Obstetric brachial plexus palsy: a population-based retrospective case-control study and medicolegal considerations

AIMS: The aim of this study was to examine 24 cases of obstetric brachial plexus palsy (OBPP) in 41,002 deliveries occurred at San Camillo-Forlanini Hospital in Rome, during the period 2000-2012. MATERIALS AND METHODS: A population-based retrospective case-control study was designed and the database of the hospital was searched; for each case, maternal and fetal records were examined and some risk factors were evaluated. RESULTS: A statistically significant association between the 24 cases OBPP and the following risk factors: primiparity (p < .014), birth weight (p < .002), maternal age (p < .02), diabetes (p < .03) and shoulder dystocia (p < .003) was found, moreover all the OBPP cases were recorded only in vaginal deliveries. CONCLUSIONS: The absence of OBPP cases in cesarean deliveries highlighted in this study supports the option of proposing an elective cesarean in the presence of known risk factors after a full disclosure with the mother of risks and benefits in order to obtain a valid consent. Furthermore, when cases of OBPP occur, communication between the physician and the parents of newborns is crucial and it may represent a valid risk-management tool to reduce malpractice lawsuits.