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Hypoxic Ischemic Encephalopathy (HIE)

babyHypoxic Ischemic Encephalopathy (HIE) is a brain injury suffered by an infant during the birthing process. It occurs when the brain has been deprived of oxygen for too long of a period of time. The Cerebral Palsy organization reports that HIE is the leading cause of infant mortality in the U.S., and a major cause of lifelong mental and other impairments suffered by victims of such a brain injury.

Causes of Oxygen Deprivation Leading to HIE

Although there are complications that may occur during pregnancy that can result in HIE, the most common cause of oxygen deprivation in full-term infants occurs during the labor and delivery process, referred to as the intrapartum period. Premature babies may suffer from HIE in the early hours or days following birth in what is called the postpartum period.

Intrapartum Causes of Oxygen Deprivation

In most cases, with proper medical care during the delivery process, oxygen deprivation should not occur. Some prime examples of complications occurring during labor and delivery that result in a brain injury are:

  • Failure to properly monitor the baby’s heart rate and blood pressure.
  • Failure to monitor the blood pressure of the mother.
  • There is a disproportion in size between the mother’s pelvis and the baby’s head that should have been noted earlier and led to a cesarean section delivery.
  • There is pressure on the baby’s cranium so its shape is changed and it either bleeds, or the blood flow to the cranium is decreased.
  • There is poor oxygen supply to the fetus during labor and delivery due to inadequate monitoring.
  • A placental abruption occurs, or any other condition that causes excessive bleeding from the placenta.
  • Trauma to the baby’s head occurs during delivery.
  • Poor medical management of a prolonged labor.
  • Conditions such as all the ones mentioned which cause the fetus to have a stroke during the labor process prior to delivery.

Postpartum Causes of Oxygen Deprivation

Some of the same causes for intrapartum HIE can result in postpartum infant HIE. The more premature a baby is, the more likely it is to suffer from HIE. Low neonatal blood pressure, or any brain or skull trauma that occurred during birth as well as congenital brain malformations may result in a later diagnosis of HIE.

Symptoms and Diagnosis of HIE

Newborn infants who, immediately after birth, have a low heart rate, poor muscle tone, and weak breathing are suspected of having a mild, moderate, or severe form of HIE. HIE babies may have a pale color or bluish skin tone. Excessive acid is found in their blood and the amniotic fluid may be stained with meconium.

Meconium is a dark green substance that makes up the first bowel movement of a newborn infant. Whenever meconium is excreted prior to birth and found in the amniotic fluid, it is a sign the fetus had been in distress.

Newborns are given an Apgar Score which rates their overall immediate health on a scale of 0-10. A newborn with an Apgar Score of 0-3 that does not improve within five minutes is likely to have suffered from oxygen deprivation. A strong indication the newborn has HIE is if the baby has seizures shortly after birth, or its internal organs do not function correctly.

When HIE is suspected, many tests are performed, such as CT scans, MRIs, electroencephalogram (EEG), and others in attempt to determine the severity of the damage. The extent of the damage is often not determined until the child becomes a toddler at around 3-years-old when any cognitive or developmental delays are identified.

Medical Malpractice and the Prevention of HIE

Experts agree that the best way to eliminate HIE is to prevent the fetus from experiencing oxygen deprivation (asphyxia) during the labor and delivery process. Electronic fetal monitoring during labor, with immediate follow-up attention by medical personnel when warranted, may make a difference in whether the baby lives or dies, and whether the child has permanent cognitive and motor impairment.

If the health care professional was negligent —-either  the hospital, nurse, physician, midwife, or any other professional caring for the mother and baby during labor and delivery, and that negligence is what caused the birth injury, they can be held liable for the damages you and your child suffered. When an infant is permanently damaged and needs lifelong medical care, custodial care, rehabilitation, and other services, those whose negligence are responsible for this should be held accountable.

Austin HIE Attorneys

If your child has been diagnosed with HIE, or suffered any birth injury of any kind, contact the birth injury attorneys at Cagle Law Firm in Austin, Texas. We have the experience and skill you need to pursue your medical malpractice case, and we offer a free case evaluation.

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