Facial Paralysis

After passing through the stylomastoid foramen, the facial nerve is left unprotected. It is affected by direct forceps blade pressure or by bleeding and edema around the nerve.

Causes

• Forceps placement
• It might happen during spontaneous delivery when you grab the head and apply pressure to the mastoid process or the ramus of the lower jaw, where the facial nerve is superficially located.

Clinical features

• There is unilateral facial paralysis, with the affected side's eyelid remaining open and the lips dragged over to the normal side.
• The side that is paralyzed is smooth.
• When you cry, your mouth is attracted to the uninjured side of your face.
• There may be some initial feeding difficulties if the baby is unable to form an adequate seal on the nipple or teat.

Management

• There is no special treatment; the problem improves in 1 to 2 weeks.
• Antiseptic ointment should be used to protect the eyes, which stay open even while sleeping.
• Feeding issues are normally overcome by the baby's own adaptability, though a different feeding position can be used.
• Maintain proper dental hygiene.
• If the infant is injured after an instrumental birth, clean and dress with antiseptic lotion.
• Unless worsened by intracranial injury, the illness normally resolves within a few weeks.

Brachial palsy

The nerve roots or trunk of the brachial plexus are both involved. The nerve is damaged as a result of straining, effusion, or bleeding within the sheath. Tearing of the fibers is uncommon. The reason is excessive neck traction during the attempted delivery of the shoulder dystocia or even during normal delivery. The affection is caused by a hyperextension of the neck to one side, with forcible digital extension and arm abduction in an attempt to deliver the shoulder.

Erbs palsy

When the 5th and 6th cervical nerve roots are implicated, this is the most common form. The resultant paralysis leads the arm to lie on its side, with the elbow extended, the forearm pronated, and the wrist flexed. On the afflicted side, the Moro reflex and biceps jerks are absent. The arm is rotated inwards, while the half-closed hand is turned outwards.

Klumpke palsy

The lower brachial plexus has been damaged, involving the 7th and 8th cervical and 1st thoracic nerve roots. The upper arm moves normally, but the lower arm, wrist, and hand are restricted. Wrist drop and flaccid paralysis of the hand with no grip reflex are present.