Is it possible to reduce obstetrical brachial plexus palsy by optimal management of shoulder dystocia

Stergios K. Doumouchtsis, Sabaratnam Arulkumaran

Research output: Chapter in Book/Report/Conference proceedingConference contribution

17 Citations (Scopus)

Abstract

Obstetrical brachial plexus palsies (OBPP) have been historically attributed to the impaction of the fetal shoulder behind the symphysis pubis and to excessive lateral traction of the fetal head during maneuvers to deliver the fetal shoulders in shoulder dystocia. Shoulder dystocia is indeed a major risk factor as it increases the risk for OBPP 100-fold. The incidence of OBPP following shoulder dystocia varies widely from 4% to 40%. However, a significant proportion of OBPPs are secondary to in utero injury. The propulsive forces of labor, intrauterine maladaptation, and compression of the posterior shoulder against the sacral promontory as well as uterine anomalies are possible intrauterine causes of OBPP. Many risk factors for OBPP may be unpredictable. Early identification of risk factors for shoulder dystocia, as well as appropriate management when it occurs, may improve our ability to prevent the occurrence of OBPP in those cases that are caused by shoulder dystocia.

Original languageEnglish
Title of host publicationWomen's Health and Disease
Pages135-143
Number of pages9
Volume1205
DOIs
Publication statusPublished - Sep 2010

Publication series

NameAnnals of the New York Academy of Sciences
Volume1205
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632

Keywords

  • brachial plexus
  • labor
  • management
  • shoulder dystocia

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    Doumouchtsis, S. K., & Arulkumaran, S. (2010). Is it possible to reduce obstetrical brachial plexus palsy by optimal management of shoulder dystocia. In Women's Health and Disease (Vol. 1205, pp. 135-143). (Annals of the New York Academy of Sciences; Vol. 1205). https://doi.org/10.1111/j.1749-6632.2010.05655.x