As the risk of brachial plexus injury is lower in cesarean
deliveries, an elective cesarean delivery might
prevent OBPP in cases of known risk factors. Yeo
et al. suggested that elective cesarean deliveries for
estimated fetal weights in >4 kg would prevent 44%
of shoulder dystocias and halve the perinatal mortality
in cases with shoulder dystocia with a 2% subsequent
increase of the cesarean section rate.46 On the
other hand, Gilbertet al. found that 92% of the high
risk cases (diabetic women delivered by operative
vaginal delivery with infants of >4.5 kg birthweight)
did not have OBPP and cesarean delivery would have
therefore been unnecessary.14 Rouse et al.
47 found
no benefit to elective cesarean delivery in women
with estimated fetal weights of >4.5 kg, unless they
were also diabetic. For diabetic women, 443 cesarean