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What are the causes of brachial plexus injuries?

North Carolina parents whose newborn babies suffered brachial plexus injuries during birth may have questions about how their children's injuries could have happened. It is usually impossible for doctors to predict whether shoulder dystocia, the complication that often causes brachial plexus injuries, will occur during a birth.

Shoulder dystocia occurs when a baby becomes trapped in an abnormal position during birth. Babies who are positioned sideways, with their shoulders perpendicular to the ground, cannot exit the birth canal because the upper shoulder presses against the pubic symphysis, a mass of cartilage that connects the two pelvic bones. Doctors must pull babies who are stuck in this position free because their supply of oxygen is compromised. When doctors exert too much force in trying to remove the baby, they may stretch the brachial plexus, a network of nerves in the neck that is associated with the use of the arm.

Some risk factors increase the likelihood of a brachial plexus injury resulting from shoulder dystocia. Babies who are larger than typical are more likely to get stuck in the birth canal, forcing medical staff to pull them free. Gestational diabetes and maternal weight gain of 30 pounds or more often cause babies to become very large, increasing a baby's risk of becoming trapped in the birth canal. Babies born to women who have small or misshapen pelvises or who are smaller in stature may be more likely to experience shoulder dystocia.

While predicting shoulder dystocia emergencies is impossible, doctors can identify risk factors that will help them form a plan should such an emergency arise. Parents who believe their obstetricians failed to properly diagnose maternal diabetes and other risk factors for brachial plexus injuries sometimes consider seeking compensation for the ongoing care and treatment their children will need as a result of their injuries.

Source: Birthinjury.org, "How Brachial Plexus Injuries Occur", accessed on Jan. 12, 2015

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