Journal of Isfahan Medical School

Journal of Isfahan Medical School

Investigation of Complaints of Medical Malpractice Related to Cerebral Palsy in the Years before and after Announcement of Ministerial Circular Promoting Vaginal Childbirth Referred to the Tehran Medical Commission, Iran

Document Type : Original Article (s)

Authors
Seyed Amirhossein Mahdavi 1
Abdolrazagh Barzegar 1
Zahra Shabannejadkhas 2
Asieh Jafari 2
Khadijeh Azimi 3
1 Assistant Professor, Legal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, Iran
2 Forensic Specialist, Legal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, Iran
3 Department of MPH, School of Health, Iran University of Medical Sciences, Tehran, Iran
10.22122/jims.v39i628.13925
Abstract
Background: Cerebral palsy is one of the common causes of complaints in obstetrics field. It is assumed that after the announcement and implementation of ministerial circular promoting vaginal childbirth in 2014, complaints related to neonatal brain damage and cerebral palsy due to hypoxic ischemic injuries during labor and delivery have increased. So in this study, this claim was investigated by comparing the complaints before and after this time.Methods: This was a cross-sectional study on 117 complaints on cerebral palsy selected by census in the Tehran Medical Commission, Iran, from 2011 to 2017. Data were extracted from the files using a data registry form, and analyzed using SPSS software.Results: Out of 117 complaints related to cerebral palsy, 64 cases (54.7%) were born before announcement of circular and 53 (45.3%) after it. Out of 64 cases born before it, 33 cases complained before and the rest (31cases) after its announcement; so all the complaints after its announcement reached to 84 while number of cases born in this period were just 53. There was statistically significant difference between the time of birth and the time of complaints (P < 0.001).Conclusion: Despite the increase in the number of complaints on cerebral palsy in recent years, the majority of these cases are related to those born in the years before the announcement. So announcement of this circular has not caused excess in complaints on cerebral palsy during this period of time.
Keywords
Malpractice
Parturition
Cerebral palsy
Brain hypoxia-ischemia
  1. Hermansen MC, Hermansen MG. Perinatal infections and cerebral palsy. Clin Perinatol 2006; 33(2): 315-33.
  2. Miller F, Bachrach SJ. Cerebral palsy: A complete guide for caregiving. Baltimore, MD: Johns Hopkins University Press; 2017.
  3. Blair E, Cans C, Sellier E. Epidemiology of the cerebral palsies. In: Panteliadis CP, editor. Cerebral palsy: A multidisciplinary approach. Cham, Switzerland: Springer International Publishing; 2018. p. 19-28.
  4. Sajedi F, Soleiman F, Ahmadi MA. Cerebral palsy in children. Journal of Health and Care 2013; 15(4): 88-97. [In Persian].
  5. MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: Causes, pathways, and the role of genetic variants. Am J Obstet Gynecol 2015; 213(6): 779-88.
  6. Soleimani F, Vameghi R, Biglarian A. Antenatal and intrapartum risk factors for cerebral palsy in term and near-term newborns. Arch Iran Med 2013; 16(4): 213-6.
  7. Buttigieg GG, Mihaylova AA, Uchikova EH. A 50 year old myth: The relationship of intra-partum cardio-tocographic monitoring to cerebral palsy at clinical and medico-legal level. Knowledge International Journal 2019; 32(2): 221-9.
  8. Johnson SL, Blair E, Stanley FJ. Obstetric malpractice litigation and cerebral palsy in term infants. J Forensic Leg Med 2011; 18(3): 97-100.
  9. Zhou L, Li H, Li C, Li G. Risk management and provider liabilities in infantile cerebral palsy based on malpractice litigation cases. J Forensic Leg Med 2019; 61: 82-8.
  10. Taghizadeh Z, Pourbakhtiar M, Azimi K, Ghadipasha M, Soltani K. Claims about medical malpractices resulting in neonatal and maternal impairment in Iran. J Forensic Leg Med 2019; 66: 44-9.
  11. Babaei F, Aghajani M, Estambolichi L, Joshari M, Mazaheri Z, Kykhosravi F, Maher A. Study of the promotion of normal delivery program in government hospitals in line with the health transformation plan and its achievements. Hakim Res J 2017; 20, 44-53. [In Persian].
  12. Maleki M, Mousavizadeh A, Parhizkar S, Shamsi M. Promotion of normal vaginal delivery among Primigravidae: An application of social marketing in the field of health. J Sch Public Health Inst Public Health Res 2017; 15(2): 110-20. [In Persian].
  13. Bjellmo S, Andersen GL, Martinussen MP, Romundstad PR, Hjelle S, Moster D, et al. Is vaginal breech delivery associated with higher risk for perinatal death and cerebral palsy compared with vaginal cephalic birth? Registry-based cohort study in Norway. BMJ Open 2017; 7(4): e014979.
  14. Surveillance of Cerebral Palsy in Europe (SCPE). Scientific report 1998-2018. SCPE; 2019.
  15. Sadeghnia A, Mohammadpoor S. The investigation of rate of birth asphyxia and its relationship with delivery mode at Shahid Beheshti Hospital of Isfahan during 2013, 2014, and 2015. Int J Prev Med 2019; 10: 23.
  16. Glaser LM, Alvi FA, Milad MP. Trends in malpractice claims for obstetric and gynecologic procedures, 2005 through 2014. Am J Obstet Gynecol 2017; 217(3): 340.
  17. Hwang CY, Wu CH, Cheng FC, Yen YL, Wu KH. A 12-year analysis of closed medical malpractice claims of the Taiwan civil court: A retrospective study. Medicine (Baltimore) 2018; 97(13): e0237.
  18. Sartwelle TP, Johnston JC. Cerebral palsy litigation: Change course or abandon ship. J Child Neurol 2015; 30(7): 828-41.
  19. Boog G. Cerebral palsy and perinatal asphyxia (II--Medicolegal implications and prevention). Gynecol Obstet Fertil 2011; 39(3): 146-73. [In French].

  • Receive Date 22 February 2021
  • Accept Date 06 April 2022