Infant Skull Fractures

skull fracture

During childbirth, labor, and delivery, pregnancy complications are bound to arise, with some being more preventable than others in hindsight. However, from medical standpoint, the pathway and pattern of care required during any birth process is well-rehearsed and subject to reasonable standards of care in commensurate contexts. In the event that complications arising in the delivery process of an infant increase the urgency or risk of the removal of the fetus, medical professionals are further bound to additional standards of care in light of the expected and known risk-factors posed by both mother and child.

However, a strong number of birth process complications are simply preventable from a medical standpoint.

Infant Skull Fractures and the Birth Process

Should a newborn infant present with a skull fracture, the infant should be immediately checked for the presence of intracranial hematomas that could cause sudden cranial pressure to develop, potentially leading to the onset of cerebral palsy and other complications related to infant oxygen deprivation. In the case of infant skull fractures, clinicians categorize these injuries as traumatic birth injuries.

Clinicians also note that common pathway in which infant skull fractures may occur during the birth process, including commenting that while minor injuries commonly occur to the fetus during delivery, traumatic injuries comparable to cranial fractures in childbirth are almost always linked to distressed or high-risk births. Complications that increase the likelihood of a newborn undergoing a distressed birth resulting in a skull fracture include:

  • Vaginal canal of mother relatively small compared to larger size of the infant, requiring obstetrical tools that ultimately likely were the proximate cause of the neonatal skull fracture
  • Unusual positioning during the labor process necessarily forces the medical community to more intensely intervene, thus increasing the risk of external trauma to the infant
  • Unwillingness or unfeasibility of performing a C-section procedure

Furthermore, any infant cranial fracture incurred during the birth process requires vigilant monitoring for the development of intracranial hematomas and other complications by medical professionals during the postpartum period. Finally, significant medical literature and research has linked distressed births, skull fractures, and especially intracranial bleeds such as epidural hematomas to the onset of cerebral palsy in children. In these cases, continual monitoring of the child for warning signs of delayed developmental milestones and the onset of cerebral palsy should be performed.

Causes of Infant Skull Fractures

In virtually all cases outside of infant abuse or infant neglect, a skull fracture in an infant is indicative of a complicated or belabored vaginal delivery process. Specifically, obstetrical tools reserved for distressed or complicated births, such as vacuum-extraction or forceps, are frequently cited as the cause of linear skull fractures in infants. Moreover, depressed skull fractures are frequently seen in the aftermath of significant and inordinate compression upon the skull of the infant during the delivery process.

Three Categories of Infant Skull Fractures Explained

Not all skull fractures present comparably, and as such, the location of the external trauma and the ensuing location of the site of the fracture relative to certain brain regions dictates the type of fracture, as well as the likely causes and consequences, if appropriately and quickly identified by medical professionals.

The three medical categorizations of skull fractures include:

  • Linear skull fractures, which consists of thin or hairline fractures visible on the skull under imaging observation, but the linear fracture fails to depress, distort, or deform the neonatal patient’s skull
  • Depressed skull fractures, which entail actual depression of the skull and pressure exertion onto the brain itself
  • Occipital Osteodiastasis, which is a relatively rare phenomena in newborn infants in which occipital squama tear away from the occipital bone due to highly antiquated or substandard delivery practices by attending physicians

In all instances of skull fractures during the birth process, parents of the child should consider legal counsel alongside the ongoing medical treatment and advice proffered by an existing neonatal care provider. Though not universally, skull fractures during the birth process are frequently indicative of significant deviations from a reasonable standard of care in most, if not all distressed birth situations, and likely, present grounds for filing legal claims against negligent practitioners and other liable parties.

Resources:

http://www.webmd.com/baby/understanding-preterm-labor-birth-basics

http://www.acog.org/~/media/For%20Patients/faq087.pdf

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