The case for the routine use of umbilical cord pH in all deliveries

Abstract

Cerebral palsy (CP) cases are some of the primary reasons for litigation of high quantum amounts against obstetricians both in the public and private sector, on the basis of acute intrapartum hypoxia resulting in hypoxic ischaemic foetal brain damage and by extension invoking “negligent intrapartum care”. This has resulted in a steep rise of insurance premiums placing service delivery in both the public and private sector under a serious threat. This is a worldwide phenomenon and MacLennan already expressed his concerns in 2005 by asking: ‘Who will deliver our grandchildren?’. It has widely been believed that CP is the direct result of an adverse event at birth and that it could have been prevented, but <10% of CP is caused by “birth asphyxia”. There are multiple risk factors and causes now identified to be associated with CP.