Common birth injuries: head injury, nerve injury, spinal injury, bone injury during difficult child birth

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What are common birth injuries?

The following are common birth injuries. Some have serious consequences:

Head Injury during Difficult Child Birth

Head Injury: In most births, the head is the first part to enter the birth canal and experiences much of the pressure during the delivery. Swelling and bruising are not serious and resolves within a few days.

--Cephalohematoma
Cephalohematoma is an area of bleeding underneath one of the cranial bones that often appears several hours after birth as a raised lump on the baby's head. The body re-absorbs the blood. Depending on the size, most cephalohematomas take two weeks to three months to disappear completely. If the area of bleeding is large, some babies may develop jaundice as the red blood cells break down.

Nerve Injury during Difficult Child Birth

Pressure to the facial nerves caused by forceps can result in weakness of the muscles on one side of the face. This injury is evident when the newborn cries and the face appears asymmetric. No treatment is needed, and the newborn usually recovers within a few weeks.

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--Brachial palsy
Brachial palsy occurs when the brachial plexus (the group of nerves that supplies the arms and hands) is injured. It is most common when there is difficulty delivering the baby's shoulder, called shoulder dystocia. The baby loses the ability to flex and rotate the arm. If the injury caused bruising and swelling around the nerves, movement should return within a few months. Tearing of the nerve may result in permanent nerve damage.

In a difficult child birth delivery of a large infant, some of the larger nerves to one or both of the newborn's arms can be stretched and injured. Weakness or paralysis of the newborn's arm or hand results. Occasionally, the nerve going to the diaphragm (the muscle that separates the organs of the chest from those of the abdomen) is damaged, resulting in paralysis of the diaphragm on the same side. In this case, the newborn may have difficulty breathing.

Some infant nerve injuries heal within a few weeks and some last a lifetime. Extreme movements at the shoulder should be avoided to allow the nerves to heal. Very rarely, the arm and possibly the diaphragm remain weak after several months. In this case, surgery may be needed to reattach torn nerves.

--Facial paralysis
During labor or birth, pressure on a baby's face may cause the facial nerve to be injured. Facial paralysis may also occur with the use of forceps for delivery. The pediatric injury is often seen when the baby cries. There is no movement on the side of the face with the injury and the eye cannot close. If the nerve was only bruised, the facial paralysis usually improves in a few weeks. If the nerve was torn, surgery may be needed.

--Damage to the spinal cord is often permanent. Injuries to the spinal cord due to overstretching during delivery are extremely rare. These injuries can result in paralysis below where the injury occurred.

Bone Injury during Difficult Child Birth

Rarely do bones break during a difficult child birth delivery. A fracture of the collarbone is most common. Bone fractures in newborns are splinted and almost always heal completely and rapidly.

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--Fractures
Fracture of the clavicle or collarbone is the most common fracture during labor and delivery. The clavicle may break when there is difficulty delivering the baby's shoulder or during a breech delivery. The baby with a fractured clavicle rarely moves the arm on the side of the break. However, healing occurs quickly. As new bone forms, a firm lump on the clavicle often develops in the first 10 days. If the fracture is painful, limiting movement of the arm and shoulder with a soft bandage or splint may be helpful.

Other Birth Injuries

--Bruising/forceps marks
Some babies may show signs of bruising on the face or head simply as a result of the trauma of passing though the birth canal and contact with the mother's pelvic bones and tissues. Forceps used with delivery can leave temporary marks or bruises on the baby's face and head. Babies delivered by vacuum extraction may have some scalp bruising or a scalp laceration (cut).

--Caput succedaneum
Caput is a severe swelling of the soft tissues of the baby's scalp that develops as the baby travels through the birth canal. Some babies have some bruising of the area. The swelling usually disappears in a few days without problems. Babies delivered by vacuum extraction are more likely to have this condition.

--Subconjunctival hemorrhage
Subconjunctival hemorrhage is the breakage of small blood vessels in the eyes of a baby. One or both of the eyes may have a bright red band around the iris. This is very common and does not cause damage to the eyes. The redness is usually absorbed in a week to ten days.

Very Serious Birth Injuries

--Erb's Palsy
Erb’s Palsy is a condition when your newborn can move one arm but not the other. The inability to move the arm may be a symptom of an injury to the brachial plexus, a network of nerves that provides movement and sensation to the arm, hand, and fingers.

--Meningitis
Meningitis is an inflammation of the membranes (meninges) and cerebrospinal fluid surrounding your brain and spinal cord, usually due to the spread of an infection. Newborns and young infants may not have the classic signs and symptoms of headache and stiff neck. Instead, they may cry constantly, seem unusually sleepy or irritable, and eat poorly. Sometimes the soft spots on an infant's head may bulge. A very late sign may be a spasm consisting of extreme hyperextension of the body.

--Respiratory Distress Syndrome (IRDS or RDS)
Infant RDS is one of the most common lung disorders in premature infants and causes increasing difficulty in breathing. Respiratory distress syndrome affects 10% of all premature infants. It rarely affects those born full-term. IRDS occurs when the lungs lack a chemical that helps them inflate with air and keeps the air sacs from collapsing.

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--Meconium Aspiration Syndrome (MAS)
Meconium is the first feces of the newborn. It is thick, sticky, and greenish-black. Aspiration means the newborn inhales a mixture of the meconium and amniotic fluid, either in the uterus or just after delivery. The possibility of inhaling meconium occurs in about 5-10% of births. It typically occurs when the fetus is stressed during labor, especially when the infant is past its due date.

The condition is serious -- meconium aspiration syndrome is a leading cause of severe illness and death in the newborn injuries.

Has your newborn suffered a debilitating injury? Don’t hesitate to contact a Pennsylvania law firm specializing in birth injuries. Contact Anapol Schwartz. This is a difficult time; let us help.

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