Abstract:
Basal ganglia and thalamus (BGT) hypoxic-ischaemic brain injury is currently the most contentious issue in cerebral palsy (CP) litigation
in South Africa (SA), and merits a consensus response based on the current available international literature. BGT pattern injury is strongly
associated with a preceding perinatal sentinel event (PSE), which has a sudden onset and is typically unforeseen and unpreventable.
Antepartum pathologies may result in fetal priming, leading to vulnerability to BGT injury by relatively mild hypoxic insults. BGT injury
may uncommonly follow a gradual-onset fetal heart rate deterioration pattern, of duration ≥1 hour. To prevent BGT injury in a clinical
setting, the interval from onset of PSE to delivery must be short, as little as 10 - 20 minutes. This is difficult to achieve in any circumstances
in SA. Each case needs holistic, multidisciplinary, unbiased review of all available antepartum, intrapartum and postpartum and childhood
information, aiming at fair resolution without waste of time and resources.
