Advertisement

Neurological Morbidity of Term Infants as an Indicator of Safe Obstetrical Practice

  • C. Amiel-Tison

Abstract

The Stresses of a “Normal” Delivery Have Been a Long-standing Source of Anxiety Among Obstetricians. Lacomme wrote in 1960: “I do not know what a ‘normal delivery’ is; I only know of an ‘optimal’ labor, i.e. labor where minimal stress is exerted on the fetus.” Later on, with fetal heart rate (FHR) monitoring and acid base balance measurements during labor, the definition of an “optimal labor” was refined by taking into account: mechanical forces related to uterine contractions, hemodynamic changes associated with uterine contractions, and secondary fetal changes, as reviewed in 1974 by Sureau. However, the obstetrical anxiety not only persisted but increased with each new method of evaluating the risk of fetal asphyxia. In 1973, Valkeakari offered the first echoencephalographic demonstration of changes in the fetal brain as the result of a normal cephalic delivery. These changes were midline shifts depending on the fetal position during the vaginal delivery (significant with p less than 0.05 from 6 to 12 h postnatally) which were probably related to cerebral edema (normal up to 3 h and back to normal at 24 h). At the same time, it appeared clinically (Amiel-Tison et al. 1977 a) that mild signs of cerebral dysfunction linked with the birth process were often observed in the absence of overt fetal distress and therefore with Apgar scores of 8 or more at 1 and 5 min, particularly in occipito posterior presentations.

Keywords

Cesarean Section Fetal Heart Rate Cesarean Section Rate Birth Asphyxia Cerebral Dysfunction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Amiel-Tison C (1969) Cerebral damage in full-term newborn. Aetiological factors, neonatal status and long term follow-up. Biol Neonate 14: 234–250.CrossRefGoogle Scholar
  2. Amiel-Tison C (1973) The follow-up of infants presenting neurological abnormalities in the first days of life. In: Brossart H, Cruz JM, Huber A, Prod’hom LS, Sistek J (eds) Perinatal medecine. Huber, Bern, pp 207–218.Google Scholar
  3. Amiel-Tison C (1979) Birth injury as a cause of brain dysfunction in full-term newborns. In: Korobkin R, Guilleminault C (eds) Advances in perinatal neurology. Spectrum, New York, pp 57–83.Google Scholar
  4. Amiel-Tison C, Ellison P (1986) Birth asphyxia in the full-term newborn. Dev Med Child Neurol 28: 671–682.PubMedCrossRefGoogle Scholar
  5. Amiel-Tison C, Grenier A (eds) (1986) Neurological assessment during the first year of life. Oxford University Press, New York.Google Scholar
  6. Amiel-Tison C, Henrion R, Esque-Vaucouloux MT, Goujard J, Firtion G, Tehobroutsky C, Varangot J (1977 a) La souffrance cérébrale du nouveau-né à terme. J Gynecol Obstet Biol Reprod (Paris) 6: 971–989.Google Scholar
  7. Amiel-Tison C, Korobkin R, Esque-Vaucouloux MT (1977 b) Neck extensor hypertonia: a clinical sign of insult to the central nervous system of the newborn. Early Hum Dev 1(2): 181–190.PubMedCrossRefGoogle Scholar
  8. Amiel-Tison C, Dalisson C, Henrion R (1980) Evolution de la pathologie cérébrale du nouveau-né à terme. Arch Fr Pediatr 37: 87–92.PubMedGoogle Scholar
  9. Amiel-Tison C, Barrier G, Shnider SM, Levinson G, Hughes SC, Stefani SJ (1982) A new neurologic and adaptive capacity scoring system for evaluating obstetric medications in full-term newborns. J Anesthesiol 56: 340–350.CrossRefGoogle Scholar
  10. Amiel-Tison C, Dube R, Garel M, Jequier JC (1983) Outcome at age five years of full-term infants with transient neurologic abnormalities in the first year of life. In: Stern L, Bard H, Friis-Hansen B (eds) Intensive care of the newborn, vol 4. Masson, New York, pp 247–258.Google Scholar
  11. Bottoms SF, Rosen MG, Sokol RJ (1980) The increase in the cesarean birth rate. N Engl J Med 302: 559–563.PubMedCrossRefGoogle Scholar
  12. Brazelton TB (ed) (1984) Neonatal behavioral assessment scale, 2nd edn. SIMP, London (Clinics in developmental medecine, 2nd edn, no 88).Google Scholar
  13. Chasnoff IJ, Bussey ME, Savich R, Stack CM (1986) Perinatal cerebral infarction and maternal cocaine use. J Pediatr 108: 456–459.PubMedCrossRefGoogle Scholar
  14. Cyr RM, Usher RH, McLean FH (1984) Changing patterns of birth asphyxia and trauma over 20 years. Am J Obstet Gynecol 148: 490–498.PubMedGoogle Scholar
  15. Erasmus C, Blackwood WA, Wilson J (1982) Infantile multicystic encephalomalacia after maternal bee sting anaphylaxis during pregnancy. Arch Dis Child 57: 785–787.PubMedCrossRefGoogle Scholar
  16. Feldman GB, Freiman JA (1985) Prophylactic cesarean section at term? N Engl J Med 312: 1264–1267.PubMedCrossRefGoogle Scholar
  17. Fitzhardinge PM, Flodmark O, Fitz CR, Ashby S (1981) The prognostic value of computed tomography as an adjunct to assessment of the term infant with postasphyxiai encephalopathy. J Pediatr 99: 777–781.PubMedCrossRefGoogle Scholar
  18. Gosseye S, Golaire MC, Larroche JC (1982) Cerebral, renal and splenic lesions due to fetal anoxia and their relationship to malformations. Dev Med Child Neurol 24: 510–518.PubMedCrossRefGoogle Scholar
  19. Koffler H, Keenan WJ, Sutherland JM (1974) Hydranencephaly following elevated hematocrit values in a newly born infant. Pediatrics 54: 770–772.PubMedGoogle Scholar
  20. Lacomme M (ed) (1960) Pratique obstétricale. Masson, Paris.Google Scholar
  21. Lagercrantz H, Slotkin TA (1986) The “stress” of being born. Sci Am 254: 92–98.CrossRefGoogle Scholar
  22. Larroche JC (ed) (1976) Developmental pathology of the neonate. Excerpta Medica, Amsterdam.Google Scholar
  23. Lebrun F, Cabrol D, Amiel-Tison C (1985) Sécurité de la naissance à terme et taux de césarienne. In: Blanc B, Thoulon JM (eds) 14 et 15èmes Journées Nationales de Médecine Périnatale. Arnette, Paris, pp 49–59.Google Scholar
  24. Mannino FL, Trauner DA (1983) Stroke in neonates. J Pediatr 102: 605–610.PubMedCrossRefGoogle Scholar
  25. Ment LP, Duncan CC, Ehrenkranz RA (1984) Perinatal cerebral infarction. Ann Neurol 16: 559–568.PubMedCrossRefGoogle Scholar
  26. Naidu S, Messmore H, Caserta V, Fine M (1983) CNS lesions in neonatal isoimmune thrombocytopenia. Arch Neurol 40: 552–554.PubMedCrossRefGoogle Scholar
  27. Sarnat HB, Sarnat MS (1976) Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol 33: 696–705.PubMedCrossRefGoogle Scholar
  28. Sureau C (1974) The stress of labor. In: Aladjem S, Brown AK (eds) Clinical perinatology. Mosby, St Louis, pp 291–335.Google Scholar
  29. Touwen B (ed) (1976) Neurological development in infancy. SIMP, London (Clinics in developmental medecine, no 58).Google Scholar
  30. Valkeakari T (1973) Analysis of serial echoencephalograms in healthy newborn infants during the first week of life. Acta Paediatr Scand [Suppl] 242: 1–62.Google Scholar
  31. Voorhies TM, Ehrlich ME, Frayer W, Lee BCP, Vannucci RC (1984) Occlusive vascular disease in asphyxiated newborn infants. J Pediatr 105: 92–96.PubMedCrossRefGoogle Scholar
  32. Yoshioka H, Kadomoto Y, Mino M, Morikawa Y, Kasabuchi Y, Kusunori T (1979) Multicystic encephalomalacia in liveborn twin with a stillborn macerated co-twin. J Pediatr 95: 798–800.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • C. Amiel-Tison

There are no affiliations available

Personalised recommendations