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21. Birth Trauma (Overview)

below): Abrasions Erythema petechia Ecchymosis Lacerations Subcutaneous fat necrosis Location of injury in soft tissue planes on the scalp and head. Skull injuries with a favorable long-term prognosis include the following: Caput succedaneum Cephalhematoma Linear fractures Facial injuries with a favorable long-term prognosis include the following: Subconjunctival hemorrhage Retinal hemorrhage Musculoskeletal injuries with a favorable long-term prognosis include the following: Clavicular fractures (...) sampling for pH or fetal scalp electrode for fetal heart monitoring, which has a low incidence of hemorrhage, infection, or abscess at the site of sampling. Cephalhematoma Cephalhematoma is a subperiosteal collection of blood secondary to rupture of blood vessels between the skull and the periosteum; suture lines delineate its extent. Most commonly parietal, cephalhematoma may occasionally be observed over the occipital bone. The extent of hemorrhage may be severe enough to cause anemia and hypotension

2014 eMedicine Pediatrics

22. Skull Fracture (Treatment)

be made on the basis of 4 criteria [ ] : Age < 5 years with cephalhematoma Bone diastasis 4 mm or more Underlying brain contusion Contrast MRI showing dural tear and herniation of the brain matter (dural tear with herniation of the brain matter is the main etiopathogenic factor for the development of growing skull fracture) A fracture line crossing over a vascular groove, such as the middle meningeal artery, may form an epidural hematoma. [ ] Similarly, a fracture line that crosses over a suture may

2014 eMedicine Surgery

23. Skull Fracture (Follow-up)

be made on the basis of 4 criteria [ ] : Age < 5 years with cephalhematoma Bone diastasis 4 mm or more Underlying brain contusion Contrast MRI showing dural tear and herniation of the brain matter (dural tear with herniation of the brain matter is the main etiopathogenic factor for the development of growing skull fracture) A fracture line crossing over a vascular groove, such as the middle meningeal artery, may form an epidural hematoma. [ ] Similarly, a fracture line that crosses over a suture may

2014 eMedicine Surgery

24. A prospective randomized study comparing maternal and fetal effects of forceps delivery and vacuum extraction. Full Text available with Trip Pro

 % delivery rate in forceps vs. 90 % in VE); however, maternal trauma (40 % in forceps vs. 10 % in VE, p < 0.001), use of analgesia (p < 0.001), and blood loss at delivery (234 ml in VE vs. 337 ml in forceps group, p < 0.05) were significantly less in the group allocated to deliver by vacuum extraction. Vacuum extraction, however, appears to predispose to an increase in neonatal jaundice and incidence of cephalhematoma. More serious neonatal morbidity was rare in both groups.Extrapolation of the data from

2013 Journal of obstetrics and gynaecology of India Controlled trial quality: uncertain

25. Vaginal breech delivery: results of a prospective registration study. Full Text available with Trip Pro

and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar < 4. Twenty-nine in the planned vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p < 0.001) were transferred

2013 BMC Pregnancy and Childbirth

26. Neonatal hyperbilirubinemia in infants with G6PD c.563C &gt; T Variant. Full Text available with Trip Pro

of hyperbilirubinemia and the postnatal bilirubin trajectory in infants having G6PD c.563C > T.This was a case-control study conducted at The Aga Khan University, Pakistan during the year 2008. We studied 216 icteric male neonates who were re-admitted for phototherapy during the study period. No selection was exercised. Medical records showed that 32 were G6PD deficient while 184 were G6PD normal. Each infant was studied for birth weight, gestational age, age at the time of presentation, presence of cephalhematoma

2012 BMC Pediatrics

27. Birth Injuries

greater trauma and is characterized by a fluctuant mass over the entire scalp, including the temporal regions, and manifests in the first few hours after birth. This potential space under the scalp is large, and there can be significant blood loss and hemorrhagic shock, which may require a blood transfusion. A subgaleal hemorrhage may result from the use of forceps or a vacuum extractor, or may result from a coagulation disorder. Treatment of subgaleal hemorrhage is mostly supportive. Cephalhematoma (...) Cephalhematoma is hemorrhage beneath the periosteum. It can be differentiated from subgaleal hemorrhage because it is sharply limited to the area overlying a single bone, the periosteum being adherent at the sutures. Cephalhematomas are commonly unilateral and parietal. In a small percentage of neonates, there is a linear fracture of the underlying bone. The hematoma usually presents in the first few days of life and resolves over weeks. Treatment of cephalhematoma is not required, but anemia or may result

2013 Merck Manual (19th Edition)

28. Perinatal Anemia

by breakdown of sequestered blood in cephalhematomas). Hepatosplenomegaly suggests hemolysis, congenital infection, or heart failure. Hematomas, ecchymoses, or petechiae suggest bleeding diathesis. Congenital anomalies may suggest a bone marrow failure syndrome. Testing Anemia may be suspected prenatally if ultrasonography shows increased middle cerebral artery peak systolic velocity or hydrops fetalis, which, by definition, is abnormal, excessive fluid in ≥ 2 body compartments (eg, pleura, peritoneum

2013 Merck Manual (19th Edition)

29. Encephalocele

and protrude anywhere along a line from the occiput to the nasal passages but can be present asymmetrically in the frontal or parietal regions. Small encephaloceles may resemble cephalhematomas, but x-rays show a bony skull defect at their base. often occurs with encephalocele. About 50% of affected infants have other congenital anomalies. Symptoms and signs of encephalocele include the visible defect, seizures, and impaired cognition, including intellectual and developmental disability. Prognosis depends

2013 Merck Manual (19th Edition)

30. Traumatic brain injury in infants and toddlers, 0–3 years old Full Text available with Trip Pro

Traumatic brain injury in infants and toddlers, 0–3 years old Children 0-3 years old present a completely different neurotraumatic pathology. The growing and the development processes in this age group imply specific anatomical and pathophysiological features of the skull, subarachnoid space, CSF flow, and brain. Most common specific neurotraumatic entities in children 0-3 years old are cephalhematoma, subaponeurotic (subgaleal) hematoma, diastatic skull fracture, grow skull fracture (...) , and outcome. We found 72 children with diastatic skull fracture, 61 cases with depressed ('ping-pong') skull fracture, 22 cases with grow skull fracture, 11 children harboring intrusive skull fracture, 58 cephalhematomas, 26 extradural hematomas, and 7 children with severe brain injury and major posttraumatic diffuse ischemia ('black-brain'). Usually, infants and toddlers present with seizures, pallor, and rapid loss of consciousness. First choice examination, in all children was cerebral CT-scan

2011 Journal of medicine and life

31. Short stature, smoking habits and birth outcome in international adoptees in Sweden (Abstract)

with a mother born in Sweden.Register study.Pre-eclampsia, instrumental delivery, preterm delivery, small for gestational age (SGA), Apgar score, cephalhematoma and perinatal mortality and birth weight.Short stature and smoking were more common in international adoptees compared with non-adopted, odds ratios (ORs) 29.07 (95% C.I.: 25.29-33.42) and 1.39 (1.27-1.52), respectively. International adoptees had a slightly increased risk for instrumental delivery (OR: 1.42; 1.32-1.54) and preterm delivery (<37

2009 EvidenceUpdates

32. Role of Oral Sucrose in Reducing the Pain to Orogastric Tube Insertion in Preterm Neonates

: Neonates requiring ventilatory support. Neonates requiring oxygen supplementation. Having any facial congenital anomalies. Having any neurological impairment. Receiving opiates or born to mothers receiving opiates. New born babies to whom muscle relaxants, sedatives and analgesics have been administered. With grade 3 and 4 IVH. With major congenital anomalies Any history of birth trauma especially involving face or scalp (including cephalhematoma/ subgaleal bleed). Face presentation. Contacts

2009 Clinical Trials

33. Rapid versus stepwise negative pressure application for vacuum extraction assisted vaginal delivery. (Abstract)

rate, degree of perineal tears, Apgar score less than seven at one and five minutes, umbilical venous pH less than 7.2, scalp laceration greater than a quarter, cephalhematoma and number of tractions.The rapid negative pressure application for vacuum assisted vaginal birth reduces the duration of the procedure whilst there is no evidence of differences in maternal and neonatal outcome. Due to a small number of participants in the single included trial, the evidence is limited and either policy may

2008 Cochrane

34. Neonatal complications of vacuum-assisted delivery. (Abstract)

screening using transfontanellar ultrasonography and skull X-ray was performed after vacuum extraction.Among 913 successful vacuum-assisted, full-term deliveries, 25.7% were admitted to the neonatal intensive care unit. Scalp edema, cephalhematoma, and skull fracture were assessed by cranial radiography and were present in, respectively, 18.7%, 10.8%, and 5.0% of cases. Intracranial hemorrhage occurred in eight cases (0.87%). Nulliparity, a vacuum attempt at mid station, an extraction requiring more

2007 Obstetrics and Gynecology

35. Comparison of neonates born outside and inside hospitals in a children emergency unit, southwest of Nigeria. (Abstract)

less than secondary level of education and those from the lower social class were more likely to deliver outside the hospital (P < 0.05). Out-of-hospital births were significantly associated with many complications, namely, hypothermia (53.6%), perinatal asphyxia (48.5%), hemorrhage (26.5%), cephalhematoma (12.9%), prematurity (9.9%), and neonatal tetanus (4.2%). Neonatal mortality rate of 12.6% in the out-of-hospital group was significantly higher than 6.3% obtained in the hospital birth group (P

2008 Pediatric Emergency Care

36. Head injuries after instrumental vaginal deliveries. (Abstract)

of cephalhematoma comparing a sequential operative vaginal delivery and a caesarean section following a failed vacuum delivery.Instrumental vaginal deliveries carry substantial risks. Only practitioners who are adequately trained or are under supervision should undertake instrumental delivery. The mode of intervention needs to be individualized after consideration of the operator's skills and experience and the clinical circumstances.

2006 Current Opinion in Obstetrics and Gynecology

37. Maternal and neonatal effects of outlet forceps delivery compared with spontaneous vaginal delivery in term pregnancies. (Abstract)

scores, or umbilical arterial pH values between the forceps and spontaneous delivery groups. Seventeen infants in the forceps group and 16 in the control group had cephalhematoma, facial bruising, subconjunctival hemorrhage, or scalp abrasion (not significant). No neonate had fractures, nerve palsies, or intracranial hemorrhage (determined by cranial ultrasound). In the nulliparous population, significant differences were found in the use of episiotomy (93 versus 78%) and the incidence of deep

1991 Obstetrics and Gynecology Controlled trial quality: uncertain

38. A randomized trial of two vacuum extraction techniques. (Abstract)

= .97), nor did it lead to a reduction in method failures (continuous 12, intermittent nine; P = .72). The intermittent method did not appear to offer any benefit to the neonate regarding cephalhematoma formation (continuous 20, intermittent 17; P = .686) or any other measure of neonatal outcome. Maternal lacerations and episiotomy extensions were evenly distributed between the groups. Overall, the efficacy rate of the vacuum cup was 93.5% and the cephalhematoma rate was 11.5%.No differences

1997 Obstetrics and Gynecology Controlled trial quality: uncertain

39. A randomized prospective trial of the obstetric forceps versus the M-cup vacuum extractor. (Abstract)

levels (p = 0.166) was not significantly different. Forceps deliveries were associated with fewer clinically diagnosed cephalhematomas (p = 0.015) than M-cup deliveries were, but there were no differences in the number of neonates diagnosed with hyperbilirubinemia (p = 0.377) or in the number of infants treated with phototherapy (p = 0.660).The M-cup vacuum extractor cup appears to be as efficient (and faster) than the obstetric forceps but is associated with significantly more fetal cephalhematomas

1996 American journal of obstetrics and gynecology Controlled trial quality: uncertain

40. Hemophilia during pregnancy. Full Text available with Trip Pro

is the preferred test to determine the sex of the fetus and whether a male infant is affected with hemophilia. Vaginal delivery is not contraindicated and has been proven during the last two decades to be as safe as cesarean section. Vacuum extraction should be avoided to minimize risk of intracranial hemolysis and severe cephalhematoma.

2003 Canadian Family Physician

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