Bombay Hospital Journal, Vol. 54, No. 2, 2012 202 Charusheela Warke*, Sushma Malik**, Manish Chokhandre***, Ashwin Saboo**** *Associate Professor,** Professor, ***Resident, **** Assistant Professor Division of Neonatology, Dept. of Paediatrics, BYL Nair Ch. Hospital and TN Medical College, Mumbai-400 008. Birth Injuries - A Review of Incidence, Perinatal Risk Factors and Outcome Abstract Introduction : Birth injuries are avoidable or unavoidable forms of birth trauma which occur during the process of labour and delivery. Incidence of birth injuries is 6- 8 per 1000 live births. Predisposing factors were instrumentation (forceps/vacuum), macrosomia, difficult labour, shoulder dystocia, maternal pelvic anomalies. Current study focuses on determination of incidence, risk factor and outcome of mechanical birth injuries in all live born neonates admitted at our tertiary level NICU. Methods : In this retrospective study, medical records of all neonates in our NICU and postnatal ward in our hospital during year January 2009 to December 2010 were reviewed. Data were analysed to calculate rates for all birth trauma and specific types of birth injuries. Parameters including type of delivery, birth weight, gender, known risk factors in mother and type of birth injuries were recorded. Setting : Level III NICU in a tertiary care referral centre. Results : Incidence of birth trauma (19 cases amongst 5837 live born) in our institute was found to be 3.26 per 1000 live births in 2 years study period. Medical records of all newborns with birth injuries were analysed. Most common birth injury being bleeds (51.16%) of which cephal haematoma (38.7%) was commonest. Higher incidence being noticed in vaginal deliveries (83.9 %) as compared to caesarean deliveries (16.1%) and 25.8% birth injury cases were associated with instrumentation (forceps and vacuum). The predisposing factors were difficult labour (41.9%), difficult breech extraction, macrosomia, shoulder dystocia, maternal pelvic anomalies, 25.8% were associated with instrumentation (forceps/vacuum) and no risk factor was found in 32.3%. Conclusion : Regular follow up during ANC period, early identification of risk factor for difficult delivery, stoppage and avoidance of traumatising manoeuvres and instrumental deliveries and early intervention in form of LSCS when indicated are key factors in reducing traumatic birth injuries. Introduction irth injury is damage sustained to the Bbaby during the birth process, usually during transit through birth 1,2 canal. Birth related trauma was suggested to be mostly due to difficult vaginal delivery especially with the shoulder in the vertex presentation or extended arms in a breech delivery, macrosomia, shoulder dystocia, and use of instruments like forceps or vacuum during delivery. The average incidence of birth injuries is 6-8 cases per 1000 live Original/Research Articles