Mechanical birth injuries in the Niger Delta: a ten-year review (1989-1998)

Abstract

Context: Birth traumas associated with poor obstetric services contribute significantly not only to the high perinatal morbidity and mortality, but also to long-term sequelae in the survivors in many developing countries. Birth asphyxia, one of the commonest sequelae of such injuries, has remained a common cause of neonatal deaths in this setting. These injuries however remain under-reported, hence this report.

Objectives: To determine the incidence, types and associated factors in mechanical birth injuries in babies delivered at the University of Port Harcourt Teaching Hospital (UPTH) in the Niger Delta from January 1989-December 1998.

Design: A retrospective analysis of hospital records of deliveries during the study period.

Setting: The Labour and Isolation Wards for delivery records and the Special Baby Care Unit's records on UPTHdelivered babies.

Subjects and Methods: All mother-baby pairs delivered at UPTH during the study period were studied. For each mother-baby pair the following data were obtained: biodata, obstetric records and examination findings on the babies. Further analysis was on neonates with mechanical birth traumas. Fisher's Exact and Chi square tests were used for data analysis.

Results: Of 16, 631 livebirths, 50 babies had mechanical birth injuries, giving an incidence of 3.1/1000 livebirths. Mechanical birth injuries were commoner in normal weight, term male babies, whose mothers were unbooked and or nulliparous. The common injuries were cephalhaematoma (48%), Erbs' palsy (14%) and facial ecchymoses.

Conclusions: Mechanical birth injury remains a problem in this setting. The contributory factors to birth injuries were similar to those in other developing countries.

Keywords: mechanical birth injuries, Niger Delta

Tropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 50-55