Brachial Plexus Palsy Can Occur in the Absence of Shoulder Dystocia

Neonatal brachial plexus palsy (BPP) is a rare but potentially serious complication of childbirth. Although many cases have been linked to shoulder dystocia, some have been reported with cesarean delivery. Investigators searched records of the Los Angeles County and University of Southern California Medical Center for cases of persistent BPP not related to shoulder dystocia or other risk factors. Among 43,337 births, 477 cases of shoulder dystocia (1.1%) and 91 cases of BPP (0.2%) were identified. Severe BPP was defined as the presence of injury requiring admission to the neonatal intensive care unit. Shoulder dystocia was considered to have occurred if obstetric maneuvers other than gentle downward traction were required to complete the bi…