Influence of perinatal asphyxia on neurologic outcome: consequences for family practice accoucheurs.

Inappropriate concern with perinatal asphyxia, based on false notions about causes, may be behind the decision of some family physicians to avoid obstetrics. Asphyxia can cause motor or mental deficits, but only if the insult was severe and prolonged (when there will be evidence of hypoxia in systems other than the CNS). Even abnormal CNS signs do not necessarily reflect clinically important neurologic damage. Intrapartum care has much less impact on neonatal outcome than previously believed, and most bad outcomes have their origins in events occuring long before the onset of labour and outside the detection capabilities of current technology. Nevertheless, family physicians require resuscitation skills because vigorous, effective management of even very hypoxic neonates can improve and normalize outcome.