Mecanismos patogénicos de la parálisis braquial congénita

Abstract

Background: Classically congenital brachial palsy was defined as a flaccid paresis of the upper limb, secondary to traumatic brachial plexus stretching during delivery of the anterior shoulder in the context of shoulder dystocia. Numerous series have reported the lack of relationship between congenital brachial palsy and traumatic stretching of the brachial plexus during shoulder dystocia, in a significant number of cases. Objective: To review the literature to identify the causes related to congenital brachial palsy. Results: Up to 50% of cases of congenital brachial palsy are not associated to shoulder dystocia. These cases, have worse prognosis, mainly affect the posterior shoulder, presents in infants of lower birth weight and may even be in a cesarean delivery. Congenital brachial palsy not associated with shoulder dystocia recognizes multiple pathogenic mechanisms such as: vicious fetal position in utero, traction of the posterior shoulder on the sacral promontory, fetal tumors, uterine tumors, and othe s. Conclusion: Congenital brachial palsy, should be understood as a syndrome, clinically characterized by flaccid paresis/paralysis of one upper limb detected in the newborn, being the consequence of different pathogenic mechanisms and having variable prognosis.