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Biomedical subjects

K R Niswander

Publications and source records attributed to K R Niswander.

At least 19 recordsLinked to original sources
PubMed1985

Quality of obstetric care and occurrence of fetal asphyxia and cerebral palsy. Is there a relationship?

Whether a relationship exists between the quality of obstetric care and poor fetal outcome, notably cerebral palsy, remains uncertain. We herein report a study which suggests that substandard obstetric care bears little relationship to the etiology of cerebral palsy. In none of our 34 cases of cerebral palsy was there any recognized delay on the physician's part in reacting to evidence of fetal asphyxia.

Cerebral Palsy↗
PubMed1980

Fetal distress in term pregnancies.

A diagnosis of fetal distress was made in 75 term obstetrical patients from a population of 3,972 term deliveries. Twenty-three percent of the infants were scored 6 or less on the 5-minute Apgar rating. One or more determinations of fetal scalp pH were available in 27 of these patients. The scalp pH improved the accuracy of the diagnosis of fetal distress modestly. Follow-up evaluation to at least 1 month of age was available in 75% of the infants. Six infants were not neurologically normal; in four of them this was of major importance, and in the other two it was of minor importance. In one, the condition was almost certainly unrelated to prenatal or perintal factors, whereas in the other five, evidence of chronic fetal asphyxia as well as perinatal asphyxia was elicited. An additional 10 term infants with a 5-minute Apgar score of 6 or less had entirely normal electronic fetal monitoring tracings.

Apgar Score↗
PubMed1979

The obstetrician, fetal asphyxia, and cerebral palsy.

In the current legal climate, the recognition of cerebral palsy or other major brain dysfunction in a child is likely to lead to a malpractice action against the obstetrician who delivered the child. Perinatal asphyxia is usually considered the most likely cause of the brain damage, and the obstetrician is presumed by the lawyer either to have failed to recognize the fetal asphyxia or to have ignored it. In this essay, the illogic in this reasoning is discussed. While fetal asphyxia clearly can cause fetal brain damage, the infrequency of this relationship is stressed. The dilemma faced by the obstetrician as a result of modern perinatal care is discussed.

Cerebral Palsy↗
PubMed1975

The effect of intrauterine hypoxia on the child surviving to 4 years.

Intrauterine hypoxia/asphyxia is an unchallenged cause of perinatal death, but whether sublethal degrees of hypoxia result frequently in brain damage in surviving infants is less certain. To test this hypothesis, obstetric patients with abruptio placentae, placenta previa, and prolapse of the umbilical cord were computer matched on several factors with normal control patients to determine the degree of risk of lower 4 year Stanford-Binet I. Q. scores or abnormalities on the 4 year fine motor and gross motor testings. The mean I. Q. score of babies born of mothers with one of these complications was no different from that of the normal controls. Similarly negative results were recorded on the 4 year fine motor and gross motor testings. Children of low birth weight in either group experienced lower I. Q. scores and higher risk of abnormal findings on the motor tests at 4 years than the babies of mature birth weight. Intrauterine hypoxia/asphyxia apparently is not a major cause of neurologic dysfunction in the surviving child.

Abruptio Placentae↗