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Absence of Fetal Corpus Callosum Associated with Intrapartum Cardiotocographic Nonreacthity
Author(s) -
Cincotta Robert,
Brennecke Shaun
Publication year - 1995
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1995.tb02166.x
Subject(s) - cardiotocography , medicine , abnormality , fetus , obstetrics , pediatrics , pregnancy , psychiatry , genetics , biology
EDITORIAL COMMENT: We accepted this paper for publication because it shows an interesting association between a cerebral malformation and abnormal cardio‐tocography. Chew and colleagues have previously reported that in series of patients with evidence of critical fetal reserve detected by antenatal cardiotocography the incidence of major fetal malformations ranged from 10–12%, a figure very similar to the major malformation rate of infants of women with prepregnancy diabetes delivered at the Mercy Hospital for Women 1971–1994 (47 of 392). These authors have recommended that when time permits ultrasonographic assessment of a fetus should be performed to seek evidence of major malformations when there is evidence of severe fetal compromise on antenatal cardiotocography. Nonetheless, most infants are not malformed when this type of cardiotocograph is seen, and it is also true that many infants with a major malformation may not show an abnormal cardiotocograph. This can also apply to cases with defects as severe as anencephalus. The association between a major cerebral abnormality and an abnormal cardiotocograph seen in this case is of interest but cannot be implied universally to the interpretation of abnormal cardiotocographs apart from suggesting the need to exclude malformation with ultrasonography. Authors'reply to editorial comment: Given the currently vexatious medicolegal climate in which obstetric care and paediatric neurological outcomes feature prominently, it is worthwhile to have on record a case such as this. Specifically, an implication of this report is that, whether or not there is any demonstrable anatomical cerebral abnormality, it remains possible that an abnormal intrapartum cardiotocograph may reflect abnormal paediatric neurological function which Caesarean delivery would not influence. Other means of assessing fetal well‐being in addition to cardiotocography are required to distinguish those cases that may benefit from interventional delivery from those that would not.