Obstetric brachial plexus palsy: a comparison of affected infants delivered vaginally by breech or cephalic presentation.

In this retrospective study we compared obstetric brachial plexus palsy (OBPP) in two non-operated groups of newborn babies delivered vaginally by breech or cephalic presentation. There were 35 cases of OBPP in the breech group and 663 cases in the cephalic group. The former group was more likely to develop upper Erb's palsy while the latter group was more likely to develop total palsy. The breech group also had a significantly lower mean birth weight, a significantly higher percentage of bilateral OBPP palsies and concurrent phrenic nerve palsy. Spontaneous recovery of shoulder abduction and elbow flexion in newborn babies with upper Erb's palsy was significantly worse in the breech compared with the cephalic group. It was concluded that OBPP following vaginal breech delivery has several unique demographic features and breech babies with upper Erb's palsy have a worse prognosis for spontaneous recovery than those in the cephalic group.