Brachial Plexus Birth Palsy

The brachial plexus innervates upper limbs and is formed by the ventral roots of the 5th-8th cervical spinal nerves (C5-C8) and the 1st thoracic spinal nerve (T1). All peripheral nerves of the upper limb originate from different parts of the brachial plexus (1). Figure 1 illustrates the anatomy of this area. The brachial plexus may be injured during childbirth, a condition known as brachial plexus birth palsy (BPBP). Its prevalence varies in different geographical regions, ranging from approximately 0.4 to 2 cases per 1000 live births (2-6). The perinatal risk factors include high birth weight (macrosomia), gestational diabetes, multiparity, difficult/ prolonged delivery, shoulder dystocia, and breech presentation. Following these conditions, especially shoulder dystocia, the main cause of injury is cervical traction and brachial plexus stretching. Given that the most common fetal presentation is left occiput anterior (LOA), the right side is more affected (7, 8).