Focal upper extremity neuropathy in neonates

Alfonso, Israel; Alfonso, Daniel T.; Papazian, Óscar

doi:10.1016/s1071-9091(00)80005-4

Cited by 39 publications

(19 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When there is no mechanical disruption to the nerve or the axons, the stretching results in temporary dysfunction of nerve conduction (23). Since midwifes and obstetricians can only exert limited control over maternal pushing and uterine forces, the initial focus must be on how clinician-applied traction may be reduced (61).…”

Section: The Mechanism Of the Force Factormentioning

confidence: 99%

High birthweight and shoulder dystocia: the strongest risk factors for obstetrical brachial plexus palsy in a Swedish population‐based study

Mollberg

Hagberg

Bager

et al. 2005

Acta Obstet Gynecol Scand

138

View full text Add to dashboard Cite

Background: Obstetric brachial plexus palsy (OBPP) at birth is one important cause of neurological disability in children and adults; the incidence has increased substantially in Sweden over the past decade. Several risk factors for OBPP have been identified, e.g. high birth weight and shoulder dystocia, but it remains difficult to predict based on antenatally available information. Despite extensive research on OBPP, there is no generally accepted strategy for prevention. The overall objective of this thesis is to study predisposing risk factors for OBPP in vaginally delivered infants and to identify specific obstetric procedures that are strongly associated with OBPP. Based on this knowledge, our ultimate aim is to develop a prevention strategy with respect to manual assistance in the second stage of labour. Methods: Paper I reports on a retrospective case-control study aimed at investigation of the incidence and risk factors for OBPP in a large population studied in 1987-1997. All deliveries recorded in the Swedish Medical Birth Register during the period were investigated. Cases of OBPP were compared with all cases without OBPP. Paper II describes a retrospective casecontrol study, the purpose of which was to identify risk factors for OBPP, specifically in women delivered by vacuum extraction. The groups with and without OBPP were compared with regard to possible risk factors, including those linked to the vacuum extraction procedure. The aim of the prospective population-based case-control study presented in Paper III was to evaluate the association between OBPP and obstetric manoeuvres during the second stage of delivery. Obstetric management in OBPP cases was compared to management in a randomly selected control group. Paper IV and Paper III are based on the same cases. The aims of the study presented in Paper IV were a) to describe neurological deficits in children with remaining OBPP at 18 months of age; b) to compare maternal, infant and obstetric data in infants with and without OBPP at 18 months of age and c) to evaluate if differences in force applied in downward traction of the head (ranked on a 100-point visual analogue scale) correlated to the number of affected nerve roots (C5-C6, C5-C7, C5-Th1). Results:The incidence of OBPP in Sweden increased from 0.17% to 0.27% between 1987 and 1997. Infants with high birth weight, especially >4500 g, were at increased risk of shoulder dystocia and OBPP. However, high birth weight was not or only weakly overrepresented among children with persistent OBPP, compared with those who recovered, suggesting that other factors are important. Hence, many factors related to prolonged second stage and difficulties in delivering the shoulders were overrepresented in the OBPP group, compared to controls. In particular, forceful downward traction applied to the head after the fetal third rotation represented an important risk factor for OBPP in cephalic-presentation vaginal deliveries. Downward traction of the head had been applied more often and with greater force in the...

show abstract

Section: The Mechanism Of the Force Factormentioning

confidence: 99%

High birthweight and shoulder dystocia: the strongest risk factors for obstetrical brachial plexus palsy in a Swedish population‐based study

Mollberg

Hagberg

Bager

et al. 2005

Acta Obstet Gynecol Scand

138

View full text Add to dashboard Cite

show abstract

“…Isolated lesion of the upper trunk (C5-C6), also known as Erb's palsy or Narakas grade I injury, occurs in about half of cases. The typical limb posture is called "waiter's tip", in which the arm is adducted and internally rotated, the elbow is extended, and the wrist is flexed 20 ( Figure 1). The Moro reflex is absent in the affected side, but the grasp reflex is normal.…”

Section: Clinical Picturementioning

confidence: 99%

“…Some patients can still show minor finger movements and are classified as Narakas grade III injury. Narakas grade IV picture is of a complete flail arm, with abnormal sensibility, and sympathetic ocular involvement known as Claude-Bernard-Horner syndrome 3,20 ( Figure 2). Isolated lower plexus lesions, known as Klumpke's palsy, are extremely rare 22 .…”

Section: Clinical Picturementioning

confidence: 99%

Neonatal brachial plexus palsy: a permanent challenge

Heise

Martins

Siqueira

2015

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Neonatal brachial plexus palsy (NBPP) has an incidence of 1.5 cases per 1000 live births and it has not declined despite recent advances in obstetrics. Most patients will recover spontaneously, but some will remain severely handicapped. Rehabilitation is important in most cases and brachial plexus surgery can improve the functional outcome of selected patients. This review highlights the current management of infants with NBPP, including conservative and operative approaches.

show abstract

“…Clinicamente, observamos déficit da abdução e rotação externa do braço; flexão e supinação do antebraço (ALFONSO et al, 2000). Os recém-nascidos tipicamente apresentam reflexo de Moro assimétrico, mantendo o membro comprometido junto ao corpo (PAINTER e BERGMAN, 1982).…”

Section: Formas Clínicasunclassified

“…Além dos déficits descritos para a forma superior, observa-se também paresia ou plegia da extensão do antebraço, extensão do punho e dos dedos. A fixação deficiente do punho compromete a movimentação da mão, mas a preensão palmar ainda está preservada (ALFONSO et al, 2000).…”

Section: Formas Clínicasunclassified

Avaliação eletroneurográfica comparativa precoce de pacientes com plexopatia braquial obstétrica

Heise¹

View full text Add to dashboard Cite

Focal upper extremity neuropathy in neonates

Cited by 39 publications

References 24 publications

High birthweight and shoulder dystocia: the strongest risk factors for obstetrical brachial plexus palsy in a Swedish population‐based study

High birthweight and shoulder dystocia: the strongest risk factors for obstetrical brachial plexus palsy in a Swedish population‐based study

Neonatal brachial plexus palsy: a permanent challenge

Avaliação eletroneurográfica comparativa precoce de pacientes com plexopatia braquial obstétrica

Contact Info

Product

Resources

About