-
Women's Health (London, England) 2016Shoulder dystocia is a complication of vaginal delivery and the primary factor associated with brachial plexus injury. In this review, we discuss the risk factors for... (Review)
Review
Shoulder dystocia is a complication of vaginal delivery and the primary factor associated with brachial plexus injury. In this review, we discuss the risk factors for shoulder dystocia and propose a framework for the prediction and prevention of the complication. A recommended approach to management when shoulder dystocia occurs is outlined, with review of the maneuvers used to relieve the obstruction with minimal risk of fetal and maternal injury.
Topics: Birth Injuries; Brachial Plexus; Delivery, Obstetric; Dystocia; Female; Fetus; Humans; Pregnancy; Risk Factors; Shoulder Injuries
PubMed: 26901875
DOI: 10.2217/whe.15.103 -
Academic Forensic Pathology Dec 2018Injury to a fetus or neonate during delivery can be due to several factors involving the fetus, placenta, mother, and/or instrumentation. Birth asphyxia results in... (Review)
Review
Injury to a fetus or neonate during delivery can be due to several factors involving the fetus, placenta, mother, and/or instrumentation. Birth asphyxia results in hypoxia and ischemia, with global damage to organ systems. Birth trauma, that is mechanical trauma, can also cause asphyxia and/or morbidity and mortality based on the degree and anatomic location of the trauma. Some of these injuries resolve spontaneously with little or no consequence while others result in permanent damage and severe morbidity. Unfortunately, some birth injuries are fatal. To understand the range of birth injuries, one must know the risk factors, clinical presentations, pathology and pathophysiology, and postmortem autopsy findings. It is imperative for clinicians and pathologists to understand the causes of birth injury; recognize the radiographic, gross, and microscopic appearances of these injuries; differentiate them from inflicted postpartum trauma; and work to prevent future cases.
PubMed: 31240076
DOI: 10.1177/1925362118821468 -
Revista de Neurologia Jul 2020Obstetric brachial palsy is involved with affected upper limb, resulting in permanent structural and function sequelae that limit the motion articular range and reduce...
INTRODUCTION
Obstetric brachial palsy is involved with affected upper limb, resulting in permanent structural and function sequelae that limit the motion articular range and reduce independence in daily activities, as well as the children participation in their natural environment.
AIM
To describe the physiotherapy treatments currently used to increase the affected upper limb functionality in children from 0 to 10 years diagnosed with obstetric brachial palsy.
PATIENTS AND METHODS
A bibliographic search of published studies between 2009 and 2018 was carried out in the PubMed, PEDro, ScienceDirect and The Cochrane Library databases.
RESULTS
After applying the inclusion/exclusion criteria, ten studies were obtained with favorable results for the affected upper limb functionality and bone mineralization density, regardless of the technique of choice used during the intervention. The used physiotherapy programs in the different studies such as Constraint Induced movement therapy, kinesiotape, electrotherapy, virtual reality and use of splints or orthotics were analyzed.
CONCLUSION
All the described techniques suggest favorable results for the affected upper limb functionality in obstetric brachial palsy from 0 to 10 years.
Topics: Arm; Bone Density; Brachial Plexus Neuropathies; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Paralysis, Obstetric; Physical Therapy Modalities; Quality of Life; Secondary Prevention
PubMed: 32583409
DOI: 10.33588/rn.7101.2020029 -
Pediatric Clinics of North America Dec 1993Although significant birth injury accounts for few neonatal deaths and stillborns in the United States, it still occasionally and unavoidably occurs. This article... (Review)
Review
Although significant birth injury accounts for few neonatal deaths and stillborns in the United States, it still occasionally and unavoidably occurs. This article reviews soft tissue, peripheral nerve, intrathoracic, and intra-abdominal injury.
Topics: Abdominal Injuries; Birth Injuries; Connective Tissue; Humans; Infant, Newborn; Peripheral Nerve Injuries
PubMed: 8255629
DOI: 10.1016/s0031-3955(16)38665-5 -
The Journal of Hand Surgery Feb 2021Brachial plexus birth injury can differ in presentation, depending on whether the nerve ruptures distal to, or avulses proximal to, the dorsal root ganglion. More...
PURPOSE
Brachial plexus birth injury can differ in presentation, depending on whether the nerve ruptures distal to, or avulses proximal to, the dorsal root ganglion. More substantial contracture and bone deformity at the shoulder is typical in postganglionic injuries. However, changes to the underlying muscle structure that drive these differences in presentation are unclear.
METHODS
Seventeen Sprague-Dawley rats received preganglionic or postganglionic neurectomy on a single limb on postnatal days 3 and 4. Muscles crossing the shoulder were retrieved once the rats were sacrificed at 8 weeks after birth. External rotation range of motion, muscle mass, muscle length, muscle sarcomere length, and calculated optimal muscle length were measured bilaterally.
RESULTS
Average shoulder range of motion in the postganglionic group was 61.8% and 56.2% more restricted at 4 and 8 weeks, respectively, compared with that in the preganglionic group, but affected muscles after preganglionic injury were altered more severely (compared with the unaffected limb) than after postganglionic injury. Optimal muscle length in preganglionic injury was shorter in the affected limb (compared with the unaffected limb: -18.2% ± 9.2%) and to a greater extent than in postganglionic injury (-5.1% ± 6.2%). Muscle mass in preganglionic injury was lower in the affected limb (relative to the unaffected limb: -57.2% ± 24.1%) and to a greater extent than in postganglionic injury (-28.1% ± 17.7%).
CONCLUSIONS
The findings suggest that the presence of contracture does not derive from restricted longitudinal muscle growth alone, but also depends on the extent of muscle mass loss occurring simultaneously after the injury.
CLINICAL RELEVANCE
This study expands our understanding of differences in muscle architecture and the role of muscle structure in contracture formation for preganglionic and postganglionic brachial plexus birth injury.
Topics: Animals; Birth Injuries; Brachial Plexus; Brachial Plexus Neuropathies; Muscle, Skeletal; Range of Motion, Articular; Rats; Rats, Sprague-Dawley; Shoulder; Shoulder Joint
PubMed: 32919794
DOI: 10.1016/j.jhsa.2020.07.017 -
Brain Pathology (Zurich, Switzerland) Oct 2008Birth injury of the scalp, skull and central nervous system (CNS) is a well-recognized complication of a difficult delivery. The rate of birth trauma has dropped... (Review)
Review
Birth injury of the scalp, skull and central nervous system (CNS) is a well-recognized complication of a difficult delivery. The rate of birth trauma has dropped precipitously and now accounts for less than 2% of neonatal deaths. Despite this dramatic decrease in birth-trauma mortality significant injuries still occur. A variety of risk factors clearly predispose certain infants to birth-related injury. Recent neuroradiology studies indicate that intracranial hemorrhage, even in asymptomatic infants, is not rare. Pathologists' (neuropathologists and forensic pathologists) appreciation of the spectrum of birth injuries and their sequelae is critical in order to be able to distinguish these from inflicted injuries and post-mortem changes.
Topics: Birth Injuries; Brain Injuries; Causality; Central Nervous System; Diagnosis, Differential; Female; Head Injuries, Closed; Humans; Intracranial Hemorrhages; Pregnancy; Skull; Skull Fractures; Subarachnoid Hemorrhage
PubMed: 18782168
DOI: 10.1111/j.1750-3639.2008.00205.x -
Journal of Musculoskeletal & Neuronal... Dec 2017The objective was to evaluate the effects of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The objective was to evaluate the effects of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury.
METHODS
Forty children with Erb's palsy were selected for this randomized controlled study. They were assigned randomly to either group A (conventional physiotherapy program) or group B (virtual reality program using Armeo® spring for 45 min three times/week for 12 successive weeks). Mallet system scores for shoulder function and shoulder abduction, and external rotation range of motion (ROM) were obtained; shoulder abductor, and external rotators isometric strength were evaluated pre-and post-treatment using Mallet scoring system, standard universal goniometer, and handheld dynamometer.
RESULTS
The results of this study indicate that the children in both groups showed improvement in shoulder functions post-treatment with greater improvements in group B. The abduction muscle strength after treatment was 8.53 and 11.3 Nm for group A and group B, respectively. The external rotation muscle strength after treatment was 5.88 and 7.45 Nm for group A and group B, respectively.
CONCLUSIONS
The virtual reality program is a significantly more effective than conventional physiotherapy program in improving the upper extremity functions in children with obstetric brachial plexus injury.
Topics: Birth Injuries; Brachial Plexus Neuropathies; Child; Child, Preschool; Exercise Therapy; Female; Humans; Male; Muscle Strength; Range of Motion, Articular; Shoulder; Treatment Outcome; Upper Extremity; Virtual Reality Exposure Therapy
PubMed: 29199193
DOI: No ID Found -
Cureus Dec 2017Birth injuries are a diverse set of traumas afflicting a newborn during labor and/or delivery. These range from temporary paralysis to hematomas. Herein, a comprehensive... (Review)
Review
Birth injuries are a diverse set of traumas afflicting a newborn during labor and/or delivery. These range from temporary paralysis to hematomas. Herein, a comprehensive review of the birth injuries is presented, including the risk factors, classification of various paralyzes and nerve damage, as well as bleeding complications. The predicted outcomes and complications, as well as the treatment options for various birth injuries, are also discussed.
PubMed: 29464145
DOI: 10.7759/cureus.1938 -
BMC Pregnancy and Childbirth May 2023Caesarean section (CS) is widely perceived as protective against obstetric brachial plexus injury (BPI), but few studies acknowledge the factors associated with such...
BACKGROUND
Caesarean section (CS) is widely perceived as protective against obstetric brachial plexus injury (BPI), but few studies acknowledge the factors associated with such injury. The objectives of this study were therefore to aggregate cases of BPI after CS, and to illuminate risk factors for BPI.
METHODS
Pubmed Central, EMBASE and MEDLINE databases were searched using free text: ("brachial plexus injury" or "brachial plexus injuries" or "brachial plexus palsy" or "brachial plexus palsies" or "Erb's palsy" or "Erb's palsies" or "brachial plexus birth injury" or "brachial plexus birth palsy") and ("caesarean" or "cesarean" or "Zavanelli" or "cesarian" or "caesarian" or "shoulder dystocia"). Studies with clinical details of BPI after CS were included. Studies were assessed using the National Institutes for Healthy Study Quality Assessment Tool for Case Series, Cohort and Case-Control Studies.
MAIN RESULTS
39 studies were eligible. 299 infants sustained BPI after CS. 53% of cases with BPI after CS had risk factors for likely challenging handling/manipulation of the fetus prior to delivery, in the presence of considerable maternal or fetal concerns, and/or in the presence of poor access due to obesity or adhesions.
CONCLUSIONS
In the presence of factors that would predispose to a challenging delivery, it is difficult to justify that BPI could occur due to in-utero, antepartum events alone. Surgeons should exercise care when operating on women with these risk factors.
Topics: Female; Pregnancy; Humans; Cesarean Section; Brachial Plexus; Brachial Plexus Neuropathies; Case-Control Studies; Risk Factors; Paralysis; Birth Injuries; Dystocia
PubMed: 37198580
DOI: 10.1186/s12884-023-05696-1 -
International Journal of Gynaecology... Oct 2022To examine severe birth-related injuries in neonates among mothers with different types of diabetes.
OBJECTIVE
To examine severe birth-related injuries in neonates among mothers with different types of diabetes.
METHODS
Retrospective cohort study based on Finnish Medical Birth Register data from 2004 to 2017. The study included singleton neonates born vaginally with cephalic presentation (n = 623 649) after 35 weeks of gestation. The primary outcome variable was severe birth injury. Incidences, crude and adjusted odds ratios, and probabilities in regression analysis were calculated for different types of diabetes.
RESULTS
There were 1952/623 649 (0.3%) severe birth injuries of which brachial plexus injury occurred most frequently. The injury incidence was highest in neonates of women with type 1 or type 2 diabetes, 42/1659 (2.5%) and 10/548 (1.8%), respectively. For gestational diabetes, the injury incidence was comparable to non-diabetic women: 422/77 810 (0.5%) and 1478/543 632 (0.3%), respectively. Shoulder dystocia, high birthweight, and vacuum-assisted delivery were associated with the highest probability for injury. Birthweight and obesity had a stronger impact on injury risk in women with pregestational diabetes compared to other pregnancies.
CONCLUSION
Neonates of women with pregestational diabetes have a higher risk for severe birth injury than other neonates. The injury risk in neonates delivered by women with gestational diabetes or non-diabetic women is generally low.
Topics: Birth Injuries; Birth Weight; Diabetes Mellitus, Type 2; Diabetes, Gestational; Dystocia; Female; Finland; Humans; Infant, Newborn; Pregnancy; Retrospective Studies; Risk Factors
PubMed: 34927725
DOI: 10.1002/ijgo.14073