Brachial plexus injury in vaginal delivery

OBJECTIVE: To study the incidence and persistence of brachial plexus injury (BPI) and the ability to predict its occurrence pre-natally depending on patients’ criteria and antepartum-partum course.

METHODS: During a 3-year period from June 2001-June 2004 at Queen Alia Military Hospital, Royal Medical Services, Amman, Jordan, all newborns with BPI were identified (patients group) and followed-up for a one-year period. Obstetric details were compared with a control group who were delivered during the same period. Obstetrical neonatal features of both groups were compared.

RESULTS: Over the mentioned period, 30 cases of BPI were identified from a total 11560 deliveries (0.25%). Persistency for more than one year was present in 5 cases (17%). Both groups were compared regarding certain known maternal and intra-partum risk factors. Significant risk was history of having shoulder dystocia in previous and current pregnancy (p<0.05) and duration of labor (p<0.05).

CONCLUSION: Brachial plexus impairment was encountered in the presence of normal course of labor and delivery. No predictable risk factors were found that could be avoided antenatally to prevent BPI.