An obstetric paralysis is called a violation from the upper limb of a newborn baby, which arose due to the wrong obstetric tactics in childbirth. The immediate cause of this violation is the shoulder plexus - the "tank" of nerve endings.

The main symptoms of pathology are the deterioration of the mobility and the sensitivity of the upper limb from the defeat. Pathology is complicated by the contracture - "jamming" hands in the shoulder joint and the inability to fulfill any movement in it.

Preliminary diagnosis put based on clinical signs And information about how childbirth was grew, was the pathology of pregnancy observed. Additional research methods are attracted to clarify the degree of violation. Treat pathology with drugs that improve nervous conductivity.

Obstetric paralysis: what is it?

Obstetric Paralysis is one of the oldest problems of obstetrics, the relevance of which did not decrease over several centuries - since obstetrics only began to develop as a branch of medicine, and so far. The emergence of pathology depends on both the tactics of the objects in general and from the skills of obstetrician - non-accurant actions in the conditions of cetenic (lack of time) can lead to the development of pathology, due to which the quality of the child's life will be irreversibly reduced. The problem is also in the fact that the obstetric paralysis is difficult to influence - the state of the affected upper limb can be improved, but it is not possible to fully lead it to normal, even with modern achievements in the field of medicine. This is explained by the general pattern of nerve structures - irreversibility of pathological tissue and cellular processes that occur in them.

Obstetric paralysis: who is to blame?

The immediate cause of the development of the obstetric paralysis is damage to the nerve branches, of which there is a shoulder plexus, when promoting a child by generic paths. Such damage can be both squeezing the nerve structures and their more serious damage - dumps of varying degrees.

Damage to the shoulder plexus of a child may occur at the moment when the obstetrician:

• removes it from the head of the mother, capturing his fingers shoulder belt;
• uses auxiliary toolkit - obstetric tongs.

Also identified factors that contribute to the appearance of the described pathology. It:

• prolonged childbirth;
• large fruit;
• the birth of a child in the "shirt";
• incorrect behavior of a woman in childbirth;
• threat of crotch break.

Intrauterine hypoxia of the fetus (insufficient oxygen flow in its body) is one of the most significant factors that increases the risk of developing the obstetric paralysis. On its background, the risk of ischemia is increasing - oxygen fasting fabrics, due to which nervous structures become extremely sensitive even to small damage with incorrect birth.

The reasons for the development of intrauterine hypoxia of the fetus can be the following violations:

• placental insufficiency - so-called blood flow violation in the "Mother - Placenta - Fruit" system, which is why fetal hypoxia is developing;
• heavy late - perverted reaction of the parent body for the presence of a fetus in the uterus;
• incorrect attachment of the placenta, due to which, in varying degrees, the output from the uterine cavity can be blocked (it is also called the uterine zev);
• premature (separation from the inner surface of the uterus) with normal attachment;
• - its protracted dates;
• incixing of the body of the fetus - poisoning of toxic substances. It can occur when proceeding in its fabric both products of the life of microorganisms and external toxins (as a rule, these are substances that are used in everyday life, agriculture, industry, as well as some medicinal products);
• anomalies of intrauterine development - violation of both bookmarks and further growth and development of organs and tissues.

Factors associated with the development of hypoxia of the fetus, and therefore the emergence of obstetric paralysis are:

Why is the risk of developing obstetric paralysis increase with prolonged birth? The reasons are two:

• the hypoxia of the fetus, contributing to its development;
• with the appearance of her signs, the obstecker tries to quickly extract the child from the marriage of the mother and in a hurry can, inactively capturing her shoulder, damage the shoulder plexus.

A large fruit is a risk factor for the same reasons - childbirth are delayed, the oxygen starvation of the child develops, and due to hasty manipulations, shoulder plexus may be damaged to extract it.

note

The risk of developing the obstetric paralysis increases sharply if the mass of the fetus is 4 kg and more.

The curse of the fetus is able to provoke those violations that are fraught with hypoxia - this is:

• premature placental detachment;
• the prevention of the fetus is its improper location in relation to the axis of the uterus.

At the birth of a child in the "shirt" (the fetal bubble), the risk of both direct traumatization of the shoulder plexus and hypoxia, which leads to this accuracy is indirectly.

The buttock prevention of the fetus is fraught with the development of obstetric paralysis for the following reasons:

• with it, difficulties arise when moving the child by generic paths and, as a result, an increase in the risk of squeezing in the field of shoulder plexus. At the same time, the likelihood of a donkey or breaking of the breast-curable-preceding muscle increases, against the background of which the shoulder plexus is damaged, obstetric paralysis arises;
• due to the difficulties of the child's movement, obstetric tongs can be used, the use of which increases the risk of damage to the shoulder plexus.

Incorrect behavior of a woman in childbirth can also indirectly contribute to the development of an obstetric paralysis in a child - due to the protracted generic process, as well as due to the violation of the child's promotion by the generic paths.

note

In the threat of a cringe of the crotch, the child's extraction may be hasty or vice versa slowed down, which is fraught with damage to the shoulder plexus, entailing obstetric paralysis.

The development of pathology

Obstetric paralysis is a classic neurological violation. The damaging factors (mechanical impact on the shoulder plexus or oxygen starvation of its structures) lead to a violation of the nervous conductivity, due to which the muscles of the upper limb do not receive adequate signals - this is poured into violation of their abbreviations.

Depending on which the shoulder plexus is damaged, the main three types of obstetric paralysis are highlighted:

• upper;
• lower;
• total.

Besides them may be diagnosed combined defeat structures of different beams, and with various degrees lesions - this means that there are a number clinical options obstetric paralysis.

Upper obstetric paralysis It is also called Duceda-Erba paralysis. It occurs if structures are broken:

• upper primary beam of shoulder plexus;
• upper nerve roots that depart from spinal cord In the area of \u200b\u200bthe cervical vertebrae (from the first to sixth).

Lower obstetric paralysis Also known under a different title - as paralysis decerer-keyplace. It can be amazed:

• lower beam of shoulder plexus;
• spinal roots that correspond to the sixth cervical vertebrae and those vertebrae that are below.

For total formthe structures of the whole shoulder plexus are damaged by the described pathology. At the same time, the most severe clinical picture is developing with the most severe consequences (complications).

Clinic of the obstetric paralysis

The main manifestations of the obstetric paralysis are:

• muscle hypotension;
• deterioration different species sensitivity;
• hand hanging;
• lack of some natural reflexes that should manifest themselves in a child in different periods of his life.

Muscular hypotension in this case is manifested by a decrease in the tone of muscle groups, which provide the motor activity of the upper limb.

When obstetric paralysis, sensitivity deterioration is observed:

• temperature;
• pain;
• tactile.

note

A child with an obstetric paralysis does not wither hand, accidentally touched to a hot cup, batteries and so on. Also, the baby does not react or reacts poorly to pain irritants - for example, hitting the damage hand, it does not cry and does not apply that it hurts him.

Hand hanging is often one of the most indicative symptoms of obstetric paralysis. In particular, it hangs in an uncomfortable / unnatural position, which is most noticeable if changing general Child in space or put it in the crib.

For the presence of an obstetric paralysis indicates the absence of the following reflexes, which are manifested in the norm:

• Moro (the child spreads his hands and squeezes the cams, and then returns them to the opposite position in response to a blow on the surface on which it lies, the extension of its lower extremities and some others);
• Robinson (the child is enough and clamping a pen stretched out his finger or any other item);
• paludo-rota (when pressed to palm, the child opens his mouth and bends his head).

The violation of tone and sensitivity depends on the localization of the lesion - they can be observed in the part of the hand, which is closer to the shoulder joint or to the brush.

Similarly, signs of other violations that arose due to hypoxia of the fetus can develop with the symptoms of the obstetric paralysis.

• excitation;
• trembling limbs and torso;
• disruption of unconditional reflexes.

Diagnosis of obstetric paralysis

Obstetric paralysis manifests immediately after the birth of a child. Experienced neonatologists can identify it even with a light course, the recognition of which is often difficult - with this course, obstetric paralysis can be diagnosed only in a few months from the moment of the child's birth. The late detection is also due to the fact that the child from nature can be very calm. At the same time, its overall motor activity is reduced, due to which a minor violation of the movement of the affected hand becomes small and recognized only in the case when the child is developing new movements, becomes more active.

When inspecting such a baby, not only the possibilities of the development of the obstetric paralysis are being studied, but also the parameters of other organs and systems are evaluated.

For the formulation of an accurate diagnosis, the details of the history (history) of pathology are important, the result additional methods Research.

When communicating with the mother of the child, such details should be found:

• whether she identified any pathology of pregnancy;
• how did childbirth passed;
• did the motive activity of the child changed.

In physical examination, the following violations are identified:

• when inspection - the hand from the lesion is hanging. With the upper paralysis, it is close to the body, while the palm is turned out, the child's head is tilted. With lower paralysis, the brush may be similar to clawed paw (due to voltage), and the entire hand is deployed inside;
• when palpation (tackling) - the skin covers of the injured upper limb are cold to the touch. The child does not react to pain irritation (plugs, squeezing soft fabrics of the limb). But the opposite effect may occur - amplification of sensitivity;
• when percussion (climbing) - percussion (using the hammer), the absence of pain of the affected limb is confirmed.

Instrumental methods that are used in the diagnosis of obstetric paralysis, this is:

Of laboratory methods Studies in the diagnosis of the described disease are attracted:

• - in some cases it allows differential diagnosis The obstetric paralysis with the damage to the structures of the upper limb of an inflammatory nature. When inflammation, an increase in the number of leukocytes (leukocytosis) and EE is detected. With a pronounced inflammatory process, a shift can also be observed leukocyte formula left;
• - The amount of potassium, sodium, chlorine, calcium and other microelements are determined, which are important for normal nervous conductivity and muscle activity.

Differential diagnosis

Differential (distinctive) diagnostics are carried out:

• between different forms obstetric paralysis;
• other pathologies.

In the latter case, this is most often:

• my sum is inflammatory damage to muscle tissue;
• neuritis is inflammation of nerve fibers.

Complications

Obstetric paralysis is accompanied by such complications as:

• muscular contracture - violation of motor activity in the joint (in this case - in the shoulder);
• ankylosis - complete blocking of movements in the shoulder joint;
• muscle atrophy - violation of their nutrition, "depletion" of muscle tissue due to a decrease in motor activity, which is observed against the background of contractures (that is, it is the secondary complication of the obstetric paralysis);
• the curvature of the bones of the upper limb by the defeat - arises due to the unnatural position of the affected upper limb. Also is a secondary complication;
• paresthesia - the emergence of atypical sensations in soft tissues In the form of "running goosebumps", numbness and so on. It is determined hypothetically, based on the understanding of pathological processes that may occur during damage to nerve endings.

Treatment obstetric Paralyach

The early beginning of the treatment of the obstetric paralysis contributes to the best results, so it is prescribed during the stay of the child with his mother in the maternity hospital. Further treatment is carried out in the neurology department.

Appointments are as follows:

• immobilization of the affected upper limb;
• massage;
• physiotherapeutic treatment;
• medical therapy.

Immobilization Conduct so. The victim's finiteness of the child is gently exaggerated until it stops (at the same time it should be allocated from the body and launched out the palm) and fixate. The lead is carried out in stages, each time a few centimeters, then fix in that position. The procedure is carried out until the hand is given at an angle of 90 degrees. At the time of physiotherapy treatment methods, the tire (it is called abduction) is removed, then set again. The child when the limb should not feel pain - otherwise they "signals" crying about them.

note

Palsy massage perform to prevent stagnation In the affected upper limb (in particular, during the installation of the abduction tire). It is carried out in the form of courses that are repeated after a short pause. Massage is prescribed for a long time.

Of physiotherapeutic treatment methods First of all, thermal procedures have proven well. Most often, with the described disease, uses:

• paraffin applications;
• electrophoresis with anticholinesterase preparations and antispasmodics.

As medical treatment Assigned:

• injection antichointerase preparations;
• . They are also used in the form of injections.

Prevention

Measures of the prevention of obstetric paralysis are:

• providing a woman of normal pregnancy conditions - in order to prevent the occurrence of pathologies of this period or minimize their manifestations;
• prevention of influence on the body of the mother and the fetus of aggressive factors - in particular, the prevention of revenues of toxic substances, prevention of the development of infectious pathologies;
• in identifying pathologies of pregnancy - adequate medical tactics depending on the individual characteristics of a woman;
• proper guidance.

Forecast

Forecast with obstetric paralysis is different. It depends on such factors as:

Pares of the limbs is a disease of the nervous system, in which motor abilities are limited. Unlike paralysis, the limb is not completely immobilized in the parish. Violation of motor functions occurs when the motor's nervous path is damaged in the head or spinal cord. The motor path consists of two neurons: central and peripheral. In case of damage to the central neuron, spastic paresis occurs, characterized by an increased muscle tone. If the violation occurred in the peripheral nerve, sluggish paresis develops. It manifests itself in the form of a reduced tone of muscles.

The reasons

In the newborn baby, the development of the pares can be caused by several reasons.

Most frequent cause The development of pathology is a generic process. Defeature of neurons may occur during generic activities. The error of the doctor who has taken childbirth, the large size of the fetus and a narrow generic channel, a long generic process, various methods of obstetrics - all these factors can provoke damage to motor and peripheral neurons. Complicated pregnancy, which can cause hypoxia, fetal asphyxia and other negative consequences for the fetus. In premature babies, the diagnosis of the larger of the limbs occurs more often than the docking children. Viral diseases transferred by mom during pregnancy can affect the state of neurons. Stressful situations, the reception of some drugs also negatively affect the nervous system of the future child. After birth, the kid can get injured, transfer or get infected infectious disease. These reasons can provoke the development of the label of limbs in a newborn.

Symptoms

Determine the disease in newborns may not immediately because of the low active infant activities. But pair of limbs is characterized by some signs.

The baby has cerebral violations that tremor belongs to the Tremelor, an increase or reduction of muscle tone, elevated excitability. Unconditional reflexes of a child with a passage limbs are weakly developed or not completely. Pares can occur from different sides of the limbs, but usually signs of pathology are brighter expressed on one side of the legs or hands. With a peripheral paresis of the upper limb, a hand lies next to the torso in a sluggish condition, and the palm is usually stripped. If the kid has spastic paresis, hands will be compressed in fists. With the sluggish paresis of the lower limbs, the baby's feet can be divorced in different directions more than 90 degrees. In the case of a spastic pass, the angle of divorce the newborn legs will be less. More pronounced symptoms of pathology will be noticeable when the baby starts pulling his hands to toys, try to roll over on the stomach, sit, get up and walk.

Diagnostics of the lady of limbs in the newborn

A neurologist will be able to diagnose pathology. If the baby has congenital parires of the limbs, the diagnosis is usually happening immediately after its birth. Inspection by a specialist and checking unconditional reflexes in a newborn helps to diagnose parires of the limbs. But in the case weak degree Damage to the motor nervous path. Signs of illness appearance are noticeable badly. Electromiographic studies are conducted to detect localization location and degree of damage to neurons.

Complications

What is dangerous pathology for a newborn baby? Complications may arise in some cases.

If the treatment of the extremities is started in a timely manner, it is possible to complete a total of 3-6 months. For middle degree The lady of limbs in newborn treatment can last about three years. In the event of the ineffectiveness of treatment or with a serious form of the disease, the development of muscle atrophy, as well as paralysis.

Treatment

What can you do

It is impossible to treat the disease yourself. If the signs of the lady of the limbs began to appear after discharge from the maternity hospital, it is necessary to consult a doctor on their own. The earlier a qualified treatment is prescribed, the higher the probability of the complete cure of the label of the limbs in the newborn. If therapeutic gymnastics is prescribed, parents can exercise with a child at home. How to properly engage in gymnastics, will be able to prompt the attending physician.

What does the doctor do

After finding out the cause and place of the defeat of neurons, the doctor will be able to determine how to treat the pathology in the infant. But usually the treatment of the lady of limbs in the newborn is complex. For a patient, the baby is usually prescribed massage and therapeutic gymnastics. Orthopedic styling, which help to prevent muscle atrophy and the development of paralysis can be used. Physiotherapy procedures are prescribed, such as electrophoresis, electrostimulation. Medical therapy can be appointed. Surgical intervention in the paresis of limbs in the newborn is prescribed in the event of a break or squeezing the nerve. Also, the operation can be carried out if conservative treatment It turned out ineffective.

Prevention

To prevent the occurrence of pathology in the baby, mom needs to take care of it at the stage of pregnancy.

With viral diseases, it is necessary to cure them in a timely manner. Do not expose the body with experiences, do not take medicines without consulting the doctor. During pregnancy, eat right, use fresh vegetables and fruit. If necessary to take vitamin complexesBut only after consulting with the attending physician. During childbirth, doctors should be attentive, with caution to use obstetric accessories. After the appearance of the baby on the light, parents should prevent infection viral infections children's body, not to transfer the baby and follow its common condition.

At paralysis, a person cannot arbitrarily moving the affected parts of the body. There is such a phenomenon due to the innervation of certain muscle tissues. One of these pathological processes is obstetric paralysis (paresis). It is also called Dushen Erba syndrome and for it is characterized by amyotrophy of the upper extremities due to the injury of the shoulder nerve beam.

The disease is usually manifested in the form of a paralysis or a bag of a hand. There is such a deviation, both in adults due to injury or infection and children. The newborn, obstetric paralysis of the hand occurs due to damage to the shoulder obtained during childbirth.

For the first time I saw such a rejection to the famous French doctor Dushen at the end of the XIX century. He described an obstetric paresher's hand in a child, which arose due to injury obtained at birth. It took 5 years old, as a talented German doctor V. Erb diagnosed Erba paralysis in an adult. It was obtained due to the usual injury of the plexus. By decision of the medical community, the disease was named after both authors, namely, paralysis or paresis of Erba Dushen. After all, they equally helped to open this disease.

Nowadays, an experienced pediatrician will be able to predict the development of this pathology, focusing on the following factors:

• Malposition;
• Large weight (over 4-4.5 kg);
• Non-easy childbirth with special tools.

The main reason for the appearance of the Erba Duceda car is too big fruit. Most often, the kid is simply not suitable in size, so the chances of getting injury during childbirth increase. Doctors try to pull the stucking child outside, and to simplify the mothers' swells use special tongs. They are used to grab the fruit by hand, but with any sharp movement, nerve fibers are torn because of what the Erba paralysis arises. In such a situation, the problem concerns the right side.

Similar damage kid can get with cesarean section. In more rare cases, Parables Duceda and Erba arises due to the injury of the neck or spinal cord obtained at birth.

At an older age, pathology is mainly a consequence of injury, which most often arises due to such factors:

• Injury in the area of \u200b\u200bthe cervical and shoulder joint;
• Stretching obtained due to a sharp thread back;
• Strong hand pulling forward;

Often, doctors observed cases of the appearance of Paralice Duzhen and Erba after the automotive accident experienced. During the collision, the seat belt holds a person in one place, but the limbs at the same time drops sharply.

Toxins and infections can also cause pathology, but this phenomenon occurs very rarely. Incication occurs mainly due to the running sugar diabetes or poisoning different chemical compounds. In turn, the infection affects nerve fibers with tuberculosis, typhoid, malaria, rheumatism, etc.

Symptoms

With the development of Paralle, the innervation of individual muscles gradually deteriorates, namely, the innervation of individual muscles, namely, shoulder, supervising, double-headed and deltoid. Less frequency muscles suffer less often. The disease is manifested depending on the severity of damage gained. The same criterion affects further restoration. After all, it is extremely difficult to return the nervous conductivity, especially when it is obtained by severe injury.

In infants, the disease manifests itself quite clearly, so parents can easily notice the deviations arising. The child becomes very restless due to severe pain and he has such signs of paralysis:

• The tone of muscle tissue is worse;
• Lack of opportunity to bend your hand. The limb is constantly in a dispere position;
• Deterioration of sensitivity of the skin;
• Turning the injured limb to the other side;
• Weak breathing;
• Taking a damaged brush forms of the cam and at the same time the thumb inside is clamped;
• Lying and reducing the temperature of the injured hand.

Under Palsy Dushen and Erba, the injured limb is strongly pressed against the body and despite the weakening of its muscle tissue, the brush and fingers are most often moving. Similar symptoms are characteristic of both children and adults.

For such a pathological process, certain consequences are characterized even with timely detection of the problem and the correctly composed course of treatment. In kids, one limb can lag in development from the other and the same applies to the formation of the blade.

Often in children who survived obstetric paralysis, scoliosis appears with age. It affects mostly the cervical department, but sometimes together with his chest. In addition to the twist of the spine, there may be signs of weakening muscles in the damaged limb that often remain for life.

Doctors mentioned many times and more than a rarer symptom of the disease, namely, an unlaimed narrowing of the eye on the damaged side. Such a deviation occurs infrequently and mainly disappears after treatment.

Disease flows

Obstetric Paralysis gradually progresses, so it is recommended to start a course of therapy immediately after the first sign of injury is detected. For the disease such steps are characteristic:

• Acute stage. It lasts from 4-5 hours to 2-3 days after damage. During this period of time, the patient cannot bend a hand in locks Susta Or does it with difficulty. The damaged shoulder at the same time freezes in one position, and the fingers on the same limb become inactive;
• Stage of recovery. It lasts extremely long and even with competently composed treatment, this period takes about 3 years. During this time, swelling will gradually decrease and, as it will be possible to restore blood circulation in the damaged limb. Over time, the person gradually begins to move the paralyzed muscles, and to what extent this ability will return depends on the injuries received;
• Stage of residual phenomena. It is characteristic of most neurological pathologies. People who have previously suffered from Paralice Duzhen and Erba, can observe the residual contracture (tightening) of the shoulder. For this stage, the deformation of the blade is also characterized, which manifests itself as a change in the form and location. Sometimes abnormal rotary (circular) movements in the forearm and contracture when flexing their hands in the elbow. In rare cases, the patient has minor difficulties when flexing the fingers and brushes on the injured limb.

According to statistics, most of all residual phenomena remains in such cases:

• With a serious breaking of the nervous plexus;
• Due to intoxication;
• With infectious defeat.

If the problem has touched an adult, then it is often not possible to restore lost sensitivity. In children in this regard, the situation is better, since the healing of tissues they have much faster, but there is a chance that one hand will be shorter than another.

Diagnostics

Initially, the child needs to show a pediatrician, and in the case of an adult man therapist who will already send to the neuropathologist. Further, the specialist will examine the patient and ask a few questions, but for the formulation of accurate diagnosis it will be necessary to take advantage of the instrumental methods of the examination:

• Ultrasound areas of neck and shoulder plexus;
• Electroneuromyography;
• Dynamometry;
• Renowmography;
• Radiography;
• Computer myelography;
• Woods of the head and spinal cord vessels.

Focusing only on external symptoms, the doctor will be able to make a diagnosis without additional methods of examination. However, for accurate differentiation of the pathological process, as well as to prepare the forecast of the further flow of the disease, they will be required. After all, without these moments it is impossible to make an effective course of therapy.

Course of therapy

From such pathological processes it is impossible to completely protect themselves, so only avoidance of injuries can be distinguished from the prevention measures and the choice of a professional doctor for making birth. The course of therapy doctor selects strictly individually, as it mainly depends on the severity of the damage obtained, as well as from the age of the patient.

When the disease is in the sharp stage of the doctors try to limit the movement of the hands as much as possible with the help of a special tire. If a shoulder joint It is shifted to the side, then in this case it is used for 1 year. It is allowed to remove the bus only to perform activities aimed at eliminating the problem and in order to implement hygienic procedures. In particularly severe cases, limit the movement damaged hands for 2-3 years.

Despite damage, it will be necessary to maintain the tone of muscle tissues and for this it is necessary to visit therapeutic massage and perform special exercises. If the treatment does not bring results, the doctor may advise to make surgery. It is usually extremely effective, but after it will need a long recovery rate. It usually consists of such methods:

• Reflexology;
• Physiotherapy;
• Electrostimulation of muscle tissue of the upper limbs;
• Acupuncture;
• Massage.

The course of therapy should also include medicines with an anesthetic and anti-inflammatory effect to reduce discomfort and accelerate tissue regeneration. Improve the conductivity of nerve tissues and general state The patient should vitamin complexes. Among them, it is better to choose preparations with a large concentration of vitamins from group V.

If the infection is the main cause of damage to the nerve fibers, it will take antibiotics. Often they are combined with ointments with an anesthetic effect.

Forecast

The lifespan is not reduced due to the obstetric paralysis, but it often leaves certain consequences. In general, the forecast is quite positive and the kids have an improvement in the state occurs after the beginning of the course of therapy. In about 4 years, an unpleasant consequence may arise, namely the lag in the development of one hand from another. You can correct the situation by the continuation of the course of therapy, but sometimes only surgery helps.

Operations for kids up to 3 years are usually minimally invasive (do not require strong intervention) and are performed mainly using optical fiber. Arthroscopy in such a situation is met most often and according to statistics, it gives excellent results in fact in all cases.

In an adult, the disease often leaves its traces in the form of a partial loss of sensitivity in the damaged limb. Full recovery is observed extremely rarely.

Obstetric paralysis is not a fatal pathological process, but he leaves his unpleasant consequences. If you do not start the treatment immediately, it will be actually impossible to avoid them.

A newborn baby may have paresis of facial nerve, intestines or limbs. There are various reasons why there may be pathology in the infant.

Complicated pregnancy. Hypoxia and asphyxia of the fetus. Infectious I. chronic diseases During pregnancy. The consequences after the operation carried out in the newborn. Pares of the limbs occurs in a newborn due to damage to the nerve beams, shoulder plexus, as well as when the nerve root root from the spinal cord. Pares of facial nerve is developing due to damage to the peripheral beams of the nerve. You can select several factors that provoke the occurrence of the pack in the newborn. Damage to the nervous system when the baby is passing through the generic paths. During childbirth, the kid can get a generic injury that will cause the development of the pan. The use of obstetric tongs can lead to the occurrence of a pack of facial nerve. Intestinal paresis in the newborn may occur due to increased gas formation, microcirculation disorders in the intestines and other problems of the gastrointestinal tract.

Symptoms

To recognize the pathology of the baby, parents should know signs of manifestation of the pan. Depending on the place of damage to the nerve, the symptoms of the illness differ.

Parameres of facial nerve can be determined by an asymmetrical face of a newborn.

o The infant omitted corners of the mouth. This phenomenon is well noticeable during crying.

o Facial muscles are a little numb.

o Baby is experiencing difficulty sucking breasts or bottles.

o When screaming the child can feel pain in the lip area, cheek.

o Dry in the eyes or increased tears.

o may occur partial paralysis of the language.

Pares of limbs in a newborn is usually associated with obtaining generic injury.

o Tremor arises - fast and rhythmic movements of limbs and torso.

o reduced muscle tone during damage to the peripheral nerve, and when the central portion of the spinal or brain is damaged, an increased muscle tone is observed.

o The kid has an increased excitability.

o Insufficient limb functionality.

The intestinal paresis in the newborn is diagnosed with the following signs:

o bloating and abdominal pain;

o. Increased gas formationbut in some cases it is absent, as stopped by the release of the feces;

o may be uncontrolled feast;

o Sometimes the attacks of vomiting.

Diagnostics of the pan in the newborn

Diagnose the disease is often a doctor may with a primary inspection of the baby after delivery. Party of the face nerve is especially well noticeable. To determine the accurate diagnosis of a pack of facial nerve, an electronomiography method can be assigned. With this method, it is possible to identify the location of the nervous system. To diagnose the pares of limbs, the newborn is also conducted an electronomyography. Intestinal paresis is diagnosed with radiological results, as well as using clinical inspection.

Complications

What is dangerous for paresis for a newborn baby? Depending on the degree of damage to the nerve roots and other elements of the nervous system, various complications may occur.

With light degree of paresis and timely treatment There is a possibility of complete restoration of the damaged nervous system. But the occurrence of trophic violations that affect bone changes are possible. You can detect the unpleasant consequences of the cut immediately, but only a few months later. Pares of the limbs can lead to the development of osteoporosis, hypoplasia and a slowdown ossification. The intestinal paresis is dangerous by the development of intestinal obstruction, the frequent occurrence of constipation that can provoke hernia and others dangerous disease. The paresis of the face nerve in the newborn usually passes in a few weeks. In case of irreversible damage to the facial nerve, lifelong signs of paralysis are possible. There is a possibility of incorrect restoration of nerve fibers, which will result in further to involuntary muscle contractions. It is possible to complete or partial loss of sight with one eye, which is on the damaged side of the face. Due to the inability to completely close the eye, it can dry and damage the cornea.

Treatment

What can you do

Treat independently paresis in newborns is impossible. Consultation and inspection of the doctor is necessary to get the right appointment of treatment. Parents can independently carry out a massage in a game form, but first needed medical advice. In order to eliminate the passage of the face nerve, the baby should be given a pacifier. With its help, the newborn baby will make sucks. To train a search reflex with facial paresis, parents can stroke a brush with a brush on the damaged side. If you spend and slightly pressed the baby's palm, the baby will open the mouth. It helps in training facial muscles. In the intestinal paresis, parents can alleviate the painful state of the abdomen, using the laid out of the newborn on the stomach. Stroking on the stomach and tech also helps to reduce the pain in the intestine.

What does the doctor do

After the doctor receives research results, he will be able to determine how to cure parires in a newborn. Treat the passage of the facial nerve is necessary as soon as possible after diagnosing it. This will reduce the likelihood of complications. Treatment of facial paresis is carried out using dehydration therapy. It reduces the personnel of the face. To improve blood circulation in the affected area, drug therapy is used, as well as warming procedures. Physiotherapy is allowed from the first day of the life of the baby and is good method Restoration of the amazed nerve. In the paresis of limbs, the kid is appointed a course of therapeutic massage and gymnastics, drug and physiotherapy treatment. Also, the child should spend time in a position that helps reduce the tension of the nerve trunks. Such a position helps prevent stretching damaged muscles. This uses special equipment. To cure the intestinal paresis in a newborn, it is necessary to restore the reflex peristaltics of intestinal walls to the desired level. It is necessary to improve the intestinal blood circulation, as well as restore nervous impulse. For this purpose, medication and intravenous infusion therapy is carried out.

Prevention

To prevent the development of pathology in a newborn baby, you need to doctors and a future mother during the generic process to be attentive. Mom should listen to the recommendations of doctors and obstetricians to prevent the generic injury to the newborns.

At the stage of pregnancy, mom should pass regular surveys. The future mother should timely cure infectious diseases.

Obstetric Parares - This is a violation of the function of the upper extremities of the child during childbirth, due to damage to the nerve paths of the child. This is facilitated by difficult and delayed labor, the inconsistency of the fetal size of the generic channel, the pathological prevention of the fetus, the use of various methods of obstetric intervention. Most often the cause of the anomaly is trauma shoulder plexusShe can also lead to paralysis.

Signs of obstetric paresis

With obstetric paresis, there is a significant decrease in muscle tone (muscle hypotension). As a rule, the striking limb hangs along the body, all joints are dispersed. Muscular hypotension in a paretic hand is pronounced. The active movements are completely absent, only light movements in the clotted position are possible. The leather affected by paresa pale and cold to the touch. Early development of muscle atrophy, especially in distal departments. Reduced pain threshold and temperature sensitivity in the entire limb. Tendor reflexes are missing. There are no grabbing and climbing reflexes in the hand.

The degree of muscle lesion is different: from a minor reduction of strength and tone of muscles to deep functional disorderscharacterized by the complete absence of active movements. Identification of localization and depths motor disorders It is necessary for properly reasonable conduct of therapeutic measures.

What if your child has obstetric paresis?

When the obstetric car is found in the child, it is necessary to immediately turn to a specialist. At the first stage, the doctor prescribes a survey of damaged limbs to determine the degree of damage to nerve roots. According to the results of the survey, the doctor appoints a course of treatment: conservative or operational.

Consultation I. operational treatment Conducts the reconstructive microsurgeon Mikhail Leonidovich Novikov.

You can create a preliminary organizational advice and ask questions. You can call 8-800-555-84-21 or leave a message in the form of on-line consultation in the right column of the site.

Operational treatment is carried out free of charge with the support of Rusfond. In order for the treatment to be free, it is necessary to collect documents on, send to check and register (you can in color scanned form per mail: [Email Protected]site), further wait for the call for treatment.

Types of obstetric paresis

By severity Obstetric paresis are:

• middle
• lungs
• heavy (total).

Obstetric couples depending on the location of damage are divided into:

- Upper: At the top type, which occurs more often than the bottom, the hand is passively hanging, there are no movements in it or can be preserved only in the brush, the hand is usually given to the body and rotated inside, and the brush is in the position of the palm flex. The fold between the torso and shoulder is in-depth. If the child is lifted, the handle disperses the stop. Muscular tone is sluggish, passive movements and joints are saved.

- Nizhny: With lower paralysis, there are no movements of the brush and fingers, the hand hangs and the child carries her, supporting a healthy hand. Comes atrophy of the small muscles of the brush, as a result proximal phalanxes Take the position of hyperextenia, and distal bent.

- Total: Total hand paresis (total type of obstetricular hand) arises as a result of damage to the upper and lower primary beams of the shoulder plexus of the spinal cord or separating the roots of the nerves from the spinal cord.

Symptoms

The newborns with the pares are often cerebral violations: tremor, a decrease in muscle tone, increased excitability, depression of unconditional reflexes. All violations are associated with the integrated effect on the body of newborn labor injury and asphyxia. These changes are overcome and are quickly smoothed, which indicates a connection with a violation of liquorocirculation and brain circulation.

The course of paresis depends on the severity of the lesion. With a small degree of damage, the function of the hand is restored since the first days of life and for 2-5 months active movements become complete. In some cases, the lesions of muscle weakness can remain long. She becomes more noticeable when the child begins to move in vertical position, that is, sit, stand. The lack of function of the hand is detected when lifting it above horizontal position Or reject your hand back. The reduction of muscle strength can be noted when the child begins to reach toy.

In cases of lesions of medium and severe, the restoration of the function of the hand is slower and may be incomplete due to muscle atrophy, contractures and degeneration of nerve fibers. In severe injury of the spinal cord, the root of the roots from the spinal cord, the breaking of the shoulder plexus the restoration of the function of the hand is minimal, atrophy, muscular contractures are developing, a tendency to dislocation in the shoulder joint is seen.

Treatment of parares

The diagnosis of the passage is placed on the first inspection of the newborn based on a characteristic clinical picture. The clarification of the lesion localization occurs with the help of electromyographic studies. Detection of localization and depth of motor disorders is necessary for properly reasonable conduct of therapeutic measures.

From the first months of the child's life, two groups of events are held:

• treatment of the provision that contributes to a decrease in the tension of the nerve trunks, a warning stretching of the affected muscles and the development of contractures;
• massage and medicinal gymnastics.

Parares treatment is early, complex and continuous at all stages of the child's age. It includes orthopedic styling (with the help of plastic or multisherrian mine of the upper limb, give the reserved position with the rotation of the shoulder outward, suspended forearm, dispelled brush), as the method of preventing the development of muscle contractures, gymnastics, massage, physiotherapeutic procedures and medication therapy.

A serious complication of obstetric paresis is the early development of muscle contractures that fix the hand in a pathological position. Therefore, the prevention of contractures should begin in the hospital. The hand-affected hand is fixed by the removal tire in the position of the blade of the shoulder at an angle of 90 degrees, flexions in the elbow joint, outdoor rotation, the suspension of the forearm. The brush of the child is fixed by Longets in the rear bending. Shoulder dilution can not be done immediately at right angles, as this will cause a pain of a child. With the help of Longets or gypsum buses of the affected limb attach physiological position.

Along with tire manipulations from the first days of the child's life, massage and gymnastics, injections of vitamins, aloe, ATP, physiotherapeutic and thermal procedures are included in the complex therapy. Health gymnastics in obstetric paresis should be individual for each case depending on the degree and type of the pares, the age of the child and the stage of the disease. Development of individual complexes of therapeutic gymnastics with paresis both during the exacerbation period and in the recovery period should be carried out by a neuropathologist with a clinic and pathogenesis of motor function disorders.

Health gymnastics in the first days of life is mainly passive, then begin to gradually include the motor elements of the child's activity. At the age, when the child learned to sit well, keep balance standing and when walking, all gymnastic exercises should have the form of the game. The positive emotions of the child facilitate movement and well stimulate on their repetition. In games, as in passive gymnastics, you need to train outdoor rotation, handwhacking, lifting it above the horizontal level.

Also, in order to improve the conductivity and excitability of the affected neuro-muscular apparatus, electrophoresis of anticholinesterase substances (prozerne, galantamine), a variable magnetic field of high frequency, paraffino-, ozochetic field, in combination with electrostimulation of the affected muscles and the corresponding spinal cord segments. Electrostimulation (see the full arch of knowledge), causing muscle contraction, improves their blood supply and trophy, prevents muscle atrophy, enhances the afferent impulsation, which helps to restore the impaired muscle motor function. For electrostimulation, various impulse currents are used, the parameters of which are selected depending on the severity of the damage and the state of excitability of the neuromuscular apparatus.

If the treatment is started in a timely manner and is fulfilled in stages, then the obstetric parires will disappear within 3-6 months. Middle severity is treated for about three years.

Operational treatment of paralysis is carried out mainly with the anatomical break of the nerve (partial or full), squeezing or dismissing the nervous trunk and in the ineffectiveness of conservative treatment.