García HJ, Peña A

Language: Spanish
References: 18
Page: 25-30
PDF size: 62.30 Kb.

ABSTRACT

Objective: our aim was to identify incidence and type of birth trauma.
Setting: Neonatology Department, General Hospital Dr. Manuel Gea González, SS, México.
Design: this was observational, descriptive, and prolective.
Patients: we studied 4033 newborns, 50 with birth trauma.
Measurements: the following variables were recorded: maternal age; prenatal control; length of labor; gestational age; birth weight; sex; delivery route; forceps use; external maneuvers for delivery; Apgar score; injury type, and condition of newborns at discharge (live or dead).
Results: median gestational age was 38 weeks, median birth weight was 2820 g, and median Apgar score at the first min was 5; 64% of newborns were male. In 46 %, delivery route was cesarean surgery and most frequent indication was acute fetal distress. Birth trauma incidence was 12.5 per 1000 live newborns. Most frequent injuries were echimosis and petechiae. Mortality was 12 %. No death was due to birth trauma.
Conclusions: birth trauma incidence where this study was carried out is still high; however, frequency of life-threatening injuries has diminished significantly, and none was found.

REFERENCES

1. Curran JS. Traumatismo durante el parto. Clin Perinatol 1981;1:111-129.

2. Faix RG, Down SM. Tratamiento inmediato del niño traumatizado. Clin Perinatol 1983;9:483-499.

3. Down SM, Faix RG. Pronóstico a largo plazo del niño con grave traumatismo fetal. Clin Perinatol 1983;10:507-520.

4. Levine M, Holroyde J, Woods J, Siddiqi T, Scott ML. Birth trauma: incidence and predisposing factors. Obstet Gynecol 1984;63:792-795.

5. Leung WC, Lam HSW, Lam HW, Lee CP. Unexpected reduction in the incidence of birth trauma and birth asphyxia related to instrumental deliveries during the study period: was this the Hawthorne effect? BJOG 2003;110:319-322.

6. Schullinger JN. Birth associated injury. Pediatr Clin North Am 1993;40:1351-1358.

7. Kaplan M, Dollberg G, Itzchaki M. Fractured long bones in a term infant delivered by cesarean section. Pediatr Radiol 1987;17:256-257.

8. Marshall W, Curci M, Dibbins A, Haddow J. Perinatal management of ventral wall defects. Obstet Gynecol 1984;64:646-654.

9. Donald R, Imarah J. Prophylactic insulin treatment of gestational diabetes, reduces the incidence of macrosomia, operative delivery and birth trauma. Am J Obstet Gynecol 1984;50:836-842.

10. Bell D, Johanson D, McLean F, Usher R. Birth asphyxia, trauma and mortality in twins has cesarean section improved, outcome. Am J Obst Gynecol 1986;54:235-239.

11. Boyd M, Usher R, McLean F, Norman B. Failed forceps. Obst Gynecol 1986;68:779-783.

12. Towner D, Castro MA, Eby-Wilkens E, Gilbert W. Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 1999; 341:1709-1714.

13. Michael J, Bergman I. Obstetrical trauma to the neonatal central and peripheral nervous system. Semin Perinatol 1982;6:89-103.

14. Hayden K, Shattuck K, Richardson J, Ahrendt D, House R, Swischuk L. Subependymal germinal matrix hemorrhage in full-term neonates. Pediatrics 1985;75:714-718.

15. Lara-Díaz VJ, López-Jara C, Silva-Cavazos MJ. Traumatismo obstétrico. Incidencia, clasificación y factores asociados. Perinatol Reprod Hum 1992; 6:10-13.

16. Ponce-de-León TMM, Hernández SMD, Ibarra VRA, Rosas SS, Valdivia BA. Frecuencia y tipo de lesiones obstétricas en neonatos nacidos en un hospital general. Rev Mex Pediatr 2000;67:161-165.

17. Guzmán SA, Panduro BG, Briceño AC. Trauma obstétrico del neonato en el hospital civil de Guadalajara. Ginecol Obstet Mex 1988; 56:82-85.

18. Minkoff H, Chervenak FA. Elective primary cesarean delivery. N Engl J Med 2003;348:946-950