TY - GEN
T1 - Is it possible to reduce obstetrical brachial plexus palsy by optimal management of shoulder dystocia
AU - Doumouchtsis, Stergios K.
AU - Arulkumaran, Sabaratnam
PY - 2010/9
Y1 - 2010/9
N2 - 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.
AB - 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.
KW - brachial plexus
KW - labor
KW - management
KW - shoulder dystocia
UR - http://www.scopus.com/inward/record.url?scp=77957054018&partnerID=8YFLogxK
U2 - 10.1111/j.1749-6632.2010.05655.x
DO - 10.1111/j.1749-6632.2010.05655.x
M3 - Conference contribution
C2 - 20840265
AN - SCOPUS:77957054018
SN - 9781573317689
VL - 1205
T3 - Annals of the New York Academy of Sciences
SP - 135
EP - 143
BT - Women's Health and Disease
ER -