Birth trauma: a review of 84 babies presenting at the Mount Hope Women's Hospital - abstract

ABSTRACT

A retrospective study of mechanical birth trauma at the Mount Hope Women's Hospital during the period June, 1981 to December, 1984, revealed that 84 neonates with birth trauma were admitted to the Neonatal Unit with a total of 113 birth injuries. Birth trauma occurred in 4.0 babies per 1,000 live births (LB) one injury for every 185 LB babies weighing 3,000 gm and over accounted for 71 percent of those injured. Injuries occurred regardless of the mode of delivery. The risk of birth trauma was 42 times higher in forceps delivery occurred in babies weighing 3,000 gm and over. Junior medical staff accounted for 56 percent of all birth-injured babies, all those (24) injured after forceps delivery, and 5 of 6 of those injured during breech delivery. Brachial plexus injury was the commonest single injury (31 or 27 percent). The total number of deliveries increased by 85 percent during the period 1982-84. Both the number and rate of forceps deliveries declined markedly while the number and rate of caesarian sections increased significantly over the same period. The incidence of birth trauma following caesarian section fell by about one-half from 1982 to 1984 although the absolute number of Caesarian sections performed had increased. There was a small increase in both the incidence and frequency of trauma following forceps delivery between 1981 and 1982, with a marked increase in 1983. Important risk factors predisposing to mechanical birth trauma were forceps and breech deliveries, birth weight of 3,000 gm over, and deliveries performed by junior medical staff (AU)