[Brachial plexus palsy associated with birth. A review of 30 cases]

Abstract

Objective: Our objective was to perform an updated analysis of the incidence and risk factors during pregnancy and labor related to obstetrical brachial palsy.

Patients and methods: A retrospective study of all cases of brachial palsy associated with birth detected in our hospital between January 1994 and March 1998 was performed. Data recorded included age of mother, parity, gestational age at the moment of birth, type of birth, presentation, duration of delivery, sex of child, weight, Apgar test at 5 minutes, arterial pH of umbilical cord, type of brachial palsy, side affected and association with other injuries.

Results: Thirty cases of brachial palsy associated with birth were diagnosed. The incidence was 1.04%. In addition to a high birth weight, other factors related to the increase in the incidence of obstetric brachial palsy were the presence of dystocia of shoulders at birth, the use of forceps and Apgar and pH under the usual limits. No case of distal paralysis was found.

Conclusions: This study demonstrates the influence of the risk factors known in the development of brachial palsy associated with birth. However, it also establishes doubts about the etiology of traction as the only cause. In addition, it stresses the necessity of adequate birth planning of babies suspected of being macrosomic.