Obstetric brachial plexus palsy: a population-based retrospective case-control study and medicolegal considerations.
作者信息
Zaami Simona, Busardò Francesco Paolo, Signore Fabrizio, Felici Nicola, Briganti Vito, Baglio Giovanni, Marinelli Enrico, Fineschi Vittorio
机构信息
a Department of Anatomical, Histological, Forensic and Orthopaedic Sciences , Sapienza University of Rome , Rome , Italy.
b Department of Obstetrics and Gynecology , San Camillo Forlanini Hospital , Rome , Italy.
出版信息
J Matern Fetal Neonatal Med. 2018 Jun;31(11):1412-1417. doi: 10.1080/14767058.2017.1317737. Epub 2017 May 14.
AIMS
The aim of this study was to examine 24 cases of obstetric brachial plexus palsy (OBPP) in 41,002 deliveries occurred at San Camillo-Forlanini Hospital in Rome, during the period 2000-2012.
MATERIALS AND METHODS
A population-based retrospective case-control study was designed and the database of the hospital was searched; for each case, maternal and fetal records were examined and some risk factors were evaluated.
RESULTS
A statistically significant association between the 24 cases OBPP and the following risk factors: primiparity (p < .014), birth weight (p < .002), maternal age (p < .02), diabetes (p < .03) and shoulder dystocia (p < .003) was found, moreover all the OBPP cases were recorded only in vaginal deliveries.
CONCLUSIONS
The absence of OBPP cases in cesarean deliveries highlighted in this study supports the option of proposing an elective cesarean in the presence of known risk factors after a full disclosure with the mother of risks and benefits in order to obtain a valid consent. Furthermore, when cases of OBPP occur, communication between the physician and the parents of newborns is crucial and it may represent a valid risk-management tool to reduce malpractice lawsuits.
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