Michigan Birth Injury Attorneys FAQ | What Are Birth Injuries? What Causes Birth Injuries?
A birth injury, or birth trauma, is an injury with long-term consequences that happens to a baby during or near the time of delivery. Most often, birth injuries and trauma are associated with permanent brain damage and conditions such as hypoxic ischemic encephalopathy (HIE), cerebral palsy, seizures, meningitis, periventricular leukomalacia (PVL), intellectual disabilities and developmental delays. Throughout this page, our Michigan birth injury attorneys will cover everything you need to know about medical malpractice, birth injuries and birth trauma cases.
Birth injuries can occur during delivery, shortly before birth, or during the neonatal period. The complications involve a lack of oxygen to the baby’s brain (birth asphyxia), brain bleeds, placental abruption, uterine rupture, umbilical cord problems such as the cord wrapped around the baby’s neck, premature birth, delayed C-section, Pitocin, Cytotec, and neonatal ICU injuries. These conditions and many others are described below. We also discuss different types of brain damage and shoulder injuries, what the treatments are for these conditions, and what the outlook may be for a child with a birth injury.
Michigan Birth Injury Attorneys Discuss Birth Asphyxia and Hypoxic Ischemic Encephalopathy (HIE)
One of the most common causes of birth injuries is a lack of oxygen to the baby’s brain. Hypoxic ischemic encephalopathy (HIE) is a brain injury caused by oxygen deprivation. In babies, HIE is one of the leading causes of severe impairments such as cerebral palsy. Anything that deprives a baby of oxygen can cause HIE.
There are many conditions that can occur during or near the time of delivery that can cause a lack of oxygen to the baby’s brain. These conditions include placental abruption, uterine (womb) rupture and umbilical cord problems. When these and other oxygen-depriving conditions occur, the baby will have a non-reassuring heart tracing on the fetal heart rate monitor, which is called fetal distress. The baby has a chance at being uninjured, as long as physicians act quickly to deliver her.
Fetal distress means the baby is being deprived of oxygen. When this occurs, the baby almost always needs to be delivered immediately by emergency cesarean (C-section) delivery. The longer a baby’s brain is deprived of oxygen, and the more severe the oxygen deprivation, the more severe the brain damage will likely be. The medical team must quickly get the baby out of the oxygen depriving conditions because that is the only way the infant can be directly helped.
When a baby is in distress, a delayed emergency C-section delivery is a significant cause of HIE and lifelong problems such as cerebral palsy.
Michigan Birth Injury Attorneys Discuss Placental Abruption
Placental abruption occurs when the placenta separates from the uterus before the baby is delivered. The placenta delivers oxygen from the mother to the baby prior to birth. A placental abruption can cause extreme bleeding, which can cause shock (major loss of blood to the mother and baby) and severe oxygen deprivation in the baby. If the abruption occurs at the umbilical cord, the baby will be completely cut off from her supply of oxygen. Furthermore, a minor abruption can turn severe very quickly. Thus, it is crucial for the physician to quickly diagnose an abruption, prepare for emergency C-section delivery, and monitor the mother and baby very closely. The standard of care is prompt delivery when significant placental abruption occurs. If a minor abruption is present and the baby is at term, the standard of care is delivery. If the baby is not at term and the abruption is minor, the mother and baby should be closely monitored by the medical team. If the abruption gets worse, a quick C-section delivery must occur. Magnesium sulfate may be given to help protect the premature baby’s brain.
Physicians should check for conditions that raise the risk of a placental abruption. Mothers who have had a previous abruption are at risk of having another one. Also, if the mother suffers from high blood pressure / preeclampsia or is over the age of 34 she has an increased risk of abruption.
When physicians decide to wait and watch an abruption, the abruption can be treated with blood transfusions and IV fluid replacement. The mother should be carefully monitored for symptoms of fetal distress and shock. The baby’s heart rate should be monitored to ensure it is neither too low nor too high and to make sure contractions do not cause a non-reassuring heart rate. Of course, maternal bleeding or fetal distress usually require an emergency C-section.
Michigan Birth Injury Attorneys Discuss Umbilical Cord Problems: Cord Prolapse and Compression
The umbilical cord is the baby’s lifeline. Through the umbilical cord, oxygenated blood is transported from the placenta to the baby. Any disruption in normal blood flow and gas exchange through the umbilical cord can lead to oxygen deprivation in the baby.
An umbilical cord prolapse, or a prolapsed cord, is when the umbilical cord descends or falls ahead of the part of the baby that is being delivered, often referred to as the “presenting part.” When the cord is in front of the baby, it often gets compressed by the baby and birth canal, which can reduce or stop the flow of oxygen-rich blood going to the baby.
Additionally, umbilical cord prolapse can result in vasospasm (constriction) of the blood vessels in the umbilical cord, and a prolapsed cord may decrease in temperature. Both of these conditions can significantly impair the transfer of oxygenated blood to the baby.
Umbilical cord prolapse is frequently associated with malpresentation of the baby. Instead of being in the vertex position, where the head of the baby is at or near the pelvic inlet, malpresentation refers to those situations where some other part of the baby, such as the baby’s buttocks or feet, present at or near the mother’s pelvic inlet. Accordingly, whenever a baby is assessed as being in a breech or transverse lie presentation, the physician should be alerted to the fact that an umbilical cord prolapse is likely.
An umbilical cord prolapse is an obstetrical emergency and the baby must be delivered right away, usually by emergency C-section delivery.
Michigan Birth Injury Attorneys Discuss Nuchal Cord (Umbilical Cord Wrapped Around the Baby’s Neck)
When the umbilical cord wraps around a baby’s neck, it is called a nuchal cord. Nuchal cords may form at any time and then disentangle and possibly reform, or they may persist. In some cases, the nuchal cord causes a lack of blood flow to the baby’s brain, decreased fetal development and movement, and complicated delivery. A nuchal cord causes the baby to be deprived of oxygen due to the following reasons:
- The tightness around the neck restricts blood flow from the neck artery to the head;
- The blood from the veins gets backed up and circulation is decreased;
- The vessels in the cord get compressed due to the cord being tightly compressed against itself or the baby’s neck.
Indeed, a nuchal cord can cause severe oxygen deprivation when the cord is extremely tight around the neck, is wrapped around the neck more than once, or where low amniotic fluid permits cord compression. During delivery, the cord may get tighter, and this is especially dangerous if there is a true knot in the cord. Nuchal cords during delivery are obstetrical emergencies that almost always requires an emergency C-section delivery.
Nuchal cords have been associated with fetal demise, impaired fetal growth, meconium stained amniotic fluid, and an increased rate of fetal heart rate abnormalities leading to an increased rate of forceps and vacuum extractor use, and umbilical artery academia (acidic blood, meaning the baby was deprived of oxygen).
Michigan Birth Injury Attorneys Discuss Other Umbilical Cord Problems
Other umbilical cord complications include a short umbilical cord, a cord that is in a true knot, and vasa previa, which is when an umbilical cord blood vessel crosses the cervix under the baby and is torn. In these circumstances, the baby may experience fetal distress due to decreased oxygen and blood flow. Close monitoring of the baby is essential, and prompt delivery by C-section must occur when fetal distress is present.
Michigan Birth Injury Attorneys Discuss Preeclampsia
Preeclampsia is a complication which occurs during pregnancy and is characterized by hypertension (high blood pressure). Preeclampsia most often occurs during a first pregnancy. Women who suffer from hypertension, diabetes, obesity and those who are greater than 35 years of age, also are at increased risk for preeclampsia.
Preeclampsia is generally classified as being mild, moderate or severe. In many cases, however, a mother with even mild preeclampsia can rapidly progress to a more severe form of the disease. Moderate and severe cases of preeclampsia can cause the mother to have problems with her kidneys, liver and blood vessels. Undiagnosed or untreated preeclampsia can also lead to eclampsia (the mother has a seizure), a potentially deadly consequence associated with significant maternal mortality and severe oxygen deprivation in the baby.
In cases where preeclampsia is undiagnosed or untreated, the baby can suffer from long term oxygen deprivation. Preeclampsia can cause a decrease in the blood flow from the mother’s placenta to the baby, thereby reducing the transfer of oxygen and nutrients. Thus, in cases of moderate to severe preeclampsia, there can be reductions in the amniotic fluid (oligohydramnios), intrauterine growth restriction (IUGR) or placental abruption.
In any mother with preeclampsia, prudent management is critical in achieving a good outcome for the baby. Physicians managing mothers with preeclampsia must conduct thorough maternal evaluations, including blood and urine lab tests, to continually assess the extent of the disease. It is also essential that physicians refer mothers who suffer from preeclampsia to maternal-fetal specialists.
In addition to carefully monitoring and treating the mother with preeclampsia, physicians must also initiate a regimen of close fetal monitoring to determine what effects the preeclampsia may be having on the baby. These prenatal tests include weekly nonstress tests, biophysical profiles and ultrasound examinations to assess the level of amniotic fluid, and to determine whether the baby is growing normally. Because of the extreme risks associated with even mild to moderate preeclampsia, many physicians deliver the babies prior to term.
Michigan Birth Injury Attorneys Discuss Uterine Rupture
A uterine rupture is a serious condition that typically occurs when the forces and stresses of uterine contractions associated with attempted vaginal delivery cause the uterus to tear open. This can cause the unborn baby to spill into the mother’s abdomen. A uterine rupture can cause the baby to be deprived of oxygen. The oxygen deprivation depends on the location and severity of the rupture. If the rupture occurs where the placenta attaches to the uterus, the baby could be severely – even completely – cut off from her supply of oxygen. In any case, a ruptured uterus requires prompt diagnosis and quick delivery by emergency C-section.
The most common cause of uterine rupture is the separation of a previous C-section scar during labor. Thus, the induction or augmentation of labor in mothers who previously had a C-section, called a “VBAC” delivery, is associated with an increased risk of uterine rupture. Research indicates that when prostaglandin agents such as Cervidil are utilized to induce labor in a mother who had a previous C-section, there is also an associated increased risk of uterine rupture.
Because of the risk of uterine rupture and trauma to the baby, many physicians will not use any medications such as Pitocin or prostaglandins to either induce or augment the labor of a mother who has had a prior C-section. A uterine rupture, or the separation of a surgical scar from a prior C-section, can result in massive maternal hemorrhage and oxygen deprivation in the baby.
Because of the serious risks to the mother and baby associated with uterine rupture, physicians should closely monitor the labor of any mom who has increased risk factors for uterine rupture. If uterine rupture occurs, maternal hemorrhage must be promptly controlled and the baby must be delivered as quickly as possible to prevent birth asphyxia, hypoxic ischemic encephalopathy and cerebral palsy.
Michigan Birth Injury Attorneys Discuss VBAC (Vaginal Birth After Cesarean)
VBAC carries a number of risks, many of which are not fully explained or discussed with the mother. These risks include the dangers of uterine rupture.
Because of the substantial risks, many physicians have questioned whether VBAC is an appropriate and safe mode of delivery for mothers who have had prior C-section deliveries. Unfortunately, perhaps as a result of inexperience or economic pressures, many physicians encourage their patients to undergo VBAC deliveries and fail to adequately inform them of the risks and alternatives, including repeat C-section delivery.
Michigan Birth Injury Attorneys Discuss Forceps and Vacuum Extractors
Inappropriate use of vacuum extractors and forceps can cause brain damage through several mechanisms. These include brain bleeds, cerebral contusions, stretching and tearing of blood vessels and brain tissue, compression of the brain with changes in blood flow, and/or skull fractures.
When a baby is in distress during delivery, forceps, which resemble large salad tongs, are placed on either side of the baby’s head. As each contraction occurs, the physician guides the baby’s head downward and out of the birth canal. A vacuum extractor uses a small, soft cup that is applied to the top and back of the baby’s head. A tube runs from the cup to a vacuum pump that provides suction. During a contraction, the physician pulls or applies gentle traction to the baby’s head while suction from the vacuum assists in pulling the head out of the birth canal. If forceps and vacuum extractors are used improperly, the damage can be extensive and permanent. If they are applied unevenly to the baby’s head, the strain could cause compression of the head as well as brain bleeds and hemorrhages.
Other potential problems with delivery instruments include facial bone distortions, brain swelling, and brain damage, which can generate other secondary issues such as seizures, epilepsy, ischemia and cerebral palsy. Similar problems can occur if the suction cup of the vacuum extractor is not placed correctly. The physician’s technique to pull the baby out is critical – there should be no twisting of the head or neck, no excessive pulling, and no pulling for more than 10 to 15 minutes. In addition, if the vacuum extractor comes off 3 times during use, the physician should move on to a C-section delivery. Incorrect use of vacuum extractors can result in skull fractures, retinal hemorrhages, brain hemorrhages or bleeds, and seizures. Trauma from forceps and vacuum extractors can also cause the formation of blood clots inside blood vessels, leading to strokes, hypoxic ischemic encephalopathy, and cerebral palsy.
Michigan Birth Injury Attorneys Discuss Brain Bleeds and Intracranial Hemorrhages
Sometimes during labor and delivery, trauma to the baby’s head occurs, causing hemorrhages or brain bleeds. Sometimes, the hemorrhages are very serious and result in permanent brain damage, cerebral palsy, and even death.
Many brain bleeds are the result of mismanaged labor and delivery. Listed below are some of the types of brain bleeds that can occur around the time of birth:
Intracranial hemorrhages (brain bleeds): Intracranial hemorrhage refers to any bleeding within the skull or brain. Listed below are types of intracranial hemorrhages.
- Cerebral hemorrhage: A form of stroke in which bleeding occurs within the brain.
- Subarachnoid hemorrhage: This occurs when there is bleeding in the subarachnoid space, which is the area between the innermost two membranes that cover the brain. This type of hemorrhage usually occurs in full term babies and produces seizure activity, lethargy and apnea.
- Intraventricular hemorrhage: This is bleeding into the brain’s ventricular system, where spinal fluid is produced. It is the most serious type of intracranial bleeding and is usually seen in premature infants and infants with low birth weight. This is because blood vessels in the brain of premature infants are not fully developed.
- Subdural hemorrhage or subdural hematoma: This occurs when there is a rupture of one or more blood vessels that are in the subdural space – the area between the surface of the brain and the thin layer of tissue that separates the brain from the skull. These ruptures are usually caused by difficult deliveries. Seizures, high levels of bilirubin in the blood, rapidly enlarging head, a poor Moro reflex, or extensive retinal hemorrhages (bleeding of the vessels in the retina) sometimes occur with these kinds of hemorrhages.
Extracranial hemorrhages: These are brain bleeds that occur just outside the skull, and they can be life threatening.
- Cephalohematoma: This is bleeding that occurs between the skull and its covering, starting as a raised bump on the baby’s head. It occurs a few hours after birth and lasts anywhere from 2 weeks to a few months.
- Subgaleal hemorrhage: This occurs when a vein or veins rupture and then the vein bleeds into the space between the scalp and the skull. This is life threatening for the baby and can cause severe oxygen deprivation. If the bleed is not properly managed, almost half of the baby’s blood volume can end up in the subgaleal space. A vacuum extraction delivery puts a baby at a high risk of sustaining this type of hemorrhage.
CAUSES OF BRAIN BLEEDS
There are a number of things that can cause brain bleeds during labor and delivery. They include:
- Misuse of vacuum extractors and forceps
- Mismanaged delivery of a baby in breech position
- Mismanaged delivery of a baby who is large for gestational age (macrosomic)
- Mismanaged cephalopelvic disproportion (CPD). CPD occurs when the baby is too large to fit through the mother’s pelvis
- Trauma from prolonged labor
- Abnormal changes in blood pressure
- Blood disorders (such as vitamin K deficiency, hemophilia)
- Hypoxic ischemic encephalopathy (HIE)
In these cases, the physician must closely monitor the baby for fetal distress and give the mother the option for a C-section. Informed consent is imperative. If fetal distress occurs and normal methods of delivery are unsuccessful, an emergency C-section is required to minimize the risk of hemorrhage and cerebral palsy.
As discussed above, severe head and brain trauma to newborns can occur from medical intervention during labor and delivery. Improper use of delivery instruments, such as forceps and vacuum extractors, are well-documented as causes of intracranial and extracranial bleeding. In addition, improper delivery techniques (excessive twisting or pulling of the infant’s head) can cause severe hemorrhages.
Michigan Birth Injury Attorneys Discuss Pitocin and Cytotec
Trauma causing brain injury can also occur from the cumulative effect of prolonged periods of contractions and pushing, forcing the baby’s head and brain repeatedly against the mother’s pelvis in a setting where the baby is a very tight fit for the pelvis, which can happen in cases of CPD and macrosomia. Pitocin (oxytocin) is often used in this scenario in an attempt to avoid a C-section.
Excessive Pitocin can cause contractions to occur less than 2-3 minutes apart, thereby reducing the ability of the placenta to replenish its oxygen supply. Excessive frequency and strength of contractions is called hyperstimulation. When hyperstimulation prevents replenishment of oxygen in the placenta, the baby’s brain may be deprived of oxygen. Hyperstimulation with Pitocin is indeed very dangerous because there are no precise methods of measuring the effects of Pitocin on the uterus. The effects of any given dose vary widely; they can range from excessive and severe contractions and fetal oxygen deprivation / asphyxia to absolutely no discernible effect on uterine contractility.
Cytotec is also used to induce labor. It works by ripening the cervix and producing contractions. The drug has serious risks, however, which include uterine rupture, hemorrhage, and amniotic fluid embolism (amniotic fluid enters the mother’s bloodstream, causing a stroke). The dosage and method of administering Cytotec raises safety concerns. Unlike Pitocin, Cytotec is a pill that is inserted vaginally. The pill is typically cut into quarters with one quarter inserted every four hours. However, this drug can affect every pregnant woman and baby differently, and there is no way to predict how they will tolerate Cytotec. If the mother or baby has an adverse reaction to the drug, it cannot be rapidly discontinued like other drugs since the medication is absorbed into the body. In recent years, there have been concerns over the number of birth injuries that have occurred in cases where Cytotec was used. Like Pitocin, Cytotec causes hyperstimulation that can cause serious oxygen deprivation and heart rate changes in the baby. When hyperstimulation is evident, there is also a danger that the umbilical cord is being compressed and the baby is not receiving enough oxygen. This is an obstetrical emergency which requires an immediate C-section delivery.
Uterine rupture occurs when the excessive contractions associated with hyperstimulation cause the uterus to tear, either partially or completely. The baby then must be delivered by an emergency C-section to prevent birth asphyxia, hypoxic ischemic encephalopathy and cerebral palsy.
Michigan Birth Injury Attorneys Discuss Breech Presentation (Breech Births)
A breech birth is when the baby enters the birth canal with the buttocks or feet first. Breech presentation presents some hazards to the baby, including the mode of delivery (vaginal versus C-section). Though labor and vaginal birth are possible for the breech baby, certain fetal and maternal factors influence the safety of vaginal breech birth. The majority of breech babies are delivered by C-section.
At the beginning of labor, the baby is generally facing either the right or left side of the mother’s back. Delay in descent is a sign of problems with the delivery of the head. Umbilical cord prolapse may occur, particularly in the complete, footling, or kneeling breech position. This is caused by the lowermost parts of the baby not completely filling the space of the dilated cervix. When the water breaks, it is possible for the cord to drop down and become compressed. When this occurs, the baby must be delivered immediately (usually by C-section).
Because the umbilical cord is significantly compressed while the head is in the pelvis during a breech birth, it is important that the delivery of the fetal head not be delayed. Oxygen deprivation may occur from either cord prolapse or prolonged compression of the cord during birth, as in head entrapment. If this deprivation of oxygen is prolonged, it may cause permanent brain damage and cerebral palsy or death. Injury to the brain and skull may occur due to the rapid passage of the baby’s head through the mother’s pelvis. Positioning the baby incorrectly while using forceps to deliver the head can damage the brain, spine or spinal cord, which often results in cerebral palsy.
Michigan Birth Injury Attorneys Discuss Post-Term Pregnancy
When a baby remains in the womb beyond the due date, usually beyond 41 or 42 weeks, there is great potential for birth injuries. In general, the longer a pregnancy continues after 40 weeks, the more risks there are to the baby, including cerebral palsy. Research suggests that due to the increase in fetal death and injury at 42 weeks and beyond, it is much safer to induce labor by about 40 or 41 weeks than to allow the pregnancy to continue.
A baby can face numerous problems if a pregnancy continues beyond the normal gestation period. While some problems resolve on their own, others are more serious and result in irreversible and lifelong disabilities. This includes:
Postmaturity Syndrome: Occurring in 20% of post-date pregnancies, this syndrome develops due to uteroplacental insufficiency which causes chronic stress, trauma and oxygen deprivation in the baby. The baby has a unique appearance when born, including overgrown fingernails and hair, a long body with little fat, and wrinkled or dry, parchment-like skin. Postmaturity syndrome features a number of disorders:
- Uteroplacental insufficiency: The major risk to the baby comes from the fact that the placenta reaches its maximum size and surface area around 37 weeks. After 37 weeks, its surface area and function gradually deteriorate. This means that the placenta is less able to supply sufficient oxygen-rich blood to the baby.
- Fetal Distress: In post-term pregnancies, there is increased risk of fetal distress and trauma due to the higher incidence of cord compression. It is crucial that physicians pay close attention to the fetal heart rate monitor.
- Meconium aspiration: Sometimes fetal stress and an older gestational age induce a bowel movement by the baby while in the womb. In some cases, the baby will actually inhale the tainted amniotic fluid into her lungs. This can cause trauma to the airway, irritation, airway obstruction, infection, problems with normal lung expansion and HIE.
- Oligohydramnios: The volume of amniotic fluid increases during pregnancy and reaches its peak at around 34 weeks. When there is an unexpected decrease in the amount of amniotic fluid, it is called oligohydramnios. Oligohydramnios can cause cord compression and oxygen deprivation.
- Umbilical cord compression: When oligohydramnios occurs, there is a serious risk of cord compression. This is because the baby and umbilical cord no longer float in the fluid. Instead, the baby’s movements can put direct pressure on the cord, which can decrease or totally cut off the supply of oxygen-rich blood going to the baby.
- Macrosomia: A baby can become very large when a pregnancy is post-term. This can make it traumatic to deliver vaginally. This may prompt the physician to use forceps or a vacuum extractor, which increases the likelihood of birth trauma to the baby, such as brain bleeds. Macrosomia also increases the chances for shoulder dystocia (the baby’s shoulder is stuck on the mother’s pelvis) and cephalopelvic disproportion (CPD). CPD requires C-section delivery, and when macrosomia is present, a C-section delivery is usually the safest way to deliver the baby in order to prevent Erb’s palsy.
Michigan Birth Injury Attorneys Discuss Cephalopelvic Disproportion
Cephalopelvic disproportion (CPD) injuries occur when the baby’s head or body is too large to pass through the mother’s pelvis and instead of delivering the baby by C-section, the physician makes prolonged attempts at vaginal delivery. Initially, physicians should have information about the mother’s pelvis type and size from x-ray and examination. Ultrasounds also give the physician an idea of the baby’s head measurements. Another important factor is how the baby’s head is positioned in the pelvis – some parts of the head can mold to conform to the mother’s pelvis.
Except for macrosomia, physicians will usually not assume CPD based on measurements alone, although measurements are one piece of information that should be considered when deciding whether to deliver vaginally or by C-section. One indication of CPD is the failure to progress. Failure to progress means that labor either ceases or does not move as quickly as it should. Physicians should identify any risk factors for CPD before the start of labor. Risk factors include:
- Small or abnormal pelvis
- Large head measurement of baby
- Mother with diabetes or gestational diabetes
- Post-term pregnancy
- Mother over age 35
When CPD is identified during pregnancy, it may be necessary to plan to deliver the baby early.
If physicians fail to diagnose CPD prior to labor, they must identify the condition right away during labor and delivery and move on to a C-section. The treatment for CPD is C-section delivery. When CPD is present, attempts to deliver the baby vaginally will cause trauma, which can lead to permanent injuries, such as cerebral palsy.
When CPD is present, some mistakes that can cause trauma include the following:
- Pitocin/Oxytocin: Physicians may react to CPD by administering Pitocin, which can cause excessive contractions, leading to oxygen deprivation and HIE.
- Continued Labor: Physicians may allow labor to progress for too long. Labor is stressful and traumatic for babies, and when prolonged, it can cause oxygen deprivation and HIE.
- Prolapsed Umbilical Cord: When there is less room in the uterus, a prolapsed umbilical cord is more likely, which puts the baby at risk for HIE.
- Shoulder Dystocia: When CPD is a problem, babies are more likely to have shoulder dystocia injuries, including Erb’s Palsy.
Michigan Birth Injury Attorneys Discuss Premature Rupture of Membranes (PROM)
Premature rupture of the fetal membranes (PROM) is a dangerous condition, leading to fetal distress and other complications before labor or near the end of the third trimester. Without the protective amniotic fluid, an unborn baby is prone to infections, loss of nutrients, premature birth and other traumatic complications. Complications from PROM can include:
- Prolapsed umbilical cord
- Inflammation and infection of the fetal membranes (chorioamnionitis)
- Infections such as GBS, UTI and BV, and HSV
- Premature birth and hypoxia
Prolapsed umbilical cord, premature birth, hypoxia and infection in the baby all may lead to hypoxic ischemic encephalopathy, cerebral palsy and other serious conditions.
Michigan Birth Injury Attorneys Discuss Maternal Infections, Sepsis and Meningitis
Certain infections in a mother can be passed on to the baby at birth, which is why it is crucial for physicians to recognize and properly treat maternal infections. These infections include Group B streptococcus (GBS), chorioamnionitis, herpes simplex virus (HSV), E Coli, and Staphylococcus (staph) infections.
When these infections are passed on to the baby, the baby can get a very serious infection in her bloodstream called sepsis. Sepsis can damage the brain either by direct infection of the central nervous system or by causing inflammation in the brain (encephalitis). Sepsis can cause meningitis, which is inflammation of the membranes around the brain and spinal cord. The most common source of meningitis is GBS.
Sepsis can also cause the baby to go into septic shock, which causes a severe reduction in blood flow and blood pressure. When the blood pressure gets really low, the baby’s brain can become deprived of oxygen, which can cause hypoxic ischemic encephalopathy, permanent brain damage and cerebral palsy.
Michigan Birth Injury Attorneys Discuss Gestational Diabetes
Gestational diabetes is when a woman is diagnosed with diabetes for the first time during pregnancy. This is one of the most common medical conditions that occurs during pregnancy. Gestational diabetes usually begins midway through pregnancy and it occurs when the body cannot make and use as much insulin as it needs. Insulin is needed to convert glucose (blood sugar) into energy.
Babies born to mothers who have gestational diabetes – especially poorly managed diabetes – are likely to be macrosomic, which puts them at risk for a number of health problems and it also increases babies’ chances of experiencing a traumatic birth. In addition, at birth, these babies are left with ongoing high insulin production and susceptibility to hypoglycemia (low blood sugar levels). Hypoglycemia can lead to brain damage and cerebral palsy if not promptly recognized and treated.
Neonatal Ventilator (Breathing Machine) Injuries
If a baby is on a breathing machine (ventilator) after birth, she is susceptible to certain injuries if she is not closely monitored and her vent settings are mismanaged. One cause of injury is hypocarbia. Hypocarbia is when the baby’s carbon dioxide level is below normal for too long. This can cause constriction of the blood vessels in the brain, which causes reduced blood flow and oxygen deprivation. These conditions often cause cerebral palsy. Another type of injury is a pneumothorax, which is when there is a hole (or holes) in the lungs, causing air to go into the space just outside the lung. This puts pressure on the lung and causes that lung to not be able to expand properly. This can cause severe oxygen deprivation and even respiratory arrest.
Michigan Birth Injury Attorneys Discuss Jaundice and Kernicterus
When a baby has jaundice, it means the body isn’t breaking down and getting rid of excess bilirubin, causing the skin and eyes to turn yellow. This is somewhat normal for newborns, but if too much bilirubin is allowed to build up in the baby’s blood, the bilirubin can enter the brain tissue. Bilirubin is toxic to brain tissue, and it can cause a permanent form of brain damage called kernicterus, which often causes cerebral palsy.
High bilirubin levels are very easy to treat and babies should have these levels frequently checked.
Michigan Birth Injury Attorneys Discuss Delayed C-Section Delivery
As discussed earlier, when delivery complications occur, a baby will usually be unharmed if the physician quickly delivers her by C-section in order to get her out of the stressful conditions and administer direct help.
Certain conditions require a C-section delivery, such as placenta previa, cephalopelvic disproportion and certain types of breech presentation. When other ominous pregnancy conditions occur, such as placental abruption, uterine rupture, and umbilical cord prolapse or compression, a C-section is also the safest way to deliver the baby, in most cases. When physicians fail to recognize these conditions and attempt a vaginal delivery, the baby can become permanently injured.
When required, an emergency C-section should be performed as quickly as possible, and many times it should be performed within 10 – 18 minutes or less.
When a baby is suffering from a lack of oxygen, the oxygen deprivation can get progressively worse. Mere minutes can make a difference in how much damage the lack of oxygen inflicts on the brain. Indeed, small amounts of time can make a difference when fetal distress and other complications are occurring, which is why it is critical – and the standard of care – for a labor and delivery facility to be fully prepared to timely deliver a baby by C-section. This means that the facility must have proper anesthesia and surgical personnel to permit the start of C-section delivery well within 30 minutes of the decision to perform the procedure. Many experts state that in certain cases, a C-section must be performed in just a few minutes, such as when there is a complete placental abruption or umbilical cord occlusion. These and other conditions that cause oxygen deprivation will manifest as a non-reassuring heart rate on the fetal heart monitor.
Michigan Birth Injury Attorneys Discuss Erb’s Palsy
A common birth injury that does not involve the brain is called a brachial plexus injury or Erb’s palsy. This occurs when the baby’s shoulder gets caught on the mother’s pelvis during delivery and the doctor applies too much force to the baby’s head in an attempt to remove her from the birth canal. Excessive force can cause the baby’s nerves to stretch or tear, resulting in extreme weakness or paralysis of the affected arm. Sometimes the baby is stuck for too long in the birth canal, causing head trauma, brain bleeds and / or oxygen deprivation and HIE.
Reiter & Walsh, P.C. | Michigan Birth Injury Attorneys Representing Injured Children
The award-winning birth injury attorneys at Reiter & Walsh ABC Law Centers have been helping children with birth injuries and cerebral palsy throughout the nation since the firm’s inception in 1997. Jesse Reiter, the firm’s president, has been focusing on birth injury cases his entire career. Jesse and his team help children all over the country, and when they take a case, they spend a lot of time getting to know the child and family they are helping so they can fully understand the child’s needs.
Birth injury is a difficult area of law to pursue due to the complex nature of the medical records. The award-winning Michigan birth injury attorneys at Reiter & Walsh have decades of experience with birth injury, hypoxic ischemic encephalopathy and cerebral palsy cases. To find out if you have a case, contact our firm to speak with one of our attorneys. We have numerous multi-million dollar verdicts and settlements that attest to our success, and no fees are ever paid to our firm until we win your case. Email or call us at (888) 812-6009. We give personal attention to each child and family we help and our Michigan birth injury attorneys are available 24/7 to speak with you.
Video: Michigan Birth Injury Attorneys Discuss Cerebral Palsy and Other Birth Injuries
In this video, Michigan birth injury attorneys Jesse Reiter and Rebecca Walsh discuss how a lack of oxygen to a baby’s brain (asphyxia) can cause birth injuries such as hypoxic ischemic encephalopathy (HIE) and cerebral palsy.
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