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Birth Injuries in Neonatology.
ŠKVOROVÁ, Adéla
Current status: Mechanical damage to the newborn during childbirth can cause traumatic injuries. These may be visible immediately after delivery or within hours or days thereafter (Dort et al., 2013). Several risk factors or improperly managed childbirth can contribute to birth injuries, the most common at present including fractures of the collarbone and bleeding under the periosteum or paresis (Huml et al., 2013). Many injuries do not have permanent consequences, however, in such cases, multidisciplinary expert care is required. Objectives: The aim of the study was to determine the frequency and types of birth injuries in full-term newborns in a selected maternity hospital, to map their risk factors and consequences, to evaluate the frequency of increased bilirubin in the body in full-term newborns with cephalhematomas, and last but not least, to describe the nursing process in full-term newborns with a selected birth injury. Methodology: In the empirical part of this work, a mixed design combining quantitative and qualitative research was used. Selection of the research set was intentional, where in the quantitative part of the study 1733 full-term newborns delivered in a selected Prague maternity hospital in the period 1 January 2019 to 1 July 2019 were included. The research sample for the qualitative part of the study consisted of 10 nurses working in a selected maternity ward. The size of the research sample was given by theoretical saturation of the data. Results: Out of the total number of 1733 newborns, 280 newborns with birth injuries were delivered (16.2%). The most common injuries included obstetric tumors (12.2%), cephalhematoma (2.9%) and clavicle fractures (0.6%). Statistically significant risk factors increasing the likelihood of birth injuries involved prolonged labour (p < 0.001), shoulder dystocia (p = 0.045), irregular fetal position (p < 0.001), use of forceps (p= 0.005), and vacuum extraction (p < 0.001). Conclusion and use for practice: Based on the results, educational material was created for parents of newborns with birth injuries - a collarbone fracture.
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