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.
KeywordsDepression Lactate Respiration Brittle Noradrenalin
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- Babyn PS, Chuang SH, Daneman A, Davidson GS (1988) Sonographic evaluation of spinal cord birth trauma with pathologic correlation. Am J Roentgenol 151: 763–766Google Scholar
- Butler NR, Bonham DG (1963) Perinatal mortality. The first report of the 1958 British Perinatal Mortality Survey under the auspices of The National Birthday Trust Fund. Livingstone, Edinburgh.Google Scholar
- Dawes GS (1968) Fetal and neonatal physiology. Year Book Medical Publishers, Chicago, p 97Google Scholar
- Dunkerton MC (1989) Posterior dislocation of the shoulder associated with obstetric brachial plexus palsy. J Bone Joint Surg 71: 764–766Google Scholar
- Friedman EA, Sachtleben MR (1971) High risk labour. J Reprod Med 7: 28–32Google Scholar
- Samms-Vaughan ME, Golding J (1992) Area variation in perinatal mortality in Jamaica: Association with type of hospital services available. In: Perinatal problems of islands in relation to prevention of handicap. INSERM, Paris, pp 90–98Google Scholar
- Scottish Stillbirth and Neonatal Death Report 1989 (1990) Common Serivces Agency for the Scottish Health Service, EdinburghGoogle Scholar
- Stanley F (1984) Perinatal risk factors in the aetiology of the cerebral palsies. In: Stanley F, Alberman ED (eds) The epidemiology of the cerebral palsies. Clinics in developmental medicine No 87, SIMP, Blackwell, Oxford, pp 98–115Google Scholar
- Steer PJ (1985) Fetal distress. In: Crawford JW (ed) Risks of labour. Wiley, Chichester, pp 11–13Google Scholar
- Walker CHM (1985) Birth trauma. In: Crawford JW (ed) Risks of labour. Wiley, Chichester, pp 71–93Google Scholar
- Wigglesworth JS, Husemeyer RO (1977) Birth trauma in vaginal breech delivery. Br Med J I: 320–321Google Scholar