ACOG/AAP Neonatal Encephalopathy and Cerebral Palsy Defining the Pathogenesis and Pathophysiology First Edition 2003

This monograph explores the mechanisms and timing of possible etiologic events that contribute to fetal and neonatal neurologic injury. The report presents evidence that most cases of cerebral palsy are a result of multifactorial and unpreventable causes that occur during fetal development or in the newborn after delivery, and not a result of an isolated intrapartum hypoxic event. The report contains a set of criteria that may be used to define (or rule out) an acute intrapartum hypoxic event sufficient to cause or suggest cerebral palsy.

The 2003 ACOG and AAP report, Neonatal Encephalopathy and Cerebral Palsy, established that most cerebral palsy cases result from multifactorial, unpreventable prenatal factors rather than intrapartum hypoxia. To link an acute event during labor to cerebral palsy, the report outlined four strict, mandatory criteria.

The task force determined that an acute intrapartum hypoxic-ischemic (oxygen-depriving) event can only be definitively linked to cerebral palsy if all four of the following essential criteria are met:

Metabolic Acidosis: Evidence of severe metabolic acidosis in fetal umbilical cord arterial blood obtained at delivery, defined as a pH of less than 7.00 and a base deficit of 12 mmol/L or more.

Early-Onset Encephalopathy: Early onset of moderate or severe neonatal encephalopathy in infants born at 34 weeks of gestation or later.

Specific Type of CP: The cerebral palsy must be of the spastic quadriplegic or dyskinetic (non-spastic) type.

Exclusion of Other Causes: All other identifiable etiologies must be ruled out, including trauma, coagulation disorders, infectious conditions (e.g., chorioamnionitis or sepsis), and genetic disorders.

The report also lists "timing criteria" that together suggest intrapartum timing—such as a sudden, sentinel hypoxic event (like uterine rupture) and a rapid deterioration in the fetal heart rate—to guide clinical risk management and medical-legal evaluations.

Condition: New

Publisher ‏ : ‎ Amer College of Obstetricians &
Publication date ‏ : ‎ January 1, 2003
Edition ‏ : ‎ 1st
Language ‏ : ‎ English
Print length ‏ : ‎ 94 pages
ISBN-10 ‏ : ‎ 0915473917
ISBN-13 ‏ : ‎ 978-0915473915
Item Weight ‏ : ‎ 12.8 ounces
Dimensions ‏ : ‎ 8.5 x 0.35 x 10.9 inches