answer 3

Excellent prognosis

Surgical elevation of skull is performed to prevent brain compression.

Question 4

What causes subarachnoid hemorrhage?

Answer 4

Rupture of bridging veins leading to bleeding into the subarachnoid space

Rare complications include seizures and massive hemorrhage requiring craniotomy.

Question 5

What is the common cause of facial nerve injury during birth?

Answer 5

Compression of the facial nerve against maternal sacral promontory

Can occur due to incorrect forceps applications or in utero compression.

Question 6

What are the symptoms of facial nerve injury?

Answer 6

Facial asymmetry

Mild cases resolve in a few days, while full recovery may take weeks to months.

Question 7

What is caput succedaneum?

Answer 7

Accumulation of serum above the periosteum

Commonly occurs during delivery.

Question 8

What is cephalohematoma?

Answer 8

Ruptured blood vessels between the periosteum and skull

Accumulates beneath the periosteum.

Question 9

What constitutes a sentinel event according to JCH?

Answer 9

Any perinatal death or major permanent loss of function unrelated to a congenital condition in an infant >2500g

Highlights the severity of birth trauma.

Question 10

What are maternal risk factors for birth trauma?

Answer 10

• Diabetes
• Obesity
• Prolongation of pregnancy > 298 days
• Short maternal stature
• Instrumented delivery

These factors increase the risk of birth-related injuries.

Question 11

What are infant risk factors for birth trauma?

Answer 11

• Macrosomia
• Abnormal presentation
• Large weight gain
• Shoulder dystocia
• History of macrosomic infant

These factors contribute to the likelihood of injury during delivery.

Question 12

What are the characteristics of superficial lesions in birth trauma?

Answer 12

Bruising and abrasions that are usually benign

Can include lacerations to the scalp, face, cheek, or ear.

Question 13

What is the significance of subdural hemorrhage?

Answer 13

Bleeding between the dura and arachnoid

Can present asymptomatically or with severe symptoms like seizures and brain stem compression.

Question 14

What is a common eye injury related to forceps delivery?

Answer 14

Corneal damage

Can lead to permanent vision impairment.

Question 15

What is a common form of peripheral nerve injury during birth?

Answer 15

Brachial plexus injury

Occurs from lateral traction applied to the infant’s neck.

Question 16

What are the symptoms of phrenic nerve injury?

Answer 16

• Cyanosis
• Respiratory distress
• Asymmetric chest movement

Indicates potential diaphragm paralysis.

Question 17

What is a common sign of vocal cord paralysis?

Answer 17

Unilateral paralysis leading to a hoarse or breathy cry

Can present with aspiration risk and GERD.

Question 18

What is a common complication of intraabdominal organ injuries during birth?

Answer 18

Hematoma formation and risk of rupture

Typically involves the spleen, adrenal glands, and liver.

Question 19

What is a potential sign of adrenal hemorrhage in infants?

Answer 19

Discoloration of the scrotum

Can be mistakenly evaluated as testicular torsion.

Question 20

What is the treatment for hematoma in the liver due to birth trauma?

Answer 20

Avoid surgery if possible and manage coagulopathies

Liver injuries can be life-threatening due to vascularity.