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Brachial plexus injuries occur when something stretches or tears the nerves. Most frequently this can be caused by an injury like a tree fall or motorcycle accident, but it can also be caused in childbirth.
The brachial plexus is a network of nerves that run from the spine through the neck and armpit region and into the arm. It encompasses the lower four cervical nerves and first thoracic nerve roots (C5-C8, T1) and enables movement of the upper arm, forearm and hand.
In the case of a birth injury, the nerves of the brachial plexus can be injured in a number of ways, such as the head and neck being pulled to the side as the shoulders pass through the birth canal, the doctor pulling on the baby’s shoulders in a traditional delivery, or pressure on the infant’s raised arms in a breech birth. These stretches “can cause ruptures to the superior portions of the brachial plexus or avulse the roots from the spinal cord.”
Injuries of this nature are most commonly found in difficult deliveries, such as breech births or when the infant is larger-than-average (this is more common with diabetic mothers). Studies have shown a correlation between birth weight and brachial plexus injuries.
In a 1997 study at the Brigham and Women’s Hospital in Boston, Birth weight as a predictor of brachial plexus injury, neonatal records from 1985 to 1993 reporting brachial plexus injury were studied.
The findings showed that: “Among 77,616 consecutive deliveries, there were 80 brachial plexus injuries identified, for an incidence of 1.03 per 1000 live births. The incidence of brachial plexus injury increased with increasing birth weight, operative vaginal delivery, and the presence of glucose intolerance. In the group of women without diabetes, between 19 and 162 cesarean deliveries would have been necessary to prevent a single immediate brachial plexus injury. Among women with diabetes, between five and 48 additional cesareans would have been required.”
Defining the Damage
In an infant, the amount of arm paralysis defines the type of brachial plexus injury. Two are named for the doctor who discovered them.” In 1874, Dr. Erb described C5-C6 paralysis in and in 1885, Dr. Klumpke described paralysis of the lower plexus. The types are:
- Traditional brachial plexus injury affecting the upper arm only
- Erb’s paralysis affecting the upper and lower arm (Erb’s palsy)
- Klumpke paralysis which affects the hand (Klumpke’s palsy)
Brachial plexus injury is sometimes confused with pseudoparalysis, which is when the infant isn’t moving its arm due to pain from a fracture. However, pseudoparalysis does not include nerve damage.
According to MedlinePlus, symptoms of brachial plexus can be seen soon after childbirth with a physical exam. They may include:
- No movement in the newborn’s upper or lower arm or hand, and the arm may flop when the infant is rolled
- Absent Moro reflex (startle reaction) on the affected side
- Arm flexed (bent) at elbow and held against body
- Decreased grip on the affected side
Brachial plexus injury is less common with new delivery techniques. With the threat of difficult delivery, cesarean sections are often used, lowering the risk of this injury in childbirth. If brachial plexus injury should occur to a baby, the estimate is that most infants will recover in 3 to 6 months.
For those who do not recover, doctors may attempt surgery to repair the damage. However, it is not known for sure if surgery can fix the nerve problem.
If you’re the parent of a child injured at birth through negligence, you may be eligible for compensation. Medical malpractice lawyers litigate hundreds of birth injury lawsuits each year, so help may be available.
Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The medical malpractice attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual birth injury lawsuit or class action lawsuit is best for you. [In general, birth injury lawsuits are filed individually by each plaintiff and are not class actions.] Hurry — statutes of limitations may apply.
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