[Damage to the brachial plexus in vaginal delivery from breech presentation--correlation with reducing the extended...

Brachial plexus injuries in foetuses delivered spontaneously by breech presentation is very rare. The aim of this study was to evaluate the frequency of brachial plexus injuries in connection with the rate of the reduction of the extended arm.

In our retrospective study we examined 1194 vaginally intended breech deliveries (> 32 completed weeks) for the frequency of extended arms and subsequent plexus brachialis palsies.

One brachial plexus injury occurred in 796 vaginally delivered newborns (1.2@1000). The outcome corresponds with the frequency of brachial plexus palsy in spontaneous deliveries with cephalic presentation (1@1000). The mean frequency of reduction of the extended arm in vaginal deliveries in breech is 10-20%.

We found that the rate of reduction of the extended arm was not associated with an increase in morbidity of newborns.

Many reports in the literature demonstrate that a higher rate of caesarean section does not prevent these severe foetal injuries. Noxious factors already occurring during the prenatal phase of development can be suspected as possible causes.