“Generally speaking, Brachial plexus palsy (Erb’s Palsy) cases fall into three groups: pre-natal, labor and/or delivery.”

Pre-natal:

• Pre-existing diabetes
• Maternal weight (>180 lbs)
• Prior gestational diabetes
• Prior macrosomia (large baby)
• Multiparity (a woman who has previously had a child)
• Short maternal stature
• Advanced maternal age
• Prior shoulder dystocia

Antepartum (pregnancy):

• Onset of gestational diabetes
• Postdatism (pregnancy continuing past 42 weeks)
• Excessive maternal weight gain (>35 lbs.)
• Macrosomia (large baby >4000grams i.e. 8.8 lbs)

Intrapartum (birth):

• Use of epidural
• Protracted descent
• Prolonged second stage (>2 hours)
• Failure of descent of head
• Need for mid-pelvic or assisted delivery
• Abnormal first stage
• Induction of labor
• Improper delivery technique when shoulder dystoca is incurred (No use of the McRobert’s maneuver, Woods maneuver, suprapubic pressure etc.)
• Use of forceps or vacuum