Birth injuries to the organs of abdominal cavity and retroperitoneal space in newborn infants

Kozlov Yuri Andreevich, V. M. Kapuller

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

The frequency of intra-abdominal injuries associated with childbirth reaches 3,5%, and is mainly due to trauma to the parenchymal organs. Injuries to organs of the abdominal cavity and retroperitoneal space are rare and include rupture or hemorrhage in the liver, spleen or adrenals. Liver injury is most severe. Three potential mechanisms lead to the damage to parenchymal organs: 1 - direct injury; 2 - compression at chest surface of spleen or liver; 3 - chest compression, leading to the rupture of hepatic or splenic ligaments. Birth injuries are characterized by 2-stage lesion development, consisting in the initial formation of subcapsular hematoma, and then the development of abdominal cavity bleeding in several hours/days period. Intra-abdominal bleeding in newborns is always dramatic, resulting from obstetric/intrauterine factors, including pelvic or complicated delivery, hepatosplenomegaly, macrosomia, and anoxic/hypoxic damage to infant’s liver, spleen, and adrenals. Early diagnostics can provide better survival rates for the patients. Clinicians and radiologists should be aware of this complication and use an abdominal ultrasonics or CT scans to assess the state of parenchymal organs in infants with unexplained hematocrit failure or shock of unknown etiology. Hemorrhage in the adrenals is more common than ruptures of liver and spleen. The mechanism of damage to this organ is different from injuries to parenchymal organs and obviously includes compression of veins, draining blood from this organ. However, due to the injury’s severity, these traumata cause no substantial harm to the infants, and are prone to natural involution resulting from blood resorption. Treatment of birth traumata (injuries) of parenchymal organs is mainly conservative and includes blood transfusion, coagulopathy correction, and patients’ careful handling during the observation period. Surgery is rarely used and performed to break a subcapsular hematomas with massive intra-abdominal bleedings, nonsensitive to conservative therapy. Considering potentially life-threatening complications, timely diagnosis establishment and use of appropriate research methods are essential to minimize morbidity and mortality from abdominal cavity and retroperitoneal space birth injuries.

Original languageEnglish
Pages (from-to)175-184
Number of pages10
JournalPediatriya - Zhurnal im G.N. Speranskogo
Volume99
Issue number5
DOIs
StatePublished - 1 Sep 2020
Externally publishedYes

Keywords

  • Adrenal gland
  • Birth injury
  • Liver
  • Newborns
  • Non-surgical treatment
  • Spleen

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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