Cervical Cord Injuries Secondary to Hyperextension of the Head in Breech Presentations

Two infants presenting by breech with severe hyperextensinn of the head were born, one by cesarean section and the other through the pelvis. The latter suffered a complete lower cervical cord transection; paraplegia was noted at birth. After repeated respiratory infections, tins infant died at 9 months. The infant born by cesarean section, was neurologically normal. Most case reports since 1910 of infants with hyperextension of the head associated with breech and transverse presentations arc tabulated. The overall incidence of complete transeclion of the cervical cord in the 88 cases reviewed was 21%. All of the infants were born by the pelvic route. No infant delivered by cesarean section suffered permanent spinal cord injury. It is recommended that these infants be delivered by cesarean section because the risk of permanent ]H>M natal paraplegia is significant.