Head trauma (birth trauma) during labor and delivery may result in...
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Birth trauma (Head trauma) during labor and delivery may result in newborn intracranial hemorrhages (brain bleeds) and permanent brain damage

Jan 22, 2012 @ 10:48 AM — by Jesse Reiter

In many labor and deliveries, it’s normal for a baby to have a certain amount of bruising and swelling to the head. This is typical due to the trauma exerted as the baby passes through the birth canal. In most circumstances, the symptoms disappear on their own within a few days and do not require any medical intervention.  

Sometimes, however, complications can arise during labor and delivery that result in much more trauma to the baby’s head than a normal delivery. This includes situations where labors are prolonged,  where the baby is large for its gestational age (macrosomic), where the mother has small pelvis or the baby’s head does not easily fit through the pelvis (cephalo-pelvic disproportion) or when the baby’s presentation is not normal (for example breech or face presentation). In cases such as these, it is critical for physicians and healthcare professionals to closely monitor the baby for any type of fetal distress and give informed consent about the option of C-section. If distress occurs and conventional methods are unsuccessful, an emergency C-section is required to minimize the risk of intracranial hemorrhage, and possible brain injuries.  

Unfortunately, severe head trauma in newborns can also occur from medical intervention during delivery, especially when there are delivery room errors. Incorrect use of and performance of forceps deliveries and vacuum extractions are both well-documented as causes of intracranial hemorrhages and resulting brain damage.

What is intracranial hemorrhage or brain bleeds?

An intracranial hemorrhage is simply bleeding that occurs within the skull. There are several types of intracranial hemorrhages in infants including:

  • Subarachnoid hemorrhage: probably the most common type and is where there is bleeding in the subarachnoid space – the area between the arachnoid membrane and the pia mater (protective coverings that surround the brain). This is a form of stroke and is a medical emergency that can lead to death or severe disability. Symptoms in newborns include seizures, apnea, lethargy, and abnormal neurological exams. 
  • Subdural hemorrhage or subdural hematoma: this is bleeding that is due to a rupture of one or more blood vessels that are in the subdural space (between the surface of the brain and the thin layer of tissue that separates the brain from the skull). In infants, symptoms include bulging fontanels, focal and generalized seizures, increased head circumference, lethargy, vomiting, and irritability.
  • Intraventricular hemorrhage: this is a bleeding into the brain’s ventricular system, where spinal fluid is produced. It is the most serious type of intracranial bleeding and occurs most oftenly in premature infants and infants with low birth weight.

How is intracranial bleeding in newborns diagnosed and treated?

Once the symptoms above are observed, the next step is generally brain imaging studies such as head CTs and MRIs to confirm the presence of blood within the skull. Sometimes ultrasonography and testing of cerebral spinal fluid is also done. Treatment of intracranial bleeds is mostly of a supportive nature although neurosurgical intervention may be necessary to manage subdural hematomas. The prognosis varies depending on the severity and location of the bleed. Some infants do very well with little or no residual effects. More severe bleeds can result in mental and physical impairments such as mental retardation, learning disabilities, and cerebral palsy.

Intracranial hemorrhages and resulting brain damage may result from a mismanaged labor and delivery, an error in judgment, or an error in the use of delivery equipment such as forceps or vacuums. If your child was diagnosed with any type of intracranial bleeding immediately after birth, the birth trauma attorneys at Reiter & Walsh ABC Law Centers can help. We have the knowledge and professional experience to thoroughly examine the complex medical records of your child’s case, determine whether there was an error or negligence, and help you obtain the monetary compensation your child deserves. Contact ABC Law Centers today.

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