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Cerebral PalsyFrom: Dr. Ainsworth (ainsron@sbcglobal.net)Wed May 28 01:30:41 2003
A recent ACOG update tape is on this topic and gave a lot of food for thought, pointing out that only 5-15% of the cases of CP can be attributed to intrapartum events. One statement caused me trouble in justifying the recommended mode of delivery. One of the discussants stated that the risk of an adverse event occurring intrapartum during induction of a severely IUGR infant (<3%) and development of CP was so high, he would go directly to C/S and avoid attempted induction. The implication was that the risk of CP was in the range of 50x greater for that infant and in order to avoid the risk of vaginal delivery and being seen as the cause of that case of CP, a C/S was preferrable, even though they felt CP was caused by events antecedent to labor. So basically, you tell the mother: " I believe your baby has irreversible brain damage, related to IUGR and although I don't think a C/S will give you a better baby, we need to deliver you by C/S in order to avoid a law suit."
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