Chauhan Suneet P, Christian Briery, Gherman Robert B, Magann Everett F, Kaluser Chad K, Morrison John C
Aurora Health Care, West Allis, WI 53227, USA.
J Matern Fetal Neonatal Med. 2007 Apr;20(4):313-7. doi: 10.1080/14767050601165805.
To delineate factors that differentiate shoulder dystocia with and without brachial plexus injury (BPI).
A case-control study culled from an established shoulder dystocia database. Cases of shoulder dystocia-related BPI were identified and matched (1:1) with a control group of shoulder dystocia in which BPI did not result. Odds ratios (OR) and 95% confidence intervals (CI) were calculated.
From 1980 to 2002, there were 89 978 deliveries with 46 cases of dystocia and BPI. The rate of dystocia with BPI was 0.5 per 1000 births and of permanent BPI, 0.9/10 000 deliveries. The two groups were similar for maternal demographics, diabetes, gestational age, induction, use of epidural, the duration of labor, operative vaginal delivery, rate of macrosomia, and maneuvers used to relieve the dystocia. Fracture of the clavicle occurred significantly less often among those without (2%) vs. with BPI (17%; OR 0.10, 95% CI 0.01, 0.88).
Neither antepartum nor intrapartum factors can differentiate the patient who will have shoulder dystocia with vs. without BPI.
明确区分伴有和不伴有臂丛神经损伤（BPI）的肩难产的相关因素。
一项从已建立的肩难产数据库中筛选出的病例对照研究。确定与肩难产相关的BPI病例，并与未发生BPI的肩难产对照组进行（1:1）匹配。计算优势比（OR）和95%置信区间（CI）。
1980年至2002年，共有89978例分娩，其中46例为难产合并BPI。伴有BPI的难产发生率为每1000例出生0.5例，永久性BPI发生率为每10000例分娩0.9例。两组在产妇人口统计学特征、糖尿病、孕周、引产、硬膜外麻醉使用情况、产程、阴道助产、巨大儿发生率以及用于缓解难产的手法等方面相似。未发生BPI者锁骨骨折发生率（2%）显著低于发生BPI者（17%；OR 0.10，95%CI 0.01，0.88）。
产前和产时因素均无法区分会发生伴有或不伴有BPI的肩难产的患者。
