Incidence of obstetric brachial plexus palsy after a training program in shoulder dystocia

• Published in: Anales de Pediatría 2022-12, Vol.97 (6), p.415-421
• Main Authors: Salvador López, Rita, Cruz Melguizo, Sara, Sanz Lorenzana, Amelia, Diez de los Rios Quintanero, Blanca, Malalana Martinez, Ana, de la Cruz Conty, Maria Luisa, Martínez Pérez, Oscar
• Format: Article
• Language: English
• Subjects: Brachial Plexus; Brachial Plexus Neuropathies - complications; Brachial Plexus Neuropathies - etiology; Distocia de hombros; Dystocia - epidemiology; Dystocia - etiology; Dystocia - therapy; Emergencia obstétrica; Female; Humans; Infant, Newborn; Obstetric brachial plexus palsy; Obstetric emergency; Paralysis - complications; Parálisis braquial obstétrica; Pregnancy; Retrospective Studies; Shoulder dystocia; Shoulder Dystocia - epidemiology; Shoulder Dystocia - therapy; Simulación; Simulation
• ISSN: 2341-2879; 2341-2879
• DOI: 10.1016/j.anpede.2022.06.011

[Display omitted] Shoulder dystocia is a nonpreventable obstetric emergency that causes severe complications, such as obstetric brachial plexus palsy. The objective of the study was to determine the incidence of obstetric brachial plexus palsy and other neonatal complications associated with shoulder dystocia in deliveries managed in a university hospital after the implementation of a simulation-based training that was offered to all the labour and delivery staff on a voluntary basis. Retrospective observational study including all cases of shoulder dystocia and associated complications (mainly obstetric brachial plexus palsy) documented between January 2017 and December 2020, after the implementation of the training. In addition, we collected retrospective data on cases of obstetric brachial plexus palsy that developed in the hospital before the training (2008–2016). In the 2017–2020 period, in the total of 125 cases of shoulder dystocia (amounting to 1.38% of vaginal deliveries), there were 14 cases of obstetric brachial plexus palsy (11.2% of the cases of shoulder dystocia), 7 clavicle fractures and 1 humerus fracture; none of the cases of obstetric brachial plexus palsy was permanent or required treatment or rehabilitation past six months. In the years preceding the training, there were 7 cases of obstetric brachial plexus palsy, 2 permanent and 5 temporary (3 of which required rehabilitation). These results reflect the importance of knowing the morbidity present in the labour and delivery ward and the potential benefit of simulation-based training programmes in the resolution of these obstetric complications. La distocia de hombros es una emergencia obstétrica no prevenible que causa graves complicaciones, como la parálisis braquial obstétrica. El objetivo del estudio fue determinar la incidencia de parálisis braquial obstétrica y de otras complicaciones neonatales asociadas a la distocia de hombros en los partos atendidos en un Hospital Universitario tras la implantación de un curso basado en simulación, de carácter voluntario y destinado a todos los profesionales en paritorio. Estudio observacional retrospectivo; registro de los casos de distocia de hombros y de las complicaciones asociadas (principalmente parálisis braquial obstétrica) que tuvieron lugar entre enero de 2017 y diciembre de 2020, tras la implantación del curso. De forma paralela, se rescataron los casos de parálisis braquial obstétrica que tuvieron lugar en el hospital antes del entr