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Mechanical birth-related trauma to the neonate: An imaging perspective

机译:新生儿机械性与出生相关的创伤:影像学的角度

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摘要

Mechanical birth-related injuries to the neonate are declining in incidence with advances in prenatal diagnosis and care. These injuries, however, continue to represent an important source of morbidity and mortality in the affected patient population. In the United States, these injuries are estimated to occur among 2.6% of births. Although more usual in context of existing feto-maternal risk factors, their occurrence can be unpredictable. While often superficial and temporary, functional and cosmetic sequelae, disability or even death can result as a consequence of birth-related injuries. The Agency for Healthcare research and quality (AHRQ) in the USA has developed, through expert consensus, patient safety indicators which include seven types of birth-related injuries including subdural and intracerebral hemorrhage, epicranial subaponeurotic hemorrhage, skeletal injuries, injuries to spine and spinal cord, peripheral and cranial nerve injuries and other types of specified and non-specified birth trauma. Understandably, birth-related injuries are a source of great concern for the parents and clinician. Many of these injuries have imaging manifestations. This article seeks to familiarize the reader with the clinical spectrum, significance and multimodality imaging appearances of neonatal multi-organ birth-related trauma and its sequelae, where applicable. Teaching points • Mechanical trauma related to birth usually occurs with pre-existing feto-maternal risk factors.• Several organ systems can be affected; neurologic, musculoskeletal or visceral injuries can occur.• Injuries can be mild and transient or disabling, even life-threatening.• Imaging plays an important role in injury identification and triage of affected neonates.Electronic supplementary materialThe online version of this article (10.1007/s13244-017-0586-x) contains supplementary material, which is available to authorized users.
机译:随着产前诊断和护理的进步,与机械性出生相关的新生儿伤害发生率正在下降。但是,这些伤害仍然是受影响患者人群发病率和死亡率的重要来源。在美国,估计这些伤害发生在2.6%的婴儿中。尽管在现有的胎儿-母亲风险因素中更为常见,但它们的发生可能无法预测。尽管通常是表面和暂时的,功能性的和后遗症的后遗症,但由于与生育有关的伤害而可能导致残疾甚至死亡。美国医疗保健研究与质量局(AHRQ)通过专家共识制定了患者安全指标,其中包括七种类型的与出生相关的伤害,包括硬膜下和脑内出血,颅骨膜下神经膜下出血,骨骼损伤,脊柱和脊柱损伤脐带,周围神经和颅神经损伤以及其他类型的特定和非特定性出生创伤。可以理解,与生育有关的伤害是父母和临床医生极为关注的问题。这些伤害中许多都有影像学表现。本文旨在使读者熟悉新生儿多器官与出生相关的创伤及其后遗症的临床范围,重要性和多模态成像表现(如果适用)。教学要点•与分娩有关的机械性创伤通常是由既有的胎儿-母亲风险因素引起的。可能会发生神经,肌肉骨骼或内脏损伤。•损伤可能是轻度的,短暂的或致残的,甚至危及生命。•成像在受影响的新生儿的损伤识别和分类中起着重要作用。电子补充材料本文的在线版本(10.1007 / s13244-017-0586-x)包含补充材料,授权用户可以使用。

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