TY - CHAP M1 - Book, Section TI - Traumatic Delivery A1 - Gomella, Tricia Lacy A1 - Eyal, Fabien G. A1 - Bany-Mohammed, Fayez PY - 2020 T2 - Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e AB - An infant is noted to have severe bruises after birth, and a nurse observes that the infant is not using his right arm. The birth was noted to be traumatic, and the nurse calls you to evaluate the infant. The terms birth injuries and birth trauma are used interchangeably. According to the National Vital Statistics Reports, birth injury is “the impairment of the infant’s body function or structure due to adverse influences that occurred at birth.” Birth trauma is defined as “a physical injury sustained by an infant in the process of birth.” The rate of birth trauma has declined over the past 20 years, and the incidence is unclear, with study estimates ranging from approximately 6 to 8 per 1000 live births. The highest percentage of birth injuries occurs in mothers who were subjected to birthing instruments (eg, vacuum extraction, forceps). African Americans and Hispanics experience lower rates of birth injuries than whites and Asians/Pacific Islanders. Birth injuries occur from both vaginal and cesarean deliveries. Infants delivered by cesarean section are at risk for different types of birth trauma than infants delivered vaginally. Infants delivered by cesarean have a decreased risk of all birth trauma due to the decreased risk of clavicle fractures and injuries to the brachial plexus and scalp. Birth injuries can range from minor (petechiae) to severe (spinal cord injury resulting in death). The most common birth injuries are brachial plexus palsy (Erb palsy), bone fractures (fracture of the clavicle most common), cephalohematoma, caput succedaneum, intracranial hemorrhage, subconjunctival hemorrhage, facial paralysis, spinal cord injuries, and cerebral palsy. Documentation of injuries (Mongolian spot [now called congenital dermal melanocytosis], rib fractures, clavicle fractures, retinal hemorrhages) is very important at the first physical examination because some of these injuries can be confused with nonaccidental trauma after discharge. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/14 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1168357112 ER -