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Obstet Gynecol. 2003 Sep;102(3):544-8.

A comparison of shoulder dystocia-associated transient and permanent brachial plexus palsies.

Author information

1
Department of OB/GYN, Division of Maternal/Fetal Medicine, National Naval Medical Center, Bethesda, Maryland, USA.

Abstract

OBJECTIVE:

To estimate differences between shoulder dystocia-associated transient and permanent brachial plexus palsies.

METHODS:

We performed a retrospective case-control analysis from national birth injury and shoulder dystocia databases. Study patients had permanent brachial plexus palsy and had been entered into a national birth injury registry. Cases of Erb or Klumpke palsy with documented neonatal neuromuscular deficits persisting beyond at least 1 year of life were classified as permanent. Cases of transient brachial plexus palsy were obtained from a shoulder dystocia database. Non-shoulder dystocia-related cases of brachial plexus palsy were excluded from analysis. Cases of permanent brachial plexus palsy (n=49) were matched 1:1 with cases of transient brachial plexus palsy.

RESULTS:

Transient brachial plexus palsy cases had a higher incidence of diabetes mellitus than those with permanent brachial plexus palsy (34.7% versus 10.2%, odds ratio [OR] 4.68, 95% confidence interval [CI] 1.42, 16.32). Patients with permanent brachial plexus palsies had a higher mean birth weight (4519+/-94.3 g versus 4143.6+/-56.5 g, P<.001) and a greater frequency of birth weight greater than 4500 grams (38.8% versus 16.3%, OR, 0.31, 95% CI 0.11, 0.87). There were, however, no statistically significant differences between the two groups with respect to multiple antepartum, intrapartum, and delivery outcome measures.

CONCLUSION:

Transient and permanent brachial plexus palsies are not associated with significant differences for most antepartum and intrapartum characteristics.

PMID:
12962939
[Indexed for MEDLINE]

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