You have just assisted in the delivery of an approximately 4 kg newborn whose mother is a rather petite primapara. On assessment, you note that there is no spontaneous movement of the infant's right arm at the shoulder, but he moves the elbow and wrist. He otherwise exhibits vigorous movement and has a 1-minute APGAR score of 9. Which of the following should you suspect?

Question

Quizplus · Accepted Answer

The lack of spontaneous movement of the infant's right arm at the shoulder is suggestive of a potential fractured clavicle, which is a common birth injury in large babies or petite mothers. The infant's ability to move the elbow and wrist suggests that the nerves to the arm are intact, but the fracture may be causing pain and limitation of movement at the shoulder joint. Neonatal abstinence syndrome would present with symptoms related to drug withdrawal in the infant, such as jitteriness, poor feeding, and respiratory distress. Spinal cord damage is unlikely to be present in the absence of any other neurologic symptoms, such as weakness or paralysis. Caput succedaneum refers to swelling of the soft tissues of the scalp and would not affect movement of the arm.

You Have Just Assisted in the Delivery of an Approximately