A recent study identified several specific conditions during pregnancy that appear to increase a baby’s chances of suffering hypoxic-ischemic encephalopathy (HIE) which is a very serious type of childbirth brain injury. This research helps advance our understanding of HIE’s causes, which will allow improvements in prevention and treatment. This is what we have to work towards — getting the science and the medicine better so we have less oxygen-deprived children during the birthing process.
What is hypoxic-ischemic encephalopathy?
Hypoxic-ischemic encephalopathy (HIE), is a type of brain injury resulting from a lack of oxygen and blood flow to the baby’s brain. It can lead to seizures, difficulty feeding, low muscle tone, organ dysfunction, and breathing difficulties. HIE may result in long-term neurologic disabilities such as cerebral palsy, intraventricular hemorrhages, and learning disabilities.
What risk factors did the new study link to HIE?
There are many additional pregnancy conditions or issues that are already known to be associated with HIE. All of them involve some type of disruption of the delivery of oxygen to the fetus. They include, but not are limited to
- Nuchal cord: a nuchal cord occurs when the umbilical cord wraps around in a knot or a loop around a baby’s neck. When this occurs the cord can become obstructed, which limits the amount of oxygen-rich blood that flows from the mother to the baby. In some cases, it can get wound so tightly that it affects the blood vessels on the neck, which deprives the baby’s brain of oxygen.
- Umbilical cord prolapse: umbilical cord prolapse occurs when the umbilical cord drops down into the cervix/birth canal with or before the baby. The prolapsed cord becomes trapped and squeezed between the baby and the mother’s pelvis. The pressure put on the cord may slow or completely stop the flow of blood to the baby. Cord prolapses are obstetrical emergencies that necessitate immediately delivery, usually via C-section.
- Preeclampsia: this condition can increase a baby’s risk of developing HIE. It occurs when a pregnant woman experiences acute high blood pressure towards the latter stages of pregnancy. This can result in decreased blood flow to her baby because of damage or constriction to the placental vessels.
- Prolonged pregnancy: A post-term pregnancy, also known as a prolonged pregnancy, can result in HIE. They are pregnancies with a gestation period beyond 40 weeks, the standard gestation period. When the gestation period goes beyond 40 weeks, the placenta deteriorates and the amount of amniotic fluid is reduced. Post-term pregnancies run the risk of the baby becoming too large. This may result in a difficult delivery that increases the HIE risk.
- Chorioamnionitis: Chorioamnionitis is an infection that inflames placenta and fetal membranes. This can lead to premature rupturing of the amniotic sac and chorionic, which is supposed to happen during birth. Known as the prelabor, or premature, rupture of the membranes (PROM), it can affect lung development. Underdeveloped lungs may result in oxygen deprivation and HIE.
- Meconium aspiration syndrome: Meconium aspiration syndrome (MAS) occurs when a newborn baby experiences breathing complications. Meconium is a combination of amniotic fluid and a newborn’s fecal matter. Around childbirth, babies may inhale this material. This can lead to respiratory problems that can deprive the baby of oxygen and HIE.
- Fetal Macrosomia: Macrosomia occurs when the baby is too large to pass through the mother’s pelvis. Labor can be prolonged, which can be dangerous because the more contractions the baby has to withstand, oxygen flow becomes limited. Doctors may have to result to forceps or vacuum extractors to pull out the baby. However, these tools may lead to head trauma, hemorrhages, and HIE.
- Cephalopelvic disproportion: Cephalopelvic disproportion (CPD) happens when the baby’s head is too large. It can lead to similar complications as macrosomia, such as prolonged labor.
- Placental abruption: Placental abruption happens when the placenta separates from the uterus’ inner wall during pregnancy. It may also completely or partially cut off blood supply from the placenta and the umbilical cord. This can cause internal bleeding for the mother and oxygen deprivation to the baby.
- Uterine rupture: A uterine rupture occurs when there is an open tear in the uterus. This could lead to the unborn baby being expelled into their mother’s abdomen. This usually happens to a mother who has previously undergone uterine surgery or a C-section birth. A torn uterus can also cause significant blood loss that result in oxygen deprivation in the baby. The uterine rupture can also result in both the placenta and umbilical cord become cut from circulation. Having a vaginal birth after C-section (VBAC) increases a mother’s risk of having her uterus tear open.
- Delayed C-section: emergency C-sections occur as a response to a risky childbirth. They should usually take about 5 to 30 minutes. Any longer than 30 increases the birth injury risk. Sometimes, doctors not properly trained to handle an emergency C-section or do not properly recognize fetal distress signs.
Contact Miller & Zois About HIE and Birth Injuries
HIE and other birth injuries involving oxygen deprivation are frequently related to negligent medical care during labor and delivery. Contact the birth injury lawyers at Miller & Zois to find out if you have a malpractice case for your child’s brain injury. Call us at 800-553-8082 or contact us online.