January 25, 2016
MAYWOOD,
Ill -- January 25, 2016 -- A study published in the Journal of
Perinatology is providing new evidence that the vast majority of babies
who are born with severe brain damage are not the result of mismanaged
deliveries.
Jonathan Muraskas, MD, Loyola University Medical Center and Loyola University, Chicago, Illinois, and colleagues examined the medical records of 32 full-term infants who developed severe cerebral palsy and mental retardation. The records indicated that this brain damage occurred after the babies were born, and despite proper resuscitation.
“All too often in cases of professional liability, the focus is on the last 2 hours of a normal 7,000-hour term pregnancy,” the authors wrote. “This study would support closer scrutiny of the first 2 hours [following birth] as a possible [cause] for non-preventable adverse neurological outcomes in newborns.”
Out of every 1,000 full-term newborns, between 1 and 3 infants experience encephalopathy, marked by impaired level of consciousness, seizures, difficulty breathing, and depressed reflexes. While studies have found that only 8% to 14.5% of such cases are due to inadequate blood supply to the brain during delivery, the syndrome remains a leading cause of allegations of mismanagement by obstetricians.
The cases Dr. Muraskas examined included 18 newborns with chorioamnionitis and 14 newborns with severe anaemia.
Medical records examined in the study showed that the gases in the umbilical cord blood of these newborns were normal, and there was little injury to the brains' deep gray matter. These and other indicators strongly suggest that the babies had not suffered brain damage before birth. However, once the babies were born, they were unable to cope on their own with the devastating effects of their infections or anaemia.
For example, babies infected by chorioamnionitis developed sepsis, an overwhelming immune response to infection that can cause tissue damage and organ failure. Severe cases of chorioamnionitis and anaemia can impede delivery of oxygen to the brain and other vital organs. In such cases, even the best resuscitation efforts are unable to prevent severe brain damage.
Despite appropriate obstetrical and paediatric-neonatal management, the presence of chorioamnionitis or fetal anaemia can result in “devastating outcomes,” the authors wrote.
SOURCE: Loyola University Health System
Jonathan Muraskas, MD, Loyola University Medical Center and Loyola University, Chicago, Illinois, and colleagues examined the medical records of 32 full-term infants who developed severe cerebral palsy and mental retardation. The records indicated that this brain damage occurred after the babies were born, and despite proper resuscitation.
“All too often in cases of professional liability, the focus is on the last 2 hours of a normal 7,000-hour term pregnancy,” the authors wrote. “This study would support closer scrutiny of the first 2 hours [following birth] as a possible [cause] for non-preventable adverse neurological outcomes in newborns.”
Out of every 1,000 full-term newborns, between 1 and 3 infants experience encephalopathy, marked by impaired level of consciousness, seizures, difficulty breathing, and depressed reflexes. While studies have found that only 8% to 14.5% of such cases are due to inadequate blood supply to the brain during delivery, the syndrome remains a leading cause of allegations of mismanagement by obstetricians.
The cases Dr. Muraskas examined included 18 newborns with chorioamnionitis and 14 newborns with severe anaemia.
Medical records examined in the study showed that the gases in the umbilical cord blood of these newborns were normal, and there was little injury to the brains' deep gray matter. These and other indicators strongly suggest that the babies had not suffered brain damage before birth. However, once the babies were born, they were unable to cope on their own with the devastating effects of their infections or anaemia.
For example, babies infected by chorioamnionitis developed sepsis, an overwhelming immune response to infection that can cause tissue damage and organ failure. Severe cases of chorioamnionitis and anaemia can impede delivery of oxygen to the brain and other vital organs. In such cases, even the best resuscitation efforts are unable to prevent severe brain damage.
Despite appropriate obstetrical and paediatric-neonatal management, the presence of chorioamnionitis or fetal anaemia can result in “devastating outcomes,” the authors wrote.
SOURCE: Loyola University Health System
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