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Fetal Monitoring as a Cerebral Palsy Predictor

by Dr. James C Johnston

A board-certified neurologist and credentialed attorney, Dr. James C. Johnston earned his doctor of medicine from the University of Texas Health Science Center in San Antonio, TX. Dr. James C. Johnston now serves as the director of Legal Medicine Consultants and is a partner in GlobalNeurology. He has authored a number of articles on neurological care and litigation, including a recent piece on fetal monitoring and cerebral palsy.
Cerebral palsy is a neurological disorder that inhibits an individual's ability to properly control the muscles. For many years, medical science believed that the disorder resulted from a lack of oxygen supplied to the brain during birth. Electronic fetal monitoring, which tracks heart rate patterns believed to be related to oxygen deprivation, became a common way of assessing risk and prompting interventions.
Now, however, research has revealed that asphyxia and hypoxia contribute to only a small number of cerebral palsy cases. Fetal monitoring has also proved faulty as a measure, largely due to the fact that its false-positive rate of 99 percent has prompted numerous Caesarean deliveries without the effect of reducing the occurrence of cerebral palsy. In fact, one study revealed an increase in cerebral palsy rates among infants who experienced electronic monitoring as compared to infants tracked with more traditional techniques. As a result, experts have begun to question the relevance of electronic monitoring as an indicator of cerebral palsy risk.
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