One of the more common birth injuries is caused by insufficient oxygen for an infant at delivery. This medical condition is known by many names. Most often it is referred to as birth hypoxia. When a newborn is without sufficient oxygen for even a very short time, seconds perhaps, he or she can suffer permanent brain injury. Birth hypoxia is also referred to as birth asphyxia or anoxia.
Whatever the alternate names for birth hypoxia might be, they are all related to the lack of sufficient oxygen during the time of the child’s delivery. Anoxia or asphyxia has been known to cause fetal brain damage. The most serious is hypoxic-ischemic encephalopathy or HIE. 75% of babies born with HIE die of multiple causes, but usually because of organ failure. The babies who do survive HIE are seriously and permanently effected with cerebral palsy, epilepsy or mental retardation. Preventing this outcome is paramount in labor and delivery methods, including the way the fetus is monitored during the onset of labor.
Causes of birth hypoxia are varied. Hypoxia at birth may be caused by a delay in which the baby is delivered. Naturally, most children are delivered out of the uterus head first. If the child is in breech position, the child comes out foot or bottom first, rather than head first. This delivery is not that uncommon, but can be very dangerous to the unborn child if delivery is attempted. When an unborn is confirmed to be in a breech position, many obstetricians will call for a Cesarean birth, rather than attempt to deliver in the breech position. The child would be at greater risk for birth hypoxia if delivery were feet or bottom first.
Hypoxia could also be caused by a cord prolapse when the umbilical cord arrives through the uterus before the child. Another possible cause of birth hypoxia is excessively long labor or rupture of the uterus.
There are many other possible causes of birth hypoxia. Babies born with hypoxia are at greater risk for sudden infant death syndrome (SIDS) and other medical deficits including, epilepsy or attention deficit disorder. Cerebral palsy is a physical and motor condition deficit that severely impacts a child who has suffered hypoxia at birth.
When a child is born without sufficient oxygen or birth hypoxia, a treatment called body cooling or head cooling has been implemented. The infants are kept in an intensive care unit wherein the body temperature is kept cool in an effort to decrease neurological deficits caused by the lack of oxygen at birth.
Keeping the body cool, below normal body temperature is called hypothermia. According to a 2012 New England Journal of Medicine article, an infant is kept at lower body temperatures where risk of birth hypoxia is present and if treated within six hours after birth. According to the report, when the hypothermia is introduced to the infant within six hours after birth, there has been a marked reduction in reports of death or disability. The hypothermia procedure has been proven to increase the rate of infant survival without disability at 18-24 months of age.
A baby who is known to be in fetal distress, given the heart rate, electronic fetal monitoring system and objective evidence, including even the size of the unborn baby, the timing of delivery and delivery interventions should be well-known by the medical providers involved. The old “rule” was the “30-Minute Rule”. That meant Cesarian delivery should be done as soon as possible for a given hospital for certain dire fetal conditions like a prolapsed cord or uterine rupture. But in 2014 this rule was changed by the American College of Obstetricians and Gynecologists (ACOG) together with the American Academy of Pediatrics wherein it was stated that performing a C-section delivery within 30 minutes does not make a difference in outcome. “Exceeding 30 minutes from decision to incision in many clinical circumstances, which were categorized as an emergency Cesarian delivery, may not represent substandard care.” Neonatal Encephalopathy and Neurologic Outcome, ACOG, March 2014, p. 102, 105.
Many medical professionals have criticized ACOG’s changed position as to its “essential criteria” as having limited scientific substance. There were no announced changes relating to another common cause of HIE, choriamnionitis, or when there is present maternal and fetal tachycardia, elevated white blood cell count and maternal fever to name few.
If you or a loved one has been harmed by a birth injury case, causing injury or death, you may have a birth injury claim. The Chicago lawyers at Kreisman Law Offices have more than 40 years of trial experience, successfully trying birth injury cases. Please call us 24 hours a day at 312.346.0045 or toll free 800.583.8002 for a free and immediate consultation or complete a contact form online.