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A brief overview of obstetric brachial plexus palsy

02 October 2023
Volume 31 · Issue 10
 Being fully present with women allows midwives to respond attentitively and develop a supportive responsive relationship
Being fully present with women allows midwives to respond attentitively and develop a supportive responsive relationship


Obstetric brachial plexus palsy is an injury in newborn babies that is often associated with increased force on the neck during passage through the birth canal. This puts excessive strain on the brachial plexus and causes nerve injury. Obstetric brachial plexus palsy results from injury to the cervical roots C5–C8 and thoracic root T1. Although it has been known for patients to make a spontaneous recovery, there is a large subset who do not recover and require primary or secondary surgical intervention. This article discusses classification of the differing injuries within obstetric brachial plexus palsy, its prevalence and its aetiology. It also discusses the impact that the injury can have on individuals and the role of healthcare professionals involved in the diagnostic phases.

The brachial plexus is an intricate, complex peripheral neural unit (Gilcrease-Garcia et al, 2020). It supplies the upper limbs, allowing expression of the mind through art, writing and exercise, as well as being the most useful aid to carry out almost all aspects of daily functioning. Injuries to the brachial plexus have consequences far beyond initial structural damage. While the initial injury is to the nerves, adverse events that follow involve the muscles, bones and joints of the affected extremity.

Obstetric brachial plexus palsy in newborn babies is often associated with increased force on the neck during passage through the birth canal, putting excessive strain on the brachial plexus and causing nerve injury (Palomo-Carrion and Sanchez, 2020). Obstetric brachial plexus palsy results from injury to the cervical roots C5–C8 and thoracic root T1 (Al-Qattan and El-Sayed, 2017) (Figure 1). As a result of the nerves exiting through the anterior vertebral foreman along the clavicle and towards the upper part of the arm, they can be injured with traction. Although many infants will regain function with no long-term deficits, a large proportion of children do not regain adequate function of the limb (Frade et al, 2019).

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