Birth-related soft tissue injury due to transverse malpresentation at delivery: a case report

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Perinatal Medicine Pub Date : 2023-01-01 DOI:10.1515/crpm-2023-0009

Celine Rohaert, A. Poleij, Chantal Quispel, M. de Jong, P. Ciet, Florian Cassel

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引用次数: 0

Abstract

Abstract Objectives Birth-related mechanical trauma to the newborn is an important issue and may be underestimated [Chaturvedi A, Chaturvedi A, Stanescu AL, Blickman JG, Meyers SP. Mechanical birth-related trauma to the neonate: an imaging perspective. Insights Imag 2018;9:103–18]. Risk factors for birth-related injuries include vacuum or forceps delivery, large size for gestational age and abnormal presentation before delivery [Gupta R, Cabacungan ET. Neonatal birth trauma: analysis of yearly trends, risk factors, and outcomes. J Pediatr 2021;238:174–80]. When a newborn has a soft tissue mass, there is a wide range of potential diagnoses, ranging from benign traumatic origins to aggressive phenotypes of malignant tumors [Thacker M. Benign soft tissue tumors in children. Orthop Clin N Am 2014;44:433–44]. Diagnosing a congenital tumor in a newborn creates uncertainty for parents and health care providers. Accurate imaging is crucial for distinguishing soft tissue mass origins. Case presentation A 32 weeks 6 days pregnant Caucasian woman was admitted after premature prelabor rupture of membranes (PPROM). Fetal ultrasound showed no abnormalities, the infant was born by a caesarean section. The delivery was complicated by the infant’s transverse position. A female infant was born with a large left-sided dorsal soft tissue mass at the thoracic level with elastic consistency, and multiple skin lacerations. A broad differential diagnosis was made. Additional imaging was suggestive for a posttraumatic swelling due to transverse position during birth. The mass decreased and disappeared over three days. Conclusions The diagnosis of a soft tissue mass in a newborn can be challenging. A birth-related trauma affecting the soft tissue should be considered, especially if prenatal ultrasound findings were normal. Malpresentation during birth is a significant risk factor. Accurate diagnostic imaging is important to do before conducting further diagnostic examinations. The time course of the mass, before and after birth, can aid in determining its origin.

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出生相关的软组织损伤，由于横向表现不佳在分娩:1例报告

【摘要】目的新生儿机械损伤是一个重要的问题，但可能被低估了[Chaturvedi A, Chaturvedi A, Stanescu AL, Blickman JG, Meyers SP.新生儿机械损伤:影像学视角]。[j].中国影像科学，2018;9:103-18。分娩相关损伤的危险因素包括真空或产钳分娩、胎龄过大和分娩前的异常表现[Gupta R, Cabacungan ET.新生儿出生创伤:年度趋势、危险因素和结局分析]。中华儿科杂志(英文版);2009;38(3):391 - 391。当新生儿有软组织肿块时，可能的诊断范围很广，从良性创伤起源到恶性肿瘤的侵袭性表型[Thacker M.儿童良性软组织肿瘤]。中华骨科杂志，2014;44(4):433 - 441。新生儿先天性肿瘤的诊断给父母和医疗保健提供者带来了不确定性。准确的影像是鉴别软组织肿块来源的关键。一例怀孕32周6天的白人妇女因早产胎膜破裂(PPROM)入院。胎儿超声检查未发现异常，婴儿通过剖腹产出生。婴儿的横卧位使分娩变得复杂。一女婴儿出生时在胸部水平有一个大的左侧背软组织肿块，弹性一致性，多处皮肤撕裂伤。作出了广泛的鉴别诊断。额外的影像学提示，创伤后肿胀由于横卧位在分娩。三天后，肿块减少并消失。结论新生儿软组织肿块的诊断具有挑战性。应考虑影响软组织的出生相关创伤，特别是如果产前超声检查结果正常。出生时表现不良是一个重要的危险因素。在进行进一步的诊断检查之前，准确的诊断成像是很重要的。胎儿出生前和出生后的时间过程有助于确定其起源。

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来源期刊

Case Reports in Perinatal Medicine OBSTETRICS & GYNECOLOGY-

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期刊介绍： Case Reports in Perinatal Medicine is a double-blind peer-reviewed journal. The objective of the new journal is very similar to that of JPM. In addition to evidence-based studies, practitioners in clinical practice esteem especially exemplary reports of cases that reveal specific manifestations of diseases, its progress or its treatment. We consider case reports and series to be brief reports describing an isolated clinical case or a small number of cases. They may describe new or uncommon diagnoses, unusual outcomes or prognosis, new or infrequently used therapies and side effects of therapy not usually discovered in clinical trials. They represent the basic concept of experiences for studies on representative groups for further evidence-based research. The potential roles of case reports and case series are: Recognition and description of new diseases Detection of drug side effects (adverse or beneficial) Study of mechanisms of disease Medical education and audit Recognition of rare manifestations of disease.