Birth trauma refers to damage of the tissues and organs of a newly delivered child, often as a result of physical pressure or trauma during

childbirth Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...

. It encompasses the long term consequences, often of cognitive nature, of damage to the brain or cranium. Medical study of birth trauma dates to the 16th century, and the morphological consequences of mishandled delivery are described in Renaissance-era medical literature.

Birth injury Birth injury refers to damage or injury to the child before, during, or just after the birthing process. " Birth trauma" refers specifically to mechanical damage sustained during delivery (such as nerve damage and broken bones). The term "birth in ...

occupies a unique area of concern and study in the medical canon. In

ICD-10 ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social cir ...

"birth trauma" occupied 49 individual codes (P10–Р15). However, there are often clear distinctions to be made between brain damage caused by birth trauma and that induced by intrauterine asphyxia. It is also crucial to distinguish between "birth trauma" and "

birth injury Birth injury refers to damage or injury to the child before, during, or just after the birthing process. " Birth trauma" refers specifically to mechanical damage sustained during delivery (such as nerve damage and broken bones). The term "birth in ...

". Birth injuries encompass any systemic damages incurred during delivery ( hypoxic,

toxic Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacterium, or plant, as well as the effect on a subst ...

biochemical Biochemistry, or biological chemistry, is the study of chemical processes within and relating to living organisms. A sub-discipline of both chemistry and biology, biochemistry may be divided into three fields: structural biology, enzymology, ...

, infection factors, etc.), but "birth trauma" focuses largely on mechanical damage. Caput succedaneum,

bruise A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur c ...

s, bleeding along the displacements of cranial bones, and subcapsular hematomas of the

liver The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...

are among reported birth injuries. Birth trauma, on the other hand, encompasses the enduring side effects of physical birth injuries, including the ensuing compensatory and adaptive mechanisms and the development of pathological processes (

pathogenesis In pathology, pathogenesis is the process by which a disease or disorder develops. It can include factors which contribute not only to the onset of the disease or disorder, but also to its progression and maintenance. The word comes . Descript ...

) after the damage.

Signs and symptoms

Complications from birth trauma can include damage to the head, spinal cord, soft tissues, and organs. Trauma to the head of the infant can manifest as caput succedaneum, skull fractures, extracranial and intracranial hemorrhages, and cranial nerve injuries. Caput succeedaneum is seen as

edema Edema (American English), also spelled oedema (British English), and also known as fluid retention, swelling, dropsy and hydropsy, is the build-up of fluid in the body's tissue (biology), tissue. Most commonly, the legs or arms are affected. S ...

in the scalp due to squeezing of the veins from increased pressure while passing through the

birth canal In mammals and other animals, the vagina (: vaginas or vaginae) is the elastic, muscular reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix (neck of the uterus). The vaginal int ...

. Birth trauma is uncommon in the Western world in relation to rates in the third world. In the West injury occurs in 1.1% of C-sections.

Causes

* cephalopelvic disproportion * rapid delivery * delayed and prolonged delivery * abnormal birth position * asynclitic birth (asinclitismus) * abnormal fetal attitude (extensor inserting head) * obstetric turn * acceleration and stimulation of birth * breech presentation *

forceps Forceps (: forceps or considered a plural noun without a singular, often a pair of forceps; the Latin plural ''forcipes'' is no longer recorded in most dictionaries) are a handheld, hinged instrument used for grasping and holding objects. Forcep ...

and vacuum extraction While any number of injuries may occur during the birthing process, a number of specific conditions are well described. Brachial plexus palsy occurs in 0.4 to 5.1 infants per 1000 live births. Head trauma and brain damage during delivery can lead to a number of conditions include: caput succedaneum,

cephalohematoma A cephalohematoma (American English), also spelled cephalohaematoma (British English), is a hemorrhage of blood between the skull and the periosteum at any age, including a newborn baby secondary to rupture of blood vessels crossing the periosteu ...

subgaleal hemorrhage Subgaleal hemorrhage, also known as subgaleal hematoma, is bleeding in the potential space between the skull periosteum and the scalp galea aponeurosis (dense fibrous tissue surrounding the skull). Symptoms The diagnosis is generally clinical ...

subdural hemorrhage A subdural hematoma (SDH) is a type of bleeding in which a collection of blood—usually but not always associated with a traumatic brain injury—gathers between the inner layer of the dura mater and the arachnoid mater of the meninges surroun ...

subarachnoid hemorrhage Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid (brain), arachnoid membrane and the pia mater surrounding the human brain, brain. Symptoms may include a thunderclap headache, severe heada ...

, epidural hemorrhage, and

intraventricular hemorrhage Intraventricular hemorrhage (IVH), also known as intraventricular bleeding, is a bleeding into the brain's ventricular system, where the cerebrospinal fluid is produced and circulates through towards the subarachnoid space. It can result from p ...

. The most common fracture during delivery is that of the

clavicle The clavicle, collarbone, or keybone is a slender, S-shaped long bone approximately long that serves as a strut between the scapula, shoulder blade and the sternum (breastbone). There are two clavicles, one on each side of the body. The clavic ...

(0.5%).

Epidemiology

Birth asphyxia and birth trauma world map - DALY - WHO2002

References

External links

{{Authority control Childbirth Birth trauma (physical)