Birth trauma of newborns: safe and effective treatment

Waiting for the birth of a child in the brightness of sensations can only be compared directly with his long-awaited birth. This moment becomes the happiest in the life of every family and fundamental for the newborn itself. After all, the future fate of the child, and then of the adult, largely depends on how the birth goes. Despite the high achievements of modern medicine, childbirth to this day remains one of the most unpredictable processes, since its course is influenced by the condition of the mother, the size and characteristics of the presentation of the fetus, the competence of the obstetric team and a number of other factors. Therefore, birth injuries remain quite common today.

What is birth trauma?

This is a mechanical effect that leads to disruption of the integrity of the organs and tissues of the newborn during childbirth.

The diagnosis of birth injury is made by taking into account the mother’s obstetric history, the characteristics of the course of labor, examination data and a number of additional studies of the baby (ultrasound, radiography, electroencephalography).

Childbirth traumatism has a broad classification: mechanical damage that occurs due to external negative influence, and hypoxic damage due to oxygen starvation of tissues. It can be spontaneous, or caused by the action of obstetricians and gynecologists.

If we talk about injuries, the classification is as follows:

Damage to the central nervous system (CNS) is often determined not only by mechanical impact, but also by associated acute fetal hypoxia. May be accompanied by injuries to the bones of the skull and dura mater (intracranial): • epidural hemorrhages or cephalohematomas are localized between the bone and periosteum; • subdural – between the dura and pia maters; • rupture of the tentorium cerebellum, which forms during delivery in the breech presentation; • subarachnoid hemorrhages are localized between the thin, arachnoid membrane and the cerebral hemispheres.

The most severe injury is cerebral hemorrhage. Of these, hemorrhages around the ventricles of the brain or directly into the ventricles have an unfavorable prognosis. Such injury is facilitated by the prematurity of children, the immaturity of the nervous system and its high sensitivity to hypoxia.

Damage to the peripheral nervous system The most common among them is damage to the brachial plexus, leading to partial or complete paresis of the child’s arm. Often combined with a clavicle fracture. The cause of this birth injury is the baby's shoulders getting stuck in the pelvic outlet and improper delivery by the medical staff.

Birth injury to the spinal cord of a newborn - hemorrhage into the epidural tissue and paralysis of the thoraco-abdominal diaphragm are now extremely rare. In connection with modern gentle management of childbirth.

Damage to the child's musculoskeletal system

The most common is a clavicle fracture. By applying a special bandage, a quick recovery can be achieved. Fractures of the humerus and femur are injuries from old obstetrics textbooks.

Birth trauma, which only osteopaths can see, includes a block of the occipital bone and the first 2 cervical vertebrae, subluxation of the upper cervical vertebrae. With these “hidden” minor pathologies, pronounced asymmetry of the baby’s body tone and malocclusion may develop.

Damage to a child's soft tissues

These include muscle hemorrhages and skin abrasions.

The most significant of them is hemorrhages in the sternocleidomastoid muscle, which in the future can give a picture of false torticollis.

Treatment at Doctor Simkin's Clinic

In our clinic, therapy is aimed at eliminating the causes and unwanted symptoms of birth trauma. The main role in the mechanism of development of such consequences is played by anatomical and physiological disorders in the functioning of the body.

Treatment of birth trauma involves a complex effect on the child’s body. The goal of the course of therapy is not only to get rid of symptoms, but also to find the root cause of pathological changes. Only in this case is it possible to achieve the goals set and restore the child’s lost health.

What does a doctor do

The first stage of work is to examine the child and identify deviations from the norm. They can be caused by both anatomical changes and failures in the coordinated functioning of organ systems. The doctor identifies the most significant areas of osteopathic damage. After the examination, the second stage begins - the use of osteopathic techniques to eliminate the identified problems. An osteopathic doctor influences damaged structures through gentle external influence with his hands.

A child’s body is not yet a formed system. Its work can be compared to a complex mechanism. The cause of a violation of any function is not always associated with a specific part in the violation zone; it is often caused by damage in another area or a failure in the interaction between parts of the whole. The human body also works on this principle.

By influencing certain areas of the body with the help of hands, the doctor corrects pathological changes not only at the site of impact, but also in remote areas of the body. Eliminating tension in muscles and connective tissue leads to improved blood supply to tissues and nerve function. At the same time, existing problems are eliminated and the body’s functioning is “tuned” to a natural physiological way.

When to seek help from an osteopath

It is recommended to visit a doctor after discharge from the hospital, even if the birth proceeded without visible complications. The sooner the child is examined by an osteopath and any changes in the functioning of the body are identified, the easier they are to correct.

This statement is especially true with regard to damage to the skeletal system. Injuries to the head and neck during childbirth are common and easier to correct in infancy, when the child’s bones, ligaments and soft tissues are more pliable and sensitive to external influences, and also before the chain of disorders caused by birth trauma has not gone too far. It is better to carry out a course of osteopathic procedures before the child begins to actively move (6-7 months) in order to avoid the progression of existing pathologies.

What are the reasons?

As the fetus develops, the world in which it grew, lived and existed becomes cramped, squeezing and at a certain moment pushes, spews into the unknown. And these “doors”, that is, the birth canal, do not always open easily - this is what causes damage.

It is very difficult to predict the course of labor. Even the calmest process of the birth of a baby has an impact on its body: the body is under pressure, and it takes enormous effort to be born.

There are many prerequisites for birth trauma: a woman’s lifestyle, characteristics of pregnancy, past infections, exacerbation of diseases, fetal development abnormalities, discrepancy between the size of the baby’s head and the mother’s pelvis. Circumstances such as the tactics of medical personnel, the administration of drugs that stimulate labor, and the method of delivery are important.

Analysis of the causes of birth trauma in newborns allows us to identify 3 groups of predisposing factors . Some authors note that they are also immediate causes.

Associated with the woman’s condition: • complications of the second half of pregnancy, for example, gestosis; • pathologies of the uterus, for example, kinks, etc.; • narrow pelvis; • post-term pregnancy; • maternal age: the likelihood of complications in the form of birth trauma in babies is higher in very young mothers - up to 18 years old, as well as already “aged” - after 30 years, if we are talking about repeated births - then after 35 years; • characteristics of work and health, bad habits.

Related to the condition of the fetus: • if the fetus is not positioned correctly in utero; • if large (although this factor depends not only on it); • lack of water; • umbilical cord entanglement; • prematurity; • asphyxia during intrauterine development and childbirth; • incorrect positioning of the fetal head as it passes through the birth canal.

With the course of the birth process: • if labor is rapid or, conversely, protracted; • discoordination of uterine contractions and their features, for example, weak or, conversely, too violent; • excessive use of oxytocin in case of weak labor; • the use of obstetric forceps (which are now practically not used in obstetrics); • vacuum extraction of the fetus; • caesarean section (difficulty in removing the baby); • Kristeller's maneuver is prohibited, but is still used in obstetrics. The doctor presses on the fundus of the uterus, helping her push out the baby. But, often, it simply “squeezes out” the child.

The likelihood of fatal consequences is higher when several factors are combined.

How is childbirth normal?

Normally, during natural childbirth, the fetus leaves the uterus through the narrow cervical canal, and then the vagina, head first, paving the way for the body. Literally, the child must squeeze through a “tunnel” that does not suit his parameters, in which enormous pressure is exerted on him from all sides.

Since this is how nature intended the process of childbirth in humans, it provided a mechanism that allows the child to pass all tests without damage. All bones of the fetal skull remain unconnected. Therefore, when passing through the birth canal, they can shift without breaking, and after leaving the mother’s womb, they can gradually restore their normal position. In addition, the entire body of the fetus is built in such a way that its proportions allow it to overcome all the difficulties of birth without damage. But, unfortunately, not everything always goes as nature intended.

Symptoms of injuries

A newborn, unlike an adult, has pliable bones, because some of them consist of almost half of cartilaginous tissue. What is it for? First of all, to be able to pass through the birth canal, so that the main support of the small body can withstand the loads during childbirth.

For example: the occipital bone is formed by 4 separate bones, which are connected by cartilage, and their complete fusion occurs only by the age of 7. This provides space for the baby's growing brain, as well as adaptation to changes in atmospheric pressure during childbirth, etc.

There is danger hidden in this adaptation mechanism. If something goes wrong, there is a high risk of birth injury. Every child is at risk. Symptoms depend on what kind of injury the baby received.

In case of soft tissue injury, abrasions, scratches, etc. are considered the most common. Diagnosis is carried out during a visual examination of the baby by a neonatologist. As a rule, they are not dangerous, rarely cause complications and require only local treatment. There are also more serious ones, which occur when the fetus is in an unnatural position and are accompanied by swelling and pain.

Other, more complex injuries include:

• Birth tumor – swelling with pinpoint hemorrhages in the parieto-occipital region of the head. Symptoms develop as they pass through the birth canal and disappear within 1–4 days. • Cephalohematoma – hemorrhage in the area of the skull bones. This is a dense, elastic hematoma, but painless.

In case of injury to the musculoskeletal system, the most common are injuries to the collarbone and limbs, and these problems are classified as obstetric birth trauma.

Fractures without displacement are not diagnosed immediately, but only after a while when characteristic symptoms appear: dense swelling, indicating the formation of a callus. And this is a signal for parents, a reason to visit a doctor and rule out injury.

Symptoms of displaced fractures will be: • lack of active movements; • intense, hysterical crying, which is explained by severe pain; • swelling in the area of the fracture.

With such an injury, there is a decrease in basic reflexes, depression of tone and the development of torticollis.

In case of injury to internal organs They arise as a result of a negative external impact on the fetus as a result of a pathological birth process. External signs in newborns appear only after 3 or more days; most often, hemorrhages are detected in the liver and adrenal glands. But as soon as the hematomas rupture, the following symptoms appear: • repeated vomiting; • muscle hypertonicity; • inhibition of some reflexes; • lowering blood pressure, etc.

In case of trauma to the nervous system The concept of birth injury of the spinal cord in newborns includes: hemorrhages, stretching, compression or even rupture at different levels, damage to roots, plexuses, spinal and cranial nerves. Such consequences are associated with various symptoms and are quite serious, but they directly depend on the diagnosis: • decreased muscle tone; • absence of one or more reflexes; • weak cry at birth; • unnatural act of breathing; • paresis or paralysis, etc.

For mild injuries of the central or peripheral nervous system, the prognosis is favorable, although many of them are accompanied by changes in normal muscle tone, inhibition of reflexes and basic motor reactions.

With intracranial birth trauma, for example, hemorrhages, extremely severe symptoms develop, but they depend on the location of the hematoma.

Common signs include: • sudden and sharp deterioration in the condition of children; • change in cry, sounds similar to meowing and moaning appear; • abnormal movements; • thermoregulation disorders; • suppression of reflexes, up to complete absence; • violation of the act of sucking and swallowing; • attacks of suffocation; • tremors and convulsions; • pathological regurgitation and vomiting; • anemia.

If cerebral edema or hematoma increases, death is possible.

Diagnostics

A neck injury in a baby can be detected after birth. It is worth considering some signs:

redness and swelling of the neck;
the neck looks either very short or very long;
muscle spasms appear on the back of the head or neck;
irregularities of the cervical spine.

Symptoms that are difficult to notice right away:

the body and limbs of the newborn are very relaxed;
the baby breathes heavily and hoarsely, groans;
the appearance of a blue tint in the nose area;
nervousness in the behavior of the newborn, disturbed sleep and constant crying;
difficult to agree to feeding, constant regurgitation;
cardiac arrhythmia.

It is important to correctly and timely diagnose natal trauma

These signs indicate natal damage to the cervical spine. For accurate diagnosis, it is worth using ultrasound and X-ray examination, Dopplerography. As a result, information about blood flow in the head and neck area is obtained. After the examination, you can find out where birth injuries are located and how severe they are.

Hidden symptoms

With complex and serious birth injuries, the symptoms are more than obvious, and there are no problems with diagnosis. But there are also hidden symptoms, when they appear you need to enlist the support of a good specialist and begin treatment.

Doctors at the Quality of Life clinic will help not only to promptly recognize birth trauma, but will also prescribe comprehensive treatment for newborns, which will help get rid of the consequences without complications, and in most cases, medications. But the main thing is a timely visit to an osteopath.

Signs of a hidden birth injury will be: • crying that appears when lying on your back, for example, during sleep, changing a diaper, etc.; • the baby categorically refuses to lie on his stomach, and attempts to raise his head are accompanied by crying; • does not hold his head in an upright position by 1.5 months; • it seems that the neck is pulled into the shoulders; • the baby throws his head back while lying on his back; • the child's head is tilted to one side and the hair is not worn in the middle of the back of the head; • the baby falls asleep only with his head buried in the hard side of the bed; • symptoms of intestinal colic are prolonged; • frequent and profuse regurgitation (literally like a fountain), monthly weight gain is not normal; • the large fontanel closes quickly; • there are signs of psychomotor development disorders; • if during a complex of revival (reaction to communication) one side of the body noticeably predominates in movement, for example, the right arm and leg are more active in comparison with the left, or the legs move actively, but the arms do not. • does not take the breast well, sucking activity is reduced, which affects weight gain, as well as the condition of the mother’s breasts (cracked nipples, etc.).

Doctors at the Quality of Life clinic remind us that the first year of children’s lives is the most important; it is during this time that health is created. And almost anything can be fixed, sometimes without drugs.

Consequences of birth trauma

The consequences and complications of injuries can be more than serious: severe neurological disorders (cerebral palsy), mental retardation, and in complex cases, disability and even death can occur.

By the way, the early signs of cerebral palsy will be: hypotonicity of the muscles, the baby does not hold his head up, and practically does not roar; by 1.5 months, the grasping reflex and the revival complex are absent.

Doctors at the Quality of Life clinic understand well that all emerging diseases are not spontaneous. In the overwhelming majority of cases, they are natural stages in the development of a single pathological process, which begins in newborns and is often associated with birth trauma.

These initial deformations gradually take root, leading to even greater problems that only get worse over time.

The consequences of birth trauma also affect psychological health, and this is where fears, complexes, depression and anxiety are formed. Therefore, only by taking timely measures, visiting a doctor who can identify non-obvious symptoms that hide the injury, and starting a complex of treatment, can you overcome the consequences of birth trauma and ensure a healthy life for your children.

Signs

Symptoms of birth trauma largely depend on the type of injury and severity. For soft tissue injuries, the main signs are: swelling, pain and hematomas at the site of injury. In the case of fractures, visible skeletal deformation and dysfunction of the injured limb may occur.

Neck and head injuries have the most severe manifestations. In the case of hemorrhage and ischemia, symptoms appear immediately after childbirth in the form of impaired consciousness, breathing, blood circulation and neurological deficit corresponding to the site of injury (paralysis of a certain muscle group, impaired swallowing, changes in muscle tone and reflexes). With subluxations and fractures, compression of the nerve fibers occurs, which cannot always be determined in the early postpartum period.

After discharge from the hospital, symptoms begin to appear in the form of lethargy and atonicity of the muscles, lack of sensitivity when touching the child, or, conversely, increased tone of the muscles of the neck or limbs. At a later date, muscle dystrophy occurs due to motor disorders, constant pain, inability to hold the head, stand and walk.

Injuries to the spine and skull often lead to retardation in mental and physical development, cerebral palsy and neuropathies.

Treatment tactics

Eliminating the consequences of birth trauma always requires an integrated approach. If we are talking about complex injuries, then in addition to drug therapy, possibly surgical treatment, the care and love of parents, the work of an osteopath, physical therapy methods, manual techniques and massage play a big role.

In case of birth injuries, the main task of the osteopath is to normalize the “breathing” and “nutrition” of the brain, which is carried out by “releasing” the sutures of the skull, as well as the connection of the occipital bone and the first cervical vertebra. When working with soft osteopathic techniques, metabolic processes and blood supply are normalized, which ensures “breathing” and “nutrition” of the brain.

The sooner the baby is in the “seeing” hands of an osteopath, the greater the likelihood that the consequences will be reversed. And with active treatment, it will be possible to at least smooth out the consequences.

Treatment of birth trauma by an osteopath allows you to restore the position of the skull bones, and this effect is without pain, stress and “twisting”, but most importantly, it is possible to avoid taking medications. After all, the body has reserve forces for self-healing; the main thing is to set the vector of movement. An integrated approach involves the participation of a movement specialist – a physical therapy doctor. Depending on the type of birth injury received and the condition of the toddler, an individual set of exercises is developed and techniques are selected: Vojta therapy, activation of the motor zones of the brain, through reflexogenic zones of the body, etc.

Can a C-section prevent injury?

Cesarean delivery rarely results in cervical trauma. At first glance, it may seem that unnatural childbirth is a cure for trauma, but this is not entirely true. Injuries during caesarean section can occur due to the following reasons:

Caesarean sections are not performed on women in excellent health;
not prescribed to women who can easily give birth on their own.

It is a mistake to believe that a cesarean section can help avoid problems with a newborn’s cervical spine.

A caesarean section is prescribed in cases where a threat to the baby’s life is detected. Even at the time of surgery, the fetus is subjected to mechanical stress. To extract the baby, an incision is made in the uterus measuring 25 cm in length, despite the fact that the baby's shoulders reach approximately 35 cm or more. As a result, obstetricians must deliver the newborn using their own efforts. When the fetus moves through the birth canal of the mother, all its organs, including the lungs and heart, automatically work in the body. If the child is removed through surgery, such processes do not occur. Therefore, obstetricians start the functioning of organs through other methods that can affect the baby’s nervous system.

According to statistics, a caesarean section is considered as dangerous as a natural birth. In many cases, babies born this way are diagnosed with skull trauma, displacement of the vertebrae in the neck and blood flow into the eyeball. Therefore, it can be argued that it is almost impossible to avoid birth damage with surgical intervention.

Prevention and prognosis for trauma

The prognosis directly depends on the type of birth injury received, its severity and, of course, the measures taken.

It is possible to completely avoid the consequences of injuries in 70-80% of cases, but only with timely treatment. Although echoes are possible: anxiety, headaches, poor sleep, prolonged colic.

In case of serious injuries in combination with late provision of assistance, or if it turns out to be unqualified, then more serious consequences are possible: cerebral palsy, epilepsy, developmental delays of varying severity, etc.

If we talk about preventive measures, these include: • competent management of pregnancy; • assessment of factors that can lead to injury: related to intrauterine development of the fetus, maternal history; • formation of a serious attitude of the mother towards pregnancy; • caring attitude towards mothers and children during childbirth, prevention of unnecessary obstetric intervention and refusal of caesarean section without indications; • examination of the baby to exclude possible injury and careful attention to developing symptoms over time.

Birth trauma can come back to haunt you after a period of time - months or even years - and can remain with you for the rest of your life. But you need to choose a specialist carefully and with all seriousness, because the health and full life of the baby depends on the actions of the doctor.

At the Quality of Life clinic, appointments are conducted by specialists with many years of experience in osteopathy, physical therapy and, of course, working with children. An integrated approach is a guarantee of success and absence of complications.

How does it manifest?

A birth injury to the cervical spine in a young patient can be noticed immediately after birth. The first signs of injury include: the appearance of swelling and redness in the neck, a too short or too long neck, excessive tension in the muscle tissue and at the back of the head, while the neck itself is in an injured state.

In addition to noticeable symptoms, signs of damage include relaxation of the whole body, although it is normal for the baby to develop hypertonicity after a month of life. The baby’s breathing process is complicated; groans, hoarseness and other extraneous sounds may occur. The nose area may become blue.

Birth trauma can manifest itself in different ways - it all depends on the type of damage

The baby may notice excessive anxiety, constant tearfulness, night cries, poor sleep, reluctance to breastfeed, and regular regurgitation. In some cases, a heart rhythm disturbance is detected. The diagnosis of natal neck injury can only be made after a complete detailed examination of the newborn. Ultrasound, radiography and Doppler ultrasound are performed. After the examination, an accurate diagnosis can be made, the degree of injury, the level of severity and the nature of the lesion can be determined.