Weisman
et al.1976
Review of literature: 71 cases of unilateral paralysis due to birth
trauma, presenting in newborn period. The right side is affected 68%
of the time and 56% are associated with Erb palsy. Fifty percent were
diagnosed in the first 24 hours.
Aldric
et al.,1980 J Peds.
He
mentioned 10 cases of bilateral diphragmatic paralysis in newborns,
which were reported in literature and 50% were related to birth trauma.
The remainder were the results of malformation or were unknown. The
outcome: 5/10 patients had plication, only one of them survived. The
4/5 patients who did not have plication, had improvement of diaphragmatic
function with time.
Plication
of diaphragm
It is indicated in severe respiratory distress and in inability to wean
from a ventilator for over 2-6 weeks. It decreases the paradoxical motion
of the affected side (Aldric et al.1980) and can increase the lung volume
(Schonfeld et al.1980).
Tsugawa
et al.1997
They reported 50 patients who had plication at ages 4 days-7 years.
Twenty-five of them had phrenic nerve injury (PNI) and 25 had congenital
muscular deficiency (CMD). Respiratory distress was the present in most
patients. Ten of twenty-five patients with PNI were on ventilatory support.
Four of the CMD patients required mechanical ventilatory support. In
patients with PIN, ventilatory support was stopped within 0-6 days after
plication. They concluded that symptomatic patients should be operated
on immediately
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