Neonatal spinal cord injury after an uncomplicated vaginal delivery

Neonatal spinal cord injury has been reported after traumatic births and as a consequence of underlying lesions in the spinal cord. This report describes an infant who was born with bilateral flaccid paralysis of the upper extremities after an atraumatic, noninstrumented vaginal delivery. The infant was otherwise neurologically intact. The infant was initially thought to exhibit bilateral brachial plexus injury. However, magnetic resonance imaging demonstrated an upper cervical spinal cord hemorrhage, with no underlying lesions of the spinal cord or surrounding vasculature. This case highlights the importance of thoroughly evaluating any neurologic deficit in the newborn, and suggests that normal mechanical forces of labor and delivery may be sufficient to cause damage to the newborn spinal cord.