Michigan HIE Attorneys Discuss Hypothermia Treatment for HIE | Treating Hypoxic Ischemic Encephalopathy
A new father, Joel Mildinhall, will run up a mountain in an event to raise money for hypothermia (brain cooling) treatment machines that are used to treat babies who have hypoxic ischemic encephalopathy (HIE). HIE often causes cerebral palsy, seizure disorders and even death.
When Julia Mildinhall went into labor, she experienced placental abruption, which means her placenta started to become detached from the womb. The placenta transports oxygen to the baby from the mother through the umbilical cord. When it becomes detached from the mother’s supply of oxygen-rich blood, the baby can be severely deprived of oxygen. When the placental abruption occurred, baby Nancy was not delivered quickly enough by emergency C-section delivery and she was deprived of oxygen for over 20 minutes. At birth, Nancy was lifeless, floppy, pale and not breathing, and she had to be resuscitated. Nancy was diagnosed with hypoxic ischemic encephalopathy right away, and the small hospital transferred her to a larger medical facility that offered hypothermia treatment for HIE.
Julia and Joel were very scared. Physicians told the new parents that Nancy may not survive, and if she does, there is a good chance that the HIE could cause the little girl to have cerebral palsy, intellectual disabilities and lifelong seizures. Luckily, the hospital quickly transferred Nancy and she was able to receive the hypothermia treatment for HIE, which must be given within 6 hours of the oxygen depriving insult that caused the HIE. In Nancy’s case, this meant that she needed treatment within 6 hours of the placental abruption.
Although physicians were slow with the C-section delivery, they acted very quickly after delivery to give Nancy lifesaving hypothermia treatment for HIE. The physicians that administered the brain cooling therapy told Julia and Joel that it probably saved Nancy’s life.
Understanding Hypoxic Ischemic Encephalopathy and Hypothermia Treatment for HIE (Brain Cooling)
Hypoxic ischemic encephalopathy (HIE) is a brain injury caused by a lack of oxygen in the baby’s brain (hypoxia) and/or a restriction of blood flow in the brain (ischemia). HIE is often caused by events that occur during or near the time of delivery, such as placental abruption, the umbilical cord being wrapped around the baby’s neck (nuchal cord), uterine rupture, hyperstimulation caused by Pitocin or Cytotec, and brain bleeds and hemorrhages caused by the use of a vacuum extractor or forceps during delivery.
Hypothermia treatment brings to a halt almost every injurious process that starts to occur when a baby’s brain suffers an oxygen-depriving insult. The more severe the brain injury and HIE, the sooner the treatment should be initiated. Hypothermia treatment lasts for 72 hours, and a cooling blanket or cool cap is used to cool the baby’s body temperature just a few degrees below normal.
Most hospitals require a diagnosis of HIE in order for a baby to be eligible for hypothermia treatment for HIE, which is why it is critical for the medical team to closely monitor a baby who experienced any difficulty during pregnancy and delivery. Research shows that when a baby has HIE, properly administered hypothermia treatment decreases the risk that the baby will die or have cerebral palsy. In addition, the treatment can decrease the severity of the cerebral palsy.
It is important to note that if a baby has to be transported to a different hospital, hypothermia treatment for HIE can be given while she is on the flight or in the ambulance.
Preventing HIE: The Importance of a Timely C-Section Delivery
A timely C-section can save a baby’s life and prevent permanent brain damage and lifelong problems, such as hypoxic ischemic encephalopathy (HIE), cerebral palsy, seizures, hydrocephalus and periventricular leukomalacia (PVL).
Most of the four million babies born every year are healthy at birth. However, when something goes wrong during or near the time of delivery, it can get serious very quickly. Physicians can’t exactly see what is happening with the baby in the womb, and there is no way to give the baby direct help until she is delivered. Indeed, when certain conditions occur, the baby can be partially or even totally cut off from her supply of oxygen.
There are numerous complications that can be very dangerous for the unborn baby. Often, the only apparent sign that a baby is in trouble is her heart rate on the fetal monitor. For this reason, it is crucial–in fact, it is the standard of care–to continuously monitor the baby’s heart rate during labor and delivery. If the baby starts to suffer from a lack of oxygen to her brain, this will cause her heart tracing to be non-reassuring. A non-reassuring heart tracing means the baby is in distress, called fetal distress. When fetal distress occurs, the baby must be delivered right away to remove her from the oxygen-depriving conditions, get her to breathe on her own, and be outside of the womb where the medical team can directly help her.
Permanent brain injury occurs when the baby is not delivered quickly once she starts to experience oxygen deprivation and distress. Due to the potential for severe consequences if a complication occurs, all facilities that hold themselves out as labor and delivery units must have the capacity to perform continuous fetal heart rate monitoring and prompt emergency C-sections should the baby suffer from distress.
When a baby is suffering from a lack of oxygen, the oxygen deprivation (hypoxia) can get progressively worse. Mere minutes can make a difference in how much damage hypoxia inflicts on the brain. 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 a matter of minutes, such as when the baby is high risk and has a non-reassuring heart rate.
Certain conditions always require a C-section delivery, such as certain breech and face presentations, placenta previa, cephalopelvic disproportion and uterine rupture. Listed below are other labor and delivery complications that usually mandate a C-section delivery.
Complications that can cause fetal distress, thereby necessitating prompt C-section delivery:
- Preeclampsia / eclampsia
- Umbilical cord problems, such as a nuchal cord (cord wrapped around the baby’s neck), umbilical cord prolapse, short umbilical cord and cord in a true knot
- Oligohydramnios (low amniotic fluid)
- Premature rupture of the membranes (PROM) / premature birth
- Prolonged and arrested labor
- Intracranial hemorrhages (brain bleeds), which can be caused by a traumatic delivery. Forceps and vacuum extractors can cause brain bleeds. Sometimes intense contractions (hyperstimulation) caused by labor induction drugs (Pitocin and Cytotec) can cause head trauma. Mismanagement of cephalopelvic disproportion (CPD), abnormal presentations (face or breech presentation), and shoulder dystocia also put a child at risk of having a brain bleed
- Hyperstimulation caused by Pitocin and Cytotec can cause oxygen deprivation that gets progressively worse
- Fetal stroke
Fundraising Initiatives | Hypothermia Treatment for HIE (Hypoxic Ischemic Encephalopathy)
Joel will be running the grueling Total Warrior Race as well as the Man versus Mountain Race in September. He hopes his efforts will raise enough money to buy HIE hypothermia treatment machines for all local ambulances. Funds raised in excess of this will be used to help smaller hospitals get the lifesaving machines. Donations can be made at www.justgiving.com/babycoolingchallenge.
Although Joel and Julia are grateful that their daughter promptly received lifesaving hypothermia treatment for her hypoxic ischemic encephalopathy, the new parents still have a lot of waiting to do to determine if baby Nancy will have any permanent problems caused by the HIE, such as cerebral palsy.
Reiter & Walsh: Detroit, Michigan HIE Attorneys Advocating for Kids with Hypoxic Ischemic Encephalopathy and Cerebral Palsy
When you need the help of a birth injury lawyer, it is very important to choose a lawyer and firm that focus solely on birth injury cases. Reiter & Walsh ABC Law Centers is a national birth injury law firm that has been helping children for decades. Cerebral palsy lawyer Jesse Reiter, president of the firm, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy. Jesse is currently recognized as one of the best medical malpractice lawyers in America by U.S. News and World Report 2014, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation. The lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).
If your child was diagnosed with a permanent disability, such as cerebral palsy, a seizure disorder, hypoxic ischemic encephalopathy (HIE), periventricular leukomalacia (PVL), intellectual disabilities or developmental delays, the award winning lawyers at ABC Law Centers can help. We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent. Our nationally recognized firm has 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 Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation. Our award winning lawyers are available 24 / 7 to speak with you.