Birth injuries in an extremely low birth weight newborn delivered by cesarean section: a case report

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Abstract

There has been a recent increase in the proportion of newborns with extremely low birth weight. Prematurity is one of the risk factors for birth trauma. However, the relevant biomechanical mechanisms are described in Russian publications only for full-term newborns. Meanwhile, in foreign countries there is a current practice of reducing the number of autopsies, especially for extremely low birth weight newborns. Consequently, practical experience concerning birth injuries in extremely low birth weight newborns is highly appreciated.

The article discusses the morphological characteristics of the injury in an extremely low birth weight newborn delivered by cesarean section. The forensic examination revealed birth injuries consisting of soft tissues hemorrhages in the trunk, upper and lower extremities as a result of compression of the fetus during its extraction through a surgical incision in the uterus. Additionally, the examination revealed abnormal cranial configuration and soft tissue hemorrhages in the occipital region and left temporal muscle.

The increasing tensional stress resulted in the dissociation of the medullary veli and the falx cerebri, with an intradural hemorrhage in its posterior portion. Therefore, the reported case demonstrates the severity and the characteristics of the injury in an extremely low birth weight newborn as a result of an emergency cesarean section.

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About the authors

Ekaterina Yu. Gorun

Moscow Regional Research and Clinical Institute

Author for correspondence.
Email: katuhka30@mail.ru
ORCID iD: 0000-0002-7008-2975
SPIN-code: 4298-5402

MD

Россия, 61/2 Shchepkina st, Moscow,129110

Sergey L. Parilov

Moscow Regional Research and Clinical Institute

Email: parilov.s@mail.ru
ORCID iD: 0000-0001-9888-4534
SPIN-code: 1764-7532

MD

Россия, 61/2 Shchepkina st, Moscow,129110

Aleksandr V. Maximov

Moscow Regional Research and Clinical Institute; State University of Education

Email: mcsim2002@mail.ru
ORCID iD: 0000-0003-1936-4448
SPIN-code: 3134-8457

MD, Dr. Sci. (Medicine), Assistant Professor

Россия, 61/2 Shchepkina st, Moscow,129110; Moscow

References

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  2. Valiulina A Ya, Akhmadeyeva EN, Kryvkina NN. The problems and perspectives of successful resuscitation and rehabilitation children born with low and extremely low birth weight. The Bulletine of Contemporary Clinical Medicine. 2013;6(1):34–41. doi: 10.20969/VSKM.2013.6(1).34-41 EDN: PYUCNF
  3. Parilov SL. Birth trauma of the nervous system in children. Moscow: LAP LAMBERT Academic Publishing; 2018. (In Russ.)
  4. Kozlov YuA, Kapuller VM. Birth trauma of the abdominal organs and retroperitoneal space in newborns. Pediatriya. Zhurnal im. G.N. Speranskogo. 2020;99(5):175–184. doi: 10.24110/0031-403X-2020-99-5-175-184 EDN: MMIRUR
  5. de Sévaux JLH, Nikkels PGJ, Lequin MH, Groenendaal F. The value of autopsy in neonates in the 21st century. Neonatology. 2019;115(1):89–93. doi: 10.1159/000493003
  6. Patankar SP, Patankar SS. Penetrating abdominal injury and peritonitis: a rare case of birth Injury. Journal of Indian Association of Pediatric Surgeons. 2008;13(1):22–24. doi: 10.4103/0971-9261.42569
  7. Gorun EYu. Differential diagnosis of traumatic hemorrhages in a newborn with extremely low body weight during luminescence: a case from practice. In: Materials of the XI International Congress «Current issues of forensic medicine and expert practice — 2024». Moscow, 2024 Apr 17–18. P. 45–46. (In Russ)
  8. Parilov SL, Zemlyansky DYu, Gorun EYu, Koshak KV. Causes, features of the mechanism and expert interpretation of birth trauma in newborns with extremely low body weight (500–1000 g). Izbrannyye voprosy sudebno-meditsinskoy ekspertizy. 2020;19:97–100. (In Russ) EDN: LGVXLE
  9. Ailamazyan EK, Kulakov VI, Radzinsky VE, Savelyeva GM editors. Obstetrics: national guidelines. M.: GEOTAR-Media; 2014. (In Russ.)

Supplementary files

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2. Fig. 1. Hemorrhages in the skin and soft tissues of the shoulder girdle on the right with transition to the scapular and paravertebral regions, the presence of a hematoma in the scapular region.

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3. Fig. 2. Hemorrhage into the serratus anterior muscle on the right.

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4. Fig. 3. Overlap of the parietal bones onto the frontal and occipital bones.

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5. Fig. 4. The falciform process has areas of fiber disintegration, with a rounded focal intradural hemorrhage 0.5×0.5 cm in the posterior part, measuring.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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