Fri

10

May

2013

Definition of birth injuries to babies

Birth injuries to new-borns are fortunately extremely rare, but even a forceps delivery may cause some trauma such as bruising or a head/brain injury if care is not taken by medical staff. More serious birth injuries involving brain injury can occur if the baby is starved of oxygen during delivery. This can happen if a delivery is delayed, an emergency Caesarean does not take place when needed urgently – or the umbilical cord is wrapped round the baby’s neck at birth and starves the baby of oxygen for a period of time.

 

The Apgar score test is used to test a baby’s appearance, breathing and reflexes one minute after birth and again five minutes after birth. It is also performed 10 minutes after birth if the initial scores cause concern. A score of around five might indicate your baby needs a little support such as help with breathing and this would be usual if a baby were premature or of low birth weight.


There are recognised birth injuries, however, among new-borns and sometimes these result in personal injury claims if the injury could have been avoided or occurred as the result of medical negligence.


Some widely accepted birth injuries include:

  • ·         Asphyxia (lack of oxygen)
  • ·         Bell’s palsy (injury to facial nerve causing drop in features on one side of the face – usually heals itself)
  • ·         Cerebral palsy (brain injury causing movement dysfunction, epilepsy and hearing or visual problems)
  • ·         Head or facial injuries (eg after forceps delivery)
  • ·         Nerve damage
  • Bone fractures
  • Brachial plexus injury (damage to nerves operating shoulders, hands and arms)
  • Caput succedaneum (swollen head tissues)
  • Cephalhaematoma (bleeding between the skull and periosteum which usually heals itself )
  • Cranial nerve injury (damage to one of the12 cranial nerves – usually the facial nerve causing asymmetrical facial reactions and movements)
  • Intracranial haemorrhage (bleeding round the brain caused by traumatic birth eg if baby is too large or delivery to a first-time mother)
  • Neck injury
  • Peripheral nerve damage (nerve damage which extends to surrounding tissues)
  • Spinal cord injury (from minor to severe cases leading to paralysis or partial paralysis or movement problems)
  • Sternocleidomastoid haematoma (also known as congenital torticollis, baby’s head is twisted round to one side during delivery)
  • Subaponeurotic haemorrhage (serious brain haemorrhage requiring urgent blood transfusion)
  • Subgaleal haematoma (swollen head tissues and blood clots after vacuum suction delivery).

 

Birth injuries can occur in a wide range of circumstances – and not all of them may be the result of medical negligence.

Breech births – when the baby is in the wrong position – can be rectified before delivery, but sometimes babies may just turn themselves round again. Breech babies are sometimes the result of a twin conception when only one twin survives the pregnancy and the other may fail to develop at an early stage of gestation – as many as one in 8-10 single births are thought to have started as twins. Turning baby in breech position can also mean that care needs to be taken to ensure that the umbilical cord does not become wrapped round the baby’s neck and impair breathing.


Births involving first-time mothers or mothers giving birth to large babies – or who need an emergency Caesarean – may also result in some degree of birth injury. Many birth injuries rectify themselves and are a case of bruising or minor grazes or cuts during assisted births, when forceps or vacuum extraction (VE) is required to help the delivery along, especially if the baby is in distress.


In the case of cerebral palsy, the symptoms of birth injury may not become evident for a few months after the event – and if the Apgar score was reasonable or no incidence of medical negligence can be pinpointed, then it can be very difficult to assess how the birth injury occurred.


The most commonly heard of cases involving birth injury usually relate to oxygen deprivation during birth, or at some stage during pregnancy if the mother has undergone surgery during pregnancy and was herself deprived of oxygen. This is a common cause of cerebral palsy being diagnosed shortly after birth – and the difficulties a child with severe disability as a result of brain injury or cerebral palsy may face means that compensation cases can become extremely involved.


Birth injuries may simply be caused by circumstances, however – the size and shape of a woman’s pelvic area, combined with the size of her baby and intervention by the supervising medical team can all combine to result in minor injury to a bay during delivery. Emergency Caesareans can cause injury both to mother and baby if an incision is not carefully placed or the baby is lying awkwardly in the womb. However, small nicks and grazes usually heal well and good infection control can prevent postnatal complications in mothers and babies.

 

 

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