The fetal inflammatory response syndrome and cerebral palsy: yet another challenge and dilemma for the obstetrician.

There is increasing evidence demonstrating a relationship between intrauterine infection and the development of neonatal intraventricular haemorrhage and periventricular leukomalacia with the subsequent occurrence of cerebral palsy, which is thought to be mediated through the generation of pro-inflammatory cytokines by the fetus. In the light of this relationship, a review of the current management of intrapartum infection and the associated complications of intrauterine infection such as preterm labour and preterm premature rupture of the membranes would seem timely along with the development of potential strategies which might prevent or ameliorate the effects of the fetal inflammatory response syndrome. The suggested changes in the understanding and management of the fetal inflammatory response syndrome provide a challenge and pose a dilemma for the practising obstetrician.