7. Birth Injuries, Neonatal Abstinence & FASD

what maternal history should be reviewed when assessing birth-complication risk? *

previous birth complications

what is the most common fracture during birth?

clavicle fracture

what findings suggest a newborn clavicle fracture?

• crepitus

• local swelling

• decreased arm movement

• asymmetric Moro reflex

what is Erb palsy?

brachial plexus injury affecting the arm

what findings suggest Erb palsy?

• limp, adducted, internally rotated arm

• asymmetric Moro reflex

• grasp usually intact

what finding suggests facial nerve injury after forceps delivery?

facial asymmetry, especially when crying

what complication is a newborn with cephalohematoma at increased risk for?

hyperbilirubinemia

what is neonatal abstinence syndrome?

withdrawal after prenatal substance exposure, most commonly opioids

what findings suggest neonatal abstinence syndrome?

• high-pitched cry

• tremors and hypertonia

• frantic, uncoordinated sucking

• poor sleep

• loose, watery stools

• sweating or temperature instability

what nonmedication care helps a newborn with neonatal abstinence syndrome?

• low-stimulation environment

• swaddling

• small, frequent feeds

• nonnutritive sucking

what is the finnegan score?

a clinical tool used to evaluate and quantify withdrawal symptoms in newborns experiencing Neonatal Abstinence Syndrome

when may medication be needed for neonatal abstinence syndrome?

finnegan scores remain elevated despite supportive care

• meds: oral morphine, methadone

what three major findings characterize fetal alcohol spectrum disorder?

1. growth restriction

2. craniofacial abnormalities

3. central nervous system dysfunction

what facial findings suggest fetal alcohol spectrum disorder?

• smooth philtrum

• thin upper lip

• flat midface

• small eye openingsmicrocephaly