PE19.6 | Birth Injuries — Summary & Reflection

KEY TAKEAWAYS

Birth injuries span a spectrum from trivial to life-threatening and are best understood through anatomy. Caput succedaneum is a subcutaneous oedema that crosses sutures, is present at birth, and resolves in days with no treatment. Cephalhaematoma is a subperiosteal blood collection that respects suture lines, appears hours after birth, resolves in weeks, and may cause jaundice — avoid aspiration. Subgaleal haemorrhage is a medical emergency: blood accumulates beneath the galea aponeurotica, crosses sutures widely, can expand to accommodate the entire blood volume, and requires immediate resuscitation. Erb palsy (C5–C6) causes the classic waiter's tip posture and recovers spontaneously in ~90% with physiotherapy; Klumpke palsy (C8–T1) produces claw hand ± Horner syndrome. Clavicle fracture is the most common birth fracture — greenstick, middle-third, excellent prognosis, managed with gentle immobilisation. Facial nerve palsy from forceps pressure is usually peripheral and resolves spontaneously.

REFLECT

Think about the examination you would perform on every newborn baby you attend over the next week. Which specific aspects of the examination would you focus on to screen for birth injuries? How would you explain the difference between a cephalhaematoma and a subgaleal haemorrhage to a worried parent — using language that is accurate but accessible? Reflect on the key anatomical fact (periosteum adherent at sutures) that anchors the entire clinical distinction. If you were the admitting intern for a baby with suspected Erb palsy, what would your verbal handover to the next team include? Reflecting on these scenarios helps consolidate anatomy-driven clinical reasoning.