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Hypoxic-Ischemic Encephalopathy & Infant Brain Injuries

Even brief periods of oxygen deprivation can have serious consequences for newborns and their parents. Infants who experience birth asphyxia are at risk of suffering significant brain damage, injuries that can lead to neurological impairments and developmental delays. For some families, legal action may be possible. When a medical professional’s negligence causes harm, families may be eligible to secure financial compensation by filing a medical malpractice lawsuit.

Birth Asphyxia & Brain Damage In Newborn Babies

Nearly 1 in 4 infant deaths are linked to birth asphyxia, according to the medical experts at Medscape. Most of these children are killed by the complications of hypoxic-ischemic encephalopathy, a form of brain damage caused by oxygen deprivation. Those who survive are often left with serious disabilities, including life-long neurological impairments. Cerebral palsy, a neuromuscular disorder and the leading cause of childhood disability, is caused by birth asphyxia in up to 20% of cases.

While brain damage can be caused by mechanical trauma, often inflicted by birth-assistive devices like forceps, most children will sustain brain injuries due to birth asphyxia. In fact, recent research has found that over 75% of all brain disorders in infants are the result of oxygen deprivation experienced during labor or delivery.

For more information from our birth injury lawyers, continue reading. 

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What Is Hypoxic-Ischemic Encephalopathy?

Researchers call these brain injuries, caused by a sudden drop of oxygen during childbirth, hypoxic-ischemic encephalopathy:

  • hypoxia – a decrease in oxygen
  • ischemia – a drop in blood flow reaching the organs
  • encephalopathy – a disease of the brain

Hypoxic-ischemic encephalopathy is the type of brain injury that infants suffer after being deprived of oxygen, damage often compounded by prolonged decreases in blood circulation.

Causes Of Hypoxic-Ischemic Encephalopathy

Children sustain hypoxic-ischemic encephalopathy during labor or delivery. Numerous childbirth complications can lead to oxygen deprivation, from pre-existing maternal health complications to outright medical negligence:

  • low maternal blood pressure
  • high maternal blood pressure, or preeclampsia
  • maternal infections
  • placental insufficiency
  • placental abruption
  • placental blood clots
  • umbilical cord prolapse
  • shoulder dystocia
  • infant anemia
  • physical trauma sustained during delivery

In some cases, infants suffer brain injuries through no fault of a healthcare provider. Some complications are simply unavoidable. But that isn’t always true. We can say with absolute certainty that many neonatal brain injuries are entirely preventable. Doctors have a legal duty to uphold the accepted standards of medical care. That means diagnosing critical health complications whenever possible, and enacting the appropriate medical interventions promptly.

We all know that doctors can make mistakes. But when a child’s health and well-being is on the line, medical professionals must be held to a rigorous standard. When physicians violate these standards, allowing harm to befall a child, the laws in New York are clear. Negligence has no place in the delivery room, and when medical malpractice injures children, families have every right to pursue justice by filing a birth injury lawsuit. Our New York birth injury lawyers can help.

How Does Hypoxic-Ischemic Encephalopy Work?

Every cell in the human body requires a fairly constant supply of oxygen to survive. Oxygen itself is transported throughout the body in the blood. In other words, blood flow and oxygen intake are intimately connected. Without one, there can be little hope of, or need for, sustaining the other.

Emergency Measures

When infants experience a reduction in oxygen intake, their bodies struggle to maintain appropriate blood flow. To compensate for the loss of oxygen, a newborn’s circulatory system will automatically redistribute blood toward the body’s most crucial organs: the heart, adrenal glands, and brain. Blood pressure rises momentarily, as does the child’s cerebral blood flow.

Meanwhile, some of the cells in an infant’s body will also switch into an emergency mode. Without oxygen, which cells use to create energy, the baby’s cells will shift to anaerobic respiration, an energy-creation process that doesn’t require oxygen. While anaerobic respiration can keep the cells alive, at least for a little while, it also has adverse side effects. In a condition known as acidosis, the cells begin to produce lactic acid and hydrogen ions. These by-products of anaerobic respiration increase the level of blood acids in the bloodstream, which is already filling up with carbon dioxide.

These compensatory mechanisms can only be sustained for so long. If oxygen deprivation continues, the child’s blood pressure will eventually decrease, depriving brain cells of the oxygen they require to survive. At this point, at least minor brain damage is inevitable.

Symptoms Of Infant Brain Injuries

The symptoms and early warnings signs for brain injuries in newborns can vary widely, depending on the length of oxygen deprivation and the specific areas of the brain that were harmed.

Infants who suffer oxygen deprivation during childbirth are often delivered unconscious and need to be resuscitated. That’s not always the case, although most children will experience some respiratory problems after birth asphyxia occurs. Other early warnings signs can include:

  • cyanosis, a bluish tinge to the skin and/or eyes
  • weakened reflexes
  • hypotonia, or low muscle tone
  • seizures, a complication of brain injury that can result in further brain damage

Hypoxic-ischemic encephalopathy, on the other hand, is a well-defined clinical syndrome. According to the American Academy of Pediatrics, doctors should use a four-step procedure to diagnose the condition:

  • testing umbilical cord blood for severe acidemia, a low blood pH
  • low Apgar scores, between 0 and 3, that last for longer than five minutes
  • neurological symptoms, including seizure or coma
  • the involvement of multiple organs

Readings from an electroencephalogram, which registers electrical activity in the brain, can also be helpful to diagnose the extent and precise location of brain damage.

Effects Of Hypoxic-Ischemic Encephalopathy

HIE can lead to a wide range of disorders, from relatively-minor conditions like attention deficit hyperactivity disorder (ADHD) to severe neurological impairments.

Developmental delays and intellectual disabilities are relatively common. After long periods of oxygen deprivation, infants can develop cerebral palsy and associated epilepsy disorders. Death is a significant, and tragic, possibility. Worldwide, more than 840,000 newborns will die soon after delivery due to oxygen deprivation and the brain injuries it so often causes.

Treating Hypoxic-Ischemic Brain Injuries

When an infant has only experienced a momentary blockage in oxygen supply, respiratory support – often a mechanical ventilator – and observation can be sufficient to prevent permanent brain damage. Medications can be prescribed to ensure proper blood pressure and prevent or manage seizures.

Even more critically, doctors now have an effective way to inhibit the progression of brain damage, which can continue even after a child’s oxygen supply has been restored. In a number of large clinical trials, hypothermia treatment has been shown to reduce the risk of mortality and severe neurological injury in newborns. By cooling an infant’s body temperature, from the normal 98.6 degrees to 92.3 degrees, physicians can minimize the risk of long-term brain damage.

This method is now widely-acclaimed as a breakthrough in the treatment of HIE, supported by such groups as the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists. In a recent press release, the two organizations called hypothermia treatment “a medical milestone.” The technique, however, must be begun within 6 hours of a child’s birth and continued for another 72 hours.

Continue learning about other types of birth injures: Erb’s Palsy & Brachial Plexus Injuries

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