Spontaneous vaginal delivery: a risk factor for Erb's palsy?
OBJECTIVE
Our purpose was to determine whether Erb's palsies occurring in the absence of shoulder dystocia differ from those occurring after shoulder dystocia.


METHODS
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.
Gherman
R B
RB
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.
Ouzounian
J G
JG
Miller
D A
DA
Kwok
L
L
Goodwin
T M
TM
D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D002968:Clavicle / Q000293:injuries; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004420:Dystocia / Q000150:complications*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D010246:Paralysis, Obstetric / Q000196:embryology / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D013997:Time Factors