BIRTH INJURIES
Definition An impairment of the infant’s body or structure due to adverse
influences, which occurred at birth.
Risk factors 1
Primiparity
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Small maternal stature 
Prolonged or rapid labour
Oligohydramnios
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Malpresentation
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Assisted delivery
Macrosomia or large head
Fetal anomalies.
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Pelvic anomalies
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Cephalhematoma:subperiosteal 
haemorrhage,common site is the parietal
bones,rarely the occiput.it is limited by
the suture line.It may cause anemia and
jaundice.Linear skull fractures may
underlie a cephalhematoma(5-20%).
Resolution occurs over weeks ending
with calcification.
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NO TREATMENT
Aspiration should never be done
Subgaleal hematoma
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CT scan if N.manifestations.
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Hemorrhage under the aponeurosis of
the scalp
Hematoma may cause shock
Mortality 20%
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Investigate for bleeding disorders.
Not limited by suture lines
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n
Erbs palsy: It involves C5,C6 nerve roots, 
the limb is held limply on the side of the
body. With forearm pronated (waiter” tip
position). Grasp reflex is
present.Recovery>80%
Physical therapy should start by 7-10 days.
Chignon:edematous part of the scalp
when a vacum extractor is used.
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Facial nerve injury
The most common N. injury. 
Incidence 1.8-7.5/1000 live birth 
Etiology:Compression by sacral promontory,forceps,masses
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Central
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Peripheral N.branch injury 
Recovery by 3 weeks.Good prognosis 
DD:Con.abscence of Depressor Anguli Oris Muscle,cong. Absence of Facial ms.
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Klumpkes;paralysis:C7-8,T1 are involved, the small muscles of the hand and wrist
are affected, loss of sweating and sensation may also be seen.
Grasp reflex is absent. 
Bad prognosis 
Fracture of the clavicle 
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Most common bone injury 
Asymptomatic or features of pseudoparalysis
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A callus at 7-10 days. 
Treatment:Analgesics,Pinn the sleeve to the bed of the infant. 
Complete recovery is expected. 
Sternocleidomastoid tumor 
1-2 cm mass 

Appears at 2-3 weeks. 
Usually unilateral 
Recovery in 80% in 3-4 months by physiotherapy. 
Plastic Surgery is needed if lesion persists for 6 months. 
-Caput succidinum

Subcut.collection of fluid 
Poorly defined margins 
Crosses the midline and sutures. 
Resolves spontaneously. 
Ruptured organs
1-ruptured liver. 
2-ruptured spleen. 
3-adrenal hemorrhage.common in infants of diabetic mothers. 
all are seen due to pressure on these organs during delivery,commonly in breech
presentation.
Contributing factors:large infants,perinatal asphyxia,coagulation disorders,extreme
prematurity.
Shock. 
Abdominal mass. 
Cyanosis. 
Treatment:supportive,surgical repair,treatment of adrenal failure. 
Other injuries
Linear skull fractures. 
Subcojunctival hemorrhages&Retinal hemorrhages. 
Fractures of long bones. 
Significant birth injuries accounts for <2% of causes of death in neonates. 
Larger infants are more liable. 
Most birth traumas are self-limited. 50% are avoidable. 
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