An injury to the brachial plexus can be a devastating, life-changing injury
to a child that occurs during birth. To identify these types of injuries,
it's first important to examine what the cause of the
birth injury is. The brachial plexus is a nerve network that travels from the spinal
column, through the neck, and out through the shoulder and into the arms.
It essentially functions as a branch that allows nerve signals to be sent
to the wrists, arms, hands, elbows, and shoulders.
Excessive pressures during labor caused by excessive use of
Pitocin, a fetal-pelvic misfit or cephalopelvic disproportion, or excessive traction
forces during delivery with
vacuum can cause the nerves of the brachial plexus to stretch or tear. If the
pressures applied are strong enough to cause a major stretch or tear,
a baby can loose feeling in his or her arms, wrists, and hands. Nerve
tissues can regenerate, and sometimes this injury will resolve itself.
However, if a major tear, or "abruption", occurs, the damage
is likely permanent and total paralysis can be the result.
These types of injuries are usually caused by a long labor in which the
baby, due to his or her size or the size or shape of the mother's
pelvis, has difficulty navigating the birth canal and being delivered.
This "stalled" labor is known as labor dystocia. If a baby's
shoulder gets trapped in an awkward angle, and becomes stuck on the maternal
pelvis, the doctor will often apply excessive forces, which cause the
nerves to stretch or tear.
Maternal factors that are related to shoulder dystocia include diabetes,
excessive weight gain in pregnancy (more than 30 pounds above normal weight
gain), and small stature. Patients with these risk factors should be assessed
prior to birth, and alternatives to natural birth should be discussed.
There are procedures, such as suprapubic pressure (pressure applied to
the pelvic floor) that can assist in delivering a baby who is experiencing
shoulder dystocia. Doctors and nurses have a duty to manage these types
of labors safely to prevent any injury from occurring to mother or baby.