Electromyography and related electrodiagnostic techniques are being applied to clinical studies of neuromuscular diseases with increasing frequency and effectiveness. Four patients with obstetrical palsy were examined and followed up with electromyography. The findings from clinical observation and electromyographic studies were discussed in regard to the site of the lesion, prediction of prognosis and the degree of nerve regeneration. It is emphasized that findings provided by electromyographic examinations can not only contribute to accurate diagnosis, but also serve as a guide for selecting appropriate means of treatment with physical therapy for the patients with obstetrical palsy as well as to monitor progress, by doing a series of periodic examinations. Adler and Patterson(1967) reported that the incidence of Erb's palsy has remarkably decreased. From 1939 to 1962 they found only one hundred and twenty three cases instead of four hundred and ninety one cases in the period from 1928 to 1939 at the Hospital for Special Surgery. Statistics on obstetrical palsy due to the brachial plexus injury are not available in Korea. It is assumed however that its incidence here must also be decreased as the obstetric services have advanced significantly in recent years. The clinical picture of a brachial plexus palsy is dependent on the location of the pathology in the plexus and it is not easy to predict the prognosis without knowledge of the degree of injury. With electromyographic studies it is possible to detect the exact site of the lesion in the brachial plexus, the degree of injury and the progress of nerve regeneration. Therefore, it is a useful tool for making accurate diagnosis and prognosis and the findings provided by the electromyographic studies permit appropriate selection of treatment as the nerve regeneration takes place. Four cases of obstetrical palsy of the brachial plexus were referred to Severance Hospital for electromyographic examination and subsequent treatment from February to September 1972.
Child, Preschool ; Electromyography* ; Female ; Human ; Infant ; Infant, Newborn ; Male ; Paralysis, Obstetric/diagnosis* ; Paralysis, Obstetric/therapy

Electromyography and related electrodiagnostic techniques are being applied to clinical studies of neuromuscular diseases with increasing frequency and effectiveness. Four patients with obstetrical palsy were examined and followed up with electromyography. The findings from clinical observation and electromyographic studies were discussed in regard to the site of the lesion, prediction of prognosis and the degree of nerve regeneration. It is emphasized that findings provided by electromyographic examinations can not only contribute to accurate diagnosis, but also serve as a guide for selecting appropriate means of treatment with physical therapy for the patients with obstetrical palsy as well as to monitor progress, by doing a series of periodic examinations. Adler and Patterson(1967) reported that the incidence of Erb's palsy has remarkably decreased. From 1939 to 1962 they found only one hundred and twenty three cases instead of four hundred and ninety one cases in the period from 1928 to 1939 at the Hospital for Special Surgery. Statistics on obstetrical palsy due to the brachial plexus injury are not available in Korea. It is assumed however that its incidence here must also be decreased as the obstetric services have advanced significantly in recent years. The clinical picture of a brachial plexus palsy is dependent on the location of the pathology in the plexus and it is not easy to predict the prognosis without knowledge of the degree of injury. With electromyographic studies it is possible to detect the exact site of the lesion in the brachial plexus, the degree of injury and the progress of nerve regeneration. Therefore, it is a useful tool for making accurate diagnosis and prognosis and the findings provided by the electromyographic studies permit appropriate selection of treatment as the nerve regeneration takes place. Four cases of obstetrical palsy of the brachial plexus were referred to Severance Hospital for electromyographic examination and subsequent treatment from February to September 1972.
Child, Preschool ; Electromyography* ; Female ; Human ; Infant ; Infant, Newborn ; Male ; Paralysis, Obstetric/diagnosis* ; Paralysis, Obstetric/therapy

OBJECTIVETo identify the risk factors and related degrees associated to obstetric brachial plexus palsy(OBPP).

METHODSA case-control study was performed. Neonatal records of thirty-one cases with OBPP and their corresponding maternal records from the Department of Gynecology and Obstetrics of eight hospitals in Shanghai city from 1988 to 2002 were reviewed. Four controls, all living in Shanghai were selected to match each case and were born within the same year at the same hospital. The control group also included 124 cases without OBPP. According to the uniformed data and tables used were from medical records and from pregnant women. Epidemiological study was carried out on both case group and control group. Variables for analyses would include: (1) race, age, height, family history, pre-pregnancy weight, body mass index at the pre-pregnancy (weight/height2) on those pregnant women as well as on parity of their mothers; (2) the process of delivery which includeing clinic pelvis evaluation, height of uterus, abdomen circumference,antepartum weight,body mass index before delivery, mode of delivery,the duration of active phase and 2nd stage of labor, shoulder dystocia; (3) on neonates: sex, gestational age, birth weight,affected limb, Apgar scores of 1 and 5 minutes, other birth trauma and resuscitation of infant. Statistical tests applied to these data would include Student's T test for continuous variables and chi2 analysis for discrete data. Risk calculation of OBPP was performed by univariable and multivariable conditional logistic regression analysis.

RESULTS12 factors related to expsure were identified for OBPP through univariable conditional logistic regression analysis. When multivariable conditional logistic regression model at P = 0.1 was applied, four factors such as cesarean (OR = 0.060), forceps (OR = 65.237), birth weight (OR = 35.468), and pre-pregnancy body mass index (OR = 23.901) were selected.

CONCLUSIONForceps delivery,macrosomia, and increase of pre-pregnancy body mass index (> or = 21) were risk factors of OBPP in the order of degrees to risk while cesarean seemed to serve as a protective factor.

Adult ; Brachial Plexus ; pathology ; Case-Control Studies ; Female ; Health Surveys ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Multivariate Analysis ; Paralysis, Obstetric ; epidemiology ; pathology ; physiopathology ; Pregnancy ; Risk Factors