Hove Lars Dahlgaard, Bock Johannes, Christoffersen Jens Krogh, Hedegaard Morten
Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 2008;87(1):72-5. doi: 10.1080/00016340701797567.
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.
The authors retrospectively investigated peripartum hypoxic brain injuries registered by the Danish Patient Insurance Association.
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.
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.
医学上最令人担忧的并发症之一是新生儿缺氧性脑损伤。作者调查了已登记的围产期缺氧性脑损伤情况，以确定改善患者安全和预防损伤的潜在机会。
作者回顾性调查了丹麦患者保险协会登记的围产期缺氧性脑损伤。
1992年至2004年，登记并随后分析了127例关于围产期缺氧性脑损伤的批准索赔。38名新生儿死亡，89名存活儿童中的大多数患有严重残疾，主要是脑瘫。在69例病例中，大多数缺氧性脑损伤的原因是对异常胎心监护（CTG）的错误解读或行动迟缓。
采用既定的产科做法，所有损伤都有可能避免。CTG常常被错误解读。作者认为，CTG解读方面的教育和培训至关重要。使用胎儿心电图的ST分析（STAN）可能会减少此类损伤的数量。
