Cerebral Palsy: Perspective and Clinical Relation to Perinatal Complications/Events in Japan

Foreword
Foreword
Preface
Contents
Part I: Perspective
History and Definitions
1 History of Cerebral Palsy
2 Recent Epidemiological Research in Cerebral Palsy
3 Definition
4 Classification of Cerebral Palsy
5 Fetal Heart Rate Monitoring and Neonatal Encephalopathy
References
Epidemiology of the Cerebral Palsy
1 Definition of Cerebral Palsy
2 Incidence of Cerebral Palsy
3 Cerebral Palsy “Causes” and “Risk Factors”
4 Causative Diseases of CP from the Perspective of the Report on Prevention of Recurrence, the Japan Obstetric Compensation System for Cerebral Palsy
References
Current Status of the Japan Obstetric Compensation System for Cerebral Palsy
1 Current Status and Challenges of the Japan Obstetric Compensation System for Cerebral Palsy
1.1 Background to Launch the System
1.1.1 Perinatal Care and Conflict
1.1.2 Discussion on the Establishment of a No-Fault Compensation System
2 Review and Compensation
2.1 Investigation
2.1.1 Production of Investigative Report
2.1.2 The Relationship Between the Disclosure of the “Summarized Edition” of the Investigative Report and the Latest Revision of the Personal Information Protection Law and Relevant Administrative Guidelines
2.2 Prevention of Cerebral Palsy
2.2.1 Publication of Annual Prevention Reports, Educational Materials on Fetal Heart Rate Monitoring, and Leaflets for Professionals and Expectant Mothers
2.2.2 Activities of the Prevention Working Group
2.3 Impact on Conflict Mitigation
2.4 Review of the System
2.4.1 Review Timetable Agreed at the Inception of the System
2.4.2 Review in 2015
2.4.3 2020–2021 Review for Further Expansion
References
Clinical Diagnosis of Cerebral Palsy
1 Diagnosis of Cerebral Palsy
2 Symptoms and Findings That Raise Suspicion of Cerebral Palsy During a Health Examination
2.1 One Month [1]
2.2 Four-Month Health Examination [1]
2.3 Six to Seven-Month Examination [2]
2.4 Nine to Ten-Month Examination [1]
2.5 One-Year-Old Health Examination [2]
2.6 One Year and 6-Month Examination [3]
3 Type of Cerebral Palsy
3.1 Classification by Site of Injury
3.2 Classification According to the Type of Abnormal Muscle Tone [4]
4 Severity of Cerebral Palsy [5]
5 Diagnosis of Cerebral Palsy Due to Hypoxic-Ischemic Encephalopathy
References
Imaging Findings of Perinatal Brain Injury that May Cause Cerebral Palsy
1 Subependymal Hemorrhage and Intraventricular Hemorrhage
2 Hypoxic-Ischemic Encephalopathy (HIE)
2.1 Mild to Moderate Hypoxic Ischemic Injury (Partial Asphyxia) in Premature Infants
2.2 Mild to Moderate Hypoxic Ischemic Injury (Prolonged Partial Asphyxia) in Term Infants
2.3 Profound Hypoxic Ischemic Injury (Profound Asphyxia)
2.4 DWI and MRS
References
Part II: Relations of Perinatal Complications/Events to CP
Chromosomal Abnormality
1 Overview of Chromosome Aberrations
1.1 What Are Chromosomes, Genomes, Genes, Exons, and Introns [1, 2]?
1.2 Genetic Diseases and Chromosomal Abnormalities [1, 2]
1.2.1 Genetic Disease
1.2.2 Chromosomal Abnormalities [Aberrations]
1.3 Findings and Symptoms of Chromosomal Abnormalities and Related Information
1.4 Methods for Detecting Chromosomal Abnormalities [2, 3]
1.4.1 Chromosomal Banding (Particularly, G-Banding)
1.4.2 FISH (Fluorescence In Situ Hybridization)
1.4.3 Microarray Chromosome Analysis (Chromosomal Microarray; CMA)
Array CGH (Array Comparative Genomic Hybridization; aCGH)
SNP (Single Nucleotide Polymorphism) Array
1.4.4 Analysis Using Next-Generation Sequencers (NGS)
2 Possible Associations Between Genetic Factors, Including Chromosomal Abnormalities, and Cerebral Palsy
2.1 Study Results That Indicate Involvement of Genetic Factors in the Cause of Cerebral Palsy
2.1.1 Indirect Evidence from Epidemiological Studies and Other Sources [4–6]
2.1.2 Evidence from Genetic Analysis
2.2 Mechanism of Cerebral Palsy Due to Genetic Factors
3 Chromosomal Abnormalities as a Possible Cause of Cerebral Palsy: Current Status and Future Projections
3.1 Report of Cerebral Palsy Due to Chromosome Aberration (Japan)
3.2 Toward Personalized Medicine in the Treatment of Cerebral Palsy
References
Congenital Anomalies Mainly in the Central Nervous System
1 Association with Cerebral Palsy
2 Ventriculomegaly
3 Microcephaly
4 Holoprosencephaly
5 Lissencephaly
6 Schizencephaly
7 Porencephaly
8 Hydranencephaly
References
Cytomegalovirus Infection, Toxoplasmosis
1 Diagnosis and Problems
1.1 Problems with the IgM Antibody Test
1.2 Problems with IgG Avidity Assay
2 Relationship with Cerebral Palsy (Pathophysiology) and Current Status
2.1 Congenital CMV Infection
2.2 Congenital Toxoplasmosis
3 Toward Prevention
3.1 Congenital CMV Infection
3.2 Congenital Toxoplasmosis
References
Herpes Infection
1 Overview of the Underlying Disease (Perinatal Complications)
2 Pathophysiology Associated with Cerebral Palsy
3 Current Status of Underlying Diseases in Cerebral Palsy
4 Toward Prevention
References
Multiple Pregnancy
1 Perinatal Complications in Twins
1.1 Conditions of MCDA Twins Associated with Cerebral Palsy
2 Twin-Twin Transfusion Syndrome
3 Intrauterine Fetal Demise in MCDA Twin
4 Selective Intrauterine Growth Restriction
5 Twin Anemia Polycythemia Sequence/Acute Feto-Fetal Hemorrhage
6 Role of Anastomotic Vessels in MCDA Twins
7 Cerebral Palsy Development Due to Blood Flow Imbalance of Monochorionic Twins in Japan
8 Toward Prevention of Cerebral Palsy
References
Hypertensive Disorders of Pregnancy
1 Overview of Hypertensive Disorder of Pregnancy
2 Current Status of Hypertensive Disorders of Pregnancy in Cerebral Palsy Cases
2.1 Therapeutic Preterm Birth
3 Fetal Growth Restriction and Uteroplacental Dysfunctions
4 Toward Prevention
5 Conclusion
References
Threatened Premature Labor\Premature Rupture of the Membrane
1 Imminent Premature Birth
2 Preterm Premature Rupture of the Membranes (pPROM)
3 Pathophysiology Associated with Cerebral Palsy (CP)
3.1 Intraventricular Hemorrhage (IVH)
3.2 White Matter Disorder, Periventricular Leukomalacia
4 Current Status of Underlying Diseases in Cerebral Palsy
5 Toward Prevention
References
Fetal Growth Restriction/Small for Dates
1 Overview of Fetal Growth Failure/SFD
2 Risk Factors for FGR
3 Pathophysiology Associated with CP
4 FGR/SFD in CP in Recent Reports
5 Toward the Prevention of CP
References
Cases Probably Considered as Intrauterine Onset
1 Overview and Pathophysiology of In Utero-Onset CP
2 Current Status of Prenatal Onset CP
3 Toward Prevention
References
Reduced Fetal Movement
1 Actual Fetal Movement
2 Difficulties in Observing Fetal Movement
3 Fetal Movement Evaluation Method
4 Evidence on Fetal Movement Counting
4.1 Cochrane Systematic Review [1]
4.1.1 Method
4.1.2 Results
Fetal Movement Count Group vs. Usual Obstetric Care Group
Once-Daily Fetal Movement Count Group vs. After-Meal Fetal Movement Count Group
Fetal Count Group vs. Human Placental Lactogen Measurement Group
4.2 A Systematic Review by Bellussi et al. [13]
4.2.1 Method
4.2.2 Results (Table 1)
5 Findings on Reduced Fetal Movement Identified Through the Japan Obstetric Compensation System for Cerebral Palsy [17]
6 Recent Research Findings Related to Fetal Movement
6.1 Association Between Reduced Fetal Movement and Long-Term Prognosis of the Child [18]
6.1.1 Objective
6.1.2 Method
Study Group (Reduced Fetal Movement Group)
Comparison Group
6.1.3 Results
6.2 Association Between Fetal Movement Changes and Stillbirth [19]
6.2.1 Objective
6.2.2 Method
Study Group (Stillbirth Group)
Comparison Group
6.2.3 Results
6.3 Reduced Fetal Movement Cases and Placental Findings [20]
6.3.1 Objective
6.3.2 Method
Study Group (Reduced Fetal Movement Group)
Comparison Group
6.3.3 Results
6.4 Effect of Reduced Fetal Movement on Induction of Labor [21]
6.4.1 Objective
6.4.2 Method
Study Group (Reduced Fetal Movement Group)
Comparison Group
6.4.3 Results
6.5 Characteristics of Fetal Movement in Obese Pregnant Women [22]
6.5.1 Objective
6.5.2 Method
Study Group (Obese Group)
Comparison Group
6.5.3 Results
References
Placental Abruption
1 Definition and Pathogenesis of Placental Abruption (PA)
1.1 Definition
1.2 Clinical Progress
2 Symptoms of Placental Abruption (PA) Associated with Cerebral Palsy (CP)
2.1 Relation to Cerebral Palsy (CP)
2.2 Brain MRI Findings of the Neonates Associated with Cerebral Palsy (CP)
2.3 Clinical Manifestations Associated with Cerebral Palsy (CP)
3 Diagnosis of Placental Abruption (PA)
3.1 Clinical Findings
3.2 Ultrasound Examination
3.3 Fetal Heart Rate Monitoring
3.4 Case Report of Placental Abruption (PA)
4 Treatment and Prevention of Placental Abruption (PA)
4.1 What to Do at Diagnosis
4.2 Risk Factors and Prevention
References
Intrauterine Infection/Chorioamnionitis
1 Diagnosis and Problems of Intrauterine Infection/Chorioamnionitis
1.1 Inflammatory Reaction
1.1.1 Findings Indicative of Chronic (Subacute) Inflammation
1.2 Clinical Chorioamnionitis (cCAM)
1.3 Introduction of Triple I
2 Association with Cerebral Palsy
2.1 Current Situation in Japan
2.2 A Systematic Review
2.2.1 Relationship Between cCAM/hCAM and CP
2.2.2 Association of CP with Maternal Infections Other Than CAM
2.2.3 Report by Freud et al.
2.2.4 Report by Shevell et al.
2.3 Pathophysiology
3 Toward Prevention
References
Fetomaternal Hemorrhage
1 Overview
2 Causes and Risk Factors
3 Symptoms
4 Diagnostic Tests
4.1 Hemoglobin F (HbF)
4.2 Alpha-Fetoprotein
4.3 Fetal Middle Cerebral Artery Peak Systolic Velocity (MCA-PSV)
5 Management
5.1 Intrauterine Transfusion
5.1.1 Complications of Fetal Blood Transfusion Procedures
5.2 Delivery or Fetal Transfusion?
6 Cerebral Palsy and Related Conditions
7 Prevention of Cerebral Palsy
References
Cases Associate with Umbilical Cord
1 Problems with Umbilical Cord Problems
2 Pathophysiology of Various Umbilical Cord Problems
2.1 Umbilical Cord Prolapse
2.2 Umbilical Cord Anomaly as a Developmental Abnormality
2.2.1 Abnormality of the Umbilical Cord Attachment on the Placenta
2.2.2 Abnormalities of the Umbilical Cord Coiling (Hyper-coiled Cord and Hypo-coiled Cord)
3 Current Status of Cerebral Palsy Occurrence due to Umbilical Cord Problems
4 The Prevention of CP due to Umbilical Cord Abnormalities
4.1 Limitations of CTG Management
4.2 Perinatal Management for Pregnant Women Using Ultrasound and CTG
4.3 Avoidance of Umbilical Cord Prolapse During Delivery
4.4 Appropriate Response to Umbilical Cord Prolapse
References
Intrapartum Hypoxia
1 An Overview of Parturient Hypoxia
2 Pathophysiology Associated with Cerebral Palsy
3 Conditions That Can Cause Fetal Hypoxia During Delivery
3.1 Umbilical Cord Compression
3.2 Prolapse of the Umbilical Cord and Forelying of the Umbilical Cord
3.3 Hypertonic Contractions
3.4 Uterine Rupture
3.5 Placental Abruption
3.6 Maternal Respiratory and Circulatory Abnormalities (Supine Hypotension Syndrome, Cardiac Arrest)
3.7 Maternal Convulsions (Eclampsia, Epileptic Seizures)
3.8 Epidural and Spinal Anesthesia
4 Toward Prevention
4.1 Prepartum Care
4.2 Response to Delivery (Intrapartum Resuscitation)
4.2.1 Maternal Positioning
4.2.2 Oxygen Administration to the Mother
4.2.3 Emergency Uterine Relaxation
4.2.4 Rapid Infusion
4.2.5 Transvaginal Elevation of the Advanced Fetal Portion
4.2.6 Handling the Neonatal Period
4.3 CTG Patterns Directly Related to Cerebral Palsy
References
Uterotonic Agents
1 Types of Uterine Contractions and How to Use Them
2 Involvement of Bishop Score
3 Indications for Induction of Labor/Augmentation of Labor
4 Uterotonic Agents Used in Japan
4.1 Oxytocin
4.1.1 Pharmacological Action
4.1.2 Instructions for Use (Monitoring Uterine Contraction and Fetal Heart Rate)
4.1.3 Regarding Dosage and Administration (Low-Dose Method) [16]
4.1.4 Side Effect
4.1.5 Contraindications and Cautious Administration [16]
4.2 PGE2
4.2.1 How to Use
4.2.2 Dosage and Administration
4.2.3 Side Effects
4.2.4 Contraindications and Cautious Administration [16]
5 Association with Cerebral Palsy
6 Pathophysiology
7 Toward Prevention
References
Assisted Vaginal Delivery (Including Kristeller Maneuver)
1 Assisted Vaginal Delivery and Cerebral palsy
2 Summary of Assisted Vaginal Delivery
2.1 Causes of Cerebral Palsy in the Cause Analysis Report
2.2 Medical Assessment in the Cause Analysis Report
2.3 Author’s Discussion
3 Method of Assisted Vaginal Delivery
3.1 Causes of Cerebral Palsy in the Cause Analysis Report
3.2 Medical Assessment in the Cause Analysis Report
3.3 Author’s Discussion
4 Shoulder Dystocia After Assisted Vaginal Delivery
4.1 Causes of Cerebral Palsy in the Cause Analysis Report
4.2 Medical Evaluation in the Cause Analysis Report
4.3 Author’s Discussion
5 Neonatal Complications of Assisted Vaginal Delivery, Importance of Documentation
5.1 Causes of Cerebral Palsy in the Cause Analysis Report
5.2 Medical Evaluation in the Cause Analysis Report
5.3 Author’s Discussion
References
Prolonged Labor
1 Overview of Prolonged Labor/Arrest of Labor
1.1 Definition
1.2 Causes of Prolonged Labor
1.3 Management of Prolonged Labor
1.4 The Prolonged Labor Prognosis
1.5 Association with Cerebral Palsy
2 Case Control Study
3 Current Situation in Japan/Report from the Recurrence Prevention Committee (Toward the Prevention of Recurrence)
References
Maternal Respiratory and Circulatory Failure
1 Overview of Respiratory and Circulatory Failure
2 Chronic Reduction of Circulation and Its Relation to Fetal Growth
3 Acute Respiratory and Circulatory Failure and Cerebral Palsy
4 Amniotic Fluid Embolism and Cerebral Palsy
5 GAS Infection and Cerebral Palsy
6 Total Spinal Subarachnoid Anesthesia and Cerebral Palsy
7 If the Mother Has Acute Respiratory and Circulatory Failure
References
GBS Infection
1 Neonates and Group B Streptococcal Infections
2 Neonatal Meningitis and the Pathogenesis of Brain Damage
3 A Case in Which the Main Cause of Cerebral Palsy Was Considered to Be Group B Streptococcal Infection [4]
4 Early-Onset Group B Streptococcal Infection
5 CQ603 How Can We Prevent Early-Onset Group B Streptococcus (GBS) Infection in Full-Term Neonates?
5.1 Answer
6 Delayed-Onset Group B Streptococcal Infection
7 Future Challenges in Delayed-Onset Group B Streptococcal Infections
8 Prevention: Delayed-Onset Group B Streptococcal Infection
References
Birth Asphyxia
1 Underlying Disease (Concept of Perinatal Complications)
2 Pathophysiology Associated with Cerebral Palsy
3 Current Status of Underlying Diseases in Cerebral Palsy
4 Towards Prevention
4.1 Delivery Management
4.2 Neonatal Resuscitation
References
Prematurity
1 Prematurity as a Risk Factor for Cerebral Palsy
2 Report on Prematurity and Cerebral Palsy
3 Type of Cerebral Palsy
4 Pathogenesis of Prematurity
4.1 Immaturity of the Central Nervous System
4.2 Immaturity of Respiration
4.3 Immaturity of Circulatory Dynamics
4.4 Immaturity of the Gastrointestinal Tract and Liver Function
4.5 Other Causes
5 Prevention
References
Intraventricular Hemorrhage, Periventricular Leukomalacia
1 Intracranial Hemorrhage/Intraventricular Hemorrhage
1.1 Pathophysiology
1.2 Prognosis and Prevention
2 Periventricular Leukomalacia
2.1 Pathophysiology
2.2 Prognosis and Prevention
3 Intraventricular Hemorrhage, Periventricular Leukomalacia, and Cerebral Palsy
References
Neonatal Stroke
1 Overview of Neonatal Stroke
1.1 Definition
1.2 Classification
1.3 Etiology
1.4 Factors of the Development of Neonatal Stroke
1.5 Clinical Characteristics
1.6 Treatment and Management
2 Pathophysiology Associated with Cerebral Palsy
3 Current Status of Neonatal Stroke in CP
4 Prevention and the Reduction of Incidence in Neonatal Stroke
References
Neonatal Hypoglycemia
1 What Is Neonatal Hypoglycemia?
2 Risk Factors for Neonatal Hypoglycemia
3 The Mechanism of Neonatal Hypoglycemia Causing Neurological Disorders
4 The Association Between Neonatal Hypoglycemia and Cerebral Palsy
References
Bilirubin Encephalopathy
1 Medical Examination
2 Symptoms
3 Pathophysiology Associated with Cerebral Palsy
4 Current Status in Cerebral Palsy
5 Toward Prevention
References
Apparent Life-Threatening Event (ALTE)
1 Concept
2 Sudden Infant Death Syndrome
3 SUPC (Sudden Unexpected Postnatal Collapse)
4 Epidemiology of ALTE/SUPC
5 Causes and Prognosis of ALTE/SUPC
6 Reducing the Risk of Sudden Unexpected Neonatal Change
References
Part III: Prevention
Neonatal Hypothermia
1 What Is Neonatal TH?
2 Basics of Neonatal TH
3 Indication Criteria for Neonatal TH (Table 1)
4 Neonatal TH in Practice
5 Short-Term Outcomes of Neonatal TH
6 Long-Term Outcomes of Neonatal TH
7 Neonatal TH for HIE in Preterm Infants
8 Expanded Options for Neonatal TH
References
Recent Findings on the Perinatal Brain Protective Effects of Magnesium
1 Current Status of the Neuroprotective Effect of Magnesium on the Brain
2 Methods of Administration of Magnesium for Cerebral Neuroprotective Purposes
3 Mechanism of Neuroprotective Effect of Magnesium on the Brain
4 A Multicenter, Retrospective Study from Japan
References
Mechanism and Current Status of Umbilical Cord Blood Stem Cell Transplantation
1 Umbilical Cord Blood Stem Cells and Regenerative Medicine (Fig. 1)
2 Treatment of Hypoxic-Ischemic Encephalopathy with UC-BSCs
3 Treatment Mechanism of UC-BSCs
4 From Prevention to Treatment of Cerebral Palsy
References