1166 Brachial Plexus Injury Patterns Have Remained Unchanged Over Two Time Epochs

Abstract

Objective: Brachial Plexus Injury (BPI) is a potentially serious complication following shoulder dystocia at birth. Its The NMH previously published our findings on BPI for the period of 1994-1998. In this study, we have addressed the question as to whether BPI is changing in incidence or severity over time. Methods: All cases of BPI from 2004-2008 were included. The diagnosis was confirmed by a Paediatrician and Physiotherapist. Clinical details and background hospital statistics were recorded. Data regarding the severity of persisting neurological deficits was obtained from the Central Remedial Clinic. The findings for 2004-2008 were compared to the previously published data for the period 1994-1998. Results: 77749 patients were included within the two study periods. In the series from 2004-2008, the incidence of BPI was 1.7/1000 (72 cases/41953 births) compared to 1.5/1000 for the preceding time period of 1994-1998 (54 cases/35796 births). The Caesarean section rates were 18.4% (2004-2008) and 10.7% (1994-1998). The proportion of births weights >4000g was 19.2% (2004-2008) and 19.3% (1994-1998). In 2004-2008, of 9 infants referred for follow-up of persisting neurological deficit, 2 required surgical intervention. In 1994-1998 10 infants had persisting deficits, 3 requiring surgery. Summary: It was believed that the BPI rate had improved through the increased rate of operative deliveries and the employment of Obstetric drills for the management of shoulder dystocia. This study reveals the incidence of BPI remains unchanged over two time epochs. These findings suggest the pathogenesis and prevention of BPI are more complex than we realised.