scholarly journals Birth Injury: Birth Asphyxia and Birth Trauma

2018 ◽  
Vol 8 (4) ◽  
pp. 788-864
Author(s):  
Kim A. Collins ◽  
Edwina Popek
Keyword(s):  
Risk Factors ◽  
Birth Asphyxia ◽  
Birth Trauma ◽  
Mechanical Trauma ◽  
Birth Injury ◽  
Permanent Damage ◽  
Severe Morbidity ◽  
Birth Injuries ◽  
Clinical Presentations ◽  
Organ Systems

Injury to a fetus or neonate during delivery can be due to several factors involving the fetus, placenta, mother, and/or instrumentation. Birth asphyxia results in hypoxia and ischemia, with global damage to organ systems. Birth trauma, that is mechanical trauma, can also cause asphyxia and/or morbidity and mortality based on the degree and anatomic location of the trauma. Some of these injuries resolve spontaneously with little or no consequence while others result in permanent damage and severe morbidity. Unfortunately, some birth injuries are fatal. To understand the range of birth injuries, one must know the risk factors, clinical presentations, pathology and pathophysiology, and postmortem autopsy findings. It is imperative for clinicians and pathologists to understand the causes of birth injury; recognize the radiographic, gross, and microscopic appearances of these injuries; differentiate them from inflicted postpartum trauma; and work to prevent future cases.

Assessment of Hearing Impairment in NICU Graduates by Otoacoustic Emission and Brainstem Evoked Response Audiometry Tests

2020 ◽  
Vol 34 (3) ◽  
pp. 109-117
Author(s):  
Aparna Aradhana ◽  
Gadadhar Sarangi ◽  
Prasant Saboth ◽  
Radha Tripathy
Keyword(s):  
Risk Factors ◽  
Hearing Impairment ◽  
Very Low Birth Weight ◽  
Birth Asphyxia ◽  
Otoacoustic Emission ◽  
Evoked Response ◽  
Complete Evaluation ◽  
Brainstem Evoked Response Audiometry ◽  
Tertiary Teaching ◽  
Evoked Response Audiometry

Objectives: To find out the incidence of hearing impairment in Neonatal Intensive Care Unit (NICU)-admitted newborns and to correlate between several risk factors. Design: Prospective observational study. Setting: In a tertiary teaching hospital of Odisha between October 2014 and October 2016. Study population: 100 newborns delivered in the institution and admitted in NICU with usual indications and risk factors that underwent otoacoustic emission 1 and 2 (OAE1, OAE2) and Brainstem Evoked Response Audiometry (BERA). Results: 84 babies in OAE1 and 86 babies in OAE2 got “pass” results. In BERA test, 92 babies got normal waveform. 7 (13.7%) of 51 premature babies, 5 (38.5%) of 13 very low birth weight babies, 7 (17.5%) of 40 babies receiving ototoxic medication for >5 days, 7 (31.8%) of 22 babies with hyperbilirubinemia, 6 (42.9%) of 14 babies with sepsis, 5 (20%) of 20 babies with birth asphyxia, 3 (60%) of 5 babies under mechanical ventilation for >5 days, 1 baby with ear abnormality, and 1 (50%) out of 2 babies with congenital infections had hearing impairment and statistically significant association with abnormal OAE and BERA test. Conclusion: There is high incidence of hearing loss in NICU-admitted newborns. OAE and BERA both should be performed for complete evaluation of hearing. Important risk factors are elaborated. Predischarge hearing assessment in NICU is most important.

Obstetric brachial plexus palsy: A birth injury not explained by the known risk factors

2008 ◽  
Vol 87 (10) ◽  
pp. 1027-1032 ◽  
Author(s):  
Bjørn Backe ◽  
Elisabeth Balstad Magnussen ◽  
Ole Jakob Johansen ◽  
Gerd Sellaeg ◽  
Harald Russwurm
Keyword(s):  
Risk Factors ◽  
Brachial Plexus ◽  
Brachial Plexus Palsy ◽  
Birth Injury ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus

Compression neuropathies of the forearm: anatomy, clinical features and management

2021 ◽  
pp. 1-10
Author(s):  
Alexander Scarborough ◽  
Robert J MacFarlane ◽  
Michail Klontzas ◽  
Rui Zhou ◽  
Mohammad Waseem
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Peripheral Nerves ◽  
Clinical Presentation ◽  
Permanent Damage ◽  
Peripheral Nerve Lesions ◽  
Clinical Presentations ◽  
Wide Range ◽  
Prompt Diagnosis

The upper limb consists of four major parts: a girdle formed by the clavicle and scapula, the arm, the forearm and the hand. Peripheral nerve lesions of the upper limb are divided into lesions of the brachial plexus or the nerves arising from it. Lesions of the nerves arising from the brachial plexus are further divided into upper (proximal) or lower (distal) lesions based on their location. Peripheral nerves in the forearm can be compressed in various locations and by a wide range of pathologies. A thorough understanding of the anatomy and clinical presentations of these compression neuropathies can lead to prompt diagnosis and management, preventing possible permanent damage. This article discusses the aetiology, anatomy, clinical presentation and surgical management of compressive neuropathies of the upper limb.

Risk Factors for Adverse Maternal Outcomes following Expectantly Managed Preterm Prelabor Rupture of Membranes

2021 ◽  
Author(s):  
Alice J. Darling ◽  
Hailey M. Harris ◽  
Gregory E. Zemtsov ◽  
Maria Small ◽  
Matthew R. Grace ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Acute Kidney Injury ◽  
Venous Thromboembolism ◽  
Maternal Morbidity ◽  
Private Insurance ◽  
Kidney Injury ◽  
Severe Morbidity ◽  
Prelabor Rupture Of Membranes ◽  
Postpartum Hysterectomy

Objective We sought to characterize the incidence and risk factors associated with developing maternal morbidity following preterm prelabor rupture of membranes. Study Design Retrospective case–control study of patients with preterm prelabor rupture of membranes at a single institution from 2013 to 2019 admitted at ≥23 weeks gestational age. The primary outcome was a composite of maternal morbidity which included: death, sepsis, intensive care unit (ICU) admission, acute kidney injury, postpartum dilation and curettage, postpartum hysterectomy, venous thromboembolism, postpartum hemorrhage, postpartum wound complication, postpartum endometritis, pelvic abscess, postpartum pneumonia, readmission, and/or need for blood transfusion were compared with patients without above morbidities. Severe morbidity was defined as: death, ICU admission, venous thromboembolism, acute kidney injury, postpartum hysterectomy, sepsis, and/or transfusion >2 units. Demographics, antenatal, and delivery characteristics were compared between patients with and without maternal morbidity. Bivariate statistics and regression models were used to compare outcomes and calculate adjusted odd ratios. Results Of 361 included patients, 64 patients (17.7%) experienced maternal morbidity and nine (2.5%) had severe morbidity. Patients who experienced maternal morbidity were significantly (p < 0.05) more likely to be older, have private insurance, have BMI ≥40, have chorioamnionitis at delivery, and undergo cesarean or operative vaginal delivery when compared with patients who did not experience morbidity. After controlling for confounders, cesarean delivery (aOR 2.38, 95% CI[1.30,4.39]), body mass index ≥40 at admission (aOR 2.54, 95% CI[1.12,5.79]), private insurance (aOR 3.08, 95% CI[1.54,6.16]), and tobacco use (aOR 3.43, 95% CI[1.58,7.48]) were associated with increased odds of maternal morbidity. Conclusion In this cohort, maternal morbidity occurred in 17.7% of patients with preterm prelabor rupture of membranes. Private insurance, body mass index ≥40, tobacco use, and cesarean delivery were associated with higher odds of morbidity. These data can be used in counseling and to advocate for smoking cessation. Key Points

scholarly journals A cohort study of risk factors, clinical presentations, and outcomes for dermatophyte, nondermatophyte, and mixed toenail infections

2018 ◽  
Vol 79 (6) ◽  
pp. 1145-1146 ◽  
Author(s):  
Nuntida Salakshna ◽  
Sumanas Bunyaratavej ◽  
Lalita Matthapan ◽  
Kamonpan Lertrujiwanit ◽  
Charussri Leeyaphan
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Clinical Presentations

scholarly journals RISK FACTORS ASSOCIATED WITH NEONATAL HYPOGLYCEMIA

2006 ◽  
Vol 13 (04) ◽  
pp. 687-690
Author(s):  
MUNIR AKMAL LODHI ◽  
GHULAM SHABBIR ◽  
NASIR ALI SHAH
Keyword(s):  
Risk Factors ◽  
Low Birthweight ◽  
Birth Asphyxia ◽  
Neonatal Hypoglycemia ◽  
Factors Associated ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Associated Risk Factors ◽  
Glucose Estimation

Objectives: Recurrent episodes of neonatal hypoglycemia are strongly associated with long termphysical and neuro-developmental deficits. (1) Moreover in neonates hypoglycemia can be overlooked as it may havenonspecific symptoms only. (2) This study was therefore carried out to analyse the risk factors associated with neonatalhypoglycemia and to evaluate the risk factors which have predictive value in its diagnosis. .Design: Based case controlstudy. Period: Six months from January 2005 to June 2005. Setting CMH Pano Aqil. Material and Methods: 385newborns were studied. Newborns of both civilians as well as military personnel were included in the study. 11newborns were excluded. Out of remaining 347 patients 101 were found to be hypoglycemia. Five risk factors (low birthweight, Birth Asphyxia, Neonatal sepsis, Meconeum aspiration syndrome delayed feeding ) strongly and independentlypredicated the risk of hypoglycemia. Results: The most common associated risk factor was low birth weight (47.47%)followed by delayed feeding (46.29%). Blood sampling for glucose estimation was done at birth / admission at 6 hours,12 hours, 24 hours and 48 hours. Test was initially performed by glucometer, the reading which were confirmed bylaboratory testing in border line case. Conclusions: In neonates with associated risk factors it is cost affective to carryout blood glucose levels at the time of birth and follow up readings taken as indicated by clinical progress later on.

scholarly journals Birth Injuries: Assessment Of Clinical Findings And Maternal, Fetal And Obstetric Risk Factors

2017 ◽  
Author(s):  
Rüya Çolak ◽  
Kazım Çoban ◽  
Kıymet Çelik ◽  
Ezgi Yangın Ergon ◽  
Senem Alkan Özdemir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Findings ◽  
Birth Injuries

scholarly journals A retrospective study of predisposing factors and outcome of persistant pulmonary hypertension among newborns at rural tertiary care centre

2020 ◽  
Vol 8 (1) ◽  
pp. 92
Author(s):  
B. C. Yelamali ◽  
Gangadhar S. Mirji ◽  
Mirnalini Rajput
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Retrospective Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Birth Asphyxia ◽  
Male Gender ◽  
Predisposing Factors ◽  
Positive Pressure ◽  
Increased Risk

Background: Persistent pulmonary hypertension in newborns (PPHN) remains a significant cause of perinatal morbidity and mortality. Early recognition of factors that increase the risk of PPHN is of great importance in either to prevent or to treat PPHN optimally. Aim was to study the neonatal predisposing factors, profile and outcome of PPHN.Methods: This retrospective study was conducted in level III neonatal care unit, a rural referral centre of North Karnataka, India from January 2018 to April 2020.Results: During the study period a total of 50 infants with PPHN were identified with the incidence of 5.43/1000 live births. Mean gestation age (±SD) was 38.28±2.49 weeks and mean birth weight (±SD) was 2624±512 gm. The most noted risk factors were meconium aspiration syndrome (42%), birth asphyxia (16%), RDS (10%), positive pressure ventilation at birth (52%) and male gender (62%). Out of 50 infants with PPHN, high mortality was seen in low birth weight babies (66.6%). Use of sildenafil showed increased mortality (56.2%) whereas use of surfactant scored better with decreased mortality of 42.8%.Conclusions: Major risk factors for PPHN are MAS, birth asphyxia, RDS and low birth weight. Poor prognosis is seen in male gender, prematurity and CDH with increased risk of mortality. The use of systemic pulmonary vasodilators can be considered with caution and use of surfactant has a role in management of PPHN.

scholarly journals No Take Home Baby After Caesarian Birth for Foetal Distress in Women with Risk

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Risk Factors ◽  
Neonatal Outcome ◽  
Meta Analysis ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Cord Compression ◽  
High Rate ◽  
Neonatal Deaths ◽  
Fetal Ecg ◽  
Foetal Asphyxia

Sometimes interventions are done for the baby in women with risks but it turns out to be unnecessary caesarian section (CS). However it may be delayed decision and / or delayed execution of intervention, CS too, with no take home baby. While lack of adverse outcome reflected that the decision was not for a compromised foetus, still birth or asphyxiated baby at birth meant delayed decision and / or execution. Recent studies revealed an estimated 9.04 million perinatal deaths related to birth asphyxia. Of them 1.02 million were intrapartum deaths leading to still births, many after CB for foetal concern. Birth asphyxia is a significant global health problem, responsible for around 1.2 million neonatal deaths each year worldwide [1-3]. Those who survive often suffer from a range of disorders. Chauhan et al. conducted, a meta analysis comprising of 169 articles and 37 reports and concluded that the overall risk of prompt CB for fetal concern was 3.1 % (43,340 of 13,98,9740 cases) [4,5]. From time to time several hospital based studies have proved the role of various antepartum or intrapartum maternal & foetal risk factors which lead to foetal asphyxia. It is known that some disorders which could cause foetal asphyxia are obvious during pregnancy, some are labour related, be it mother or baby. Kaye reported association of primiparity, anaemia, hypertensive disorders of pregnancy, foetal growth restriction, malpresentation, antepartum haemorrhage, premature rupture of membranes, prematurity, fever, oxytocin augmentation of labour, umbilical cord prolapse, as risk factors ,with complex interplay between factors which predispose foetuses to poor outcome, due to decreased oxygenation, ACOG reported that foetal hypoxemia which if not compensated or corrected in time progressed to birth asphyxia and even death, either in utero or immediately after birth [6,7]. Gaffineet and James have reported, intrapartum hypoxia complicating around 1% of labours, resulting in foetal / neonatal deaths in 0.5/1000 pregnancies and cerebral palsy in 1 in 1000 cases diagnosed after swift delivery for clinically diagnosed “fetal distress’’ [8]. Earlier Murphy et al had suggested that reduced uterine perfusion uteroplacental vascular disease, low fetal reserve foetal asphyxia, foetal sepsis and cord compression with other gestational and antepartum factors could affect the fetal response which needed to be known. However diagnosis of FD also has to be correct and timely [9]. Cardiotocography (CTG) has been criticized for unnecessary high rate of operative delivery [10-12]. In the study by Roy, non-reassuring fetal heart rate (FHR) detected by CTG did not correlate well with neonatal outcome [13]. In the era of defensive practices, ‘play safe’ attitude results in high CS rate for non-reassuring FHR. The concept of detecting fetal acidosis, using fetal scalp blood appeared attractive, but practical difficulties in carrying it out restricted its use [14,15]. Roy et al suggested that since non-reassuring FHR detected by CTG did not correlate well with adverse neonatal outcome and resulted in unnecessary CS, fetal ECG needed to be introduced in addition to conventional CTG, wherever possible [13]. There are many such issues about timely appropriate authentic diagnosis and action.

Sign in / Sign up

Export Citation Format

Share Document