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World J Obstet Gynecol. Nov 10, 2014; 3(4): 148-161
Published online Nov 10, 2014. doi: 10.5317/wjog.v3.i4.148
Published online Nov 10, 2014. doi: 10.5317/wjog.v3.i4.148
Prevention of shoulder dystocia related birth injuries: Myths and facts
Leslie Iffy, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103, United States
Author contributions: Iffy L solely contributed to this paper.
Correspondence to: Leslie Iffy, MD (Bp. Hon.), FRCS (Canada), Professor of Obstetrics and Gynecology (retired), 5 Robin Hood Road, Summit, NJ 07901, United States. liffy@comcast.net
Telephone: +1-908-2732651
Received: December 29, 2013
Revised: July 14, 2014
Accepted: September 4, 2014
Published online: November 10, 2014
Processing time: 319 Days and 11 Hours
Revised: July 14, 2014
Accepted: September 4, 2014
Published online: November 10, 2014
Processing time: 319 Days and 11 Hours
Core Tip
Core tip: Traditionally, brachial plexus injury at birth has been considered traction related. Recently, several authors proposed that one-half or more of these injuries occur spontaneously “in utero” resulting from myometrial activity. Study of 338 birth injuries found close association with deliveries that had involved manual and instrumental extractions. Only one Erb’s palsy occurred following cesarean section. These findings indicate that spontaneous intrauterine brachial plexus damage is extremely rare. Meticulous antenatal care, elective abdominal delivery of grossly macrosomic fetuses and non-interference with the natural birthing process are recommended for preventing shoulder dystocia and its dire consequences.