Мать и дитя в Кузбассе (May 2022)
EARLY DIAGNOSIS OF CERVICAL NATURAL INJURY IN BABIES
Abstract
Cervical birth trauma often goes unnoticed by specialists if neurological symptoms are not severe. As a result, the child retains pain. Torticollis and deformity of the skull develops. Reflex activity forms asymmetrically. The aim is to analyze the peculiar properties of anamnesis collecting during first weeks and months of life for early diagnosis of cervical birth trauma. Material and methods. Full-term breastfed babies were examined once. Researchers collected complaints and anamnesis, observed the behavior of the infant at the mother's breast, carried out a clinical examination, spondylography with functional tests. Randomization was carried out on the basis of the child's preference for one breast. 194 babies revealed this symptom. They made up the basic group. 151 babies who sucked equally well from both mammary glands made a comparison group. Logistic regression analysis was used to assess the association of single-breast feeding preference with the presence of cervical birth trauma. Results. Persistent head turn to one side, decreased muscle tone in the upper limb, decreased reflexes on the undesirable side, flattening of the occipital bone from the preferred turn were observed in children of the main group. A cervical spine block was diagnosed and confirmed by X-ray. The comparison group babies freely turned their heads in both directions. Tone, physiological reflexes were normal, symmetrical. Signs «Babies’ preference to one breast», «The categorical refusal to suck from the undesirable breast» and «Rapid return to the previous position and crying when somebody turned the head to the undesirable breast» were accompanied by a cervical block in 100 % of cases, that had been proved by statistical analysis results. The sign «Flattening of the occipital bone from the side of the preferred rotation» increased the probability of cervical spine block by 16.9 times, and the sign «Asymmetry of physiological reflexes» – by 211.7 times. Conclusion. The emphasis in the collection of complaints and anamnesis on the baby's preference for one breast suggests the presence of a cervical birth trauma.
