Birth injuries occur at the rate of approximately 2-7 per 1000 live births. The risk factors include macrosomy, prematurity, amniocentesis, cordocentesis, fetal surgical manipulations, dystocia, cephalopelvic disproportion, and the prolonged labor (Fanaroff & Hack, 1999). The most common consequences of birth injuries include blood clots, paralysis, and fracture. Neurological consequences are considered rare and are usually attributed to asphyxia.
Asphyxia is a combination of acidemia, hypoxia, and metabolic acidosis. An infant who exhibits acute neurological injury proximate to asphyxia usually has had profound metabolic or mixed academia (pH < 7) on an umbilical cord arterial blood sample, an Apgar score of 0-3 for longer than 5 min, neonatal neurological manifestations of seizures, coma, or hypotonia, and dysfunction on a multisystem level. The neurological outcome of asphyxiated infants is difficult to determine in the immediate postnatal period since the sequella are related to the period during development when the event occurred. Fetal asphyxia is associated with cerebral palsy although experts estimate that no more than 15% of cases of CP are explained by this mechanism (Goldenberg & Nelson, 1999).
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