Long-Term Outcomes of Obstetric Brachial Plexus Injury: A Single-Center Experience
Fatih Kurt1, Tuba Erdem Sultanoglu2
1Pediatrics, Duzce University, Duzce, TUR.
Insights
Obstetric brachial plexus injury (OBPI) is a preventable birth complication. Oxytocin administration is a significant risk factor, and extensive nerve involvement indicates a poorer prognosis with limited motion and muscle atrophy.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Neonatal Care
Background:
- Obstetric brachial plexus injury (OBPI) is a significant preventable complication during birth.
- While many cases resolve spontaneously, a notable percentage develop long-term sequelae.
- Risk factors are established, yet OBPI can occur without apparent predisposing factors.
Purpose of the Study:
- To identify prenatal risk factors associated with OBPI.
- To compare the prognosis of OBPI cases with panplexopathy versus those without.
- To provide insights into the long-term outcomes of OBPI.
Main Methods:
- Retrospective review of 31 OBPI cases managed at a single institution.
- Investigation of maternal and infant risk factors, including oxytocin administration.
- Assessment of range of motion, muscle strength, atrophy, and scoliosis in affected extremities.
Main Results:
- 84.1% of OBPI cases had identifiable risk factors, with oxytocin administration being most prevalent.
- Panplexopathy cases showed significantly more limitations in shoulder abduction/adduction and wrist flexion/extension.
- Muscle atrophy was notably more frequent in the panplexopathy group.
Conclusions:
- Oxytocin administration emerges as a critical risk factor for OBPI.
- Panplexopathy is associated with a worse prognosis, characterized by increased range of motion limitations and muscle atrophy.
- Identifying OBPI risk factors is essential for prevention strategies.
Abstract:
Obstetric brachial plexus injury (OBPI) is an important preventable complication of the birth process. While most cases recover in the early period, a substantial number result in sequelae. Despite established risk factors, there are cases that occur without any apparent risk factors. Our study aims to identify prenatal risk factors by examining OBPI cases born in our hospital and to provide insights into the prognosis of the disease by comparing cases with panplexopathy to those without. We included 31 cases followed for OBPI in our hospital. Risk factors related to the infant and the mother were investigated. The range of motion (ROM) measurements of the affected upper extremity joints, muscle strength, atrophy, and scoliosis status were evaluated. Of the cases, 71% were girls, and 61.3% had left-sided involvement. Additionally, 84.1% had risk factors, with oxytocin administration being the most frequently identified risk factor. In our study, we compared cases with panplexopathy to those without. Shoulder abduction, shoulder adduction, wrist flexion, and wrist extension restrictions were significantly more common in cases with panplexopathy. Furthermore, muscle atrophy was significantly more frequent in the panplexopathy group. Since OBPI is a preventable injury, identifying risk factors is crucial. However, there are conflicting results regarding the most significant risk factor. Our study highlights that oxytocin administration is a very important risk factor for OBPI. We found that cases with panplexopathy had a worse prognosis, with more frequent ROM limitations and muscle atrophy.
