Types of birth injury
Obstetrics And Gynecology / / May 01, 2016
Differentiation birth trauma damage should be made taking into account the whole complex of clinical and morphological data.
Generic tumor develops in the fetal presenting part - the head, face, buttocks and limbs.The pressure on the presenting part of the fetus is less, so it developed venous congestion, edema and small hemorrhages in the subcutaneous tissue and aponeurosis.Absorbable birth after birth swelling in 1 to 2 days.Only in rare cases, prolonged circulatory disorders in the presenting part or fallen limbs cause necrosis.
Cephalohaematoma is bleeding under the periosteum flat bones of the skull.The mechanism of injury is to shift the skin together with the periosteum and vascular rupture when pressure during tangential movement of the head through the birth canal.What matters is a bleeding disorder.Blood in cephalohematoma accumulates gradually, and therefore tumor appeared during or shortly after birth, it continues to grow for 1-2 days.
Cephalohaematoma located on one or both parietal bones, rare in the occipital, frontal, even less in the temporal lobe.It can accommodate 5-150 ml of blood, the blood remains liquid for a long time.Due to the fact that the periosteum is tightly adherent to the bone in the joints, kefalogematomy borders are within the affected bone.Under cephalohematoma sometimes detect bone fracture through which to communicate with epidural hematoma.
Complications kefalogematomy - anemia, jaundice due to resorption of hemorrhage, abscess.Cephalohematoma resolve long time (months), thickening of the bone can be formed in their place.
Trauma skull bones
Trauma skull bones can be in the form of fractures, cracks, dents, tears of ligaments and joints of divergence.Localized they parietal, frontal, and occipital bones, rarely on the bones of the skull base and facial parts.Fractures often have a radial direction along the ossification center of the bone.The trauma of the skull bones found in the now rarely (less than 1% of cases of fatal birth trauma).
epidural hemorrhage formed at the cracks and fractures of the cranial vault, as well as occasionally at break of the middle meningeal artery.The dura mater is quite tightly linked with the skull bones and her blood delamination occurs with difficulty, so epidural hematoma indicative of the severity of injury.
Breaks duplikatury dura
Breaks duplikatury dura mater and the large veins and accompanying subdural hemorrhage are the most frequent types of generic skull injury.Break tentorium cerebellum is 90-93% of all fatal birth defects.It is located in the middle third of the free edge of the tentorium.The gap may be unilateral (usually left) or bilateral.Incomplete rupture concerns only the top sheet duplikatury the dura mater, a complete break is broken, the integrity of both leaflets.Subdural haemorrhage due to rupture of the cerebellum tentorium localized supratentorial, and a complete break infratentorialno in the middle and posterior cranial fossa.Subdural hemorrhage in the middle cranial fossa is also formed with infrequent breaks lower cerebral veins draining into the transverse sinus.Complete rupture may be accompanied by rupture of the transverse sinus, which is particularly strong hemorrhage, sometimes with the destruction of the cerebellum tissue.In casuistic cases this leads to pulmonary embolism, or coronary artery.
gap sickle dural sheath of the brain occurs in 2,5-8,1% of cases of fatal birth defects.It is usually not affected region sickle, and the gap has the form of a bore diameter of from 1 to 4 cm. Izlivshayasya blood located on the fornix and the upper longitudinal slit.Similarly, the location of subdural hemorrhage at break higher cerebral veins draining into the superior sagittal sinus, but in this case at the same time are available and subarachnoid hemorrhage.Break large cerebral vein (of Galen) occurs in 0.6-1% of injuries.Bleeding in the cranial cavity thus is particularly massive and subdural located in a longitudinal slot on the basis of the hemispheres, and subarachnoid and may even penetrate along the choroid plexus in the ventricles.Congenital brain aneurysm large veins contribute to its injury.
Subdural hemorrhage in most cases are the result of birth trauma.The severity of damage in this so significant that the vast death occurs intrapartum haemorrhage or shortly after birth.