nach oben

Erschienen in:

01.04.2016 | Maternal-Fetal Medicine

Risk factors for clavicle fracture concurrent with brachial plexus injury

verfasst von: Ertugrul Karahanoglu, Taner Kasapoglu, Safak Ozdemirci, Erdem Fadıloglu, Aysegul Akyol, Erhan Demirdag, E. Serdar Yalvac, N. Omer Kandemir

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study was to evaluate the risk factors for clavicle fracture concurrent with brachial plexus injuries.

Methods

A retrospective study was conducted at a tertiary centre. The hospital records of 62,288 vaginal deliveries were evaluated retrospectively. There were 35 cases of brachial plexus injury. Of these patients, nine had brachial plexus injuries with clavicle fracture and 26 without clavicle fracture. The analysed risk factors for clavicle fracture concurrent with brachial plexus injury were gestational diabetes, labour induction and augmentation, prolonged second stage of labour, estimated foetal weight above 4000 g, birth weight above 4000 g, risky working hours, and the requirement of manoeuvres to free the impacted shoulder from behind the symphysis pubis.

Results

Labour augmentation with oxytocin increased the risk of clavicle fracture in cases of brachial plexus injury (OR 6.67; 95% CI 1.26–35.03). A birth weight higher than 4000 g also increased the risk of clavicle fracture. Risky working hours, gestational diabetes, estimated foetal weight higher than 4000 g, and requirement of shoulder dystocia manoeuvres did not increase the risk of clavicle fracture.

Conclusions

Labour augmentation and actual birth weight higher than 4000 g were identified as risk factors for clavicle fracture in cases of brachial plexus injury.

Ohel G, Haddad S, Fischer O, Levit A (1993) Clavicular fracture of the neonate: can it be predicted before birth? Am J Perinatol 10(6):441–443. doi:10.1055/s-2007-994626 PubMed

Chauhan SP, Rose CH, Gherman RB, Magann EF, Holland MW, Morrison JC (2005) Brachial plexus injury: a 23-year experience from a tertiary center. Am J Obst Gynecol 192(6):1795–1800. doi:10.1016/j.ajog.2004.12.060 (discussion 1800–1792) CrossRef

Wall LB, Mills JK, Leveno K, Jackson G, Wheeler LC, Oishi SN, Ezaki M (2014) Incidence and prognosis of neonatal brachial plexus palsy with and without clavicle fractures. Obstet Gynecol 123(6):1288–1293. doi:10.1097/AOG.0000000000000207 CrossRefPubMed

Roberts SW, Hernandez C, Maberry MC, Adams MD, Leveno KJ, Wendel GD Jr (1995) Obstetric clavicular fracture: the enigma of normal birth. Obstet Gynecol 86(6):978–981. doi:10.1016/0029-7844(95)00277-X CrossRefPubMed

Lurie S, Wand S, Golan A, Sadan O (2011) Risk factors for fractured clavicle in the newborn. J Obstet Gynaecol Res 37(11):1572–1574. doi:10.1111/j.1447-0756.2011.01576.x CrossRefPubMed

al-Qattan MM, Clarke HM, Curtis CG (1994) The prognostic value of concurrent clavicular fractures in newborns with obstetric brachial plexus palsy. J Hand Surg 19(6):729–730CrossRef

Ouzounian JG, Korst LM, Miller DA, Lee RH (2013) Brachial plexus palsy and shoulder dystocia: obstetric risk factors remain elusive. Am J Perinatol 30(4):303–307. doi:10.1055/s-0032-1324698 PubMed

Foad SL, Mehlman CT, Ying J (2008) The epidemiology of neonatal brachial plexus palsy in the United States. J Bone Joint Surg Am 90(6):1258–1264. doi:10.2106/JBJS.G.00853 CrossRefPubMed

Chauhan SP, Blackwell SB, Ananth CV (2014) Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends. Semin Perinatol 38(4):210–218. doi:10.1053/j.semperi.2014.04.007 CrossRefPubMed

10.

Greenwald AG, Schute PC, Shiveley JL (1984) Brachial plexus birth palsy: a 10-year report on the incidence and prognosis. J Pediatr Orthop 4(6):689–692CrossRefPubMed

11.

Backe B, Magnussen EB, Johansen OJ, Sellaeg G, Russwurm H (2008) Obstetric brachial plexus palsy: a birth injury not explained by the known risk factors. Acta Obstet Gynecol Scand 87(10):1027–1032. doi:10.1080/00016340802415648 CrossRefPubMed

12.

Evans-Jones G, Kay SP, Weindling AM, Cranny G, Ward A, Bradshaw A, Hernon C (2003) Congenital brachial palsy: incidence, causes, and outcome in the United Kingdom and Republic of Ireland. Arch Dis Child Fetal Neonatal Ed 88(3):F185–F189CrossRefPubMedPubMedCentral

13.

Linder N, Linder I, Fridman E, Kouadio F, Lubin D, Merlob P, Yogev Y, Melamed N (2013) Birth trauma–risk factors and short-term neonatal outcome. J Matern-Fetal Neonatal Med: Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet 26(15):1491–1495. doi:10.3109/14767058.2013.789850 CrossRef

14.

Mehta SH, Bujold E, Blackwell SC, Sorokin Y, Sokol RJ (2004) Is abnormal labor associated with shoulder dystocia in nulliparous women? Am J Obstetrics and gynecology 190(6):1604–1607. doi:10.1016/j.ajog.2004.03.067 (discussion 1607–1609) CrossRef

15.

Ouzounian JG (2014) Risk factors for neonatal brachial plexus palsy. Semin Perinatol 38(4):219–221. doi:10.1053/j.semperi.2014.04.008 CrossRefPubMed

16.

Weizsaecker K, Deaver JE, Cohen WR (2007) Labour characteristics and neonatal Erb’s palsy. BJOG: Int J Obstet Gynaecol 114(8):1003–1009. doi:10.1111/j.1471-0528.2007.01392.x CrossRef

17.

Okby R, Sheiner E (2012) Risk factors for neonatal brachial plexus paralysis. Arch Gynecol Obstet 286(2):333–336. doi:10.1007/s00404-012-2272-z CrossRefPubMed

18.

Kaplan B, Rabinerson D, Avrech OM, Carmi N, Steinberg DM, Merlob P (1998) Fracture of the clavicle in the newborn following normal labor and delivery. Int J Gynaecol Obstet: Off Organ Int Fed Gynaecol Obstet 63(1):15–20CrossRef

19.

Melendez J, Bhatia R, Callis L, Woolf V, Yoong W (2009) Severe shoulder dystocia leading to neonatal injury: a case control study. Arch Gynecol Obstet 279(1):47–51. doi:10.1007/s00404-008-0668-6 CrossRefPubMed

20.

Temerinac D, Chen X, Sutterlin M, Kehl S (2014) Influence of fetal birth weight on perinatal outcome in planned vaginal births. Arch Gynecol Obstet 289(2):313–318. doi:10.1007/s00404-013-2973-y CrossRefPubMed

21.

Baskett TF, Allen AC (1995) Perinatal implications of shoulder dystocia. Obstet Gynecol 86(1):14–17. doi:10.1016/0029-7844(95)00099-D CrossRefPubMed

22.

Malinowska-Polubiec A, Romejko-Wolniewicz E, Szostak O, Dobrowolska-Redo A, Tolloczko J, Zareba-Szczudlik J, Smolarczyk R, Czajkowski K (2015) Shoulder dystocia in diabetic and non-diabetic pregnancies. Neuro Endocrinol Lett 35(8):733–740

23.

Tsur A, Sergienko R, Wiznitzer A, Zlotnik A, Sheiner E (2012) Critical analysis of risk factors for shoulder dystocia. Arch Gynecol Obstet 285(5):1225–1229. doi:10.1007/s00404-011-2139-8 CrossRefPubMed

24.

Beall MH, Ross MG (2001) Clavicle fracture in labor: risk factors and associated morbidities. J Perinatol: Off J Calif Perinat Assoc 21(8):513–515. doi:10.1038/sj.jp.7210594 CrossRef

25.

Spain JE, Frey HA, Tuuli MG, Colvin R, Macones GA, Cahill AG (2015) Neonatal morbidity associated with shoulder dystocia maneuvers. Am J Obstet Gynecol 212(3):353, e351–e355. doi:10.1016/j.ajog.2014.10.001 CrossRef

26.

Gherman RB, Ouzounian JG, Goodwin TM (1998) Obstetric maneuvers for shoulder dystocia and associated fetal morbidity. Am J Obstet Gynecol 178(6):1126–1130CrossRefPubMed

27.

Murphy DJ, Liebling RE, Patel R, Verity L, Swingler R (2003) Cohort study of operative delivery in the second stage of labour and standard of obstetric care. BJOG: Int J Obstet Gynaecol 110(6):610–615CrossRef

28.

Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R (2001) Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet 358(9289):1203–1207. doi:10.1016/S0140-6736(01)06341-3 CrossRefPubMed

29.

Inglis SR, Feier N, Chetiyaar JB, Naylor MH, Sumersille M, Cervellione KL, Predanic M (2011) Effects of shoulder dystocia training on the incidence of brachial plexus injury. Am J Obstet Gynecol 204(4):322, e321-e326. doi:10.1016/j.ajog.2011.01.027 CrossRef

30.

Revicky V, Mukhopadhyay S, Morris EP, Nieto JJ (2012) Can we predict shoulder dystocia? Arch Gynecol Obstet 285(2):291–295. doi:10.1007/s00404-011-1953-3 CrossRefPubMed

Titel: Risk factors for clavicle fracture concurrent with brachial plexus injury
verfasst von: Ertugrul Karahanoglu
Taner Kasapoglu
Safak Ozdemirci
Erdem Fadıloglu
Aysegul Akyol
Erhan Demirdag
E. Serdar Yalvac
N. Omer Kandemir
Publikationsdatum: 01.04.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 4/2016
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-015-3917-5

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Alter der Mutter beeinflusst Risiko für kongenitale Anomalie

28.05.2024 Kinder- und Jugendgynäkologie Nachrichten

Welchen Einfluss das Alter ihrer Mutter auf das Risiko hat, dass Kinder mit nicht chromosomal bedingter Malformation zur Welt kommen, hat eine ungarische Studie untersucht. Sie zeigt: Nicht nur fortgeschrittenes Alter ist riskant.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Risk factors for clavicle fracture concurrent with brachial plexus injury