Threshold of metabolic acidosis associated with newborn cerebral palsy: medical legal implications

Training in the use of intrapartum electronic fetal monitoring with cardiotocography: systematic review and meta‐analysis

“… 2 However, suboptimal practice, particularly in relation to electronic fetal heart rate monitoring (EFM) using cardiotocography (CTG) in labour, is a known problem and remains frequently cited in successful obstetric malpractice claims. 3 , 4 Training of maternity personnel remains the most frequently recommended intervention to improve EFM. 5 , 6 Despite its ubiquity, it is unclear whether CTG training improves birth outcomes, and, if so, which form of training is most effective.…”

“…Intrapartum fetal monitoring is intended to identify fetal compromise and facilitate appropriate action in response 2 . However, suboptimal practice, particularly in relation to electronic fetal heart rate monitoring (EFM) using cardiotocography (CTG) in labour, is a known problem and remains frequently cited in successful obstetric malpractice claims 3,4 . Training of maternity personnel remains the most frequently recommended intervention to improve EFM 5,6 .…”

Gestational weight gain and foetal acidosis in vaginal and caesarean deliveries: The Japan Environment and Children’s Study

“…Additionally, because the JECS is a nationwide prospective birth cohort study, long-term neonatal and offspring outcomes can be analysed in the future. Although foetal acidosis is associated with neonatal mortality 10 and foetal hypoxic-ischaemic brain injury 12 , long-term outcomes related to foetal acidosis increased by maternal GWG remain unclear. Further studies may clarify the effect of GWG on long-term neonatal and offspring outcomes in the JECS.…”

“…a Adjusted for maternal age, maternal education, annual household income, maternal smoking during pregnancy, parity, preterm birth and small-for-gestational age infants. www.nature.com/scientificreports/ between foetal perinatal asphyxia and neonatal encephalopathy and/or cerebral palsy 12,32 because purely respiratory acidosis is not associated with neonatal adverse outcomes 32,33 . Here, foetal acidosis included foetal respiratory acidosis.…”

“…Foetal acidosis is a major factor associated with birth asphyxia, generally resulting from the interruption of placental blood flow and subsequent foetal hypoxia and hypercarbia [9][10][11] . A low umbilical artery pH (UmA-pH) is significantly associated with neonatal mortality 10 and metabolic acidosis is significantly associated with foetal hypoxic-ischaemic brain injury 12 . Thus, reducing foetal acidosis during antepartum and intrapartum is an important issue to resolve 13 .…”