BRACHIAL PLEXUS PALSY AMONG NEONATES IN BINT AL-HUDA TEACHING HOSPITAL . THI-QAR
AbstractBackground and Objective : The brachial plexus are injured mostly due to severe lateral traction of neck during delivery mainly in shoulder dystocia , large baby and prolonged labour . Method : A prospective study was carried out on (26) cases of brachial plexus palsy . The information depend on clinical examination at nursery care unit and delivery room notes at Bint Al-Huda Maternity and Pediatric Teaching Hospital in Al-Nassirya city through out 2009. Results : Brachial plexus palsy ( BPP ) is found in ( 1.5 per 1000 live birth ) of total delivery and usually type Erb's palsy (80.8%) more than Klumpke (7.7%). Shoulder dystocia (38.8%) , Macrosomia (23 %) , Prolonged labour ( 15.3 % ) were significant risk factors for BPP . Male ( 53.8 % ) affected little more than female ( 46.2 % ) and right side ( 61.5 % ) more affected than left side ( 38.5 % ) . Most cases of Erbs ( 76 % ) improve with time opposite to that of Klumpke type ( 3.3 % ) during the period of follow up for 6 months . Conclusion : BPP still a problem in our overload delivery room . Well trained medical staff necessary beside education about risk factors of BPP .
Pal D. Sponseller : Neonatal Neurology . In : Oski's Essential Pediatrics . Michael Crocetti , Michael A. Barone . 2nd (ed) . 2004 : 61 .
Elizabeth H. Tnilo , MD and Adam A. Rosenberg , MD : The Newborn Infant In : Current Diagnosis and Treatment in Pediatrics. William W. Hay , JR . Myron J. Levin. 18th (ed) . 2009 : 22
Clarence W. Gowo . Jr. : Fetal and Neonatal Medicine . In : Nelson Essential of Pediatric . Robert M. Kleigman , Karen J. Marcdante . 5th (ed ) . 2006 : 294 .
Cunnigham , Leveno : Diseases and Injuries of the Fetus and Newborn . In Williams Obstetrics . 23th (ed ) . 2010 : 636 .
Neonatology . In : Obstetrician by Ten Teachers ( International Student Edition ) . 18th (Ed) . 2006 : 322 .
McIntosh N : The newborn . In : Forfar and Arneils Textbook of Pediatrics . A. G. M. Campbell , Neil McIntosh . 5th ( ed ) . 1998 : 122 .
Gherman RBB . Goodman TM . Souter I : The Mc Roberts maneuver for the alleviation of Shoulder dystocia how successful is it ? American Journal of Obst. And Gyn. ( 1997 ) ; 179 : 656 – 661 .
Brachial Plexus injury and Obstetrical risk Factors . Int. J Gyn. Obst. 2001 ; 73 (1) : 21 – 5 .
Ira Adams – chapman and Barbara J . Stoll : The Fetus and the Neonatal Infant . In : Nelson Textbook of Pediatrics , Kliegman , Behrman , Jenson. 18th ( ed ) . 2007 : 720.
Graham EM ; Forouzan I ; Morgan MA. : A retrospective analysis of Erb's palsy and their relation to birth weight and trauma at delivery . Journal of Maternal- Fetal Medicine . ( 1997 ) ; 6 : 1 – 5 .
Hoeksma AF , Wolf H , Oei SL : Obstetrical brachial plexus injuries : Incidence , natural course and shoulder contracture . Clin Rehabil 2000 ; 14 : 523 – 526 .
Foad SL . Mehlman CT , Ying J. The epidemiology of neonatal brachial plexus palsy in the united states . J Bone Joint surgery Am . 2008 ; 90 : 1258 – 1264 .
McAbee GN , Ciervo C. Medical and legal issues related to brachial plexus injuries in neonate . JAM Osteopath Association . 2006 ; 106 : 209 – 212 .
M. A. Thomason and A. D. Edwards : Neonatal care for Obsetricians . In : Dewhurst's Text book of Obstet. and Gyn. D. Keith Edmonds . 7th (ed ) 2007 : 89 .
Pitt M. Uredeveld JW . The role of electromyography in the management of the brachial palsy of the newborn . Clin Neurophysiol . 2005 ; 116 : 1756 – 1761 .
Crossman JA . Early operative intervention for birth injuries to the brachial plexus pediatric Neurology . 2000 ; 7 : 36 – 43 .
Pondaag W. , Malessy MJ , Van Dijk JG. Thomeer RT . Natural history of obstetric brachial palsy : A systematic review . Dev Med child Neurol. 2004 ; 46 : 138 – 144 .
Gilbert A , Pivato G. Kheiralla T. long – term results of primary repair of brachial plexus . Microsurgery . 2006 ; 26 : 334 – 342 .
Strombeck C, Krumlinde – Sundholm L . Forrsberg H : Functional outcome at 5 yrs in children with Obstetrical brachial plexus palsy with and without microsurgical reconstruction . Der Med child Neural 2000 ; 42 : 148 – 157 .