Possible Reduction of Cerebral Palsy with Novel Strategies
Infantile cerebral palsy (CP) was constantly 0.2 to 0.25% and did not reduce for 30 years in a 2003 report , particularly the CP incidence was high in low birth weight preterm infants, while the CP reduced after full external fetal heart rate (FHR) monitoring in a general hospital , and pediatric research of whole deliveries in Tottori area  revealed 0.25% of CP incidence (98/40,532 births) in 1960 before introduction of fetal monitoring and significant reduction to 0.06% (29/50,814) in 1980 after wide spread of fetal monitoring.
Recently, there are trends of CP decrease in very low birth weight and preterm birth infants in the reports in 2007 [4,5]. The survival rate was high in the babies born in 22 to 25 weeks, while there were considerable number of CP cases. Since fetal brain damage was studied in the FHR response to fetal movement using actocardiogram [7,8], relations of fetal periventricular echo density (PVE) and neonatal periventricular leucomalacia (PVL) , developmental mechanism of labor contraction , and the gray-level histogram width (GLHW) ultrasonic tissue characterization have been progressed [11-15], some new strategies probably to decrease the CP are proposed in the present report as follows.
The CP developed after intrapartum brain damage will be the incidence of fetal brain damage followed by cerebral palsy is around 1 in 5,000 births, thus, the number of CP will be 200 in 1,000,000 births in a year in Japan. The CP rate caused by preterm births are 0.2%, which is close to CP rate due to intrapartum damage in a year in Japan, thus, preterm delivery should be treated with novel techniques in the future, also.
The cerebral palsy caused by intrapartum fetal brain damage will be cured by timely caesarean delivery decided with novel fetal heart rate monitoring, as well as fetal lung immaturity is detected by noninvasive tissue characterization to contribute neonatal health and disorder treatments.
Journal of Reproductive Health and Contraception