PP-015 Birth injuries in newborns, about 132 cases

Birth trauma (BT) is an acquired injury that results from physical pressure during childbirth, usually during delivery from the birth canal. It is a major public health problem and a determining factor in neonatal morbidity and mortality, threatening life and/or function.
To study the clinical, therapeutic and evolutionary aspects of neonatal BT.

Descriptive, retrospective study conducted in the neonatal intensive care unit of Farhat Hached Hospital of Sousse, over a period of 8 years and 3months (January 2016 - March 2024). We included all patients admitted to the unit and presented with BT. We excluded newborns with simple serosanguineous bumps.

We documented 132 cases of BT. Delivery was by vaginal route in 84% of cases, including 24.3% by forceps. Newborns were at term in 72% of cases and macrosomic (weight over 4000g) in 34%. The most common injuries were : Nerve injuries (elongation of brachial plexus, facial paralysis, diaphragm paralysis…) in 34% of cases, Bone Fracture (clavicle fracture, humerus fracture and femur fracture) in 26,5% of cases, Head injuries (cephalhematoma, skull bone fracture, bleeding in and around the brain…) in 24.2% of cases, and skin injuries (ecchymosis or hematoma…) in 15,3% of cases. The association of two or more lesions was noted in 25% of cases. Reasons for hospitalization included respiratory distress in 53% of cases, neurological distress in 28%, jaundice in 12% and hypoglycemia in 9%. The most common risk factors were advanced maternal age (56%), gestational diabetes (47%), primiparity (44%), instrumental delivery (20.4%) and dystocic presentation (12.1%). Treatment consisted of physiotherapy in 53% of cases and orthopedic treatment in 31%. The mortality rate in our series was 6%, and the cause of death was severe multivisceral failure secondary to perinatal asphyxia. The outcome was favorable with no sequelae in 89.4% of cases.

BT can be prevented by good monitoring of pregnancy and assessment of the route of delivery, to avoid worsening the health of the newborn, who is already under the stress of childbirth and environmental change. Systematic examination of the newborn at birth is a reliable way of detecting them and managing them appropriately.