Prepared by :

Ayda khader

oct oct

20152015

Fractures are rare, the most commonly affected bones are:

clavicle, humerus, femur skull

With all such fractures, a ‘crack’ may be heard during the birth.

clavicle fracture the most frequently bone injure

in the neonate during birth and most often is an unpredictable unavoidable complication of normal birth .

The infant may present with pseudoparalysis .

Fractures can occur with shoulder dystocia or a vaginal breech birth, or if the baby is macrosomic.

The affected clavicle is usually the one that was nearest the maternal symphysis pubis.

Brachial plexus and phrenic nerve injuries should be excluded in the affected baby.

HumerusMidshaft fractures can occur if with shoulder dystocia or during a vaginal breech birth the extended arm is forced down and born.

FemurMidshaft fractures can occur during vaginal breech birth if the extended legs are forced down and born.

bone.

An X-ray examination can usually confirm the diagnosis.

The baby requires careful handling to avoid further pain, and mild analgesia, such as paracetamol may be required

Fractures of the clavicle require no specific treatment.

To immobilize a fractured humerus, place a pad in the axilla and firmly splint the arm with the elbow bent across the chest with a bandage, ensuring respirations are not embarrassed.

Immobilize a fractured femur using a splint and bandage

union of a fractured clavicle usually occurs in 7–10 days, while the humerus and femur take 2–3 weeks.

Skullrare, these fractures, linear or depressed may occur during prolonged or difficult instrumental births. There may be no signs but an overlying cephalhaematoma, or signs of associated complications such as intracranial haemorrhage or neurological disturbances, may suggest a fracture's presence. X-ray examination can confirm the fractureskull fractures usually heal quickly with no sequelae

Convulsionsseizure/fit is a sign of neurological disturbance, not a disease, and is a medical emergencyconvulsions present quite differently in the neonateAbnormal, sudden or repetitive movements of any part of the body that are not controlled by repositioning or containment holds

:classify the convulsion as Subtle convulsions found in term and pre-term babiesFocal tonic convulsions are more common in pre-term babies and there is extension or flexion of a limb, asymmetric postures of the body or neckgeneralized tonic convulsions the baby sustains a rigid posture that is not usually detected on EEG.clonic convulsions as focal or generalized more common in term babies Myoclonic convulsions are the least common and affect term and pre-term babies

causes of neonatal convulsions

Central nervous systemIntracranial haemorrhageIntracerebral haemorrhageHypoxic-ischaemic encephalopathyKernicterusCongenital abnormalities

MetabolicAcquired disorders of metabolismHypo- and hyperglycaemiaHypo- and hypercalcaemiaHypo- and hypernatraemiaInborn errors of metabolism

OtherHypoxiaCongenital infectionsSevere postnatally acquired infectionsNeonatal abstinence syndromeHyperthermia

Immediate treatment necessitates obtaining assistance from a doctor

ensuring that the baby has a clear airway and adequate ventilation

Gentle oral and nasal suction may be required to remove any milk or mucus

The need for intravenous access should be assessed

Any necessary handling must be gentle nature of the convulsion is documentedthe pharmacologic control of the convulsion](phenobarbital and phenytoin )most common drug

Parents Trauma during birth are unexpected complications and parents may be shocked and anxious, and perhaps find themselves in a crisis situationnot all parents experience such feelings and some can adapt quickly to their baby's condition One of the most important aspects of caring for the parents is in relation to communicationAll parents are entitled to be given information about their baby's condition, treatment and care in ways that are considered best practiceThe baby must be valued as a babyinvolvement in their baby's care is essential and the family-centered care/partnership with parents approach