Mechanical Birth Trauma -- An Evaluation of Predisposing Factors at the Ogun State University Teaching Hospital, Sagamu.

Abstract

Summary: Fifty neonates were identified in a study carried out to determine the factors predisposing to mechanical birth trauma in neonates at the Ogun State University Teaching Hospital, Sagamu. Data were collected retrospectively from 1989 to 1990 and prospectively from 1991 to 1994. The incidence of mechanical birth trauma among inborn babies was 9.17 per 1000 live births. Non-booked deliveries were at a higher risk for birth trauma than booked ones (x2 = 14.03, p < 0.01). The common injuries encountered were scalp haemorrhage, fractures and nerve palsies. Birth weight above 4000g was associated with a higher risk of birth trauma than the reference group weighing 2500 – 2999g (odds ratio = 10.17, 95% confidence limits = 2.02 -- 51.2). Five of eight cases of fractures occurred following breech delivery, and three (37.5 percent) occurred in preterm, very low birth weight retained second twins or triplets. Forty four percent of all cases suffered concomitant severe birth asphyxia. It is recommended that greater effort be made through health education to encourage early presentation or referral to centres capable of handling high-risk cases and improvement of facilities at those centers. A cautious approach to Caesarean section for delivering very low birth weight twins is advocated vis-à-vis available facilities for intensive neonatal care and therefore, chances of survival.