Skip to main content
SpringerLink
Log in

In Utero Causation of Brachial Plexus Injury: Myth or Mystery?

  • Chapter
  • First Online:
Shoulder Dystocia and Birth Injury

Summary

In utero causation is a manufactured theory based on speculation that contradicts known anatomic and physiologic principles. Brachial plexus injury (BPI) is a very-low-velocity and very-low-impact injury. Adult BPI is a high-velocity and high-impact injury. Labor forces are compressive and expulsive, not traction or stretching. “Using a statistical model it is possible to identify adverse combinations of factors that are associated with shoulder dystocia and neonatal injury [1].”

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Dyachenko A, Ciampi A, Fahey J, Mighty H, Oppenheimer L, Hamilton E. Prediction of risk for shoulder dystocia with neonatal injury. Am J Obstet Gynecol 2006;195:1544–1549.

    Article  PubMed  Google Scholar 

  2. Gurewitsch E, Johnson E, Hamzehzadeh S, Allen R. Risk factors for brachial plexus injury with and without shoulder dystocia. Am J Obstet Gynecol 2006;194:486–492.

    Article  PubMed  Google Scholar 

  3. Jennett R. Brachial plexus palsy: An old problem revisited. Am J Obstet Gynecol 1992;166:1673–1677.

    PubMed  CAS  Google Scholar 

  4. Gherman R, Goodwin T. Shoulder dystocia. Current opinion. Obstet Gynecol 1998;10:459–463.

    CAS  Google Scholar 

  5. Hankins G, Clark S. Brachial plexus palsy involving the posterior shoulder at spontaneous vaginal delivery. Am J Perinatol 1995;12:44–45.

    Article  PubMed  CAS  Google Scholar 

  6. Sandmire H, DeMott R. The physician factor as a determinant of cesarean birth rates for the large fetus. Am J Obstet Gynecol 1996;174:1557–1564.

    Article  PubMed  CAS  Google Scholar 

  7. Gherman R, Ouzounian J, Miller D, Kwak L, Goodwin T. Spontaneous vaginal delivery: A risk factor for Erbs palsy? Am J Obstet Gynecol 1998;178:423–427.

    Article  PubMed  CAS  Google Scholar 

  8. Allen R. Severe brachial plexus injury in the posterior arm: An alternative explanation [letter]. Am J Obstet Gynecol 2002;186:1377–1378.

    PubMed  Google Scholar 

  9. Gonik B, Hollyer V, Allen R. Shoulder dystocia Recognition. Am J Perinatol 1991;8:31–34.

    Article  PubMed  CAS  Google Scholar 

  10. Koenigsberger M. Brachial plexus palsy at birth: Intrauterine or due to birth trauma [abstract]? Ann Neurol 1980;8:228.

    Google Scholar 

  11. Jennett R, Tarby T. Diffuse asteoporosis as evidence of brachial plexus palsy due to intrauterine fetal maladaption. Am J Obstet Gynecol 2001;185–237.

    Google Scholar 

  12. Gonik B, McCormick E, Verwey B, et al. The timing of congenital brachial plexus injury: A study of electromyography findings in the newborn piglets. Am J Obstet Gynecol 1998;178:688–695.

    Article  PubMed  CAS  Google Scholar 

  13. Gherman R. Spontaneous vaginal delivery: A risk factor for Erb’s palsy. Am J Obstet Gynecol 1998;178:423–427.

    Article  PubMed  CAS  Google Scholar 

  14. Gherman R. Brachial plexus palsy associated with cesarean section: An in-utero injury? Am J Obstet Gynecol 1997;177:1162–1164.

    Article  PubMed  CAS  Google Scholar 

  15. Gherman R. Shoulder dystocia. The Female Patient 1998;23:79–90.

    Google Scholar 

  16. Gherman R. A comparison of shoulder dystocia-associated transient and permanent brachial plexus palsies. Am J Obstet Gynecol 2003;102:544–548.

    Article  Google Scholar 

  17. Allen R, Gurewitsch E, Shoukas A. Computer modeling of shoulder dystocia. Am J Obstet Gynecol 2003;188:1804–1805.

    Google Scholar 

  18. Spellacy W. Erb’s palsy without shoulder dystocia [letter]. Am J Obstet Gynecol 1998;179:561.

    Article  PubMed  CAS  Google Scholar 

  19. Gonik B. Walker A, Grimm M. Mathematic modeling of forces associated with a shoulder dystocia. Am J Obstet Gynecol 2000;182:689–691.

    Article  PubMed  CAS  Google Scholar 

  20. Gonik B, Zhang N, Grimm M. Defining forces that are associated with shoulder dystocia: The use of a mathematic dynamic computer model. Am J Obstet Gynecol 2003;188:1068–1072.

    Article  PubMed  Google Scholar 

  21. Gonik B, Zhang N, Grimm M. Prediction of brachial plexus stretching during shoulder dystocia using a computer simulation model. Am J Obstet Gynecol 2003;189:1168–1172.

    Article  PubMed  Google Scholar 

  22. Allen R, Edelberg S. A problematic model to predict intrauterine forces during shoulder dystocia. Am J Obstet Gynecol 2001;182:689–691.

    Google Scholar 

  23. Sandmire H, DeMott R. Erb’s palsy causation: A historical perspective. Birth 2002;29:52–54.

    Article  PubMed  Google Scholar 

  24. Sandmire H, DeMott R. Erb’s palsy: Concepts of causation. Obstet Gynecol 2000;95:941–942.

    Article  PubMed  CAS  Google Scholar 

  25. Allen R, Edelberg S. Brachial plexus palsy causation [letter]. Birth 2003;30:141–143.

    Article  PubMed  Google Scholar 

  26. Allen RH, Cha SL, Kranker LM, Johnson TL, Gurewitsch ED. Comparing mechanical fetal response during descent, crowning, and restitution among deliveries with and without shoulder dystocia. Am J Obstet Gynecol 2007;196:539–541.

    PubMed  Google Scholar 

  27. Creasy R, Resnik R. Maternal Fetal Medicine. 5th ed. Philadelphia: Saunders; 2004;79–87.

    Google Scholar 

  28. Cunningham FG, MacDonald PC, Gant NF, Leveno KJ, Gilstrap III LC, eds. Williams Obstetrics. appleton & Lange 19th ed. Norwalk, CT: 1993:297–363.

    Google Scholar 

  29. Dunn D, Engle W. Brachial plexus palsy: Intrauterine onset. Pediatr Neurol 1985;1:367–369.

    Article  PubMed  CAS  Google Scholar 

  30. Allen R, Edelberg S. Erb’s palsy: Concepts of causation. Obstet Gynecol 2000;96:801–802.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Professor Obstetrics & Gynecology (retired), University of south Florida, Tampa, Florida, USA

    James A. O’Leary

Authors
  1. James A. O’Leary
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

James A. O'Leary

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

O’Leary, J.A. (2009). In Utero Causation of Brachial Plexus Injury: Myth or Mystery?. In: O'Leary, J. (eds) Shoulder Dystocia and Birth Injury. Humana Press. https://doi.org/10.1007/978-1-59745-473-5_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-473-5_11

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-934115-28-2

  • Online ISBN: 978-1-59745-473-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation