[Antepartum brain injuries]

It is generally accepted that congenital brain lesions and especially cerebral paralysis are produced nearly always during the process of delivery. The origin can be hypoxia or obstetrical trauma. This has been true until the 70s, but from that period onwards, the incidence due to the delivery process has been reduced so dramatically, that its appearance can be considered as an accident, as in the umbilical cord prolapsus or during abruptio placentae. More than 80% of the cerebral paralysis occur before delivery due to a variety of causes that are detailed in this report and only the resting 20% can be related to foetal asphyxia, only if the following 4 signs appear: 1 Umbilical artery pH lower than 7.2 Apgar test after 5 minutes of 3 or less. 3 Appearance of a neurological hypoxic-isquemical syndrome. 4 Lesions in another organ that can be attributed to hypoxia. This new international definition indicates, the necessity to put aside the old definition still more generally accepted when a fetus is simply depressed but not with asphyxia. In the same way, the actual concept of fetal suffering during delivery needs also to be rejected not necessarily alterations are followed and can be considered as pejorative. Only if the suffering continues with asphyxia can be accepted.