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Birth Injury

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What is a Birth Injury

A birth injury results from complications that develop during labor and delivery.

In some cases, birth injuries are caused by medical malpractice. Some common medical errors include:

• Failing to anticipate birth complications with a large baby
• Failure to respond appropriately to bleeding
• Failing to observe or respond to umbilical cord entrapment
• Failure to respond to fetal distress
• Delay in ordering cesarean section (c-section) when medically necessary
• Misuse of forceps or a vacuum extractor during delivery
• Inappropriate administration of Pitocin

Common Types of Birth Injuries

Cerebral palsy is an "umbrella term" in that it refers to a group of different conditions. It has been suggested that no two people with CP are alike even if they have the same diagnosis. Cerebral palsy is divided into three major classifications to describe the different movement impairments. These classifications reflect the area of brain damaged. The three classifications are: (1) Spastic; (2) Dyskinetic; and (3) Ataxic. Cerebral palsy is further classified by topography, dependent on the region of the body affected. These typography classifications include: (1) hemiplegia; (2) diplegia; (3) quadriplegia.

Cerebral palsy can occur during pregancy (~75%), at birth (~5%) or after birth (~15%). 80% of causes are unknown. For the small number where cause is known this can include infections, lack of iodine and significant head injury in very early childhood

From Wikipedia

Erb's Palsy, also known as Brachial Plexus Paralysis, is a condition which mainly due to birth trauma can affect 1 or all of the 5 primary nerves that supply the movement and feeling to an arm. The paralysis can be partial or complete; the damage to each nerve can range from bruising to tearing. Some babies recover on their own; however, some may require specialist intervention.

From Wikipedia

Dystocia (antonym eutocia) is an abnormal or difficult childbirth or labour. Dystocia may arise due to incoordinate uterine activity, abnormal fetal lie or presentation, or absolute or relative cephalopelvic disproportion. Oxytocin is commonly used to treat incoordinate uterine activity. However, pregnancies complicated by dystocia often end with assisted deliveries including forceps, ventouse or, commonly, caesarian section.

Shoulder dystocia is a specific case of this complication whereby the anterior shoulder of the infant cannot pass below the pubic symphysis, or requires significant manipulation to pass below, the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head.

A number of obstretical maneuvers are used to facilitate delivery at this point, including McRobert's maneuver; suprapubic pressure (or Rubin I); Rubin II or posterior pressure on the anterior shoulder; Woods' screw maneuver which leads to turning the anterior shoulder to the posterior and vice versa; and Jacquemier's maneuver (also called Barnum's maneuver), or delivery of the posterior shoulder. More drastic maneuvers include Zavanelli's maneuver or internal cephalic replacement followed by Cesarean section; intentional clavicular fracture, symphisiotomy, and abdominal rescue, described by O'Shaughnessy, where a hysterotomy facilitates vaginal delivery of the impacted shoulder.

Although the definition is imprecise, it occurs in approximately 1% of vaginal births. There are well-recognised risk factors, such as diabetes, fetal macrosomia, and maternal obesity, but it is often difficult to predict (Breeze and Lees, 2004). Despite appropriate obstetric management, fetal injury (such as brachial plexus injury) or even fetal death can be a complication of this obstetric emergency.

From Wikipedia

The brachial plexus is a network of nerves that conducts signals from the spine to the shoulder, arm and hand. Brachial plexus injuries are caused by damage to those nerves. Symptoms may include a limp or paralyzed arm, lack of muscle control in the arm, hand, or wrist, and lack of feeling or sensation in the arm or hand. Although injuries can occur at any time, many brachial plexus injuries happen during birth: the baby's shoulders may become impacted during the birth process causing the brachial plexus nerves to stretch or tear. There are four types of brachial plexus injuries: avulsion, the most severe type, in which the nerve is torn from the spine; rupture, in which the nerve is torn but not at the spinal attachment; neuroma, in which the nerve has tried to heal itself but scar tissue has grown around the injury, putting pressure on the injured nerve and preventing the nerve from conducting signals to the muscles; and neuropraxia or stretch, in which the nerve has been damaged but not torn. Neuropraxia is the most common type of brachial plexus injury.

From Wikipedia