Case-control study of intrapartum care, cerebral palsy, and perinatal death

Abstract

There is an association between quality of intrapartum care and death. The findings also suggest an association between suboptimal care and cerebral palsy, but this seems to have a role in only a small proportion of all cases of cerebral palsy. The contribution of adverse antenatal factors in the origin of cerebral palsy needs further study.

Antenatal antecedents of moderate or severe neonatal encephalopathy in term infants – a regional review

“…This is a persistent finding of similar audits. 2,7,12,13 It is not just the interpretation of CTG changes that is problematic, but also the choice of fetal monitoring techniques. Many high risk women were monitored with intermittent auscultation or intermittent CTG when continuous CTG was indicated.…”

Timing of injury in the fetus and neonate

“…Taken with the epidemiological association of HIE with antepartum complications [8][9][10], it has been speculated that abnormal heart rate patterns during labour may be the first signs of preexisting neurological abnormality [10,16]. There is little direct evidence, however, that this is a significant issue.…”

Foetal ECG and STAN technology—a review

“…The limitations are, however, well recognised regarding the identification of infants at risk of asphyxia [86]. The interpretation of CTG by midwives and obstetric staff is of concern and has been highlighted by several reports (Annual Report of the Confidential Enquiry into Stillbirths and Deaths in Infancy, Maternal and Child Health research Consortium, UK 1998) [87][88][89]. Some authors report the overall incidence of hypoxic seizures in term infants not being reduced, despite evidence of improved obstetric practice in the identification and delivery of high-risk foetuses [90], and, even in studies where the incidence of hypoxic seizures was decreased, there were no long-term consequences of their decrease [91].…”