Objective
The
purpose of this study was to analyze the data on brachial plexus injury and its
relationship with shoulder dystocia from a tertiary center for a 23-year
period. Study
design
A review
of the logbooks on labor and delivery and the nursery and the International
Classification of Diseases codes identified all newborn infants with brachial
plexus injury who were delivered at our center. Results
During
the 23 years (1980-2002), there were 89,978 deliveries, of which there were 85
cases of brachial plexus injury (1/1000 births) with vaginal delivery. The
injury was permanent (≥1 year) in 12% of the cases, and only 2 cases have been
litigated. Newborn infants that weighed ≥4 kg were significantly more common
among those infants who had shoulder dystocia and brachial plexus injury than
those infants without injury (odds ratio, 6.55; 95% CI, 2.30, 18.63). The rate
of permanent brachial plexus injury was similar between the 2 groups. Conclusion
A case of
brachial plexus injury occurs 1 time in every 1000 births, is permanent in 1 of
every 10,000 deliveries, and is litigated 1 time for every 45,000 deliveries.
The infrequent nature of injury may preclude prevention.
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