A: Cerebral palsy, a disorder that often leads to physical disabilities and cognitive impairments, is caused by damage to the part of the brain that controls movement. Injury to the baby’s developing brain at or near the time of birth can cause cerebral palsy. Issues like brain hemorrhaging, placental abruption, and uterine rupture can put a baby at risk for severe brain damage that can lead to cerebral palsy. When the brain is injured, it can impair a child’s reflexes, posture, balance, muscle tone, coordination, fine and gross motor skills, and, in some cases, his or her ability to communicate verbally. It is important to note that while some conditions increase the risk for cerebral palsy in a child, cerebral palsy is often preventable. Medical professionals must recognize and appropriately manage high risk conditions that can make a child more vulnerable to brain injury at birth.
A number of conditions and pregnancy complications can cause cerebral palsy. Cerebral palsy often occurs as the result of a traumatic or oxygen-depriving event that leads to brain damage. The cerebrum is the part of the brain that is most heavily affected in cases of cerebral palsy, although the cerebellum can also be impacted. Because cerebral palsy is a permanent condition, it is crucial that medical professionals recognize its causes, and handle them appropriately.
The causes of cerebral palsy can be broken down into three categories based on the time in which brain damage occurred. These categories are:
1. Cerebral Palsy from Problematic Development or Oxygen Deprivation (Before Birth)
- Oligohydramnios: Oligohydramnios occurs when the volume of amniotic fluid is lower than average, usually because the placenta is not functioning properly. This leads to umbilical cord compression which impairs the delivery of oxygen and nutrients to the baby and increases the risk of adverse pregnancy outcomes, including cerebral palsy.
- Maternal Infection: Infections such as chorioamnionitis and villitis, Group B Strep (GBS), urinary tract infection (UTI), bacterial vaginosis (BV) and herpes simplex virus (HSV) can all be extremely dangerous for a developing baby. Maternal infection can cause premature birth, which often results in underdeveloped lungs, periods of oxygen deprivation, and other complications that may increase the risk for cerebral palsy and permanent brain damage.
- Preeclampsia: Pregnancy-induced high blood pressure, or preeclampsia, can result in cerebral palsy. Preeclampsia can cause constriction of and damage to the vessels in the placenta that supply oxygen-rich blood to the baby through the umbilical cord. This decreased blood flow to the baby can cause severe oxygen deprivation when not carefully monitored and managed.
- Premature Rupture of the Membranes (PROM): This condition occurs when a mother’s “water breaks” before labor starts. PROM can cause chorioamnionitis, sepsis, premature birth, respiratory distress, and oxygenation problems. All of these complications increase the risk of brain damage and cerebral palsy.
- Post-term pregnancy: When a baby is in the womb for longer than the standard gestation time (approximately 40 weeks), postmaturity syndrome may occur. After 37 weeks, the placenta begins to deteriorate. If the baby remains in the womb for longer than 40 weeks, placental deterioration can threaten the baby’s oxygen-rich blood supply. Additionally, the baby may become too large, making delivery difficult and injuries more likely.
2. Cerebral Palsy from Oxygen Deprivation (Hypoxic-Ischemic Encephalopathy) or Trauma During Labor and Delivery
- Macrosomia or Cephalopelvic Disproportion (CPD): Macrosomia (when a baby is much larger than normal) and cephalopelvic disproportion (CPD) (when the mother’s pelvis and fetus’ head are not in proportion for delivery) can both lead to a traumatic delivery, which can in turn increase the risk of resultant cerebral palsy.
- Hypoxic-Ischemic Encephalopathy (HIE): HIE is brain injury that occurs due to a lack of oxygen-rich blood in the brain, either caused by restricted blood flow or decreased oxygen in the baby’s body. HIE resulting from a hypoxic-ischemic event can lead to cerebral palsy.
- Use of Pitocin or Cytotec: Pitocin and Cytotec are drugs given to mothers to speed up labor. Sometimes contractions can get too fast and strong (hyperstimulation), and this pressure can deprive the baby of oxygen-rich blood. Hyperstimulation also can cause excessive pressure on the baby’s head, which can cause brain trauma. Both oxygen-deprivation and brain trauma can lead to cerebral palsy.
- Umbilical Cord Problems: The umbilical cord is the baby’s lifeline; it carries oxygen-rich blood from the placenta to the baby. A prolapsed umbilical cord (where the cord exits the birth canal in front of the baby) or nuchal cord (where the cord gets wrapped around baby’s neck) can cause oxygen deprivation and result in cerebral palsy.
- Placental Abruption: Placental abruption, when the placenta separates prematurely from the uterine wall, can cause bleeding in the mother, which decreases the supply of oxygen-rich blood to the baby, possibly causing cerebral palsy.
- Uterine rupture: Uterine rupture occurs when the uterus (womb) tears open, potentially expelling the unborn baby out of the womb and into the mother’s abdomen. When the uterus tears, the baby may lose his or her supply of oxygen-rich blood and cerebral palsy may result.
- Forceps and Vacuum Extractors: The use of operative tools like forceps and vacuum extractors during delivery put the baby at risk for head trauma during the delivery process. This head trauma can cause brain damage which, in turn, can result in cerebral palsy.
- Prolonged and/or Arrested Labor: When labor is prolonged or stalled, a baby can become very distressed due to a lack of oxygen. The force of repeated contractions can place intense physical stress on the baby, which may result in further trauma and decreased access to oxygen, which can lead to cerebral palsy.
3. Cerebral Palsy from Complications in The Perinatal Period
- Fetal Stroke: Fetal strokes occur when the blood supply to brain is cut off. If these strokes are prolonged, they can cause brain damage. The risk of pediatric stroke is highest in the newborn period. Brain damage resulting from stroke can lead to cerebral palsy.
- Brain Hemorrhage: Brain bleeds, or intracranial hemorrhages, are traumatic birth injuries distinguished by abrupt, rapid bleeding within the brain of a newborn baby. If not treated properly, intracranial hemorrhages can lead to brain damage, and subsequently to cerebral palsy.
- Hydrocephalus: Hydrocephalus occurs when there is an excess of fluid within the brain. This condition can cause swelling of the brain’s ventricles, which can lead to permanent brain damage and cerebral palsy.
- Jaundice and Kernicterus: If neonatal jaundice is not properly treated, too much bilirubin (a byproduct of red blood cells) can build up in the brain. Bilirubin is a neurotoxin, and when it moves into the brain tissue, a condition called kernicterus occurs, which damages the brain and can lead to cerebral palsy.
- Seizures: Seizures are uncontrolled events caused by abnormal electrical activity in the brain due to brain damage or problems with the brain’s chemistry. Seizures can damage the brain; the longer a seizure lasts or the more frequently the seizures occur, the worse the brain damage. If seizures and resultant brain damage are severe, they can lead to cerebral palsy.
Legal Help For Cerebral Palsy
If your baby suffered any birth complications, including the ones listed above, and has been diagnosed with cerebral palsy, please contact our team of birth injury attorneys at Reiter & Walsh ABC Law Centers. For decades, we have been helping families whose children have cerebral palsy. We have numerous multi-million dollar verdicts that attest to our success, and we will fight to obtain the compensation you and your family deserve. We will evaluate your case to determine if your newborn suffered injuries due the the negligence of the physician or medical staff, and you never pay any money until we win your case.
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