An Overview of Brachial Plexus Birth Injuries
The brachial plexus is a network of nerves located near the neck. These nerves lead to and control the nerves that govern movement, strength, and function in the shoulder, arm, hands, and fingers. A brachial plexus birth injury is any injury that damages some or all of the brachial plexus nerves, and it can result in a number of problems and disabilities, including:
- Tingling in the shoulder, arm, hand, or fingers
- Partial or complete paralysis of the shoulder, arm, and/or hand
Range of motion may be affected, as well, and the patient may have a weaker grip in the affected hand. Though brachial plexus injuries are almost invariably caused by stretching of the arm or shoulder away from the head and body, causing pressure on the brachial nerves, there are a number of causes for this type of birth injury.
Causes of Brachial Plexus Birth Injuries
Most brachial plexus injuries can be prevented if a doctor is observant and has the foresight to call for a cesarean section procedure or perform other actions to relieve stress on the baby and prevent pulling or stretching of the brachial plexus. The most common causes of brachial plexus birth injuries are:
- Cephalopelvic disproportion (CPD) – The baby is too large in proportion to the mother’s birth canal to pass through without injury. One or both shoulders may be caught, and the pressure of the birth canal on the baby may cause injury.
- Premature birth – In some cases of premature births, the baby’s neck muscles will be underdeveloped and will not protect the shoulder and arm from being over-stretched, causing injury to the brachial plexus nerves.
- Shoulder dystocia – If the baby’s shoulders are too wide to pass beyond the pelvic bone, pulling and stretching can occur. To avoid this, the doctor should recognize the problem early and call for a cesarean section.
- Breech delivery – If a baby is in breech presentation, the doctor should in most cases call for a cesarean section procedure or should take action to ensure that the baby is not in breech presentation at the time of delivery.
- Misuse of birth-assisting tools – Forceps and vacuum equipment are sometimes used in difficult labors, but if misused these tools can cause excess pulling and result in brachial plexus injuries.
Other factors, such as maternal diabetes and obesity may also be risk factors for brachial plexus birth injuries. However, a good doctor will recognize these risks early on and will do everything possible to avoid any birth injuries.
Understanding Brachial Plexus Injuries
There four basic types of brachial plexus birth injuries that can occur during labor:
- Neurapraxia – The mildest and most common brachial plexus injury, neurapraxia occurs when there is minor strain on the brachial plexus nerves, which may include a few tears but no major damage. Symptoms include muscle weakness, some tingling or numbness, and sensitivity. The condition is typically temporary and will usually heal on its own.
- Erb’s palsy – When there’s a rupture in the upper brachial plexus nerves, full or partial paralysis may occur in the affected arm. Other symptoms include numbness, loss of motor function, and weakness.
- Klumpke’s Palsy – When there’s a rupture in the lower brachial plexus nerves, your baby will generally experience numbness in the lower part of the arm, and they may have difficulty gripping with their hand. The hand may rest in a claw-like shape.
- Neuroma – After a brachial plexus injury, neuroma may occur when scar tissue grows over the area of the injury, adding undue pressure to the injured nerves. This can result in partial or total paralysis and other symptoms, as the affected nerves will have difficulty sending signals to the shoulder, arm, hand, and/or fingers.
Treatments for brachial plexus injuries include physical therapy, hydrotherapy, medication, surgery, and/or occupational therapy. If untreated, a brachial plexus injury may result in permanent disability and disfigurement, but proper treatment will greatly increase the chances of regaining range of motion, strength, and normal function in the affected arm.
Brachial plexus birth injuries are almost always preventable, and a good doctor will notice risk factors and take action to prevent a birth injury. For more information on brachial plexus birth injuries, contact us at Birth Injury Center today.