Phrenic nerve palsy from obstetrical origin: favourable course using continuous nasal positive airway pressure

Introduction. - Isolated diaphragmatic paralysis due to obstetrical factors is rare and therapeutic management modalities are not quite clear. Case report. - A neonate born by breech delivery presented with respiratory distress due to isolated paralysis of the right hemidiaphragm. The clinica l course was progressive, his condition worsening with oxygen supplementati on, Continuous positive airway pressure (CPAP) delivered via a nasal cannul a was started in the one-month-old child, inducing gradual improvement towa rds recovery at the age of two months and a half. Conclusion. - Non-invasive nasal CPAP should be proposed for the treatment of phrenic nerve obstetrical palsy before introducing more invasive ventila tion techniques. Surgical plication should be delayed until the child reach es the age of at least three months. (C) 2000 Editions scientifiques et med icales Elsevier SAS.