There’s nothing more stressful than hearing that the baby that you just gave birth to has sustained an injury during childbirth. Unfortunately, accidents happen that can lead to birth complications. One of the injuries that a newborn can suffer from during delivery is a hemorrhage.
What’s a Hemorrhage?
A hemorrhage is a type of condition where blood can escape from a blood vessel. This could mean the blood is escaping from either an artery or a vein. Arteries are larger and responsible for carrying blood away from the heart and supplying it to other areas of the body. On the other hand, veins are responsible for bringing deoxygenated blood back to the heart for reoxygenation. Hemorrhages of arteries display as bright red in color and exit as spurts, while veins are dark red in color and exit as a consistent or steady flow. There are many different types of hemorrhages that can occur. In newborns, though, some are more common than others1.
Types of Hemorrhages in Newborns from Childbirth
Some of the most common types of hemorrhages that newborns can sustain during delivery include subarachnoid hemorrhages, intracranial hemorrhages, and subconjunctival hemorrhages. Each is unique in their characteristics.
Subarachnoid hemorrhages occur when there is bleeding located within the subarachnoid space. This space is the area between the brain itself and the membrane that covers the brain. When vessels in this area bleed in newborns, it usually occurs because of trauma. If left untreated, this can lead to permanent brain damage or death2.
Intracranial hemorrhages are similar to subarachnoid hemorrhages in that they occur in the brain region. However, intracranial hemorrhages are defined by bleeding either in the brain or between the brain and the skull, rather than between the brain and one of its membranes. This is a severe condition, especially in newborns. Intracranial hemorrhages are typically associated with premature babies3.
A final common type of hemorrhage in newborns is the subconjunctival hemorrhage. These occur due to blood vessel damage done in the eye. This is less concerning than a subarachnoid and intracranial hemorrhage, as it does not cause pain or a change in vision. However, it does make the whites of the eye appear red. The subconjunctival hemorrhage is relatively common for newborns, as pressure changes during childbirth leads to blood vessel damage4.
Causes of Hemorrhages in Childbirth
The causes of intracranial hemorrhages vary depending on the type of hemorrhage sustained. However, they are all typically related to pressure changes that cause a burst of a vessel. This could mean that a newborn sustained trauma during birth. There are many ways that a baby can undergo trauma during birth. For example, fetal distress, especially if not addressed, could be a precursor to hemorrhages. Fetal stress typically indicates that the baby is undergoing some type of complication, and if ignored by a physician this could further develop into more harmful conditions.
Another cause of hemorrhages can be difficult and lengthy deliveries. When excess pressure is put on the baby during birth, it can lead to complications where blood flow is limited. This is known as asphyxia. Further, asphyxia causes the decrease of available oxygen in the blood, affecting the baby’s heart rate and blood pressure. When paired with a difficult delivery, asphyxia can cause bleeding complications and hemorrhages5.
Symptoms of Hemorrhages
There are many symptoms, both temporary and lasting, that occur due to a hemorrhage in a newborn. First, as described previously with subconjunctival hemorrhages, you might observe eye staining. This is when the whites of the eyes take on a red tone, especially as one dark red spot. This occurs because of small, disrupted blood vessels in the eye. Thankfully, this form of hemorrhage often heals on its own without further medical intervention.
Other symptoms of hemorrhages in newborns include seizures, sleep apnea, lethargy, feeding difficulties, and irritability. These relate to both a loss of blood, oxygen, and increased pressure in the body.
In the case of unattended intracranial and subarachnoid hemorrhages, swelling could lead to permanent brain damage, or even death. It’s vital that any signs and symptoms, including vomiting, loss of consciousness, and soft bulging areas on the baby’s head, be properly addressed.
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