Med Mal News

A study conducted by Johns Hopkins researchers finds that fetal heart monitoring does not help identify babies who are likely to be born with cerebral palsy. Doctors attempt to identify babies in danger of brain damage during the birth process by reviewing their heart monitor charts. If the fetal heart rate is abnormal, one theory for the cause is that an inadequate supply of oxygen is getting to the fetus' brain. Thus, birth by caesarian section is often ordered so that the baby will not sustain white matter brain damage due to a lack of oxygen over a prolonged period. But this study, presented to the Society for Gynecologic Investigations in March, found no correlation between abnormalities in fetal heartbeat and the incidence of cerebral palsy.

The researches undertook the study because the percentage of babies born with cerebral palsy has not gone down since fetal heart monitoring became standard practice. They looked at 40 children born with white-matter brain injuries and compared them with a control group of children born at the same gestational ages, in the same manner, who did not have brain damage. Comparing the fetal heart monitor readouts of these two groups, the researchers found nothing significantly different that would indicate that one group would experience brain damage while the other would not.

Drug Helps Lungs But Harms Childhood Development

A study published in the New England Journal of Medicine claims that the administration of dexamethasone to premature babies with lung abnormalities, although beneficial in preventing chronic lung disease, causes long-term brain damage. The study, conducted by a researcher at China Medical University, in Taiwan, followed 146 children who were born prematurely and were given the drug for 4 weeks as infants. Of those children, 28% of those who took a placebo developed chronic lung disease, while only 15% of those who were given dexamethasone did. Those who took the drug, however, were by 8 years of age shorter in stature than those who did not take it, and their motor skills and IQ scores were less favorable.

CPR Administrators May Cause More Harm Than Good

In April, the medical journal Circulation published the results of a study conducted by Dr. Tom P. Aufderheide of the Medical College of Wisconsin that claims that some emergency medical technicians (EMTs) are harming patients by giving them cardiopulmonary resuscitation (CPR) incorrectly. The American Heart Association recommends that those receiving CPR be given 10 to 12 breaths of air per minute, but the EMTs the researchers observed in the Milwaukee area tended to give more than three times that many breaths to heart attack victims. Even after retraining, the EMTs continued to give heart attack victims about twice as many breaths as recommended. All the patients observed before and after the retraining died. The cause for some of these deaths may be that the victims have too much air in their chest cavities. This excess air may exert enough pressure to keep blood from flowing properly back into the heart.

Strong Link Found Between Periodontal Disease and Pre-Term Birth

As many as 30% of women harbor bacteria associated with periodontal disease in their bloodstreams, and these bacteria may be a cause of pre-term births, according to researchers at Case Western Reserve University School of Dental Medicine. The researchers, led by microbiologist Yiping Han, studied mice that had been infected with the common periodontal bacteria Fusobacterium nucleatum. The bacteria targeted the placentas and amniotic fluid of the mother mice, triggering pre-term births. In addition, live-born mice of the infected mothers were more likely to die soon after birth than the offspring of uninfected mice. A companion study involving injecting mice with live bacteria taken from the placentas and amniotic fluid of human mothers who had experienced pre-term births resulted in those mice exhibiting a high incidence of pre-term births.

Legislation Remains in Senate

Republican Senator Bill Frist of Tennessee has vowed to continue pushing federal legislation aimed at limiting medical malpractice pain-and-suffering damages against obstetricians and emergency-room personnel. But, in the third vote in the past year on such a bill, the measure failed to gain the 60 votes needed to overcome the threat of a Democrat-led filibuster. The White House is in favor of the reforms, but Democrats argue that Republicans are merely pandering to their constituents, the medical and insurance lobbies. The Foundation for Taxpayer and Consumer Rights, which opposes the proposed reforms, has made a complaint to the Senate Ethics Committee charging Senator Frist with promoting his and his family's own financial interests. Senator Frist is a heart surgeon, and his family founded the H.C.A. Hospital chain and its malpractice insurer, Health Care Indemnity.

Fetal Heart Monitoring Does Not Prevent Cerebral Palsy

A study conducted by Johns Hopkins researchers finds that fetal heart monitoring does not help identify babies who are likely to be born with cerebral palsy. Doctors attempt to identify babies in danger of brain damage during the birth process by reviewing their heart monitor charts. If the fetal heart rate is abnormal, one theory for the cause is that an inadequate supply of oxygen is getting to the fetus' brain. Thus, birth by caesarian section is often ordered so that the baby will not sustain white matter brain damage due to a lack of oxygen over a prolonged period. But this study, presented to the Society for Gynecologic Investigations in March, found no correlation between abnormalities in fetal heartbeat and the incidence of cerebral palsy.

The researches undertook the study because the percentage of babies born with cerebral palsy has not gone down since fetal heart monitoring became standard practice. They looked at 40 children born with white-matter brain injuries and compared them with a control group of children born at the same gestational ages, in the same manner, who did not have brain damage. Comparing the fetal heart monitor readouts of these two groups, the researchers found nothing significantly different that would indicate that one group would experience brain damage while the other would not.

Drug Helps Lungs But Harms Childhood Development

A study published in the New England Journal of Medicine claims that the administration of dexamethasone to premature babies with lung abnormalities, although beneficial in preventing chronic lung disease, causes long-term brain damage. The study, conducted by a researcher at China Medical University, in Taiwan, followed 146 children who were born prematurely and were given the drug for 4 weeks as infants. Of those children, 28% of those who took a placebo developed chronic lung disease, while only 15% of those who were given dexamethasone did. Those who took the drug, however, were by 8 years of age shorter in stature than those who did not take it, and their motor skills and IQ scores were less favorable.

CPR Administrators May Cause More Harm Than Good

In April, the medical journal Circulation published the results of a study conducted by Dr. Tom P. Aufderheide of the Medical College of Wisconsin that claims that some emergency medical technicians (EMTs) are harming patients by giving them cardiopulmonary resuscitation (CPR) incorrectly. The American Heart Association recommends that those receiving CPR be given 10 to 12 breaths of air per minute, but the EMTs the researchers observed in the Milwaukee area tended to give more than three times that many breaths to heart attack victims. Even after retraining, the EMTs continued to give heart attack victims about twice as many breaths as recommended. All the patients observed before and after the retraining died. The cause for some of these deaths may be that the victims have too much air in their chest cavities. This excess air may exert enough pressure to keep blood from flowing properly back into the heart.

Strong Link Found Between Periodontal Disease and Pre-Term Birth

As many as 30% of women harbor bacteria associated with periodontal disease in their bloodstreams, and these bacteria may be a cause of pre-term births, according to researchers at Case Western Reserve University School of Dental Medicine. The researchers, led by microbiologist Yiping Han, studied mice that had been infected with the common periodontal bacteria Fusobacterium nucleatum. The bacteria targeted the placentas and amniotic fluid of the mother mice, triggering pre-term births. In addition, live-born mice of the infected mothers were more likely to die soon after birth than the offspring of uninfected mice. A companion study involving injecting mice with live bacteria taken from the placentas and amniotic fluid of human mothers who had experienced pre-term births resulted in those mice exhibiting a high incidence of pre-term births.