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Comparison in Obstetric Management on Infants With Transient and Persistent Obstetric Brachial Plexus Palsy

Perinatal Centre, Department of Obstetrics and Gynaecology, The Institute of Clinical Sciences, Sahlgrenska Academy at Göteborg University, m.mollberg{at}telia.com

Anna-Lena Lagerkvist, RPT, PhD

Department of Paediatrics, Sahlgrenska University hospital, Göteborg

Urban Johansson, RPT

Child Rehabilitation, Central Hospital, Skövde, Sweden

Börje Bager, MD

Child Rehabilitation, Central Hospital, Skövde, Sweden

Annika Johansson, RPT

Child Rehabilitation, Central Hospital, Skövde, Sweden

Henrik Hagberg, MD, PhD

Perinatal Centre, Department of Obstetrics and Gynaecology, The Institute of Clinical Sciences, Sahlgrenska Academy at Göteborg University

The outcome of obstetric brachial plexus palsy depends on the severity of the lesion of the nerve fibers. The aim of the prospective study is to evaluate if differences in force used in downward traction on the fetal head correlate to the number of nerve roots affected. At final neurological examination at 18 months of age, complete neurological recovery occurred in 80 of 98 children (82%). Downward traction of the fetal head was applied more often and with greater force in the group with persistent damage. There was a significant correlation between the force used to the number of nerve roots affected. The risk of persistent obstetric brachial plexus palsy at age 18 months depended on obstetric management and increased significantly with increasing force used in downward traction of the fetal head.

Key Words: brachial palsy • obstetric management • functional deficit • brachial plexus

Journal of Child Neurology, Vol. 23, No. 12, 1424-1432 (2008)
DOI: 10.1177/0883073808320620


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