A Study on the Risk Factors for Obstetrical Brachial Plexus Palsy

Objective
Considerable medical and legal debates have surrounded the prognosis and outcome of obstetrical brachial plexus injuries and obstetricians are often
considered responsible for the injury. In this study, we assessed the factors related to the outcome of brachial plexus palsy.

Material & Methods
During 24 months, 21 neonates with obstetrical brachial plexus injuries were enrolled.
Electrophysiology studies were done at the age of three weeks. They received physiotherapy and occupational therapy. They were examined every 3 months
for one year and limbs function was assessed according to Mallet scores; also, maternal and neonatal factors were collected by a questionnaire.

Results
There were 10 boys and 11 girls.
Of all, 76.2% had Erb's palsy, 19% had total brachial palsy and 4.8% had
klumpke paralysis.
Risk factors including primiparity, high birth weight, shoulder dystocia, and
prolonged second stage of labor were assessed.
Electrophysiology studies showed neuropraxia in 52.4% and axonal injuries in
42.9% of the patients.
At the end of the first year, 81% of the patients had functioned recovery around
grade III or IV of Mallet scores.
There were only significant relationships between functional improvement and
neurophysiologic findings.
Conclusion
Outcome of obstetrical brachial injuries has a close relationship to
neurophysiologic study results than other risk factors.