Birth Injuries

Many birth injuries are not discovered by the parents because the doctors and nurses either do not know about the injury or, if they suspect an injury, do not inform the parents. Parents must be aware of common birth injuries in order to know what to look for and what questions to ask the doctors and nurses. Below is medical information and resources that cover common birth injuries. Websites that give more detail are listed for each condition.

Cerebral Palsy – Oxygen Deprivation Injury

Cerebral palsy covers a number of neurological disorders that babies suffer and appear shortly after birth or in early childhood. The conditions are permanent and can be seen in body movement and muscle coordination. They generally do not get worse over time. Even though cerebral palsy affects muscle movement, it isn’t caused by problems in the muscles or nerves.  It is caused by abnormalities in parts of the brain that control muscle movements.  The majority of children with cerebral palsy are born with it, although it may not be detected until months or years later. The early signs of cerebral palsy usually appear before a child reaches 3 years of age.  The most common are a lack of muscle coordination when performing voluntary movements (ataxia); stiff or tight muscles and exaggerated reflexes (spasticity); walking with one foot or leg dragging; walking on the toes, a crouched gait, or a “scissored” gait; and muscle tone that is either too stiff or too floppy.  A small number of children have cerebral palsy as the result of brain damage in the first few months or years of life, brain infections such as bacterial meningitis or viral encephalitis, or head injury from a motor vehicle accident, a fall, or child abuse.

Additional Cerebral Palsy Resources

CP Family Network Survival Guide
United Cerebral Palsy
National Institute of Neurological Disorders and Stroke

Brachial Plexus Injury – Erb’s Palsy – Arm, Shoulder Injury

Avulsion, Rupture, Neuroma and Stretch injuries are four types of brachial plexus injuries can can occur during delivery. Avulsion is the most severe, and stretch injuries are usually the least severe and can heal without surgery.

Erb-Duchenne (Erb’s) palsy refers to paralysis of the upper brachial plexus. Dejerine-Klumpke (Klumpke’s) palsy refers to paralysis of the lower brachial plexus. According to the American Academy of Orthopeadic Surgeons, Erb’s Palsy occurs in .1 to.2 percent of all births, while it is rare to have a true case of Klumpke’s palsy, as the condition usually occurs in a breech delivery with the baby’s arm above its head.

Erb’s palsy can usually be diagnosed when a newborn has one arm hanging straight at its side and cannot move the arm despite prodding from hospital staff.

Symptoms of Erb’s and Klumpke’s Palsy include, but may not be limited to, paralysis, atrophy and limpness of the arm, hand or wrist. Loss of sensation may also result. Over time, the damaged arm may grow smaller than the other.

Source: Legal Examiner (used with permission)

Failure To Diagnose Hip Dysplasia

Mother delivered her first child (female) which was in a breech position and required an emergency C-section. The child was not checked for hip problems. As the child grew, she had a limp and at age 5 was diagnosed with hip dysplasia, with the joint completely worn out. Are first born females born in a breech position at high risk of developing hip dysplasia?

Issue: Whether the pediatrician should have checked for hip dysplasia by sonography or otherwise in the hospital or at any time thereafter.

Standard of Care: The doctor must examine the baby’s hips at every routine visit in the first year of life.  Most cases of hip dysplasia can be diagnosed before the first birthday.  The fact that this was not discovered until 5 years of age and that the child had a limp suggest that the problem was overlooked by the pediatrician. Hip dysplasia is more common in female infants and in breech infants. Breech and being female are 2 risk factors for DDH and should have generated intense follow-up of her hips, although the 2000 AAP guidelines recommends imaging, the 2006 summary by AHRQ does not.