Placental examination can help determine cause of brain damage in neonates.

Intrapartum asphyxia rarely causes cerebral palsy. More than 90% of cases of cerebral palsy are now believed to result from an antecedent intrauterine developmental abnormality. It is now also known that there is an association between subacute and chronic intrauterine hypoxia (decreased uteroplacental blood flow) and brain damage. We present an evaluation protocol that includes clinical findings of the mother and infant combined with pathologic examination of the placenta. The purpose of this protocol is to better identify and separate cases of acute from chronic perinatal asphyxia. We believe that improved screening and identification of perinatal asphyxia will reduce the number of malpractice suits for infants with brain damage. The objective is to eliminate from litigation those cases due to antecedent developmental abnormality over which the clinician has no responsibility and should not be held medically liable.