Open AccessObstetric brachial plexus palsy: a prospective study on risk factors related to manual assistance during the second stage of labor
Author(s) -
MOLLBERG MARGARETA,
WENNERGREN MARGARETA,
BAGER BÖRJE,
LADFORS LARS,
HAGBERG HENRIK
Publication year - 2007
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340601089792
Subject(s) - medicine , brachial plexus , palsy , fetal head , population , odds ratio , prospective cohort study , vaginal delivery , incidence (geometry) , shoulder dystocia , surgery , obstetrics , pregnancy , fetus , physics , alternative medicine , environmental health , pathology , biology , optics , genetics
Background . To evaluate the association between obstetric brachial plexus palsy and obstetrical maneuvers during the second stage of delivery. Methods . Prospective population‐based case control study. Cases of obstetric brachial plexus palsy were compared with a randomly selected control group with regard to obstetric management. Results . Five or more obstetrical maneuvers were used to deliver the infants in 82% in the obstetric brachial plexus palsy group versus 1.8% in the controls. Risk factors independently associated with obstetric brachial plexus palsy were force applied when downward traction was imposed on the fetal head (odds ratio 15.2; 95% confidence interval 8.4–27.7). The incidence of obstetric brachial plexus palsy in the infants in the population was 3.3‰. At 18 months of age 16.1% (incidence of 0.05%) of children had residual functional deficits and downward traction with substantial force was applied in all these cases. Conclusions . Forceful downward traction applied to the head after the fetal third rotation represents an important risk factor of obstetric brachial plexus palsy in vaginal deliveries in cephalic presentation.