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Obstetric palsies

Orhan Beger, Uğur Dinç, Burhan Beger, Deniz Uzmansel, Zeliha Kurtoğlu
PURPOSE: The main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants. METHODS: Twenty-five formalin-fixed fetuses (11 male-14 female) with a mean gestational age of 21.80 ± 2.61 (range 18-27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Eduardo de Almeida Guimarães Nogueira, Vitor Martinez de Carvalho, Marcos Vinicius de Queiroz, Gleysson Rodrigues Rosa, Yara Dadalti Fragoso
Augusta Marie Déjerine-Klumpke (1859-1927) was a formidable neurologist, neuroanatomist and researcher in France. One of the first women to be accepted for medical internship, externship and research in Paris, Augusta made her name studying and teaching anatomy, histology and dissection, attending clinical activities in neurology, obstetrics, pediatrics and neurologic trauma, performing necropsies, and writing scientific papers and book chapters. Her main research in neurology awarded her an eponym for the avulsion of the lowest root of the brachial plexus (Klumpke's palsy)...
February 2018: Arquivos de Neuro-psiquiatria
Mark I Evans, Robert D Eden, David W Britt, Shara M Evans, Barry S Schifrin
BACKGROUND: Even key opinion leaders now concede that electronic fetal monitoring (EFM) cannot reliably identify fetal acidemia which many vouch as the only labor mediated pathophysiologic precursor for cerebral palsy (CP). We have developed the "Fetal Reserve Index" - an algorithm combining five dynamic components of EFM (1. Rate, 2. Variability, 3. Accelerations, 4. Decelerations, and 5. Excessive uterine activity) considered individually that are combined with the presence of: 6...
February 28, 2018: Journal of Maternal-fetal & Neonatal Medicine
Maher Barsaoui, Hatem Safi, Walid Said, Med Nabil Nessib
BACKGROUND: Obstetric brachial plexus palsy aredue to elongation of the brachial plexus during delivery by increasing thedistance between the head and shoulder. The majority of paralysis recoverspontaneously, but in some cases, nerve repair is necessary. The timing of thisnerve surgery and criteria for its indication are topics of discussion in theworld literature.The aim of this study is to askdirections and to evaluate the contribution of nerve surgery in improving theprognosis of this disease...
March 2017: La Tunisie Médicale
Zeynep Hosbay, Safiye Ozkan, Muberra Tanriverdi, Atakan Aydin
STUDY DESIGN: Clinical measurement and cross-sectional study. INTRODUCTION: Numerous scales have been developed to examine activities of daily living and function in children with brachial plexus palsy. The Brachial Plexus Outcome Measure (BPOM) scale was developed in 2012 by Emily S. Ho and contains 14 items that measure activity and self-evaluation. PURPOSE OF THE STUDY: The aim of the study was to cross-culturally translate the BPOM scale into Turkish and test its measurement properties in children with brachial plexus palsy...
January 27, 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Junichi Hasegawa, Tomoaki Ikeda, Satoshi Toyokawa, Emi Jojima, Shoji Satoh, Kiyotake Ichizuka, Nanako Tamiya, Akihito Nakai, Keiya Fujimori, Tsugio Maeda, Hideaki Masuzaki, Satoru Takeda, Hideaki Suzuki, Shigeru Ueda, Tsuyomu Ikenoue
AIM: The study identifies the relevant obstetric factors associated with fetal heart rate (FHR) monitoring for cerebral palsy (CP) in pregnant women with hypertensive disorders of pregnancy (HDP). METHODS: The subjects were neonates with CP (birth weight ≥ 2000 g, gestational age ≥ 33 weeks) who were approved for compensation for CP by the Operating Organization of the Japan Obstetric Compensation System between 2009 and 2012. After selection of women with antepartum HDP, obstetric characteristics associated with FHR monitoring were analyzed...
January 23, 2018: Journal of Obstetrics and Gynaecology Research
C M Aiudi, E E Sharpe, K W Arendt, J J Pasternak, H P Sviggum
Selective dorsal rhizotomy is a surgical spine procedure used to reduce spasticity in patients with upper motor neuron dysfunction caused by conditions such as cerebral palsy. The optimal anesthetic approach for obstetric patients who have undergone a selective dorsal rhizotomy is unknown. The use and efficacy of neuraxial anesthesia in these patients has not been described. We describe the use of neuraxial anesthesia in two patients with prior selective dorsal rhizotomy. Unless contraindicated for other reasons, a neuraxial anesthetic approach appears to be an effective option in patients with a history of a selective dorsal rhizotomy...
December 15, 2017: International Journal of Obstetric Anesthesia
Ricardo Monreal
PURPOSE: The one-bone forearm arthrodesis has been performed to change the position of the forearm in children with fixed supination deformity due to upper extremity neurologic deficit. In this article, we present a retrospective review of children with late obstetric brachial plexus palsy who underwent palliative surgery to correct severe supination contracture by one-bone forearm osteodesis and biceps re-routing. This technique has not been described previously. MATERIALS AND METHODS: In this retrospective study, four consecutive patients with upper extremity weakness and severe supination contracture who underwent forearm osteodesis in neutral or slight pronation and biceps re-routing...
January 12, 2018: International Orthopaedics
Vaishali Upadhyaya, Divya Narain Upadhyaya, Brijesh Mishra
OBJECTIVES: Many studies have elaborated on the role of magnetic resonance neurography (MRN) in evaluating traumatic brachial plexopathies. Most of these deal with MR findings in adult traumatic plexopathies or children with obstetric brachial plexus palsy (OBPP). Hence, the authors felt the need for this particular study, which focuses on MRN findings in children with non-obstetric traumatic brachial plexus palsy, to find out the distribution and severity of injuries in these patients...
January 9, 2018: European Radiology
Claire Thuillier, Sophie Roy, Violaine Peyronet, Thibaud Quibel, Aurélie Nlandu, Patrick Rozenberg
BACKGROUND: The dramatic rise in cesarean delivery (CD) rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery. OBJECTIVE: We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary CD rate safely...
December 29, 2017: American Journal of Obstetrics and Gynecology
Jean-Sébastien Bourseul, Anais Molina, Mael Lintanf, Laetitia Houx, Emmanuelle Chaléat-Valayer, Christelle Pons, Sylvain Brochard
OBJECTIVE: To report current evidence regarding the safety of intramuscular BTI in children with orthopaedic- and neurological-related musculoskeletal disorders under the age of 2 years. DATA SOURCE: PUBMED, The Cochrane Library, and Science Direct, Google Scholar and Web of Science. STUDY SELECTION: Two reviewers independently selected studies based on predetermined inclusion criteria. DATA EXTRACTION: Data relating to the aim were extracted...
December 26, 2017: Archives of Physical Medicine and Rehabilitation
Vanessa Costil, Claudia Romana, Frank Fitoussi
PURPOSE: Obstetric brachial plexus palsy (OBPP) may result in a severe impairment of upper limb function, especially when major motor functions do not recover with or without early microsurgical reconstruction. Various methods to restore elbow flexion have been described. The aim of this study was to report the results after pectoralis minor transfer for elbow flexion restoration in late OBPP. METHODS: Nineteen patients were included. Mean age at surgery was six years (range, 2...
December 28, 2017: International Orthopaedics
S El-Shamy, R Alsharif
OBJECTIVES: The objective was to evaluate the effects of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury. METHODS: Forty children with Erb's palsy were selected for this randomized controlled study. They were assigned randomly to either group A (conventional physiotherapy program) or group B (virtual reality program using Armeo® spring for 45 min three times/week for 12 successive weeks)...
December 1, 2017: Journal of Musculoskeletal & Neuronal Interactions
Robert Bains, Abdullah Kattan, Christine G Curtis, Derek Stephens, Gregory Borschel, Howard M Clarke
PURPOSE: In our experience, and from the personal report of others, children with obstetrical brachial plexus palsy appear to lose some of their initially recovered active range of motion over the time in both operated and nonsurgical patients. This study investigates whether such a diminution of active movement occurs over time. METHODS: We performed a retrospective analysis of data from our obstetrical brachial plexus clinic. Between 1991 and 2000, 139 patients with a minimum follow-up of 10 years were included in the study...
November 21, 2017: Journal of Hand Surgery
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: The near-ubiquitous use of electronic fetal monitoring has failed to lower the rates of both cerebral palsy and emergency operative deliveries (EODs). Its performance metrics have low sensitivity, specificity, and predictive values for both. There are many EODs, but the vast majority have normal outcomes. The EODs, however, cause serious disruption in the delivery suite routine with increased complications, anxiety, and concern for all. METHODS: We developed the fetal reserve index (FRI) as multicomponent algorithm including 4 FHR components (analyzed individually), uterine activity, and maternal, obstetrical, and fetal risk factors to assess risk of cerebral palsy and EOD...
January 1, 2017: Reproductive Sciences
J Bahm, A Gkotsi, S Bouslama, W El-Kazzi, F Schuind
Background  In rare, selected cases of severe (extended) upper obstetric brachial plexus palsy (OBPP), after supraclavicular exposure and distal mobilization of the traumatized trunks and careful neuroma excision, we decided to perform direct nerve coaptation with tolerable tension and immobilized the affected arm positioned in adduction and 90-degree elbow flexion for three weeks. Objectives  We present our surgical technique and preliminary results in a prospective open patient series, including 22 patients (14 right and 8 left side affected) between 2009 and 2016, operated at a mean age of 8...
January 2017: Journal of Brachial Plexus and Peripheral Nerve Injury
Kishore Kislay, Bhagavatula Indira Devi, Dhananjaya Ishwar Bhat, Dhaval Prem Shukla, Arun Kumar Gupta, Rajanikant Panda
BACKGROUND: The response of the brain to obstetric brachial plexus palsy (OBPP) is not clearly understood. We propose that even a peripheral insult at the developmental stage may result in changes in the volume of white matter of the brain, which we studied using corpus callosum volumetry and resting-state functional magnetic resonance imaging (rsfMRI) of sensorimotor network. OBJECTIVE: To study the central neural effects in OBPP. METHODS: We performed an MRI study on a cohort of 14 children who had OBPP and 14 healthy controls...
October 28, 2017: Neurosurgery
Christopher J DeFrancesco, Divya K Shah, Benjamin H Rogers, Apurva S Shah
BACKGROUND: The epidemiology of brachial plexus birth palsy (BPBP) in the United States may be changing over time due to population-level changes in obstetric care. METHODS: The Kids' Inpatient Database from 1997 to 2012 was analyzed. Annual estimates of BPBP incidence and disease determinant distribution were calculated for the general population and the study population with BPBP. Long-term trends were analyzed. A multivariate logistic regression model was used to quantify the risk associated with each determinant...
October 9, 2017: Journal of Pediatric Orthopedics
Mohammad M Al-Qattan, Amel A F El-Sayed
BACKGROUND: Primary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach. METHODS: A series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots)...
2017: European Journal of Plastic Surgery
Isaac Blickstein
Understanding the intrapartum development of cerebral palsy (CP) may improve obstetrical management, would decrease the incidence of CP, and would help the court in judging whether CP is a result of negligence. In 1999, the Australian task force, and in 2003 the American task force, published their consensus regarding the criteria to establish intrapartum development of CP (recently reaffirmed by the American task force). The rationale is that CP is the end product of a continuum starting with an intrapartum hypoxic event that continues with the birth of an asphyxiated neonate, that exhibit specific neurological manifestations, and ends with a specific type of CP...
August 2017: Harefuah
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