title: Fault and blame, insults to the perinatal brain may be remote from time of birth.
abstract: There is a certainty in malpractice cases that neurodevelopmental deficits are caused by preventable events at birth when the onset, nature, and timing of the insult in the antenatal and natal period are unknown. The biggest problem is determining timing. Electronic fetal monitoring is given excessive importance in legal cases. Before assigning fault on events at birth, a better understanding of developmental neurobiology and limitations of the present clinical biomarkers is warranted. The issues of single versus repeated episodes, timing of antenatal insults, pros and cons of legal arguments, interaction of various etiologic and anatomic factors are discussed.
authors: NorthShore University Health System, University Chicago Pritzker School of Medicine, 2650 Ridge Avenue, Evanston, IL 60201, USA. Electronic address: sidtan@uchicago.edu.
authors: Sidhartha
authors: S
authors: Tan
mesh_terms: D000137:Acid-Base Imbalance / Q000150:complications; D016470:Bacteremia / Q000150:complications; D001720:Birth Injuries / Q000150:complications / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000150:complications / Q000473:pathology*; D002547:Cerebral Palsy / Q000209:etiology / Q000473:pathology*; D020345:Enterocolitis, Necrotizing / Q000150:complications; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000473:pathology*; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D009774:Obstetrics / Q000331:legislation & jurisprudence; D011247:Pregnancy; D049188:Prenatal Injuries / Q000473:pathology*; D013997:Time Factors
keywords: Anoxia; Antenatal; Birth; Brain; Cerebral palsy; Fetus; Newborn