Call for action on cerebral palsy litigation

Monday, 22 May 2006

South Australia should be taking the lead in "saving" Australian maternity services and preventing costly litigation over cerebral palsy. This will be the message from the University of Adelaide's Professor Alastair MacLennan when he delivers the annual Healthy Development Adelaide Oration this Thursday, 25 May.

Professor MacLennan will tell the assembled researchers and representatives from government, industry and the health services that obstetric litigation is discouraging practice in midwifery and obstetric services.

"The main costs and injustice of litigation centre on cerebral palsy, which occurs in one in 500 babies and is not preventable," says Professor MacLennan. "Indeed, this rate has not changed in 50 years, despite many more caesareans, electronic fetal monitoring and better obstetric and neonatal care."

Professor MacLennan is Professor in Obstetrics and Gynaecology at the University of Adelaide and is an international expert on the menopause with a special interest in cerebral palsy. He is Director of the South Australian Cerebral Palsy Research Group and is actively involved in promoting professional and legislative changes in cerebral palsy litigation around the world.

On Thursday at the Oration, University of Adelaide Vice-Chancellor, Professor James McWha, will present Professor MacLennan with the Healthy Development Adelaide Award in recognition of his internationally acclaimed research in this area.

Professor McWha said: "Professor MacLennan has an outstanding reputation for his research on the menopause and feto-maternal medicine, especially the causation of cerebral palsy. His contribution to knowledge in this field is significant, as is his research leadership."

Professor MacLennan says: "In most cases of cerebral palsy a major pregnancy risk factor can be identified if appropriate data is collected and retained. These factors include prematurity, intrauterine infection, growth restriction, antepartum haemorrhage, congenital brain anomalies, fever during labour and complications in a multiple pregnancy. Hypoxia (asphyxia) beginning during labour - around which most litigation is centred - is a rare cause of cerebral palsy."

New research published internationally in 2005 and 2006 from the South Australian Cerebral Palsy Research Group shows that cerebral palsy cases are significantly associated with three new risk factors: certain hereditary thrombophilias (clotting disorders), cytokine polymorphisms (gene mutations in one of the body's main defence mechanisms to infection) and increased exposure during pregnancy to viruses.

"As yet there is no obstetric policy that has been shown to reduce the rate of cerebral palsy," Professor MacLennan says.

"There is an urgent need for cerebral palsy to be removed from the litigation arena if Australian maternity services are to be saved. It is necessary for each state to introduce such legislation and South Australia should take the lead. Such legislation will reduce the huge costs associated with the cerebral palsy litigation process often borne by the State and Federal Governments, will encourage recruitment back into the midwifery and obstetric services and with professional counselling rather than legal advocacy should allow quicker closure about causation and more services for the children and families affected by this disabling congenital disorder."

Healthy Development Adelaide is a University of Adelaide research cluster that aims to promote and facilitate multidisciplinary research advancing an understanding of healthy development and contributing to the physical, psychological and social health of young South Australians.

The general public is invited to the HDA Oration at 5-7pm on Thursday, 25 May, 2006 at the State Library of South Australia, Institute Building Lecture Theatre, corner Kintore Avenue and North Terrace. Please RSVP to Anne Jurisevic on (08) 8222 6878 or email anne.jurisevic@adelaide.edu.au

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