The brachial plexus may be stretched and damaged during a difficult delivery. In minor cases, the nerves heal and full use of the hand and arm is recovered. In more severe cases, the child may sustain permanent nerve damage and may not have full use of the shoulder, arm, or hand. Brachial plexus injuries occur in 1-3 children per 1,000 live births.See Erbs palsy and Klumpkes palsy. Brain damage
Brain damage may be caused by a number of factors, including fetal malformation due to genetic mutation or exposure to toxins, intrauterine hypoxia, or physical trauma during delivery.Cerebral palsy is one example of brain damage incurred before or during delivery; about 10,000 children are diagnosed with cerebral palsy every year. Bruising
A difficult delivery may lead to bruising, especially on the head and face, from pressure against the mothers pelvis or pressure caused by forceps or a vacuum device (see ventouse) used in delivery. Bone fractures
Bone fractures can occur during a difficult delivery. Fracture of the clavicle is the most common birth injury. Meconium aspiration syndrome
Meconium is a sticky substance that usually makes up the childs first bowel movement. If the fetus is stressed before or during delivery, the meconium may be released and may mix with the amniotic fluid. If it gets into the childs airways or lungs, it can cause meconium aspiration syndrome. Serious cases may result in pneumonia or a collapsed lung. Legal issues
Birth injuries may be unavoidable or they may be attributable to medical malpractice.
Pharmacokinetics
It is a metabolite of etretinate, which was used prior to the introduction of acitretin. Etretinate was discontinued because it had a narrow therapeutic index as well as a long elimination half-life (t1/2=120 days), making dosing difficult. In contrast, acitretins half-life is approximately 2 days. However, because acitretin can be reverse metabolised into etretinate which has an extremely long half-life, women must avoid becoming pregnant for at least three years after discontinuing acitretin. Therefore, acitretin is generally not recommended for women of child-bearing age with a risk of becoming pregnant. References
External links
"Acitretin". Drug Information Portal. U.S. National Library of Medicine.