Who Will Deliver Our Grandchildren? Implications of Cerebral Palsy Litigation

摘要

In CP trials, the plaintiffs expert witness often testifies that the damage to the child's brain was caused by oxygen deprivation during delivery and that if the defendant had performed a cesarean delivery, or performed a cesarean delivery earlier, the child would have escaped harm. That was once the prevailing view of how CP occurred. Well-designed studies, however, have shown that lack of oxygen causes only a small proportion of CP cases,67 and despite serious efforts, CP due to birth asphyxia has not been shown to be preventable.8 Antenatal risk factors for CP under current investigation are indicators of viral infection, fetal throm-bophilias, and polymorphisms of genes regulating inflammation, coagulation, and endothelial activation.910 Known risk factors for CP include chorioamnionitis, death of a co-twin in utero, arterial ischemic stroke in the fetus or newborn, an umbilical cord wrapped tightly around the neck