title: Pattern of external birth trauma in southwestern Saudi Arabia.
abstract: The pattern and associations of 62 instances of external birth trauma (EBT) in 57 of 2222 consecutive hospital-born neonates were studied. Macrosomia and vaginal instrumental or breech delivery were identified as significant risk factors for EBT. In contrast to previous reports, subgaleal hemorrhage (SGH) was the predominant form of trauma (n = 33) and it was associated with vacuum application in 28 of 33 (85%) neonates. Brachial plexus palsy (BPP) (n = 10) occurred with the highest frequency (6.4%) after breech delivery. Fractures were uncommon. Multiple injuries (10 items in 5 babies) were mainly associated with vacuum extraction. The high rate of vacuum extraction (VE) and problems with its use including a high VE failure rate (30/242 = 12.4%) were considered contributory to the unusual pattern of EBT seen in the study. Regular audit of delivery practices, greater care in excluding cephalopelvic disproportion and judicious use of VE are recommended to reduce the morbidity from EBT.
authors.affiliation: King Saud University College of Medicine, Abha, Saudi Arabia.
authors.forename: B
authors.initials: B
authors.lastname: Benjamin
authors.forename: M R
authors.initials: MR
authors.lastname: Khan
mesh_terms: D001720:Birth Injuries / Q000453:epidemiology / Q000209:etiology*; D001724:Birth Weight; D001917:Brachial Plexus / Q000293:injuries; D006259:Craniocerebral Trauma / Q000209:etiology; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009772:Obstetrical Forceps / Q000009:adverse effects; D010243:Paralysis / Q000209:etiology; D011247:Pregnancy; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects