High-risk obstetrics, medicolegal problems.
The perinatal period is one of the most dangerous time of life. The responsibilities of the obstetricians are multifold. It is very difficult to draw a line between good and substandard care, therefore in perinatology and especially in high-risk obstetrical cases there are no absolute rules of management. The lay public is convinced through media channels, that modern reproductive research eliminated all the risks and hazards associated with childbirths, therefore only 100% healthy babies are accepted. Pregnancy is regarded as a 'success story' and if the baby is born with neurological defects (cerebral palsy) the parents and their advisors feel, that someone responsible for the defect should be found in the chain of management. This attitude starts a legal battle focusing on the events of labor and delivery. But in most cases it is very difficult to determine if a peripartal neonatal encephalopathy originated from the time period of labor and delivery, or started weeks earlier during pregnancy as an unnoticed event. Perinatal morbidity indicators are best based on neonatal clinical signs, which are predictive of later morbidity of the child. Neonatal seizures within 48 h of delivery of the baby could be a good index of later morbidity.
Herczeg
J
J
Teaching Hospital, Albert Szent-Györgyi Medical University, Szeged, Hungary. h7507her@ella.hu
D001925:Brain Damage, Chronic / Q000209:etiology; D005260:Female; D005315:Fetal Diseases / Q000209:etiology; D005554:Forensic Medicine; D006801:Humans; D008403:Mass Screening; D009774:Obstetrics / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications; D018570:Risk Assessment