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Biomedical subjects

Jeffrey P Phelan

Publications and source records attributed to Jeffrey P Phelan.

4 recordsLinked to original sources
PubMed2005

Perinatal risk management: obstetric methods to prevent birth asphyxia.

Because obstetric care frequently is associated with the potential for liability, the purpose of this article is to familiarize the reader with perinatal risk management using the concept of foreseeability of harm and its potential application to obstetric care. At the same time, this article introduces the concept of notice, and explains the critical conduct intervals that are used to gauge how well the health care teams handle obstetric emergencies. The focus then shifts to incorporate these concepts into several maternal-child health quality management programs. It is hoped that this article will result in an improvement of perinatal outcome for pregnant women and their unborn children.

Asphyxia Neonatorum↗
PubMed2005

Birth asphyxia and cerebral palsy.

There has been a societal presumption that most, if not all, cases of hypoxic ischemic encephalopathy-induced cerebral palsy occur during the 3 hours that are related to the events of labor and delivery; society has tended to overlook the remaining 7000 hours of the pregnancy. As a result of this societal perspective, often times the obstetrician has been targeted unfairly as the person who is responsible for a given child's neurologic injuries. Rather, the entire pregnancy, labor, delivery, and well beyond birth require examination to understand fully the pathophysiologic mechanisms that are responsible for an infant's brain injuries, and their long-term impact on the child.

Asphyxia Neonatorum↗
PubMed2003

A comparison of shoulder dystocia-associated transient and permanent brachial plexus palsies.

OBJECTIVE: To estimate differences between shoulder dystocia-associated transient and permanent brachial plexus palsies. METHODS: We performed a retrospective case-control analysis from national birth injury and shoulder dystocia databases. Study patients had permanent brachial plexus palsy and had been entered into a national birth injury registry. Cases of Erb or Klumpke palsy with documented neonatal neuromuscular deficits persisting beyond at least 1 year of life were classified as permanent. Cases of transient brachial plexus palsy were obtained from a shoulder dystocia database. Non-shoulder dystocia-related cases of brachial plexus palsy were excluded from analysis. Cases of permanent brachial plexus palsy (n=49) were matched 1:1 with cases of transient brachial plexus palsy. RESULTS: Transient brachial plexus palsy cases had a higher incidence of diabetes mellitus than those with permanent brachial plexus palsy (34.7% versus 10.2%, odds ratio [OR] 4.68, 95% confidence interval [CI] 1.42, 16.32). Patients with permanent brachial plexus palsies had a higher mean birth weight (4519+/-94.3 g versus 4143.6+/-56.5 g, P<.001) and a greater frequency of birth weight greater than 4500 grams (38.8% versus 16.3%, OR, 0.31, 95% CI 0.11, 0.87). There were, however, no statistically significant differences between the two groups with respect to multiple antepartum, intrapartum, and delivery outcome measures. CONCLUSION: Transient and permanent brachial plexus palsies are not associated with significant differences for most antepartum and intrapartum characteristics.

Acute Disease↗