Emergency caesarean delivery in prolonged obstructed labour as risk factor for obstetric fractures--a case series

Birth fractures predominantly affect the clavicle, humerus or femur. Brachial plexus injury may co-exist with humeral or clavicular fractures. From January 2002 to December 2010, 8 neonates with fractures after caesarean section were treated under the supervision of the first author following obstructed labour and caesarean delivery. The most classical of the cases is a vertex-presenting neonate who was delivered by caesarean section for obstructed labour in a primipara in whom ipsilateral klumpke's palsy and fractures of the clavicle and humerus were confirmed. Literature review did not consider emergency caesarean delivery as one of the predisposing factors for such birth injuries. This case series, in addition to presenting emergency caesarean section as a predisposing factor for birth injuries, offers to suggest a manoeuvre that may reduce severity and rate of birth injuries in caesarean section for obstructed labour in our environment where obstructed labour is still rife.