Benjamin B, Khan M R
King Saud University College of Medicine, Abha, Saudi Arabia.
J Trauma. 1993 Nov;35(5):737-41. doi: 10.1097/00005373-199311000-00015.
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.
对2222例连续住院分娩新生儿中的57例62例外部产伤（EBT）的模式及相关因素进行了研究。巨大儿、阴道助产或臀位分娩被确定为EBT的重要危险因素。与既往报道不同，帽状腱膜下出血（SGH）是主要的创伤形式（n = 33），33例中有28例（85%）与使用真空吸引器有关。臂丛神经麻痹（BPP）（n = 10）在臀位分娩后发生率最高（6.4%）。骨折并不常见。多发伤（5例婴儿共10处损伤）主要与真空吸引助产有关。高真空吸引助产率（VE）及其使用问题，包括高VE失败率（30/242 = 12.4%），被认为是本研究中EBT异常模式的促成因素。建议定期审核分娩操作，更谨慎地排除头盆不称，并合理使用VE，以降低EBT的发病率。
