ERB’S PALSY

Although rare, this may result from a difficult assisted delivery. The baby’s arm is flaccid. One must exclude a fractured clavicle and arrange physiotherapy. If it does not resolve by 6 months, the outlook is poor.

SKULL FRACTURES

These are associated with difficult forceps extractions. They are commonest over parietal or frontal bones. If fractures are associated with neurological deficit, surgery may have to be considered to elevate the affected bone.

INTRACRANIAL INJURIES

Intracranial hemorrhage is especially associated with difficult or fast labor; instrumental labor and breech delivery. Premature babies are especially vulnerable. Normally a degree of motility of brain is buffered by cerebrospinal fluid. Excessive moulding and sudden changes in pressure are associated with trauma. In all cases of intracranial bleeding both babies’ as well as mother’s blood has to be examined for presence of platelet antibodies. Subsequent babies are at equal risk.