Cerebral palsy (CP) is a complex neurological disorder primarily caused by brain injury or abnormal brain development before, during, or shortly after birth. One important factor in preventing some cases of CP is timely and accurate fetal monitoring during labor, which helps detect fetal distress, particularly oxygen deprivation (hypoxia), that can lead to brain injury. However, cerebral palsy is not simply caused by ignoring fetal monitoring alarms; rather, it results from a combination of factors including the severity and timing of oxygen deprivation, prematurity, infections, and other complications.
Fetal monitoring, especially electronic fetal monitoring (EFM), is a vital tool used during labor to continuously assess the baby’s heart rate and detect signs of distress such as hypoxia. When fetal monitoring alarms indicate abnormal heart rate patterns or other warning signs, it signals that the baby may not be receiving enough oxygen, which can lead to hypoxic-ischemic encephalopathy (HIE), a brain injury strongly linked to cerebral palsy[1]. Early detection through fetal monitoring allows healthcare providers to intervene promptly, for example by performing an emergency cesarean section, to prevent or reduce brain injury.
Ignoring or misinterpreting fetal monitoring alarms can increase the risk of brain injury and subsequent cerebral palsy. Studies show that inadequate fetal monitoring contributes to approximately 18% of HIE cases and 21% of cerebral palsy-related malpractice claims[1]. Hospitals lacking standardized protocols for interpreting fetal heart rate tracings have significantly higher rates of adverse outcomes and legal settlements. This highlights the critical importance of proper training, dual verification of abnormal readings, and timely clinical response to fetal monitoring alarms.
However, fetal monitoring is not foolproof. It has limitations and risks, including false positives that can lead to unnecessary cesarean deliveries, which have increased by about 15% in recent years partly due to over-reliance on continuous EFM in low-risk pregnancies[1]. Moreover, some cases of cerebral palsy arise from factors unrelated to intrapartum oxygen deprivation, such as prematurity, low birth weight, infections, or genetic conditions[3]. For example, premature infants born before 28 weeks gestation have a much higher risk of CP due to brain immaturity and vulnerability to injury, regardless of fetal monitoring during labor[3].
A key medical indicator linked to cerebral palsy risk is umbilical cord arterial pH at birth, which reflects the baby’s acid-base status and oxygenation. A pH below 7.05 is associated with a significantly increased risk of cerebral palsy, epilepsy, and death[2]. This acidemia indicates that the baby experienced significant oxygen deprivation before or during delivery. Fetal monitoring aims to detect such distress early enough to prevent severe acidemia and brain injury.
In summary, cerebral palsy can be caused by brain injury related to oxygen deprivation during birth, which fetal monitoring is designed to detect and help prevent. Ignoring fetal monitoring alarms or failing to respond appropriately can increase the risk of brain injury and CP, but cerebral palsy is multifactorial and not solely caused by fetal monitoring failures. Proper use of fetal monitoring, combined with skilled clinical judgment and timely intervention, is essential to reduce the incidence of cerebral palsy related to birth asphyxia[1][2][3].
—
**Sources:**
[1] Redy-Med, “Why Fetal Monitors are Vital for Safe Deliveries,” 2024.
[2] America
