The prevalence, electrophysiologic feature, and outcome of obstetric brachial plexus injury in East Azerbaijan province, Iran

Abstract

Background. Obstetric brachial plexus injury (OBPI) occurs as a result of excessive stretching of the baby's neck and an increase in cervical and shoulder angle during the second stage of labor. This study aimed to investigate the prevalence, electrophysiological panel, and motor outcome of cervical paralysis in East Azerbaijan province, Iran during 2008-2018. Methods. The total number of deliveries was obtained by census method. The annual relative frequency of OBPI was calculated using the medical records of children with this injury. Then, the electrophysiological findings and Modified Mallet Classification System (MMCS) were extracted. Results. The prevalence of OBPI during 2008-2018 was 0.026% in East Azerbaijan province. The involved nerve roots were C5 and C6 in 59.6% of cases, C5, C6, and C7 in 28.4% of cases, and wider injuries were observed in 12% following C5 to T1 involvement. No significant association was found between electrophysiological findings and MMCS in children with OBPI (P>0.05). Conclusion. Due to the sudden increase in OBPI since 2017, it seems necessary to pay special attention and take preventive measures in this regard. Practical Implications. Due to the increasing prevalence of OBPI compared to previous years, it is necessary to take the necessary measures to prevent this injury in vaginal delivery.