Predictors of neonatal brachial plexus palsy subsequent to resolution of shoulder dystocia

Narendran, Leena M.; Mendez‐Figueroa, Hector; Chauhan, Suneet P.; Folh, Kendra; Grobman, William A.; Chang, Kai-Ting; Yang, Lynda J.‐S.

doi:10.1080/14767058.2021.1882982

Cited by 6 publications

(1 citation statement)

References 42 publications

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“…Neonatal brachial plexus palsy (NBPP) occurs during the birthing process in approximately 1.5/1,000 total births [ 1 ]. When the injury persists past 12 months of age, continuing outcomes may include joint subluxation, muscle weakness, and sensory dysfunction [ 2 ]. Until the early 1990’s, it was thought that NBPP solely occurred due to trauma induced by lateral neck traction caused by the birthing attendant (exogenous force).…”

Section: Introductionmentioning

confidence: 99%

Investigating the effect of anatomical variations in the response of the neonatal brachial plexus to applied force: Use of a two-dimensional finite element model

Wright,

Grimm

2024

PLoS ONE

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The brachial plexus is a set of nerves that innervate the upper extremity and may become injured during the birthing process through an injury known as Neonatal Brachial Plexus Palsy. Studying the mechanisms of these injuries on infant cadavers is challenging due to the justifiable sensitivity surrounding testing. Thus, these specimens are generally unavailable to be used to investigate variations in brachial plexus injury mechanisms. Finite Element Models are an alternative way to investigate the response of the neonatal brachial plexus to loading. Finite Element Models allow a virtual representation of the neonatal brachial plexus to be developed and analyzed with dimensions and mechanical properties determined from experimental studies. Using ABAQUS software, a two-dimensional brachial plexus model was created to analyze how stresses and strains develop within the brachial plexus. The main objectives of this study were (1) to develop a model of the brachial plexus and validate it against previous literature, and (2) to analyze the effect of stress on the nerve roots based on variations in the angles between the nerve roots and the spinal cord. The predicted stress for C5 and C6 was calculated as 0.246 MPa and 0.250 MPa, respectively. C5 and C6 nerve roots experience the highest stress and the largest displacement in comparison to the lower nerve roots, which correlates with clinical patterns of injury. Even small (+/- 3 and 6 degrees) variations in nerve root angle significantly impacted the stress at the proximal nerve root. This model is the first step towards developing a complete three-dimensional model of the neonatal brachial plexus to provide the opportunity to more accurately assess the effect of the birth process on the stretch within the brachial plexus and the impact of biological variations in structure and properties on the risk of Neonatal Brachial Plexus Palsy.

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Section: Introductionmentioning

confidence: 99%

Investigating the effect of anatomical variations in the response of the neonatal brachial plexus to applied force: Use of a two-dimensional finite element model

Wright,

Grimm

2024

PLoS ONE

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Predictors of maternal and neonatal outcomes in labors complicated by shoulder dystocia: a comparative analysis

Tairy,

Frank,

Lev

et al. 2024

Arch Gynecol Obstet

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Introduction Studies investigating the risk factors associated with unfavorable maternal/neonatal outcomes in cases of shoulder dystocia are scarce. This study aims to uncover the predictive factors that give rise to unfavorable outcomes within the context of shoulder dystocia. Materials and methods Medical records of pregnancies complicated by shoulder dystocia was obtained between 2008–2022 from a single tertiary center. This study involved the comparison of sociodemographic, sonographic, and delivery characteristics among pregnancies complicated by shoulder dystocia resulting in favorable vs. unfavorable maternal/neonatal outcomes. Results A total of 275 pregnancies were analyzed, with 111 (40.3%) classified as unfavorable outcomes and 164 (59.7%) as favorable outcomes. Employing a multivariable regression analysis, several independent associations were identified with unfavorable maternal/neonatal outcomes. Specifically, short maternal stature, pre-gestational diabetes, vacuum extraction, Wood’s screw maneuver, and macrosomia merged as significant predictors of unfavorable maternal/neonatal outcomes. Conclusion Short maternal stature, pre-gestational diabetes, vacuum extraction, Wood’s screw maneuver, and macrosomia may all contribute to poor maternal/neonatal outcomes in shoulder dystocia cases. This knowledge allows clinicians to improve their decision-making, patient care, and counseling.

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Obstetrics injuries during shoulder dystocia in a tertiary perinatal center

Habek¹,

Prka²,

Luetić³

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Predictors of neonatal brachial plexus palsy subsequent to resolution of shoulder dystocia

Cited by 6 publications

References 42 publications

Investigating the effect of anatomical variations in the response of the neonatal brachial plexus to applied force: Use of a two-dimensional finite element model

Investigating the effect of anatomical variations in the response of the neonatal brachial plexus to applied force: Use of a two-dimensional finite element model

Predictors of maternal and neonatal outcomes in labors complicated by shoulder dystocia: a comparative analysis

Obstetrics injuries during shoulder dystocia in a tertiary perinatal center

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