Brachial plexus palsy associated with cesarean section: An in utero injury?

被引:69
作者
Gherman, RB [1 ]
Goodwin, TM [1 ]
Ouzounian, JG [1 ]
Miller, DA [1 ]
Paul, RH [1 ]
机构
[1] UNIV SO CALIF,SCH MED,DEPT OBSTET & GYNECOL,DIV MATERNAL FETAL MED,LOS ANGELES,CA 90033
关键词
brachial plexus palsy; intrauterine origin; cesarean section;
D O I
10.1016/S0002-9378(97)70034-6
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: Brachial plexus injury may be unrelated to manipulations performed at the time of delivery, occurring in the absence of shoulder dystocia and in the posterior arm of infants with anterior shoulder dystocia. To further support the hypothesis that some of these nerve injuries appear to be of intrauterine origin, we present a series of brachial plexus palsies associated with atraumatic cesarean delivery among fetuses presenting in the vertex position. STUDY DESIGN: We performed a computerized search of ail deliveries from 1991 to 1995 for the discharge diagnoses of brachial plexus injury and cesarean section. Inclusion criteria included cephalic presentation at the time of delivery and the absence of traumatic delivery. RESULTS: We noted six cases of Erb's palsy, with four palsies in the anterior shoulder and two in the posterior arm. Among those five patients undergoing cesarean section because of labor abnormalities, two had uterine cavity abnormalities whereas one had a prolonged second stage of labor. One brachial plexus palsy occurred in the absence of active labor. All nerve injuries were persistent at age 1 year. CONCLUSIONS: Brachial plexus palsy can be associated with cesarean delivery. Such palsies appear to be of intrauterine origin and are more likely to persist.
引用
收藏
页码:1162 / 1164
页数:3
相关论文
共 19 条
[1]   RISK-FACTORS FOR SHOULDER DYSTOCIA IN THE AVERAGE-WEIGHT INFANT [J].
ACKER, DB ;
SACHS, BP ;
FRIEDMAN, EA .
OBSTETRICS AND GYNECOLOGY, 1986, 67 (05) :614-618
[2]  
ACKER DB, 1988, OBSTET GYNECOL, V71, P389
[3]  
Dunn D W, 1985, Pediatr Neurol, V1, P367, DOI 10.1016/0887-8994(85)90074-8
[4]   The McRoberts' maneuver for the alleviation of shoulder dystocia: How successful is it? [J].
Gherman, RB ;
Goodwin, TM ;
Souter, I ;
Neumann, K ;
Ouzounian, JG ;
Paul, RH .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1997, 176 (03) :656-661
[5]   SHOULDER DYSTOCIA RECOGNITION - DIFFERENCES IN NEONATAL RISKS FOR INJURY [J].
GONIK, B ;
HOLLYER, VL ;
ALLEN, R .
AMERICAN JOURNAL OF PERINATOLOGY, 1991, 8 (01) :31-34
[6]  
GONIK B, 1989, OBSTET GYNECOL, V74, P44
[7]   SHOULDER DYSTOCIA - PREDICTORS AND OUTCOME - A 5-YEAR REVIEW [J].
GROSS, SJ ;
SHIME, J ;
FARINE, D .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1987, 156 (02) :334-336
[8]   BRACHIAL-PLEXUS PALSY INVOLVING THE POSTERIOR SHOULDER AT SPONTANEOUS VAGINAL DELIVERY [J].
HANKINS, GDV ;
CLARK, SL .
AMERICAN JOURNAL OF PERINATOLOGY, 1995, 12 (01) :44-45
[9]   BIRTH INJURIES OF THE BRACHIAL-PLEXUS - INCIDENCE AND PROGNOSIS [J].
HARDY, AE .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1981, 63 (01) :98-101
[10]   BRACHIAL-PLEXUS PALSY - AN OLD PROBLEM REVISITED [J].
JENNETT, RJ ;
TARBY, TJ ;
KREINICK, CJ .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1992, 166 (06) :1673-1677