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Birth Injuries
Cerebral palsy (CP) literally means "brain paralysis". It refers to
motor abnormalities caused by damage to the brain and central nervous
system. This damage or injury to the brain and central nervous
system is thought to occur during the pregnancy, birthing process or
after birth and can result from a variety of different
causes. This condition is permanent and irreversible.
CP occurs when the brain and central nervous system are injured or
deprived of oxygen and nutrients. The severity of CP will depend
on the extent of damage to the brain and central nervous system.
This damage results in various developmental defects including:
- Movement disorders
- Delayed development
- Spastic quadriplegia
- Diplegia
- Seizure disorder
- Spastic hemiplegia
- Hypotonia
There are numerous potential causes of CP that occur during the pregnancy. These can include:
- Infections
- Such as herpes simplex, untreated Group B Streptococcus, cytomegalovirus (CMV), rubella, and toxoplasmosis
- Placental abnormalities
- Such as placental insufficiency, chorioamnionitis, premature
aging of the placenta, placental abruption (premature separation of the
placenta from the uterine wall), and intrauterine growth retardation of
the fetus (IUGR)
- Severe malnutrition of the mother
- Certain prescription or non- prescription drugs
- Alcohol or illicit drug use
- Exposure to environmental chemicals or toxins
- Gestational or non- gestational diabetes
- Chronic thyroid conditions
- Genetic factors.
Evidence suggests that prenatal factors result in 70-80% of cases of
CP. In most cases, however, it is felt that the exact cause is most
likely the result of multiple factors.
Possible causes of CP during the childbirth can include:
- Untreated umbilical cord compression
- Prolapsed umbilical cord
- Hypoxia (lack of oxygen) from a failed or delayed delivery
- Thick meconium,
- Complication from placenta previa or placental abruption
Some of these are preventable causes, others aren't.
Possible causes of CP after birth include:
- Birth trauma
- Significant meconium aspiration
- Severe infection leading to sepsis
- Meningitis or encephalitis
- Any condition that produces sustained hypoxia (lack of oxygen)
There are many other conditions after births that have been associated with CP.
Occurrence Rate and Complications
CP occurs approximately 1.5 to 3 times per 1000 live births.
The most common complications for a child with CP include:
- Gastrointestinal and nutritional issues (failure to thrive due to feeding and swallowing problems)
- Chronic constipation leading to bowel obstruction
- Gastroesophageal reflux disease leading to aspiration
- Respiratory problems (aspiration pneumonia, pulmonary dysplasia, asthma)
- Ulcers of the skin
- Orthopedic abnormalities (chronic hip dislocations, scoliosis and kyphosis, chronic contractures)
- Seizures
- Psychological problems (add, learning disabilities, depression)
- Visual and hearing abnormalities
Providing Care
Patients with severe CP often have a reduced life expectancy. The
vast majority of CP patients have typical life expectancies. The
typical costs of care are anywhere from $200,000 to $400,000 per
year. A patient with CP requires the constant attention of a
medical team.
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