Medico-legal implications of Neonatal Cerebral Palsy and the responsibilities of modern Obstetric-Neonatal Unit by George Gregory Buttigieg KM in PAPN - Lupine Publishers
Modern medico-legal evaluation of Neonatal Cerebral Palsy (NCP) demands recognition of Neonatal Hypoxic Ischaemic Encephalopathy (NHIE) as an indispensable proof of peri-partum fetal hypoxia. Without proven NHIE, modern jurisprudence should not even consider obstetric/paediatric liability of causative peri-partum hypoxia of negligence on the grounds of medically responsible fetal/newborn hypoxia leading to Cerebral Palsy. Peripartum hypoxia, which comprises intra-partum hypoxia may result in damage which may with varying degrees of time manifest itself with epilepsy, neuro-developmental delay, cognitive impairment or Cerebral Palsy and the full damage may not be completely assessable before 3-4 years of age. Court cases alleging obstetric/ neonatologist liability may not commence for a number of years, at times even decades after he birth. In the case of Cerebral Palsy, it must be borne in mind that peri-partum hypoxia is not, nowadays, considered as causative in more than 9% of cases, whereas 91% may be due to premature birth, other complications or of undetermined aetiology. Since in many cases, CP litigation may reach Court without screening as to what may be liable from peripartum hypoxia or otherwise, it is crucial that in the hours or days post-birth, all relevant investigations are performed, stored safely and be accessible if and when necessary - Lupine Publishers
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