Birthing Injuries

Spinal cord and brainstem injuries often occur during the process of birth, but frequently escape diagnosis. Respiratory depression in the neonate is a cardinal signal of much injury. In infants there may be lasting neurologic defects reflecting the primary injury"
Towbin,A -Latent Spinal Cord and Brain Stem Injury in New Born Infants. Develop Med Child Neurol 1969; 11:54-68

Trauma to the cervical spine and head can cause such problems as headaches, vestibular troubles, auditory problems, visual disturbances, pharyngolaryngeal disturbances, vasomotor and secretional problems and psychic disturbances. Manipulation of the neck achieves excellent results with many of these conditions.
Maigne, R., Orthopedic Medicine, A New Approach to Vertebral Manipulations. Charles C. Thomas, 1972

Case histories of over 135 babies with K.I.S.S. syndrome {Kinematic Imbalance due to Suboccipital Strain} reveal a significantly high portion of these babies suffered birthing injuries due to prolonged labor and use of extraction devices.
Biedermann H; Kinematic Imbalance Due to Suboccipital Strainin Newborns. J Manual Medicine 1992; 6:151-6

Birthing Injuries Ignored

OBJECTIVE: A review of the medical literature was undertaken to determine cause, diagnosis, prognosis, treatment and prevention of injuries resulting from birth trauma. The primary focus was the neonate, though infant, child and adult were also considered because the effects of birth trauma can be life-long.

DATA SOURCE: A compilation of case studies and review articles were extracted from numerous "MEDLINE" literature searches. Key Terms included: Birth Trauma, Central Nervous System Injuries, Musculoskeletal Injuries, Stillbirth, Sudden Infant Death Syndrome (SIDS), Cerebral Palsy, Brachial Plexus Palsies (Erb's and Klumpke's), Neonatal-Infantile Respiratory Distress, Obstetric Accidents (Forceps, Vacuum Cup and Cesarean Deliveries), Subluxation, Chiropractic Treatment. American, British, Danish and German studies were included to show the universality of the problem.

STUDY SELECTION: Findings were selected on the basis of a clear connection between birth trauma and the resulting symptoms, syndromes and/or death.

DATA EXTRACTION: Findings were compiled by studying articles from the literature search. The quality and validity were assessed by corresponding references, method of documentation, number of case studies, length of time over which studies took place and presence of follow-up documentation.

DATA SYNTHESIS: Inadequacies and source discrepancies were also included with regard to cause and types of obstetric accidents.

CONCLUSION: Birth trauma remains an underpublicized and, therefore, an undertreated problem. There is a need for further documentation and especially more studies directed toward prevention. In the meantime, manual treatment of birth trauma injuries to the neuromusculoskeletal system could be beneficial to many patients not now receiving such treatment, and it is well within the means of current practice in chiropractic and manual medicine.

Gottlieb MS. Neglected spinal cord, brain stem and musculoskeletal injuries stemming from birth trauma. J Manipulative Physiol Ther 16 (8): 537-543 (Oct 1993)

Skull Fracture Due to Vacuum Extraction

A case of growing skull fracture following birth trauma and caused by vacuum extraction is reported in order to emphasize the incidence of this peculiar head injury at the beginning of extrauterine life and to point out its relation to possible neuropsychological disturbances that may appear later in childhood. Delivery by vacuum extraction increases the incidence of perinatal injuries and consequently the incidence of neurological deficits in children. Neurosurgical repair is advocated as the appropriate treatment, with the aim not only of cosmetically correcting the lesion's typical subgaleal protuberance with cranioplasty, but also of performing a water-tight closure of the dura, enabling the cerebral cortex to "fill in" the intracerebral lesion. The surgical technique and gross pathology of the lesion are described together with radiological findings before and after surgery. Reports by other authors are reviewed in an attempt to identify the conditioning factors and pathological features of this traumatic injury to skull and brain in neonates and infants. The literature on cranial fractures associated with intracerebral lesions at this age shows a significant difference in recovery and outcome from that after similar lesions in older children.

Papaefthymiou G, Oberbauer R, Pendl G. Craniocerebral birth trauma caused by vacuum extraction: a case of growing skull fracture as a perinatal complication. Childs Nerv Syst 12 (2): 117-120 (Feb 1996)