Yenidoğan Brakiyal Pleksus Yaralanmaları; Obstetrik Brakiyal Pleksus Yaralanması Olan Yenidoğanların Doğum Özelliklerinin Retrospektif Değerlendirilmesi

Year 2022, Volume: 10 Issue: 1, 22 - 25, 15.03.2022

Tuğrul Ergün , Sevcan Sarıkaya

https://doi.org/10.21765/pprjournal.1067688

Abstract

Amaç: Perinatal brakial pleksus yaralanması(BPY) görülen yenidoğan hastalarının doğum özelliklerini ve eşlik eden ek patolojilerini incelemektir.
Gereç ve Yöntem: 2016-2021 yılları arasında perinatal BPY nedeniyle ortopedi ve travmatoloji kliniğine konsulte edilen hastalar retrospektif olarak tarandı. Hastaların doğum özellikleri ve eşlik eden perinatal patolojileri kayıt altına alınarak istatiksel analizleri gerçekleştirildi.
Bulgular: 4687 canlı doğum arasında 75 hastada BPY görüldü. Hastaların %78.7(n=59)’sinin spontan vajinal yol ile , % 21.3(n=16)’ünün sezaryen doğum ile doğurtulduğu gözlemlendi. Hastaların % 53.3(n=40)’ü erkeklerden oluşmaktayken, %73.3 (n=55)’ünde pleksus hasarı sağ ekstremitede idi. %57.3(n=43)’ünde eşlik eden omuz distosisi, %20(n=15)’sinde klavikula kırığı bulunmaktaydı. Omuz distosili hastaların doğum ağırlığı, boy uzunlukları ve baş çevresi uzunluklarının omuz distosisi olmayan hastalara göre istatistiksel olarak anlamlı derecede yüksek olduğu gözlemlendi.(p=0.001,p=0.037,p=0.023) Klavikula kırığı gözlenen hastaların doğum ağırlığı, boy uzunlukları ve baş çevresi ve göğüs çevresi uzunluklarının klavikula kırığı olmayan hastalara göre istatistiksel olarak anlamlı derecede yüksek olduğu gözlemlendi.(p=0,000, p=0.012, p=0.044, p=0.035).
Sonuç: Yenidoğan bebeklerde artmış doğum ağırlığı, kafa çapı uzunluğu, boy uzunluğu ve göğüs çevresi uzunluğu artmış perinatal komplikasyonlarla ilişkili olduğu gözlemlendi. Bu yenidoğan bebeklerin; BPY, omuz distosisi ve klavikula kırığı oluşması açısından değerlendirilmeleri önerilir.

Keywords

Brakial Pleksus Yaralanması, Yenidoğan, Omuz Distosisi, Makrozomi.

Supporting Institution

yok

Project Number

7

Thanks

yok

Neonatal Brachial Plexus Injuries; Retrospective Evaluation Of Birth Characteristics Of Newborns With Obstetric Brachial Plexus Injuries

Abstract

Aim: To examine the birth characteristics and accompanying additional pathologies of newborn patients with perinatal brachial plexus injury (BPI).
Materials and Methods: Patients who were consulted to the orthopedics and traumatology clinic due to perinatal BPI between 2016-2021 were retrospectively screened. The birth characteristics and accompanying perinatal pathologies of the patients were recorded and statistical analyzes were performed.
Results: BPI was seen in 75 patients among 4687 live births. It was observed that 78.7% (n=59) of the patients were delivered by spontaneous vaginal delivery and 21.3% (n=16) by cesarean section. While 53.3% (n=40) of the patients were men, 73.3% (n=55) had plexus damage in the right extremity. There was accompanying shoulder dystocia in 57.3% (n=43) and clavicle fracture in 20% (n=15). It was observed that the birth weight, height and head circumference of patients with shoulder dystocia were statistically significantly higher than those without shoulder dystocia. (p=0.001, p=0.037, p=0.023) Birth weight, height and head circumference of patients with clavicle fracture and chest circumference lengths were statistically significantly higher than patients without clavicle fracture (p=0.000,p=0.012, p=0.044, p=0.035).

Keywords

Brachial Plexus Injury, Newborn, Shoulder Dystosis, Macrosomy.

Project Number

7

References

• 1. Gilcrease-Garcia BM, Deshmukh SD, Parsons MS. Anatomy, Imaging, and Pathologic Conditions of the Brachial Plexus. Radiographics.2020;40:1686-714.
• 2. Chang KW, Justice D, Chung KC, Yang LJ. A systematic review of evaluation methods for neonatal brachial plexus palsy: a review. J Neurosurg Pediatr. 2013;12:395-405.
• 3. Van der Looven R, Le Roy L, Tanghe E at al. Risk factors for neonatal brachial plexus palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2020;62:673-83.
• 4. Yang LJ. Neonatal brachial plexus palsy--management and prognostic factors. Semin Perinatol. 2014;38:222-34.
• 5. Ozturk, K., Bulbul, M., Demir, B. B., Buyukkurt, C. D., Ayanoglu, S., & Esenyel, C. Z. Reconstruction of shoulder abduction and external rotation with latissimus dorsi and teres major transfer in obstetric brachial plexus palsy. Acta Orthop Traumatol Turc. 2010;44:186-93.
• 6. Heise CO, Martins R, Siqueira M. Neonatal brachial plexus palsy: a permanent challenge. Arq Neuropsiquiatr. 2015;73:803-8.
• 7. Govindan M, Burrows HL. Neonatal Brachial Plexus Injury. Pediatr Rev. 2019;40:494-6.
• 8. Sharma S, Dhakal I. Cesarean vs Vaginal Delivery: An Institutional Experience. JNMA J Nepal Med Assoc. 2018;56:535-9.
• 9. Louden E, Marcotte M, Mehlman C, Lippert W, Huang B, Paulson A. Risk Factors for Brachial Plexus Birth Injury. Children. 2018;29:46.
• 10. Hill MG, Cohen WR. Shoulder dystocia: prediction and management. Womens Health. 2016;12:251-61.
• 11. Doumouchtsis SK, Arulkumaran S. Are all brachial plexus injuries caused by shoulder dystocia? Obstet Gynecol Surv. 2009;64:615-23.
• 12. Ouzounian JG. Risk factors for neonatal brachial plexus palsy. Semin Perinatol. 2014;38:219-21.
• 13. Kc K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab.2015;66:14-20.
• 14. Beta J, Khan N, Khalil A, Fiolna M, Ramadan G, Akolekar R. Maternal and neonatal complications of fetal macrosomia: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2019;54:308-18.
• 15. Weissmann-Brenner A, Simchen MJ, Zilberberg E, et al. Maternal and neonatal outcomes of macrosomic pregnancies. Med Sci Monit. 2012;18:77-81.
• 16. Said AS, Manji KP. Risk factors and outcomes of fetal macrosomia in a tertiary centre in Tanzania: a case-control study. BMC Pregnancy Childbirth. 2016;16:243.
• 17. Sharma S, Dhakal I. Cesarean vs Vaginal Delivery: An Institutional Experience. JNMA J Nepal Med Assoc. 2018;56:535-9.
• 18. Yenigül AE, Yenigül NN, Başer E, Özelçi R. A retrospective analysis of risk factors for clavicle fractures in newborns with shoulder dystocia and brachial plexus injury: A single-center experience. Acta Orthop Traumatol Turc.2020;54:609-13.
• 19. Ergün T, Sarikaya S. Newborn Clavicle Fractures: Does Clavicle Fracture Morphology Affect Brachial Plexus Injury? J Pediatr Orthop. 2022;42(4):373-6.