J Genet Med.  2011 Jun;8(1):71-75. 10.5734/JGM.2011.8.1.71.

Concurrence of Obstetric Brachial Plexus Injury, Congenital Muscular Torticollis and Cleft Palate

• Lee HB
• Park MC
• Kim C
• Han JD
• Lee SJ
• Kim SY
• Yim SY

• KMID: 1851095
• DOI: http://doi.org/10.5734/JGM.2011.8.1.71

Abstract

A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.

Keyword

Brachial plexus; Torticollis; Cleft palate; Gestational diabetes

MeSH Terms

Birth Injuries
Brachial Plexus
Child
Cleft Palate
Congenital Abnormalities
Diabetes, Gestational
Female
Fetus
Gestational Age
Humans
Hyperglycemia
Infant
Male
Membranes
Mothers
Neural Crest
Palate, Hard
Parturition
Pregnancy
Rupture
Torticollis
Torticollis