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[Phrenic nerve paralysis of obstetrical origin: favorable course using continuous positive airway pressure]
1Pédiatrie II, médecine néonatale et réanimation pédiatrique, hôpital de Hautepierre, Strasbourg, France.
Introduction:
Isolated diaphragmatic paralysis due to obstetrical factors is rare and therapeutic management modalities are not quite clear.
Case Report:
A neonate born by breech delivery presented with respiratory distress due to isolated paralysis of the right hemidiaphragm. The clinical course was progressive, his condition worsening with oxygen supplementation. Continuous positive airway pressure (CPAP) delivered via a nasal cannula was started in the one-month-old child, inducing gradual improvement towards recovery at the age of two months and a half.
Conclusion:
Non-invasive nasal CPAP should be proposed for the treatment of phrenic nerve obstetrical palsy before introducing more invasive ventilation techniques. Surgical plication should be delayed until the child reaches the age of at least three months.