The effect of birth-weight and instrumental delivery on neonatal birth trauma in Ethiopia: systematic review and meta-analysis

Birth trauma is one of the most common causes of neonatal mortality in a resource-limited country. However, there is no national evidence on the magnitude and associated factors of neonatal birth trauma in Ethiopia. Therefore, this study aimed to estimate pooled prevalence of neonatal birth trauma and its association with birth-weight and instrumental delivery in the Ethiopian context. PubMed, Scopus, CINAHIL, Cochrane library and Google Scholar were used to search significant articles. Suitable search terms were developed and used to retrieve studies from databases. Searching was limited to cohort, cross-sectional, and case-control studies conducted in Ethiopia and published in English language. Critical appraisal was conducted by using Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Heterogeneity across the included studies was evaluated by using the inconsistency index (I2) test. STATA™ version 11 software was used to conduct the meta-analysis. A total of 7 studies with 4063 study participants were included in this systematic review and meta-analysis. The overall pooled prevalence of neonatal birth trauma in Ethiopia was 13.4% (95% CI; (10.86, 15.95). instrumental delivery and ABO large birth weight were significantly associated with the prevalence of neonatal birth trauma. The national pooled prevalence of neonatal birth trauma was found to be high in Ethiopia. Instrumental delivery and large birth-weight were significantly associated with neonatal birth trauma in Ethiopia. Thus, it is better to give strong obstetric care during the use instrumental delivery.

Hematoma de la vaina de los rectos en un recién nacido macrosómico después de un parto distócico: A propósito de un caso / Rectus sheath hematoma in a macrosomie neonate following difficult delivery: Case report

La macrosomía es un factor de riesgo de traumatismos obstétricos y se asocia con morbimortalidad neonatal. El cefalohematoma y la fractura clavicular son los más frecuentes. Los traumatismos intrabdominales son poco frecuentes. El hematoma de la vaina de los rectos es una acumulación de sangre en la vaina del músculo recto mayor del abdomen. Se asocia con traumatismos, cirugías y tratamiento anticoagulante, en especial en los adultos y las personas de edad avanzada. En este artículo presentamos el caso de un recién nacido de sexo masculino con parto vaginal distócico. Durante el examen físico se observó un hematoma periumbilical de 1 x 1 cm y un cefalohematoma parietal de 1 x 1 cm. En la ecografía abdominal y la tomografía computada del abdomen se observó un hematoma de la vaina del recto derecho de 7 x 4 x 2 cm.

Macrosomia is a risk factor for birth injuries and is associated with neonatal morbidity and mortality. Cephalohematoma and clavicular fracture are the most frequent birth injuries. Intraabdominal injuries are uncommon birth injuries. Rectus sheath hematoma (RSH) is an accumulation of blood in the sheath of rectus abdominis muscle. It is associated with trauma, operations and anticoagulant therapy, especially in adults and elders. We present a macrosomic male neonate with difficult vaginal delivery, who had in the physical examination periumblical ecchymose of 1x1 cm and a parietal cephalohametoma of 1x1 cm. The abdominal ultrasonogram and the computed tomography scan of the abdomen showed a 7x4x2 cm right rectus sheath hematoma.

Neurodevelopmental Prognostic Factors in 73 Neonates with the Birth Head Injury / 대한신경손상학회지

OBJECTIVE: The objective of this study was to reinterpret the neurodevelopmental prognostic factors that are associated with birth head injury by performing a long-term follow-up. METHODS: Seventy-three neonates with head injuries were retrospectively analyzed after a duration of 10.0±7.3 years to determine the correlations between perinatal factors, including gender, head circumference, gestational age, body weight, and mode of delivery, and head injury factors from radiologic imaging with social, fine motor, language, and motor developmental quotients. RESULTS: There was a statistically significant difference between perinatal factors and head injury factors with respect to head circumference, body weight, gestational age, mode of delivery, Apgar scores at 1 min, cephalohematoma, subdural hemorrhage, subarachnoid hemorrhage, and hypoxic injury, but no direct correlation by regression analysis was observed between perinatal factors and developmental quotients. Of the head injury factors, falx hemorrhage showed a significant indirect relationship with the language and motor developmental quotients. Mode of delivery, subgaleal hematoma, cephalohematoma, greenstick skull fracture, epidural hemorrhage (EDH), tentorial hemorrhage, brain swelling, and hypoxic injury showed an indirect relationship with social development. CONCLUSION: In terms of perinatal factors and head injury factors, mode of delivery, subgaleal hematoma, cephalohematoma, greenstick skull fracture, EDH, tentorial hemorrhage, falx hemorrhage, brain swelling, and hypoxic injury displayed an indirect relationship with long-term development, and therefore these factors require particular attention for perinatal care.

Usefulness of Neuroimaging Study in Cephalohematoma of Newborn / 대한주산의학회잡지

PURPOSE: Cephalohematoma is a common birth injury that is absorbed spontaneously at most of the time. However, it sometimes can be accompanied with severe intracranial lesion which may ultimately lead to death. The aim of this study is to know when the CT and/or MRI study is useful by analyzing the risk factors for intracranial lesion associated with cephalohematoma in newborn. METHODS: From January 2006 to December 2010, 162 infants diagnosed with cephalohematoma were studied retrospectively. We examined the demographic and clinical data, and also examined the reasons for neuroimaging studies with CT/MRI findings. The risk factors for intracranial lesion associated with cephalohematoma were analyzed by uni- and multivariate analysis as well. RESULTS: Among 162 patients, many were groups of normal birth weight, first-born, singlet or vaginally delivered newborns. Of these patients, 13.6% had neurologic symptoms, 4.1% had other birth injuries, and 1.2% died with associated intracranial lesion. Parietal region was the commonest site and most were greater than 3 cm in diameter. Simple skull X-ray was performed in 56.8% and CT/MRI in 28.4%. Giant hematoma and neurologic symptom were the two common reasons for requesting CT/MRI. Intracranial lesions such as hemorrhage, hypoxic-ischemic encephalopathy, and infarction were shown in almost two thirds of patients who performed CT/MRI. Multivariate analysis showed that significant risk factors were being first-born, having large size hematoma (> or = 5 cm) or having seizure. CONCLUSION: CT and/or MRI is recommended in cephalohematoma of newborn, especially for first-born baby with large size hematoma (> or = 5 cm) or seizure.