COMPLICATIONS OF NEW BORN

BIRTH INJURIES
 What is birth injury?
Birth injury is damage that occurs as a result of physical pressure
during the birth process, usually during transit through the birth canal.

• Many newborns have minor injuries during birth.

• Infrequently, nerves are damage or bones are broken.
• Most injuries resolve without treatment.
 Causes of birth injury:

• Large baby size ( 8 pounds, 13 ounces )

• Prematurity ( baby have more fragile body, easily injured )
• Dystocia ( difficult labor or child birth )
• Prolong labor
• Abnormal birth presentation (such as breech position during delivery)
 Some common birth injuries

1. CAPUT SUCCEDANEUM
2. CEPHALOHEMATOMA
3. BRUISING/FORCEPS MARKS
4. SUBCONJUNCTIVAL HEMORRHAGE
5. FACIAL PARALYSIS
6. BRACHIAL PALSY
7. FRACTURES
 CAPUT SUCCEDANEUM

Caput succedaneum is swelling of the scalp in a newborn. It is most often brought on by

pressure from the uterus or vaginal wall during head-first (vertex) delivery.

SIGN AND SYMPTOMS

• Soft, puffy swelling on the scalp of the newborn infant.
• Possible bruising or color change on the scalp swelling area.
• Swelling that may extend to both sides of the scalp.
• Swelling that is most often seen on the portion of the head which presented first.
TREATMENT
 No treatment is needed. The problem most often goes away on its own within few days.
 CEPHALOHEMATOMA
Cephalohematoma is a typically harmless condition that causes blood to pool under a
newborn’s scalp after a difficult vaginal delivery. Pressure during child birth, including
the use of vacuum extractors can break blood vessels in the scalp.

Common Causes

• Assistive delivery: Forceps and vacuum delivery are often used to speed up difficult births.
• Infant size: large babies (8 pounds, 13 ounces or more) can have difficulty exiting the birth canal, causing compression
and pressure on child’s head.
• Medical negligence: Preventable mistakes made during delivery can lead to cephalohematoma.
 Symptoms

• Difficult feeding
• head swelling
• High pitch crying
• Seizures
• Soft spot on head ( bulging fontanel )
• Some babies may develop jaundice as the red blood cells break down.

Treatment

 In most instances, newborn will not need any treatment for cephalohematoma because it goes away without any medical
interventions within few days.
 BRUISING/FORCEPS MARKS
The blood vessels in an infant are especially fragile, so even a very light impact can
cause a bruise. Once the blood vessels rupture, the blood will flood into surroundings
cells, causing a blue or purplish color in the skin. In a few days, the body will completely
reabsorb the blood, and the bruise will disappear.

Common Causes

• Trauma of difficult labor

• Contact with mother pelvic bone
• Forceps used during delivery
• Vacuum extraction
 Treatment
• Apply ice pack for first 24 hrs. after injury to help reduce swelling and discomfort.
• After one or two days, try warm soaks, or a warm bath to help the area feel better.
 SUBCONJUNCTIVAL HEMORRHAGE
• Subconjunctival hemorrhage in newborns occur when a small blood vessels in the white
of the eye ( sclera ) burst and cause a bleed. Eyes may have red band around the iris.

Common Cause
• Difficult or prolong labor
• Fetal macrosomia
• Misuse of forceps or vacuum extraction
Treatment

 This is very common and does not cause damage to the eye. The redness is usually absorbed in a week to ten days.
 FACIAL PARALYSIS
During labor or birth, pressure on a baby’s face may cause the facial nerve to be injured.
There is no movement on the side of the face with the injury and eye cannot be closed.

Common Cause

• Use of forceps for delivery

• Incorrect position during delivery
• Induced labor
• Prolong pregnancy or labor
• Compression on facial nerve
 Sign and Symptoms
• Cannot close eyes
• Trouble smiling, feeding
• Inability to blink
• Speech problem
• No facial expression
• Noticeable drooping on one side of the face due to muscle weakness

Treatment

• Depending on the cause and severity of the child’s facial paralysis, non-surgical therapies may be sufficient to resolve the
problem, including physical therapy and treatment.
• A speech pathologist may be part of the child’s care team if the paralysis affects his or her ability to speak.
 Brachial palsy
• The brachial plexus is a large network of nerves running from neck to the arm these
nerve provide movement and feeling to the arm and hand. Brachial palsy is weakness or
paralysis in parts of the arm as a result of significant injury to the brachial plexus, which
can happen during childbirth.
Sign and Symptoms
• The affected arm not moving properly
• The muscles of arm started to get smaller
• Limited feeling ( temperature or pain in arm )
Other problems may occur, including:
• A broken collar bone ( clavicle )
• A broken upper arm bone ( humerus )
• Horner’s syndrome ( the eyelid droops and the pupil of the eye is slightly smaller on the same side as the weak arm.
 Treatment

 Most babies with brachial palsy injuries recover fully with minimal treatment. However, in rare cases some children may
require surgeries for nerve, muscle and bones.