scholarly journals The Japan Obstetric Compensation for Cerebral Palsy - A Social Experiment for Improving Perinatal Care through Professional Peer Review and No-Fault Compensation -

2021 ◽  
Vol 41 (7) ◽  
pp. 642-655
Author(s):  
Shin USHIRO
Keyword(s):  
Cerebral Palsy ◽  
Peer Review ◽  
Perinatal Care ◽  
Social Experiment ◽  
Fault Compensation

scholarly journals Lessons Learned from the Japan Obstetric Compensation System for Cerebral Palsy: A Novel System of Data Aggregation, Investigation, Amelioration, and No-Fault Compensation

2020 ◽  
pp. 465-484
Author(s):  
Shin Ushiro ◽  
Antonio Ragusa ◽  
Riccardo Tartaglia
Keyword(s):  
Cerebral Palsy ◽  
Pathological Condition ◽  
Perinatal Care ◽  
Compensation System ◽  
Lessons Learned ◽  
Annual Reports ◽  
Perinatal Medicine ◽  
Quality Health ◽  
Fault Compensation ◽  
Risk Treatment

AbstractCerebral palsy is a pathological condition whose prevention and treatment have been immensely studied by experts in perinatal medicine and pediatric neurology. Despite this, it is still one of the main concerns nowadays in many countries, not only for scientific reasons but for legal ones also. For instance, in Japan, an increase in lawsuits relating to cerebral palsy was observed more than a decade ago, after healthcare resources in perinatal medicine had increasingly shrunk and had become fragile under the growing burden for physicians and midwives to provide advanced treatment, emergent care, high-risk treatment, and so on. Young physicians did not specialize in obstetrics because of the increased burden, which gave rise to a vicious cycle of shrinking resources in perinatal medicine. To address this issue, the Japan Obstetric Compensation System for Cerebral Palsy (JOCS-CP) was urgently introduced in 2009 to investigate, develop preventive measures, and award monetary compensation on a no-fault basis, with the Japan Council for Quality Health Care (JQ) as its operating organization (Fig. 33.1). It has so far produced annual reports on the prevention of cerebral palsy for nine consecutive years including numerical data and specific themes relating to the occurrence and prevention of cerebral palsy. The success of the system is a good reference for responding to adverse events which may happen in and have a vast impact on perinatal care. Therefore, this chapter focuses on cerebral palsy with primary reference to materials published by the JOCS-CP in the field of perinatal medicine. The aim of this chapter is to learn about the issues mentioned above and to discuss the significance and impact of introducing a nationwide system like the JOCS-CP. It describes knowledge and idea to questions of “Why cerebral palsy is highlighted among adverse event in obstetrics?”, “How the no-fault compensation/investigation/prevention system could be introduced?”, “What has been achieved by the system?”, and “How cerebral palsy is prevented?”.

PREMATURITY AND CP: A COMMON CAUSE?

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. A72-A72
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Perinatal Asphyxia ◽  
Perinatal Care ◽  
Developed Countries ◽  
Low Birth Weight Infants ◽  
Common Cause ◽  
Improvement In Survival

. . .cerebral palsy rates in infants with birth weights under 1500 g increased from 12.1 to 64.9 [per 1000 births]. These results, which are similar to those found in other developed countries, suggest that improved perinatal care, including increased use of interventions to prevent perinatal asphyxia, has improved neonatal survival but not the rate of cerebral palsy. In low-birth-weight infants the rising cerebral palsy rate has paralleled the improvement in survival; one explanation for this finding is that low birth weight and cerebral palsy both result from an insult that occurs well before birth.

scholarly journals Weekend and off-hour effects on the incidence of cerebral palsy: contribution of consolidated perinatal care

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Satoshi Toyokawa ◽  
Junichi Hasegawa ◽  
Tsuyomu Ikenoue ◽  
Yuri Asano ◽  
Emi Jojima ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Cesarean Section ◽  
Medical Care ◽  
Perinatal Care ◽  
Night Shift ◽  
Significant Risk ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Emergent Cesarean Section ◽  
Spontaneous Delivery

Abstract Objective This study estimated the effects of weekend and off-hour childbirth and the size of perinatal medical care center on the incidence of cerebral palsy. Methods The cases were all children with severe cerebral palsy born in Japan from 2009 to 2012 whose data were stored at the Japan Obstetric Compensation System for Cerebral Palsy database, a nationally representative database. The inclusion criteria were the following: neonates born between January 2009 and December 2012 who had a birth weight of at least 2000 g and gestational age of at least 33 weeks and who had severe disability resulting from cerebral palsy independent of congenital causes or factors during the neonatal period or thereafter. Study participants were restricted to singletons and controls without report of death, scheduled cesarean section, or ambulance transportation. The controls were newborns, randomly selected by year and type of delivery (normal spontaneous delivery without cesarean section and emergency cesarean section) using a 1:10 case to control ratio sampled from the nationwide Japan Society of Obstetrics and Gynecology database. Results A total of 90 cerebral palsy cases and 900 controls having normal spontaneous delivery without cesarean section were selected, as were 92 cerebral palsy cases and 920 controls with emergent cesarean section. A significantly higher risk for cerebral palsy was found among cases that underwent emergent cesarean section on weekends (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.06–2.81) and during the night shift (OR 2.29, 95% CI 1.30–4.02). No significant risk was found among normal spontaneous deliveries on weekends (OR 1.63, 95% CI 0.97–2.73) or during the quasi-night shift (OR 1.26, 95% CI 0.70–2.27). Regional perinatal care centers showed significantly higher risk for cerebral palsy in both emergent cesarean section (OR 2.35, 95% CI 1.47–3.77) and normal spontaneous delivery (OR 2.92, 95% CI 1.76–4.84). Conclusion Labor on weekends, during the night shift, and at regional perinatal medical care centers was associated with significantly elevated risk for cerebral palsy in emergency cesarean section.

scholarly journals Cerebral Palsy: State of Art

2010 ◽  
Vol 4 (2) ◽  
pp. 189-198
Author(s):  
Ulrich Honemeyer ◽  
Amira Talic
Keyword(s):  
Cerebral Palsy ◽  
Genetic Factors ◽  
Perinatal Care ◽  
Effective Prevention ◽  
Motor Disability ◽  
Live Births ◽  
Functional Maturation ◽  
4D Ultrasound ◽  
Normal Functional ◽  
The Subject

Abstract Cerebral palsy (CP) is the most common motor disability in childhood. It affects 2 to 2.5 children in 1000 live-births, with 20 to 30 fold increased prevalence in preterm infants. Despite of progress in perinatal care, the prevalence of cerebral palsy did not change in the last 50 years. New knowledge about etiological factors, such as inflammation, elevated level of cytokines, vascular strokes and genetic factors shift the origin of cerebral palsy mostly into antenatal period, making intrapartal damage responsible for less than 10% of cases. CP is becoming increasingly the subject of interdisciplinary research. Fetal neurosonography with a growing number of studies promises better understanding of the normal functional maturation of the human brain which may lead to effective prevention and treatment of cerebral palsy. Advances in 4D ultrasound resulted in development of KANET as tool for detection of abnormal fetal behavior.

scholarly journals Aetiology and comorbidities of cerebral palsy in a developing country

2018 ◽  
Vol 6 (10) ◽  
pp. 3246 ◽  
Author(s):  
Komomo I. Eyong ◽  
Asindi A. Asindi ◽  
Chimaeze Torty
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Social Class ◽  
Perinatal Care ◽  
Birth Asphyxia ◽  
Cortical Atrophy ◽  
Dominant Type ◽  
Care Givers ◽  
Neurology Clinic ◽  
Pregnancy And Delivery

Background: Cerebral palsy (CP) is a common disabling condition of movement and posture causing activity limitation arising from a static injury to the developing brain. Common risk factors for cerebral palsy in Africa include severe birth asphyxia, kernicterus and neonatal infections. This study is aimed at determining the aetiology and comorbidities associated with cerebral palsy in our environment.Methods: All children with CP presenting to the Paediatric Neurology clinic of the University of Calabar Teaching Hospital whose parent gave consent were recruited into the study. The biodata of the children and that of the parent’s/ care givers were obtained. A detailed pregnancy and delivery history, neonatal history, seizures during first three years of life and developmental mile stones was documented.Results: Seventy children with CP were recruited into the study of which 46 (65.7%) were males and 24 (34.3%) females. Majority of the children were from low social class and products of home, church or TBA’S delivery where supervision is poor. Severe birth asphyxia and CNS infections are the commonest identified risk factors. Spastic quadriplegic CP is the dominant type of CP followed by spastic hemiplegia. There is a significant statistical relationship between the aetiology and the type of CP. Epilepsy (60%) speech defect (42.9%) and microcephaly (40%) are the predominant comorbidities seen in the study. Cortical atrophy and ventricular dilatation are predominant CT findings in contrast to periventricular leukomalecia seen in developed countries.Conclusions: Majority of the patients with CP in this study are from low social class and were delivered in places with poor obstetrics care. Improved perinatal care through an adequate social support system may reduce the burden of the disease.

scholarly journals Causes, functional outcomes and healthcare utilisation of people with cerebral palsy in Singapore

2021 ◽  
Vol 50 (2) ◽  
pp. 111-118 ◽  
Author(s):  
Zhi Min Ng ◽  
Jeremy B Lin ◽  
Poh Choo Khoo ◽  
Victor Samuel Rajadurai ◽  
Derrick WS Chan ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Functional Outcomes ◽  
Perinatal Care ◽  
Clinical Information ◽  
Healthcare Utilisation ◽  
Perinatal Period ◽  
University Hospital ◽  
Service Utilisation ◽  
Patient Reported ◽  
National University

Introduction: A voluntary cerebral palsy (CP) registry was established in 2017 to describe the clinical characteristics and functional outcomes of CP in Singapore. Methods: People with CP born after 1994 were recruited through KK Women’s and Children’s Hospital, National University Hospital and Cerebral Palsy Alliance Singapore. Patient-reported basic demographics, service utilisation and quality of life measures were collected with standardised questionnaires. Clinical information was obtained through hospital medical records. Results: Between 1 September 2017 and 31 March 2020, 151 participants were recruited. A majority (n=135, 89%) acquired CP in the pre/perinatal period, where prematurity (n=102, 76%) and the need for emergency caesarean section (n=68, 50%) were leading risk factors. Sixteen (11%) of the total participants had post-neonatally acquired CP. For predominant CP motor types, 109 (72%) had a spastic motor type; 32% with spastic mono/hemiplegia, 41% diplegia, 6% triplegia and 21% quadriplegia. The remaining (42, 27.8%) had dyskinetic CP. Sixty-eight (45.0%) participants suffered significant functional impairment (Gross Motor Functional Classification System levels IV–V). Most participants (n=102, 67.5%) required frequent medical follow-up (≥4 times a year). Conclusion: Optimisation of pre- and perinatal care to prevent and manage prematurity could reduce the burden of CP and their overall healthcare utilisation. Keywords: Cerebral palsy, functional outcomes, neonatal, registry

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