Article

[admin]

Does anyone know of a recent article that claims Erbs Palsy is most likely caused by the force of uterine contractions when there is a shoulder dystocia? Is so, where can I find a copy of it? Thank you.

[Natalie M.]

I have very good experience with this, basically, just call any bull&^$ defense attorney and ask them. They are out there and written by doctors getting paid the big bucks to come to our trials and defend these piece of *&^^% doctors against our injured children. These doctors get paid to make this stuff up.
Sorry, just still a lot of pain to get over.
Go to your search engine and put in "brachial plexus injuries". There is one doctor whose name starts with a "G" who is writing these articles. I'm sorry I can't think of his name, must be memory selection.
If you have an attorney, he will be able to find these articles with out any problem. Or are youuuu digging for defense??? Just wondering...

[admin]

Natalie,
Thank you for the info. I will search some more. The other side plans on showing this article, so I wanted to see if I could find it online.

[stateilx3]

Probably digging for the defence, I suppose, maybe they need to go somewhere else and dig !

[marymom]

I am very sorry if the legal system failed you all, that totally blows and I do not wish to negate your anger- I am in NO WAY defending a system that unjustly served you-
However in my opinion it is not far fetched to want to read information re: causes other than mismanagement.

[admin]

I don't support this view but here are some references:

Am J Obstet Gynecol 1999 May;180(5):1303-7 Related Articles, Links

Comment in:
* Am J Obstet Gynecol. 1999 Nov;181(5 Pt 1):1271-2.

 
Brachial plexus palsy: an in utero injury?
Gherman RB, Ouzounian JG, Goodwin TM.
Divisions of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Portsmouth Naval Hospital, Virginia, USA.
Acquired brachial plexus injury historically has been linked with excessive lateral traction applied to the fetal head, usually in association with shoulder dystocia. Recent reports in the obstetric literature, however, have suggested that in utero forces may underlie a significant portion of these injuries. Brachial plexus palsies may therefore precede the delivery itself and may occur independent of the actions of the accoucheur. Thus we propose that the long-held notions of a traction-mediated pathophysiologic mechanism for all brachial plexus injuries warrant critical reappraisal.

Am J Obstet Gynecol 1997 Nov;177(5):1162-4 Related Articles, Links
 
Brachial plexus palsy associated with cesarean section: an in utero injury?
Gherman RB, Goodwin TM, Ouzounian JG, Miller DA, Paul RH.
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.
OBJECTIVE: Brachial plexus injury may be unrelated to manipulations performed at the time of delivery, occurring in the absence of shoulder dystocia and in the posterior arm of infants with anterior shoulder dystocia. To further support the hypothesis that some of these nerve injuries appear to be of intrauterine origin, we present a series of brachial plexus palsies associated with atraumatic cesarean delivery among fetuses presenting in the vertex position. STUDY DESIGN: We performed a computerized search of all deliveries from 1991 to 1995 for the discharge diagnoses of brachial plexus injury and cesarean section. Inclusion criteria included cephalic presentation at the time of delivery and the absence of traumatic delivery. RESULTS: We noted six cases of Erb's palsy, with four palsies in the anterior shoulder and two in the posterior arm. Among those five patients undergoing cesarean section because of labor abnormalities, two had uterine cavity abnormalities whereas one had a prolonged second stage of labor. One brachial plexus palsy occurred in the absence of active labor. All nerve injuries were persistent at age 1 year. CONCLUSIONS: Brachial plexus palsy can be associated with cesarean delivery. Such palsies appear to be of intrauterine origin and are more likely to persist.

Am J Obstet Gynecol 1998 Mar;178(3):423-7 Related Articles, Links

Comment in:
* Am J Obstet Gynecol. 1998 Aug;179(2):561-2.


Spontaneous vaginal delivery: a risk factor for Erb's palsy?
Gherman RB, Ouzounian JG, Miller DA, Kwok L, Goodwin TM.
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.
OBJECTIVE: Our purpose was to determine whether Erb's palsies occurring in the absence of shoulder dystocia differ from those occurring after shoulder dystocia. STUDY DESIGN: We compared the time course of resolution and incidence of persistent injury at 1 year of age in 17 cases of Erb's palsy without shoulder dystocia and 23 cases associated with shoulder dystocia. RESULTS: The rate of persistence at 1 year was significantly higher in those Erb's cases without identified shoulder dystocia, 7 of 17 (41.2%) versus 2 of 23 (8.7%), p = 0.04. These cases of Erb's palsies also took longer to resolve (6.4 +/- 0.9 vs 2.6 +/- 0.7 months, p = 0.002), had a higher rate of associated clavicular fracture (12 of 17 vs 5 of 23, p = 0.006), and were more likely to occur in the posterior arm (10 of 15 vs 4 of 21, p = 0.009). CONCLUSIONS: Erb's palsy occurring without shoulder dystocia may be a qualitatively different injury than that occurring with shoulder dystocia.

[Elisa M.]

When you locate any such articles I would be very interested as well. I also would be very interested to know the doctors background, if currently delivering babies, if had any personal bpi's, who funded the research and how valid the research really is.

Seems if inutero contractions were the cause, that we would be seeing a heck of a lot more of these injuries. From your understanding, do you think it is the forces of the contractions (sure would take an incredible amount of force) or more of a positional crush in the utero (which specialists do they and they can see a clear difference in the injury when compared to a traction injury caused when the shoulders are impacted and the head is out and being turned, twisted, pulled or pushed down on).

I am one of the parents that Mary is talking about. I would be very interested in seeing these bogus articles, although it would probably make me feel sick. Who is producing research and TRUTHFUL articles recently in regards to the cause of this injury? Money & motivation for the other side is clear, but who is here for our children? Any recent research publications or any in the works that anyone knows of?

(p.s. I can understand and feel the anger of the previous poster. It is a bunch of b.s. and we are all entitled to express our feelings, whether we may be in line or not. Who knows, she may be right on about "guest" and if not, guest, please try not to take offense, this is just a very rough journey and the emotions it brings out can be overwhelming for us.)