CEREBRAL PALSY:  Continuous fetal heart rate monitoring . . . does not lead to the reduction in the incidence of cerebral palsy


A study published in the March 7, 1996, edition of The New England Journal of Medicine (NEJM) reported that continuous fetal heart rate monitoring during labor has not led to the reduction in the incidence of cerebral palsy.

It was thought that by expediting the delivery of babies experiencing abnormally high stress just prior to birth, they could reduce the incidence of cerebral palsy. Cerebral palsy is thought to be due, at least in part, to a shortage of oxygen to the brain. It was also thought that "by expediting the delivery of babies experiencing abnormally high stress just prior to birth, they could reduce the incidence of cerebral palsy."

The study in the NEJM, reviewed 155,638 birth records, concluding that intervention by cesarean delivery, and fetal heart rate monitoring and have not reduced the incidence of cerebral palsy. In a accompanying editorial, it was noted that these rates have remained fairly constant, despite increased prenatal care, reduced birth trauma and increased use of cesarean delivery over the past 25 years.

Diana Danilenko-Dixon, M.D., a Mayo Clinic physician who specializes in treating high-risk pregnancies remarked, "We suspect that factors causing cerebral palsy usually occur well before the start of labor and delivery and cannot be prevented by heart rate monitoring, cesarean delivery or by any other intervention during labor and delivery."

According to Dixon, there is no way to test for cerebral palsy before delivery. Citing from the same study, Dixon said that "37 percent of babies with cerebral palsy and 60 percent of normal babies had no known risk factors."

According to Mayo pediatric neurologist Marc Patterson, M.D., we seldom find the cause of cerebral palsy. "Human fetal development is a highly complex process," he said. "It's amazing that difficulties occur as infrequently as they do."

SOURCES:  New England Journal of Medicine, March 7, 1996

Mayo Online Health Magazine, April 10 1996


 

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