Detroit, Michigan HIE Lawyers Discuss Birth Injury Prevention

Award-Winning Detroit, Michigan HIE Lawyers Helping Children Affected by Birth Injuries such as Hypoxic Ischemic Encephalopathy (HIE), Cerebral Palsy, Seizures & Developmental Delays | Serving Detroit, Michigan & All 50 States

In order to avoid premature birth, many physicians recommend waiting about 6 months before becoming pregnant again because mothers who become pregnant within 6 months of a previous birth are at a high risk of having a premature baby.  For many additional reasons, physicians recommend actually waiting 1 – 2 years before having another baby.  Having a baby too soon after a previous birth not only increases the risk of premature birth, but it increases the mother’s chances of having a baby that is small for gestational age, having a baby with a low birth weight, experiencing a placental abruption, and, in some cases, having a uterine rupture.  These conditions can cause a baby to have birth injuries, such as the following:

Detroit, Michigan HIE Lawyers Helping Children Nationwide

Detroit, Michigan HIE lawyers Jesse Reiter & Rebecca WalshThe award-winning Detroit, Michigan HIE lawyers at Reiter & Walsh ABC Law Centers have helped hundreds of children affected by hypoxic ischemic encephalopathy and cerebral palsy. Attorney Jesse Reiter, president of ABC Law Centers, 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.  Partners Jesse Reiter and Rebecca Walsh are currently recognized as two of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation.  The attorneys 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 Detroit, Michigan Association for Justice (MAJ).  In fact, Jesse is one of only 2 attorneys in Detroit, Michigan to have been elected Chair of the BTLG.

If your child experienced a birth injury such as HIE, brain damage, seizures, cerebral palsy or any other long-term condition, contact Reiter & Walsh today at 888-419-2229.  Our award-winning Detroit, Michigan HIE lawyers are available 24/7 to speak with you.

Detroit, Michigan HIE Lawyers Discuss Placental Abruption and Hypoxic Ischemic Encephalopathy (HIE)

A pregnancy that occurs 12 months after giving birth increases the risk of placental abruption.  The placenta is the organ the helps transport nutrients and oxygen-rich blood to the baby through the umbilical cord.  In a placental abruption, the placenta tears away from the uterus, either partially or completely.  This is very dangerous for the baby because it can cause the baby to receive insufficient oxygen-rich blood from the mother.  In addition, the abruption can cause severe bleeding in the mother, which can also cause a decreased flow of blood from the mother to the baby.  A minor abruption can turn severe very quickly.  When a complete placental abruption occurs, the baby will be totally cut off from her supply of oxygen.  This is a medical emergency and it requires immediate delivery of the baby, usually by an emergency C-section.  In fact, since a minor abruption can turn severe very quickly, experts recommend prompt delivery of a term baby even if a minor placental abruption is present.  If the baby is not at term, very close, continuous monitoring of the mother and baby must take place so that fast delivery of the baby can occur if the abruption becomes more severe.  Failure to quickly delivery a baby when a placental abruption occurs can cause the baby to be severely deprived of oxygen, which can cause the baby to have HIE, cerebral palsy, seizures and other lifelong conditions.

placental abruption; hemorrhage; fetal oxygen deprivation; hypoxia; hypoxic ischemic encephalopathy; birth asphyxia

Detroit, Michigan HIE Lawyers Discuss Vaginal Birth After C-Section (VBAC) and Uterine Rupture

Mothers who attempt a vaginal birth after a C-section delivery (VBAC) within 18 months of the delivery are at an increased risk of experiencing a uterine rupture.  A ruptured uterus (womb) is a complete tear through all layers of the uterus.  A VBAC increases the mother’s risk of experiencing a rupture because the uterine scar from the C-section delivery can tear open during the forces and stress associated with labor.  If located near the placenta, a uterine tear can severely affect the flow of oxygen-rich blood being delivered to the baby.  Regardless of the location of the tear, a ruptured uterus can cause severe hemorrhaging in the mother, which can cause so much blood loss that the flow of oxygen-rich blood to the baby is significantly decreased.  This loss of blood can cause shock and cardiac arrest in the mother, which can lead to severe oxygen deprivation and even death of the mother and baby.  If the baby survives, she may have HIE, cerebral palsy, seizure disorders, intellectual disabilities and other problems caused by a lack of oxygen to her brain.

PREMATURE BABIES, LOW BIRTH WEIGHT (LBW) INFANTS & BABIES WHO ARE SMALL FOR GESTATIONAL AGE (SGA)
A pregnancy within 18 months of giving birth is associated with an increased risk of the baby having a low birth weight (LBW), being small for gestational age (SGA) and / or being born prematurely.  These conditions are associated with numerous problems in the baby.  Babies that are premature, SGA and / or LBW are likely to have body systems that aren’t fully developed, including the lungs, which means they may need help breathing after birth.  When babies have their breathing assisted by a breathing machine, called a ventilator, they are at risk of having problems caused by overventilation, such as hypocarbia and and pneumothoraces, which are holes in the lungs.  These complications can cause the baby to have permanent brain damage and cerebral palsy.

Indeed, lung problems are a serious issue in LBW, SGA and premature babies.  These infants are likely to suffer from respiratory distress syndrome (RDS) and pneumonia, which can cause hypoxic ischemic encephalopathy (HIE) and seizures.  In addition, since the vessels in their brains are not fully developed, these newborns are more susceptible to intraventricular hemorrhages (IVH – brain bleeds), which can lead to cerebral palsy.

Periventricular Leukomalacia (PVL) is a very serious birth injury that primarily affects premature babies.  PVL is a type of white matter brain injury characterized by the softening or death of the white matter near the ventricles.  When the white matter dies, cysts filled with fluid are usually left behind.  White matter is very important; it helps transmit signals throughout the largest parts of the brain.  PVL can cause lifelong problems in a child, such as seizures, cerebral palsy, intellectual disabilities and developmental delays.  PVL is typically caused by a lack of oxygen to the baby’s brain (birth asphyxia), brain bleeds, restricted blood flow in the brain, hypocarbia and infections that are passed from the mother to the baby during birth.

PREVENTION OF PREMATURE BIRTH
Detroit, Michigan HIE Lawyers Discuss HIE and Premature BirthDue to the serious consequences that can occur when a baby is born prematurely – and often these babies are LBW and SGA – it is critical for physicians to follow standards of care in the prevention of preterm birth.  The physician must take a thorough history of the mother.  This includes a discussion of the mother’s previous births.  The physician should explain all the risk factors for premature birth, which include a birth within 18 months.  Risk factors for preterm birth include the following:

  • A short interpregnancy interval.  The sooner a mother becomes pregnant after a previous pregnancy, the higher the risk of preterm delivery.
  • History of premature birth, either with twins or a single baby.  History is the strongest risk factor for premature birth.
  • History of abortion.  This includes abortion induced by medical intervention as well as spontaneous abortion.
  • Assisted reproduction.  Pregnancies conceived with assisted reproductive technology, such as in-vitro fertilization (IVF), are at a higher risk of preterm delivery.
  • Vaginal bleeding caused by partial shedding of the uterine lining in early pregnancy (decidual hemorrhage).
  • Infection.  This includes chorioamnionitis, which is inflammation of the placenta and fetal membranes caused by infections in the mother, such as Group B strep (GBS), a urinary tract infection (UTI), bacterial vaginosis (BV), and E coli.  Even if maternal infections don’t cause chorioamnionitis, they are still risk factors for preterm delivery.  Having a short cervix is an independent risk factor for both infection and premature birth.
  • Preterm premature rupture of the membranes (PPROM)
  • Having a short or incompetent cervix
  • High blood pressure during pregnancy / preeclampsia
  • Being pregnant with twins, triplets or more
  • Uterine abnormalities
  • African American race
  • Low or high maternal age
  • Substance abuse

It is very important to prevent risk factors that are associated with premature birth, such as a maternal infection.  Treatments such as progesterone and cervical cerclage are the only medical treatments that have proven effective in significantly reducing the incidence of preterm birth.

Progesterone

Progesterone is a hormone produced by a mother’s body that helps her become and remain pregnant.  Progesterone helps keep the uterus from contracting and it helps the uterus grow.  If the uterus contracts early in pregnancy, the mother may go into premature labor, which is why progesterone is so important.

Intramuscular progesterone is a treatment to reduce the risk of preterm birth in women who previously experienced a spontaneous preterm delivery.  There are different types of progesterone treatments depending on the reason the mother is at risk for preterm labor.  The types of treatment are listed below.

The Mother had a Preterm Birth in the Past

When physicians suspect that a mother may have preterm labor because she experienced preterm birth in the past, progesterone therapy is usually started around 16 – 20 weeks of pregnancy, continuing into the 36th week.  For this type of treatment, progesterone 17 P is injected into a muscle every week.

The Mother has a Short Cervix

When a mother has a short cervix, which is another major risk factor for giving birth prematurely, progesterone is usually given at the 18th week of pregnancy and continued through week 36.  This type of treatment involves daily vaginal administration of natural progesterone.

Some experts recommend this therapy for mothers with a short cervix who are currently pregnant with twins.

The Mother had PPROM in the Past

Research has not shown that progesterone is effective in women who have preterm premature rupture of the membranes (PPROM) in the current pregnancy.  However, women who have had previous PPROM appear to benefit from progesterone therapy in subsequent pregnancies.

Cervical Cerclage

A short cervix is one of the largest risk factors for premature birth.  It is recommended that all pregnant women have their cervices measured between weeks 14 and 28 of pregnancy.  If tests show that the mother’s cervix is incompetent or short, a surgical procedure, called cervical cerclage placement, should be performed.  A cerclage helps reinforce the cervical muscle and can help prevent premature birth.  During cerclage placement, the cervix is stitched closed with strong sutures, which helps the cervix remain closed under the weight of the baby.  Cerclage is recommended when a mother has a short or incompetent cervix, and it is typically recommended for the following women:

  • Mothers with cervical incompetence based on a prior second trimester loss and / or a premature birth.  This is a history-indicated cerclage, and it is usually performed at 12 – 14 weeks of gestation.
  • Mothers pregnant with one baby and a short cervical length (<25 mm) on transvaginal ultrasound exam at 14 – 24 weeks of gestation.  This is an ultrasound-indicated cerclage.
  • Mothers with cervical incomptence based on a dilated cervix on a digital or speculum exam at 16 – 24 weeks of gestation (cervix is opening).  This is a physical exam-indicated cerclage.

Although cerclage placement can occur earlier, the surgery is usually performed between weeks 14 and 24 of pregnancy.

Cervical Cerclage - Preventing Premature Birth


Award-Winning Detroit, Michigan HIE Lawyers Helping Children with Birth Injuries Due to Premature Birth

Premature birth puts a baby at risk of having numerous birth injuries.  Physicians must recognize risk factors for premature birth and follow standards of care to prevent the baby from being born preterm.

Award-Winning Michigan HIE Lawyers If your baby was born prematurely and has a birth injury such as hypoxic ischemic encephalopathy (HIE), cerebral palsy, a seizure disorder or periventricular leukomalacia (PVL), contact the award-winning Detroit, Michigan HIE lawyers at Reiter & Walsh ABC Law Centers.  Our firm is unique in that we focus solely on birth injury law and have been practicing in this area for almost 3 decades.  ABC Law Centers is currently recognized as one of the best medical malpractice law firms in the nation by U.S. News and World Report 2015, and the partners of the firm, Jesse Reiter and Rebecca Walsh, are recognized as two of the best medical malpractice lawyers in America by U.S. News and World Report.  In fact, U.S. News and World Report has given Jesse the honor of being one of the “Best Lawyers in America” every year since 2008.  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 birth injury, the nationally recognized HIE 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 birth injury 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 firm’s award-winning Detroit, Michigan HIE lawyers are available 24 / 7 to speak with you.

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