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Doody's Review ServiceReviewer: Harley Ginsberg, M.D.(Ochsner Clinic Foundation)
Description: This 94 page book reports the findings of the American College of Obstetricians and Gynecologists Task Force on the antecedents of neonatal encephalopathy and cerebral palsy.
Purpose: The report is intended to provide a "consensus statement...for Fellows of the College which will succinctly summarize the neuroscience of neonatal encephalopathy and provide a framework for explaining to patients and the general public...medicine's ability to detect, treat or in any way affect the pathophysiologic mechanism which results in neonatal encephalopathy."
Audience: As contributors to this book include obstetricians, maternal-fetal medicine specialists in addition to pediatricians, neuroepidemiologists, radiologists and pathologists, one would expect this publication to be a readily available source for physicians practicing in any of these medicinal subspecialties. Perhaps more importantly however, this report is written at a level which housestaff can comprehend and immediately apply to their developing practice of medicine. Additionally, attorneys, whether representing the family of a damaged baby or defending the hospital or physicians who cared for the mother or infant, will assuredly find this book to be a valuable reference.
Features: The book begins with an executive summary which is meant to "complement, not substitute, the full report." The summary reminds the reader that "the pathway from intrapartum hypoxic-ischemic injury to subsequent cerebral palsy must progress through neonatal encephalopathy" and also states, "...absent cerebral palsy, neither epilepsy, mental retardation nor attention-deficit hyperactivity disorder are caused by birth asphyxia." Chapters examine the topic of encephalopathy from the points of gestational age, maternal and fetal conditions, and ramifications of genetic problems of the fetus. Each section of a chapter concludes with bullet points that the reader should accept as the take home message. A chapter devoted to pharmacologic prevention of neonatal encephalopathy is conspicuously short, indicating the lack of intervention currently available for the treatment of this condition. This task force report provides the long- awaited modified criteria used to define an acute intrapartum event sufficient to cause cerebral palsy. So important is this data that the report devotes the entire final chapter of the book to presenting these essential and suggestive criteria in precise detail. The report provides evidence-based information and is very well referenced. The 2-1/2 page glossary is a useful adjunct and provides assistance for precise definitions and clarification of many terms used in this area of medicine. The book is admittedly a work in progress, as it seeks to combine data from studies with resultant neonatal encephalopathy and cerebral palsy.
Assessment: This publication is an invaluable resource for all healthcare providers who engage in the practice of delivering babies or are involved with newborn resuscitation, stabilization, and subsequent care. Any attorney involved in the litigation of a suspected injured baby case would do well to have this report at his or her side when evaluating allegations of malpractice.