Transphyseal fractures of the distal humerus are usually seen in children younger than 3 years of age and are considered as Salter-Harris Type I epiphysiolysis. Neonatal transphyseal distal humerus injuries are extremely rare. It usually occurs due to trauma during difficult labour but can also be seen after child abuse. Since the distal humerus is composed of cartilaginous tissue in newborns, it is difficult to make a diagnosis with direct radiography. Patients are often diagnosed with elbow dislocation. However, elbow dislocation is almost never seen under the age of 3 years. Transphyseal fractures can be seen as a result of manoeuvres performed to deliver the baby during difficult normal delivery. Transphyseal humeral injuries can also be seen after caesarean section, child abuse and falling on the hyperextended arm. Clinical symptoms include pain, swelling, ecchymosis and crepitation at the elbow. Pseudoparalysis is present due to pain. In children with a history of difficult birth or trauma, evaluation with direct radiography should be performed initially. Radiocapitellar line is distorted on radiographs and the elbow joint appears subluxated. The treatment algorithm for transfusional humeral fractures in neonates is varied. It should be remembered that patients in this age group have a tremendous healing capacity. In conservative treatment, 2-4 weeks of follow-up with a long-arm splint after reduction is sufficient. In addition, closed reduction-internal fixation or open reduction-internal fixation can be applied according to the amount of displacement of the fracture. Cubitus varus, osteonecrosis, growth disturbance, decreased range of motion, compartment syndrome, neurovascular injury and infection are the main complications seen after transfusional humeral fractures.

• MeSH
• fraktury distálního humeru MeSH
• fraktury humeru * chirurgie   MeSH
• lidé MeSH
• loketní kloub chirurgie   patofyziologie   MeSH
• novorozenec MeSH
• poranění lokte MeSH
• porodní poranění novorozence MeSH
• rentgendiagnostika metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Serious intrapartum fetal injuries are unfortunate events that confer severe consequences on medical personnel. Most birth traumas are noncritical and resolve for a few days. Permanent effects or fatal outcomes occur infrequently. We report an unusual case of intrapartum complete fetal decapitation. The labor was complicated by shoulder dystocia, with resultant repeated mechanical trauma to the fetal neck and, finally, decapitation. The tragic results of biological processes in human organisms do not automatically confirm medical malpractice. However, there may be grave ethical and forensic outcomes.

• MeSH
• dekapitace * MeSH
• dospělí MeSH
• dystokie ramének * MeSH
• indukovaný porod MeSH
• lidé MeSH
• novorozenec MeSH
• porodní poranění novorozence komplikace   MeSH
• těhotenství MeSH
• vakuová extrakce porodnická škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: Evaluation of maternal and neonatal outcomes in operative vaginal deliveries in prospective study analysis. DESIGN: Prospective case-control study analysis. SETTING: Prospective analysis of 292 operative vaginal deliveries (VEX, forceps) for the period June 2016 - August 2017 from overall 6056 vaginal deliveries. Type and frequency of maternal and neonatal trauma occurence was observed in connection with using vacuum-assisted delivery and forceps delivery, mainly the cephalohematomas and their complications. Collected data were statistically analysed. RESULTS: In the reported period from overall 6056 deliveries there were 216 vacuumextractions (3.6%) and 72 forceps deliveries (1.2%) performed. Both methods were used in four patients (VEX and forceps). The most frequent trauma in newborns were cephalohematomas. Remarkable cephalohematoma, requiring further observation has occured in 40 newborns (18.5%) after vacuum-assisted delivery and in 5 newborns (6.9%), (p = 0,017) after forceps delivery. Consequential punction of cephalohematoma occured only after vacuumextraction delivery and in 6 newborns (15.0 %). The third degree perineal rupture occured after vacuumextraction in 20 patients (9.3%) and after forceps delivery in 12 patients (16.7%), (p = 0,091). The fourth degree perineal rupture occured only after vacuumextraction and in 1 case (0.5%). CONCLUSION: The vacuumextraction compared with forceps is more likely to be associated with the statistically significant incidence of cephalohematomas and their further treatment. Forceps deliveries compared with vacuumextraction are more likely to be associated with the maternal perineal trauma, but the diference was not statistically significant.

• Klíčová slova
• cephalohematoma, forceps delivery, maternal trauma, neonatal trauma, vacuum-assisted delivery,
• MeSH
• hematom etiologie   MeSH
• lacerace etiologie   MeSH
• lidé MeSH
• novorozenec MeSH
• porodní poranění novorozence etiologie   MeSH
• porodnické kleště škodlivé účinky   MeSH
• prospektivní studie MeSH
• studie případů a kontrol MeSH
• těhotenství MeSH
• vakuová extrakce porodnická škodlivé účinky   MeSH
• vedení porodu metody   MeSH
• výsledek těhotenství MeSH
• ženské pohlavní orgány zranění   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Sagittal craniosynostosis associated with midline cephalhematoma is a rare finding. Despite the controversy regarding its etiopathogenesis, this condition represents a clear indication for surgery. CASE REPORT: We present a case of a 10-week-old boy with an ossified midline vertex cephalhematoma and sagittal craniosynostosis. The child underwent a cephalhematoma excision and minimally invasive non-endoscopic narrow vertex craniectomy, with calvarial vault remodeling followed by 2 weeks use of a cranial orthosis. On 5-month follow-up, mesocephaly was achieved. CONCLUSION: Our case is well documented with native CT, 3D CT, intraoperative pictures, and 3D head scan imaging. We described our minimally invasive non-endoscopic technique that led to a rapid cranial vault remodeling with reduction of cranial orthosis need. A review of literature focused on surgical techniques is included.

• Klíčová slova
• Cephalhematoma, Cranial orthosis, Minimal invasive technique, Scaphocephaly,
• MeSH
• epidurální hematom komplikace   patologie   chirurgie   MeSH
• heterotopická osifikace patologie   MeSH
• kojenec MeSH
• kraniosynostózy komplikace   patologie   chirurgie   MeSH
• lidé MeSH
• porodní poranění novorozence patologie   chirurgie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

BACKGROUND: The aim of this study was to evaluate the results achieved using various surgical techniques in patients with partial and total obstetrical brachial plexus palsy. METHODS: From 2000 to 2013, 33 patients with obstetrical brachial plexus injury underwent surgery. Twenty had follow-up periods greater than 24 months and met the criteria for inclusion in the study. All patients were evaluated using the Active Movement Scale. RESULTS: The outcomes of different nerve reconstructive procedures including nerve transfers, nerve grafting after neuroma resection and end-to-side neurorrhaphy are presented. The overall success rate in upper plexus birth injury was 80 % in shoulder abduction, 50 % in external rotation and 81.8 % in elbow flexion with median follow-ups of 36 months. Success rate in complete paralysis was 87 % in finger and thumb flexion, 87 % in shoulder abduction and 75 % in elbow flexion; the median follow-up was 46 months. Useful reanimation of the hand was obtained in both patients who underwent end-to-side neurotization. CONCLUSION: Improved function can be obtained in infants with obstetrical brachial plexus injury with early surgical reconstruction.

• MeSH
• kojenec MeSH
• lidé MeSH
• nervový transfer metody   MeSH
• neurochirurgické výkony metody   MeSH
• neuropatie brachiálního plexu etiologie   chirurgie   MeSH
• plexus brachialis zranění   MeSH
• porodní poranění novorozence komplikace   chirurgie   MeSH
• radikulopatie patologie   chirurgie   MeSH
• výsledek terapie * MeSH
• zákroky plastické chirurgie metody   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The traumatic intracranial haemorrhage still remains a serious complication of instrumental deliveries with an uncertain prognosis. Regarding tentorial haemorrhage, surprisingly few clinical neurological data are available. Most of the references in literature are older case reports, associated frequently with an unfavourable outcome. We report a newborn after a serious tentorial haemorrhage with an excellent neurodevelopmental outcome. Computed tomography (CT) scan of our patient demonstrated an extensive bilateral tentorial haemorrhage extending to the foramen magnum. The newborn showed a good respiratory effort, but a neurological impairment including anisocoria, apathy, hypotonia, incomplete grasp and Moro reflex. Despite these signs, the development at 9 and 18 months of age was appropriate. The aim of this report is to accentuate that the prognosis of infants with tentorial haemorrhage should be always evaluated carefully with main respect to clinical signs. The outcome of the newborn even after a large tentorial haemorrhage can be surprisingly without a serious neurological deficit. Spontaneous breathing without support, normal blood pressure and absence of seizures are clinical indicators that may be associated with a good outcome despite an extensive tentorial haemorrhage.

• MeSH
• cerebrální krvácení diagnóza   etiologie   MeSH
• lidé MeSH
• novorozenec MeSH
• porodní poranění novorozence komplikace   diagnóza   MeSH
• porodnické kleště škodlivé účinky   MeSH
• prognóza MeSH
• těhotenství MeSH
• vedení porodu škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Upper limbs palsy as a result of affliction of plexus brachialis nervous bunch is disorder, whose frequency moves among 0.42-5.1 / 1000 liveborn children. Delivery mechanism itself certain weighty, no however only cause rising paralysis. Some way paralysis rise already intrauterinne, some way then at surgical childbirth per sectionem caeseream. Brachial plexus palsy isn't benign disorder. If isn't this disorder in time diagnosed and accordingly treated, child threatens late aftermath, especially significant limitation of limbs movement with functional consequencies.

• MeSH
• lidé MeSH
• neuropatie brachiálního plexu * diagnóza   etiologie   terapie   MeSH
• novorozenec MeSH
• porodní paralýza * diagnóza   etiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVE: In the retrospective study to evaluate whether the number of newborns over 4000 grams weight is greater under expectative management of post-term pregnancy and explain its influence on perinatal and maternal morbidity and mortality. DESIGN: Retrospective study. SETTING: Gynaecology and Obstetric Clinic, Medical Faculty, Masaryk University, Brno. METHODS: Two groups were compared. Group I includes 1906 women, who delivered in the year 1996 under the active management of the post-term pregnancy with induction of labour in the 41st week. Group II includes 2008 parturients who delivered under the expectative management of the post-term pregnancy with induction of labour at the end of 42nd week. Perinatal mortality, brachial plexus injuries, clavicle fractures, Caesarean section rate for cephalopelvic dysproportion and injuries in mothers were evaluated. Students T test and chi square test were used for statistical purposes. RESULTS: In the group with expectative management of the post-term pregnancy there was significantly higher number of newborns over 4000 grams. Perinatal mortality and morbidity did not differ between the two groups. There is no difference in maternal morbidity as well. CONCLUSIONS: Our results of expectative management in post-term pregnancies with newborns over 4000 grams did not confirm our worries about higher morbidity both in newborns and mothers. There is no need to consider the expectative management of the post-term pregnancies to be dangerous.

• MeSH
• císařský řez MeSH
• indukovaný porod škodlivé účinky   MeSH
• kojenecká mortalita MeSH
• lidé MeSH
• makrosomie plodu * MeSH
• novorozenec MeSH
• porodní hmotnost * MeSH
• porodní poranění novorozence etiologie   MeSH
• přenášené těhotenství * MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• vedení porodu škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

The authors have compared the frequency of occurrence of nasal septum deformation in two groups of newborns, using the simplest testing methods for: 1. newborns born by spontaneous labor (254 newborns), 2. newborns born by caesarean section (52 newborns). The deformation from the central position of the nose were found in 2 newborns from group 2 (3.9%) and in as many as 50 newborns from group 1 (approx. 20%) providing the evidence that most deformations occur as a result of birth injury (during labor). 32 deformations (26 in the cartilaginous section of the nasal septum and 6 in the osseous section) have been tested repeatedly in the third or fourth week of life. 19 out of 26 deformations of the cartilaginous section of the nasal septum (73%) have been repositioned automatically. All deformations in the osseous section detected after birth were also analyzed physically in the third or fourth week of life.

• MeSH
• lidé MeSH
• nosní kost abnormality   zranění   chirurgie   MeSH
• nosní přepážka abnormality   zranění   chirurgie   MeSH
• novorozenec MeSH
• porodní poranění novorozence * MeSH
• rinoplastika MeSH
• získané deformity nosu diagnóza   epidemiologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Polsko epidemiologie   MeSH

• MeSH
• asfyxie novorozenců etiologie   MeSH
• chybná diagnóza MeSH
• císařský řez MeSH
• dvojčata MeSH
• lidé MeSH
• novorozenec MeSH
• porodní poranění novorozence etiologie   MeSH
• předčasná porodní činnost terapie   MeSH
• těhotenství mnohočetné * MeSH
• těhotenství MeSH
• ženská infertilita farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH