After months of anticipation and doing everything in your power to prepare your baby for a healthy life, it is heartbreaking to learn, either immediately after birth or years later, that your child suffered a brain injury when they were born.
Even though unborn babies can’t breathe air, they still need oxygen. They get that oxygen from the mother’s blood, which is transferred through the placenta and umbilical cord. During or around the time of birth, a variety of circumstances may cause the baby’s oxygen levels to drop.
While babies can recover from short periods of oxygen deprivation, when a baby’s brain is deprived of oxygen for an extended period of time, they will likely suffer brain damage. This type of brain injury is called hypoxic-ischemic encephalopathy (HIE). HIE is one form of neonatal encephalopathy and can be caused by birth asphyxia or intrapartum asphyxia.
Brain Damage Caused By Ischemia & Hypoxia
Ischemia occurs when the fetus experiences a shortage of oxygen. Hypoxia is a complete lack of oxygen. Reduced blood flow during birth can affect the overall health of the fetus, but it primarily causes damage to the brain. This brain damage can result in HIE. Obstetrical caregivers must be prepared to treat ischemia, hypoxia, and other emergency conditions. If they fail to recognize the symptoms and respond appropriately, the child could suffer permanent brain damage.
Turn to the Becker Law Firm for Help
The Becker Law Firm has represented the families of children suffering from brain injuries like HIE for more than 40 years in Ohio. We are committed to doing everything in our power to hold medical professionals accountable for the long-lasting injuries they cause due to negligence or malpractice.
The Becker Law Firm can and will help you find answers to your questions. We have medical experts on our staff and employ a team of physicians to understand every aspect of your case. We also know the additional questions that need to be asked to get to the root of the negligence that either caused the harm to your baby or allowed it to happen. We stay up to date with the newest and most common defenses to HIE cases, and we are prepared to rebut them.
Levels of HIE Severity
Babies who have suffered HIE are classified as having mild, moderate, or severe HIE according to the Sarnat Grading Scale:
- Mild HIE is characterized by the baby being hyper-alert and having normal muscle tone, dilated and reactive pupils, and regular breathing. Mild HIE usually lasts less than 24 hours.
- With Moderate HIE, the baby is usually lethargic and has reduced muscle tone, frequent seizures, small and reactive pupils, and irregular breathing. Moderate HIE typically lasts between two and 14 days.
- In cases of Severe HIE, the baby is in a coma, rarely has seizures, intermittently stops breathing, and has no muscle tone and fixed pupils. Severe HIE usually lasts for weeks.
While the symptoms of HIE may subside, the effects of oxygen deprivation may or may not be immediately evident. Parents, teachers, and caregivers are advised to pay close attention to a child who has experienced HIE to determine if they are reaching developmental milestones.
HIE Causes and Risk Factors
The tragic and sad truth is that many cases of HIE are preventable. Medical professionals should timely diagnose, treat, and manage conditions and circumstances that put a baby at risk for HIE.
Some of the most common HIE causes and risk factors are:
- C-Section Issues: A delayed a C-section, or the failure to perform a C-section when the baby is in distress can cause oxygen deprivation;
- Labor Issues: Prolonged and arrested labor, misuse of labor-inducing drugs, and excessive uterine contractions can result in a lack of oxygen or blood flow to the baby;
- Umbilical Cord Issues: A baby’s brain can be denied oxygen when the cord is wrapped around his or her neck, knotted, collapsed, compressed, prolapsed, or is too short. Often, electronic fetal monitoring will indicate if the unborn baby is sustaining an umbilical cord problem;
- Placental Issues: When the placenta covers the mother’s cervix, detaches from the uterus, or when the placenta does not have the necessary blood volume, oxygenated blood cannot properly flow from the mother to the baby;
- Positioning of the Baby: When the head or body of a baby is too big to fit through the mother’s pelvis, the baby is in the breech or face position, or when forceps or other delivery tools are misused, the baby can be deprived of oxygen or blood flow for an extended period of time;
- Amniotic Fluid Issues: Having too much or not enough amniotic fluid, or having the fluid sac break too early can lead to HIE through either cord compression or infection;
- Timing Issues: When a baby is born prematurely or after the due date, the risk of HIE increases;
- Medical Mistakes: Obstetricians or other medical personnel can improperly treat the mother’s health issues, such as anemia, high blood pressure, preeclampsia, or gestational diabetes, or fail to notice the baby’s health issues, such as an infection or breathing problems. In addition, the failure to treat within six hours of birth with head or whole-body cooling, may lead to HIE.
- Infection: Obstetricians and obstetrical nurses should recognize mothers and fetuses at risk for medical infection and treat prophylactically. Failure to timely or adequately treat the infection can lead to encephalitis, meningitis, sepsis, or septic shock with resulting brain damage.
Lifelong Challenges of HIE
Complications and disabilities caused by HIE may not be readily noticeable. The challenges a child born with HIE can face range from developmental delays and gross and fine motor impairment to lifelong issues such as:
- Neurological disorders, such as cerebral palsy, epilepsy, dysautonomia, and seizure disorders;
- Sensory issues, such as vision loss, hearing loss, crossed eyes, nystagmus, and;
- Physiological problems with the respiratory, endocrine, digestive, skeletal, and musculoskeletal systems.
Providing adequate care for the medical challenges these issues pose is a lifelong endeavor. In addition to needing medical procedures, children with permanent brain damage from HIE often require one or more types of therapy. Some children may need both physical and occupational therapy, while others may need special education and speech or language therapy. Adaptive and assistive technologies and recreational therapy may also be helpful to children born with HIE.
Let Us Help You Fight for Full Justice
If your child has suffered a birth injury, please contact us today. You can use the contact form on this page or call us at (440) 252-4399 to schedule a free consultation. The Becker Law Firm accepts cases on a contingency basis, meaning you will not be charged unless we win your case.
If you would like to discuss your legal options with a Cleveland HIE lawyer at The Becker Law Firm, call us at (440) 252-4399. Your initial consultation is free.