BRACHIAL PLEXUS PARESIS IN NEWBORNS IN THE CLINIC FOR GYNECOLOGY AND OBSTETRICS AT CLINICAL HOSPITAL CENTER RIJEKA IN THE PERIOD OF 01.01.2015.-31.12.2016.- PHYSIOTHERAPEUTIC INTERVENTION

Brahijalni pleksus živčani je splet za senzoričku i motoričku inervaciju gornjih ekstremiteta. Njegovo oštećenje može se klinički prezentirati u obliku pareze odnosno trenutne oduzetosti i slabosti ili paralize kao potpune oduzetosti. Klinička slika ovisit će o višestrukim faktorima, a samo oštećenje najčešće nastaje tijekom poroda. Unatoč rijetkoj pojavnosti, navodi se među najčešćim porođajnim ozljedama perifernih živaca. Cilj rada je istražiti pojavnost ovog entiteta u novorođenčadi na Klinici za ginekologiju i porodništvo KBC-a Rijeka u vremenskom periodu od 01.01.2015. – 31.12.2016. te utvrditi kakva je povezanost tih slučajeva u odnosu na spol, rodnu masu i dužinu, gestacijsku dob, Apgar-indeks i dominantnu stranu tijela. Također, jedan od ciljeva je i istaknuti važnost što ranije fizioterapijske intervencije radi sprječavanja neželjenih posljedica. Retrospektivnom analizom baze podataka Klinike za ginekologiju i porodništvo u navedenom dvogodišnjem periodu zabilježeno je 25 slučajeva porođajne pareze brahijalnog pleksusa koji čine reprezentativni uzorak kako bi se ispitala pojavnost u tom periodu u odnosu na sveukupni broj poroda te radi utvrđivanja pojavnosti u odnosu na izabrane parametre. Statistička obrada podataka bila je provedena Hi (2) kvadrat testom. Prevalencija porođajne pareze u 2015. godini bila je 5,33 na 1000 živorođenih dok je u 2016. godini iznosila 3,77 na 1000 živorođenih. Prilikom ispitivanja pojavnosti pareze po spolu, s obzirom na zahvaćenu stranu tijela te s obzirom na ocjenu prema Apgar testu, rezultat dobiven analizom nije se pokazao statistički značajnim. Statistička značajnost utvrđena je samo prilikom ispitivanja utjecaja rodne mase na pojavnost pareze. Pareza brahijalnog spleta entitet je kojega je teško predvidjeti i prevenirati zbog velike varijabilnosti rizičnih čimbenika. Unatoč tome, kvalitetnom procjenom, a kasnije i sveobuhvatnom habilitacijom, u većini se slučajeva mogu postići zadovoljavajući rezultati pa i do potpunog oporavka.The brachial plexus is a network of nerve fibers that innervates the skin and the musculature of the upper limb. Its damage could be clinically presented as paresis (i.e. temporary paralysis or weakness) or as paralysis (i.e. complete and permanent function loss). Clinical presentation is multifactorial with damage being mostly caused during birth. Despite its seldom prevalence it is stated as the most common neonatal peripheral nerve damage. The purpose of this paper is to investigate the prevalence of this entity in newborns in The Clinic for Gynecology and Obstetrics at Clinical Hospital Center Rijeka during the period of 01.01.2015. – 31.12.2016. and to establish the correlation between these cases and sex, birth weight and lenght, gestational age, Apgar score and dominant side of the body. Also, one of the aims is to emphasise the importance of early physiotherapeutic intervention to prevent unwanted consequences. Retrospective data base analysis has been performed in The Clinic for Gynecology and Obstetrics at Clinical Hospital Center Rijeka in the previously specified two-year period. The number of 25 newborns has been found with neonatal brachial plexus palsy diagnosis in order to investigate the prevalence in regard to the number of births at the specified period and to establish the prevalence in regard to chosen parameters. Statistical analysis has been performed with Chi (2) square test. In year 2015, the prevalence of the paresis was 5,33 per 1000 live births, while in year 2016 the prevalence was 3,77 per 1000 live births. During statistical scanning of the paresis prevalence by sex, affected side of the body and Apgar test results, no statistical significance was found. Statistical significance was determined only after statistical scanning of the prevalence in regard to birth weight. Brachial plexus paresis is an entity that is difficult to predict and prevent due to the large variability of risk factors. Despite this, with a quality assessment, and later with a comprehensive habilitation, in most cases satisfactory results can be achieved even until complete recovery