Obstetric brachial palsy

What is obstetric brachial palsy?

Obstetric brachial palsy is an injury to the peripheral nerves, specifically the brachial plexus. It consists of the loss of mobility or sensation in the upper limb (arm, forearm or hand) of a newborn.

It is an injury that is related to complicated vaginal deliveries, which occurs when at the time of birth the head has emerged, but the shoulders are still trapped by the maternal pelvic bone. In this sense, generally, specific maneuvers are required to get the newborn to come out in its entirety.

Prognosis of the disease

This is a traumatic injury that occurs at birth, so the chance of recovery is greater, with a better prognosis than injuries that occur in adults.

Symptoms of obstetrical brachial palsy

Symptoms indicating obstetric brachial palsy include decreased mobility or sensation of the upper limb. Usually, only one of the limbs is affected, but in some cases this injury may be accompanied by another injury, such as a clavicle or humerus fracture, among other injuries.

Generally, obstetric brachial palsy can be seen by asymmetry in mobility.

Medical tests for obstetrical brachial palsy

To diagnose obstetric brachial palsy, a physical examination can be performed, through which it can be observed that the newborn has no mobility in the upper arm. In addition, in some cases, an x-ray may also be done to confirm the injury.

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What are the causes of obstetric brachial palsy?

Obstetric brachial palsy can have its origin in a compression inside the mother’s uterus or in a complicated delivery. This injury can have different causes such as the following:

  • Shoulder dystocia
  • Prolonged labor
  • Maneuvers used to free the shoulders
  • Instrumented vaginal deliveries, in which forceps or spatulas are used.
  • Fetal malposition

There are a number of factors that also increase the risk of obstetric brachial palsy, which are as follows:

  • Breech delivery
  • Excessive maternal weight: obesity
  • Mother’s diabetes

Can it be prevented?

It is difficult to prevent obstetric brachial palsy. However, it is important to follow the proper steps to avoid a complicated delivery to reduce the risk of injury.

Treatments for obstetric brachial palsy

The main treatment to correct obstetric brachial palsy is physiotherapeutic and rehabilitative, using gentle massage, postural treatments and mobilization.

If the symptoms have not improved after 3 months of age, the specialist may consider the possibility of surgery.

Which specialist treats it?

The doctor in charge of the treatment of obstetric brachial palsy is the specialist in infantile traumatology.