Re: Cerebral Palsy

From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
Thu May 29 08:32:22 2003


And your point is? That is what the populace wants, as long as they continue to vote for representatives that prevent tort reform. The American public, not so much the lawyers, but the 20% who vote in elections, have determined that we must practice defensive medicine.

Just my opinion...

--
Richard Chudacoff, MD

"If you think it's hard to meet new people, try picking up the wrong golf ball." -Jack Lemmon

-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Dr. Ainsworth Sent: Wednesday, May 28, 2003 1:31 AM To: Multiple recipients of list OB-GYN-L Subject: Cerebral Palsy

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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