Brachial Plexus Palsy ( Shoulder Dystocia
) is a birthing complication in which the fetus’
shoulders are too large for the birth canal and subsequently become
trapped behind the pubic bone after the delivery of the head.
From this complication a range of injuries can occur, such as
a broken arm or clavicle, and strain of the nerves traveling through
the neck – a condition doctors
call brachioplexus.
In many cases, doctors can anticipate and prevent shoulder
dystocia by watching for early warning signs such as gestational diabetes,
obesity in the mother or excessive weight gain during the pregnancy. Expectant
mothers with a small pelvis, those who’ve previously given birth
to a large baby, and those in post-term pregnancy are also at risk.
In most instances, even if unforeseen complications arise,
your doctor should be familiar with the methods necessary to ensure a
healthy delivery. Despite the medical community’s efforts to develop
methods to ensure safe deliveries, 3 in 1000 births suffer an injury to
the brachial plexus as a result of a shoulder dystocia. In many of these
cases, medical negligence
is to blame.
Examples of negligence include:
Failure to obtain a proper obstetrical history.
Failure to check for or manage diabetes during pregnancy
Failure to manage excessive weight gain during maternity
Failure to assign qualified personnel to the delivery
room
Failure to offer the option of cesarean section
Failure to manage shoulder dystocia
Exerting pressure on the abdomen during birth, which
actually worsens shoulder dystocia
Exerting excessive force or traction on the head during
delivery
Improper use of forceps or vacuum extractors
The Brachial Plexus, which is located on right and left
side of neck between the neck and shoulder area, is a group of nerves
that run from the spinal cord through the arm to the wrist and the hand.
Injuries to the Brachial Plexus are commonly referred to, as Erb’s
Palsy or Brachial Plexus Palsy. Brachial Plexus Palsy and Erb's Palsy
are nerve injuries affecting the nerves that control the muscles in the
arm and hand.
Common examples of Brachial Plexus Plasy and
Erb's Palsy injuries include:
Decrease in sensation in the arm or hand
No muscle control or feeling in the arm or hand
Ability to move arms, but little movement in wrist and
hand
Ability to use hands, but no use of shoulder or elbow
Paralysis
in arm and limp, hanging fingers
Facial paralysis on affected side Inability to sit up
without assistance
Limp or paralyzed arm
Lack of muscle control in arm
Some injuries heal on their own and many children improve
or recover by 3-4 months of age. More severe cases improve slowly over
18-21 months and by two years any recovery that will occur should have
occurred. Brachial Plexus Palsy treatment avenues include physical and
occupational therapy and in some cases, surgery
