Intrapartum Asphyxia and Birth Trauma
There has been a commendable reduction in intrapartum and neonatal deaths associated with birth trauma and asphyxia during the last 40 years. Any death related to intrapartum insult deserves attention. Necropsy and clinical management should be carefully reviewed to identify any avoidable factors. It is particularly important that a good obstetric and neonatal history is available in these cases before necropsy is begun, so that evidence of asphyxia or trauma is not overlooked. A history of intrapartum death or a description of intrapartum difficulties will not be found in all cases. The pathologist should be aware that pallor, shock, hypotonia and difficulty in initiating or maintaining respiration at birth may be the result of intrapartum asphyxia or trauma. These signs do not specifically imply intrapartum insult and may be the presenting features of some major malformations, particularly those accompanied by pulmonary hypoplasia (see Table 17.1, p. 415), congenital heart disease or infection.
KeywordsObstet Gynecol Birth Asphyxia Breech Presentation Fetal Head Instrumental Delivery
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