§ Mr. Bill MichieTo ask the Secretary of State for Health (1) what steps his Department is taking to eliminate the damage caused by (i) Erb's palsy and (ii) brachial plexus injuries during the birth process; [2885]
(2) if he will list the incidence of (a) Erb's palsy and (b) brachial plexus injuries over the past 20 years. [2886]
§ Mr. GreenTo ask the Secretary of State for Health what steps he plans to take to raise national awareness of Erb's palsy. [2878]
§ Mr. GogginsTo ask the Secretary of State for Health if he will introduce a programme(a) for the recording of every incidence of (i) Erb's palsy and (ii) brachial plexus injuries and (b) to raise the general awareness about Erb's palsy. [2930]
§ Ms JowellWe are of course concerned about the damage to babies caused by Erb's palsy and brachial plexus injuries during birth. The safety of the mother and her unborn child are of paramount importance and childbirth is safer now than at any other time. Most cases of Erb's palsy and brachial plexus injuries arise spontaneously but are also considered to be influenced by misplacement of the shoulders in the birth canal. In 529W recognition of this problem, the Royal College of Obstetricians and Gynaecologist has issued guidelines stating that every maternity unit should have agreed protocols for the management of shoulder malpresentations to minimise the risk of these conditions. We are not aware of any evidence to suggest that obstetric intervention contributes to the incidence.
Information on the number of finished consultant episodes of those patients admitted to hospital with primary diagnosis "Erb's Palsy" and "brachial plexus" injuries in NHS hospitals in England up to 1994–95 is available through HES (Hospital Episode Statistics) data and is shown in the attached table. The definition of a consultant episode is the period that a patient spends under the continuous care of a specific consultant in a specific health care provider. A hospital provider spell can comprise one or more consultant episodes. Hospital Episode Statistics will therefore pick up cases where the diagnosis was not made at birth and the baby was subsequently re-admitted. Information prior to 1989–90 recorded discharges and deaths and is therefore not directly comparable to Hospital Episode Statistics Data.
Primary diagnosis—of Erb's palsy (ICD9 code 767.6) and brachial plexus injuries (ICD9 code 953.4) Ordinary admissions and day cases combined NHS hospitals, England Estimated number of Finished Consultant Episodes (FCEs) 1989–90 1990–91 1991–92 1992–93 1993–94 1994–95 Erb's palsy/Klumpke's palsy 142 158 202 240 370 330 Injury to brachial plexus 337 191 181 149 135 148 Notes:
ICD9 code 767.6: Injury to brachial plexus (birth trauma)—Erb's palsy and Klumpke's palsy combined.
ICD9 code 953.4: Injury to brachial plexus.
Data in this table is grossed for both coverage and unknown/invalid clinical data.
Source:
Department of Health, Hospital Episode Statistics (HES).