title: Analysis of 127 peripartum hypoxic brain injuries from closed claims registered by the Danish Patient Insurance Association.
abstract: BACKGROUND
  One of the most feared complications in medicine is hypoxic brain damage to a newborn. The authors investigated the circumstances of registered peripartum hypoxic brain injuries in order to identify potential opportunities to improve patient safety and prevent injuries.
  
  
  METHODS
  The authors retrospectively investigated peripartum hypoxic brain injuries registered by the Danish Patient Insurance Association.
  
  
  RESULTS
  From 1992 to 2004, 127 approved claims concerning peripartum hypoxic brain injuries were registered and subsequently analysed. Thirty-eight newborns died, and a majority of the 89 surviving children suffered from major handicaps, primarily cerebral palsy. In 69 of the cases, misinterpretation of or late action on an abnormal cardiotocography (CTG) were the reasons for the majority of the hypoxic brain injuries.
  
  
  CONCLUSIONS
  All injuries could potentially have been avoided using established obstetric practice. CTGs are often misinterpreted. In the authors' opinion, education and training in CTG interpretation is essential. The use of ST-analysis of the fetus ECG (STAN) could probably reduce the number of these injuries.
authors.affiliation: Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. ldhove@hotmail.com
authors.forename: Lars Dahlgaard
authors.initials: LD
authors.lastname: Hove
authors.forename: Johannes
authors.initials: J
authors.lastname: Bock
authors.forename: Jens Krogh
authors.initials: JK
authors.lastname: Christoffersen
authors.forename: Morten
authors.initials: M
authors.lastname: Hedegaard
mesh_terms: D020208:Brain Injury, Chronic / Q000209:etiology*; D015148:Cardiotocography / Q000379:methods* / Q000592:standards; D036861:Delivery, Obstetric / Q000379:methods* / Q000592:standards; D003718:Denmark; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology*; D007231:Infant, Newborn; D007348:Insurance, Health; D012189:Retrospective Studies