8. Birth Injuries, Substance Exposure & FASD

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

previous birth complications;similar complications may recur

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?

arm adducted and internally rotated;asymmetric Moro reflex;grasp usually intact

how is the affected arm managed in Erb palsy?

immobilization for about 1 week, then prescribed gentle passive ROM

what finding suggests facial nerve injury after forceps delivery?

facial asymmetry, especially when crying

what is caput succedaneum?

scalp edema that crosses suture lines

what is cephalohematoma?

blood collection over one cranial bone that does not cross suture lines

what placental complications are associated with cocaine use?

placental abruption;placental insufficiency

what newborn risks are associated with maternal tobacco use?

impaired oxygenation;low birthweight;increased SIDS risk

what is neonatal abstinence syndrome?

withdrawal after prenatal substance exposure, most commonly opioids

what findings suggest neonatal abstinence syndrome?

high-pitched cry;tremors and hyperactive reflexes;irritability and poor sleep;temperature instability;feeding difficulty;vomiting and diarrhea

what is the purpose of neonatal abstinence scoring?

measure withdrawal severity and guide treatment

what comfort measures help a newborn with neonatal abstinence syndrome?

swaddling;skin-to-skin;nonnutritive sucking;dim lights and low stimulation

what medications may treat severe neonatal opioid withdrawal?

oral morphine;methadone

what is fetal alcohol spectrum disorder?

growth and developmental abnormalities caused by prenatal alcohol exposure

what findings suggest fetal alcohol spectrum disorder?

prenatal and postnatal growth restriction;microcephaly;small eye openings;smooth philtrum and thin upper lip;cognitive and behavioral difficulties